Patients labelled with “Multiple Chemical Sensitivity” (MCS) frequently present with multi-system complaints, high avoidance, and substantial psychiatric burden. Etiology remains disputed. Psychiatric care must validate suffering while remaining agnostic about toxic causality. A 67-year-old woman with lifelong somatic vulnerability, chronic tobacco use, and extensive occupational exposure to pesticides and solvents reported odor-linked autonomic surges, fatigue, pain, and cognitive fog. External physicians documented GSTM1 null genotype; abnormal red-ox/mitochondrial markers (elevated lactate–pyruvate ratio, high SOD, low GPx), disturbed vitamin-D metabolism (low 25-OH with high 1,25-di-OH), and MRI/MRS (2013) interpreted by neuroradiology as diffuse toxic leukoencephalopathy “compatible with chronic solvent exposure.” Autonomic testing reproduced paroxysmal tachycardia. Psychiatric evaluation identified depressive and anxiety symptoms, illness‑focused ruminations, high environmental vigilance, and moderate structural vulnerabilities in affect regulation and mentalization. Psychodynamic counseling (OPD-guided focus on self-esteem regulation, affect tolerance, and relational patterns), paced functional restoration, and liaison with medical care. No etiologic assertions were made. Improved affect regulation and role function with a reduced avoidance radius; persistent sensitivity to strong odors. Psychodynamic treatment can reduce distress and disability in IEI/MCS-labelled presentations while remaining causally neutral. Transparent attribution of external medical findings and CARE‑standard reporting enable constructive interdisciplinary dialogue.