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This article emphasises the difficulty of certain therapeutic relationships and the necessity of writing to enable the analyst to retrospectively elaborate on countertransference issues and use this in these relationships. It focuses on the case of a patient suffering from a serious illness, at the end of her life, using analysis to attempt to retain a minimum of organisation. A great deal of psychological work is required to allow the analyst-patient dyad to handle the approaching death of the patient, in particular when there is a major libidinal expansion and an increase in relational appetite in a profoundly regressive transferential relationship, which requires the analyst to have a satisfactory capacity for reverie.