The author takes the view the patients with psychosomoatic disturbances show peculiarities in their psychic structure based on psychological ego defects. These typical characteristics are closely related to what is described as the "psychosomatic phenomenon" and the patient's resulting inability to give himself over spontaneously to the therapeutic process. The objectification of these clinical observations in patients taken from various branches of medicine is described. These studies support a number of hypotheses on aspects of the characteristic "lack" and have contributed to the development of a special theoretical model based on an object-psychological approach to understanding psychosomatic pathology. On the basis of this model the author developed a special analytically-oriented therapeutic method for the treatment of psychosomatic patients, which has proved itself in many years of application in a model research ward. Follow-up studies show that the positive therapeutic results achieved remained stable over a period of at least 4 years.