Mysticism has long featured in discussions among psychoanalysts and mental health practitioners, anthropologists and scholars of religion. In this paper I analyse the life and visions of a twentieth century mystic in the Catholic Mediterranean. Through this case study I seek to compare the psychoanalytic and to a lesser extent the psychiatric discussions of ‘hallucinations’ with the theological explanations of visions. Via a Lacanian discussion of the case of the first Maltese saint I argue that there are interesting points of convergence between the two. An adequate understanding of the cultural context within which visions are articulated as meaningful experiences is essential to our understanding and clinical treatment of people presenting symptoms associated with religious content. A psychoanalytical understanding can serve to enrich and enliven theological discussions on madness as a path to sanctity.