Primary and secondary gain

Gain from illness (English: morbid gain ) is a general term for the objective and / or subjective benefits that attracts a ( real or perceived ) patient from his disease or a patient of his diagnosis.

General

Once a person takes on the role of the patient, he can go out in European culture usually assume,

  • To be relieved of everyday duties,
  • To learn compassion / pity / compassion and / or
  • To be handled with care of the environment.

Also, the patient can expect economic support from social security institutions; he is thereby partially or completely relieved from its own acquisition.

This generally socially desired setting is to be distinguished from the opposite aggravation and simulation:

  • Simulation is a deliberate and conscious counterfeit and imitation of disease symptoms without clinical significance.
  • When Aggravation actual disease changes are present; they are intentionally overemphasized.

The division into primary disease and secondary gain profit goes back to Sigmund Freud, the founder of psychoanalysis.

Primary and secondary gain

  • The primary gain from illness consists in the internal or direct benefits that pulls the sick person from his symptoms: for example, it may thus go perceived as unpleasant situations or conflicts out of the way. The symptom is then indeed experienced as unpleasant, but it allows the patient to need to take any immediate ( leading out of the conflict ) decision (often it detects a conflict, which he has or where he is, not as such ). He feels only in an awkward (at the seemingly hopeless for him) situation, which weakens him. The relationship between conflict and disease symptoms is not considered possible and remains unconscious. Also, the symptom may unconsciously serve unpleasant conflicts to go out of the way (for example, the sudden sickening facing a severe test ).
  • The secondary gain from illness consists in the external benefits that the sick person can draw from existing symptoms to be able to remain as the gain in attention and consideration by its environment and / or for example the possibility, in bed, and there served food to get. Stavros Mentzos provides a general meaning of the symptom, not only in hysteria, but also with other psychiatric disorders such as phobias and compulsions in a communicative aspect of this symptom reveal language and at the same time allow for a therapeutic approach in this aspect.

Tertiary gain from illness

  • The tertiary gain of illness consists in benefits for the environment of the patient. For example, for members of the care to be provided will be perceived as an asset, because the nurses felt to be needed, given a particular expertise and can thus see themselves as saviors (in DE Biegel, E. Sales, R. Schulz: Family caregiving in chronic illness Newbury. Park, Sage, 1991. ). In the broadest sense, all the health professions receive a tertiary gain of illness, see also helper syndrome.

Swell

  • Psychoanalysis
  • Nosology
Medical diagnosis Unconscious mind Jean Laplanche
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