Repetition compulsion is a psychodynamic concept that explains an attempt to master trauma. This case study attempts to understand the possible meanings of symbol repetition that occurred in the art therapy process of a twelve-year-old boy with acute methylmalonic acidemia. Over 29 sessions of art therapy, the client demonstrated repetition through themes of struggles, calls for help, entombment, and a woman superhero. This recurrence seemed to relate to resolving trauma, gaining power, regulating anxiety, and seeking a savior.