Background: There have been few clinical case studies which explored somatoform disorder patients’ mind, in particular, that they are unaware. Purposes: By analyzing clinical records of a male patient with a somatoform disorder, this study aimed at 1) To examine how the core personality pathology behind the somatoform disorder developed in his early life, 2) To elucidate how his attitudes and behaviors in his interpersonal relationships relate to the pathology, 3) To understand the reason behind his decision to discontinue therapy, and 4) To propose a role for psychiatry when treating patients with somatoform disorder. Methods: The patient’s psychotherapeutic process over three years from initiation to termination was described in three periods, based on changes in the nature of the therapeutic relationship. Results: Somatic symptoms, the attitudes and behaviors in the therapeutic relationship, and his decision to terminate the therapy were understandable in relation to his adversity since infancy. These relations were discussed by attachment theory and a theory of structural dissociation of personality. Conclusion: This study provided a perspective that the core pathology of some somatoform disorder patients has its origin in adversity since infancy.
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