Disability is a long-term physically or mentally, limiting condition that significantly impacts various life domains. It is associated with a trajectory of emotional adaptation that encompasses diverse internal and external processes. Though rare, psychoanalytic views on adaptation to and acceptance of disability have been proposed, with potential value for rehabilitation. Freud’s relatively brief contributions to this field inspired later theorists to elaborate on his concepts and adjust them to address the phenomenology of disability. The majority of these theorists focused on ego and self formulations, while taking external reality into account. Psychopathology in disability was also addressed, as well as acceptance as a primary goal of adaptation. Authors have emphasized the uncertainty of acceptance, highlighting the importance of attunement to individual patient needs and suggesting that psychoanalytic formulation can help psychotherapists to better understand and treat individuals with disability. The meanings and implications of the various conceptualizations are integrated and illustrated through a case example.