Repetition Compulsion Trauma: Signs, Causes, & Treatment

What Is Repetition Compulsion?

Repetition compulsion, also known as traumatic reenactment, is a psychological concept where a person repeatedly acts out the same negative patterns, often unconsciously.¹ They may gravitate towards familiar but harmful relationships or have recurring nightmares. The behaviors often stem from past traumatic events, although they can have non-traumatic origins.¹

Sigmund Freud thought of repetition compulsion as a way for someone to gain mastery over the original trauma, but modern psychology has not found evidence of his thought process.⁴ In fact, the repetition of compulsive thoughts and behaviors in therapy may actually increase a person’s obsession with their past.⁴

Repetition Compulsion in Relationships

Psychoanalytic theorists believe that an individual’s earlier relationships can unconsciously influence their choice in current relationships. Therefore, repetition compulsion may play out in an individual’s relationships when they have early experiences of interpersonal trauma, like physical, emotional, or sexual abuse.¹ For example, witnessing domestic violence in the childhood home may result in the adult individual partnering with an abuser.

Repetition Compulsion Types

Repetition compulsion can show up in different ways, including through a person’s actions, thoughts, or relationships. Some types of repetition compulsions may be easier to notice than others; it may be easier to see them in relationship problems but harder to spot in ruminative thinking. Understanding the various types of repetition compulsion can help a person see and change harmful patterns in their feelings, behaviors, and relationships.

Common types of repetition compulsion include:

• Repeating behaviors: Individuals can repeat certain behaviors that they may have repeated during the traumatic event for survival. Sometimes, these behaviors can present as a form of self-sabotage, such as seeking potentially abusive relationships.
• Repeating situations: Individuals may repeat traumatic situations to gain insight into the actual event’s occurrence.
• Re-enacting trauma: Individuals can re-enact trauma on a physiological, behavioral, or emotional level.
• Rumination: Repetitive thoughts are sometimes seen as a repetition compulsion because the individual is circling through the same material in an effort to generate understanding or insight. Unfortunately, rumination does not lead to the solution of the problem but rather keeps the individual stuck in a cycle of the past.
• Acting as a victim: Learned helplessness can be an effect of earlier traumatic experiences.³ Sometimes, an individual might have learned early on that they could not depend on others to emotionally support them and may show up in adult relationships during a conflict with learned helplessness.
• Acting as the perpetrator: The research is clear that individuals who commit violent crimes against others often have links to earlier instances of childhood physical or sexual abuse.³ Perpetrating against others may be motivated to feel powerful and overcome the sense of learned helplessness.

Signs of Repetition Compulsion

Repetition compulsion often shows up as repeated self-destructive patterns in a person’s behaviors and relationships. For example, an individual choosing hurtful relationships or engaging in impulsive or dangerous situations.  There are also more subtle signs of repetition compulsion, such as frequent nightmares. Recognizing the signs can help a person gain insight into how these patterns affect them or a loved one.

Repetition compulsion presents itself in the following ways:

• Nightmares and dreams: Having recurring dreams or nightmares can be a form of repetition compulsion trauma. This may be a person’s unconscious attempt at making sense of prior, sometimes traumatic, experiences.
• Romantic attachments: Experiencing multiple abusive or toxic relationships as an adult can be a form of repetition compulsion trauma, as repeating the abuse cycle may be an individual’s unconscious attempt to gain mastery over the past abusive experience.
• Re-enactment of victimization: Some research has found re-enactment of victimization to be a risk factor for violence, as a repetition compulsion.⁴ For example, individuals who commit crimes often have histories of physical or sexual abuse during childhood.⁴
• Self-harm: Self-harm, such as head-banging, self-mutilation, or starving, are common forms of repetition compulsion for abused children.³ Adults may also repeat these types of self-destructive acts, which can be seen as a behavioral form of repetition compulsion trauma.
• Re-victimization: Research is consistent that re-victimization is common for survivors of trauma. Particularly for victims of sexual trauma, repetition compulsion can occur through prostitution or other abusive sexual relationships.⁵
• Re-enacting trauma on anniversary: Some research has found incidences where individuals compulsively repeat their trauma on the anniversary of the event.³
  This repetition compulsion may be treated through insight-oriented therapy to integrate the traumatic event into an individual’s understanding of their current life.
• Trauma bonding: One interpersonal sign of repetition compulsion trauma is when individuals trauma-bond. Trauma bonding occurs when the individual forms an attachment to the person who is actively abusing them.³

Repetition Compulsion Causes

There is no single cause of repetition compulsion, but researchers agree that repetition compulsion tends to happen at an unconscious level. One theory suggests that they are an attempt to gain mastery over a past traumatic event in an effort to understand why or how it happened. Alternatively, repetition compulsions can stem from attachment issues or obsessive-compulsive disorder (OCD) compulsions.

Some potential causes of repetition compulsion may include:

• Unconscious patterns: Sometimes, people develop certain patterns to cope with intense stresses or traumas. When these patterns are repeated once the trauma or stressful event has ended, they can be viewed as trauma re-enactment or even a form of self-sabotage. For example, someone who once got stuck in an elevator may now refuse to use anything but the stairs.
• Obsessive-compulsive disorder (OCD): Some individuals with a diagnosis of OCD who have also suffered previous traumas may find that their repetition compulsions are connected to their OCD compulsions that stem from obsessions. For example, an individual who choked on food as a child may develop a compulsion to always cut food into very tiny pieces before eating.
• Attachment issues: Sometimes, individuals may develop insecure attachments with their caregivers. Because caregivers are supposed to be a child’s safe space, these children may grow into adults with attachment disorders who seek out relationships that are abusive or partners who are narcissistic, in some way mimicking their experiences as children.³
• Childhood sexual trauma: Someone who experiences sexual trauma as a child, such as parental or sibling sexual abuse, may seek experiences as an adult that mimic the abuse. For example, they may choose partners who are sexually abusive or occupations that victimize them sexually. It is also important to distinguish that sex work is a valid occupation, and not all sex workers have experienced childhood sexual abuse.
• Surviving a disaster: Some individuals who are victims of natural or man-made disasters may utilize behavioral re-enactments of the trauma.³ They may also re-experience the trauma through symbolic or visual recollections.³
• Proneness to avoidance: Since repetition compulsion happens at an unconscious level, individuals who are prone to avoidance or dissociation may be more likely to develop these habits to cope.¹
• Trauma anniversaries: Some research supports individuals as repeating behaviors related to their trauma on the anniversary.³

Repetition Compulsion Treatment

Seeking treatment for repetition compulsion can help you gain insight into how these unconscious patterns formed. Understanding the “why” behind certain behaviors may help you and your therapist develop a plan for healing from trauma. There are many treatments available for trauma therapy, and it may take some research and patience to find the right treatment for you.

If an individual’s repetition compulsion occurs in their relationship, therapy can create awareness of how you may be replaying your early experiences of trauma in current relationships. Understanding these patterns can improve the quality of the relationships an individual chooses and help them establish healthier boundaries in their relationship.

Some possible treatment options for repetition compulsion include:

• Psychodynamic therapy: Psychodynamic therapy focuses on unconscious motives and offers insights into unresolved past traumas and patterns stemming from them. Through psychodynamic therapy, you will gain insights into how past behaviors are affecting you and learn strategies for overcoming these impulses.
• Trauma-focused cognitive behavioral therapy (TF-CBT): TF-CBT is a short-term therapy generally used to treat children with trauma. Through therapy, the child and parent learn how negative thoughts and emotions, perhaps about previous trauma, result in problematic behaviors.
• Eye movement desensitization and reprocessing (EMDR): EMDR for PTSD is a specialized technique that uses bilateral stimulation to help individuals process and integrate traumatic memories.
• Trauma-informed care: Trauma-informed care focuses on the question, “What happened to you?” rather than “What’s wrong with you?” The principles of trauma-informed care include safety, choice, collaboration, trustworthiness, and empowerment, which guide how a provider interacts with patients.
• Exposure-response prevention (ERP): ERP can help repetition compulsion behaviors, especially if your compulsions are rooted in OCD-related obsessions. ERP teaches the individual to slowly increase their tolerance for situations that cause distress while avoiding the impulse to utilize compulsions to regulate anxiety.

How to Cope With Repetition Compulsion

Coping with repetition compulsion will likely involve developing insight into when these behaviors started, what triggers them, and replacing them with healthier ways to cope. Developing insight is a key approach to repetition compulsion because it is often an unconscious behavior. Building self-care strategies to keep your mental and emotional health stable can help prevent the risk of repetition compulsion.

Here are some coping strategies for repetition compulsion:

• Journaling: Journaling for trauma can help repetition compulsion trauma by uncovering insights around patterns of the behavior. You can utilize prompts focused on healing from trauma to help foster these insights and review what you write with a counselor who can help you understand these patterns in behavior.
• Meditation: Meditation for PTSD can help provide a stable baseline for mental and emotional health, better equipping your mind and body for dealing with external stressors without using compulsions. Meditation can help you feel more in control around “pressing pause” before engaging in impulsive behaviors, like repetition compulsion.
• Yoga: Trauma-informed yoga can also help facilitate a strong mind-body connection. Trauma-informed yoga focuses on helping establish safety in your body so that you feel less need to use self-destructive behaviors like repetition compulsion.
• Learning about attachment style: If your repetition compulsion is centered around unhealthy relationships with others, learning about your own attachment style can help you understand why you may be attracted to abusive patterns. Instead of actions centered on self-sabotage, you can learn how to pursue secure attachment in relationships.
• Affirmations: Some people find relief in using positive affirmations. You can use affirmations related to the type of life you would want to live outside of your trauma.
• Using compassion-focused strategies: Repetition compulsion can sometimes cause feelings of shame when you feel you aren’t able to break free from your patterns of behavior. Approaching yourself with compassion when you repeat behaviors can help you avoid ruminations and step into adaptive approaches to healing.
• Tracking: Once you are aware of certain repetition compulsions, using a tracker can help you see just how often these behaviors are occurring. It may also help you track certain people, places, or situations which trigger your compulsions.
• Mindful breathing: Mindful breathing can help as a preventative strategy, but can also be used in moments of impulse before engaging in a compulsion. Mindful breathing can help emotional dysregulation by creating some space between your urge to use the compulsion.

Where to Seek Professional Help

If repetition compulsion is affecting your professional and personal life, it can be important to find a therapist. You may wonder how to choose between a therapist, counselor, or psychologist. When you make that first contact, you can ask questions regarding the best course of action for your particular needs. If leaving the house seems overwhelming, you may want to use an online therapist directory.