What Does “secondary Benefit” From The Disease Mean And How To Get Rid Of It?

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

Each time we talk about the meaning of psychosomatic symptoms, we in one way or another touch upon the topic of the "secondary benefit" of the disease. However, not only the term itself causes resistance from clients, but also the common questions "Why do you need your illness" or "Why do you choose this symptom", etc. I have not asked such questions to clients for a long time, because on the one hand they are uninformative, because if a person knew "why" he had an illness, he would not have come to a psychotherapist in search of the causes of his psychosomatics. At the same time, the very understanding that a disease can be used by a person for some purpose, let alone a benefit, evokes in different people a range of feelings from open indignation to psychological protection and resistance. Let's look at some of the questions directly, as they are:

"That is, according to you, I deliberately took and created myself a heart attack, right?"

Very often, when it comes to secondary benefits, the client understands this in no other way than the reproach that he himself is the cause of his condition. At the same time, none of us like it when we are directly or indirectly accused of something. This is what is read behind the question "Why or how do you choose your disease." Neither why and in any way - in fact, more than an adequate answer, because the nature of the emergence of primary psychosomatics (when psychological factors become decisive for the onset of the disease) is always unconscious. Sometimes pathology is generally related to our genetics, which we cannot influence in any way with willpower or affirmations.

At the same time under benefit it implies that the very fact of sublimation of the psychological into the bodily is a kind of defense mechanism. Experiencing a strong intrapersonal conflict, the brain chooses between two evils - to get stuck in a conflict and split the personality like a schizophrenic, or to pretend that nothing happened, and suppress, hide, and repress all frustrating feelings. But it is precisely everything suppressed, repressed and ignored that disrupts the chemistry of the brain, depletes the body's resources and leads to the development of somatic pathology. At the same time, it is still more profitable to suppress, if the brain asked the owner that he would choose schizophrenia or gastritis, he would rather choose the latter (although the first also happens).

My mother-in-law has one hundred percent benefit, but she doesn't want to see it

However, benefits differ. In the concept of "secondary benefit" we share paranosic (primary) as in the described example above, i.e. when the nature of repression is unconscious, and epinosic (secondary) - when, against the background of an already existing disease or symptom, the patient begins to use it consciously, up to aggravation (exaggeration of the severity of symptoms) or simulation. At the same time, again, a person with epinosic benefit is not always a malicious manipulator. Sometimes such family stories really develop into codependent relationships, sometimes we just take the opportunity, finding at least some positive in what happened (broke a leg - got paid vacation, which we haven't taken for several years). When a secondary benefit is evident, it is up to the individual to decide whether to maintain their symptom and keep getting sick, or letting go and recover.

At the same time, the most common cause of "prolonged failure to recover" is a mixed form of benefits. When the pathology initially developed against the background of a repressed conflict, but the position in which a person found himself ill becomes comfortable for him. In this case, psychotherapy begins with an analysis of superficial benefits, but the main goal is to find the primary conflict.

And what do you think is the benefit of crawling along the wall for years and throwing thousands on ineffectual treatment?

It is in a state of mixed secondary benefit that a person is most vulnerable. On the one hand, he really did not choose his disease and did not want this to happen. On the other hand, its habit living with the disease prevents him from returning to a healthy state. As many people erroneously interpret the concept of "comfort zone" as reducing it to something positive, so it is wrong in this case to interpret the secondary benefit as pleasure or something good. In this case, we are also talking about the fact that the person "keeps" the symptomatology not because he likes it, but because he is familiar and predictable with it, he controls the situation.

Your therapy is another divorce, I thought at least you would help me, but you are no better than those others

And at that moment, when it would seem that we realized that not every person who uses the secondary benefit is a manipulator, we are faced with the case when the manipulator creates the appearance of a mixed form. Having once experienced the symptoms of a certain ailment, having learned and memorized its details, he begins to present them in the form of psychosomatic disorders (when the examination does not reveal pathology). A true disorder from an imaginary one differs in that in the second case, the person only pretends to accept the treatment - he follows the recommendations, without bringing anything to the end. He goes from psychologist to psychologist, and as soon as the specialist comes to the fact that the client presents symptoms of epinosic benefit, he quits therapy. Unfortunately. Because having "played" with the patient, he himself begins to believe in his illness, and over time it develops into a real pathology, but not somatic, but psychological. it was written above, if we do not sublimate the conflict through the body, we choose the path to splitting the psyche (trying to keep himself adequate, he unconsciously separates himself from the "incurable" symptomatology). It is fair to say that people become manipulators not from boring life, but from distorted educational methods. And only the realization of this and the decision to work on their relationship with the outside world, and not a symptom, leads a person to recovery.

What happens now if the subconscious has decided that it is beneficial to me, I now suffer from this all my life?

As long as the benefit remains paranoid - primary and unrecognized, a person may not even guess that his illness has some psychological factors. He heals the body, and in the meantime life circumstances can change in such a way that the recent intrapersonal conflict is resolved by itself, under the influence of external factors. When we move on to realizing the benefits of the disease, we can write down in a column all those uncomfortable symptoms and the problem behaviors associated with them, and opposite each of them write what benefits they bring us. After that, customers do not always see anything special in their description, but as soon as we add the third column - the price we pay for such behavior, they often start to wonder if it is really beneficial, useful and harmless. If the benefits that are listed to us are really so important, then you can simply add the 4th column and write in it how you can achieve these "benefits" constructively, without resorting to symptom or problem behavior. For the most active, the 5th column will not be superfluous, in which you can outline a plan, tools and implementation timelines for each action.

At the same time, if it seems to us that the cost of our disorder is minimal, and the benefit is much higher, it is important to track in which direction we are pushing it out - towards somatic pathology or mental. However, in any case, the choice is ours;)