As hypnotherapists, we help clients with a vast range of issues and goals. However, some client issues are not quite as straightforward as the ‘presenting problem’ might lead you to believe.
What is a secondary gain?
In psychological terms, the phrase ‘secondary gain’ refers to a benefit that the therapy client gets from maintaining their problem. This is different to the ‘primary gain’, which will usually be much more apparent and easy to recognise when you’re discussing the problem and the desired therapy outcome with the client.
Often, secondary gains are less easy to spot than primary gains, yet they are frequently more powerful motivators for someone to maintain their problem, and can cause issues with progression through the hypnotherapy process if they are not properly addressed.
An example of a secondary gain
As an example of the difference between a primary gain and a secondary gain, a hypnotherapy client who wants to lose weight may have both primary and secondary gains (or ‘benefits’) that cause them to maintain their weight. In this example, our weight management client, Roberta, has a common primary gain, in that she loves food and presents herself as an epicurean (a devotee of ‘sensual enjoyment’, especially relating to the enjoyment of food and drink). However, that’s not the only motivator for her ongoing weight gain. Roberta also has a deeper need, a secondary gain, that is encouraging her to add to her excess weight. Up until recently, she was married to her ex-husband who she fell out of love with, and for the last few years she no longer felt physically attracted to him – in fact, she no longer liked him much at all due him progressively becoming more disrespectful and even brutish with her. The problem was, he didn’t feel the same way. So, as the relationship deteriorated for her, the husband still wanted to maintain their sexual relationship.
Roberta did not have the confidence or assertiveness to flatly refuse her husbands romantic advances, and the only thing that eventually stopped the romantic advances from happening, was when she gained some weight. He then no longer found her attractive. She didn’t initially gain weight on purpose with this result in mind, but when her husband decided that he no longer found her as attractive, and therefore stopped trying to initiate sex, this spurred her on to continue doing what she was doing, as she was ‘gaining’ from it, in more ways than one!
The problem arose later, when they got divorced. Roberta maintained a dislike of the idea of having another sexual partner, and so her secondary gain persisted in helping her gain weight so she could continue to avoid having a sexual relationship. In fact, it became even stronger, because now her being overweight also ‘protected her’ from getting into another toxic relationship where she might have gotten hurt again.
Identifying secondary gains
As a professional hypnotherapist, it is important to identify and recognise secondary gains early on in the therapy process. The reason for this is, if the hypnotherapist only helps the client to work on reducing the problem, or helps them move towards their therapy goal, the secondary gain is still there. If not addressed, it continues to influence the client’s behaviours and thoughts, whether consciously or subconsciously.
With the example of Roberta, if the hypnotherapist was not aware of the secondary gain, they may have worked with Roberta to reduce her portion sizes, to choose healthier foods, to exercise more, etc. However, these changes in behaviour would likely only last temporarily (if at all), because as soon as she began to lose weight, she would be concerned about her relationship anxieties, and would make an effort to go back to her old (weight gain) strategies.
During our hypnotherapy training, we teach our students exactly how to identify secondary gains during the hypnotherapy session. In some cases they can be relatively easy to identify, in other cases, specific techniques can be used to draw the secondary gain out from the client. Though the skill of recognising secondary gains is not necessarily taught on all hypnotherapy courses in the UK, I feel that it is an integral tool that all professional hypnotherapists should have at their disposal!
Working with secondary gains
Once a secondary gain has been identified, you can then help the client to effectively move forwards in their therapy process. In many cases, the secondary gain can come as a bit of a surprise to the client. Roberta may not have consciously realised that she was gaining weight to avoid sex. Sometimes, it can just happen that a certain behavioural or cognitive ‘habit’ can have additional benefits. Other times, the client may be aware of the secondary benefit, but it can be embarrassing or more personal than they’d originally intended on sharing during the therapy session. However, you can work both in hypnosis and conversationally, taking behavioural, cognitive, analytical and even regression therapy approaches in order to help the client find a new way to fulfil the positive benefit that their secondary gain gives them, but without keeping hold of the problem itself.
If you’d like to learn more about how to address secondary gains during a hypnotherapy session, check out our hypnotherapy training options for more info: