Im curious. When we first play the game, we see alex being carted down a hallway, and put int a room. Obviously, he still has on his regular clothes, which means that he must of just been admitted to the hospital( whatever hospital it is). But why is he restrained? what did he do? Did he put his knife or a knife into the mirror because he saw something?

Well he is in a [spoiler]mental hospital[/spoiler] patients there, especially outwardly violent patients need to be restrained.

It was a dream while driving to Shepherd's Glen. Know how in most Silent Hill games there is a dream at the beginning foreshadowing the future events?

Yeah. The rooms show different plot points. And as per the map, it is Alchemilla Hospital.

[spoiler]Judging by the memo in the boys' room in the OW Shepherd house, Alex is the patient in room 206. We also see the other three children being sacrificed (they're all Josh, actually, but the parents are going through the act.

We also see Adam, as the doctor, and he is presumably killed by the Bogeyman, and sliced neatly in half as he is later in the game. The water sounds coming from 206 before you leave are also indicative of Alex as that's presumably the sound from out on Toluca lake.[/spoiler]

It's a dream, dude. It doesn't necessarily reflect the clothes he was actually wearing when he was institutionalized.

And have you even finished the game yet? Because those questions are answered, and you find out it's Alchemilla before you even beat the hospital area.

"find out it's Alchemilla before you even beat the hospital area"

Or, if you play it on the 360, you also get an achievement for taking down the first nurse, which is called"Alchemillas Finest"

The map reads "ALCHEMILLA HOSPITAL." It's impossible not to know what hospital it is. . . .

It's a dream, but I think it's also a memory. I think that's basically how he [spoiler]escaped the mental hospital in the first place. He was on his way to get electroshock therapy (which is still used today, interestingly) when he broke out of his restraints and cut up a lot of the nurses on his way out.[/spoiler]

Electroconvulsive therapy is an incredibly safe treatment for depressive disorders, among others, so it's not unusual for Alchemilla Hospital to have it available.

That's the thing. The whole stereotype with getting electric shocked, mixed in with crazy therapy treatment, as caused some to think that electroshock therapy incredibly sucks and hurts like hell.

It doesn't hurt. I've had it.

I would imagine it probably USED TO hurt like hell. Many infamous medical procedures are much more efficient these days.

So then it was all a dream? So then there is nothing indicating when he was admitted to his release/escape? And how do you explain the memos in the dream? were they never real either?

Dude, it's a dream. . . Don't you remember Alex waking up after Pyramid stabs him in the elevator. . .?
It's kinda like those dreams that predict the future or something. But if you count the Hospital ending as the canon one then the whole game is meant to be a dream.

oh. i gotta play it again

It's a lot like the dream in SH3... Not necessarily completely unconscious, more that Silent Hill is making the dream happen.

what dream in sh3?

The intro level to the game is Heather's dream. Taking place in Lakeside amusement park. It foreshadows the events at the amusement park later in the game.

right. does she dream again during the mall part too?

She awakes from the dream in the Mall, if that's what you mean.

oh ok. I havent really paid attention to when alex is dreaming and when he wakes up, which makes it all more confusing