There has not been much systematic research done concerning the causes of somatoform disorders. Many of the problems in conducting research concern the fact that the diagnostic criteria for these disorders require that no organic cause of the symptom be identifiable. This may lead to many cases of misdiagnosis, since a great deal of somatoform disorders usually follow the rule of diagnosis by exclusion. Physicians, then, are faced with two possibilities: either to incorrectly diagnose a psychological problem as a physical one, or to incorrectly diagnose a real physical illness as having a psychological basis. A significant number of individuals who have been initially diagnosed with somatoform disorders are later found to have genuine somatoform diseases. Psychoanalytic theory believes that by converting psychological conflict resulting from a traumatic event into a physical symptom unconsciously, there is a primary gain to the individual of protecting conscious mechanisms and a secondary gain of gaining sympathy and attention and avoiding responsibilities. Cognitive psychologists attribute this concept of secondary gain in terms of the reinforcement paradigm, while social psychologists hypothesize a possible type of learning or modeling of a sick role.

Socio-cultural theories hypothesize that individuals describe and experience their psychological distress due to lack of insight into their emotions and because of limited social tolerance of psychological complaints. As proof, these theorists point to the high rates of somatoform disorders among non- industrialized countries and individuals of lower socioeconomic standing, whom they believe do not have the financial means or opportunity to be introspective. Socio-cultural theorists also point to the apparent decrease in conversion disorders reported as indicative of an increase in social toleration of emotional insight.

There is no systematic evidence to support the classical psychoanalytic assertion that helping patients to recount psychologically painful events of the past is an effective method of treating somatoform disorders. Evidence does suggest, however, that cognitive behavioral therapy is effective in treating various types of somatoform disorders, such as body dysmorphic and pain disorders . Operant techniques, which attempt to alter the rewards system for assuming the sick role and pained behavior by introducing the new goal of coping and life adaptation, has also been a successful form of therapy for pain disorders. One of the major problems with treating somatoform disorders is that individuals with these disorders usually come to the attention of a primary care physician, not a therapist. Many times, the physician-patient relationship becomes very frustrating, since the physician is unable to identify any genuine physical ailments. Physicians are urged to make routine monthly examinations of these patients, which not only provides emotional support and helps to eliminate the iatrogenic effect of the somatization disorder by reducing unnecessary medical procedures and treatment, but also produces the necessary sense of empathy and concern required for an effective patient-client relationship.