Secondary gain in psychology. Benefit from illness

In psychology there is such a concept - secondary benefit. This is a hidden bonus that is obtained as a result of seemingly useless behavior. An example of secondary benefit is often given to a person who gets sick intentionally (sometimes in secret from himself) in order to get the desired attention and care of others that comes with the disease.

Even more often, “profitable” helplessness is deliberately practiced in order to shift heavy responsibilities onto the shoulders of others. Trying to extract secondary benefits, they pretend to be incapable and weak so that the demanding people around them will lag behind, taking full responsibility upon themselves.

In early childhood, the child intuitively senses what role to play in order to obtain the desired benefit. But over the years, he gets used to this role - he accepts his pretense as nature. For example, not wanting to strain his mind, he feigns an inability to understand, and over time he himself begins to believe that this is his real insurmountable weakness. Subsequently, an adult person continues again and again, out of a long-standing habit, to close himself off from the need to turn on his thinking. As a result, he really becomes stupid and inhibited both in the eyes of others and in his own.

Often, the fear of disturbing one’s high self-esteem in real life, the reluctance to overcome difficulties and bear responsibility for one’s own passivity, is “profitably” covered up by an external impossibility - they say, our country is inconvenient for initiatives, the society is unfair, or the tyrant spouse does not give rest.

I recently gave another clear example in an article about laziness - this is a person who is constantly “distracted” from supposedly desired sports activities, as if forced to sit in a soft place against his will.

You already understand what really distracts him, right?

The real, but unrecognized desire that drives behavior is the secondary benefit. Laziness, its clear manifestation, is a refusal to recognize your prevailing desire to do exactly what you are doing when you shirk the things approved by your conscience.

And the top of the “hit parade” of popular aspirations, which the mind disavows, is headed by a sense of self-importance. They cover it up depending on the situation, with anything - noble intentions, defense of truth and justice, health benefits - any pretext that will not choke the conscience. A banal example is a luxurious item, bought in words for “business”, but in reality – for show-off. He spoke about this in more detail on progressman.ru in the article “ChSV-2”.

Secondary benefit - escape into illness

Secondary benefit is the benefit that a person receives at the stage when painful symptoms have already formed the disease .
This is a kind of “additional profit” that a person does not always count on when consciously or unconsciously deciding to get sick. Without provoking new symptoms of the disease, secondary benefit stimulates the consolidation of the disease and psychological resistance to cure. For example, if quarrels in the family or at work occur regularly, the secondary benefit may be increased blood pressure with ongoing headaches. Like primary, secondary benefit manifests itself externally and internally. At the external level, these are the advantages that a person can receive in interpersonal relationships and current life situations. On the internal side – the opportunity to satisfy your narcissistic needs. Since Freud, psychiatrists have called this phenomenon “flight into illness,” where the symptoms of the disease become “pleasant and desirable.”

A classic example: the first attack of bronchial asthma in a child, which occurred at the time of a fierce parental quarrel. Seeing the child’s condition, the parents immediately forget about the quarrel and join forces in helping. This is how the child receives the primary benefit from the unconsciously arising symptom. Further, his unconscious establishes a logical connection between peace in the family and the illness he is experiencing, but at the level of secondary benefit.

In any illness there are two components: meaning and a set of satisfied needs. As long as there is meaning and an unsatisfied need, a person is sick.

What to do with the benefits?

I offer two options.

1. Consciously refuse benefits. Next to each benefit, write at least three alternatives that will help you get what you want when achieving the goal.

For example, personal free time is important to you. It seems to you that there will not be enough of him in the relationship. As alternatives you can:

Improve your communication and negotiation skills. This will allow you to explain to your partner what is important to you without quarrels or scandals.
Look for a partner with the same values as you. Do not hesitate to ask what is important to him (her) in a relationship, and also tell him what you are waiting for.
Think about how to set priorities without infringing on your freedom. For example, switch to remote work if your partner works in the office, plan not only joint weekends.

2. Give up the goal for a while. Sometimes it happens that the list of benefits turns out to be very “juicy and tasty”; you understand that there are more advantages in the current situation. Then for a while, six months to a year, you can abandon the goal. Perhaps you will use this period to work on your values and beliefs and be able to return to your goal at a more appropriate moment.

Five secondary benefits from Carl and Stephanie Simonton

Psychologists Carl and Stephanie Simonton mentioned the main benefits that a person’s illness brings to them:

Temporarily leaving a situation that causes discomfort and complex inconvenient problems that require solutions. The subconscious, “keeping its hand on our pulse,” will always signal us when the body or psyche needs a break. An example of such a reaction is heaviness or pain in the head. This makes ORZ a great way to spend the last week before a planned vacation at home. Moreover, work is like a bone in the throat.
An opportunity to receive the missing portion of love, care and attention from those around you. Most often, loved ones become donors of positive emotions.
Comfortable conditions for the redistribution of mental energy, which allows you to concentrate on solving the problem. This factor greatly helps psychotherapists when working with couples.
An incentive to re-evaluate oneself as a person and correct the stereotypes and behavior patterns used. The disease, in this case, is a warning from the body and subconscious, giving a person time to reassess his way of life and search for alternative areas of activity.
Complete leveling, or a significant reduction in the level of demands placed on a person by others, or by oneself. This secondary benefit, oddly enough, is often sought out by members of “workaholic” groups – people suffering from addictions or eating disorders.

WHAT'S THE POINT?

Psychologist and physician Stephanie and Carl Simonton name five main “meanings” of illness:

1. Allows you to “get away” from an uncomfortable situation and solve a complex problem.

2. Provides an opportunity to receive care, love, and attention from others.

3. Creates conditions for the reorientation of mental energy necessary to resolve the problem.

4. Provides an incentive to re-evaluate oneself as an individual and change habitual patterns of behavior.

5. Reduces or completely eliminates the need to meet the requirements set by yourself and the people around you.

Secondary gain, like “honest” blackmail

A lonely old woman, in a fit of revelation, confessed to a psychotherapist that she was ready to die from the disease that she had been diagnosed with. In return, she would like one thing - to see her son more often. Because he, having started a family and become a respectable father of the family, completely forgot the way to home. Such secondary gain, in the language of psychotherapists, is called “honest blackmail.”

Sometimes illness becomes a way for a person to protect himself from something that, in his opinion, poses a more serious danger. This could be the threat of dismissal, divorce or other large-scale life troubles. This is exactly how a man explains why he can leave his wife and go to his young mistress when his wife is “seriously ill.”

Whining about bonuses

A typical example is that a person is constantly sick , his quality of life is definitely deteriorating, but at the same time he does not receive treatment, does not comply with doctors’ orders, that is, he does everything to continue to suffer. It would seem that a normal person should strive to be healthy, cheerful and energetic, but many people, although they constantly complain about their painful condition, are in no hurry to fight it. They are not in a hurry, because they “reap” the sympathy of others, a gentle attitude towards themselves (“you can’t upset dad, he has a heart”), attention to his person, help and care.

There are “misunderstood geniuses” who seem to be talented and capable, and their ideas are not empty - but they will either leave the project with a scandal, or quarrel with their partners, or suddenly do something rash - and that’s the end of the matter. Illogical? Yes. However, a person can insure himself in this way against the risk of failure, for example, from the collapse of self-esteem. His projects always collapse due to circumstances, accidents, someone else's will, and never because of his own mistakes. You can reassure yourself with this: “It was not I who made a mistake, it was not I who failed - it is the world that is cruel and unfair to talents.”

“Black sheep” can also benefit from their status. They are guaranteed to receive attention, albeit peculiar. If the family as a system in itself is not very healthy, then the household members also need their “black sheep”. Sometimes it is only on the discussion and condemnation of a family member who is “not like other normal people” that the whole system rests.

Naturally, such a strategy of behavior in a person is not formed from a good life.

As a rule, “eternal patients”, “misunderstood geniuses”, “black sheep”, “complainers” are people from dysfunctional families or people who have experienced significant life disasters that they were unable to cope with.

Fear of big goals and change

There is an opinion that each disease can be associated with a certain psychological problem, that “all diseases are caused by nerves.” A mystery for medicine is presented by apparently completely healthy patients who demonstrate all the symptoms of a certain disease, without “apparent” reasons. This is exactly the situation when the reason is the search for secondary benefits, for which no cure has yet been invented.

Example: one patient, for several years, diligently collected several phobias at once, including claustrophobia, cardiophobia - fear of dying from heart disease, fear of unfamiliar food due to fear of an allergic reaction. Considering that at her age the woman had an unusually healthy young heart, and never suffered from allergies a single day in her life. At the moment of “insight,” she revealed to the psychotherapist that “... She is mortally afraid of another, better life!”

In our example, the person was ready to acquire many medical problems and artificial restrictions in order to forever push away the problem of personal unfulfillment. And in fact, why strive for something and achieve something if, firstly, “I have chronic depression and am not interested in anything at all.” And secondly - “if something interested me, it would probably only be until the moment of dramatic changes”?

Having puzzled the psychotherapist, she soon gave up on treatment and found an outlet - “the love of her life”, who created all the conditions for maintaining her phobias.

Victim position in the Karpman triangle

The position of the Victim in the Karpman triangle suggests that a person in this case simply does not have a choice of another way of behavior. In this case, a certain fatalistic moment comes into play, that you can’t escape fate, this is a punishment, nothing depends on me anyway, and so on. In this case, any of the three positions of the triangle - Victim, Rescuer or Persecutor, to one degree or another - are victims, since they are not able to choose another way of responding. They simply cannot behave differently, and do not see an alternative behavior scenario for themselves. To some extent, the Karpman triangle is a prison, once in which it is not so easy to get out.

When a friend or girlfriend complains to you, they are in the position of the Victim. At the same time, the Persecutor himself is in the same state. No matter how much he strives to punish the Victim, in response to finding out the main motive of his activity, you can hear something in the spirit: what could I do? For example, if the Victim did not wash the dishes, the Persecutor will shout, press, remind, punish for this offense, so what else can he do if the desired action is not performed? Unfortunately, many are convinced that thanks to a request based on fear and in a raised tone, the effectiveness of performing an action increases. Fortunately, this is not the case. Very often, the rescuer becomes the pursuer. After he has made many senseless and unsuccessful attempts to save the victim, his nerves, relatively speaking, give out, and he turns into an executioner, a persecutor who seeks to punish the victim.

Hide and seek

Suffering is the most fertile ground for escape from oneself and self-justification. A suffering person always finds meaning in living. Life acquires a special dimension, value, meaning and clarity. Pain and fears help create an additional wall from reality and oneself. This is why people so carefully protect the true causes of their problems from outsiders. Pain, fears and unimportant routine are all ways to avoid being face-to-face with yourself and your life. Time crammed full of things to do, constant overload, poor sleep and unhealthy diet guarantee nervous breakdowns or exhaustion.

The philosophy of secondary gain is simple - everything and everyone is more important than myself. I am not yet ready to solve the piles of my own problems.

Zero balance

The concept of “secondary benefits” is intuitive and even pleasant. The inhabitants love her very much; saying “if a person doesn’t change anything, then everything suits him, it’s beneficial for him for some reason” has become almost a sign of good education and understanding of human psychology. Don’t feel sorry, don’t sympathize, don’t help – just hit them in the forehead with “that means you need this for some reason,” without understanding the situation.

But it turns out that often the situation does not imply any “secondary benefits”.

A typical case is a situation of domestic violence. Here is a woman who has been beaten by her husband for several years. They tell her: “If you don’t leave, it means you get something!” Do you want to be pitied? Do you want to be the unfortunate victim that everyone helps? Or a heroine bravely fighting for love? Or maybe you just live on your husband’s money, in his apartment, and don’t want to leave a warm place?” These are the questions they ask, and sometimes they add that the victim herself is to blame, and therefore should remain silent and not complain.

But let's figure it out - people meet, fall in love, get married. I don’t know of a single case where a man beat a woman to death on the third date, and after that she continued to develop a relationship with him. Not a single one - always in a couple, both initially try for each other, regret and forgive, make compromises. Even if conflicts occur, after them people try to make peace, make amends and promise their partner and themselves not to do this again.

Violence enters a couple’s relationship quietly, slowly, seeps in drop by drop, hides in corners, in small things.

When it becomes noticeably a lot, codependency has already formed, and material dependence, and the whole set. From an attractive, energetic woman, the victim turned into a downtrodden creature with a completely damaged psyche.

Where are the “secondary benefits” here? There is none of them. The sympathy of others (if there is any), a little self-pity and the opportunity to somehow use the family’s material assets is the only benefit that there is in this situation, “primary” (we now, of course, do not take situations where one side is openly slanders the other, lies and embellishes in order to gain attention and sympathy). It is especially sad to hear about “secondary benefits” when the victim was clearly given to understand what would happen to her, her children and loved ones if she left - probably staying alive and keeping her loved ones calm is also a “secondary benefit”, according to this logic, and deserves condemnation.

The same thing happens with people who, due to certain circumstances, find themselves in a very difficult situation on all fronts. It’s bad at work, my old mother is sick, and my children require constant care and attention, and I’ve already collapsed from overexertion. And now the man looks like a circus performer holding a dozen fragile plates in the air - if you concentrate on one, the rest will fly to the floor.

Yes, our will is also a finite resource, and if we, for example, direct all of it to solving one problem, there will not be enough for the rest. So it turns out that “being stuck” in such a state is sometimes the only opportunity to keep all important areas of life under control (at least relative), and again, there is no talk of any “secondary benefits” here - the only primary benefit is “worse.” it’s gone, and that’s okay.”

Secondary benefit of the victim and “codependent” rescuers

Secondary benefits from “social” diseases deserve special attention. Let's think: who will be the first to suffer if an alcoholic or drug addict with experience is cured? Of course, the entire burden of such changes will fall on the immediate family. First of all, those who fought for many years to save a drowning man and saw in this the highest meaning of their whole life. It’s a paradox, but it is they who often unconsciously oppose the physical and psychological recovery of the victim. In case of recovery of an addicted person, the usual meaning of life disappears - they are left alone with themselves.

In turn, the “victim,” dependent on his addiction, has a socially disadvantaged status that promises secondary benefits. And in fact, they have no reason to bother themselves with thoughts about the future, since there is no goal in life. They have no reason to put effort into self-development, waste time on studying, and energy on earning money. “Are you having a bad time?” - You ask. “Not a fact,” comes the balanced answer.

Professional psychologists working with street children will say that six months of a teenager’s stay in the realities of the “street” will require one to two years of rehabilitation under normal conditions in order to return their psyche to its starting point. If he lives on the street for more than two years, all known measures of pedagogical influence no longer work. In this case, social secondary benefits are: the absence of any coercion; the opportunity to live not as society dictates, but “as you want”; specific conditions of survival.

Despite the obvious disadvantages and significant risks, such an existence turns out to be attractive in its own way. That is why Mark Twain’s hero, Huckleberry Finn, even in the most favorable conditions, repeated to himself: “... and I’ll probably run away again.” And he ran away.

Rescuer

In this triangle, the rescuer often does not have the true meaning of salvation. It's not about helping. He has some hidden capabilities, a hidden motive, which, in fact, is beneficial to this rescuer, and only he knows why he is doing this.

For example, this could be some kind of secondary benefit - to show: “I am good in the eyes of these people or this particular person. That's why I take this role. I want to be a rescuer. I find the role of a lifeguard very inspiring.”

Perhaps this person receives some specific pleasure or has everything under control. He has the victim under his control. In this state, you can get closer to the victim, gain confidence, and you need to understand, depending on the situation and why.

If now the victim is inadequate, then it will seem to her that she is really being saved, that she is really being helped, that is, this person came with a deep conscious understanding to save this person. The victim at this moment does not understand that she is either simply being played or manipulated.

Delayed secondary benefit

Sometimes a secondary benefit, which a person did not even think about, catches up with him after a certain time. Imagine a girl who breaks her leg out of the blue and at the most inopportune time. A crucial moment and the threat of layoffs at a promising job, an upcoming trip abroad in a month, etc. According to the usual logic, she should have been present at work, flashed before her boss and completed work with the project.

The girl accidentally found out that the fracture that left her bedridden had brought quite tangible benefits a few days later, after taking a pregnancy test. Thanks to the fracture, she was able to spend the first critical three months at home. Today, years later, she remembers this turning point with gratitude. Without him, taking into account her medical record, everything could have ended completely differently.

People defend nothing as fiercely as their own pain and helplessness, which has become a habit. And most often, the underlying reason is the lack of purpose and desire to meet oneself.

Patients who are “accustomed” to being sick and “to the fullest” use of secondary benefits become a real challenge for the psychotherapist. They really don’t want to admit that the basis of a bunch of diseases is not harmful viruses and infections, but manifestations of laziness, fears and fear of responsibility, elevated to the level of a clinic. Most of us, yearning for warmth and attention, have at least once succumbed to the temptation to be the center of attention, even in such an unconventional way. The main thing is the other side of the coin, which we often forget about, or don’t even know about.

What do you have to pay?

- constant feeling of loneliness;

— somatic manifestations of a different nature (or, more simply, a variety of diseases);

- lack of close relationships, and in those that arise there is no love (instead, anything: fear of loss, attachment, control, humiliation, neediness, dependence, patience-humility-forgiveness, etc.);

- any relationship that exists is not healthy, it is broken from the very beginning;

- use by other people

- the choice in a person’s life is made by someone else, and is always not in favor of the first, which cannot be said about the consequences, the victim will deal with them;

- depression, sadness as the main experience;

- permanent dissatisfaction

- very strong anger (which is not expressed, but the tension in the field of such a person is very high);

- high level of anxiety all the time;

- constant feeling of fear;

- high degree of dependent behavior (in all forms: alcohol addiction, drug addiction, emotional addiction, etc.).

— the incompleteness of this situation constantly reproduces similar situations, only the characters change;

- as a result of all of the above, low quality of life.

If you are looking for an effective solution to get rid of the victim role, contact psychologists. A specialist will help you overcome this stereotype of thinking and get rid of ways of reacting to life’s difficulties from the position of a victim.

Result

Secondary gain is a common cause of many problems and failures. Why is it still secondary? Because the primary thing is loss. In particular, such a loss may be illness. And only then the patient receives his “bonus” for losing - excessive attention from loved ones; the opportunity to completely legally take time off from work you don’t like, meeting with colleagues whose presence causes a nervous shock; or the opportunity to hold a loved one by your bed. And then along the long list of unfulfilled desires. In any case, the primary loss is from which the person himself suffers, and which is obvious to an external observer. The gain received unconsciously, in the form of secondary benefit, is very clearly felt, although it is not realized.

The very sequence of events determines the outcome. A person wants to get rid of a loss, but cannot and does not want to decide on this, since with a loss the benefit itself will melt away. In reality, a person either hangs around in illness, delaying his recovery, or hangs between two poles, periodically recovering and falling ill again. Alternatively, recovery from one illness and illness from another may occur.

If we describe the secondary cause in a few words, we can compare it to resistance. Moreover, we are not talking about resistance to something external, but resistance to the very possibility of change. In truth, a person is not at all inclined to get rid of the situation that worries him, although he himself is not aware of this fact.

What other benefits of loneliness are there?

Sympathy and pity for others. Alone, it is easier to receive pity and support. You will always be a welcome guest among married friends with many children. A married friend who is tired of routine, looking at you, will most likely think that everything is fine and excellent in her life.
Availability of free time. You can do whatever you want without taking into account the interests of others.
The opportunity to remain yourself. When a person does not know his potential and is in no hurry to realize it, loneliness can be used as an excuse. “If my loved one were nearby, then I would... But now I’m alone and I can’t do anything.”
Lack of everyday problems and routine. You don’t need to serve anyone, think about what to cook for dinner or what brand of refrigerator to choose.

So is it good or bad?

There are no absolutely bad and absolutely good things in nature, and there cannot be. We apply the subjective labels at our disposal ourselves. Consciousness helps us in this, and the unconscious reasons, sees further and deeper. It is able to see both sides of the coin, and white in black. Therefore, secondary benefit - as a tool that protects the human psyche - was, is and will be. The whole question comes down to how beneficial it is for us? To what extent can it determine/limit human behavior? To what extent is it realized?

Of course, for a person who knows his goal and is moving towards it, focusing on secondary benefits is one of the proven ways to deprive himself of any opportunity to change. As long as the secondary benefit exists, fundamental psychological changes will not be able to occur. And we are left with only two options: either identify it, realize it and make a decision on how to continue to be with it and at the same time with ourselves; or endure and perceive it as a fact until receiving it loses its meaning for us.

Imagine if your illness allowed you to hold on to your loved one. And now he is gone - the meaning was lost, but the illness also subsided. And no magic.

From the editor

"Women's loneliness. Can it not be tragic? is a book by the famous Russian publicist Marina Kravtsova, in which the author offers effective advice on overcoming this sad condition:.

Natalia Dorfman-Chiarini knows how to make loneliness your ally and stop feeling like an empty place if you are not in a relationship .

The Cartesian coordinate method is one way to look at a problem from different angles. How to make an informed decision using this method, coach, manager of psychological games Alexandra Moshchenskikh tells: .

Who is the victim?

This is a person who gets into trouble everywhere.
Wherever he is, no matter what he does, disasters always happen to him. Such people love to live next to difficult or unloved partners, work in jobs they hate for the lowest wages, and tolerate tyrant bosses. They also often get sick, become victims of scammers, cannot get out of debt because they do not control their lives, and act on orders from above (parents, partner, society). What distinguishes people with victim syndrome from healthy representatives? Low self-esteem. Victims love to belittle their dignity, devalue their work, and shift responsibility for making important decisions onto others. They consider themselves incapable, stupid, weak losers, so they actively adapt to the opinion of the majority, expecting sympathy and love for themselves.

It would seem that if life is so bleak, maybe you need to reconsider old habits, abandon the old way of life, the destructive scenario in relationships? But the catch is that the victim loves his suffering and will not exchange it for anything, since he receives hidden benefits from the torment.

How to deal with yourself?

But what if you suddenly discovered that this “complainer”, crushed by the burden of unsolvable problems, is you?

Firstly, don’t blame yourself, and it doesn’t matter whether you find those same “secondary benefits” in your bad situation, or in fact, you sincerely want to change everything, but you can’t. Self-flagellation can be a fun activity, but, unfortunately or fortunately, it is absolutely useless for solving problems.
Secondly, if possible, without unnecessary emotions and thoughts about the “cruel, unfair world,” analyze what is happening in your life (possibly with the help of a psychotherapist, written practices, or other methods).

Even if you were horrified to discover that you were still receiving some secondary benefits, this is not a death sentence, it is not a sin, and it does not make you a terrible person. This is just a reason to start changing your life for the better.

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