A chronic emergency room visitor with chest pain: successful treatment by stress management training and biofeedback.

The successful treatment of a patient with chest pain who at baseline visited the emergency room (ER) up to 20 times monthly is described. Treatment consisted of re-education, stress management training and biofeedback. The importance of conceptualizing multiple ER visitations as an interaction of physiological, psychological, social and iatrogenic factors is discussed, and suggestions are made for recognizing such behavior and effectively referring patients for appropriate treatment.