Psychosocial guidance in patients with gynecological cancer means to offer help to cope with the disease. Paramount goals include information about the disease, dietary measurements, physical rehabilitations programs, and emotional support for the person affected and her family. Psychotherapy in cancer patients differs from classical psychoanalytical psychotherapy by a more casual setting, less abstinence, goals other than cure, a more direct approach in technique, and different training and qualification of the therapist. Goals to be achieved might be stabilizing the patient’s self-esteem, helping her to get a new orientation towards what is left of her life, and strengthen her social status. Trying to understand the psychosomatic, i.e. psychological etiology of oncologic disease involves individual interpretation of life events, forms of adaptation, and the specifity of a somatic response. Different methods of psychological intervention are depicted (relaxation therapy, the Simonton method, group psychotherapy including self-help groups, and individual psychotherapy). The different goals of patients and therapists are described. A critical review is given on theories of the so-called cancer personality as well as a historical review of the psychoanalytical theory of disease. Some of the very few reports on individual psychotherapy, especially psychoanalyses in women dying of cancer, are mentioned. Therapists working with terminally ill patients should display a high degree of introspection to avoid overestimation of their own ability.