Many older Pakistanis make use of lay healers whose practices are directly or indirectly influenced by the mystical dimension of Islam known as Sufism. It is stated that professionals working within a consumerized health-care system premised on the rational welfare maximizing subject may have difficulty grasping the meaning of help-seeking strategies which foreground the aesthetic and relational dimensions of devotion, teaching, and healing. Rights-based, anti-discriminatory approaches affirm entitlements to culturally sensitive provision but have failed to develop services that this population might actively want to use. This paper draws on research findings which suggest that the experience of migration and modernization has led in some cases to psychically catastrophic breaches of connection. The psychoreligious responses to this rupture involve rituals and incantations which play on the tension between states of merger and separation. The author states that their therapeutic function can therefore be conceived, though not entirely explained, in terms of the central preoccupation of western psychoanalytic thought. Traditional healing conventions offer their own routes to psychic integration and their appeal may be best understood in terms of a quest for recognition.