title: The somatically preoccupied patient in primary care: use of attachment theory to strengthen physician-patient relationships.
abstract: BACKGROUND
  Individuals with somatic preoccupation constitute a substantial number of primary care patients. Somatically preoccupied patients are challenging to primary care physicians for several reasons including patient complaints consuming a great deal of physician time, expense to diagnose and treat and strain on the physician-patient relationship. This paper examines and discusses how disruptions in early attachment relationships such as often occurs when a female is a victim of child sexual abuse may result in somatic preoccupation in adulthood.
  Attachment theory provides a useful framework for primary care physicians to conceptualize somatic preoccupation. Utilization and containment techniques grounded in an understanding of attachment dynamics aid the physician in developing a sound physician-patient relationship. Successfully engaging the patient in treatment prevents misunderstandings that frequently derail medical care for somatically preoccupied patients.
authors.affiliation: Assistant Professor, Neuropsychiatry and Behavioral Sciences Edward Via Virginia College of Osteopathic Medicine 2265 Kraft Drive Blacksburg, Virginia, 24060, USA. rcmiller@vt.edu.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Miller