BACKGROUND Asthma attacks are not no so much correlated to endofamilial accumulation of stress, as they are connected with the toxic influence of environmental factors creating uncertainty in conjunction with elements of depression. Modern psychological / psychosomatic models in the pathogenesis of asthma attacks are discussed through a case report, with the aim to provide a better approach and treatment to a multi-etiology disease, like asthma. CASE PRESENTATION An 18-year-old teenage girl who suffers from asthma attacks was studied. Through the analysis of the patient's genogram, it is suggested that there are burden factors on behalf of the family, which seem to be responsible for the appearance and aggravation of her asthma attacks. Paradoxically, the attacks prove to be very functional and offer a secondary benefit to the patient, as they establish boundaries in the family: only in cases of these attacks do the parents become interested in her health, assuming the role of protective parents toward their child and ignoring their own problems and impasses. A type of "asthma game" is created, a type of "double game", in which the patient takes the role of the family pillar, although at the same time she is psychologically weak. Being unable to verbalize her despair and psychological fatigue she breaks out in asthma attacks. These attacks function like "inhibited fraction and scream". With the help of psychotherapy, the patient was able to realize the connection between her depressive feelings and the subsequent asthma attacks. She was also relieved from the difficult and weighty role of the "parental child" and was able to set her own personal bounds. We concluded that a bio psychosocial approach with targeted psychological interventions for the patient and her family as well as the recommended medication is essential in order to target long term results. [ABSTRACT FROM AUTHOR]