What a surpring resolution to the case. Who would have guessed he was faking his psychosis. On the other hand, he probably wasn't faking and now, in looking back, regards his hospitalization in more cognitive, legalistic terms rather than to truly acknowledge he was crazy. It seems that Don Klein was on target when he didn't see more clear cut DSM-IV evidence of a Brief reactive psychosis, yet I trust Don Nathanson's clinical sense that whatever the diagnosis, Otto needed structure and hospitalization. I am reminded that the lengths some of our patients will go to protect themselves from growing up emotionally. I guess everyone just does the job they are capable of doing and no more despite our best efforts: in other words, patients always know how to protect themselves. I now await the experts comments on this most fascinating twist in the treatment story.