Throughout his career, Freud believed that psychiatry in general and psychoanalysis in particular would one day be rooted in anatomical/biological ground. He felt confidant that such ground would replace the psychological understanding on which he had been forced to base most of his clinical theory and practice. He felt confidant that one day psychotherapy would be more “scientific.” This article seeks to demonstrate that this day is arriving. A clinical case is presented where assessment and formulation are largely based on neurobiology, where treatment was conducted less in accord with psychodynamic theory than neurodynamic data of anatomy and biology.