Why change?

When I was studying for my psychotherapy diploma, there was a sizable manual to accompany the course. Towards the back, there was a section that took up one third of the page. It was titled ‘Secondary Gain’. It was a topic for discussion towards the end of the course and didn’t take too long to cover.

Fifteen years later, there is a consensus of opinion amongst many colleagues, that 'Secondary Gain' has been the largest contributor to clients not succeeding in solving their problems in a totally satisfactory manner. I feel that much more should have been made of its consequences in therapeutic practice.

“I won’t”. Often a statement accompanied by a childish sulk or tantrum. Certainly some physical behaviour can be observed. Personally, I have see the bottom lip pushed out on numerous occasions.

On the other hand, refusing to do something, in an adult way can be a good thing. Perhaps something suggested by someone else that isn't really a good idea?  The peer pressure felt by young people to do something that perhaps they are not comfortable with, should be encouraged. As I write, at the beginning of 2013, there is much publicity about the pressure young girls are experiencing, to take part in ‘sexting’. Sending texts of themselves in a sexual pose or sexual act to a boy or man. An unhealthy way to feel needed, accepted and thought ‘good enough'. 

I'm sure we've all felt that sort of peer pressure with regard to whatever was the 'in thing' at the time. 

This particular blog is about someone who acknowledges that there is a problem to be solved, but isn’t willing to give up a behaviour that they have developed, as part of the solution. "I won't"

At the top of the secondary gain list is financial gain. It’s tempting. Why change, if it may mean a financial loss in some way? The top of the financial gain list? A tie, between Welfare Benefits and insurance claims.

Therapists can take on insurance cases. In the end, I refused to, for ethical reasons. I advertised as a short-term brief therapist. That meant that I usually saw people for between two-six appointments. After a time, I realised that the secondary gain of having an insurance claim, meant that the motivation to get better and not have the problem arising from the accident, was missing. I could have carried on, but as satisfaction in my work came from helping people change their lives, I found the work a struggle.

I have to admit that when I did work on some insurance cases, I wasn’t always enamoured with some of the companies and legal practices that I came in contact with. There was a gain for them too, in having their client stay unwell. 

I become frustrated when I read about cases of PTSD (Post Traumatic Stress Disorder). This is a severe condition, but is treatable. Though not everyone wants to lose the label, as it can attract 'secondary gains'. 

A friend was involved with a large compensation case as the claimant. After a period of time, a large award was made. She won her case.  She walked out of court as a women, who could have been considered wealthy. She was physically injured and severely traumatised. She could live off her award and the benefits she was entitled to. Was she a happy woman? No, she certainly was not. 

To win her case, the lawyers had to show that my friend was incapable of ordinary day-to-day living. The emphasis was on everything she’d lost. Everything she couldn’t do. Everything she could never have. 

She returned home a sad and broken women. Yes, she had money in the bank, but what good was it? She felt worthless.

It took a few years for to turn her life around and she has developed a passionate dislike of the term 'Benefits'.  Her view is that they 'benefit' a few and encourage a ‘won’t do/can't do’ society. This is not political, it's based on experience.

Certainly, claiming benefits is the other area of financial gain that I have observed in holding people back from making some beneficial changes in their lives.

It’s the same for illnesses and chronic conditions. I’m sure you will know people who have experienced similar chronic conditions. They may have similar backgrounds and living conditions. One person will be working, holding down a job, keeping a career going and running a home and social life. For the other person, the chronic condition becomes their very existence, their reason to be. Attempting to minimise the discomfort and problems that the condition presents are an anathema to them. They won’t. 

The gains for them may be financial, but there will also be another gain.

Getting attention: If the problem being presented succeeds in getting people’s attention, then why change it?  We have a genuine need to give and receive attention. If sulking and tantrums succeed in giving a person what they want, then they are likely to carry on. The same can happen with illnesses.

“Will my dad still love me, if I become well?” Said by a young woman, who knew she was creating health problems, where they may not have existed. But she had become genuinely unwell as a little girl. At the same time, her younger sibling was born. She knew what she was doing and acknowledged it. She decided to grow up and became a healthy young woman.

Phobias: They are genuine and a phobic reaction can be most unpleasant and frightening. They can be cured. Avoidance tactics will have been developed over the years to manage them. The thought of having to do daily tasks such as the shopping, a social activity, childcare or family visiting, can seem not worth giving up the phobia for.

Keeping hold of old belief systems:  "because I never have..."  "because I can’t/won't...”  As children we can make some dogmatic statements.

My personal favourite ones were, “I will never eat tomatoes.” “ I will never wear a skirt over my knees again.” How limited my life would have been, had I kept those two beliefs.

We can hold on to childhood beliefs, because we’ve never had to challenge ourselves to change. Mind you, I am still dogmatic about one thing, many decades later. “I will never drink tea.” Horrible stuff...and I have tried, I promise you.

We can change. From childhood, we’ve changed our age, our physical appearance, our intellectual capacity. We may have changed families, friends, location, jobs and hobbies. 

We can change our behaviour. We can change our attitude.
I have already written about that.

http://emotionalgrowth.blogspot.co.uk/2011/10/let-goplease-emotional-baggage.html

©RitaLeaman2013