[Attachment and somatoform disorders: low coherence and unresolved states of mind related to chronic pain]

Although attachment theory has become an influential approach used for the study of mental disorders, hitherto little has been known about the relation of attachment to somatoform disorders. In this study 15 patients with a somatoform pain disorder were compared with 15 non-clinical control participants. Attachment representations were measured by the Adult Attachment Interview (AAI). Compared to the control group, the patient group describes parental behavior as less loving and more rejecting, expresses more anger towards the mother, shows more signs of unresolved loss and trauma, and their interviews are markedly less coherent. None of the patients is classified as secure; the majority falls within the unresolved category. The findings of this study can contribute to a better understanding of the often described adversities in the therapeutic alliance with these patients.