The client (34 years old) attends a single interview in which she presents her historical psychosomatic condition as the reason for consultation, characterised by acute episodes of vomiting, gastric pain and immobilisation in bed. Regarding its temporal status, the client specifies that the main somatic symptom is in remission: «llevo cinco años sin ninguna crisis», with the last episode occurring during the handover of the family business in 2018. At present, what she describes as active and limiting is the anticipatory fear of relapse («a volverme a quedar en la cama»), the experience of being blocked from actively seeking employment and the difficulty of setting boundaries in her everyday interpersonal relationships.
Regarding her biographical and background history, she reports that the emetic episodes began around the age of nine or ten, after her parents' separation, initially using them as a behaviour to seek maternal attention: «Yo era la que me provocaba el vómito para llamar la atención de mi madre». She describes her mother's sudden death from a stroke when she was fifteen (around 2004), a prolonged distancing from her father —who died in 2022 from pancreatic cancer, whom she cared for in his final moments and with whom she carried out a farewell ritual in [localidad]— and a relationship of distance and fear towards her middle brother. Regarding critical medical events in the past, she reports a prolonged hospital admission with an ICU stay due to a seizure caused by hyponatraemia from dehydration. She currently lives with her husband and has temporarily taken in her older sister after a divorce, positioning herself as mediator in the tension at home between them.
In the observable behavioural and affective sphere, the client cries and has tearful eyes when evoking her historical need for affection («siempre he anhelado que me quieran»), alternating with laughter when narrating situations of financial overload, family conflicts and past experiences of helplessness. She verbalises a constant pattern of putting others' needs first in order to feel useful («hago cosas por los demás que no hago por mí misma»), as well as rejecting affectionate physical contact when she is vulnerable («a mí el contacto físico no, no me gusta»).
Regarding risk history, the client reports self-harming behaviours in adolescence («cogía una cuchilla y me cortaba los brazos») and suicidal ideation during past moments of overload: «o tiras pa'lante tú o te tiras de un puente, que también lo he pensado muchas veces», verbalising thoughts such as «si yo no estoy, estos problemas no existen», which she frames as past ideas that were not acted upon.
During the session, the professional carries out interventions aimed at exploring the relational origins of her need to please, reformulates the somatic manifestations as a physical expression of unverbalised affects («el cuerpo traduce aquello que no pueden decir las palabras») and validates the internal dialogue strategies that the client has developed in previous therapeutic processes. The client participates actively, validating the observations and recognising her current learning process for expressing disagreement directly. As this is a single-session framework, no between-session tasks or continuity of treatment are established.