Abteilung für Psychosomatische Medizin, Robert-Bosch-Krankenhaus, Stuttgart, Germany.
Sigmund-Freud-Institut, Frankfurt a.M., Germany.
Int J Psychoanal. 2020 Dec;101(6):1172-1187. doi: 10.1080/00207578.2020.1809155.
This paper examines the repetition compulsion as a composite structure and explores the elements that are involved in it. After examining the difference between playful repetition, which promotes psychic development, and the repetition compulsion, which obstructs psychic change, the author discusses Freud's models of the repetition compulsion (as the return of the repressed vs an expression of the death drive). Further elements that contribute to the repetition compulsion include the role of a primitive, punitive superego, the persistence of raw, unsymbolized elements, obsessional doubt, the retreat into timeless states of mind as well as a re-entry mechanism in certain psychotic patients. Finally, the failure of reparative processes seems to be a central mechanism in sustaining the repetition compulsion. Brief clinical vignettes illustrate the author's arguments.
本文考察了强迫性重复作为一种复合结构，并探讨了其中涉及的要素。在考察了促进心理发展的游戏性重复与阻碍心理变化的强迫性重复之间的区别之后，作者讨论了弗洛伊德对强迫性重复的模型（作为压抑的回归与死亡本能的表达）。进一步促成强迫性重复的因素包括原始、惩罚性超我的作用、原始的、未符号化的元素的持续存在、强迫性怀疑、退行到无意识的心理状态以及某些精神病患者的重新进入机制。最后，修复过程的失败似乎是维持强迫性重复的核心机制。简要的临床案例说明了作者的观点。
