ABSTRACT
This chapter explains the applicability of attachment theory to illness behavior as the relationship between adverse childhood events and medical outcomes in adulthood. Particular emphasis will be placed on the long-term consequences of endocrine system reactivity and implications of the overlap in brain structures involved in the experience of physical pain and emotional pain. The chapter discusses the concepts "biopsychosocial vortex" and somatoform "solution," borrowed from Bruns and Disorbio. It describes an approach to psychotherapy that reflects cross-breeding of neuropsychology and attachment theory. Physical and emotional pain are intimately related and may generate a "somatoform solution" that involves medically unexplained symptoms (MUS). These symptoms are best understood in the context of a biopsychosocial approach. Assessment of MUS is often complicated by dualistic/reductionistic thinking, changes in nosology, and the overlap among, as well as lack of consensus regarding, various conditions. Terms that have been used interchangeably include medically unexplained symptoms, functional somatic syndromes, somatic symptom disorders, and somatoform disorders.
