Just as we seemed on the brink of some real progress, where patient verged on accepting his dream state as a delusion rendered by his traumatized subconscious - patient is pulling back to the sanctuary of his delusion. On the very day patient agreed to his wife's proposed move out of state, he claimed to have received a message from a drive-thru restaurant speaker warning him not to move without reopening a dead case. Now patient is convinced that he needs to find justice in this unsolvable case.
Three things here: Patient is now moving into hallucinatory state for starters. It's as if patient is exercising a mental pentimento, wherein his memory is reinterpreting the past, manufacturing a crowning layer of experience that is slightly skewed from what really happened. Further, despite his claims to the contrary - that moving out of state will NOT impact his dual reality - patient is backing away from the move by manufacturing a mystery that cannot be solved, i.e. backing himself into an emotional corner. The challenge - how can he be encouraged to budge?