How does the client's pain serve them?

In psychology it is referred to as "secondary gain," and we've all had to deal with it at one point or another. I see it often in my practice do the high number of pain management cases I'm invited into. The people who seem to be stuck in a 9 out of 10 pain cycle can be pretty disheartening to the caring therapist. It leaves questions in your head: "Where am I failing them?" "Am I not good enough to fix this?" When dealing with secondary gain, there really is little to nothing we as massage therapist can do. Often that is a time to refer to psychotherapy, or hypnotherapy. How does the client's pain serve them? Is it all they talk about? Maybe they think it's what keeps them interesting? Do they get special attention because of it? In a lot of cases these types either don't want to get better, or are scared to. This can be a very offensive idea and as we are not talk therapists (no matter how often it seems) it is certainly not our place to correct it. Much like we can recognize symptoms of many medical conditions, we are not qualified to diagnose. These clients are usually bread and butter, they will see you for years and still need you just as much. If the success of therapy is measured by results though, do you really want someone to pay you for years and never get better? As therapist we should be focusing on the best course of action for our clients. Establish a relationship with specialist you are comfortable referring out to. Make sure it is mutually beneficial, and that you're not just feeding them. They have clients that need your help too. It is important for you to be viewed as more interested in the clients well being than how much money you can get out of them. Help them get better, and they will tell the world! If you don't help them, they also have the right to tell that to world.