Thinking about encountering masochism/masochistic elements in analytic practice in the Kleinian tradition then and now.

Masochistic elements are puzzling entanglements for most of us in the beginning. Taking Melanie Klein's attempts to think about them thus show one way how to make sense of them. Starting from her struggles with masochistic symptoms in child analyses in the early 1920ies Melanie Klein tried to conceptualize those experiences in a way that could help to fact them in the analytic process. In this article the development is outlined, the move from thinking about them in libidinal terms to gradually grasping in greater depth their destructive quality. She speaks of an "evil principle" and then finds a conclusive solution in conceptualizing masochism as a representation of the death drive. In the next decades her followers would further work on the complexities of the countertransference issues and superego organizations in masochism in more detail as will be shown. Finally, a look in a piece of present analytic work will exemplify the clinical usefulness of the Kleinian conceptualization.

Psychoanalytic training in the Eitingon model and its controversies: A way forward.

Psychoanalytic training has been an object of controversy for many years. Arguments have been intense about the details, sometimes called "requirements", and particularly over whether or not training institutes should have routine external validation. We describe these arguments and present preliminary conclusions about the core challenges psychoanalytic trainings face using a unique set of detailed observations collected during structured "conversations" inside nine European institutes. We conclude that whether a psychoanalytic training is "working" is not a matter of compliance with requirements. Rather, it is an issue of how candidates, training analysts, supervisors and committee members, confront within and between each other the consequences of the unconscious dynamics that psychoanalytic training must inevitably create. Institutional psychoanalytic capacity is to take itself as the object. Consequentially, we propose that training committees that seek to claim that their psychoanalytic training is genuinely and safely producing psychoanalysts would be ones that institute routine procedures to show to themselves, transparently, how they attend to the dynamics just mentioned and how they take a neutral inquisitive stance towards them. Fear of oversight, we suggest, is a symptom of deeper anxieties. They can be faced by creating an appropriate setting. Properly conducted visits from outsiders are welcomed.

Step-by-step monitoring of a magnetic and SERS-active immunosensor assembly for purification and detection of tau protein.

We report a bottom-up synthesis of iron oxide and gold nanoparticles, which are functionalized and combined to form a nanohybrid serving as an immune sensor, which selectively binds to tau protein, a biomarker for diagnosis of Alzheimer's disease. Detection of the target analyte is achieved by surface-enhanced Raman scattering originating from the diagnostic part of the nanohybrid that was prepared from Au nanoparticles functionalized with 5,5'-dithiobis-(2-nitrobenzoic acid) as a Raman reporter and monoclonal anti-tau antibody. The magnetic part consists of Fex Oy nanoparticles functionalized with polyclonal anti-tau antibody and is capable to separate tau protein from a complex matrix such as cerebrospinal fluid. We further identified and validated a set of analytical tools that allow monitoring the success of both nanoparticle preparation and each functionalization step performed during the assembly of the two binding sites by an immune reaction. By applying UV/Vis spectroscopy, dynamic light scattering, zeta potential measurements, X-ray diffraction, small-angle X-ray scattering, and transmission electron microscopy, we demonstrate a proof-of-concept for a controlled and step-by-step traceable synthesis of a tau protein-specific immune sensor.

Comparison of potential higher order reference methods for total haemoglobin quantification-an interlaboratory study.

The total haemoglobin (Hb) concentration in blood is one of the most frequently measured analytes in clinical medicine because of its significance for evaluating the health state of a human. The spectrophotometric cyanmethaemoglobin (HiCN) method is the internationally accepted conventional reference method to determine this biomarker. It is frequently used in clinical routine diagnostics but is not traceable to the International System of Units and thus does not meet highest metrological demands. A further critical issue is the toxicity of the necessary potassium cyanide. Different methods to solve these problems are reported here. They all were validated against the HiCN method in an interlaboratory comparison by measuring the total Hb concentration present in the certified reference material JCCRM 912-2M. Methods considered were the spectrophotometric alkaline haematin detergent (AHD) method as well as several isotope dilution (ID)-based approaches. The latter include inductively coupled plasma mass spectrometry (ICP-MS), species-specific (SS) ICP-MS, organic MS and Raman spectrometry. Graphical abstract ᅟ.

[Herbert Rosenfeld in Germany: on the seducibility/corruptibility by the idealization of destructive elements then and now]. / Herbert Rosenfeld in Deutschland: Zur Verführbarkeit/Korrumpierbarkeit durch die Idealisierung destruktiver Elemente damals und heute.

In connection with a conference in memory of Herbert Rosenfeld in 2014 in his home town Nuremberg, from which he had to flee in 1935, the author did some research on this outstanding, later British, psychoanalyst in Germany. The first results are presented here. How the first contacts came about remains unclear but a few of his articles were published in German from 1955 and in the 70's he held occasional seminars in Munich. His contacts with colleagues from the DPV at the end of the 70's and the beginning of the 80's (until his death in 1986) seem however to have been the most influential, especially through a supervision group he led. Rosenfeld transmitted a particularly experience-near approach to the patient, which also acknowledged and took seriously (self) destructive elements in the transference and countertransference. In the following years and decades a number of colleagues wished to deepen this approach. How this line was further developed is illustrated in outlining G. Appy's clinical description of intrusive speechlessness. Rosenfeld's ideas on the pernicious effect of idealizing destructive elements are especially stressed as they contributed to thinking about the entanglements with Nazi Germany, and in addition are still useful in analytical practice, out of which they developed.

[A "clear reaction formation against death drive hypotheses" (Brun 1953): On one strand of the reception of Freud's death drive concept in German-speaking countries]. / Eine "deutliche Reaktionsbildung gegen Todestriebhypothesen" (Brun 1953): Ein Strang der Rezeptionsgeschichte von Freuds Todestriebkonzept im deutschen Sprachraum.

If the death drive hypothesis is understood as a possible concept for self-destructive clinical phenomena, one can state that before World War II a number of analysts took it up quite naturally, while others raised objections. After the break caused by the Nazi regime the situation suddenly changed. Brun's formulation, quoted in the title of this paper, was a non-intended, but accurate diagnosis of a certain strand in the history of the reception of Freud's death drive concept in the time before, but even more so in the first decades after, 1945. The author takes it as a symptom that for decades there was an uncritical acceptance of Brun's "critical", though in fact biased, study which claimed that the death drive hypothesis was and continued to be refuted in every respect. Taking the example of a few protagonists of the postwar period, she sees hints of an initial lively and positive interest which was then followed by a (relatively) quick distancing.

On the reception of the concept of the death drive in Germany: expressing and resisting an 'evil principle'?

With Beyond the Pleasure Principle, Freud attempted 'to describe and to account for the facts of daily observation in our field of study' (1920, p. 7), in particular concerning destructive clinical phenomena that confront us in the analytic situation: traumatic neuroses, melancholic states, negative-therapeutic reactions, masochism, repetition compulsion and so on. The author demonstrates in the first section how Freud's own resistance - later self-diagnosed - to recognizing these unwelcome facts was expressed in the terminological and conceptual ambiguities of the death drive hypothesis then introduced, ambiguities that to some extent continue to impede the reception of its clinical usefulness to this day. As soon as Freud had demonstrated the connection with clinical practice more directly in The Ego and the Id (1923), some contemporaries adopted it as a helpful clinical concept, while others believed that they could (and must) refute it. The second part outlines its reception in the 1920s and 1930s, which was part of an international discussion that was, of course, initially conducted mainly in German. The beginnings of an important further development of the death drive hypothesis are described in a separate section because it originated from Melanie Klein's earliest experiences in analysing children in Berlin in the early to mid-1920s. She referred at that time to an 'evil principle', and in 1932 published her view of the death drive hypothesis, which was further developed in subsequent decades by her and her followers in London. In this period, conditions changed dramatically: in Germany Freud's books (among others) were burnt, crimes against humanity were instigated and psychoanalysis ceased to exist in this country. Almost all the analysts who published on the death drive had to emigrate. From then on, entirely different discourses took place in the various regions. In Germany, the death drive hypothesis was (largely) disregarded or rejected for decades after the Holocaust. Frank demonstrates how the uncritical recourse in relevant works to this day to an article by Brun in 1953 that considered the death drive to have been comprehensively refuted on the basis of (apparently) comprehensive literature research can be understood as a symptom. Pursuing some reflections by Beland (1988) and Cycon (1995), the author expounds her thesis that in Germany the clinical usefulness of the death drive hypothesis could not be considered as long as destructive impulses were still an immediate social reality. According to the author's observations, in stating that there had been a 'definite reaction formation against death drive hypotheses', Brun had unintentionally made an accurate diagnosis. It was not until the realization of inevitable perpetrator identifications ('Hitler in us') in this country became (more widely) possible that a concern with the death drive hypothesis could also resume. In the final section, the author takes up one line of this development and traces how some German analysts in the 1980s came into contact with Kleinian developments that had since occurred and how these found and find their way into their analytic working. She closes by asking whether it might be appropriate to consider Melanie Klein's concept of an evil principle - along with the pleasure and reality principles - as a less ambiguous one for the phenomena under consideration.

Improving species-specific IDMS: the advantages of triple IDMS.

Triple isotope dilution mass spectrometry (triple IDMS) has been applied for the first time on protein quantification, especially on transferrin. Transferrin as an acute phase protein is a marker for several inflammation processes in the human body. Therefore, in Germany, the accurate and precise measurement of this important analyte is required. In this work, a new approach to triple IDMS is described and compared to double IDMS. Also, complete uncertainty budgets for both methods were set up to demonstrate the ability of this method to be used as a reference procedure. The relative expanded uncertainty (k=2) for triple IDMS (3.6 %) is smaller than the one for double IDMS (4.0 %). The content of transferrin found in the human serum reference material ERM-DA470k/IFCC ((2.41±0.08) g/kg) with both methods was in good agreement with each other and with the certificate. For triple IDMS ((2.426±0.086) g/kg) and for double IDMS ((2.317±0.092) g/kg), transferrin was determined. Although triple IDMS is a little more time consuming compared to double IDMS, there is the advantage that the isotopic composition of the spike material does not have to be determined. This is very useful especially in case of a marginal isotopic enrichment in the spike or problems with the accurate measurement of the spike isotope ratio.

Reference measurement procedures for the iron saturation in human transferrin based on IDMS and Raman scattering.

Two reference measurement procedures are presented here that allow the determination of the iron saturation in human transferrin, based on different molecular properties. The results, directly derived from the number of ions bound to the protein molecule, are traceable to the SI. Up to now, the iron saturation has only been deduced indirectly from the amount-of-substance ratio of serum iron to transferrin in serum. Interlaboratory tests have shown the need for more accurate methods, as the results from many participant test samples for both parameters do not lie within the acceptable range of deviation given by relevant guidelines when different methods or kits are applied. Using isotope dilution, an HPLC ICP-MS procedure was developed in compliance with the requirements of a primary reference measurement procedure. In this manner, the iron saturation was measured with an associated relative expanded measurement uncertainty of 4%. Based on the results, a straightforward Raman procedure was evolved, which allows the determination of the iron saturation in transferrin with an associated relative expanded uncertainty of 7%.

["Is it an animal inside? "Melanie Klein's unpublished Don Juan Paper (1939)]. / "Ist es ein Tier im Inneren? "Melanie Kleins unpubliziertes "Don Juan Paper" (1939).

Klein had been asked to contribute an article to the birthday number of the International Journal for Jones. The author outlines how she hurriedly wrote a text about Don Juan which, however, was rejected by the editor. Essential parts of it are presented in German translation. The manuscript is discussed in the context of Klein's published work as well as of the relevant contemporary literature. In Klein's view, Don Juan's genitality is determined by oral impulses and fears. By his manic acting out he attempts to ward off a depressive break-down. The paper ends with some reflections about why Klein--ontrary to her intention--failed to revise her manuscript for later publication.

Controlled excitations of the Belousov-Zhabotinsky reaction: Experimental procedures.

The purpose of this research was to explore the unstirred, ferroin-catalyzed Belousov-Zhabotinsky (BZ) reaction as an experimental model for the response of excitable media to small perturbations (slightly larger than the threshold for excitations). Following Showalter et al. (Showalter, K.; Noyes, R. M.; Turner, H. J.Am. Chem. Soc. 1979, 101, 7463-69), we used a positively biased silver electrode to release silver ions into a BZ reaction mixture, removing bromide ions and causing an excitation if sufficient bromide was removed. We found (1) a scaling region in which the delay before activation increased linearly as the size of the perturbation decreased, qualitatively consistent with but not fully explained by the Oregonator of Field et al. (Field, R. J.; Körõs, E.; Noyes, R. M. J. Am. Chem. Soc. 1972, 94, 8649-64); (2) evidence for a 10 s oligomerization time scale; and (3) that activations were always delayed until after the end of a pulse of current, with the delay essentially constant for sufficiently long pulses, an effect not seen in simple ODE models but consistent with the anomalously large current apparently required for activation (Showalter, K.; Noyes, R. M. J. Am. Chem. Soc. 1976, 98, 3730-31) and explainable by bromide transport. Overall, the BZ system appeared to be well-suited as an experimental prototype, despite its complexity.

Spatiotemporal clustering and temporal order in the excitable BZ reaction.

The prototype experimental example of "spontaneous" pattern formation in an unstirred chemical medium is the oscillatory Belousov-Zhabotinsky (BZ) reaction: target patterns of outward-moving concentric rings are readily observed when the reaction is run in a thin layer in a Petri dish. In many experimental runs, new target centers appeared to form closer to pre-existing target centers than expected in a randomized model. Here we describe a simple direct test for the presence of temporal order in the spatiotemporal dynamics of target nucleation, and apply this test to detect significant temporal order in target formation in the ferroin-catalyzed BZ reaction. We also describe how mixing heterogeneity can generate temporal order, even in the absence of heterogeneous physical nucleating centers.

[An unpublished contribution of Melanie Klein "On Reassurance"]. / "Angstberuhigung"--Zu einem unveröffentlichten Beitrag von Melanie Klein "On reassurance" (1933).

Melanie Klein's unpublished paper on reassurance is presented in German translation. The author shows that it was a contribution to Glover's investigation on psychoanalytic technique in the 1930s. The paper is discussed against the background of the technical discussions conducted in London at that time (e. g. M. Schmideberg, J. Strachey) and of Klein's relevant publications. Although Klein consistently considered "correct" interpretation to be the most effective means of reassurance, she occasionally also accepted a non-interpreting approach. In this respect the paper presented here goes further than any other of her writings.

[A psychodynamic approach in counselling vulnerable persons for Chorea Huntington -- a case report]. / Psychodynamisch orientierte Beratung im Rahmen prädiktiver Diagnostik bei Chorea Huntington -- Ein Fallbeispiel.

The availability of predictive testing for neurodegenerative diseases such as Chorea Huntington has far-reaching consequences on psychological, ethical, and legal issues. The special situation of persons vulnerable for the disease requires a comprehensive counselling including psychotherapeutic measures. On the basis of a case report, the authors outline a psychodynamic practice, which intends not only the identification of deliberate arguments and development of coping strategies, but also a clarification of unconscious backgrounds and expectations. In the discussion, the necessity of sufficient time is stressed that allows the reflection of repressed motives in respect of the genetic testing.

Fractionated stereotactic radiotherapy for craniopharyngiomas.

PURPOSE: To investigate outcome and toxicity after fractionated stereotactic radiation therapy (FSRT) in patients with craniopharyngiomas. METHODS AND MATERIALS: Twenty-six patients with craniopharyngiomas were treated with FSRT between May 1989 and February 2001. Median age was 33.5 years (range: 5-57 years). Nine patients received FSRT after surgery as primary treatment, and 17 patients were irradiated for recurrent tumor or progressive growth after initial surgery. Median target dose was 52.2 Gy (range: 50.0-57.6 Gy) with conventional fractionation. Follow-up included MRI and neurologic, ophthalmologic, and endocrinologic examinations. RESULTS: The median follow-up was 43 months (range: 7-143 months). The actuarial local control rate and actuarial overall survival rates were 100% and 100%, respectively, at 5 years and 100% and 83%, respectively, at 10 years. Four patients showed complete response, 14 patients showed partial response, and 8 patients remained stable. In 5 patients, vision improved after radiation therapy. Acute toxicity was mild. One patient required cyst drainage 3 months after radiotherapy. Late toxicity after radiotherapy included impairment of hormone function in 3 out of 18 patients at risk. We did not observe any vision impairment, radionecrosis, or secondary malignancies. CONCLUSIONS: FSRT is effective and safe in the treatment of cystic craniopharyngiomas. Toxicity is extremely low using this conformal technique.