What keeps people from solving their problems series: Secondary Gain

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 e.g. generally the person is not being consciously manipulative or faking (the distress/impairment is still real).

Here are some examples:

– 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 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.

– Person’s partner does not leave them 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 fulfill 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 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.

Notes:

– The secondary gain trap is not something shameful. Its 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!! Secondary gain does not mean the person is “faking”.

What’s the point of understanding secondary gain?

– All the people involved are trapped by it.

– It can be helpful to understand psychological problems as like a platform being propped up by supporting beams. In therapy we work to identify the beams, and knock them out one by one.

– Significant others often have a sense that they are being manipulated by the stuck person and relationships suffer. By understanding and being upfront about the secondary gain mechanisms that might be operating, everyone can start to understand that the mechanisms are the problem, not the people involved. It can be a relief for everyone to stop thinking of the stuck person as manipulative etc

– People can learn alternative coping for getting their needs met rather than staying stuck. This helps the stuck person and their significant others.

– Significant others can learn helpful ways of dealing with illness/stuckness behaviours that help everyone get less trapped and keep more self respect

DIY Psychological Challenge

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.