Sisyphus- Your comments are very interesting. I am not familiar with Chessick's Model. I would like to learn more about it. I think Otto was testing Don in the first session. I think he was presenting himself as he felt he was a out of control disgusting person who couldn't protect his girlfriend from harm. This was very upsetting to him as he hadn't be able to protect or stop his mom from acting out of control and behaving very badly during his childhood. Don passed the test by taking Otto very seriously and helping him find a way to get in control through the use of a hospital. This is unlike his being locked up in a closet by his mom because she did that in response to her own affect needs-She was out of control and rageful. This would be likely to make her child Otto fear his own rage and cause him great anxiety. To be seen for one of the first times as and who he really was would feel good to Otto. Thus the hospitalization was saying to Otto let figure this all out in a safe place where you don't have to worry about hurting anyone or yourself.