Secondary Gain in Psychotherapy: The World as Trump and Trump-presentation

 I've always had trouble understanding this concept. But now I understand why I have trouble understanding this concept.

It's because I'm so aware of it. 

I'm not only aware of secondary gain, I'm aware of tertiary, quaternary, quinary gain. It is an uncanny Doctor House ability that makes me not fun in certain situations, and very good at reading poems. 

What does it mean? 

Something that seems unpleasant might be pleasant at a deeper level. Think drug addiction. The death drive. 

It's like a set of gears. The higher gears contain the lower ones. The point of psychoanalysis is deconstructing the higher gears into the lower ones and figuring out how the lower ones might be interfering with the higher ones. 

It's on the side of mercy, via the paradoxical pathway of murder. 

Because of being a survivor (read my new book) of really heavy stuff (really heavy) I see not only people's secondary gain but all the way to their quinary gain. It's how I sussed out Trump immediately. 

It's how Trump operates. It's where he lives. He doesn't get the higher levels at all. Everyone is out to get everyone. The world as Trump and Trump representation. Even famous sonofabitch Roy Cohn didn't realize Trump was lower than him. He got caught into his own game and in the movie he weeps as Trump gives him a paltry child's birthday cake with sparklers at the dining room in Mar a Lago as he dies of AIDS. 

Trump inhabits a Schopenhauerian universe in which to eat the other is to eat himself. Everything is Trump, struggling for existence.

Musk not knowing this is like the mildly sadistic guy in the horror movie whistling blithely as he walks around underneath the Alien mother's body.

Musk has no idea what he's let himself in for. He's like a five year old child using a one year old child as his ersatz father because his real father was cruel. He's like the idiot in a horror movie, sadistic in his own way but really advanced compared with Alien.  

So I have had trouble understanding the concept because I see the tertiary gain within the secondary gain. Look at these examples Google found: 

"A patient may receive medical treatment and also gain benefits like paid time off or extra attention from family." 

Okay, I get that one. And yet, I don't: when I first read it, I thought it was saying that the patient enjoys NOT being healed because this also gets them even more time off and attention. 

But then: 

"A person may work hard to achieve financial security, but sacrifice relationships with loved ones to repay debt." 

Tertiary gain: they ENJOY sacrificing those relationships. They love destroying themselves like that. 

And now: 

"A person may continue to smoke cigarettes despite knowing it causes cancer to avoid feeling bad about themselves." 

Tertiary gain: they LOVE feeling bad about themselves. They get off on poisoning themselves with cigarettes. 

And the final one was really hard for me to get: 

"A person with chronic pain may not like spending time with their partner's friends, but their partner doesn't pressure them to go to social events when they're in pain." 

Tertiary gain: the person LOVES hurting their partner like that. 

Quaternary gain: the person LOVES being kept in a prison by the partner. 

Quinary gain: murder-suicide for all!