When Healing Meets Resistance
Some conversations stay with you, not because they were dramatic, but because they quietly reminded you of something important.
I recently had one of those moments with Sammy, a dietitian in Physiotherapy Praktijk van Delden in The Hague. As we explored how our professional approaches, nutritional and therapeutic, can complement each other in supporting clients, we stumbled upon a topic that many care providers quietly wrestle with: Secondary Gain.
Secondary gain refers to the hidden, often unconscious benefits a person may derive from staying unwell. These gains can range from receiving extra attention, avoiding responsibilities, or maintaining a sense of identity tied to illness. For example, someone struggling with chronic fatigue might unconsciously resist recovery because their symptoms allow them to avoid overwhelming social obligations or receive nurturing care and validation they otherwise lack.
Imagine standing in a supermarket aisle. One part of you wants to walk past the chocolate, stay committed to your health goals. Another part whispers, “Just one bar won’t hurt. You deserve it.” This inner tug-of-war is a perfect metaphor for secondary gain. The ‘saboteur’ isn’t malicious—it’s trying to meet a need, often one that hasn’t been voiced or validated.
Uncovering the Hidden Layers of Resistance
As Sammy became more familiar with my therapeutic methods, she shared her observations of clients who seem to sabotage their own progress. I acknowledged how common, and frustrating this can be. Especially when the client genuinely wants to improve. Sammy told me that with about one in five cases she notices resistance and she respectfully asks her clients , “Is there something you might loose if you suddenly got better?”.
I told her that’s a fantastic first step. Simply asking the question and gently bringing the possibility of benefits into the client’s awareness can already shift something. It opens the door to curiosity, compassion, insight and change.
But to go deeper, I introduced Sammy to a method I use in hypnotherapy that woks directly with the subconscious mind. In this approach, we explore the internal conflict between two parts: the part that wants to heal and move forward, and the part that clings to the symptom for a reason—often protective, well-intentioned, and rooted in past experience.
Resolving the Inner Tug-of-War
In the therapeutic session we explore: What is your intention? What are you trying to protect? And how might you fulfill that intention in a way that supports healing rather than hindering it? It’s an elegant process of compassion, and integration, where conflicting parts realize they’re on the same team. They both want what’s best for the person, they just need help finding a new way to cooperate.
Sammy was intrigued. She saw how this could complement her work with clients who struggle to follow through on dietary changes, even when they understand the benefits. Together, we envisioned a more holistic care pathway, one that honors the emotional roots of resistance and empowers clients to move forward with clarity and self-compassion.
Secondary gain isn’t a flaw, it’s a clue. And when we learn to listen to it, we unlock a deeper layer of healing.
If you’re a care provider who’s ever felt stuck watching a client sabotage their own progress, I want to acknowledge the depth of your work. You’re not alone in facing this quiet struggle. Your efforts to support healing, despite resistance are deeply valuable.
Sometimes, what looks like non-compliance or ambivalence is actually a sign of an inner conflict that needs a different kind of attention. If you sense that a client may be caught in this dynamic, I invite you to consider referring them for deeper integrative work. My approach gently addresses these subconscious patterns, helping clients resolve the tug-of-war within and move forward with clarity and self-compassion.
Together, we can offer care that honors both the body and the mind—and helps clients truly step into their healing.