Pain: The Problem with Secondary Gain
Secondary gain is a psychoanalytic term which refers to perceived advantages or ‘gains’ patients derive from their symptoms, such as sympathy, attention, avoiding responsibilities etc. Unfortunately, this concept has been turned against chronic pain sufferers with the result that they are often left feeling like failures at best and criminals at worst. May et al (1999) has observed that the disparity between expressed symptoms, pathological signs and perceived disability in CLBP has led to the moral character of the suffer forming a constant subtext to medical discourse about the condition. For example, Nicholas (1996) writes; “a person seeking help for chronic pain could be said to be inactive with secondary physical deconditioning, to hold unhelpful beliefs, to be overly passive or reliant on others for resolution of his/her problems..” Wow. In a recent study where women chronic pain sufferers were found to have greater levels of disability than men, it was speculated that perhaps th...