This article reflects on the conceptualization and treatment strategies associated with a systems perspective of the somatic couple. It is suggested that resistance to change, nurturance of the somatic patient by his or her partner, and rigid role taking serve to promote relationship stability and individual pseudopower at the cost of patient health. The authors suggest that psychotherapists can aid primary care physicians in more effective treatment for somatizing patients by educating physicians about the role of the couple relationship in the maintenance of somatic disorder, how the somatizing patient can triangulate health care into an unstable dyadic relationship, and the usefulness of a multidisciplinary, contextual approach to the treatment of somatization. A case example is offered to demonstrate these concepts.

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