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A clinical case of somatoform disorder illustrates the process of a type of psychotherapy informed by attachment theory and research that pays heed to motivational systems that differ from attachment, and to the dynamic tensions between attachment and other motivational systems. The multimotivational theory that underpins case formulation and psychotherapy interventions is based, congruently with Bowlby’s attachment theory, on evolutionary thinking and is summarized in the first section of the article. As a necessary premise to understanding the clinical case, the second section of the article briefly outlines current knowledge on infant attachment disorganization and its developmental sequelae, considered from the perspective of the evolutionary multimotivational theory.