Thirty years of abdominal pain

In this paper, the author describes a brief psychotherapy with a man who has struggled with abdominal symptoms for most of his adult life. After an unhappy childhood, the patient (Mr A) married and then was witness to the birth of his stillborn child, in a foreign country. Soon after his abdominal symptoms started, and plagued him for the following 30 years. In the therapy, Mr A began to explore areas of guilt, hostility, and shame, together with previously unknown-about unconscious phantasies. By the end of the therapy, he reported a substantial diminution in his symptoms, as well as changes to his relationships, and mode of thinking and feeling. Some aspects of working psychoanalytically with patients with somatic symptoms, especially those pertaining to the gastrointestinal tract, are discussed.