Research Notes - Looping, Repitition Compulsion: For & Against - Various Articles

Repetition of action, sensation, memories, triggers and more has been a reoccurring theme throughout my research into PTSD, as well as a highlighted element of my own experience with it. Given that the entire mechanic-aesthetic cohesion of the game is based around this idea of repetition, iteration and loops, both in terms of narrative, design, game-play and even code, I found it imperative to take a closer look at the psychological theories behind why theses repeated sensations and actions are triggered. 

Beyond the Pleasure Principle 

by Sigmund Freud - 1922

 

Repetition Compulsion

While I did read parts of this full work, my notes on the actual paper were slim, as deciphering meaning in this article was difficult; it could be the antiquated writing style or simply a lack of familiarity with certain psychological jargon, but the process was slow going, and the notes that I did take ended up taking a backseat to the later articles I looked at that discussed this vary work. 

However, in summary, Beyond the Pleasure principal looks primarily at the concept of repetition compulsion - the repeated series of feelings, memories, sensations, actions, results and behaviors that occur following trauma, and disentangles it from Freud's previous theories about the pleasure principal. 

The basis of the repetition compulsion essential reveals that traumatized individuals would rather repeat the traumatic events over recounting them as stories that they would need to remember and deal with. 

 

Freud identified four specific symptoms or observations within patience about repetition compulsion:

1. Dreams that repeat the trauma 

2. Repeating patterns of past trauma in current experiences

3. The feeling that fate will always lead the traumatized person to the same results no matter what, as if they have no agency or control over the matter

4. Certain ways children repeat actions they witness as an expression of mastering negative emotions         -    The example he gives is of a child that throws his toys out of sight only to retrieve them when his mother leaves the room. Freud's theory here makes a case that the child, distressed by the leaving of a care giver, comforts himself by throwing a placebo object away (as revenge) before retrieving it and feeling joy at the being found. It acts as a coping mechanism 

Death Instinct

To this end, Freud noticed that certain individuals became unwilling to try and change their repetition behaviors or even acknowledge what they were being told. 

    -     Freud takes a very pessimistic outlook on this

    -    He determines that certain traumatized individuals with repetition compulsion behaviors have no capacity for change and even goes so far as to deem them "daemonic" 

    -    This irredeemably is supplanted by his later thoughts on the matter which determine that a cure or method of helping stabilize these individuals is beyond his current scope with what knowledge they had when the article was published in 1922. 

Repetition Compulsion Revisited: Implications for Technique

By Lawrence B Inderbitzin & Steven T. Levy - 1998

 

Moving forward, I looked at Inderbitzin & Levy's article, Repetition Compulsion Revisited: Implications for Technique, as they took a very critical look at Freud's theory and dismantled certain parts of it as being unhelpful for psychological help.

 Their biggest argument against repetition compulsion as a concept is that the phrase itself has become muddied. there is no strict definition of repetition compulsion, and it seems to cover a wide bredth of unrelated phenomenon, including flashback symptoms as well as long term repeated situations and responses to life events - none of which seem, to them, to have much to do with each other other than their frequent occurrence in traumatized patients. 

    -    The definition is muddled because it is too broad, even having been extended to apply to any repeated instances for the purposes of acquiring mastery in a psychologically controlled setting.  

    -    The phrase has lost its meaning.

At least until they did so in 1998, they claim that most psychologists had taken Freud at his work, and never questioned the clinical importance of these repetitive symptoms.  (p.35)

They claim that the phrase repetition compulsion has gone from referring to a explanatory concept to a descriptor of a set of behaviors, synonymous with the word "habit" (p. 37)

 One important feature of this article is that it points out that (at least by 1998) there was "no agreed upon definition of trauma" (p.39)

    -    It can be defined in a subjective sense or an objective one, and there are too many variables that make it impossible to have a one size fits all definition. There are scales such as mild - severe, sudden - longterm, childhood adulthood et al. 

Models of Trauma focus on 2 possible reasons for trauma:

1. Trauma is related to the traumatized individual

2. Trauma is related to the nature of the stressing factors

(3.) they outline how there is a middle ground where the individual's temperment, needs, etc. will influence how they are affected by the stressing factors present in the trauma, which will determine ultimately if they wind up traumatized. 

The Fallibility of the Mastery Theory

The article takes issue primarily with Freud's assertion that repetition behaviors are related to mastery over a traumatic incident

    -    They point out findings that indicate that empirical evidence and clinical experience suggest that repetition in traumatized individuals does not lead to mastery at all, and will lead "to further suffering both for themselves and for those associated with them" p.40

Instead, traumatic memories, feelings and actions are repeated without gratification or motive. 

Additionally, the authors take great issue with the pessimistic approach Freud has with his "demonic" patients with repetition compulsion that resist all attempts at curbing their emotions

They believe then that Repetition Compulsion is a bad theory with no use in medical practice today, 

    -    They feel that the feeling of Catharsis is over emphasized in treatment for PTSD and trauma

    -    They feel Repetition Compulsion is a useless grouping to cover too large a section of phenomena  related to trauma. 

Rather they point out that repeated behaviors have underlying causes that can be helped with treatment to the root causes of trauma. 

    -    Their take away is that patients who have been diagnosed as having a repetition compulsion use a mentality of "I can't help it" to ignore the painful and difficult work at curbing their tendencies. 

    -    It is an excuse. 

    -    Repetition is not random. It is a triggered response. 

    -    Stressed states increase these patterns of repetition as patients become unwilling to change their behavior as an instinctive mask to hide behind

"The more interesting question is not why we repeat but rather what enables us not to repeat"

    -    The key is in figuring out how to trigger the response not to repeat a harmful action against ourselves. 

The repetition compulsion, envy, and the death instinct 

by John Steiner - 2008

 

Compulsion to repeat = A resistance to change

    -    Noticed that certain patients would actively seek out suffering and unhappiness in patterns and found that these patients were the most resistant to changing their methods of being, 

Expanding on Death Instinct

    -    Freud used the term Death Instinct to define something he could not understand

"if we think of [death instinct] primarily as an anti-life instinct representing a hatred and intolerance of all those things that stand for life and for creativity in particular" p.138

    -    Death instinct is a resistance that arises from the intolerance of anything new

                -    New = unknown

                -    Unknown = scary

Steiner posits that [maternal] goodness is how an infant establishes a relationship with the world, stemming from a young age. Goodness has to act in direct opposition to badness 

    -    cannot exist in a vacuum

    -    Those who do not have a place from which goodness can enter their lives have envy over anything deemed good. 

      "The patient with a repetition compulsion cannot tolerate to be the recipient of goodness, which he experiences as humiliation" p.139

This type of patient will see this idea of goodness as weakness, and will, therefore reject any notion of it. 

At this point, the author delves into, a bit unprompted, Freud's unrelated theories about penis envy, in an attempt to relate this notion of good "maternal" [femininity] with revulsion, while the grasp for agency (or in this case the action of the "penis" [masculinity]. 

    -    While I can kind of see where he was going with this, and he did not do it in a way that accounted for 21st century sensibilities, it took some mental gymnastics to get there, in my opinion. I have not included much of that argument here, for this reason. 

Ultimately, death instinct is about the resistance to changing and results in Freud's compulsion to repeat.

Case Study

    -    The author uses a case study of "Mr. Y" to explain how this inability to change manifested

    -    From the outset, the patient stated directly that he was locked into his current path to ruin

            -    He resisted any attempts to change his ways

            -    He refused to connect with the Psychologist and leave himself vulnerable. 

    -    The patient suffered from repeating nightmares about a test in school and the loss of his friends and family following it.  

    -    Even the sessions themselves were enacted in a repeating pattern with the same basic structure to each that never changed or formed connections between the therapist and patient. 

Repetitive Maladaptive Behavior: Beyond Repetition Compulsion

by Brad Bowins (2010)

This article took a look at previous work on Repetition Compulsion and decided to redefine the boundaries into more useful categories of Repetitive Maladaptive Behavior: Traumatic and Non-Traumatic. 

What is repetitious behavior?

    -    thoughts

    -    images

    -    flashbacks

    -    dreams

    -    emotions

    -    somatic sensation

    -    behavioral re-enactments

 

"The dissociative function of repetitive maladaptive behavior of traumatic origins works either by re-experiencing feelings, beliefs, sensations, or behavior from the traumatic event, or over-utilization of typically less mature, or ... more cognitively distorting psychological defenses such as repression, isolation, and identification with an aggressor... Re-experiencing of a traumatic event can include thoughts, images, flashbacks, dreams, emotions, somatic sensations and behavioral re-enactments" 

(p 291)

Harks back to Freud's original assertion that patients would rather repeat the trauma event rather than remember the trauma itself

This can cause frustration for therapists because they encounter extreme resistance to change even when the patient is consciously aware of the their issue

Rather than discounting the concept of Mastery as a reason for repetition, this article sought to define two new categories based on whether or not Mastery would work to end the traumatized state:

1. Traumatic 

        -    "re-experiencing of trauma is a central symptom, repetition causes ongoing suffering and no mastery" p. 283

2. Non-Traumatic

        -    In grief, repetition of events or memories actually does culminate in mastery over the event and acceptance. 

Non-Traumatic

Loss  has several factors that accounts for mastery over the event:

1. immediately activates the repetition cycles rather than being forced behind a wall for coping

2. Stages of grief lead ultimately to acceptance of the event 

3. A person suffering from loss is fully conscious of their emotional suffering and the loss they are facing, hence able to facilitate mastery over their situation and retain control

    -    These behaviors are associated with evolution and natural selection, and have to do with how offspring imitate the behaviors and mannerisms of their characters as a method of existing in the world. 

    -    Behavior patterns are unconsciously acquired during childhood through imitation as a method of energy conservation

Its been found that generally, the larger the group of caretakers, the less likely maladaptive behaviors will occur, as the child, when forming patterns of behavior has a wider array of examples to gleen information from, and can pick and choose which behaviors to copy

    -    The lower the number of caretaker figures, the more likely maladaptive repetitive behaviors are to occur, as there are fewer sources

                -    Over the course of human history, having only 1 or 2 caretakers has actually been largely unheard of and is only a very recent development 

                -    Exceptions to this rule exist: Cults, in particular, have been shown to carry many maladaptive behaviors to their youth, however most cults are short lived and ramifications minimized. 

Memory

Maladaptive behavior is presented in Memory

    -    Memory is essential

    Two types of memory:

        1. Representational Memory

                -    conscious

                -     can be created on purpose

        2. Habit Memory

                -    Implicit      

                -    unconcious

Caregivers fall under the framework of Habit based memory

    -    If an instance of maladaptive behavior among caregivers happened only infrequently, it would act as an outlier and not be ingrained into the behavior patterns of the offspring

Genetics play a roll as well

    -    Temperment of offspring has a lot to do with exactly which behavioral patterns from the caretaker figure will be picked up on

    -    Children will not necessarily be direct copies of their parent behavioral patterns

    -    There is a chance to break cycles of neglect or maladaptive repetitive behaviors

Three neurotic personality styles

1. Moving towards [parental guidance]

    -    following along with parental behavior templates as it is shown to have affection, and "goodness"

2. Moving against [parental guidance]

    -    actively working against the parental behavior templates as they were shown to participate in criticism & humiliation. This is a working against of parental personalities

3. Moving away from [parental guidance] 

    -     Moving away has to do with inconsistant parenting styles, which sometimes showed affection and sometimes showed fear or neglect. These types of personalities have difficulty bonding with other people and will try to keep away. 

Traumatic

Maladaptive repetitive behavior is a dissociative based defense mechanism 

    -    repetitive behavior occurs either as a trauma response

or 

    -    a defense in avoiding the ramifications at the end of trauma

 

Abused individuals often have a "Moving Away From" system of parental behavioral guidance

    -    Abused persons will find it easier to abuse others than to resist this behavioral pattern, as there is not a fully encoded template to move towards or against 

Children are more sensitive to trauma

    -    The perception that death is a possible outcome of event seems to be a factor in enacting trauma in otherwise healthy adults 

 

Traumatic Events

All events have an intrinsic link between the cognitive recognition of the event and the emotional one 

    -    This linkage is often not tolerated and the link is broken between the cognitive and emotional responses

"re-experiencing aspects of past trauma can deflect from consciously linking the cognitive components of a traumatic event to the adverse emotional states produced by it"

    -    ex: a woman who was sexually abused by her father, may sleep around in emotionless one night stands without issue, however experience trauma patterns when trying to have sex with someone they feel an emotional attachment to, as the emotional connection is where the trauma is triggered in the encounter. 

    -    When something of this nature is experienced, the dissociation defense will activate and lead to avoidance behaviors and dissociation. 

There is no mastery to be found here 

 

Dissociation Defense

  Dissociation serves as one of two defense templates

(The other one being positive cognitive distortions)

It protects us from feeling negative emotional states

    -     The result is a reinforced framework for a dissociative defense mechanism

     -    Additionally linked with an avoidance mechanism

            -    Dissociation is integral to avoidance responses

Dissociation exists on a spectrum - mild (most people), medium (depersonalization / de-realization), and Severe (amnesia - Identity fragmentation)

 

PTSD vs Grief

PTSD occurs because the grieving process does not work properly, and the resulting repetitive behavior is a destructive re-living of the trauma experience

    -    PTSD is grief without leading to the acceptance stage

    -    Trauma involves loss, much like grief, but does not engage the grief process, leading to dissociation and avoidance of the emotional relationship with the cognitive self

"Extensive isolation leaves memories and ideation associated with the trauma intact, but blocks awareness of any affect associated with it" (p.292)

 Resistance is to be expected when attempting to analize a repetition compulsion

    -    Repetition compulsion is a path of resistance.