COMPARATIVE EVALUATION OF THE CONCEPT OF “REPETITION COMPULSION” FROM A PSYCHOANALYTIC AND A NEUROPHYSIOLOGICAL PERSPECTIVE

Comparative Evaluation of the Concept of “Repetition Compulsion” from a Psychoanalytic and a Neurophysiological perspective

George Skalkotοs: Social worker, psychotherapist – Mental Health Centre U.M.H.R.I. (gskalkotos@gmail.com).

Abstract The term repetition compulsion was first used by Freud in 1914 in his work “Remembering, Repeating and Working-Through”. Ever since, it has been connected with many situations in the psychoanalytic theory, which are sometimes contradictory to one another, sometimes conscious or unconscious, traumatic or therapeutic. In the first part of the present article we attempt to review the phenomenon of repetition compulsion in Freud’s, as well as in other scholars’ writings. The concept of repetition, of the act, that is, and of the outcome of “repeating” can be found in many fields. In the field of Neurosciences, research presents repetition processes in conjunction with memory function, which for some, like Modell, constitutes a kind of neurobiological support of Freud’s work. In the second part of the article we attempt to underline the points where Neurosciences and Psychoanalysis meet.

**Key-words: ** repetition compulsion, trauma, pleasure principle, transference, countertransference, death drive, memory, deferred action, pattern completion Psychoanalysis, Neurophysiology

ON THEM
Night came again like yesterday. Like yesterday night came again. Night came. Yesterday. Again. Effort in vain to strike the meaning, the solidarity of woe. Relentlessly, with whichever metathesis of words, with whichever release. In every one of them you can fit the finality of the whole. In their roots the pause flows. Well, it is better if they remain on a beaten track sentence which is also at first glance unharmed: Night came again like yesterday.
Kiki Dimoula ( On the tracks (1963) )

Introduction “The patient cannot recall all of what lies repressed. [..] He is obliged rather to repeat as a current experience what is repressed, instead of, as the physician would prefer to see him do, recollecting it as a fragment of the past” ( Freud , 2014, p. 37)

• is a 35 year old woman who comes into therapy shortly after her brother is diagnosed with liver cancer. The following material comes from one of the sessions with her, almost two years after she commenced therapy, and only a few weeks after her brother’s death.

“A few days ago I was sitting in my living room. I was thinking of my nephews. They lost their father at such a young age. It was late and I was getting ready to go to bed, when I had the desire to listen to the song Dimosthenous Lexis by Savvopoulos. For some unbeknownst to me reason, I choose to listen to it quite often these last two months. Sometimes, it is as if I cannot go to sleep without it. ‘When I get out of this jail’, Savvopoulos sings in the beginning, and every time I listen to it I feel a sense of emptiness. I was trying to remember when I heard it for the first time. And I did remember. It was in 1997, when a friend of mine had given me the cd it is on as a present”.

The aforementioned scene, as well as her emotional condition, bring to my mind the same emptiness that is described by the poet Kostas Ganas in one of his poems: “It was impossible for her to go to bed before static came on the screen. This white gives her peace – a nothing – and so she falls asleep” (1989).

It is the same emptiness that A. describes, when her desire to listen to Savvopoulos’ song was “born” anew, during the final months of her brother’s life.

She had also described the same emptiness before, when she talked about the time her father died, also of cancer in 1997. It was also around the same time that she had first heard that song.

I contemplate that in some way her emotional state now is in tune with her emotional state then. As if the loss tunes in to the same unconscious frequency in her internal “radio”. Motivated by how she felt when she heard the song, as well as by the associations she made, and I described above, I contemplate and feel that something is repeated. And I realise now, as I write these lines, that our psyches have a lot of ways to not forget, to go back to defining points of one’s history in an intangible time machine, and in some manner relive them.

** Play it again Sam **

(Rick Blaine, Casablanca, 1942)

Freud observes and describes people’s tendency to repeat situations and emotions that are especially painful for them, be it in their everyday life, their dreams or their therapy. He defines this phenomenon as “repetition compulsion”.

Elaborating on his thoughts around this phenomenon, it is as if he is weaving an invisible web, on which, some of the most important concepts of his work are “captured”. The concepts of dream, trauma, symptom, pleasure principle, transference and death drive are connected to the phenomenon of repetition.

Kierkegaard (1813-1855), writes in his book “Repetition: an Essay on Experimental Psychology” (1843): “Inasmuch as for a long time I have been engaged, at least occasionally, with the problem whether a repetition is possible and what significance it has, whether a thing gains or loses by being repeated [..] it is sure to play a very important role in modem philosophy; for repetition is a decisive expression for what "recollection" was for the Greeks. [..] Repetition and recollection are the same movement, only in opposite directions. [..] Repetition, if it is possible, makes a man happy, whereas recollection makes him unhappy. [..] The dialectic of repetition is easy; for what is repeated has been, otherwise it could not be repeated. [..] Repetition is the solution contained in every ethical view, repetition is a _conditio sine qua non _ of every dogmatic problem” (1843, p.33, 52-53).

If we were to substitute the word philosophy with that of psychoanalysis, the meaning of Kierkegaard’s writings would not change. Nor would it change if we used the word transference instead of psychoanalysis, or even the word dream.

The concept of repetition, of the act of repeating and its result, is a concept encountered and applied in many fields.

According to Levy (2000): “The concept of the repetition compulsion remains an enigma. Its etiology is not fully understood and the purpose it serves continues to be a mystery”.

Laplanche and Pontalis write: “it is difficult either to lay down its strict meaning or to define its own particular problematic: the concept reflects all the hesitations, the dead ends and even the contradictions of Freud's speculative hypotheses” (1986, p. 544). In the psychoanalytic theory, it is connected to so many different situations, sometimes even completely contradictory to one another, observable or not, conscious or unconscious, traumatic or therapeutic.

Freud, first refers to the term of repetition compulsion in his 1914 essay Remembering, Repeating, and Working-Through. He writes: “the patient does not _remember _ anything of what he has forgotten and repressed, but _acts _ it out. He reproduces it not as a memory but as an action; he _repeats _ it, without, of course, knowing that he is repeating it” (2010, p. 65).

Discussing the concept of transference, and stressing its importance for the process of psychoanalysis, he states that in essence, transference is but a type of repetition in the analytical procedure, through which the patient acts out facts and memories that have been forgotten, both in his interaction with the analyst and in the present. He also asks himself, what it is that the patient repeats, and goes on to answer: “he repeats everything that has already made its way from the sources of the repressed into his manifest personality - his inhibitions and unserviceable attitudes and his pathological character-traits [..] all his symptoms” (2010, p. 67).

In Beyond the Pleasure Principle (2014), Freud initially reminds the reader of the concept of the pleasure principle, which is the tendency of psychological procedures to avoid dissatisfaction, and produce pleasure.

Using the example of his grandson’s game, he comments on the phenomenon of repetition as a process, during which, repetition is useful in processing and controlling a situation for the development of one’s self. Through the alternation of its passive attitude, which is the traumatic situation it experiences when its mother leaves, the child passes to an active position by representing this traumatic experience in the game, thus gaining control over it. It is therefore, a positive process for the subject’s psyche that serves the pleasure principle. It is reminiscent of Aristotle’s reference, in his work Nicomachean Ethics, to the concept of bliss, the only way of obtaining which, is though moral or ethical virtue: “moral or ethical virtue is the product of habit (ethos)”. These moral virtues (i.e. justice, prudence etc.) are conquered through habituation, through the habit that results from the repetition of an action.

Elsewhere in Beyond the Pleasure Principle (2014), Freud examines what is repeated in the psychoanalytic process in conjunction with the function of transference. He mentions that no matter how unpleasant the repressed material is, it has the need to find a way into consciousness or to be diffused through an action (2014, p. 38).

As Quinodoz (2013) points out “for some patients it happens, that the processing procedure fails, which results in simple repetition becoming repetition compulsion and puts therapeutic success in danger” (2013, p.291). Here, we deal with repetition phenomena that cause anything but pleasure. We deal with phenomena where the “person seems to experience something passively, not interfering at all with it, thus encountering the repetition of destiny itself” (Freud, 2014, pp. 43-43). According to Freud, phenomena such as these transcend the pleasure principle. Taking this thought a step further, he reasons that there is another concept, which is contrary to the pleasure principle and prevails over it. Thus he introduces the concept of the death drive which is “the fundamental tendency of every living being to return to the inorganic state” (Laplanche and Pontalis, 1986, p.197) .

According to Russel (1990), something painful, especially a painful emotion, is repeated in order for the subject to be able to feel what he or she must do to heal the trauma.

Miller (1984) believes that a traumatic event is relived through a behaviour as a means to communicate something that cannot be put into words.

Skoulika mentions in an article that, in her book “Processes of Repetition and Offerings of the Ego”, Potamianou theorises that repetitions “restore older situations resisting the elimination of the past. Like discharges of mentally raw tensions, the motions of repetition compulsion plan and re-plan the main characteristics of an experience that emerges, not knowing when or where it came from” (1999, p. 20).

DeM’ Uzan (1977) suggests that there are repetition processes that lead to something that is “similar” but not “identical” to the existing mental record. It is a small difference, which creates, however, the recording of a new experience, leading to the evolution of mnemonic traces (Skoulika, 2014).

According to Chu (1991), the concept of repetition compulsion helped in the understanding of the role of trauma in mental illness. He adds that repetition compulsion becomes an almost biological need, a biological subsistence that can be compared to urinating, which is a need that can be postponed up to a certain point but at some point the person must urinate.

It is this biological subsistence that Levy (2016) underlines when he talks about a biological “urge” to repeat the trauma, a biological pressure on the subject to deal with the trauma in a constructive manner.

We conclude, therefore, that the repetition of a traumatic situation is, without a doubt, something painful. If it simply remains another unconscious representation and is not communicated, it will most probably lead to a new traumatisation. If, however, it is communicated –especially in a relationship, like in therapy – then it can only be beneficial. That which should not, or cannot be recalled, has a chance through the analysis to be named, to be constructed, and to become a memory of a past experience, thus signalling the commencement of healing.

“ _Biology is truly a land of unlimited possibilities. We may expect it to _

give us the most surprising information and we cannot guess

what answers it will return in a few dozen years to the questions we have put to it ” ( Freud , 2014, p. 94).

Almost a hundred years after this quote, Freud would have maybe been somewhat astonished, by the quantity of “information” that arises from the interaction between these two scientific fields, and the material that has been produced. His phrase in his essay On Narcissism is almost prophetic: “we must recollect that all our provisional ideas in psychology will presumably someday be based on an organic substructure” (1914, p. 5).

Modell, in his book “Other Times, Other Realities, Toward a Theory of Psychoanalytic Treatment”, writes about the theory developed by Edelman (1987) that he himself considers as a kind of neurobiological support to Freud’s work. Edelman expresses a theory, concerning the function of memory, as an alternative psychobiological explanation of the repetition compulsion phenomenon. Presenting this theory, Modell writes: “memory is not a process of passive recording of experiences, in which there exists an isomorphic correspondence between the event and the mnemonic trace. Memory is a dynamic reconstruction. What is stored is not a replica of the event, but rather the potential generalisation of the category to which it belongs” (Model, 1990, p.64). In this category, the motor system plays an important part, as it is necessary for perceptual ability. According to Edelman, perception consists of the discovery anew of the categories that are stored in memory. In order for this process to take place in the brain, a “repetitive motion” is needed. As soon as this motion locates something new in the environment, something innovative, it will be re-registered in memory as new content.

Isn’t this similar to what happens in the analytical process through the phenomena of transference and countertransference? The repetition of the patient’s behaviour towards the analyst, through transference, may cause a countertransference on the analyst’s part, which will in essence be innovative “material” for the patient. This innovation will allow the patient to experience, in his relationship with his analyst, something different from what he has been repeating, and to maybe give new meaning to his recollection. This in turn will lead him to relive the experience he had up to that point in, a different manner.

As Edelman writes in his book, Modell, in addition to comparing transference in psychoanalysis to the function of memory, also refers to the concept of “deferred action”. Laplanche and Pontalis write in “The Language of Psychoanalysis” that “deferred action” is, in a way, the effect of the past on the present. They go on to add that: “the subject revises past events at a later date, and that it is this revision which invests them with significance and even with efficacity or pathogenic force” (1986, p. 175). Modell notes that “Elelman’s theory suggest that Nachträglichkeit (Deferred Action), as evidenced in human psychology, is a special or restricted illustration of a universal characteristic of the nervous system to establish perceptual identities of categorical memories” (Modell, 1990, pp. 62-63).

Javanbakht and Ragan (2008) refer to the neurological function of pattern completion. This function plays a part in memory retrieval, and implicates parts of the brain like the amygdala and the hippocampus. More specifically, it facilitates the retrieval of a complete pattern from a pattern that may be perceivable, but is, however, incomplete (Samurai & Hattori, 2005). When the brain encounters a vague and incomplete visual or auditory stimulus, it refers back to previously stored patterns, so as to match the new incomplete one with the most relevant complete one that is already stored. The pattern then locks and the person perceives the vague incomplete present stimulus, as the already recorded pattern.

This tendency of the human brain is also manifested in the analysis. For the patient, the analyst is a person for whom he has very little information. However, information like the tone of his voice, the way he looks, his demeanour, and even how his office is decorated, will create association in the patient’s mind (Gabbad, 2006). The unknown and vague aspects about the analyst, will be “filled-in” through the pattern completion function, utilising memories of important people in the patient’s life up to that point. It is, in essence, the neurobiological explanation of the defence mechanism of projection, which is of crucial importance for the development of transference in psychoanalysis.

According to Anserment and Magistretti, the authors of the book “Biology of Freedom: Neural Plasticity, Experience, and the Unconscious”, the discovery of brain plasticity played an important role in connecting psychoanalysis and neurobiology. They point out that: “experience leaves a trace [..] beyond what is innate, beyond everything that is given at the outset, what is acquired with experience leaves a trace that modifies what went before” (2015, p 27). “What went before”, which is so different for each subject, is what returns in the analysis, as either an emotion, a physical sensation, a memory, or a construct. It is subjected to a retrospective processing, and can have modifying importance for the patient’s psyche. The neurobiological plasticity is “shaped” by opening the psyche to a psychological plasticity, a shaping of the self, as the meaning of the word psychotherapy indicates.

Concluding, I will refer to Freud’s book “An outline of Psychoanalysis”, which he wrote in the final years of his life. At the beginning of the first chapter he writes: “We know two things concerning what we call our psyche or mental life: firstly, its bodily organ and scene of action, the brain (or nervous system), and secondly, our acts of consciousness, which are immediate data and cannot be more fully explained by any kind of description. Everything between these is unknown to us” (Freud, 1940, pp.27-28). Even though the scientific data at the time did not support the existence of a bridge linking the physical and the psychological, it seems that for Freud the link between the two was undeniable, albeit unproven.

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The present essay was written for the “Psychodynamic Psychotherapy and Neurosciences” module of the Postgraduate Course “Psychodynamic Psychotherapy in Medical Settings” of the School of Medicine of the University of Athens.