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What drives repetition compulsion?

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Repetition compulsion is when a patient relives a past traumatic event, often experiencing the same emotions as when it originally occurred. This can happen through dreams, hallucinations, or constantly talking about the event. Some psychologists believe it is an attempt to overcome the past, but treatment varies depending on the therapist’s approach.

Repetition compulsion is a term used in psychology to explain when a patient relives a past traumatic event. The patient does not find the experience pleasant and often experiences the same emotions as when the event originally occurred, re-traumatizing the patient. Sometimes compulsion-to-repeat events do not exactly match the original event, but recreate the sensations the patient experienced at the time of the original event.

A patient who experiences the repetition compulsion might relive his past experience in several ways. The person might have the same dream every night, or several times a week, in which she interacts with the situation with the same results. Other people may relive their past events throughout the day, hallucinating as they see the past unfold before them. Still other patients relive past events by constantly engaging others in conversation about a topic that touches on the traumatic event, slipping into a narrative of the event.

Other people may be drawn into the patient’s repetition compulsion, filling the roles of other people who were originally present for the traumatic event. The patient might move the persona of someone who was present at the event onto a person close to them in the present, changing how the patient normally treats the person. For example, a patient might treat his therapist lovingly because he displaces his mother’s persona onto the therapist, instead of seeing her as her therapist. Alternatively, the patient could project his feelings at the time of the event onto other people, for example by assuming that another person feels angry at the patient because the patient feels anger about the past traumatic event.

Some psychologists believe that patients engage in repetition compulsion as a way to overcome the past. The patient relives past events in an attempt to overcome what they previously could not, such as dealing with an abuser or successfully caring for a loved one who was grieving. Usually, however, the patient fails in his attempts.

How a psychotherapist views the repetition compulsion depends on his training. A cognitive therapist would treat compulsions by training the patient to think rationally, instead of reliving past events. Behavior therapists work to condition a patient to stop thinking about past events, which the therapist would consider a bad habit that needs to be broken. A psychoanalytic therapist would view the behavior as operating on a person’s unconscious level and would seek to help the patient change the way she deals with past traumatic events.

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