Repetition compulsion in a trauma victim: is the "analgesia principle" beyond the pleasure principle? Clinical implications

Abstract

This paper reviews the concept of repetition compulsion (RC) from Freud's original formulation to recent contributions from psychoanalysis and the neurosciences. Literature on RC presented four major controversies: (1) Does RC describe a broad range of dysfunctional repetitive behaviors, or only the repetition of severe traumatic experiences? (2) Is RC an attempt to achieve mastery and control of a traumatic experience, or to reach a particular psychic state as analgesia or excitement, which reduces the perception of emotional pain? (3) Is the death instinct an acceptable explanation for RC? (4) Is RC a useful, meaningful, and specific concept? The author describes his personal perspective on RC which integrates psychodynamic and biological contributions. Clinical material is provided.