In the journey of personal growth and healing, we often focus on the symptoms and challenges we experience. Exploring the underlying emotional needs and unconscious motivations that influence our behaviors can offer valuable opportunities for greater self-understanding. One concept that can help illuminate these patterns is secondary gain—the indirect benefits or forms of relief that may accompany a symptom, condition, or challenging experience. Understanding these dynamics with curiosity and compassion can support meaningful personal growth and healing.
What Are Secondary Gains?
Secondary gains refer to the indirect advantages or benefits that individuals may experience in connection with a particular symptom or condition. These benefits are distinct from the original causes of the condition and may include receiving additional support, gaining relief from overwhelming responsibilities, or experiencing greater understanding from others. Some benefits arise through interpersonal or environmental circumstances, while others involve emotional processes that operate outside conscious awareness. The concept is best understood as a way of exploring how circumstances surrounding a condition may influence behavior and coping, rather than as an explanation for why someone experiences genuine symptoms. Research has examined secondary gain in relation to psychological treatment and the complex motivations that can accompany help-seeking (Van Egmond et al., 2005).
Common Examples of Secondary Gains
Understanding secondary gains becomes easier when we consider everyday situations in which important emotional or practical needs may be met indirectly through challenging circumstances:
Chronic Illness and Support: An individual living with a chronic illness may receive increased care, attention, and assistance from loved ones. This support can provide meaningful comfort and connection during a difficult time. Exploring these experiences may help the individual recognize how important continued emotional support and connection are to their well-being, regardless of changes in their health.
Workplace Stress: An employee experiencing burnout may receive a reduced workload, additional flexibility, or time away from work. These accommodations can provide valuable opportunities for rest and recovery. The experience may also reveal an underlying need for sustainable expectations, appropriate boundaries, and a healthier work-life balance.
Emotional Trauma: Individuals who have experienced trauma may receive empathy, understanding, and validation from others. These responses can foster a sense of connection and emotional safety. Exploring the importance of this support may help individuals recognize their need for ongoing understanding, acceptance, and secure relationships throughout their healing journey.
In each example, the underlying needs are meaningful and legitimate. Recognizing them creates opportunities to develop additional ways of receiving support, establishing boundaries, and cultivating emotional well-being.
The Impact of Secondary Gains on Healing
Understanding secondary gains can offer valuable insights into the complex relationship between emotional needs, coping strategies, and personal change. When an existing situation provides an important form of support or relief, contemplating change may bring up understandable concerns about how those needs will continue to be met. Exploring these concerns can help individuals approach their healing journey with greater awareness, compassion, and confidence.
For example, someone living with chronic pain may appreciate the care they receive from family members while also feeling concerned about returning to a demanding work environment as their functioning improves. Both experiences deserve thoughtful attention. Exploring these feelings through the lens of Internal Family Systems (IFS) therapy may help individuals recognize different internal perspectives, understand their protective intentions, and identify ways to support their needs as circumstances evolve. This approach respects the reality of physical and emotional symptoms while creating space for greater self-understanding.
Recognizing and Addressing Secondary Gains in Therapy
Awareness is an important part of exploring secondary gains. Therapists can help clients identify the emotional needs, sources of support, and protective patterns associated with their experiences. This exploration is most helpful when approached with empathy, curiosity, and respect for the individual's circumstances. Rather than focusing on symptoms as sources of benefit, the therapeutic process emphasizes understanding the meaningful needs that may be receiving attention through existing circumstances.
Through this process, clients can discover additional ways to meet their needs while supporting their well-being and personal goals. These may include developing coping strategies, strengthening relationships, establishing healthy boundaries, and making lifestyle adjustments that reflect their values. Exploring personal needs through Nonviolent Communication (NVC) can also provide a practical framework for identifying important emotional needs and communicating them more clearly. Similarly, cultivating self-compassion can help individuals approach their experiences with kindness and acceptance, creating opportunities for greater emotional flexibility and personal growth.
Conclusion
Secondary gains offer a useful perspective for understanding how emotional needs, environmental circumstances, and patterns of support may interact with psychological and physical challenges. By exploring these dynamics with compassion and curiosity, individuals can develop a deeper understanding of their experiences and recognize opportunities to meet their needs in meaningful and sustainable ways. This awareness supports greater self-understanding, strengthens personal agency, and encourages conscious choices that contribute to healing, resilience, and overall well-being.
References
Fishbain, D. A., Rosomoff, H. L., Cutler, R. B., & Rosomoff, R. S. (1995). Secondary gain concept: A review of the scientific evidence. Clinical Journal of Pain, 11(1), 6–21. https://doi.org/10.1097/00002508-199503000-00004
Van Egmond, J., Kummeling, I., & van Balkom, A. (2005). Secondary gain as hidden motive for getting psychiatric treatment. European Psychiatry, 20(5–6), 416–421. https://doi.org/10.1016/j.eurpsy.2004.11.012
