Disease gain

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Gain from illness ( English morbid gain ) is a general term for the objective and / or subjective benefits that a (real or imagined) sick of his disease or a patient of his diagnosis draws.

General

As soon as a person takes on the role of the sick, he can generally assume in European culture that

  • to be released from everyday duties,
  • To experience sympathy / compassion / compassion and / or
  • to be treated gently by the environment.

The patient can also count on economic support from social security agencies; he is thereby partially or wholly released from his own gainful employment.

This socially desirable attitude must be distinguished from aggravation and simulation :

  • Simulation is an intentional and conscious pretense and imitation of the symptoms of illness without any disease value .
  • In the case of aggravation , actual disease changes are present; these are intentionally overemphasized.

The division into primary gain from illness and secondary gain from illness goes back to Sigmund Freud , the founder of psychoanalysis .

Primary and secondary disease gain

The primary gain from illness (internal gain from illness ) consists of internal or direct advantages that the sick person draws from his symptoms: B. can thereby avoid situations or conflicts that are perceived as unpleasant. The symptom is then experienced as unpleasant, but it allows the patient not to have to make an immediate decision (leading out of the conflict) (often he does not even recognize a conflict that he is having or in which he is standing). He only feels himself in an uncomfortable (for him currently seeming hopeless) situation, which weakens him. The connection between conflict and symptoms of illness is not considered possible and remains unconscious . The symptom can also unconsciously serve to avoid more unpleasant conflicts (e.g. suddenly falling ill before a difficult test). An example would be when a hysterical blindness helps one no longer see fear-inducing situations.

The secondary gain from illness ( external gain from illness ) consists of the external advantages that the sick person can draw from existing symptoms, such as the gain in attention and attention from his environment and / or z. B. the possibility of staying in bed and having food served there. Stavros Mentzos sees a general meaning of the symptom in this aspect , which reveals a communicative aspect of this symptom language not only in hysteria , but also in other psychological abnormalities such as compulsions and phobias and thus at the same time enables a therapeutic approach.

Tertiary and Quaternary Disease Gain

The tertiary gain from illness consists of advantages for the patient's environment. For example, the care to be provided can be perceived as an enrichment for relatives, since the caregiver feels that he is needed, receives special competence and can thus see himself as a savior (in DE Biegel, E. Sales, R. Schulz: Family caregiving in chronic illness . Newbury Park, Sage, 1991. ). In the broadest sense, all health care professions receive a tertiary disease gain , see also helper syndrome .

The quaternary sickness gain describes the ideological revaluation and upgrading of suffering or illness.

Individual evidence

  1. ↑ Willibald Pschyrembel (abbreviation): Pschyrembel. Clinical Dictionary . 259th edition. De Gruyter, Berlin 2002, ISBN 3-11-017213-5 , p. 905
  2. ↑ Uwe Henrik Peters : Dictionary of Psychiatry and Medical Psychology . Urban & Schwarzenberg, Munich 3 1984, ISBN 3-541-04963-4 , Aggravation (p. 11), simulation (p. 250).
  3. ↑ a b Michael Zaudig, Rolf Dieter Trautmann-Sponsel, Peter Joraschky, Rainer Rupprecht, Hans-Jürgen Möller: Therapielexikon Psychiatrie, Psychosomatik, Psychotherapie . Springer-Verlag, 2006, ISBN 978-3-540-30986-4 , pp. 414 ( limited preview in Google Book search).
  4. ↑ Franziska Dietz: Psychology: Medical Sociology . tape 3 . MEDI-LEARN, 2006, ISBN 978-3-938802-04-5 , pp. 11 ( limited preview in Google Book search).
  5. ^ Jean Laplanche , Jean-Bertrand Pontalis : The vocabulary of psychoanalysis ("Vocabulaire de la psychoanalysis"). 7th edition. Suhrkamp, ​​Frankfurt / M. 1986, ISBN 3-518-27607-7 , pp. 274-276.
  6. ↑ Stavros Mentzos : Neurotic Conflict Processing. Introduction to the psychoanalytic theory of neuroses, taking into account more recent perspectives . © 1982 Kindler, Fischer-Taschenbuch, Frankfurt 1992, ISBN 3-596-42239-6 , p. 86 f.
  7. ↑ Boris Wandruszka: Logic of suffering: phenomenological-depth analytical study on the basic structure of suffering with its effects on the design of the therapeutic relationship . Königshausen & Neumann, 2004, ISBN 978-3-8260-2680-5 , p. 212 ( limited preview in Google Book search).