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Difficult Clients May Be Motivated by Secondary Gain
By: Calvin D. Banyan, MA, BCH, CI Every experienced hypnotherapist has felt frustrated by certain clients, who despite the hypnotherapist's best efforts, she just seems to refuse to change or allow the symptoms that brought her in for therapy to be removed. In some cases the culprit is Secondary Gain. This article will help you to detect it and then eliminate its affects which will help you and your clients to be more successful. In previous articles I have written about 5-PATH® (Five-Phase Advanced Transformational Hypnosis) and how it is designed to eliminate a client's problems through the use of, convincers, age regression techniques and forgiveness therapy. Then, in a recent article I gave a brief description of the final phase of that process called Parts Mediation Therapy™ or PMT. PMT is a special kind of Parts Therapy that is designed to remove Secondary Gain issues so that your clients can finally become free from their old issues when removing the cause of the problem alone was insufficient. Primary versus Secondary Gain Because of Secondary Gain issues, it is possible for a hypnotherapist to do everything right as she works with her client to remove the cause of a problem, and completely remove the cause but still have the problem exist. In these frustrating cases, the hypnotherapist needs to understand the concepts of Primary and Secondary Gain as they relate to a client's problems or issues. Primary Gain is the benefit that your client receives as a result of manifesting the issue for which she has come in to see you about. Most, if not all of your clients have their problem or issue because at one time in her life there was a benefit in having it. Here are a few examples: 1. Alcohol Abuse Primary Gain: The alcoholic may start drinking in order to be accepted by a group of peers. Secondary Gain: Then she finds out that when she drinks enough to become intoxicated she feels more relaxed and confident around others. 2. Smoking Primary Gain: The smoker may start smoking for the same reason, in order to be accepted by a particular group of peers. Secondary Gain: Then later on she finds that having a cigarette can make her feel more relaxed as she uses it to take a break from life's stressors. 1
Secondary Gain: Then she finds and learns that when she has a tantrum that her frightened mother will give in to her demands. Such added benefits. this "lack of readiness" may really be a lack on the hypnotherapists' part. This is where PMT comes in and will work when everything else has failed. which may have been unanticipated at the time when the problem first arose for your client. Secondary Gain. a Secondary Gain issue can exist. 2. the problem behavior. 3. had a reason for beginning that is different from what may be sustaining the problem today. In each case. be it drinking too much alcohol. and have proven successful through out their careers only to find that with some clients. Receiving social support from family. those tools do not work. Some types of Secondary Gain that may arise in her case are: 1. In this case. In these cases. If your therapeutic tools only consist of direct suggestion or age regression. gives her good reason (subconsciously or unconsciously) for holding on to the pain of the injury well after the injury has physically healed. the frustrated hypnotherapist may simply surmise that "This client was not ready to change. smoking cigarettes or developing an anger problem. Receiving disability payments. hence the term. Secondary Gain Can Exist When Either Primary Gain is Undiscovered or NonExistent Sometimes the Primary Gain can be difficult to identify.3. an individual may accidentally injure herself at work. Possibility of receiving new training in a more desirable job. friends and governmental services. in that she did not have the tools that she needed to help this particular client. the pain is real even though there is no longer a physical cause of the pain. 4." However. She is then relieved of her work and given medical treatment. but after the injury. Not having to return to a job that she did not care for. but even so. and as a result experience a great deal of pain because of the injury. This is often quite different from consciously malingering (pretending to be ill). when she receives these substantial benefits which would be lost if she fully recovers from her injury. For example. or may not actually exist. Childhood Tantrums Primary Gain: The child who becomes angry and throws her first tantrum may do so out of a natural reaction to an unfair situation she finds herself in. She then may even qualify for Workmen's Compensation or other form of financial aid. These benefits were not the cause of the injury. This benefit is a gain that is secondary to the original cause of the problem. Secondary Gain May Be Falsely Labeled "A Client's Lack of Readiness to Change" Hypnotherapists working in the many specialties around the world have become frustrated when they use the tools that they have come to rely on. then you will be unable to help these individuals. can become a very powerful reason to hold on to the problem later. for the client. 2 .
the mediator meets with the parties in the dispute to help them resolve it by bringing her special skills to the problem. After publishing the article I wanted to do more research on the use of these techniques and their usefulness as a therapy to help people experiencing relationship problems. It was ground breaking because I had created a new kind of therapy out of mediation technology. Then I began to realize that the process could be used to help individuals who were experiencing internal conflicts that were adding to their mental illness or other problems such as addiction. In this state. I then took this ability that we have as hypnotherapists. and applied standard mediation procedures to it. organizations and even countries. the hypnotherapist can proceed as a mediator. as was the case. wants and desires that are of interest to that Part in mind. When a mediation process has begun. Once the client had been divided into parts the mediation process could be used to 3 . I took another look at the different kinds of Parts Therapy available and studied them again. because they worked more directly on the cause of my client's problems. her client will hallucinate being that Part. to divide a client psychologically into Parts. The somnambulistic client could hallucinate sufficiently to experience being divided into parts so that the hypnotherapist. When a client has been hypnotized and sufficiently deepened to the state of somnambulism. when it was thought that using such techniques would not work as a therapy. compulsions and so on.Development of Parts Mediation Therapy When I first began my study of hypnotherapy. This kind of an agreement is often described as being a win-win agreement. Unfortunately for me at the time. along with its particular perspective on the client's situation. obsession. But at the time I found age regression and forgiveness therapies to be more appealing than Parts Therapy. Mediation is a process that is used in all kinds of disputes around the world including disputes between individuals. Very soon after receiving my certification in mediation. Hospital and Community Psychiatry. she is able to hallucinate. with all of the specific needs. But later when I found that some clients were unable to become free from their problems because of Secondary Gain. It was not until I became a Certified Hypnotherapist and began studying the different kinds of Parts Therapy did that last few pieces of the puzzle fall into place. As a result the parties are able to change what they have been doing as a result of an agreed-upon set of new behaviors that will give each or the parties what they want. acting as a mediator could work with the client using these techniques. I ran across materials from Charles Tebbitts and Gerald Kein on the subject of parts therapy. especially if the individuals were mentally ill. I was merely a graduate student and could not interest any of my professors in doing research into the idea that mediation could be used as a therapy. Once the Part has been emerged and the communication has begun. I received my training in Mediation Theory in graduate school. I used it (mediation techniques. When the hypnotherapist begins speaking directly to that Part. but without hypnosis) as a form of therapy while I was working as a Psychologist at the North Dakota State Hospital. This application of mediation techniques as psychotherapy was groundbreaking and I published a paper about it in the American Psychiatric Association journal. separate from the self. the hypnotherapist can simply suggest to her client that she has a part of herself that wants to continue in the old way.
depth testing. The hypnotherapist can aid herself in making this decision by asking herself and the client. and direct suggestion techniques. and so on. That PMT is most effective when the cause of the problem has been eliminated through the use of such insight techniques such as Age Regression Therapy and Forgiveness Therapy. PMT unless she has reason to believe that Secondary Gain issues are at work and causing the client to be unable to change." or to otherwise become more powerful or present in the client's life. in such a case a client may complain that she is not as creative as she once was. III and IV are designed to neutralize the cause of the problem (i. Phase II. etc. PMT is Different from Other Parts Therapies In my study of the different kinds of Parts Therapies.overcome internal conflicts. anger and guilt). In most cases that the hypnotherapist sees. heal. the 5-PATH® Hypnotherapist would not automatically proceed with Phase V. hence some kind of Secondary Gain. "What will she (the client) lose if she gets well or changes her behavior?" If she loses 4 . when the Primary Cause has been removed then simple direct suggestion is sufficient to change the behavior or enable a healing. and is only to be used when Age Regression Therapy and Forgiveness Therapy (or other techniques that are used to remove the cause of the problem) have successfully removed the Primary Gain issues. erroneous beliefs from the past and painful emotions that accompany them such as fear.e. For example.. Note that. at which time the hypnotherapist will conduct a Parts Therapy process in which the Creative Part will be encouraged to "move up to the front of the stage. I found that many of those approaches were an attempt to balance different aspects of the Self such as the Creative Part or the Brave Part. In fact if the problem continues after Phases I through IV have been completed. Only when she has reason to believe that Secondary Gain issues are the source of the continued problem should she consider Phase V. For example the 5-PATH™ Hypnotherapist will routinely take her clients through the first four phases: Phase I: Hypnosis Testing and Direct SuggestionPhase II: Age Regression and Informed Child TechniquePhase III: Forgiveness of OthersPhase IV: Forgiveness of Self While Phase I includes preparing the client for hypnosis. which either the hypnotherapist or the client perceived to be out of balance in the client. Using PMT before the cause of the problem had been neutralized would cause the problem to return in most cases. or even the Wisdom Part. convincers. most clients will not need any additional hypnotherapy. When this kind of work has been done successfully. PMT was designed to help the client to discontinue a symptom or behavior that is either being reinforced or demanded by her present environment (but different from the reason for which she started having the problem). When to Use PMT with Your Clients PMT is designed specifically to remove Secondary Gain issues. the therapist should first suspect that some part of one (or more) of the phases were not done sufficiently or completely. in this case caused by Secondary Gain.
something. "Was the age regression or other techniques such as forgiveness therapy completed to your total satisfaction or do think that it could have gone better?" If you believe that more could have been done. Evaluate your client's situation to determine whether PMT is indicated as a course of therapy. Suggest that the client has a part of herself that wants to change and a part that wishes to keep doing what she has been doing. Still-Wanting-To-Drink Part. 5. reevaluate what was done so far. Introduce yourself as a mediator. Once the hypnotherapist has this outline. If she has nothing to lose in getting better. If the problem has returned. Uncover the needs. then the problem exists in some incomplete part of Phase I through IV. the Still-Wanting-To-Smoke Part. then proceed to PMT. For example you might name a part. then that thing is generating the Secondary Gain and PMT is the indicated course of therapy. Then ask if you may speak to that Part directly. She will make all of the important decisions. Your role is only to improve communication between the two Parts. Here is the 12 step process: 1. 4. or if the problem stopped for a short period of time but returned. and so on. wants or desires being fulfilled by continuing in the old way. or the Still-WantingTo-Be-Ill Part. When you have decided that PMT is indicated in a particular case. Additional information about how to conduct this kind of process can be gained by reading any book on the subject of conflict mediation. so that the subconscious material that is driving the behavior can be uncovered and discussed from the different perspectives. Inform the different Parts that your role is only that of a Mediator and that you are not here to judge nor do you have any authority in this matter. 2. For example. you will suggest that part of her seems to want to continue in the old way. 3. Once your client is in hypnosis. If you believe that: 1) the previous therapies were all completed satisfactorily. This part will be named according to what behavior or symptoms that it is producing. Somnambulism is required so that your client is able to hallucinate actually being the different Parts of herself. Ask yourself. Induce hypnosis and deepen to somnambulism. was lessened but was not removed. perhaps the ISE (Initial Sensitizing Event) was not discovered and neutralized in the age regression. go back and complete it. and 2) that your client must lose something substantial in order to get well or change. It would be more beneficial for the hypnotherapist to return to doing age regression in this case than to move on to PMT. she can use it to guide her through the hypnotherapy process. make sure that you can induce and deepen your client sufficiently so that she will experience a deep level of hypnosis. 5 . How to Do PMT The process of conducting a PMT session can be easily outlined.
Narrow the ideas generated into a specific plan or agreement.Now you will proceed by honestly speaking with each Part. then we can generate other things that she can do when she feels that way. Have each Part acknowledge this and that the intent of both Parts are good and are intended to contribute to the good of the whole person. If you find out that she is eating to manage an emotion. When you speak to the Still-Wanting-To-Eat-Too-Much Part or the Still-Wanting-To-Snack-Too-Much Part. that of both Parts. wants and desires. Generate new ways to fulfill those needs. wants or desires are being met by continuing in the old way or beginning to behave in the new way (without the problems or issues that brought your client in to see you). Is it a practical plan? Can you always do what was agreed upon? If for some reason one or both parts are uncertain if the plan will work. if you find that your weight loss client has failed to lose all of the weight that she wanted to lose. wants and desires. The plan should be simple but comprehensive and provide benefits to both Parts. you can find out why that Part is causing her to do it. The Secret Language of Feelings). For example if the Still-Wanting-To-Drink Part was doing so because it helped her to relax and be social. then set up a trial period like a week after which your client will come back and have another session where the Parts can either agree to keep the plan as it is or make further 6 . and without all of the problems that were being caused by the old way. the Self and the part that does not want to change. 9. 6. Reality test the agreement. Next. then it can be renamed to the Social Part. As you uncover why each Part wants to either change or not change you will find that both want to do for some very good reasons. (For more information on emotional eating read my book. so that you can find out what needs. you can do PMT and uncover the part of her that has caused her to continue to eat too much or to continue to snack between meals. When the Part has been renamed you can then generate solutions that will fulfill the needs of the whole person. This shows the Self and the other Part that when the agreement has been made that it will still exist with a purpose. It should be a win-win agreement. worried. This will aid in the reintegration of the two parts later. Show each Part how the reasons to both change and continue in the same way are ways to fulfill real needs. you will proceed by asking each Part if the agreement seems realistic given the challenges that she has in her life. Once you have generated some ideas it is time to narrow them down and form a single agreement or plan that both Parts are willing to use. Here is another example. doing an important job. or the Relaxation Part. like when she snacks because she is either bored. 8. angry or depressed. Show both parts any common interests that they have. At this point you and her parts will be able to generate lots of ideas so that you can come up with a good plan. and that it was an important part. The name change should be made to better describe it. 7. The Still-Wanting-To-Drink Part or the Still-Wanting-To-Be-Ill Part will not want to change unless you change its name. Once you have shown that even the Part that does not want to change wanted to keep doing what it was doing for some very good reasons you will need to rename the Part.
When she does this. 10. The process follows established mediation procedures." 11. Then I continue and have and her put an ending to the following sentence." When she puts an end to the sentence. is only used when there is a reason to believe that your client has been unsuccessful despite the Hypnotherapist's efforts to help her client by removing the cause of the problem." This sentence enables your client to express how she feels about what just happened in a positive way. becoming a permanent part of her. Now you suggest that the two parts once again become one person with a new plan for success. The self now realizes that the Part that was causing all the problems was not a bad Part of herself. When I use insight techniques such as this. non-insight techniques.adjustments meant to make it more useful and practical. you and your clients will be successful when no other process has succeeded. 12. especially the goals that brought her into your office. Find other items by Cal Banyan. Emerge your client and conduct the post-hypnotic interview. which will soon solidify again. she verbalizes what changes have occurred at the intellectual level. PMT is an insight technique. on the other hand. This causes the subconscious mind to have to reorganize around this new information. Close the session by emerging your client and giving her the opportunity to talk about what had happened. she takes on a feeling of ownership for the changes made. Reintegrate the parts. I'll ask my clients to put an end to the following sentences. I like to have the client bring the changes into the waking state by doing the following. "I've changed because now I know ______________. 7 . further causing her to take ownership for the changes that have occurred during the PMT process. Use the agreement as a direct suggestion script. Once this has been done it is time to reintegrate the parts. Summary There are several approaches to using Parts Therapy which can be very useful in a number of situations. For a brief time. which are used to remove the conflict inside of your client that is causing her to respond to Secondary Gain issues. Parts Mediation Therapy. As you become proficient in using this technique. This helps your client to become more suggestible than when you use other. "I've changed because now I feel ______________. Take advantage of this time by directly suggesting that she will use this new agreement to help her meet her goals. the suggestions given can last a life time. It was doing what it was doing in an attempt to help the whole person. while the subconscious mind goes into what is a fluid-like state. During this highly suggestible state you can give your clients suggestions that will be held tightly in her subconscious mind once it has re-solidified. Insights into why she was continuing in the old behavior will be uncovered and new ideas that will enable her to change or heal were generated. I like to have them shake hands as they accept the agreement and then "melt back into being one person.
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