Secondary Gain

Secondary gain occurs when doctors think that a patient is perfectly well, but the patient doesn’t think so or the patient wants to remain ill. What’s going on is called secondary gain. What that means, in simple terms, is that the patient perceives more benefit from the state of being ill, whatever illness that is, than the state of being well. They stay unwell without any medical reason for being so.

Let’s imagine someone that’s had an accident. They’re in a wheelchair and they find suddenly that they’re being pushed around everywhere. They don’t have to walk anywhere, every door is opened for them, all their meals are made for them, and everything is taken care of for them. After a while, they start to become anxious about the responsibility of taking care of themselves and they almost get resigned to the idea that it’s better being taken care of, than taking care of themselves. I’m giving you an extreme example to make it easier to understand, but that’s what’s happening.

So we ask four related questions when trying to get to the bottom of secondary gain. The first one is: what will happen if you do this? Then, what won’t happen if you do this? Then, what will happen if you don’t do this, and what won’t happen if you don’t do this. So we’re asking these two opposites to uncover what’s going on in the mind of that person and helping to bring into their realisation that the strategies they’re deploying are counterproductive.

If we can release the negative emotions they feel around the change that they need to make it’ll be that much easier for them and they don’t need to experience secondary gain.

Quite often, secondary gain cases have a degree of complexity to them. Sometimes, the more intelligent the person is, the more sophisticated is the game of chess they play trying to justify staying exactly where they are at the centre of their own personal drama, whilst everyone else is running around after them. They have this sense of importance which they seem to value more than the opportunity to get well, and that’s quite sad. I wouldn’t say it’s that prevalent but certainly, I’ve come across it a number of times and I just want you to make sure that that isn’t you.

So if you’re experiencing any kind of secondary gain you’ve got to ask yourself what’s going on, what are the underlying patterns? When you get to the emotion behind it, we can release it. Then we can stop that game from taking place.

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