When Disease Makes Sense © Martyn Carruthers

Who benefits from the symptoms of their illnesses?

Psychosomatic Disease . Autoimmune Disease . Pain Control

When do Disease Symptoms make Sense?

Some disease symptoms appear to provide benefits. Some benefits are conscious (e.g. staying home from work) and some unconscious (e.g. getting attention). Yet if we explore the benefits of disease symptoms in people’s relationships, we often find that those symptoms make a different kind of sense.

People with medical symptoms may protest that I am implying that they are exaggerating their suffering or that they are manipulating people. No. I am suggesting that, if the underlying emotional / relationship issues are resolved … the symptoms often diminish and sometimes vanish.

Sigmund Freud introduced the concepts of primary and secondary gains of physical symptoms. Let’s add tertiary gains and somatization to these insights.

Primary gains – expressing or relieving emotions using physical
symptoms (i.e. being sick relieves anxiety, distress or conflict)

Secondary gains refer to social, occupational, or family benefits
from other people (e.g. a sick person may stay home instead of working)

Tertiary gains refer to relationship benefits (e.g. a sick person may enjoy
extra attention while a caretaker may enjoy the compliance of sick people)

Somatization – unconsciously expressing emotions through
physical symptoms (see also psychosomatic symptoms)

Primary Gains – Unconscious Benefits

Primary gains refer to internal (unconscious) motivations. For example, some people use their medical symptoms to justify not performing tasks, to have ‘good’ excuses or to avoid feeling guilt. Primary gains may be conversion disorders (physical symptoms without organic causes).

Conversion disorders are a major reason for visits to primary care practitioners.
One study of health care utilization estimates that 25–72% of office visits
to primary care doctors involve psychological distress that takes the form
of somatic (physical) symptoms.
Encyclopedia of Mental Disorders

Secondary Gains – Conscious Benefits

Short-term diseases such as colds, ‘flu, stomach pains, menstrual cramps and headaches can provide useful justifications or excuses for gaining benefits such as money, sympathy or holidays. Some people lie about or exaggerate their symptoms to obtain these benefits.

I hurt my back at work and my doctor said to take a week off.
After a few days I felt better, and I did some home renovation.
Unfortunately my boss visited me … and I was fired.
Boston

Tertiary Gains – Relationship Benefits

As chronic illnesses can disable people and exhaust caregivers, any relationship benefits tend to be unconscious. Few people choose to have a debilitating disease … although many medical symptoms seem to fit people’s lifestyle and relationships.

I was diagnosed with cancer, and went for surgery. The cancer was removed …
but soon after I was diagnosed with multiple sclerosis … it seems like only a
serious disease will get me attention from my husband and family.
Chicago

Psychosomatic Symptoms: Somatoform & Conversion Disorders

Somatoform disorders are mental disturbances characterized by physical complaints
that appear to be medical in origin but that cannot be explained in terms of a physical
disease, substance abuse, or by a mental disorder. Somatoform physical symptoms
interfere with a patient’s employment or relationships, and are not under a patient’s
voluntary control.

Conversion disorders are conditions in which the patient’s senses or ability to walk
or move are impaired without a recognized disease or cause and in which emotional
factors (such as stress or trauma) may be related to onset or exacerbation.
Examples include people who lose their voices in situations in which they are afraid to speak. ([Farlex Free Dictionary])

Does your body say what you won’t say?

We often help people recognize the benefits of their disease symptoms and help people gain those benefits in healthier ways. People’s unconscious minds (body-minds) are not stupid. Some symptoms seem to vanish when they no longer provide benefits, providing that body tissues have not been damaged beyond recovery, nor surgically removed.

Common Benefits & Advantages of Diseases or Illnesses

Emotional wellbeing seems to support healthy bodies, and healthy relationships are the golden keys to emotional wellbeing. People who cling to unhealthy relationships seem more likely to experience chronic medical problems.

Communicate Emotions Conscious Advantages Relationship Benefits
  • punish self (guilt)
  • punish family (anger, shame)
  • mourn missing person (sadness, guilt)
  • leave family (despair)
  1. feel special
  2. disability leave
  3. complete a project
  4. avoid responsibilities
  5. get special treatment
  6. financial compensation
  • gain more love
  • win arguments
  • gain acceptance
  • manipulate people
  • understand ancestor
  • follow family traditions

Many people want their symptoms to be labeled by an authority –  labeled symptoms may seem more under control. For example, people may prefer to say that suffer from Gulf War syndrome that than just listing their symptoms.

Somatic Pains Psychosomatic Pains
  • Somatic pain is not related to emotions and relationships.
  • Somatic pains have an anatomical correlation and distribution.
  • Somatic pain reflects tissue damage.
  • Somatic pains may come and go, and be worsened or relieved by specific measures.
  • Somatic pains are described with words like burning, stabbing etc
  • Psychosomatic pain may follow an emotional or relationship disturbance.
  • Psychosomatic pain may not
    follow anatomical distribution.
  • Psychosomatic pain may not
    reflect tissue damage.
  • Psychosomatic pains tend to
    be constant.
  • Psychosomatic pains may be
    difficult to describe.

I find that partners and children of medical doctors more often have wild
symptoms that gain attention from their medically trained relatives.

Does a relationship make you sick?

Some medical symptoms seem to express withheld emotions …
and most emotions seem to express relationship issues. We have seen
many people improve their physical health as they improve their relationships.

Please consult a medical doctor about diseases,
medical symptoms or medical conditions.

Contact us to manage your emotions and improve your relationships.

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