PubMed · 13302607
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C T SEYMOUR, A E COMARR. 1956. Compulsive polysurgery.. https://doi.org/10.1016/0002-9610(56)90397-x
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The concept of repetition compulsion, which has never been fully acknowledged by Kohut and his followers, is re-evaluated in this article within the context of self-psychology. In line with the underlying principles of defensive contact-shunning on the one hand, and non-traumatic empathic failure on the other hand, the repetition can be seen as the twofold expression both of the wish for a new benign relationship and of the dread of traumatic, repeated disappointment. Therefore, early non-traumatic disappointments are initiated by the patient, and role-responded to by significant others. This way, the risk of disillusionment of full-blown expectations is avoided. The repetition compulsion, then, is a complex mechanism: preventive in one part, it protects the vulnerable self from potentially traumatising experiences; thus, it is operated in response to the danger signal of emotional cravings, once the latter are experienced as getting out of hand. Providing novel experiences, in its other part, it can lead to opening the road for change; such curative impact relies on lengthy working through in a safe, empathic, holding environment.
Psychotherapy and psychotraumatology share a preoccupation with repetition phenomena, manifested as transference, compulsions to repeat, or intrusive reexperiencing. Terminological diversity obscures compelling similarities between these repetition phenomena and discourages speculation about processes involved in their genesis. This paper remedies these oversights by integrating recent empirical evidence pertaining to memory with European intellectual traditions embraced by its pioneering dynamic psychotherapists. Using dreams as a prototype repetition, the phenomenological diversity of repetition phenomena is shown to be reconcilable with current evidence about memory encoding, storage, and retrieval. Differences in persistence, intensity, pervasiveness, and treatment resilience of repetition phenomena are explained using concepts derived from psychological and biological sciences. Implications for psychotherapeutic theory, practice, and evaluation are considered.
Neuropsychiatric features characterize frontotemporal dementia (FTD). The authors evaluated the neuropsychiatric features of 53 FTD patients and retrospectively applied the Consensus Criteria for this disorder. Only one-third of the patients met Consensus Criteria for FTD on presentation. Most had early disengagement with poor insight; however, more than half retained socially appropriate interpersonal conduct and emotional expression. Supportive features, including compulsive-like acts and speech changes, were common presenting features, and 20% developed the Klüver-Bucy syndrome on 2-year follow-up. Consensus Criteria for FTD offer guidelines for diagnosis, but further refinement is needed, particularly for patients who lack early changes in social interpersonal conduct.