Although Harold enjoys "success" as a clinician and administrator, he may not provide a very good model of healthy functioning for his patients or staff. Working endless hours could be taking a toll on his health and on his family contact. (His wife and children probably see very little of him.) Is he infatuated and preoccupied with pathology--physical and psychological? Is he missing a vision of optimal psychological health to guide and inspire him? Is he obsessed with his growing empire? Reputation and prestige seem quite important to him.
Having had 900 tests by 6 doctors, his fear of dying of every known disease, his frequent anxiety symptoms, his immediate impatience with his previous psychologist, and his refusal to give up on any patient suggests a fascinating life style (general attitude toward life) juxtaposition: "no one can cure him of his symptoms, but he will be able to cure anyone if he takes long enough!" He may have a core inferiority feeling about his intelligence (feeling stupid about expressing himself) that could be compensated for by "outsmarting" other clinicians and dealing with "impossible" cases (others give up but he does not).
Was it only his wife's beauty that attracted him? He may have felt trapped by her first pregnancy, but how does he explain the next two children? If everyone, but his wife, knows about Meg, is his wife a little naive? Did he choose her because he could feel mentally superior to her, by keeping her in the dark? (His refusal to give up on anybody does not seem to extend to his wife. ) Is Meg also a little naive (marrying a man who stopped having sex with her the evening of the wedding)?
I'd like to find out more about this "bed of roses" that he imagined marriage would provide. Does he expect a lot from a woman, but give little in return? He is impressed with Meg's unselfishness, and is delighted that his two women give him "the best of both worlds" (one runs the home, and the other runs the office). How much of himself does he give to each of them? Adler used to say about relationships that "two are always less than one."
He wants everyone in the world, except his wife, to know about his feelings of happiness. (Does he have a hidden desire to punish his wife?) He believes that his sons are angry at him, and he is torn up about this. Why doesn't he talk to them and help them deal with their feelings?
Harold's discovery of "more love than he ever knew existed" with Meg, and his "beginning to love her so much" could be a positive and belated blossoming of his emotional life. I would want to explore the feelings of both of them more deeply to verify this. (His ambition to "build an empire" could get him very excited about someone who could help him.)
Don's "instruction" at the end of the first session, capitalized on Harold's complaint about the "indirection" of the previous therapist. I am not surprised that Harold appreciates "being taken care of" by Don. I suspect that he really wants to be "indulged" by all the significant people in his life. It would be interesting to discover if this desire is rooted in his early childhood experience of pampering, neglect, or abuse.