Secondary Gain
According to Freud, the primary gain from developing a neurotic
symptom is protection from being swept away and destroyed by cata-
strophic anxiety. The secondary gain is that illness gets you out of doing
things you don’t want to do.
Jane’s husband shakes his head. “I just don’t get why you never
have panic attacks when it’s time to play bunko with your
friends. But if I want you to go to a ball game, you act like I’m
some kind of insensitive idiot for even bringing it up.”*
Neil’s wife comes in soaked and muddy after a cloudburst
catches her raking leaves, under which spiders might hide. As
she puts down an armload of firewood, carefully swept outside
so as to be spider-free, she glances at her husband, warm and
dry in front of the TV. Her look says it all.Friends and family are at first overly solicitous, then they gradually
begin to see what they think is method in the madness. What was once a
serious disorder begins to look suspiciously like a stomachache on test day.
If you’re ever in this position, please remember: Secondar y gain is
not primary purpose. People don’t make up fear disorders to get out of obli-
gations. On the other hand, if doing an unpleasant task brings them nearer
to what they’re afraid of, why not kill two birds with one stone? Secondary
gain is just about universal in explosive disorders; it is almost never conscious
malingering. Think about it: Would you trade mowing the lawn for a panic
attack? Feeling guilty on top of being afraid doesn’t make the situation
any better. It makes it worse.
TheYou Think It’s All in My Head Explosion
His wife’s disapproving look chills Neil as surely as an October
rain. What kind of man are you? he asks himself. He doesn’tThe Psychology of Fear ❧ 105