The principles which govern the kind of psychotherapy best suited for patients with physical disease who may or may not have alexithymic characteristics are based on the careful psychiatric evaluation of the patient's psychological difficulties, and on the early cooperation between the psychiatrist and his medical colleagues. The nature of the alexithymic phenomena is discussed and the words 'affect', 'emotion' and 'feeling' are defined. Supportive psychotherapeutic measures are indicated for patients with alexithymic characteristics. These can be offered by the medical personnel in consultation with a psychiatrist. Psychodynamic psychotherapy, on the other hand, offered by a well-qualified psychiatrist is the treatment of choice for neurotic problems which complicate the patient's physical illness.