Racker and Heimann on Countertransference: Similarities and Differences.

Both Sigmund Freud and Melanie Klein recognized the existence of countertransference but distrusted its clinical use. This idea was the one that prevailed until the late 1940s, when Heinrich Racker in Buenos Aires and Paula Heimann in London played decisive roles in reinstating countertransference. More specifically, both Racker (in 1948) and Heimann (in 1949), independently of and without contact with each other, claimed the importance of countertransference for signifying the transference and unconscious processes that the patient re-enacts in the analytic relationship.

Effectiveness of dabrafenib in the treatment of patients with BRAF V600-mutated metastatic melanoma in a Named Patient Program.

Given the approval of dabrafenib in patients with BRAF-mutant metastatic melanoma, a better understanding of treatment patterns and clinical outcomes with dabrafenib in a clinical setting is warranted. We performed a retrospective chart review of patients who received dabrafenib in a compassionate use setting through the Named Patient Program (DESCRIBE I study) during December 2010-August 2013 in Europe, New Zealand and Australia. Of the 331 Named Patient Program patients included, the majority (95.

Coordinated epigenetic remodelling of transcriptional networks occurs during early breast carcinogenesis.

Background: Dysregulation of the epigenome is a common event in malignancy; however, deciphering the earliest cancer-associated epigenetic events remains a challenge. Cancer epigenome studies to date have primarily utilised cancer cell lines or clinical samples, where it is difficult to identify the initial epigenetic lesions from those that occur over time. Here, we analysed the epigenome of human mammary epithelial cells (HMEC) and a matched variant cell population (vHMEC) that have spontaneously escaped senescence and undergone partial carcinogenic transformation.

Lineage specific methylation of the Elf5 promoter in mammary epithelial cells.

Recent characterization of mammary stem and progenitor cells has improved our understanding of the transcriptional network that coordinates mammary development; however, little is known about the mechanisms that enforce lineage commitment and prevent transdifferentiation in the mammary gland. The E-twenty six transcription factor Elf5 forces the differentiation of mammary luminal progenitor cells to establish the milk producing alveolar lineage. Methylation of the Elf5 promoter has been proposed to act as a lineage gatekeeper during embryonic development.

Do unconscious processes affect educational institutions?

In this article I discuss the way that aspects of school and teaching have unconscious roots. Where anxiety about the process, for teachers and children, is high then there is the risk that unconscious defensive processes may occur resulting in institutionalized phenomena. These take the form of cultural attitudes and common practices which may not necessarily enhance the work and in some cases may actively interfere.

Aberrant de novo methylation of the p16INK4A CpG island is initiated post gene silencing in association with chromatin remodelling and mimics nucleosome positioning.

Changes in the epigenetic landscape are widespread in neoplasia, with de novo methylation and histone repressive marks commonly enriched in CpG island associated promoter regions. DNA hypermethylation and histone repression correlate with gene silencing, however, the dynamics of this process are still largely unclear. The tumour suppressor gene p16(INK4A) is inactivated in association with CpG island methylation during neoplastic progression in a variety of cancers, including breast cancer.

Breast cancer epigenetics: normal human mammary epithelial cells as a model system.

DNA hypermethylation and histone modifications are two critical players involved in epigenetic regulation and together play an important role in silencing tumor-suppressor genes in all cancers, including breast cancer. One of the major challenges facing breast cancer researchers is the problem of how to identify critical genes that are epigenetically silenced early in cancer initiation as these genes provide potential early diagnostic and/or therapeutic targets for breast cancer management. This review will focus on compelling evidence that normal Human Mammary Epithelial Cells (HMECs) that escape senescence in culture mimic genetic and epigenetic events occurring in early breast cancer, and provide a valuable system to delineate the early steps in epigenetic deregulation that often occur during transition of a normal breast cell to a premalignant cell.

Group therapy as psychic containing.

This article will examine how the psychoanalytic idea of containing can be used in group therapy to form a conceptual bridge such that the group dynamics are not simplistically reduced to individual dynamics, nor that the individual is lost in the "group-as-a-whole" concept. I take the concept of "containing" as versatile in the sense that Bion (1970) meant it to be-that is, the psychological phenomenon of containment is manifest at various system levels: intrapsychic, interpersonal, group, and societal. This article will explore how far this "bridging concept" can be pursued to understand groups theoretically.

Repression and splitting: towards a method of conceptual comparison.

An attempt is made to compare two psychoanalytic concepts which by 'belonging' to different psychoanalytic groups have come to be defined and used differently. The paper is also an inquiry into the possibility of a comparative psychoanalytic method. The two concepts are 'repression' and 'splitting of the ego' and an examination is made of the semantic similarities and differences.

The Kleinian theory of therapeutic action.

The author distinguishes three types of change seen in patients over the course of a psychoanalysis, noting that analysts are most interested in the type that occurs uniquely as a result of the analysis itself. He discusses Freud's views on the analytic relationship and contrasts these with the way the relationship is conceptualized within object relations psychoanalysis, and he compares Freudian views of transference and countertransference with Kleinian ideas. The use of interpretation is also examined from different theoretical viewpoints.

Melanie Klein and countertransference: a note on some archival material.

Five pages of notes were found in the Melanie Klein Archives at the Wellcome Library that concern her views on countertransference in 1953. Because of the paucity of references to countertransference in Klein's published writings these Notes fill in out knowledge. Her views were provoked by the work her students were doing in their experimental analyses of schizophrenic patients.

Concordant epigenetic silencing of transforming growth factor-beta signaling pathway genes occurs early in breast carcinogenesis.

Human mammary epithelial cells (HMEC) grown under standard cell culture conditions enter a growth phase referred to as selection, but a subpopulation is able to escape from arrest and continue to proliferate. These cells, called post-selection or variant HMECs, may be derived from progenitor cells found in normal mammary epithelium that subsequently acquire premalignant lesions, including p16(INK4A) promoter hypermethylation. Epigenetic silencing of tumor suppressor genes through DNA methylation and histone modification is an early event in tumorigenesis.

Telomere-driven karyotypic complexity concurs with p16INK4a inactivation in TP53-competent immortal endothelial cells.

Critically short telomeres promote chromosomal fusions, which in TP53-defective cells initiate the formation of cytogenetic aberrations that are typical of human cancer cells. Expression of the enzyme telomerase stabilizes normal and aberrant chromosomes by maintaining telomere length. However, previous investigations, including our own, have shown that overexpression of telomerase reverse transcriptase (hTERT) does not prevent net telomere shortening in human endothelial cells.

Epigenetic remodeling in colorectal cancer results in coordinate gene suppression across an entire chromosome band.

We report a new mechanism in carcinogenesis involving coordinate long-range epigenetic gene silencing. Epigenetic silencing in cancer has always been envisaged as a local event silencing discrete genes. However, in this study of silencing in colorectal cancer, we found common repression of the entire 4-Mb band of chromosome 2q.

Melanie Klein and Repression: an examination of some unpublished Notes of 1934.

Fifteen pages of unpublished Notes were found in the Melanie Klein Archives dating from early 1934, a crucial moment in Klein's development. She was at this time, 1934, moving away from child analysis, whilst also rethinking and revising her allegiance to Karl Abraham's theory of the phases of libidinal development. These Notes, entitled "Early Repression Mechanism," show Klein struggling to develop what became her characteristic theories of the depressive position and the paranoid-schizoid position.

Abusive help-- helping abuse: the psychodynamic impact of severe personality disorder on caring institutions.

Personality-disordered patients have invariably suffered abuse at the hands of carers when young, and they tend to repeat an abusive relationship when they encounter care in later life. The provision of care in psychiatric, forensic, penal and other institutions may degenerate into a form of unconscious abuse perpetrated against those in care. This is almost always unrecognized and the experience of carers is often to mismanage their own frustrated inability to understand what is happening to them, their charges and the institution.

The elusive concept of 'internal objects' (1934-1943). Its role in the formation of the Klein Group.

The author traces a debate about the concept of 'internal objects' that took place between 1937 and 1943 at a time when a group of British analysts was forming around Melanie Klein. The debate is set within a complex of personal, group and organisational dynamics, which the paper makes a start on unravelling. The history of the British Psycho-Analytical Society at this time exemplifies Bion's notion of group schism.

Severe personality disorders. Treatment issues and selection for in-patient psychotherapy.

Background: Severe personality disorder (SPD) is an imprecise but useful term referring to some notoriously difficult to treat psychiatric patients. Their long-term psychiatric treatment is often unsuccessful, in spite of hospitalisation. The specialist expertise of in-patient psychotherapy units (IPUs) can successfully meet some of SPD patients' needs.

[The difficult concept of "internal objects" (1934-1943). Its significance for the formation of the Klein group].

Although the concept of "inner objects" developed by Melanie Klein is hardly a major object of discussion today, it caused a furore in the ranks of the British Psychoanalytical Society in the thirties and forties. Notably the analysts from Vienna were unable to agree to the existence of inner objects engendered via processes of internalisation. The author traces the course of these discussions of a clinical problem and the confusion they caused, placing them at the same time in a specific historical context.

Psychoanalysis in Britain: points of cultural access, 1893-1918.

An attempt is made here to organise a body of facts available in the published literature concerning who, when and why Freud and his ideas were first noticed during the early years of psychoanalysis. Specific citations and references mentioning Freud reveal a surprisingly wide range of different kinds of cultural interest. In fact, we can identify seven different cultural locations which adopted some element of the ideas of Freud for specific reasons: (i) the interest in the theory of hysteria, from the Society for Psychical Research, commencing in 1893; (ii) the interest in the psychoanalytic theory of sexuality, from Havelock Ellis, from about 1895, in support of radical attitudes towards sexual freedom; (iii) as part of the reaction against the pessimistic attitude to treatment in British psychiatry, from around 1905 onwards; (iv) the endeavour of W.