I'm glad you've clarified the role of unconscious motivation in factitious disorder somewhat in this post (https://jqxvn.substack.com/p/contra-tfp-on-factitious-disorder). But I'm afraid there's some unclarity here when you discuss tertiary gain. In the scheme you reference, primary, secondary, and tertiary gains are all potentially subconscious motivations. Attention is a primary motivator, unless you're getting attention for someone else's condition, in which case it's a tertiary motivator. Financial gain is a secondary motivator in malingering, and a tertiary motivator in...whatever is malingering by proxy. Shortly, anything that's tertiary gain for FDoiA would be primary gain in FD (or secondary gain in malingering) so there's nothing special about the "tertiary gain" label that helps us understand the subsumed nature of FD/FDoiA psychopathology. So when you say "Medical textbooks refer to the unconscious process that drives this as a need for “tertiary gain," follow that up with the google pull quote from wikipedia about tertiary gain, and conclude that the crucial concept is conscious actions with unconscious motivations, I think some readers may be confused.
I was never able to find the reference to the unconscious in the DSM V (from the Take Care of Munchausen's post) but I'm not great at finding things, so maybe I overlooked it? I was really curious to see the whole quote in its context.
I'm glad you've clarified the role of unconscious motivation in factitious disorder somewhat in this post (https://jqxvn.substack.com/p/contra-tfp-on-factitious-disorder). But I'm afraid there's some unclarity here when you discuss tertiary gain. In the scheme you reference, primary, secondary, and tertiary gains are all potentially subconscious motivations. Attention is a primary motivator, unless you're getting attention for someone else's condition, in which case it's a tertiary motivator. Financial gain is a secondary motivator in malingering, and a tertiary motivator in...whatever is malingering by proxy. Shortly, anything that's tertiary gain for FDoiA would be primary gain in FD (or secondary gain in malingering) so there's nothing special about the "tertiary gain" label that helps us understand the subsumed nature of FD/FDoiA psychopathology. So when you say "Medical textbooks refer to the unconscious process that drives this as a need for “tertiary gain," follow that up with the google pull quote from wikipedia about tertiary gain, and conclude that the crucial concept is conscious actions with unconscious motivations, I think some readers may be confused.
I was never able to find the reference to the unconscious in the DSM V (from the Take Care of Munchausen's post) but I'm not great at finding things, so maybe I overlooked it? I was really curious to see the whole quote in its context.