The pursuit of illness for secondary gains

The pursuit of illness for secondary gains

Secondary gains is defined as the advantage that occurs secondary to stated or real illness.

Secondary gains are the “benefits” people get from not overcoming a problem. For many people who are stuck, secondary gains are an important mechanism in why they stay stuck. Secondary gain is usually not something people are consciously aware of. Transition into the sick role may have some incidental secondary gains for person, using illness for personal advantage and consciously using symptoms for financial or other benefits.These symptoms may contribute to social breakdown and the patient’s choice to remain in the sick role.

THIS Person finds the pressure of their work and/or achieving overwhelming. If they get “unsick” they will need to return to work and fulfill their own or others’ high expectations. Staying sick is reinforced.

It is common for symptoms of chronic pain and illness to be connected to early childhood attachment trauma. In these cases, physical symptoms may be related to emotional material that is connected to a young part of self. Here, we must recognize that we all have parts of ourselves that can sometimes be at odds with each other. For example, an adult part might be working toward self-care and symptom reduction; however, a young part might be sabotaging these efforts or unwilling to let go of pain symptoms. To work with this process, we aim to bring in support for the young part of self in the form of allies and resources.

The point of understanding secondary gain is that all the people involved are trapped by it. 

Secondary gains can be defined as any positive advantages that accompanies physical or psychological symptoms. Often, the reasons for secondary gains are deep and psychologically complex (Dersh, et al., 2004; Fishbain, 1994). As a result, people may be unaware of the psychological causes of the chronic physical pain or illness.

Secondary gains may be so reinforcing to the patient that the original depression cannot be affected by treatment and reveal narcissistic gratification because of their disorder.  Despite having a seemingly strong personality, narcissists lack a core self. Their self-image and thinking and behavior are other-oriented in order to stabilize and validate their self-esteem and fragile, fragmented self. They may exploit the kindness and attentiveness of others, shirk responsibility, and avoid the demands of interpersonal interaction.

It’s hard not to judge. Some say their natural development was arrested, often due to faulty, early parenting. Some believe the cause lies in parental harshness or criticalness.

Psychoanalyst Heinz Kohut observed that his narcissistic clients suffered from profound alienation, emptiness, powerlessness, and lack of meaning. Beneath a narcissistic façade, they lacked the sufficient internal structures to maintain cohesiveness, stability, and a positive self-image to provide a stable identity.


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