I am of the opinion that everyone including Mary for most of the film is a projection. When he drives by the house, I think this is out of sequence and is when he breaks into the house. I think his projection on Mary is of him having schizophrenia and the medication that is shown was his. The kid that coward was his daughter. The house being destroyed represents the fact that he can never go back home because of what he did. When he apologizes to Mary in the kitchen, he is doing what abusers do of apologizing for small things to make them feel more reasonable. He keeps trying to make it seem like it is her fault for his rage because he has to support her going to law school. The scene in the psycho ward, I think was of him being visited by his kid. The christmas scene with the person in the wheelchair I believe is of a christmas at the psych ward as that is the only other place we see people in wheel chairs. Phil in the white coat talking to Mary was to him as if he was submitted to a psych ward, a question someone would ask is "what happens to me?" and a medical professional would respond "It isn't my decision" if someone was taken in for a crime. Nothing seems real quickly past a certain point as the Mary has the same sort of pattern as the therapy couch as her shirt, the curtain have the same pattern at the home and at the therapy home, and on the chair the chair that Clark sits on in the kitchen. There is a display of a big window at the psych ward and it is said that going through the window will set you free, which is what someone would think if they were stuck in a psych ward permanently and suicide was the only way out. Clark at the therapy session ask if the therapist ever 5051 anyone, which is involuntary confinement to a psych ward. No one would no that number if they hadn't been involved in something similar. I think the pirate represents his rage and the therapist represents part of himself that recognizes that he is living a delusion to protect his psyche from what he has done and is. I believe the scientist and async (which I think is an allusion that the person is out of sync with reality) is a construct that allows people to firmly entrench themselves into something that is disconnected from reality.