A few things seemed really out of expositional place to me: why was he only shown doing coke when he was "taking a stab" at something real with his colleague?
To me, the sexual history with Sissy caused him guilt, but she seemed to have no lines demarcating love, need, and the physical.
I kept thinking Patrick Bateman through the whole thing as well.
I don't know what this story is about. Not always a bad thing, but they did try to tie it up, which implied to me that I missed something...