This is quite a controversial topic, so I'd like to start by saying that I'm in no way blaming anyone for being ill.  When I talk about "pay-off", this is almost always a subconscious thing that we don't even realise we're doing. However, having said that, pay-off is something that can appear when illnesses refuse to respond to treatment.  It doesn't affect everyone but, if you find you're not responding to treatment when you'd expect to, it is quite an interesting subject to explore.  

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