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After outlining the various facets—real, symbolic, and imaginary—of fatherhood in Lacan’s teaching, the author takes stock of the psychoanalytical literature concerning the difficulties a man may encounter when he becomes a father in reality. Psychotic decompensation, couvade syndrome, sympathetic pregnancy, psychosomatic and sexual disorders, appearance of pathological aggressiveness, withdrawal into one’s work, into space, into phobia, and into suicide are considered. To account for this malaise and these feelings of angst, the author calls on various psychic processes that are triggered by the child’s birth: emergence of a foreclosed signifier, identification with the mother-to-be, stimulation of one’s feminine identifications and one’s desire to have children, confusion between one’s wife and mother, a reawakening of feelings of envy and jealousy toward one’s younger sibling, stimulation of incestuous and murderous desires, and recall of the inevitable encounter with death. The article concludes with a few brief clinical vignettes illustrating the therapeutic possibilities for such situations of impasse.