By the time Conrad reaches Berger's office, the doctor is there waiting for him. Almost immediately Conrad begins sobbing. He begins to ask Berger for help, but more voices and memories cut him off. He remembers Robbie, a friend from the mental hospital who'd tried to burn himself to death. Conrad blames himself for ruining the lives of his closest friends – Buck, Robbie, and now Karen. He lashes out at Berger for making him dredge up painful memories. Conrad tries to fight back tears, but they continue to flow. Berger encourages him to let himself cry.
At this point, Conrad's thoughts, feelings, and reactions are beginning to come together. He is now able to connect his present emotions with his memories of the past. For the time being he still falls prey to the habit of self-blame, but at least he understands himself in connection to others. It's definitely a step beyond the kind of isolation to which he usually subjects himself.
Berger presses Conrad to tell him why he needs help. The truth springs up from deep within him; he blames himself for killing Buck, but isn't able to figure out why he let his brother drown. Berger insists that no one is to blame for Buck's death – his drowning was an accident. Conrad denies the idea; it sounds "too simple" to him. Berger has a theory about Conrad's guilt: he believes that Conrad could not live up to the pressure of filling his brother's shoes after he died, and saw suicide as the best solution. Berger says that Conrad's best hope of escaping guilt is to focus on being himself. Suppressing his feelings does far more harm than good.
Conrad's objection is the same one his father makes in Chapter 21. Berger wants Conrad to understand that blaming himself—and keeping a tight grip on his emotions—is far more difficult than accepting the accidents of everyday life. Achieving this realization is the last step in his recovery process.
Berger takes Conrad to breakfast. Conrad is exhausted, but Berger gently asks if Karen's suicide is what spurred his meltdown. With some hesitation, Conrad engages the topic. Berger helps him realize that, as was true for Buck, there was nothing he could have done to stop Karen's death. He also urges Conrad to value the wave of feeling that had overcome him in so short a time. Pain, as well as joy, is an emotion that is simply part of life. Berger encourages Conrad to head home and get some rest, and to come in for his regularly-scheduled appointment the next day.
The narrator notes that Conrad's vision "blends everything to gray" in the restaurant, which suggests that any feeling of failure is now a conscious choice on his part. Conrad finally gains control over his emotions, but not the kind he might want; this control has nothing to do with restraint, but with the ability to live free of guilt. All he has to do is put this realization (and Berger's advice) to work.
Instead of going to Howard and Ellen's house, Conrad returns to his own house to shower. The hot water helps him relax and to think. He remembers Berger's words about the difference between guilt and punishment, which spur another memory: Conrad and Buck have a run-in with a drugstore clerk who accuses them of stealing a comic book. Buck was confident that the clerk had made a mistake, but despite his innocence Conrad was racked with guilt.
Here, showering is a symbol with complimentary meanings. Conrad is immersed in water the same way he was during the accident, which allows him to relive the experience fully. But as a symbol of psychological strain, immersion suggests that Conrad is engulfed by difficult feelings. His breakthrough will only come with intense emotional struggle rather than an effort to avoid it.
As the water rushes over him, Conrad recalls playing a game with his brother in the garage many years ago. Buck had tied Conrad up with clothesline and gagged him with a handkerchief; as the game escalates Cal enters the garage and is shocked at the scene. He scolds and spanks Buck, who swears that he didn't intend to hurt Conrad. Cal angrily explains that "[p]eople get hurt without meaning it." Again, Conrad remembers feeling guilty about the ordeal, even though he was not to blame.
Not only does Conrad understand Berger's advice, but he discovers its relevance in his own past. As a result of getting in touch with himself, Conrad discovers that the potential for recovery has been part of him all along.
Berger's advice finally makes sense to Conrad. As he cries once more, he finishes showering. He thinks about Karen, still upset that her sudden death was undeserved. But he forces himself to accept the fact; fair or unfair, it simply happened. He slips into his bed and, exhausted, falls asleep.
Conrad is finally clean, both literally and figuratively.