From a lacanian orientation, the relation between ‘treatment’, ‘coaching’ and ‘care’ is questioned in case of what one calls ‘long term care’. This question is approached from the perspective of a case study. A young man accuses himself constantly of not adapting enough to society and even of attacking society. His attempts to find a solution though, are situated both in his failure and his singular answers to this failing, as well as in his self-incrimination about his failure. Indeed, the real problem is neither the lack of adaptation nor the self-incrimination, but the feminine enjoyment that he is confronted with, over and over again. Theoretically, Lacan’s conceptualization of the symptom as a knotting element forms the framework.