Primary gain is a person's unconscious desire to get some kind of benefit or relief from a medical symptom or illness. This could be things like attention from others, avoiding certain tasks or responsibilities, or even having a legitimate excuse for not doing something.
Secondary gain refers to the benefits a person receives as a result of their illness or symptom but are external to the individual's psychological or physical health. This includes things like financial compensation, time off from work, or gaining certain privileges.
So, let's say that you have a stomach ache. The primary gain might be that you get attention from your family or friends. The secondary gain might be that you get to stay home from school or work and watch TV all day.
It's important to note that primary and secondary gain are not always conscious desires, and they can sometimes hinder a person's ability to fully recover from their illness or ailment. That's why doctors and therapists sometimes need to work with patients to uncover these deeper motivations and help them find healthier ways to address their needs.