Healing and Hypnosis IV

Motivation and Secondary Gain

Difficulty level: *Intermediate

Secondary gain was first noted by serious hypnotherapists in World War II. A soldier may have in large part wanted to get well, but to return to the shelling and the front lines with all of the blood and terror, that was too much for the unconscious mind to bear. The soldier knew he was letting his comrades down every moment he was away. Meanwhile, deep within himself he also wanted to go home, where there was no killing, where life was better and a loved one awaited. Whatever problem or injury the soldier might have, it may not get better, and indeed might get worse because of the blessing and curse of "secondary gain." If the soldier gets out of the war hospital healthy, it's back to the means going back to the same thing that put him in the hospital in the first place. That would be an insane thing to do in the conscious and unconscious minds of many young men.

If the soldier did not get well, he would be returned to the states and those he loved. There would often be a deep psychological price to pay in this case as well. The inner struggle of guilt could be agonizing and permanently debilitating in some respects. Returning to the front would be impossible for many.

Secondary gain is the gain an individual receives from being ill or injured. In fact, it may be true that in most, if not all illness, there is some benefit derived by the patient from the illness. Sympathy, love, caring, nurturing, safety, security, peace are all among the common secondary gains a person may receive when he is ill. In the case of a wounded soldier in a MASH unit, the secondary gain of not getting well would be the ticket home. Even if he never got better, and he may not, he would not face the trauma of killing again. Unfortunately, the ridge created by the gain pushes against the forces of the conscious and unconscious mind to go back to the fighting and help his comrades. This ridge often replays itself in the individuals future as a form of post traumatic stress disorder.

This mix of values and emotions is the stuff of great Hollywood movies and chronically ill people. We clearly see deep-seated loyalties powerfully divided in the mind. God, country, the soldier's unit and the loved ones back home may meet head to head with the desire to stop killing and go home to be with those loved ones. Values of such a powerful nature collide head to head in many life situations and create powerful ridges of emotion which manifest as chronic illness of a psychological and/or physical nature.

The secondary gain refers to the benefit the individual receives from being ill. For some individuals the benefit of being ill is greater than the price to be paid for good health. The body stays ill. It should be noted however, that this is normally not a conscious decision or choice that is made by someone. In fact, most people who are ill don't give much thought at all to the benefits of being ill whether physically or emotionally. Most people simply want to feel better and assume they will deal with the future, in the future. The unconscious mind often has other plans. The desire for sympathy or safety, love or security, peace or comfort often easily exceeds and overcomes the conscious minds meager desire to get well. The unconscious mind will "win" if it is not shown that a compromise can be reached that will still assure the survival of the self. People literal ly have become paralyzed because of secondary gain issues. People have gone blind, deaf and dumb due to secondary gain issues. People have died because of secondary gain issues. Secondary gain issues destroy lives daily.

When working with a client, you should know that he will not get well if there is a significant secondary gain issue that has been neglected. What kinds of secondary gain issues will you likely run into in practice?

A Christian Scientist will not want to seek to gain healing from a practitioner or will feel greatly uncomfortable if he does because he does an honor to God if he shows his faith in the wake of illness. The secondary gain is the conscious and unconscious minds certainty that his faith will save him. His lack of faith will destroy him. Pleasing God is quite a powerful secondary gain issue and a very real one. Simply put, many people will not pursue hypnotherapy because they believe, knowing no better, that it is evil. Therefore the secondary gain they receive from their illness is the comfort they have in pleasing God.

The key value of a hypnotherapist is often his ability to discover the cause of a specific illness or challenge the client is experiencing. With experience the client will see the forest and the trees where the client often sees only one or the other. Once you, as a therapist have identified a cause, you then will gently and patiently help the client see the cause. The client will not be able to do this on his own.

The discovery process as accomplished within the team of therapist/client however is one that in all sincerity must take place in the clients own time and be a personal cognition or "pAHA" experience. When a hypnotherapist makes the mistake of telling a client that an illness is psychosomatic, he is normally rejected completely or in part by the client. Clients often will "fight for" a physical cause for a problem they are experiencing because they do not want to think that anything is wrong with their mind. This is where the axiom, "people are not broken," can be useful to adopt as a client and a therapist. The client has ridges that are supported by at least two powerful viewpoints on the problem the client is experiencing. These viewpoints do not necessarily need to be considered opposite view points on a compass. Sometimes they are only 90 degrees apart instead of 180 degrees apart.

People often believe they can figure out the cause of psychosomatic illness on their own but usually this results in nothing more than a recursive loop and time wasted. It may be possible to discover the specific sensitizing event or engram where the cause is, but more often the client will at best come up with a lock, or later event on a chain of similar events. Burning off the negative emotion of later events that triggered the emotions and somatic pains or illnesses of the initial event, can certainly be relieving. It often appears that the person is healed or improved. The symptoms normally come back in a short period of time if the incident is not the initial incident.

Speaking from my personal experience alone, I have observed that most clients that come in presenting significant illnesses or emotional problems tend to be very intelligent and/or very successful from a financial standpoint. The person with high intelligence and/or level of success normally reach such success through personal effort. They have discovered that when they set out to accomplish a task, it gets done. This mind set, paradoxically does not work as well in the therapeutic process. Insights are rare when the client is attempting to direct the process instead of being led to insight. Quite often there is a "part" of the individual that is responsible for the stubbornness of wanting to figure out the cause and healing aspects of his illness, on his own. This part has served well in achievement and assumes it will serve well in healing. Unfortunately this is not normally the case.

The extraordinary hypnotherapist, John Watkins, had this to say about this kind of phenomenon,

"An intelligent patient will make rapid strides forward, however, if he can be made to see that the more resistance he naturally feels towards accepting a concept or idea, the more likely it is that the idea is approaching close to the true heart of his illness. It is commonly noted that a person who is teased about a weakness he does not have is not much disturbed. But toss a verbal dart in the direction of a true flaw in his make up and watch him bristle up and protest." (Hypnotherapy and War Neuroses)

In effect, when the client begins to fight you (or act with certainty that you are on the wrong track) as a hypnotherapist, it is then you know that the healing is just around the corner! When you are at the core, the cause, the dynamic of the illness, the cure is there. The last step is often the most difficult of course, for this very reason! The complete release of illness, if it is psychosomatic in nature, will occur when the final layer of the onion is peeled and the cognition is made by the client.

As a competent hypnotherapist, your job is to be certain that the cause is accepted by the client. This is the moment of release. This SHOULD heal the individuals psychosomatic illness but it often does not. Something else is in the way. It is secondary gain.

Secondary Gain, as described above, is the force or forces that are in opposition to the symptomatic release or cure that keep the psychosomatic illness in place. There is a part or parts of the individual that are gaining more benefit by maintaining the illness than allowing it to be released. In the case of an unconscious "part" the client is unaware of why he is still stick. At the conscious level, the client is aware of why he doesn't want to get better and normally he will readily admit to this.

We must now eliminate the secondary gain issues that are tearing the individual apart. In the next article we will discuss how to deal with secondary gain issues in a "three dimensional" fashion. In neurolinguistic programming there is a tool called, "reframing." This is a useful tool and is a part of what will be discussed in the next article. Unfortunately, reframing by itself is not a solution, only an important key.

Kevin Hogan can be reached at:kevin@kevinhogan.com

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Go to the next article in the series: Hypnosis & Healing V

Kevin Hogan
Network 3000 Publishing
3432 Denmark #108
Eagan, MN 55123
(612) 616-0732

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