Different studies reveal that a large percentage of people frequently attending healthcare not only suffer from diffuse somatic symptoms but also from psychological distress and difficulties in dealing with everyday life. Even though they are not always diagnosed with psychiatric disease, questions arise about their mental health. The study aims at describing frequent attenders’ conceptions of life, and as a result their health, from a cognitive perspective. A qualitative content analysis of in-depth interviews was carried out with nine service users in primary healthcare. The findings reveal that participants experience themselves as inadequate and as being a burden for others, by whom they experience rejection, in different ways. In order to take part in community with others the person develops compensatory strategies that aim at concealing their inadequacies, thus also preventing them from sharing their suffering with others. The consequence is that the persons become even more alienated as they start to relate to others through a fa？ade and furthermore are unable to either improve their health or obtain adequate care. It can be concluded that these patients need to be taken seriously in order to prevent further psychological suffering. 1. Introduction Frequent attenders appear to be a group troubling the healthcare system in different ways. Firstly, it is a group that consumes much of the resources. Various studies from around the world reveal that between 2% and 10% of the population accounts for 15–40% of the costs [1–4]. Secondly, they trouble healthcare staff [5], as many of the patients present diffuse symptoms like pain and dizziness which may be hard to diagnose [6]. The group has been defined in different ways, making it hard to compare results and define the group [7]. There is also a difference between frequent attenders that attend for a diagnosed chronic disease and those suffering from vague symptoms where their general practitioners are unable to diagnose them [6]. Even though the group is not clearly defined, numerous efforts have been made to describe it, using quantitative methods that focus on quality of life [8], social factors [9–11], and comorbidity with psychiatric disease [8, 12–14]. Furthermore, frequent use of health services also appears to be associated with a low sense of coherence and low internal locus of control [15–17]. Schilte et al. [18] conclude that 80% perceive their childhood as troublesome. The authors also claim that to understand the frequent attender, one must approach the problems from a biopsychosocial
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