Chronic pain is a devastating public health problem particularly in women, who are at increased risk for chronic conditions and report more depression and disability secondary to pain relative to men. The impact of relationships, which are critical to the experience and management of pain as well as central to the female gender role, may help to explain gender disparities. The present study uses the Communal Coping Model of Pain Catastrophizing (CCM) and the Attachment-Diathesis Model of Chronic Pain (ADMoCP) to investigate how relationship patterns influence coping responses in women with chronic pain. It seeks to clarify the mechanisms by which unmet attachment needs contribute to pain catastrophizing and influence perceptions of others’ responses to pain and pain-related behaviors. Furthermore, it seeks to examine how insecure attachment might contribute to lower levels of adaptive, intrapersonal responses to pain such as self-compassion, and whether addressing these deficits might represent a viable target for intervention. A total of 355 women with generalized chronic pain conditions (Fibromyalgia, Rheumatoid Arthritis, and/or Myofascial Pain Syndrome) completed an online survey. Exploratory analyses examine relationships between attachment, pain appraisals, pain catastrophizing, self-compassion, depression, and disability. Additional analyses test the CCM and the ADMoCP by investigating: (1) two possible mechanisms by which attachment needs might influence pain catastrophizing, depression, and disability; and (2) the role of attachment and pain catastrophizing in shaping perceptions of others’ responses to pain and pain-related behaviors. Findings have implications for conceptualization and treatment from an attachment perspective.