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In this paper, a clinical impasse is used to study the philosophical premises and culture biases that inform the foundations of psychoanalytic theory. In his childhood, the patient was a migrant laborer, in a large Christian fundamentalist family. He survived through forming bonds with other children, in shared conditions of abjection. In adulthood, he has fulfilled the American Dream. And yet he suffers. He feels like anyone and no one, and is without individual subjectivity. Through his illness narrative, his devotional practices, and a near-death clinical impasse, he confronts the analyst with questions. What is missing from our psychoanalytic vision of the “family”? Can we recognize this patient in our current models of attachment? If psychoanalysis extrudes politics and culture and spirit and ethics, can we “mentalize” this patient? What happens when a patient has a collectivized self, and no individual psychology? What happens when a patient's Christian worldview is radically disjunctive with the Jewish ethos of psychoanalysis? Who is the psychoanalytic subject? Ultimately, the treatment argues for this: that we need to rewrite our understanding of the psychoanalytic subject.
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