Every hypnotherapist has a story about the client who “tries” to lose weight or regain his health but seems to do everything in his power to sabotage his own efforts. Far from being a liar, the client has one or more subconscious motivations called secondary gains that prevent him from releasing weight or healing from his illness.
What is secondary gain?
Mosby’s Medical Dictionary defines secondary gain as “an indirect benefit, usually obtained through an illness or debility.” The concept of secondary gain goes back to the 19th Century and was re-popularized by Dr. Sigmund Freud, who talked about patients “clinging to their disease” as a way to hold on to the benefits their illness provides them.
What are some examples of secondary gain?
Secondary gain can include anything from getting more attention or sympathy from others to escaping from punishment or responsibilities. Examples of secondary gains for adults include guilting your spouse into staying married to you, gaining access to pleasurable drugs, getting out of onerous household chores, not having to live up to your career potential or a way to avoid sex and/or having more children. Children also attain secondary gains from illness. They may complain of a stomach ache to get extra attention from mommy or daddy-or to stay home sick from school.
Secondary gain and resistance to weight loss: A case study
About a year ago I worked with an overweight 42-year-old client whom I’ll call “Marilyn,” who suffered from adult onset diabetes. Marilyn told me she wanted to regain the health and fitness she had enjoyed in her early 20s, but after talking with her for awhile, we both discovered there was a defiant part of Marilyn that wanted to remain overweight. Marilyn was married to a man significantly older than she was to whom she was not physically attracted. Through our work together, Marilyn identified and acknowledged the fear that if she regained her slender figure, men would start hitting on her and she would be tempted to cheat on her husband.
Secondary gain and physical disability: An EFT practitioner’s personal story
In an Internet forum concerning Emotional Freedom Techniques (EFT), a form of energy psychology involving meridian tapping, a practitioner from Great Britain who helps others heal from physical and emotional problems acknowledged the role secondary gain plays in his own physical disability: “During my daily walks I have now become the recipient of much potential secondary gain…. Doors are held open for me; seats are given up for me, shop greeters offer to carry my basket, cars stop for me to cross the road…. it is easy to see and realize that some people could get used to these privileges. Indeed I can envisage that many people will either consciously or subconsciously take advantage of their personal circumstances to elicit gain from others. How many people take advantage of their invalid status to have others love them more, fetch and carry, do chores and so on? How many people enhance their symptoms to increase their gain from others? We need to be aware that this would be a huge barrier to healing.”
How do you know if secondary gain is holding you back?
Hypnotherapists and other people involved in change work typically identify clients’ secondary gains by asking them questions in the preliminary interview such as “What are the possible upsides to holding on to this problem?” and “What are the downsides to having the solution?” Clients are often surprised by their own answers to these questions since they are often not consciously aware there is a benefit to being sick or overweight. EFT practitioner Stewart Robinson suggests additional questions to ferret out a client’s secondary gains, such as “In what way will not having this problem be unsafe or stressful?” and “Will having the solution change others’ expectations of you?” The answers to these questions can shed important light on the resistance the client has to changing his or her behavior. If you are not achieving the changes you think you want to effect in your own life, ask yourself these same questions.
What can you do to overcome secondary gain?
Just as with any problem, it is important to be in complete physical, emotional and psychological alignment to effect significant and permanent change. Just acknowledging that you benefit to some extent from keeping a problem is an important first step. In the case of a woman who clings to her extra weight because she wants to avoid having sex with her partner, the sexual problem must be resolved before the weight issue can be addressed. This could mean setting firmer boundaries about the frequency of sexual activity or having candid discussions with her partner about her sexual likes or dislikes. In extreme cases, she may even have to terminate her relationship if she continues to engage in unhealthy, life-threatening behaviors just to avoid unwanted sexual encounters.
The Corsini Encyclopedia of Psychology and Behavioral Science, Volume 4, edited by W. Edward Craighead and Charles B. Nemeroff
Frogs into Princes: Neuro Linguistic Programming by Richard Bandler and John Grinder
Mosby’s Medical Dictionary, 8th edition 2009, Elsevier