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The author, a Child psychiatrist working in the Geneva Childrens’ Hospital, describes some characteristics and specificities of her work with physically ill children and illustrates them with a clinical case. Inspired by psychoanalytic thought, the author describes the ways through which she related to a child suffering from a malignant cancer. In this kind of situation, when the suffering is too great to be mentally contained and when death seems on the way, creating links and giving meanings are almost impossible. The paper emphasizes the need, in such cases, to adapt the standard psychotherapeutic setting. Theses modifications seem necessary to sustain the dreaming ability of the therapeutic couple and to transform, as far as possible, the uncontained emotional experiences of the primarily unthinkable trauma into a potentially meaningful crisis.