Chronic illness and disability (CID) is a broad term associated with a wide range of factors, some of them emotional. Various approaches have addressed the mental reality associated with congenital and acquired disabilities, including the psychoanalytic view. The current article aimed to review the psychoanalytic literature on CID, focusing specifically on its mental features and their implications. Although few authors since Freud have addressed the psychic structure and organization of individuals with CID, there seems to be a consensus regarding shared underlying psychological characteristics with a considerable impact on ego strength and the self. These are accompanied by negative feelings that are often strong and enduring, though not always predictable because of the many factors on which they depend. Review of the relevant literature suggests that psychoanalytic conceptions can benefit CID rehabilitation, potentially providing clinicians with knowledge and tools to improve the well-being of affected persons.