Who benefits from the symptoms of their illnesses?
. 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
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
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
physical symptoms (see also
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.
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.
Psychosomatic Symptoms: Somatoform &
Somatoform disorders are mental disturbances characterized by
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
a patient's employment or relationships, and are not under a patient's
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
situations in which they are afraid to speak. ([Farlex
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
Common Benefits & Advantages of Diseases or
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.
- punish self (guilt)
- punish family (anger, shame)
- mourn missing person (sadness, guilt)
- leave family (despair)
- feel special
- disability leave
- complete a project
- avoid responsibilities
- get special treatment
- 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 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,
- 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
- 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.
Online Coaching, Relationship Counseling & Systemic Therapy
I thought you were just
another therapist - but you were not just. Not even. Not only.
Fernández Martínez and Fernández Concepción Rodríguez (Spanish)
Casey PR; Tyrer PJ. (1986). Personality, functioning and symptomatology. J
Psychiatr Res. 20:363-374.
Trethowan WH. Psychiatry and the seven ages of man. Journal of the Royal Society
of Medicine. 1988 Apr.
Plagiarism is theft. Copyright © Martyn Carruthers
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