When Healing Feels Risky: Understanding the Complications of Secondary Gains
By Chelsia Allison, LPC - Greenville Counseling Associates
Imagine you’re wearing a really cool new jacket. Like, so cool that it’s still mid-morning and you’ve already gotten a handful of compliments. Your teenager, who almost never gives verbal affirmation, told you that you’re giving main character energy; while picking up your morning coffee, the barista said you look radiant; and you feel more noticed at work than you ever have. Maybe it’s all a coincidence, but wearing this jacket seems like it comes with a whole lot of benefits. The only problem is that you live in South Carolina and it’s Fall, so even though it was chilly in the morning, now it’s 80 degrees and sunny, and you are starting to sweat. But wait, if you take off this fancy new jacket, your day might change and things won’t feel as special as they have so far. So, you keep wearing the jacket for the rest of the day even though, if you’re totally honest with yourself, you’re pretty uncomfortable.
Maybe you have encountered a similar but heavier scenario while trying to make changes in your life and it feels really complicated.
Sometimes—without even realizing it— the hardships we find ourselves stuck in can come with a few “bonus features” that quietly reinforce the struggle. These are called secondary gains. In simple terms, secondary gains are the unexpected perks that attach themselves to our suffering—benefits that aren’t the cause of the hardship, but might make it harder to let go of. Secondary gains are the unintentional external benefits someone receives from being in pain—whether emotional, psychological, or physical.
Here are a few common ways that secondary gains show up, often totally unconsciously:
1. Extra attention and support
When you’re struggling, people might lean in with kindness they don’t usually show. It’s comforting. Who wouldn’t want a bit of extra care?
2. A Break from Responsibilities
Mental health challenges can make everyday tasks feel impossible—and often, others step in to help. Suddenly, nobody’s asking you to take out the trash, attend that awkward family dinner, or finish that report.
3. Avoidance of Scary Stuff
Let’s be honest: if you’ve got social anxiety, staying home in your PJs instead of giving a speech to 50 people might feel like a hidden blessing. Your brain goes, “This panic disorder is ruining my life!” Also your brain: “...but thank goodness I didn’t have to go to that networking event.”
4. A Stronger Identity or Sense of Belonging
Being part of a mental health community can be powerful and healing. But sometimes, a
diagnosis can become the story, instead of part of it.
5. Power in Relationships
This one’s a little more complex: sometimes symptoms unintentionally shift the balance in our closest relationships. The people in your life may seem to offer more, or back off in conflict, when they know that you have a lot going on. It’s not manipulation—it’s more like your brain’s trying to wave a flag that says, “Please tread carefully; things feel too heavy already.”
Even if you relate to some of these examples, this doesn’t mean you’re faking your struggles. Secondary gains aren’t about faking or exaggerating. They are usually completely unconscious, and they do not mean your pain isn’t real. They just mean there might be some psychological “perks” riding shotgun that make healing a little more tangled and complicated than it seems on the surface.
If secondary gains are in the picture, it doesn’t mean you’re doing anything wrong—it just means part of your brain is trying to protect you in the only way it knows how. You can thank your problem-solving brain for figuring out how to survive the best way it knew how.
Understanding secondary gains isn’t about blame—it’s about awareness. When we recognize what we might be getting (emotionally, socially, or practically) from our symptoms, we can start to look for healthier ways to meet those same needs.
The goal here isn’t to be judgmental of yourself for these behaviors. The goal is to get curious about them—and then gently rewrite the script.
If you related to any of the secondary gains mentioned, or maybe you are realizing there could be a benefit or two from your current situation, even if you don’t want to still be in said situation, here’s a question that might help you do some untangling: “If I am totally honest with myself, what would I have to let go of or change in order to get some relief from _________ (this pattern I’m stuck in / my struggle / anxiety / my addiction)? I might not be ready to let go of these things yet and that’s okay. Acknowledging my hurdles is hard work. I can be grateful for the insight I am gaining along the way.”