They never really played around with the idea that the dog may actually be talking to him and jumped right into the idea that dude is mentally disturbed. That makes everything that has happened in the show take on a very ominous tone/subtext. For instance, its not clear to me whether Elijah Wood has killed a couple of people on the show so far.

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the test of a first-rate intelligence is the ability to hold two opposed ideas in the mind at the same time, and still retain the ability to function.