Secondary gain does not mean the person is “faking”. Reasons for secondary gain: Examples * For instance, often smokers aren't ready to quit because having a cigarette is the only "break" they allow themselves, and they're not willing to live life with no breaks - no relaxation periods or time away from work or family or their own stressful thoughts. Once they see that, and find a way to take a different kind of break, say, a 15-minute walk, or a quick lie-down, or whatever, the need is satisfied and they're suddenly *willing* unconsciously to let go of the cigarettes * This term is often used in chronic pain management.

Secondary gain is a psychiatric term meaning that a person has a hidden reason for holding onto an undesirable condition. Frequently this reason is unconscious. It is obviously unconscious because the loss of holding onto the condition is often far greater than the perceived gain. The secondary gain trap is not something shameful. It’s a behavioural mechanism that people get trapped in, not a negative reflection on your personality (i.e. does not mean your personality = manipulative). Secondary gain does not mean having the problem is positive for the person overall, just that there are some benefits to it. When distress/impairment is kept going by secondary gain mechanisms, it’s not any less real than any other kind!!

Chronic pain is pain that continues on past the time of an injury being healed, often having no apparent cause in the present. Finding and releasing the perception of secondary gain, such as the attention one receives, monetary compensa-tion for disability, or just the need to deny the original cause of the pain, can greatly contribute to healing. * Fear of responsibility is another secondary gain. One may feel that added success, love or prosperity is going to ultimately demand more than can be provided. One may be exposed as a fraud - being "found out" as not really capable or competent to cope with this higher level of good.

What is S econdary G ains?

R easons for S econdary G ain

* Loss of love may be a deciding factor. One may feel that they will move out of the sphere of their current peer group, family, or romantic relationship if they change too much. * Loss of income. Ironically enough, some will prevent themselves from manifesting a greater income because they will lose the current, reliable income. This can apply to

welfare, unemployment benefits or family support. * Stop drinking. Your conscious mind says, well you should stop drinking. The unconscious mind is thinking, drinking equals comfort, relaxation, ease, de-stressing, etc. That is secondary gain. And, why would anyone give that up? * A person with chronic pain

does not really like spending time with their partner’s friends. When person is experiencing a lot of pain, their partner does not pressure them to go to social events as much. Their pain is reinforced. * Client gets more encouragement and caring comments from their therapist the longer they stay distressed during sessions. Person staying

Reasons for Secondary gain

Rewards

Attention

Fear of responsibility

Loss of love

Loss of income

Reinforcement of a behaviour

Getting care and encouragement

Maintaining status quo

Ensuring conformity

Resistance to change

Reducing anxiety

Denying conflict/confrontation

Enforces a created persona

Guide 6: Secondary Gains

Stress Diary Journal Your Guide

Stress Diary Journal Guides Guide 6: Secondary Gains

‘Having a hidden reason for holding on

to an undesirable condition!

distressed is reinforced. * Person uses depression as explanation for why they can’t do something their partner wants, when they would find it hard even if they were not depressed. Their partner backs off when they cite their depression as the reason for their behaviour. Attributing problems to depression is reinforced. * A person’s partner does not leave then while they are depressed or suicidal. Staying depressed /suicidal is

reinforced * Person is scared of letting people close to them. They act outlandishly and people withdraw from them. Acting outlandishly is reinforced. * Person with social anxiety feels understood when they start learning about social anxiety. They create an identity around having anxiety. Having social anxiety is reinforced by feeling understood. * Person finds the pressure of their work and/or achieving

overwhelming. If they get “unsick” they will need to return to work and fulfil their own or others’ high expectations. Staying sick (this could be chronic fatigue, an eating disorder etc) is reinforced. * Person is scared of succeeding almost as much as they are scared of failing. Person knows making changes to their work process would give them a chance of succeeding on a much bigger scale than their current level of success. They don’t make the

work with the secondary gain to be able to increase your resourceful options. An example process to determine cause * Fear of flying. You desire to overcome your fear of flying, and have had difficulty doing so... you decide to examine what fear of flying is doing for you or allowing you to do. Ask: What does being afraid of flying get for me or allow me to

are more compatible with your overall goals and lifestyle preference. If getting drunk is the only way you know how to relax you will definitely drink. If it is one of 15 really effective ways you have of unwinding at the end of the day you have a lot of choice, and can CHOOSE the method that is right for you. If you have a desire to be a non-drinker you are more likely to choose one of the many ways available to you that do not involve drinking. You need to

do? Gives me a good excuse not to fly... What does having a good excuse not to fly get for you or allow you to do? Keeps me safe What does being safe get for you or allow you to do.? Go on living What does going on living get for you or allow you to do?

* How do you think secondary gain is trying to serve you? * What's its higher purpose for your benefit? A good idea is to examine what NOT achieving your conscious goal, or the particular way in which you go about things, is getting for you, or allowing you to do. * What's the payoff? Then examine the benefits and payoff of THAT. And so on until you come up

with an answer. Also be aware that as soon as you become conscious of the unconscious gain, it is no longer the unconscious gain. Once you have identified the underlying strong payoff you can think about and try out other ways of getting the same payoff that would still allow you to have the original conscious goal. The idea is not to give up the secondary gain but to find other ways of achieving it that

changes they know are likely to help because when they get started on the changes they get a spike in anxiety about succeeding. * Person is putting off their life (e.g. putting off dating) until they lose weight. If dating is anxiety provoking, then not losing weight is reinforced. How to work with this? Ask yourself

Page 2 Stress Diary Journal

“ How do

you think

Secondary

Gain is

trying to

serve

you?”

everything! Live, learn laugh grow... What does being able to do everything, live learn laugh and grow get for you or allow you to do? achieve my dreams What does being able to achieve your dreams get for you or allow you to do? makes life worth living and so on...

Apply it to yourself: Identify a persistent important problem where you’re not doing the things that a reasonable person would consider are likely to help solve/improve the problem. Ask yourself – * Are there any “benefits” you’re getting from staying stuck? [e.g. reduced expectations, not having to do things other people want you to do that you don’t really want to do].

* What do you not gain by having this problem? * What don't you gain by having this problem? * What do you gain by having this problem? * What don't you not gain by having this problem? Do remember it is essential to recognise the positive intention behind dysfunctional or destructive behaviours. Sometimes the gain relates to out of date or childhood inten-tions and the behaviour becomes stuck in the absence

purpose of "acting out", or being resistant to change, is that for all the negative judgement and consequence the behaviour(s) might evoke, at a level of choice, it is easier for the person to stress, use drugs, get into fights, self harm, etc, than it is to face the emotions attached to the original attention seeking behaviours, such as abandon-ment, aloneness, fear of punishment etc...whatever that might be.

of up to date alternatives that better fit in with the more adult context of how someone's life has developed. Often these patterns are laid down as a result of childhood trauma or at times abuse, and will often be embedded in the way that reflects the developmental personality stage at the time. People may choose to ‘act out’ behaviours their conscious deem appropriate and safe for them and in some cases the

To tease out the secondary gain is therefore a question, sometimes of adding resources to the situations where these learnings were first made, prior to the problem behaviour becoming habitualised or normalised as a lifestyle choice. How do we determine whether we have secondary gain issues? Many of us do not want to admit that we've been standing in our own way.

You may have more than one reason. Perhaps you're afraid of the responsibility plus the whole idea of reality creation, deep down, is a little scary. It happens. But your subconscious mind won't be willing to give it up unless you treat it with respect, that is, accept that deep within you lies a real issue that must be resolved. Once you have your issue, go to work on it. Get therapy for it,

join a support group, write or keep a stress diary or journal on it, meditate about it, do all the things you would do with a conscious issue to heal it. You may have more than one secondary gain and it will need to be dealt with as well. This doesn't make you a bad person. On the contrary, it shows you as a courageous and aware individual, willing to face the truth that lies within.

Writing it down will help hold it in consciousness for you. Here's how it works. Start coming up with ideas of what your secondary gain *might* be. Of course if you've got glimmerings of what it actually is, note it down. But, be speculative. An excellent way of viewing this is to ask yourself the above questions. Get the reason(s) on paper, spoken to your friend or on tape.

Page 3 Guide 6: Secondary Gains

“ Identify a persistent important problem

where you’re not doing the things that a

reasonable person would consider are

likely to help solve/improve the problem”

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