Wooden you know that would happen? Sorry, had to get that pun in someplace.

The "scratchy" voice jumped out at me first off. Made me think of "broken record". Interesting that the patient was pressing the wooden pegs into his face and the psychiatrist "escalated" that and punched him, also in the face. Not allowed to hurt one's self but "they"/outside can hurt you. The pegs went "into" his face which is where one expresses emotions (as opposed to the psychiatrist who would be looking in your head for your thoughts). Your voice wasn't loud enough so presumably you weren't 100% into getting help? or you feel ineffectual about being a helper? "We" need help -- who? The two of them were going at it quite happily? They weren't calling for help. Was one besting the other or was it pretty "even"? Were you afraid? Usually when guys fight, all the movies :-) show a crowd gathering to watch, not to help or interfere? What were you thinking? Was the escalating "anger" getting out of control? If you're everyone in the dream, you're sticking yourself with "pins" and also punching yourself/others in the face for no reason? Any chance your T was the psychiatrist or the patient (and you the psychiatrist and just hauled off and punched him?). Sort of sounds like some of your descriptions of some of your fantasies? Too, they were being very "direct" with one another, not "playing games". The psychiatrist stopped the patient from "playing".