Play it again Sam

The Pleasure Compulsion

The Freudians use the term repetition compulsion to describe "the mind's tendency to repeat traumatic events in order to deal with them. "1 Another Freudian term, the pleasure principle, describes the need of the infant to seek gratification.2 In adults, this would be called the "production of pleasure". 3 So what happens when we combine these concepts, and what shall we call this phenomenon? Well, for lack of a better term, I call it the pleasure compulsion, or the tendency to repeat the same pleasurable experience over and over again in an attempt to ameliorate trauma.

You can see the pleasure compulsion acted out beautifully in the movie Casablanca. Ingrid Bergman is feeling the pain of loss and it makes her feel better to hear a certain piano piece played by Sam. It is the pleasure compulsion which prompts her to wistfully say, "Play it again Sam".

The pleasure compulsion can be harmless in some people and in others it can jump start the addictive process. For example, as far as I know, Ingrid Bergman never got in trouble listening to the same song over and over again. However, if you hang around addicts long enough you will hear them talk about how their addiction started when they "used" to manage their painful emotions. "My mother didn't love me very much and I turned to food", says the compulsive overeater. "I didn't make the football team in high school and I kept going out and getting drunk", says the alcoholic.

Of course, not everyone has the pleasure compulsion. Many people who seek pleasure to dissipate anything from sadness to boredom will move on to other mood-altering experiences - they like variety. Others, however, like routine. For them, the pleasure compulsion not only exists, it gets out of control. Take the child who is rebuffed by her classmates and eats a cookie to comfort herself. The next morning she wakes up and remembers the pain. She could do a variety of things to distract herself from the sadness (or shame), but for some reason this child remembers how good the cookie tasted and she makes her way to the kitchen. Trauma, pleasure, and repetition become locked. Not just trauma and pleasure; that would not lead to addiction. It is the repetition factor that can change this child's life forever. If it is strong enough she could end up a food addict.

The pleasure compulsion is seductive and it may be linked to the desire for control. There is no trial and error necessary when you are doing something for the second or third time. Whatever worked before is guaranteed to work again - or so we think. Unfortunately, many mood-altering experiences become a magnet for problems. Food lovers get overweight. Heavy drinkers get DUIs. Gamblers lose their pay checks. Then there is the increased tolerance phenomenon. It takes more and more of the experience to get the desired affects - more food, more alcohol, more trips to Reno. This is the nightmare of addiction. The mood-altering experience becomes a problem, but you are hooked.

So why do some people comfort themselves with a variety of experiences and others get locked into a routine of reenacting one or two mood-altering experiences? Can there be a physiological explanation? Many people think so. In his book Emotional Intelligence4 Daniel Goleman discusses at length the relationship between the brain and the repetition compulsion. It's all in the amygdala he explains. The pleasure principle is probably physiological as well, or it would not be so evident in infants. It is not much of a leap, then, to see the pleasure compulsion as a brain function also.

Whatever causes the pleasure compulsion, it is developed by other factors. For instance, if our role-models are addicts, we see routine as the norm and follow their example. Daddy drinks every time he gets sad. His children follow in his footsteps even though they might get addicted to some other kind of experience or substance. In addition, accessibility must be factored in. One of my clients turned to food repetitively because it was the only thing available. Her father was an alcoholic but the liquor was locked up in the basement. She was not allowed to have friends or go out to play. All she could do was eat and read books in her bedroom. Needless to say, today she is a food addict and never leaves the house. "I like to stay home", she says, "It makes me feel good". Of course, she also eats too much during those quiet moments alone.

Why is it helpful to understand the pleasure compulsion? Well, for one thing, it helps explain why the drug addict, long after he has gone through a physical withdrawal, has a relapse. This is discussed in Craig Nakken's book The Addictive Personality: Roots, Rituals and Recovery.5 It also makes clear that addicts, with their predisposition to routine, are well advised to substitute a healthy routine for a new one. This is why 12-Step programs are so successful. They replace their negative routines with positive ones. Take my case, for example. I was in therapy for years to analyze why I was an alcoholic and food addict, but because of the pleasure compulsion I couldn't stop acting out. Then I got into the routine of going to 12-Step meetings, socializing with my new 12-Step friends, and working the 12 steps (self-improvement). Before I knew it, my self-destructive habits had disappeared. I had replaced bad habits with good habits.

I see people with overactive pleasure compulsions grouped into two camps. First of all, there are the addicts who have abused a mood altering experience and can never engage in it again. Bill Wilson puts it this way in the book Alcoholics Anonymous: "Physicians who are familiar with alcoholism agree there is no such thing as making a normal drinker out of an alcoholic. Science may one day accomplish this, but it hasn't done so yet". 6 Then there are those addicts who can successfully fight the pleasure compulsion and engage in a little of everything without getting hooked on anything in particular. This is where the battle lines are drawn in the world of substance-abuse treatment. There are those who believe you can train yourself to fight the pleasure compulsion through moderation, and then there are those who believe you can never engage in certain mood-altering experiences without risking relapse. Even some 12-Step programs are divided on this issue. In Alcoholics Anonymous any alcohol consumption at all is a relapse, while in Overeaters Anonymous some people believe you have to give up certain "trigger" foods forever and others don't.

I won't take sides on this issue of abstinence versus moderation except to say "different strokes for different folks". We each, through trial and error, must find the treatment program that works for us. However, whatever form of treatment an addict seeks, he is well advised to admit he has an overactive pleasure compulsion. Remember: "To know oneself makes for power, self-control and success. Individuals encounter difficulty in life because they do not fully comprehend their abilities, limitations or the full range of their personalities. They need a psychological mirror enabling each person to see the self as it really is, including its strengths, weaknesses, and potentialities". 7 Furthermore, those people who choose to moderate must also be vigilant and make conscientious choices that will protect them against the seductive quality of the pleasure compulsion. Let me put it this way, whether you are a snake handler or walk the other way when you see a dangerous reptile, be careful.

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