Our considerations with regard to the psychosomatic aspects in intensive care units are begun with those psychodynamic processes which can be regularly observed in life-threatened patients; namely: depression, narcissistic disorder and oral-regressive traits, aggression defense, introspective capacity limitations as well as certain specific defense mechanisms. Furthermore, we outline the inherent indirect and direct psychotherapeutic interventions. The latter concern the supportive psychotherapy and the emergency psychotherapy. The psychotherapeutic techniques will be described in detail.