[Secondary gain and the need to be ill]

Freud introduced two concepts of illness gain-one was a more external conscious adaptive form of gain, called secondary gain, and the other was a more internal unconscious destructive form of gain, called the need to be ill. Both forms of illness gain are interdependent and secondary gain can generate a need to be ill.

Empirical research was used to examine the question of how and why some disorders, such as post-traumatic stress disorder, repetitive strain injury, and whiplash injury, are liable to generate illness gain in affected individuals.

This article describes how and why these disorders are becoming more common.

It is important for the therapist to know the background of these disorders in order to be able to combat the associated secondary gain.