The most classic intervention of psychoanalysis—to give the patient an intelligent, well-thought out interpretation of why he does what he does—is depressingly ineffective in resolving a patient's self-destructive repeating. This is because an interpretation speaks to the patient's cerebral cortex, where cognition, logic, reason and ethics reside. But the cerebral cortex is also the smallest part of the human brain—it has practically no influence or control over the more primitive parts of the brain where the repetition compulsion is created.

The repetition compulsion is established in our infantile brains before the cerebral cortex has developed enough that we can remember, or even think.  Long before a baby can speak, his brain is very, very busy learning about the way the world works. Neural pathways are being established that will affect how he sees the world for the rest of his life. 

The child won't remember these impressions. He will just experience them as reality; i.e., I must get a dangerous man or a woman who is incapable of love to love me.

Meanwhile, the psychoanalyst’s interpretation and explanation of the patient’s compulsion is almost always experienced as an attack—especially if it is correct. Defenses fly up, and the explanation is rejected. 

But modern psychoanalysts have developed techniques that can break the back of the repetition compulsion. They direct their patients to "just say everything," and then they speak only when spoken to while the patient tells his story. This encouragement and acceptance of talking without intruding creates a safe environment where the patient has no need to mobilize his defenses against a brilliant interpretation.

Language resides in the cerebral cortex, and so while the patient is putting everything into words, he is strengthening this most evolved part of the brain—thus giving it increasing control over the primitive parts of the brain where the repetition compulsion resides. When a modern analyst does speak, he doesn't make an intellectual interpretation, but a well-timed emotional communication. So instead of saying, “Your relationship with your boyfriend is just a repetition of your longing to get your abusive father to love you,” a modern analyst might say, “I want you to get rid of that guy and find a kind, loving man who thinks everything you do is wonderful!” 

This kind of intervention, delivered after trust has been established in the analytic relationship, is laced with powerful feeling, and so it speaks to the deeper parts of the brain where feelings are generated.  It deactivates the neural pathways that created the repetition compulsion, and activates new neural pathways which will allow the patient to make better choices in his life. 

The repetition compulsion may be remarkably immune to reason and insight, but emotional communication has the power to rewire the brain.

To learn more about the repetition compulsion, 
read Dr. Holmes's latest book, Wrestling With Destiny,
and watch her presentation at the 2013 CMPS Annual Conference:
"The Role of Free Association in Resolving Repetitions."

Psychoanalysis is the best solution to this problem. A good analysis can literally rewire the brain in a way that can help the patient learn to make better choices in their love life. A patient of mine, who is going through a painful divorce and who has been talking about how she has chosen the wrong partners again and again, said this about it: 

This woman is ready for a new kind of relationship.

For those who don't have the inclination or the money to begin a long term analysis, there are several things to keep in mind to help a troubled marriage:

• Work on improving your fights with your spouse. Only one person is allowed to shout at any given time. If your mate is screaming, try to listen till he or she is finished. Then repeat what your partner has just said without screaming. 
  
  

• Forget being honest. I shudder when people tell me they are always scrupulously honest with their marital partner. A long term marriage is going to produce plenty of feelings that should not be communicated. You can know that you feel bored with your husband or wife, that you don't like that he or she is older or fatter than they used to be, but nothing good can be gained by being honest about it. Know what you are feeling at all times, but only communicate what will be good for the relationship. 

Yet after working with psychoanalytic patients for many years and carefully studying my successes and my failures, I can say with some conviction that saying everything is the key to a successful analysis and a satisfying life. Patients who are good talkers are the ones who get better.

Does this idea ring true in your own experience? Does talking with others about a problem you have, rather than impulsively going into action to solve it, improve your chances of finding constructive solutions to life’s challenges? If, on reflection, you find that talking things out, inserting words between your impulses and your actions, helps you make better decisions, why do you think that is so? Why is talking such a useful tool?

Most people who are unhappy with their lives are being controlled by their own primitive impulses and feelings. They get angry or anxious or sexually attracted to the wrong person, and that causes them to go into action which is self-destructive. They make a bad marriage, lose a job, destroy their relationships with their children because they are being ruled by their own out-of-control feelings.

In these unhappy people’s lives, there is no real thought or consideration between the impulse and the action. This makes for a life that is unsatisfying at best, and, more often, bleak or chaotic. Do you know people like this---people who don’t really talk very much, but instead take drugs, kick the dog, indulge in self-destructive sex, disappear from relationships? People like that are compulsive. They’re not steering their own ships but instead are being controlled by their primitive impulses. 

Talking about things in therapy disrupts that compulsive process. It delays going into action which may be self-destructive. It puts the higher levels of the brain, where logic and reason reside, in control of the more reptilian parts of the brain, where our sexual and aggressive drives are created. Talking actually strengthens the higher levels of the brain in a way that begins to give the talker control over his life. He (or she) may still have primitive impulses and feelings, but they no longer control his life.

And as he strengthens the more evolved parts of his brain by putting all thoughts and feelings into words before making any decision or taking any action, he actually takes charge of his own destiny.