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In palliative care, the identity crisis is a fundamental concept in order to understand a patient’s distress. A fatal illness painfully breaks the perception of life’s continuity. Patients become strangers to themselves, which can lead them to seek psychological help in order to rediscover their connection with themselves. The purpose of this study is to explore the identity of patients in counseling and the characteristics of their therapy. Method: 14 psychologists involved in palliative care in a French region completed an analysis report for each patient. Results: the first 100 patients are treated in 284 sessions, starting generally six weeks before their death. They are mostly men in their sixties, and the psychologists are women in their thirties. Discussion: the relatively young age of patients suggest the influence of age in the need for counseling sessions. This profile of patients and psychologists introduced sexual and generational otherness in the therapy. The study continues with content analysis of the interviews, including links between distress, identity crisis and defense mechanisms. In 2011, a second group of psychologists (brought together by the College of Psychologists of the Société Française d’Accompagnement et de soins Palliatifs) joined the study.