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Severe Somatic Symptom Disorder (SSD) are prevalent and burdensome. Dynamic Interpersonal Therapy (DIT) has shown promise for treating SSD, but its mechanisms remain unclear. This study explored both patients’ perceived outcomes of a multidisciplinary DIT program and their perspectives on its working mechanisms by semi-structured interviews with 13 patients who completed a six-month multidisciplinary DIT program. Thematic analysis was used to examine these experiences and perceived working mechanisms. Participants reported improvements in physical symptoms, mental health and daily and interpersonal functioning. Furthermore, five perceived working mechanisms were identified: (1) Facilitating conditions and environment – the importance of a balanced group composition and a healing environment; (2) Synergy of the multidisciplinary approach – how different therapeutic components reinforced each other; (3) The group works – benefits of group cohesion, altruism, and interpersonal learning; (4) Exploring patterns – recognizing and changing maladaptive interpersonal behaviour; (5) Being seen and heard – the centrality of feeling recognized and understood in fostering epistemic trust. These patients’ accounts suggest that the perceived benefits of this program may stem from its capacity to foster epistemic trust, enhance mentalization, and address maladaptive interpersonal patterns. The multidisciplinary approach enhances these therapeutic effects. However, further research is needed to gain deeper insights into potential working mechanisms.