In this chapter, we explore Lacan's use of knot theory and highlight how this brings him to elaborate a theory in which the subject is thought of as an effect of knotting the registers of the Real, the Symbolic and the Imaginary. In doing so, we review Lacan's discussion of James Joyce's life and work. We argue that his suggestion that Joyce created a so-called "sinthome' is most innovative in that it refers to a purely singular and non-universal way of creating connections between the Real, the Symbolic and the Imaginary. As Lacan's knot-theoretical model provides a most valuable tool for further reflection we illustrate its usefulness by introducing the case of David Nebreda, a Spanish photographer who severely mutilated his body and took pictures of it, which he called "photographic doubles'. These photographic doubles are a singular invention by means of which the artist gains subjective consistency as well as access to shared discourse. To conclude we address the social and political implications of Lacan's later theory on the subject. However, first we provide an overview of how Lacan's use of knot theory fits within his conception of the subject.