Paying Attention
Bill McDonald’s Website Newsletter
November 2010 - Volume 10, No. 11
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Secondary Gains

There’s an old psychological rule that when there is a both a conscious program and an unconscious program, the outcome will always be determined at the unconscious level. And Bill’s Rule is that in all human discourse, there are always at least two program levels going on, and most folks are unconscious of the difference.

Then there is Bill’s sub-rule for marital communication: The spouse is often aware of the various unconscious programs of his or her partner. The art of marriage is how that is handled.

An example (a very common example). A woman becomes uncomfortable with a particular behavior of her partner. She tells him. What she wants is for him to listen, understand, and then perhaps change his behavior for the sake of her comfort. What he hears instead is only criticism. As a man, his first hard-wired response is that he’s obviously done something wrong. Therefore his first consideration (reaction) is self-protection, emerging in the form of self-justification. (Men don’t like angry women, unless perhaps we can eroticize it.)

The conscious (CS) level of communication is her desire for him to listen, understand, and then perhaps change his behavior for the sake of her comfort (or the well-being of the household, etc.). The unconscious (UCS) level of communication is his felt need to defend/justify himself in response to a criticism. The rule is that the latter program runs the show from that point on. As long as he insists on hearing what he hears (UCS), her original communication (CS) is lost.

Now it just may be possible that her true (CS) meaning is to demean, belittle, put down, emasculate and thoroughly demoralize her husband. But usually that’s when all other attempts haven’t worked, and she is for all intents and purposes on her way out. (Or the man had better get out himself - fast!) More common is the domestically violent man, who’s UCS program brutalizes emotionally and physically, and the woman’s UCS program keeps her bound to him. The lack of an effective consciousness on either part leads to vicious consequences.

Let me introduce two additional terms from the medical and psychiatric lexicons that can help further map this territory - primary and secondary gains. A primary gain, let’s say, in the face of a medical or emotional illness is the patient’s internal desire to recover. A secondary gain involves external motivation, such as the social, employment or economic benefit involved. [1] When the secondary gain involves the ‘benefits’ of disability, or attention, or monetary compensation, even though the secondary gains here may be fully conscious, the rule is that these ‘benefits’ will co-opt the primary benefits of recovery and healing. Disability rules, just like unconsciousness rules. Secondary gains run the show.

This is one insight into the psychological power of the victim position, and scourge of entitlement mentality in our culture.

Many years ago, when I worked as a hospital Social Worker on a physical medicine (rehab) unit, one of our greatest frustrations with severely injured patients was the not-so-subtle advice of their attorneys to hold onto their injuries and disabilities for the purpose of obtaining wealthier judgments and higher disability compensation.

Another brief example: Sometimes a couple will come in for marriage counseling with the conscious (primary) purpose of working on the marriage. In the course of their initial visits they demonstrate how miserable one or both are in their relationship. There’s an unconscious program of secondary gain here. In order to justify getting a divorce, one or the other have to demonstrate how miserable they are, especially for the sake of (observing) family and friends. If they don’t appear to be sufficiently miserable, by constant fighting, etc., nobody will support them in their ‘inevitable’ divorce.

Now a third consideration, from which to provide some practical resolution to this dilemma.

In my early clinical training, I was introduced to the concept of discount. A discount is a thought or statement that denotes someone or something to be of lesser value. “I’m such a klutz.” “You’re (just) a woman.” “He’s a politician (what do you expect?). [2] ”I’m always wrong.” “I can’t make it straight (by being honest, by working on it, by taking responsibility, by believing in myself, by doing a good job, etc.). [ Straight is the opposite of crooked.]

Throughout human history, as we perceive from world literature, the crooked have always seemed stronger than the straight; the dishonest stronger than the honest, the irresponsible prevail over than the responsible, the unjust trump the just. The Biblical Book of Psalms is full of just such complaint. But the same world literature speaks of the eventual victory of the good. Humankind does not need to self-justify - which opposes caring and community.

By learning to catch ourselves when we discount ourselves or others, we can avoid the crooked power of the secondary gains. We can each learn to catch ourselves when we want to defend, justify or explain ourselves - especially when our voice tone goes up, our shoulders go up, the palms of our hands face up. At such times I say to myself “Stop! Nothing of value will happen (if I continue this)”.

When a person is angry at me, instead of an automatic program of putting myself down and then defending myself, why not just listen to him or her, and assume they want to communicate with positive intention (in spite of what we may hear in their words and voice tone)? In relationships, both parties can learn to avoid defensive and self-justifying responses. We can learn to quickly go to the place of personal responsibility, in spite of the temptations to hold onto injury and self-deprecation. We can continue to gather experiences that reinforce the path of honesty, responsibility and genuine caring. At first it only takes one.

Also it’s useful to consider that the other person often sees us much more clearly than we see ourselves. That’s why we are in relationships. That’s why we live in community. It can keep us honest, and often humble. And that’s our best hope for the future of the world.

Pay attention!


[1] Although the professional literature differentiates primary and secondary gain according to internal and external motivations, I am perhaps fudging the issue to meld with my conscious/unconscious primary model. I hope in later work on this same general subject to improve the logical acuity.
[2] Just thought I'd throw that in since this is an election month.

Comments (2)

  • Wow !!! This newsletter sounds very familiar although it can be many other couples out there too I must say again a very familiar trilogy ! What’s good for the heart is great for the soul as well !
    Good to hear from you Bill keep up all the good work !
    You ROCK !

    — Keri phillips, 11/1/2010
  • Excellent!!

    Very eye-opening, or should I say an apt reminder!! “The heart is deceitful above all things, who can know it”....? (Bible) However, we can do as you say and “pay attention”. Thanks Bill!

    — Teresa, 11/3/2010

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Bill McDonald
Fenton, Michigan

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