Psychiatry in the ER

The driving force of so many of our self-destructive tendencies is not conscious, it’s an unconscious drive called the repetition compulsion, where we try to reenact early child traumas or deficits, often consciously hoping for a different result but unconsciously walking directly and knowingly into the flames. One of the central tasks of therapy is often helping people identify their repetition compulsions and doing the deeply uncomfortable work of making different choices. For the repetition compulsion feels right, at the deepest levels of being, because it was wired into us during early childhood. Self-destructive decisions smell like home cooking, they are the blue light that draws in the unsuspecting moths over and over and over, even when they see what’s about to happen.

Here Dr. H's patient Katey describes how early emotional neglect and toxic parental modeling led her down a path of almost two decades of self-destruction, with an ongoing battle between her healthier and more resilient parts and her wounded repetition-seeking masochistic parts. Who would choose superficially “sweet” boys with good drugs and little emotional connection....why Katey would, and did, and this is her story of why she did that for so long and how she eventually broke free.
Bringing Therapy into Med Management-- An intensive training with Dr. H
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