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Adolescence and the repetition compulsion.

I describe the connexion between the failure of the procedures of adolescence and the establishment of a psychical economy dominated by the repetition compulsion. The concept of the repetition compulsion appears as early as in 1914, in 'Remembering, repeating and working-through', but is not clearly specified as a characteristic of instinctual functioning until 1919 and 1920, in 'The "Uncanny" and 'Beyond the pleasure principle'. In these two works, Freud presents what amounts to a model of the disorganization of the mental apparatus observed in 'breaks' in the adolescent process when the capacity to bind instinctual excitation in the primary process is swamped. Decompensation is precipitated by the change in the reality principle (de facto infantile impotence becoming adult potency). The repetition compulsion, in the strict sense of the term, is a matter of 'crude', unbound instincts. Moreover, the idea emerges from Freud's two texts that the instinctual demand manifested through the repetition compulsion is the persistence of the incestuous and parricidal wish. This is borne out by my analytical experience, as the two treatments I adduce to illustrate the theory show.

Adolescent↗

[Psychiatric and neuropsychological symptoms in children with arachnoid cysts--a case report].

Arachnoid cysts (AC) are intracranial, extracerebral cysts. They can produce a wide variety of neurological symptoms, but they can also be asymptomatic or produce psychological or psychiatric symptoms. First, a short overview of the clinical manifestations of AC is given. There is an astonishing lack of literature dealing with psychological problems in children with AC. The case of a 12-year-old boy with a large left temporofrontal AC without increased intracranial pressure is presented. The psychiatric symptoms, which had begun only a few months earlier, included lack of interest, attention deficit, difficulties in contact and communication, severe outbursts of aggression and obsessive-compulsive, inhibited behavior. The main neuropsychological finding was slow and hesitant expression of thoughts despite an intelligence level in the upper normal range. The findings and course are described in detail. They are discussed as signs of an organic psychosyndrome due to the AC.

Affective Symptoms↗

Malnutrition in a compulsive runner: a case conference.

A 28-yr-old, female marathon and "fitness" runner presented with leg swelling, fatigue, and loss of endurance. She was running an hour or more daily in addition to regular biking and swimming. She was an instructor in a fitness center. For 2 months prior to her leg swelling, she had increased fatigue and decreased exercise tolerance. She had been seen previously for a slow healing hamstring strain. She had not had a menstrual period for over 2 yr and had refused evaluation. She admitted to very low dietary intake, which she had always denied. She was worried about her body fat. She denied recent blood loss, diuretic or cathartic use, and induced vomiting. She appeared malnourished, pale, and older than her stated age. Her weight was 41.4 kg. Her blood pressure was 90/60, and her pulse was 100 per minute. She had pitting edema of the lower extremities to the knees. The diagnosis of anorexia nervosa was made and will be discussed.

Adult↗

"A dream is the fulfillment of a wish': traumatic dream, repetition compulsion, and the pleasure principle.

This paper describes the case of a battle veteran who suffered from a repetitive traumatic dream and symptoms of a traumatic stress disorder. Psychodynamic exploration revealed the basic wish-fulfilling aspects of both the dream and the fact of its repetition. The patient's obsessional preoccupation with his war experiences was also in significant part determined by unconscious wishes to repeat the infantile experience it represented. It is suggested that the repression of pleasure according to the classic psychoanalytic model is as important a dynamic in the dreams and symptoms associated with specific traumata as with any other neuroses. The question is raised as to whether a repetition compulsion, of normal or pathological intensity, may reflect the wish to repeat a descriptively unconscious pleasurable component of a disturbing experience, as well as to master it.

Adult↗

[Motives and circumstances of repeated suicidal attempts by taking drugs].

It has been found out that 45% of the Toxicology Clinic patients hospitalized by their suicide attempt had previous suicide attempts. Calculations have shown that there were 76 previous suicide attempts in all and that 48 (63%) among these were not followed by any psychological and/or psychiatric help. The most frequent reason of this was keeping the attempt secret from further environment. Among the persons repeating suicide attempts affective illnesses, brain damage and personality disturbances were more often diagnosed; mental disturbances of their parents and/or disruption of their families in their childhood in the cases of these patients were also more frequent. Collapse or loss of significant interpersonal relations was a more frequent motive for trying to take one's life with persons repeating suicide attempts.

Adolescent↗

Running addiction: measurement and associated psychological characteristics.

Runners frequently become addicted to running and continue to run even when it is detrimental to their health. In the present study a paper and pencil test to measure running addiction, the running addiction scale (RAS) was constructed and evaluated and used to investigate the psychological correlates of running addiction. The RAS, symptom check list, locus of control scale, commitment to running scale (CR), and a questionnaire about the individual's running habits and degree of addiction were administered to 32 male and 15 female runners. The results suggest that the RAS is reliable and valid, correlating with self-rated addiction. The CR score was correlated with self-rated addiction for males but not for females suggesting that the RAS and CR measure different characteristics and that for female runners commitment to running can occur without addiction. Large gender differences were found in the correlations between the RAS, CR, run frequency, and run duration with the personality, mood, and locus of control scores. Running addiction was found to be associated with high frequency of running and with positive personality characteristics but not with mood enhancement, while the duration of running was found to be associated with mood enhancement. These results suggest that the benefits of running to mood may be obtained without addiction.

Adult↗

The compulsion to repeat in action: a developmental perspective.

The compulsion to repeat in action is seen as being a particular way of thinking that is characteristic of the time when neurosis is formed. This type of thinking has been abundantly studied by Piaget, and is seen as a consequence of the development of more complex thought from action roots. Piaget has labelled this thinking as pre-operational, and it is seen as occurring between the ages of eighteen months and 7 years. Descriptively, it is best characterized as action-thoughts rather than as action. In the area of their neurosis, action-thoughts are a communication by the patient in the only way they can, and are consistent with Freud's earliest description of the compulsion to repeat. Finally, action-thoughts are seen as an ego restriction in the areas of a patient's conflicts.

Acting Out↗