• Individual interviews were conducted with 24 children (ages, 5 to 12 years) as part of an evaluation of unexplained physical symptoms. All of the children had refractory symptoms that had resulted in multiple medical evaluations and considerable disability. At the time of referral, all of the families suspected an organic cause and denied a major impact of psychological influences on the symptoms. Interviews with the children alone disclosed major sources of anxiety in 18 of the 24 children. The newly exposed anxieties were dealt with in a family context. Therapeutic strategies concerning the anxieties led to rapid symptom improvement in 15 of the 18 patients in whom the individual interview revealed specific sources of anxiety.