Research regarding psychological factors in head pain have generally focused upon personality traits and psychopathology. The role of illness beliefs offers another method of elucidating perceptions, attitudes and convictions towards a somatic complaint. One hundred patients, evaluated for head pain at a neurology clinic, were administered the Illness Behavior Questionnaire (IBQ) to delineate illness beliefs; the Illness Effects Questionnaire (IEQ) to quantify the disruptive aspects of head pain; and the Toronto Alexithymia Scale (TAS) to assess the subjects propensity to somatize as well as the ability to identify and report emotions. The data found no difference between subjects diagnosed with migraine syndrome and those with tension head pain in the IBQ dimensions, the TAS or in reported levels of anxiety or depression. However, chronicity of symptoms was associated with increased irritability. The clinical implications of the findings suggest that patients with head pain are psychologically distressed but often possess alexithymic characteristics that make insightful associations difficult.