Monday, January 10, 2011

Repetition Compulsion

"The patient cannot remember the whole of what is repressed in him, and what he cannot remember may be precisely the essential part of it... he is obliged to repeat the repressed material as a contemporary experience instead of remembering it as something in the past." ~Sigmund Freud

"Since Freud's time, other writers have tried to resolve its paradoxes--by positing an urge for active mastery, for example, or a drive toward self-possession, or a halting growth toward affect-competency, but regardless of theoretical perspective the repetition compulsion remains among the most vexing problems of psychoanalysis."

"By the close of the twentieth century, the psychoanalytic view of repetition compulsion had come into increasing dialogue with a variety of other discourses, ranging from attachment theory through brief psychodynamic therapy to cognitive behavioural therapy...the client will behave in ways that engender particular responses from others that conform with previous experiences in interpersonal relationships...In '"psychological schemas" described in social psychology or cognitive-behavioural psychology..."an enduring symbolic framework that organizes constellations of thought, feeling, memory, and expectation about self and others" (Knapp 1991: 94)', further parallels may be seen to the role of early unconscious fixations in fueling the repetition compulsion." 

by Bessel van der Kolk
“Many traumatized people expose themselves, seemingly compulsively, to situations reminiscent of the original trauma. These behavioral reenactments are rarely consciously understood to be related to earlier life experiences. This "repetition compulsion" has received surprisingly little systematic exploration during the 70 years since its discovery, though it is regularly described in the clinical literature. Freud thought that the aim of repetition was to gain mastery, but clinical experience has shown that this rarely happens; instead, repetition causes further suffering for the victims or for people in their surroundings.

Children seem more vulnerable than adults to compulsive behavioral repetition and loss of conscious memory of the trauma. However, responses to projective tests show that adults, too, are liable to experience a large range of stimuli vaguely reminiscent of the trauma as a return of the trauma itself, and to react accordingly.”

by Dr. Richard Grossman
“Yet, in my years of doing therapy, I  never found any client who received any pleasure at all, conscious or unconscious, from the abuse and neglect heaped on them by narcissistic or otherwise destructive partners.  Rather, my clients were simply hurt over and over again.  Still, the "repetition compulsion" was true enough:  no sooner had a client ended with one particularly hurtful person then they found another wolf in sheep's clothing…Ironically, this "repetition compulsion" is hardly masochistic.  Instead, it represents an ongoing attempt to heal the self, albeit one with disastrous results.  The cycle repeats itself because the person knows no other way of preventing themselves from feeling tiny or immaterial.”

“The concept of the "repetition compulsion" is a central idea in psychoanalysis. The compulsion to repeat is curious because what is repeated is not pleasurable. On the contrary, it is usually a painful and destructive pattern of feeling and behaving. A common refrain of my patients is: "Why do I keep doing this?"

Different "brands" of psychotherapy explain the causes of repetition compulsions in a variety of ways. For example, behavioral therapists treat the repetitions as bad habits that can be changed by conditioning. Cognitive therapists view the repetitions as irrational ways of thinking that can be changed by rational thinking. The psychoanalytic perspective, in contrast to the cognitive or rational approaches, views the repetition as unconscious. The concept of the unconscious is a cornerstone of psychoanalytic thinking…

Object relations analysts understand a repetition as some unconscious aspect of a childhood relationship (with a significant other such as a parent or sibling). From this perspective, a dynamic only becomes a repetition that is compulsively acted out if it was negative. The interaction gets internalized and becomes part of the self. It isn't all of the relationship, nor is it a perfectly accurate version of it because it was subjectively experienced and transformed. Whatever brand of psychoanalysis we practice, we believe that unconscious fantasies, prior experiences and constitutional make-up filter external reality and transform it into psychic reality. It is not the relationship as it was in its entirety or exactly as it was in reality. Bettina's feeling about her mother may not be objective reality, but it is her experienced reality and has become part of her psychic reality. It is a connection to her mother, albeit a negative connection."

by Laurie Pawlik-Kienlen
 “Repeating the past and making the same mistakes is repetition compulsion, according to Sigmund Freud. This in psychiatric terms means "the blind impulse to repeat earlier experiences and situations quite irrespective of any advantage that doing so might bring from a pleasure-pain point of view." In regular words, it means that we're repeating the past, making the same mistakes, and constantly complaining about the results – and yet we keep doing it! 

10 Ways to Stop Repeating the Past:
1.      Counseling with a therapist familiar with repetition compulsion.
2.     Self-awareness and honesty.
3.     Books. To stop repeating the past, read about habits and motivation.
4.     Workshops or lectures about repetition compulsion.
5.     Support groups.
6.     Friends or family that will support you as you stop repeating the past.
7.     Crisis moment or pivotal experience (eg, experience with death).
8.   Medication (if you're depressed, for instance, learn about antidepressants).
9.     Quitting cold turkey.
10.Find relief through vacations, exercise, hobbies, new activities. To stop repeating the past, you may need to distract yourself.

Franz Alexander
"However, the early belief that the patient "suffers from memories" has so deeply penetrated the minds of the analysts that even today it is difficult for many to recognize that the patient is suffering not so much from his memories as from his incapacity to deal with his actual problems of the moment. The past events have of course prepared the way for his present difficulties, but then every person's reactions are dependent upon behavior patterns formed in the past.

Merely remembering an intimidating or demoralizing event does not change the effect of such an experience. Only a corrective experience can undo the effect of the old. 'Fhis new corrective experience may be supplied by the transference relationship, by new experiences in life, or by both. A genetic reconstruction of the past is less important for the patient than for the physician; to him it is essential because only in the light of the past will he be able to understand and interpret the meaning of the patient's transference behavior. It is on this understanding that he bases his treatment and helps the patient to find a better and happier way to live."

Denise K. Shul

"...Perry and Pate, working on post-traumatic stress disorder (PTSD), coined the term “malignant memory” to explain the source of the hallmark flashbacks and intrusive thoughts involved in PTSD (1994). They described how malignant memories become the preferred approach for integrating information based on a prolonged reaction to a past threat. In the case of a sudden traumatic event, the brain’s reaction mechanisms fire so intensely that an overpowering memory is created. The scenario of PTSD resembles the theoretical substance of a repetition in that something repeatedly stressful, albeit unknown, creates an ongoing reaction to a historical event. We can see how the repetition compulsion essentially embodies the existence of a malignant memory.

The “compulsion to repeat” originates from the development of patterns of neurochemicals, particularly dopamine, noradrenalin and oxytocin, which send their messages across preferred synapses. Resistance to change occurs due to resonance and long-term potentiation driving firing across a neural circuit that connects the brainstem, amygdala, and the right orbitofrontal cortex. This circuit mediates implicit emotional memories from the earliest months of life that filter perceptions in order to create emotional homeostasis. By operating in this manner, the brain compels the behaviors that coalesce into an adult repetitive experience.

"...In practice, the failure to manage emotions usually plays a pivotal role in repetitive relationship scenarios. Whether it is a habit of being too quick to anger or one of being hypervigilant for abandonment, the behavior that results from the overpowering feelings in turn causes a cascade of reactions resulting in similar experience."