What Is Secondary Gain

Secondary gain, as it relates to medical diagnosis is defined as the benefits that a person receives relative (secondary) to an injury or illness.  The injury or illness may or may not be legitimate.

One example of secondary gain is a person involved in an auto accident who has a potential lawsuit against a negligent party.  The more severe the injury, the greater the value of the lawsuit.

Some exaggerate their physical condition for the purpose of appearing more injured than they actually are with a specific intention.

There are different types of secondary gain but they all include an exaggeration of symptoms for personal advantage and are recognized as resulting from a psychiatric disorder. (Those who are aware of the behavior are known as malingerers which are not a psychiatric condition).

In other words, using physical symptoms to attain personal gain can be presented in a conscious manner (knowingly) or unconsciously without a physiological basis.

The person generally seeks “compassion, increased attention, freedom from everyday responsibilities, and the like.”   (Watzlawick, 1967, p. 287).

Recognized Mental Health Conditions

Secondary gain can result from a recognized mental health condition(s) listed in the Statistical Manual of Mental Disorders, 5th Edition (DSM-5) under the section covering Somatic Symptom Disorder and Related Disorders.

The following classifications are identified:

Factitious Disorder – intentionally producing mental or physical symptoms without any external rewards.

Somatic Symptom Disorder – the expression of physical (somatic) symptoms using mental phenomenon (of the senses).

Conversion Disorder – sensory or motor symptoms with no physical basis.

Illness Anxiety Disorder – being preoccupied and consumed by a condition or illness without symptoms or with minor symptoms.

While each Disorder has its own specific characteristics that separate it from another Disorder, the commonality is that the thoughts, feelings, and behaviors are an excessive response to physical symptoms and health concerns.

Each of these disorders causes severe distress, impairment and social functioning.

What is Neuro-Linguistic Programming?

Neuro-Linguistic Programming (NLP) involves three components of the human experience:  Neurology, Language and

Programming.  Our neurological system controls body function, language is the basis of the way we communicate and programming involves the models we create.

NLP explains the interplay of the mind (neuro) and language (linguistic) and the impact on the body and our behavior (programming).

Because NLP presumes ‘all behaviors have a good intention’ it focuses on subconscious (unconscious) processes as well as the mind’s perception.

NLP acknowledges that our brain records and retains every experience whether bad or good, which is recalled through our senses.  (This theory infers there must be either a feeling, a memory picture, or  even self-talk through thought processes – or a combination – that basically activates a behavior).

NLP and Secondary Gain

In relation to the mental processes that trigger secondary gain, because there are no physical conditions occurring to cause the reported symptoms, it is obvious that some level of distorted thinking has occurred or is occurring.

The distorted thoughts originate in the subconscious processing which is located in the hippocampus and hypothalamus of the brain.

By using NLP techniques the subconscious feeling, memory or self-talk thought processes is restructured in order for it to be useful.

The goal is to assist those portions of the brain that deal with the subconscious automatic processes to realize that certain behaviors are no longer beneficial.

It is certainly not therapeutic to tell a patient that basically it’s all in the head.

NLP is similar to Cognitive Behavior Therapy (CBT) but NLP is more effective in that it teaches coping strategies through relaxation techniques of meditation as well as self-hypnosis.  

This provides a route for re-patterning the subconscious by breaking down the structure of “assumptions” which is a filter between subconscious and conscious processes.

A qualified and properly trained NLP therapist has a series of tools available to achieve that goal.

SOURCES

-Health Care Superv. 1994 Sep;13(1):10-5.
-(Watzlawick, 1967, p. 287).
-Statistical Manual of Mental Disorders, 5th Edition (DSM-5)
-www.hopkinsguides.com/hopkins/view/Johns_Hopki
-www.networks.nhs.uk/nhs-networks/nlp-in-healthcare

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