Margaret - thank you so much for your comment. I think how one understands the role of therapy is relevant here. I'm not sure that there was anything actually "shameful" about Otto's use of therapy. I believe that had Otto felt free to "use" Don in any way he needed, he would not have resorted to hiding his shameful desires. The therapist's job is to help the patient achieve his goals. I believe that it was only one of Otto's goals to avoid jail. As long as one feels comfortable and no laws are broken, there is no one right way to help a patient. Therefore there was no need in reality for Otto to feel ashamed. I believe Don would have been happy to consider any way possible to protect Otto. I agree with your comment about his family affecting his ability to consider options in relationships. I still think the hospitalization was warranted, due to his extreme disorganization. Tough call!