When an adolescent faces serious organic illness, two traumatic events coincide and reinforce each other. The Oedipus fantasy and its murderous component are exacerbated. Starting psychotherapy in these circumstances is a challenge. Teens suffering from serious organic illness rarely request psychological help. They accumulate aggressive impulses that remain unspoken but are self-directed. We will use excerpts from cases to comment upon the problems and psychical processes experienced by such teens. We will show how expressing murder fantasies can be a motor in psychotherapy. Such expression not only supports therapy but also relieves the patient and contributes to a new psychosomatic equilibrium.