\r\n\tIt is a relatively simple process and a standard tool in any industry. Because of the versatility of the titration techniques, nearly all aspects of society depend on various forms of titration to analyze key chemical compounds.
\r\n\tThe aims of this book is to provide the reader with an up-to-date coverage of experimental and theoretical aspects related to titration techniques used in environmental, pharmaceutical, biomedical and food sciences.
The recent field releases of genetically modified mosquitoes in inter alia The Cayman Islands, Malaysia and Brazil have been the source of intense debate in the specialized press [1, 2] as well as in the non-specialized mass media. For the first time in history (to our knowledge), transgenic Aedes aegypti were released in the Cayman Islands in 2010 by a private company, Oxitec, in collaboration with the local Mosquito Research and Control Unit (MRCU) [3]. The releases were followed by other releases in Malaysia in 2010/11 and then in Brazil in 2011 [4]. While the releases in Malaysia and Brazil were publicised beforehand, the releases in The Cayman Islands were only announced publicly one year after the fact [1, 5]. This lack of transparency, not to say the secrecy, in the way the first trial was conducted is without much doubt the major reason for the controversy that emerged. Brushing aside years of discussion in the scientific world and a shared recognition of the importance to consider ethical, legal and social issues this first trial could be read as a fait-accompli: the cage of transgenic mosquitoes has now been opened [6]. Oxitec faced harsh criticism for these releases, both within the scientific community, as well as from non-governmental organisations, such as GeneWatch that accused the company of acting like “a last bastion of colonialism”. A vector-borne diseases method for control has rarely been the subject of such discussion not even concerning its potential efficacy at reducing the burden associated with a vector-borne disease.
Focusing on malaria control, this chapter reviews the major technological milestones associated with this technique from its roots to its most recent development. Key-points in the understanding of mosquito ecology are going to be presented, as well as their use in models whose major aim is to determine the validity of the transgenic approach and to help designing successful strategies for disease control.
Furthermore, the ethical and social points related to both field trials and wide-scale releases aiming at modifying mosquito populations (and thus controlling vector-borne diseases) are going to be discussed as well as the question of public engagement and the role scientists might play in fostering debate and public deliberation. While large part of the laboratory research is done in the Global North, most of the vector-borne diseases are endemic in the Global South. We suggest that the geopolitics related to the genetically modified (GM) mosquitoes as well as the specificity of Southern contexts needs to be considered when discussing the application of this technology.
When discussing the epidemiology of malaria the gold standard is the description of the R0 [7-9]. Focusing on the vector compartment suggests that the spread of malaria can be curved either by reducing the mosquito population or by decreasing their vectorial capacity. In other words, one either aims to decrease the number of mosquitoes or to make them less efficient in transmitting the parasites. These two strategies can both be addressed by vector control including through a transgenic approach: population reduction or population replacement. However, when looking closely at R0 one can notice that the parameters that are affected by those strategies are not the most likely ones to curve transmission efficiently. The mortality of mosquitoes (µ) and their biting rate (a) are indeed affecting R0 in an exponential and in a quadratic manner respectively. In this respect, they are the parameters whose modifications affect R0 and consequently the human prevalence mostly (see Box 1). This means that modifying a linear parameter is less likely to lead to a drastic change in malaria epidemiology. For example halving the vector population density (m) is going to reduce R0 by two but because of the non-linear relationship between R0 and the human prevalence (y) the decrease of the latter one is not going to be affected in such a manner especially in a context of high transmission.
The Ross-MacDonald model permits to describe R0 which is the number of secondary case arising from a single one in an otherwise uninfected population (Macdonald 1957; Koella, 1991). It permits to determine the relative importance of the different parameters implicated in the transmission of malaria (equation 1). From the R0 value, a simple expression permits to determine the prevalence in the human population (equation 2). As seen on the graph above, only a large decrease in the intensity of transmission (estimated by R0) can affect significantly the human prevalence (y).
The roots of the technology can be traced back to the early 80’s/90’s when the knowledge gained in genetics in Drosophila research sparked the development of new tools in the fight of vector-borne diseases. The plan was straightforward with three milestones to be achieved in a decade: i) the stable transformation of Anopheles mosquitoes by 2000 ii) the engineering of a mosquito unable to carry malaria parasites by 2005 and iii) the development of controlled experiments to understand how to drive this genotype of interest into wild populations by 2010 [10].
Regarding malaria most recent research has concentrated on the development of an Anopheles strain that has the ability to interrupt transmission through the synthesis and production of molecules able to block the development of the parasite. A few years ago, the SM1 peptide was shown to reduce malaria oocysts number by about 80% [11]. More recently, it was synthesised from a transgenic entomopathogenic fungi [12], this later one is by-itself (in its natural version) already considered as a potentially interesting method to develop [13-15]. Other potential solutions currently developed rely on single-chain antibodies [16-18]. Using the φC31 integration system for the first time in An. stephensi it is now possible to insert the transgene of interest in a permanent manner at chromosomal ‘docking’ site using site-specific recombination and to have a tissue- and sex-specific expression. The authors have then shown that the prevalence and number of oocysts decreased when the transgenic mosquitoes were challenged with Plasmodium falciparum [17]. If technology has been able to determine how the insertion of a transgene can be made to change a vector to a quasi non-vector, the next question to answer concerns the spread of this construction in natural populations of mosquitoes.
When the ecological and evolutionary issues related to the potential use and impact of Plasmodium-resistant transgenic mosquitoes started to be discussed about a decade ago [19, 20], most studies aimed at providing information on the fitness of genetically-modified mosquitoes were based on the use of natural mosquito immune responses as a model system. This was mainly driven by the fact that using the natural immune system of mosquitoes in a transgenic approach was considered of some potential interest [21], and also because the only fully effective system against malaria parasite was the melanization response (also known as melanotic encapsulation) in selected lines of mosquitoes [22]. The mechanism leading to the death of the parasite because of melanization remains unclear. It seems that death can occur because of starvation (by isolation from the hemolymph) as well as because of the cytotoxic function of melanin [21, 23]. The melanization response was then considered as a model of what could happen with an artificial peptide mimicking an immune response and thus aiming at reducing the number of parasites in the mosquito.
Before considering the cost associated with resistance that could impair the spread of resistance in mosquito populations, it is important to notice that the sole insertion of an exogenous gene (not even conferring any anti-parasitic advantage) leads to a drastic decrease in Anopheles stephensi fitness [24]. However, recent work with site-specific insertion seems to bring a less negative outcome in term of fitness [18]. This even seems to be the case when all different groups including the control group (called wild) derive from a lab colony and the fitness reduction due to the colonisation process is probably significant. Concerning the cost of resistance, mosquitoes are no exception and reduced fitness associated with the absence of parasite can be observed. Thus, several studies have measured the associated cost in Anopheles stephensi carrying a transgene conferring resistance again the rodent malaria parasite P. gallinaceum. Regardless if resistance was provided by the expression of SM1 (termed for salivary gland- and midgut binding peptide 1) [25] or the phospholipase A2 gene (PLA2) [26], a fitness cost was associated with it. Even in conditions where harbouring an allele conferred an advantage i.e. when mosquitoes were fed on Plasmodium-infected blood, the SM1 transgene could not reach fixation revealing that the benefit of resistance was counterbalanced by the cost of resistance in the transgenic homozygotes [27]. In any case the construction needs to follow a couple of requirements for the promoter and the gene of interest for the method to have some chances of success [28]. The gene of interest needs to express in a temporal manner i.e. after a blood-meal is taken, but also only in the tissues where it could efficiently impact the parasite life cycle, such as the midgut epithelium and the salivary glands.
Recent work on GM mosquitoes have also been done with Aedes that are not resistant towards a pathogen but that are carrying a gene that makes nearly all their offspring non-viable in a natural environment [29-31]. To date such a strategy has not been developed for the Anopheles genus.
For the strategy considering the replacement of malaria vector by their modified non-vector version, this question of a cost associated with resistance leads necessarily to the idea of the need to use a driving system in order to favour the spread of resistance in natural populations of mosquitoes.
The idea of using a gene drive to affect the epidemiology of vector-borne diseases is not a recent idea as the use of chromosomal translocation to reduce mosquito populations was already proposed in 1940 by Serebrovskii [32]. It was revived later with the idea to use those translocations to drive alleles conferring refractoriness in mosquito populations [33].
Thus the spread of refractoriness in mosquito populations could be facilitated if the allele, conferring resistance but also associated with a cost, was linked with an element whose spread is not Mendelian. One of the techniques for which various models provide information is the use of transposable elements. A tandem made of a transposon and an allele of interest can spread easily and fixation can be reached [34, 35], even if the cost of resistance is particularly high [36].
Using intracellular bacteria associated with cytoplasmic incompatibility, such as Wolbachia, is also an idea that has been explored. Modifying them so that they could harbour the allele of interest would permit, at least in theory, to favour the spread of the allele of interest [37, 38]. There is no natural infection of Anopheles by Wolbachia but work is in progress trialling infections of Anopheles gambiae cells by Wolbachia pipientis (strains wRi and wAlbB) in the lab [39]. However, up to now no such sustainable transformation has been done [40].
Other constructions that would favour the spread of resistance have also been considered [41, 42]. Among them the use of HEG (Homing Endonuclease Genes) has been the centre of a lot of attention in the last years [43-45]. Apart from those systems another approach relies on the use of pairs of unlinked lethal genes. In this case, each gene is associated with the repressor of the lethality of the other one and this system is called engineered underdominance [46]. With respect to those methods a number of recent papers have been focusing on theoretical work aiming at spreading an allele conferring resistance as well as containing it. If the aim of a GM approach is to favour the spread of an allele conferring resistance it is also important to consider that self-limitation could be a real advantage to avoid the establishment of the transgene in non-target populations. Such an approach has been studied in theoretical analysis with the Inverse Medea gene drive system [47] and with the Semele one [48].
If the speed at which the construction of interest can spread in mosquito populations is a major issue, authors have also shown that in the case of the use of transposable elements one of the problems is the stability of the system with the probability of disruption [49].
However, if the spread of an allele conferring resistance is a target that can be reached, the real aim should be a strong decrease in the prevalence of the disease or even its elimination. Two models merging population genetics and epidemiology have pointed out the major importance of the efficacy of resistance [36, 50]. They have shown that a significant reduction in malaria prevalence can only be obtained if the efficacy is close to 1 especially when a release of resistant mosquitoes is done in high transmission areas.
If recent work claims that the engineered-mosquito do not suffer too much from carrying a resistant allele [17], this remain only valid under lab conditions where environmental conditions remain fairly stable and usually favourable. It is interesting to note that the survival of the mosquitoes in Isaacs et al. study reaches about 35 to 40 days which is probably far more that what happens under natural conditions.
As shown with natural immune responses, environmental conditions experienced at the larval or at the adult stage can greatly affect the host-parasite interactions and thus the outcome of an infection [51]. A reduction of 75% on food availability at the larval stage in lines selected for refractoriness [22] leads to a decrease in the proportion of the mosquitoes able to melanize half of the surface of a foreign body (a Sephadex bead) of more than 50% of it [52]. Even more worryingly, a recent paper [53] revealed the complex effects of temperature on both the cellular and humoral immune responses on the malaria vector Anopheles stephensi. What is highly interesting in this study is that not only temperature can affect immune responses but also that different immune responses are affected in different manners by temperature. The authors have studied the melanization response, the phagocytosis (a cellular immune response that lead to the destruction of small organisms or apoptotic cells) and the defensin (an antimicrobial peptide) expression. The three of them are higher at 18°C while the expression of Nitric Oxide Synthase (active against a large number of pathogens [54]) peaks at 30°C and the one of cecropin (an antimicrobial peptide) seems to be temperature-independent. Concerning melanization it is important to note that if the melanization rate is higher at 18°C, the percentage of melanised beads -introduced inside the mosquito to measure its immunocompetence- (at least partly) was higher when the temperature increased (fig. 1).
Influence of the temperature on the melanization response of Sephadex beads in the malaria vector Anopheles stephensi. The melanization of beads was measured 24h after the injection. The proportion of completely melanized beads was the highest at 18°C whereas the higher proportion of beads being at least partially melanized occurs at higher temperatures (modified after Murdock et al. 2012)[53].
This result highlights the difficulties to define what is an optimal temperature for the melanization response especially as it is also involved in developmental processes. The complexity of the immune function appears also with cecropin expression that despite being independent from temperature was affected by the administration of an injury or the injection of heat-killed E. coli. Other works have also revealed that the immune function is affected in a complex manner by a variety of environmental parameters such as the density of conspecifics or the quality of food resources [55]. Apart from showing the need to better understand the impact of the complex interactions between temperature and other variables on the vector competence, this work also highlights the crucial importance to take them into account when determining the potential outcome of the interactions between the natural immune function, the allele conferring resistance in a GM mosquito and finally the resulting vectorial competence under a large variety of ecological conditions.
What appears to be clear is that the expression of genes involved in the anti-parasitic response are not only influenced by the sole host-parasite interactions but that the environment is a crucial factor be it the abiotic conditions, such as temperature and its daily variations, or biotic factors, such as parasites encountered at the larval or adult stage [56, 57].
On the side of the parasite it would be naïve not to consider an evolutionary response in the face of selective pressure represented by any (natural or artificial) resistance. The quick selection of resistance against artemisinin in South-East Asia in the last years [58] and the evidence of its genetic basis [59] suggests that it is reasonable to envision the selection of parasite strains able to overcome any engineered resistance mechanism. Using transgenic Plasmodium-resistant mosquitoes can be considered equivalent to artificially increasing the investment of the mosquito in an immune response. Referring to some theoretical work [60] this is assumed to be followed by an increase in the parasite investment to avoid resistance. In the long term this would lead to a decrease in the effectiveness of the programme aiming at decreasing malaria prevalence or the need to ‘play evolution’ by monitoring the parasite population and releasing transgenic mosquitoes for which resistance could be modified as in an arm race with parasite evasion.
What is then important is to determine the longer-term of such a strategy regarding parasite virulence. Some answers have already been provided by theoretical work concerning the impact on parasite virulence to humans and mosquitoes in the case of dengue [61]. The authors examined four distinct situations: blocking transmission, decreasing mosquito biting rate, increasing mosquito background mortality or increasing the mortality due to infection; if all of them are associated with a benefit in terms of disease incidence, only the ones affecting mosquito mortality seem to pose the smallest risk in term of virulence to humans. It is important to note the scarcity of studies aiming at providing empirical data on this topic even if experimental evolution with mosquitoes and parasite can provide interesting results in a reasonable number of generations [62]. This lack of data not only concerns dengue but also malaria as has already been discussed in a paper on possible outcomes of the use of transgenic Plasmodium-resistant mosquitoes [63].
As mentioned earlier one of the major points to consider with transgenic mosquitoes used for malaria control are the ethical and societal issues and public acceptance of this high-tech method. Even though the importance of societal acceptance of GM mosquitoes has been recognised for a decade [64], studies on acceptability remain scarce. One first study conducted in Mali mapped out several crucial aspects of potential acceptance or rejection of GM mosquitoes [65]. While Marshall reports that his interviewees were generally “pragmatic” about the technology, acceptance was dependent on several conditions.
If people were supportive of a release of transgenic mosquitoes for malaria control, they first wanted to see evidence of safety for human health and the environment prior to releases. In addition, proof of efficacy of the technology in reducing malaria prevalence was requested. Lastly people declared that they would prefer the trial to be done outside of their village and when comparing GM crops and GM mosquitoes, people were more sceptical of the latter. Even if this not a rejection of the idea of using a GM technology for health purpose, it is important to note that a population, even if at risk of contracting malaria, remains cautious about the idea of using such a technology. This should remind us how, in the 70’s, a decade-long programme conducted by the WHO in India utilising the sterile insect technique (SIT) ended in a chaotic way after the publication of inaccurate information in the Indian press [66].
Secondly, the question of regulation has recently been highlighted as crucial [5, 67]. Because the social and environmental implications of GM mosquitoes are significant and potentially irreversible, and as the regulatory attention that GMOs have received in Europe suggests broad-based trials and releases require robust legislation and international agreements. These regulations are still under development, and it is important to note that at the time of the first releases in The Cayman Islands international guidance on open field releases of GM mosquitoes was still in preparation [67, 68]. While the existing Cartagena Protocol on Biosafety is considered to be applicable to GM crops, it is in need of specific amendments in order to work for GM mosquitoes [69].
Furthermore, in terms of regulation one has to distinguish between two different types of GM mosquitoes. While regulation and tracking might be possible for genetically sterilised mosquitoes as they are self-limiting in their spread, tracking and containment of GM mosquitoes with self-spreading genetics, i.e. fertile mosquitoes that block disease transmission, is considered almost impossible, or at the very least extremely difficult [70, 71]. This distinguishes GM mosquitoes from earlier GM technologies, such as for the modification of crops. GM and non-GM crops can be separated from each other and marked by labels on GM products, it can thus be seen as a technology of choice. However, the accuracy of this argument is only limited. As for instance Lezaun has shown, bees have proven to be effective agents of cross-pollination between GM and non-GM crops, thus subverting regulations that aim to keep GM and non-GM crops separate [72]. GM insects, however, are markedly different. The elusiveness of mosquitoes will likely be a major impediment to tracking, containment and comprehensive regulation, as for instance the spread of Aedes albopictus and herewith the increased risk of arboviral transmission in new locations across the world has shown, mosquitoes are hard to contain. This renders GM mosquitoes as a no-choice technology – once released, GM mosquitoes will stay in our environments.
A second major issue in terms of the social and ethical implications of GM mosquitoes is the question by whom and how they are produced and implemented. GM modification of insects is an expensive high-tech intervention and research so far has mainly been located in resource rich laboratories in the Global North, rather than in disease-endemic developing countries [73]. This enrols the technology thoroughly into discussions about technology transfer and development initiatives from North to South, and sits uncomfortably with the West’s history in colonial exploitation and tropical medicine. Aside from this imbalance in bio-capital and agenda setting, GM mosquitoes are as much a product of the biotech industry as they are tools for public or global health. Are GM mosquitoes currently seen as a public good or a commercial product? While most of the research and development of GM mosquitoes has so far been funded by public institutions –both national research foundations -such as the US National Science Foundation- and philanthropic organisations -such as the Bill and Melinda Gates Foundation and the Wellcome Trust, the mosquitoes that have been released were part of a commercial project. The emerging GM mosquito industry has caught the interest of private biotech firms. The first company to produce and market GM mosquitoes is Oxford Insect Technologies (Oxitec), founded by a group of entomologists as a spin-off company of Oxford University. The company is a for-profit-enterprise, so far has mainly been funded by public entities and venture capitalists, and is one of the main drivers of high-end developments in the field. As discussed in the introduction, Oxitec was the first to release sterile GM mosquitoes into the wild in the field trials in The Cayman Islands. A fundamental issue that is raised through the dominance of Oxitec in the field is the tension between GM mosquitoes as a public health tool and a commercial product [74-76]. While GM mosquitoes in malaria control would be used as a tool of disease control and to foster public health, companies like Oxitec follow different aims – they have to become profitable and eventually make profits with their GM entities. This tension brings another social issue of GM mosquitoes to the forefront, namely the question of how one conducts field trials with GM mosquitoes in an ethical way?
As we alluded to in the introduction, the first releases in The Cayman Islands were conducted in a rather secretive fashion. Oxitec only published the news about the release with a one-year delay [1], leading to accusations that the releases were deliberately done in secret [75, 76]. Oxitec stated the trials were prepared and conducted in close cooperation with local Mosquito Control and Research Unit, had conformed to the British Overseas Territory’s biosafety rules, and that information had been sent to local newspapers preceding the trials. However, many locals claimed they were not informed and no risk assessment documents were made available to the public on the internet. The only risk assessment document that can be found was published by the UK parliament in 2011, over one year after the releases started [5]. The Cayman Island releases have triggered fears for entomologists working on GM mosquitoes that such secretive trials might lead to a public backlash and undermine their own extensive efforts at public engagement, some scientists for instance claimed they have spent years preparing a study site through “extensive dialogues with citizen groups, regulators, academics and farmers”[1].
GeneWatch argued that Oxitec purposefully bypassed existing international GM regulations (developed mainly for GM crops), because Cayman Islands does not have biosafety laws and is not a signatory to the Cartagena Protocol on Biosafety or the Aarhus Convention (even though since the UK is a signatory to the protocol, Oxitec had a duty to report the export of GM eggs to UK government). As a result GeneWatch reads Oxitec’s actions as colonialist tactics: “the British scientific establishment is acting like the last bastion of colonialism, using an Overseas Territory as a private lab” [76].
All in all, this raises the question what ethically and socially responsible research on GM mosquitoes means? Here, the ability of researchers and stakeholders to communicate with each other is key for meaningful public engagement. In this respect, a recent survey has focused on the willingness of scientists to have interactions with a non-scientific audience [77]. One of the main findings of the survey indicates that more than 90% of scientists working on GM mosquitoes are agreeable to interactions with the public on their research. However, communication might not be enough and real discussion might not be easy between researchers and a non-scientific audience. This has been underlined by the reluctance of a fraction of the research community to have their research project evaluated by a non-scientific public [77]. Thus, while a significant proportion of researchers are ready to interact with a non-scientific audience, they seem to be less likely to accept an evaluation and a prior-agreement of a research proposal by the general public, interestingly especially researchers from the Global North are hesitant. On the other hand, many scientists in malarious countries do welcome exchanges with publics and are more willing to negotiate their research project with members of the disease-endemic communities.
In summary, the GM mosquito technology in malaria control raises a set of challenging questions. Challenges from a biological and ecological perspective are interlinked with questions about democratic decision-making, local acceptance and international regulation of these emerging entities. Such a potentially controversial technology cannot afford to skip these debates and time is ripe to focus on the ethical and sociological aspects governing the potential use of GM mosquitoes. Furthermore, it is crucial that the development of transgenic methods does not lead to a decrease in funding of classical, accepted and efficient vector control methods – indeed, they should be favoured and enhanced to continue curbing the malaria burden today.
Thanks to Sylvie Manguin for the kind invitation to write this chapter. Thanks to Courtney C Murdock for providing necessary data and to Silke Fuchs for a preprint. We are also grateful to Luisa Reis de Castro and Guy Reeves for helpful comments on a previous version of this paper. Both authors wish also to thank the Institut des Sciences de la Communication, CNRS (France) for financial support.
Freud’s model of the mind is a dynamic one- that is, it understands the mind as being in constant movement and conflict between impulses arising in one area, along with defenses against these impulses [1, 2]. He developed three models, adjusting them to his clinical material according to his understanding of therapeutic work with his patients as research into the human mind – “psychic apparatus,” as he first called it.
\nFreud’s first model was based on repression, which occurs when thoughts or wishes are not acceptable to the thinker, who accordingly learns to repress them from consciousness. The Unconscious – usually metaphorically conceived of as a deeper layer of the mind – tries to bring these repressed ideas back to light. The repressed induces dreams, is used in jokes, causes “Freudian slips” and forgetting things, elucidate creative ideas, and sets the formation of a symptom in motion. The return of the repressed is described by Freud in “The Psychopathology of Everyday Life” [3] in a surprising and convincing way.
\nFreud then began to conceptualize the mind less as composed in layers – his favorite archeological metaphor of the analyst who is searching for a buried culture – than as consisting of agencies or structures: the ego, the super-ego and the id. The id corresponds roughly with much of what had previously been encompassed by the concept of the Unconscious. It can be regarded as an area containing the primitive instinctual elements, dominated by the pleasure principle and functioning according to the primary process, as in dreams. The ego constitutes the rational part of the mind which is in touch with the external world, and which tries to mediate between our desires and reality so that we can stop insisting on the impossible, and settle for what is – thus postponing the fulfillment of impulses. The superego is a fiercely irrational, unreasonable half-instinctual force granting only partial gratification or even suppresses instinctual impulses. Sandler stats, that … it developed as a sort of internal stratum or residue of the child’s early conflicts in relation to his parents…, [4], p. 27. The idea that we act according to the pleasure principle was difficult to maintain when Freud discovered the repetition impulse, the negative therapeutic reaction and masochism/sadism.
\nThe concept of the death instinct, Thanatos, and the life instinct, Eros, as two basic instincts.
\nFreud introduced the idea of the death instinct in 1920 in “Beyond the Pleasure Principle” as a biological drive and expands on its psychological significance in 1923 in “The Ego and the Id.” “His view is that under the influence of the life instinct some of the death instinct is deflected out in the form of an attack on the object,” writes Spillius et al. in the New Dictionary of Kleinian Thought [5], p. 298. Freud writes:
\nBesides the instinct to preserve living substance and to join in into ever larger units, there must exist another, contrary instinct seeking to dissolve those units and to bring them back to their primeval inorganic state. That is to say, as well as Eros there was an instinct to death. The phenomena of life could be explained from the concurrent or mutually opposing action of these two instincts … a portion of the (death) instinct is diverted towards the external world and comes to light as an instinct of aggressiveness and destructiveness. In this way the instinct itself could be pressed into the service of Eros, in that the organism was destroying some other thing, animated or inanimate instead of destroying its own self. Conversely, any restriction of its aggressiveness directed outwards would be bound to increase the self-destruction, which is in any case proceeding. At the same time one can suspect from this example that the two kinds of instinct seldom – perhaps never – appear in isolation from each other, but are alloyed with each other in varying and very different proportions and so become unrecognizable to our judgment.” [6], p. 119
\nFreud distinguishes between two very general tendencies which he referred to as libido or Eros, on the one hand, and aggression, which he formulated in terms of the death instinct (Thanatos), on the other. Libido or Eros is manifested in all processes, both physiological and psychological, that impel towards synthesis. Freud assumed that the death instinct remains within and some of the remaining death instinct is fused with the libido to form sexual masochism. Other fusions occur, resulting for example in ‘moral masochism’, but some remain unfused as ‘primal sadism’ ([7], p. 164) when cruel action give pleasure and lust. The death instinct or the Nirvana principle constitutes the most fundamental aspects of instinctual life: To return to an earlier state, the absolute “Ruhe des Anorganischen” (repose of the inorganic) [8], p. 102 and is therefore an economical principle reducing energy to zero/nil; it is silent operating in the background and cannot be seen in the clinical material.
\nWith the concept of the death instinct, Freud managed to solve three riddles and explain the contradictions regarding the pleasure principal and Libido as a source of primal strength.
\nFirst, some consideration needed to be given to the phenomena of the “Compulsion to Repeat’-- repeating unconsciously unpleasant experiences from earlier life instead of overcoming them – “an irrepressible force which is independent of the pleasure principle” … “a fundamental tendency of every living being to return to the inorganic state.” [8], p. 102. The repetition compulsion occurs in a patient’s transference relationship to the analyst, patterns of thinking, feeling, and behaving from earlier life – which can be painful and distressing. The repetition compulsion also occurs outside analysis, in normal as well as in pathological relationships – Freud likened it to the death instinct in his later writing.
\nThe second riddle to be solved was the concept of sado-masochism and hate. From the very beginning, it seemed impossible to Freud that hate could be derived, metapsychologically speaking, from the sexual instinct.
\nThe third riddle was the negative therapeutic reaction, which means that some patients reacted badly to analytic interpretations even after they had acknowledged their accuracy. “One begins by regarding this as a defiance and as an attempt to prove their superiority to the physician, but later one comes to take a deeper and juster view. One becomes convinced, not only that such people cannot endure any praise or appreciation (of the analyst GDW) but that they react inversely to the progress of the treatment…. A temporary suspension of the symptoms produces in them for the time being am exacerbation of their illness; they get worse during the treatment instead of better.” ([9], p. 49) Freud explained the negative therapeutic reaction in two ways: as an expression of unconscious guilt or as an envious attack on the analyst.
\nThe death instinct is perhaps Freud’s most controversial assumption. It has been severely criticized by both psychoanalysts and others and highly appreciated and further developed by Herbert Rosenfeld [10], Betty Joseph [11] and Hanna Segal [12]- the object relation school. This was difficult for the psychanalytic community to accept, because Freud thought that the manifestation of the death instinct was silent, meaning that one could not investigate it in clinical material as they two instincts are fused and defused with the result that it can be observed in a number of different mental states, e.g. a fear of falling apart and disintegration, self-destructiveness, destructiveness, envy, sadism [5], p. 298.
\nMelanie Klein used Freud’s view of the death instinct and his concept of incorporated objects to give a theoretical basis to her clinical observations in work with small children and their harsh and punitive attitudes towards themselves and towards figures of their imagination. “Klein considers the harsh internal figure to be the introjected hostile mother whose hostility towards the child stem from the sadistic phantasies attacks that the child made of her … this hostile internal mother as an early version of the superego.” [5], p. 299.
\nKlein assumes that from the very beginning the baby has a core-ego and an inner conflict between Eros and Thanatos. In the International Journal of Psychoanalysis celebrating its 100th anniversary a chapter is dedicated to “Repletion and the Death Drive” (2019). Freud’s concept of the death instinct is seen by Blass as a “new view on the tie between narcissism and death, which is relevant for the Kleinian view of it” ([13], p. 1294). She connects Freud’s concept of a fundamentally opposed instincts, from which all emotions, sensations, desires, and activities derive as affirmation of Klein’s concept of the paranoid/schizoid and depressive position. Rosenfeld [14], Bion and Segal [12, 15] suggest an anti-object relational force with destructive attacks on the self and the object.
\nThe first year of life is of enormous significant for the baby as the basic elements of the physical and psychic development are laid. One can it compare with building the foundations of a house and of equal importance for its stability and structure. The child needs another living and caring object to perceive the real world, being aware of the difference between inner and outer sensations: although Klein assumes a core-ego since birth the baby’s thinking, and its relationship to the parents are all evolving out of raw, unintegrated feelings and perceptions. The parents or caregivers must help the infant as it copes with its raw, primitive and archaic feelings and somatic perceptions. They need to be perceptive how the baby feels and what it needs. In the first three months, a “social birth” follows the baby’s physical birth, where it builds a relationship to the world via its relationship to its mother or caregiver (primary object). The infant can establish elements of structure and inner order if its mother succeeds in containing and understanding its raw fears and giving it back to the baby describing them with words so that the baby can introject them. Winnicott calls this ability of the mother “Primary maternal preoccupation,” Stern speaks of “mother and baby being in harmony or in tune” Bion speaks of a special ability which he calls “Reverie” meaning the capacity to sense what is going on in the infant [16].
\nIn Bions’s words, the baby needs a mother/container in order to be emotionally touched; this mother/container takes in the baby’s projected raw sensory data, which Bion calls “Beta-Elements,” and transforms them into “alpha” elements which the child can introject and begin to think [16], p. 110–119. Esther Bick compares the infant with an astronaut who has been shot into space without a spacesuit. She thinks the baby fears that it will either disintegrate or die. Especially this observation when a baby is undressed and start trembling is considered as expression of this basic fear [17], p. 296.
\nBy internalizing its mother’s caring and containment the baby develops a positive core in its psyche, a “good inner object,” which remains a secure inner base. The loving, emotional care, the infant’s first encounters with chaotic forces remain embedded in the deepest levels of its personality, constituting a “psychotic core” that is normally subordinated by positive experiences. If, on the other hand the baby finds his despair and misery are not received, it leaves him with what Bion calls “nameless dread,” unspecified, unthinkable thoughts which have continually to be expelled/projected into others [18], p. 7.
\nNow I shall describe a vignette from an observation of an infant and its mother following the Tavistock model developed by Esher Bick (the observation follows Esther Bick’s method, developed at the Tavistock Clinic) [17, 19]. As the method is well known, I shall simply add that the observation is for one hour and notes are not made until after the observation. The observation is written up, presented and discussed in a weekly seminar of 4–5 participants led by a psychoanalytically trained clinician who is experienced in Infant Observation. The observation of Felix and his parents was video-recorded by Barnett [20] for research and video purposes. As he was born on a Sunday, she called him “Sunday child.”
\nFelix’s mother is 36 years old. The father brings Felix into the bathroom to his mother, who greets them both and takes Felix into her arms. After she has undressed him, she places him in the ready prepared baby bathtub.
\nFelix is just a few days old, he has his eyes closed and his hands are balled into fists. He cries in a high voice and is truly unhappy. In the background we hear father’s voice making calming comments. It seems his words are addressed at the mother to calm her more than it does Felix. When the mother starts washing Felix’s belly with soap, she talks to him saying: “Oh Felix, oh dear!” But his crying becomes even louder as the mother lifts him out of the water to wash his bottom, and he rather screams. The mother remains calm, continuing the washing and says, “Shhh”, then turns him round and washes the back holding him securely under his arms. When the mother lifts him out of the water, his crying is of penetrating and frantic volume. He turns his head back and force, stretching it backwards with increasingly louder screams. When the mother turns him around again, lowering him into the water, and slowly dribbles water over his belly and chest his crying stops. Now the mother moves her head close to his and talks to him quietly about how comfortable and warm the water is,. “Do you like the water now a bit, Felix?” she asks. For the first time Felix opens his eyes a little and looks into his mother’s eyes while she smiles at him. “Well, you see, it’s OK. Look what I am doing now,” she says, and begins to move him very gently back and forth in the water. He clearly enjoys it and has both eyes open, his fingers are relaxed. … When he seems to enjoy it even more Felix closes his eyes and lets himself drift. (Description of the scene in the film by [20])
\nIn this short observation in the film we can see how Felix needs protection from the outside world, how he presumably is anxious about falling apart without boundaries. His crying puts his mother under pressure, as if she had done something harmful to him and she is out of touch even stressed. The mother puts her head closer to his and talks with him in a calming way as the father’s voice is calming and encouraging her. With the help of his mother’s soothing voice Felix’ anxiety diminishes and he can actually enjoy slowly moving about in the water. We see that both parents (the father is in the background) comprehend Felix’s unhappiness and des pair, talk with him, and help him to cope with these overwhelming feelings and anxieties. We see an example of what Bion calls “containment” – a mental and emotional process – where the mother perceives the baby’s raw, disjointed impulses, digests them and then gives them back to Felix in a modified way. He might even remember the floating feeling in the uterus. When the mother responds in this way – being in “harmony” as Daniel Stern called it - Felix experiences his mother responding to his needs and mirroring his feelings; a communication between mother and Felix was established and will further develop day by day. Empirical infant research has made video-supported analyses of the complex tactile and verbal early communication between mother and baby in order to understand the emotional development and the learning of patterns of social interaction [21].
\nNow I want to describe a vignette from an analysis of a 3 ½ year old boy, whom I call Patrick2:
Patrick’s parents came to see me first as a family in a parent-infant psychotherapy for 5 sessions. It was clear that Patrick needed a longer therapy so the parents agreed to an analysis for him. He had nightmares and they had to wake him up to help him stop crying. He had fits of rage, and was an outsider in his playgroup. In the transference to his analyst the same patterns that he has towards his parents are developing. Patrick’s parents had not described any unusual experiences with their child although he woke up almost every night screaming and in panic. With Patrick it was his kindergarten teacher who drew the parents’ attention to his emotional difficulties.
In the first assessment Patrick showed me his chaotic inner world, turning the playroom with cruel destructiveness and sadistic pleasure into a messy world in which he had no hope of making himself understood. For me, the analyst, it felt like a massive attack and I could hardly believe what I saw when he destroyed the brand new colored pencils. He deliberately and violently broke off the tips of the pencils, then throwing them around the room, then stamping on them. I tried to transform his projections of beta-elements into words, to show him how desperate he was and that he wanted to push these unbearable sensations into me. I suggested to him that he wanted to show me how easy it was to make useless broken pencils out of the beautiful new pencils and that he perhaps felt broken himself. When he continued I told him that he was convinced that I would turn away from him and he would not be allowed to come back. Then he stopped. As if accidently, he touched my legs with his body by standing close to me, leaned trustingly on my leg. I told him that this was his way of showing me that he felt touched by my words. He looked into my eyes so that I added, “Now you feel understood” and told him that he could come three times a week and he nodded.
\nNow I shall describe a session at the beginning of Patrick’s second year of analysis, where the fine structure concealed behind his apparently unmotivated destructivity and the special quality of Patrick’s relationship to his father became visible. Here some vignettes from a therapy session:
\nFirst, we were two fishermen with fishing rods fishing small fish. Then he became aggressive demanding that I shout at him: “Dirty Patrick, he makes his pants dirty”. When he was unable to do something, he said “crap”; when he gets excited, he quickly had to use the toilet. Later he played to be the little baby who needs his pants to be changed; he wanted me to be the father who did it. With enthusiasm he was the little baby, lying down (wanted to pull down his trousers what I stopped) I should say: “Lift your bottom”, what he did pretending to put some paper towel under him as if it was a diaper. Then I should put him to bed as his father did. When I asked: “Where is the mother”, he answered: “She is dead”. After a few moments – in the middle of the night he climbed out of the bed. I was told as his father I should find him, shout furiously at him and beat him. This game was very intense. Patrick was not contend with my simulation of beating with without touching him. He became excited, took my hand and showed me how to do it saying: “You have to hit me hard, much harder!” Since I did not do this, instead expressing verbally how I (as his father) was furious with him, he began to hit himself with his own hand. “That’s how to do it,” he said.
\nIn his play Patrick shows the persecutory quality of his paranoid-schizoid feelings. He put me in the position of the sadistic father who clearly wants this punishment and denigration of his son. The pleasure of both of them was clear. Both of them are stuck in these intense sado-masochistic struggles. He wants to repeat them again and again. For the analyst, it is difficult and shocking to feel these feelings in him/her in the countertransference – but as Bion said: “If you cannot bear the heat, refrain from the kitchen.” [22], p. 40. In many sessions, Patrick demonstrated how successfully he upset both himself and his father, drawing his father into his cruel fights. He is part of a couple consisting of a man and a by – a homosexual couple - who were bound together in a pleasurable yet intimately cruel way. The child was in control: Patrick knew he could provoke his father into a state of extreme rage and complete helplessness. That was very satisfactory for him. My aim was to make him aware that he was the active agent in this. Or Patrick could provoke his father by doing the opposite of what his father wanted him to do, or pretended not to hear him. In a role play, he showed me how he could do this. He wanted me – as the child - to come and told me I had to pretend not to hear him. Then he as his father got furious and screamed “Don’t you hear me?”. I could feel the power to provoke him to get so furious. Sometimes he sat in the car ready to drive off, and I as the child was supposed to hesitate to get into the car. Then he really seemed about to drive away to threaten me as the child. I then had to scream in horror and run after him in panic. He showed he enjoyed this power game even to the extent of manipulating his father into acts of violence.
\nIn the following discussion with the parents, the father said to me that he had asked his wife to take care of all disciplinary questions with their son. Patrick now loved to build houses with his sister, including the father in the role either of mailman or policeman. The parents were impressed by all the changes in Patrick, fits of rage had completely vanished; in kindergarten, in his play he showed more ideas and fantasies than the other children. It was important to allow him to continue his analysis to stabilize his inner development. He now loved to go to the playgroup. Visibly moved, Patrick’s mother described how he could talk about his feelings. She also could discuss and explain what decisions she and his father had made. Once Patrick came to her, put his arms around her neck and said, “Mommy, I love you”; that was the first time this had happened. He could also part from her without crying.
\nIn these brief vignettes, I tried to show how useful Bion’s concept of container-contained is. Elements of destructiveness and jealousy emerged continually with Patrick, where he spat on me, tried to kick me or to tear the spectacles from my face in a fury and wanted to break them. I always had to be on guard to protect him and myself. However, he gained more control over his aggressive impulses. When I could understand his changing moods and connect them with his experience, he got softer and more sensitive; he even put his head in my lap as if he wanted to go back into mother’s belly. As a very distressed child he showed his inner conflict in a concrete way, often wanting me actually to perform the same cruel punishment and mockery as he provoked his father into doing. Patrick learned from emotionally experiencing his analyst able to take in his projections, suffer their impact, and put them into words. Pursuing the emotional truth even in very disturbing areas – as clinically visible expression of the death instinct – enabled him to acquire a knowledge that enriched his personality.
\nThe advantage of working with children as young like Patrick is that they still show their aggression in a concrete and obvious way and show by their reactions whether they take in the interpretation of the analyst – stopping the destruction as soon as they feel understood. Then, it is not any longer necessary to show their aggression in this way and we can explore the deeper anxiety behind it. With adult patients the aggressive wishes are mostly covered by a strong defense system. Now I shall show how an adult patient struggled to accept his aggressive and murderous wishes which were so vividly manifested in his dreams. In the session we observe the same struggle against understanding in the inner world of the patient, who attempts this with all means- mainly by massive projective identification, pushing these feelings into another person, his ex-wife or his analyst. In one dream he shows his aggressive side which is envious of his new baby.
\nMr. A is a 46 year old psychologist. He is in his second analysis because his first analyst was too ill to continue (Mr. A. still idealizes him). He is married for the second time to a warm and caring woman. He has a son with his first wife, a two-years-old son with the second wife and just got a new baby. He behaves as if he has no idea about insight, projects his omnipotent destructiveness into me and judges me from a moral high-ground. Often my words are felt as an attack and then he complains, he dismisses a shared responsibility. If I try to show him the situation of his ex-wife he accuses me of feminism--taking sides with women against men. Sometimes when he exposes his vulnerability and dependency he feels exposed. When I stick to the rules of time and fee – although I reduce it twice to make it possible for him to continue – he can accept them as strict but fair.
\nWhen his third son is born he is relieved and happy. It was a spontaneous birth, he is a robust baby—not as delicate as the second one. At the end of one session he says: “Maybe Prof (meaning me) was correct that the baby could develop well because I brought my aggression into the sessions.” On the following day he relates a dream he had after mentioning the worries he had had at birth of his baby because the umbilical cord was during the delivery around the baby’s neck, making a knot so that it could not be tightened.
\nP: (After a pause) I had a dream which is connected with yesterday’s session, I think. (He says it in a superior way as if he knew everything already and lets me know he does not need me to understand his dream). (Before he starts to tell the dream he goes into the details of yesterday’s session for 15 minutes. I become irritated and impatient but do not interrupt him). I felt abandoned by you.
\nThe dream is in my analytic session, you and I are there but the room is much bigger-- 5 to 6 times as large (my room is rather spacious), really big and with impressive furniture. I come in and then I see at the entrance two workers decorating the entrance. A baby is lying on the floor. One man passes by and kicks the baby a bit without doing it on purpose. Then the second worker puts his large foot on the baby and presses hard, he even turns his foot on the baby’s chest. I go to him and shake him and pull him away telling him what he is doing. Then I walk in. It is very beautiful and impressive. I am speaking and suddenly you get up and without an explanation you leave the room. I do not know what the matter is. Then Dr R. walks in and sits down on your chair and listens. I talk until the end of the session. (Pause)
\n(He continues) I understand the dream that it is my wish that you leave because you did not understand me yesterday and I felt abandoned. Dr. R. has always impressed me and a colleague who is in analysis with him spoke quite freely on how he is as an analyst.
\nA: You come in and tell me that you felt bad yesterday, abandoned by me and today you told me how tired you are not getting enough sleep … In your dream you show how you feel what you cannot feel during daytime--that you feel left behind by me, by your wife who is looking and breastfeeding the baby. In the dream I go away and let you be with another analyst who does not refer to the early years of life (Dr R is a Lacanian psychoanalyst).
\nP: That I am jealous of M (new baby) I cannot feel in any way. What I can see is how much work it is to look after two small children and my mother had 5 children, my older brother, my older sister, myself and the new baby and while she was breastfeeding she became pregnant with the youngest sister. When I spoke with my mother on the phone she said we should look after the older son so that he does not feel rejected. Respect! She can think about the older boy.
\nA: You are glad that I can look at the child part of you who feels rejected and left behind as your mother does. And can we have space to think about the two workers and what they are doing with the baby, first by accident and then on purpose hurting the baby?
\nP: Naturally this must be a part of me, I am the dreamer like the director of the dream, the author. I know this although I cannot feel any aggression towards the new baby M. I use this understanding when I interpret my patients’ dreams and it is very helpful.
\nA: It is easier to see it with other people than when it happens inside you.
\nP: Yesterday I observed how my wife’s attention was distracted when she breastfed M … I told her: Do not you realize that M is disturbed? She said: It’s just a minute.
\nA: You describe how sensitive you are and how you can understand M’s situation and another part of you feels terribly neglected and angry. And can you allow this angry part to become visible?
\nP: You are talking about murderous impulses!
\nA: When you say: ‘I am talking about murderous impulses and not you’ you show that you find it is difficult to keep in mind that it is your dream. You dreamed about the two workers putting their feet on the baby – expressing your unconscious phantasies. When you are awake you are shocked and want to push this aggressive impulses into me - you want me to be the author of this aggression: they should not show your wishes.
\nP: Sometimes I do feel tired because of this constant feeding at night. My wife told me to sleep in another room to be able to get some sleep, because I cannot help her with the breastfeeding anyway. But I cannot do it, I stay with her.
\nA: You cannot leave the two of them alone--you want to control what they are doing at night.
\nP: (laughs) To control them – well, I let them be together the whole day when I am working.
\nA: When you laugh you allow yourself to take the analytic breast and take my words in and it calms you. Now you felt understood and this dreaming part is glad to have been listened to.
\nP: I feel different now.
\nThe following day he says: “Yesterday the session made me feel calm”…
\nA: Yesterday’s session you felt you could get in touch with me for a moment and accepted what I offered. The part of you who wants to know and expresses himself in dreams, wanting to understand yourself, opens up sometimes.
\nP: Indeed-- and this only happens after a session with fighting, conflict and arguments. The image I was thinking about was the picture of the two workers who kicked the baby hard. I do not feel anything corresponding to it, no jealousy, and no anger towards M. In the dream I took the first one on the shoulders and pushed him away. It is hard to believe that this worker is really a part of me, of my wishes. But when I work with my patients and know how to interpret it I have to accept it in my dream as well even if I cannot feel anything.
\nA: You can see how difficult it is for you to see these primitive and murderous wishes in you. In your dream you were successful in pushing the two workers aside so we can assume that inside you have a part which does not to let you really harm the baby. This only happens in your fantasy and not in reality and this calms you. And you said how good it felt to be able to talk about it with me and that I can accept it.
\nThe patient struggles to accept his unconscious murderous wishes expressed in his dream by the two aggressive workers and his jealousy against his new baby M. which he also dearly loves. He is used to dealing with his aggression and destructiveness by projecting it into others, first into his first wife when he blames her for the problems of their son. He allowed his former wife to be sadistic and did not stand up against her. He could not manage it. He cannot think about his contribution to the problems of the marriage or the difficulties of his first son. Now he is married to a warm and sensitive woman. Mostly he holds on to his pompous superiority. In the session I described, he is enormously agitated and reveals himself in a puzzling way: he has a new baby but behind his pride and joy of having a new baby he feels burdened by it--it is another mouth to feed. He is struggling to earn the money for his living and his analysis. Does he know that he is fighting against the wall struggling with the new baby? Can he differentiate between his outer and inner reality? He himself is a disturbed baby with unbearable guilt. He cannot see how difficult he is and he successfully projects his anger and alarm into his analyst – I have the murderous thoughts, not he, he says at first. He can use his ability sometimes in a touching way, it is a real struggle for him to get to know himself. He makes slow progress. In his dream his aggressive fantasies are expressed by the two men. Can he accept this part of him? Sometimes he can use his abilities and have insights. He has to put himself in my position – he as the therapist – then he can understand the meaning of the dream. He has to gain enough perspective to distance himself from his dream in order to see his destructive part.
\nHe has got this lovely baby – strong and robust – but it stirred up so much rage and hatred. He felt he did not get sufficient understanding and support/containment from his mother and hardly can accept my help. He wants to see himself in a manic way as somebody who makes wonderful babies and is hardly able to accept himself as a disturbed man desperately clinging to his analyst/mother. As a baby he could not let go of the breast so his mother – after she had another baby – also allowed him to drink from her breast until the age of three, which made him feel guilty.
\nHe chose me as his analyst because he thinks I am a Kleinian who is not afraid to see and deal with his primitive, dark sides, understanding the “two strong workers” as parts of him. Finally he can integrate his love with his aggressive, jealous feelings. When I asked his permission to use his dream in this paper he answered, that he remembers this dream vividly and also his strong resistance against my interpretations. He used the opportunity to tell me how well his life and his family had developed and thanked me for his analysis “which had been the greatest enrichment in my life and professional development.”
\nIn these three vignettes, it becomes clear how variously the death instinct is manifested—with Felix’ Infant Observation as woeful cries, with fingers pressed into fists that we understand as the fear of disintegration or of death; with Patrick, chaos rules his interior life, with his great fear erupting in attacks of screaming or weeping as well as nightmares, and his destructivity and cruelty projected “successfully “onto his father—to whom he has established a sadomasochistic relationship which excludes the mother, who is “dead” in role playing; with Mr. A., his murderous rage is pushed onto the analyst through massive projective identification and he remains as a nice, protective father of his baby. The analytic work consists in containing these unbearable impulses, digesting them emotionally and mentally and rendering them discussable. Felix’ mother was able to take up the feelings projected into her through “reverie” (Bion) or “primary motherhood,” to digest them and ameliorate his fears through her loving attention, so that Felix could ultimately move about happily in the water. Only through recognizing his psychic pain could Patrick work through his painful experiences and establish a loving relationship to his parents, integrating his aggressive impulses and using them to develop a new independence. His mother takes Patrick seriously now as an independent child, whose various wishes she can understand and help him to deal with and solve conflicts without manipulating him. Mr. A can recognize his “baby part” and finally integrate it. His massive jealousy and competition from his childhood is worked through transference to his analytic “siblings,” so that his great emotionality and care for his family and his patients become visible. We can see how this competition can be constructively solved or lived by his youngest son M., for whom Mr. A is a loving father. At the age of two, M starts a special ritual: he leads his father and his older brother in the morning to the front door as if he were the head of the house and says goodbye to them there, remaining as the man of the house behind with his mother. He then proceeds to be a very good, loving child all morning. The following little episode shows how well not only Mr. A but his son managed to integrate contradictory feelings:
\nWhen M. was four years old, his father came home one evening, greeted him and asked what he was building with his blocks. The son replied enthusiastically: a castle for himself and for his mother. The father, who had never been convinced by the concept of an oedipal phase, reflected and then asked where he would live then. The son thought seriously for quite a while and said: “In the garden there is a little house—you can live there! “This constitutes a mature emotional accomplishment, granting the beloved father and rival a space.
\nHannah Segal describes the conflict between the life and death instincts and the way the individual can respond:
\n“One, to seek satisfaction for the needs; that is life-promoting and leads to object seeking, love, and eventually object concern. The other is the drive to annihilate: the need to annihilate the perceiving experiencing self, as well as anything that is perceived.” ([12], p. 18)
\nMr. A was able, after working through his repressed aggressions, experiences of humiliation and feelings of abandonment—which he projected onto others—to use his life-affirming object relations in his family and profession.
\nThere is still a controversial discussion concerning its philosophical status and its clinical usefulness. Michael Feldman however points out – and I agree – “that the gratification of this psychological drive does not lie in the annihilation of the perceiving and experiencing self, or indeed in literal death or annihilation. On the contrary, what is often clinically more compelling is the extent to which certain patients, rather than seeking to annihilate their perceiving selves, attack and distort their capacities for perception and judgement…The aim seems to be largely, but not entirely, to eliminate anything that gives rise to admiration, dependence, rivalry and, particularly envy.” [23], p. 97f.
\nWhen the patient then holds on to illness and suffering, Feldman considers this not to be a derivative or compromise, “fused” or “bound” with the life instinct, but “a direct expression of a primary destructive drive towards the self and the others” (p. 98). The means to achieve this are distorting the words of the analyst, a fascination in omnipotent destructiveness, distorting the meaning and value of the analytic work. A shift can be brought through the patient becoming more able to acknowledge and tolerate his awareness of his own hatred and anger. Mr. A can hardly agree to an interpretation but does think about it between the sessions and bring it back as his own insight in the next session. The occurrence of curiosity and the wish to know and understand himself indicates a movement towards the life instinct. As Bion puts it in his article “On arrogance” (Bion 1957, p. 86–92) “when pride appears within an individual who is dominated by the life instinct, pride becomes self-respect, but if the death instinct predominates pride then becomes arrogance. These arrogant dismissals of the analyst’s interpretations can undermine the ability to care for the patient and stir up anger in the analyst. Brenman describes his dealing with the angry countertransference by reminding himself “how ill the patient is” [24], p. 105. If we discover with the patient how he became the character he/she is and why he behaves in this particular way, being a victim of deprivation, loneliness and deal with the emotional pain of his earlier traumata he can recover the good inner object. “The good object … is the combines (intimate) relationship of the infant and mother and the subsequent development extending to other object relationships, in which persons give personal meaning to each other… nothing can be meaningful without this foundation,” says Brenman [24].
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\\n\\n4.1 The Corresponding Author represents and warrants that the Chapter does not and will not breach any applicable law or the rights of any third party and, specifically, that the Chapter contains no matter that is defamatory or that infringes any literary or proprietary rights, intellectual property rights, or any rights of privacy. The Corresponding Author warrants and represents that: (i) the Chapter is the original work of themselves and any Co-Author and is not copied wholly or substantially from any other work or material or any other source; (ii) the Chapter has not been formally published in any other peer-reviewed journal or in a book or edited collection, and is not under consideration for any such publication; (iii) they themselves and any Co-Author are qualifying persons under section 154 of the Copyright, Designs and Patents Act 1988; (iv) they themselves and any Co-Author have not assigned and will not during the term of this Publication Agreement purport to assign any of the rights granted to IntechOpen under this Publication Agreement; and (v) the rights granted by this Publication Agreement are free from any security interest, option, mortgage, charge or lien.
\\n\\nThe Corresponding Author also warrants and represents that: (i) they have the full power to enter into this Publication Agreement on their own behalf and on behalf of each Co-Author; and (ii) they have the necessary rights and/or title in and to the Chapter to grant IntechOpen, on behalf of themselves and any Co-Author, the rights and licenses expressed to be granted in this Publication Agreement. If the Chapter was prepared jointly by the Corresponding Author and any Co-Author, the Corresponding Author warrants and represents that: (i) each Co-Author agrees to the submission, license and publication of the Chapter on the terms of this Publication Agreement; and (ii) they have the authority to enter into this Publication Agreement on behalf of and bind each Co-Author. The Corresponding Author shall: (i) ensure each Co-Author complies with all relevant provisions of this Publication Agreement, including those relating to confidentiality, performance and standards, as if a party to this Publication Agreement; and (ii) remain primarily liable for all acts and/or omissions of each such Co-Author.
\\n\\nThe Corresponding Author agrees to indemnify and hold IntechOpen harmless against all liabilities, costs, expenses, damages and losses and all reasonable legal costs and expenses suffered or incurred by IntechOpen arising out of or in connection with any breach of the aforementioned representations and warranties. This indemnity shall not cover IntechOpen to the extent that a claim under it results from IntechOpen's negligence or willful misconduct.
\\n\\n4.2 Nothing in this Publication Agreement shall have the effect of excluding or limiting any liability for death or personal injury caused by negligence or any other liability that cannot be excluded or limited by applicable law.
\\n\\n5. TERMINATION
\\n\\n5.1 IntechOpen has a right to terminate this Publication Agreement for quality, program, technical or other reasons with immediate effect, including without limitation (i) if the Corresponding Author or any Co-Author commits a material breach of this Publication Agreement; (ii) if the Corresponding Author or any Co-Author (being an individual) is the subject of a bankruptcy petition, application or order; or (iii) if the Corresponding Author or any Co-Author (being a company) commences negotiations with all or any class of its creditors with a view to rescheduling any of its debts, or makes a proposal for or enters into any compromise or arrangement with any of its creditors.
\\n\\nIn case of termination, IntechOpen will notify the Corresponding Author, in writing, of the decision.
\\n\\n6. INTECHOPEN’S DUTIES AND RIGHTS
\\n\\n6.1 Unless prevented from doing so by events outside its reasonable control, IntechOpen, in its discretion, agrees to publish the Chapter attributing it to the Corresponding Author and any Co-Author.
\\n\\n6.2 IntechOpen has the right to use the Corresponding Author’s and any Co-Author’s names and likeness in connection with scientific dissemination, retrieval, archiving, web hosting and promotion and marketing of the Chapter and has the right to contact the Corresponding Author and any Co-Author until the Chapter is publicly available on any platform owned and/or operated by IntechOpen.
\\n\\n6.3 IntechOpen is granted the authority to enforce the rights from this Publication Agreement, on behalf of the Corresponding Author and any Co-Author, against third parties (for example in cases of plagiarism or copyright infringements). In respect of any such infringement or suspected infringement of the copyright in the Chapter, IntechOpen shall have absolute discretion in addressing any such infringement which is likely to affect IntechOpen's rights under this Publication Agreement, including issuing and conducting proceedings against the suspected infringer.
\\n\\n7. MISCELLANEOUS
\\n\\n7.1 Further Assurance: The Corresponding Author shall and will ensure that any relevant third party (including any Co-Author) shall, execute and deliver whatever further documents or deeds and perform such acts as IntechOpen reasonably requires from time to time for the purpose of giving IntechOpen the full benefit of the provisions of this Publication Agreement.
\\n\\n7.2 Third Party Rights: A person who is not a party to this Publication Agreement may not enforce any of its provisions under the Contracts (Rights of Third Parties) Act 1999.
\\n\\n7.3 Entire Agreement: This Publication Agreement constitutes the entire agreement between the parties in relation to its subject matter. It replaces and extinguishes all prior agreements, draft agreements, arrangements, collateral warranties, collateral contracts, statements, assurances, representations and undertakings of any nature made by or on behalf of the parties, whether oral or written, in relation to that subject matter. Each party acknowledges that in entering into this Publication Agreement it has not relied upon any oral or written statements, collateral or other warranties, assurances, representations or undertakings which were made by or on behalf of the other party in relation to the subject matter of this Publication Agreement at any time before its signature (together "Pre-Contractual Statements"), other than those which are set out in this Publication Agreement. Each party hereby waives all rights and remedies which might otherwise be available to it in relation to such Pre-Contractual Statements. Nothing in this clause shall exclude or restrict the liability of either party arising out of its pre-contract fraudulent misrepresentation or fraudulent concealment.
\\n\\n7.4 Waiver: No failure or delay by a party to exercise any right or remedy provided under this Publication Agreement or by law shall constitute a waiver of that or any other right or remedy, nor shall it preclude or restrict the further exercise of that or any other right or remedy. No single or partial exercise of such right or remedy shall preclude or restrict the further exercise of that or any other right or remedy.
\\n\\n7.5 Variation: No variation of this Publication Agreement shall be effective unless it is in writing and signed by the parties (or their duly authorized representatives).
\\n\\n7.6 Severance: If any provision or part-provision of this Publication Agreement is or becomes invalid, illegal or unenforceable, it shall be deemed modified to the minimum extent necessary to make it valid, legal and enforceable. If such modification is not possible, the relevant provision or part-provision shall be deemed deleted.
\\n\\nAny modification to or deletion of a provision or part-provision under this clause shall not affect the validity and enforceability of the rest of this Publication Agreement.
\\n\\n7.7 No partnership: Nothing in this Publication Agreement is intended to, or shall be deemed to, establish or create any partnership or joint venture or the relationship of principal and agent or employer and employee between IntechOpen and the Corresponding Author or any Co-Author, nor authorize any party to make or enter into any commitments for or on behalf of any other party.
\\n\\n7.8 Governing law: This Publication Agreement and any dispute or claim (including non-contractual disputes or claims) arising out of or in connection with it or its subject matter or formation shall be governed by and construed in accordance with the law of England and Wales. The parties submit to the exclusive jurisdiction of the English courts to settle any dispute or claim arising out of or in connection with this Publication Agreement (including any non-contractual disputes or claims).
\\n\\nLast updated: 2020-11-27
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The Corresponding Author (acting on behalf of all Authors) and INTECHOPEN LIMITED, incorporated and registered in England and Wales with company number 11086078 and a registered office at 5 Princes Gate Court, London, United Kingdom, SW7 2QJ conclude the following Agreement regarding the publication of a Book Chapter:
\n\n1. DEFINITIONS
\n\nCorresponding Author: The Author of the Chapter who serves as a Signatory to this Agreement. The Corresponding Author acts on behalf of any other Co-Author.
\n\nCo-Author: All other Authors of the Chapter besides the Corresponding Author.
\n\nIntechOpen: IntechOpen Ltd., the Publisher of the Book.
\n\nBook: The publication as a collection of chapters compiled by IntechOpen including the Chapter. Chapter: The original literary work created by Corresponding Author and any Co-Author that is the subject of this Agreement.
\n\n2. CORRESPONDING AUTHOR'S GRANT OF RIGHTS
\n\n2.1 Subject to the following Article, the Corresponding Author grants and shall ensure that each Co-Author grants, to IntechOpen, during the full term of copyright and any extensions or renewals of that term the following:
\n\nThe aforementioned licenses shall survive the expiry or termination of this Agreement for any reason.
\n\n2.2 The Corresponding Author (on their own behalf and on behalf of any Co-Author) reserves the following rights to the Chapter but agrees not to exercise them in such a way as to adversely affect IntechOpen's ability to utilize the full benefit of this Publication Agreement: (i) reprographic rights worldwide, other than those which subsist in the typographical arrangement of the Chapter as published by IntechOpen; and (ii) public lending rights arising under the Public Lending Right Act 1979, as amended from time to time, and any similar rights arising in any part of the world.
\n\nThe Corresponding Author confirms that they (and any Co-Author) are and will remain a member of any applicable licensing and collecting society and any successor to that body responsible for administering royalties for the reprographic reproduction of copyright works.
\n\nSubject to the license granted above, copyright in the Chapter and all versions of it created during IntechOpen's editing process (including the published version) is retained by the Corresponding Author and any Co-Author.
\n\nSubject to the license granted above, the Corresponding Author and any Co-Author retains patent, trademark and other intellectual property rights to the Chapter.
\n\n2.3 All rights granted to IntechOpen in this Article are assignable, sublicensable or otherwise transferrable to third parties without the Corresponding Author's or any Co-Author’s specific approval.
\n\n2.4 The Corresponding Author (on their own behalf and on behalf of each Co-Author) will not assert any rights under the Copyright, Designs and Patents Act 1988 to object to derogatory treatment of the Chapter as a consequence of IntechOpen's changes to the Chapter arising from translation of it, corrections and edits for house style, removal of problematic material and other reasonable edits.
\n\n3. CORRESPONDING AUTHOR'S DUTIES
\n\n3.1 When distributing or re-publishing the Chapter, the Corresponding Author agrees to credit the Book in which the Chapter has been published as the source of first publication, as well as IntechOpen. The Corresponding Author warrants that each Co-Author will also credit the Book in which the Chapter has been published as the source of first publication, as well as IntechOpen, when they are distributing or re-publishing the Chapter.
\n\n3.2 When submitting the Chapter, the Corresponding Author agrees to:
\n\nThe Corresponding Author will be held responsible for the payment of the Open Access Publishing Fees.
\n\nAll payments shall be due 30 days from the date of the issued invoice. The Corresponding Author or the payer on the Corresponding Author's and Co-Authors' behalf will bear all banking and similar charges incurred.
\n\n3.3 The Corresponding Author shall obtain in writing all consents necessary for the reproduction of any material in which a third-party right exists, including quotations, photographs and illustrations, in all editions of the Chapter worldwide for the full term of the above licenses, and shall provide to IntechOpen upon request the original copies of such consents for inspection (at IntechOpen's option) or photocopies of such consents.
\n\nThe Corresponding Author shall obtain written informed consent for publication from people who might recognize themselves or be identified by others (e.g. from case reports or photographs).
\n\n3.4 The Corresponding Author and any Co-Author shall respect confidentiality rights during and after the termination of this Agreement. The information contained in all correspondence and documents as part of the publishing activity between IntechOpen and the Corresponding Author and any Co-Author are confidential and are intended only for the recipient. The contents may not be disclosed publicly and are not intended for unauthorized use or distribution. Any use, disclosure, copying, or distribution is prohibited and may be unlawful.
\n\n4. CORRESPONDING AUTHOR'S WARRANTY
\n\n4.1 The Corresponding Author represents and warrants that the Chapter does not and will not breach any applicable law or the rights of any third party and, specifically, that the Chapter contains no matter that is defamatory or that infringes any literary or proprietary rights, intellectual property rights, or any rights of privacy. The Corresponding Author warrants and represents that: (i) the Chapter is the original work of themselves and any Co-Author and is not copied wholly or substantially from any other work or material or any other source; (ii) the Chapter has not been formally published in any other peer-reviewed journal or in a book or edited collection, and is not under consideration for any such publication; (iii) they themselves and any Co-Author are qualifying persons under section 154 of the Copyright, Designs and Patents Act 1988; (iv) they themselves and any Co-Author have not assigned and will not during the term of this Publication Agreement purport to assign any of the rights granted to IntechOpen under this Publication Agreement; and (v) the rights granted by this Publication Agreement are free from any security interest, option, mortgage, charge or lien.
\n\nThe Corresponding Author also warrants and represents that: (i) they have the full power to enter into this Publication Agreement on their own behalf and on behalf of each Co-Author; and (ii) they have the necessary rights and/or title in and to the Chapter to grant IntechOpen, on behalf of themselves and any Co-Author, the rights and licenses expressed to be granted in this Publication Agreement. If the Chapter was prepared jointly by the Corresponding Author and any Co-Author, the Corresponding Author warrants and represents that: (i) each Co-Author agrees to the submission, license and publication of the Chapter on the terms of this Publication Agreement; and (ii) they have the authority to enter into this Publication Agreement on behalf of and bind each Co-Author. The Corresponding Author shall: (i) ensure each Co-Author complies with all relevant provisions of this Publication Agreement, including those relating to confidentiality, performance and standards, as if a party to this Publication Agreement; and (ii) remain primarily liable for all acts and/or omissions of each such Co-Author.
\n\nThe Corresponding Author agrees to indemnify and hold IntechOpen harmless against all liabilities, costs, expenses, damages and losses and all reasonable legal costs and expenses suffered or incurred by IntechOpen arising out of or in connection with any breach of the aforementioned representations and warranties. This indemnity shall not cover IntechOpen to the extent that a claim under it results from IntechOpen's negligence or willful misconduct.
\n\n4.2 Nothing in this Publication Agreement shall have the effect of excluding or limiting any liability for death or personal injury caused by negligence or any other liability that cannot be excluded or limited by applicable law.
\n\n5. TERMINATION
\n\n5.1 IntechOpen has a right to terminate this Publication Agreement for quality, program, technical or other reasons with immediate effect, including without limitation (i) if the Corresponding Author or any Co-Author commits a material breach of this Publication Agreement; (ii) if the Corresponding Author or any Co-Author (being an individual) is the subject of a bankruptcy petition, application or order; or (iii) if the Corresponding Author or any Co-Author (being a company) commences negotiations with all or any class of its creditors with a view to rescheduling any of its debts, or makes a proposal for or enters into any compromise or arrangement with any of its creditors.
\n\nIn case of termination, IntechOpen will notify the Corresponding Author, in writing, of the decision.
\n\n6. INTECHOPEN’S DUTIES AND RIGHTS
\n\n6.1 Unless prevented from doing so by events outside its reasonable control, IntechOpen, in its discretion, agrees to publish the Chapter attributing it to the Corresponding Author and any Co-Author.
\n\n6.2 IntechOpen has the right to use the Corresponding Author’s and any Co-Author’s names and likeness in connection with scientific dissemination, retrieval, archiving, web hosting and promotion and marketing of the Chapter and has the right to contact the Corresponding Author and any Co-Author until the Chapter is publicly available on any platform owned and/or operated by IntechOpen.
\n\n6.3 IntechOpen is granted the authority to enforce the rights from this Publication Agreement, on behalf of the Corresponding Author and any Co-Author, against third parties (for example in cases of plagiarism or copyright infringements). In respect of any such infringement or suspected infringement of the copyright in the Chapter, IntechOpen shall have absolute discretion in addressing any such infringement which is likely to affect IntechOpen's rights under this Publication Agreement, including issuing and conducting proceedings against the suspected infringer.
\n\n7. MISCELLANEOUS
\n\n7.1 Further Assurance: The Corresponding Author shall and will ensure that any relevant third party (including any Co-Author) shall, execute and deliver whatever further documents or deeds and perform such acts as IntechOpen reasonably requires from time to time for the purpose of giving IntechOpen the full benefit of the provisions of this Publication Agreement.
\n\n7.2 Third Party Rights: A person who is not a party to this Publication Agreement may not enforce any of its provisions under the Contracts (Rights of Third Parties) Act 1999.
\n\n7.3 Entire Agreement: This Publication Agreement constitutes the entire agreement between the parties in relation to its subject matter. It replaces and extinguishes all prior agreements, draft agreements, arrangements, collateral warranties, collateral contracts, statements, assurances, representations and undertakings of any nature made by or on behalf of the parties, whether oral or written, in relation to that subject matter. Each party acknowledges that in entering into this Publication Agreement it has not relied upon any oral or written statements, collateral or other warranties, assurances, representations or undertakings which were made by or on behalf of the other party in relation to the subject matter of this Publication Agreement at any time before its signature (together "Pre-Contractual Statements"), other than those which are set out in this Publication Agreement. Each party hereby waives all rights and remedies which might otherwise be available to it in relation to such Pre-Contractual Statements. Nothing in this clause shall exclude or restrict the liability of either party arising out of its pre-contract fraudulent misrepresentation or fraudulent concealment.
\n\n7.4 Waiver: No failure or delay by a party to exercise any right or remedy provided under this Publication Agreement or by law shall constitute a waiver of that or any other right or remedy, nor shall it preclude or restrict the further exercise of that or any other right or remedy. No single or partial exercise of such right or remedy shall preclude or restrict the further exercise of that or any other right or remedy.
\n\n7.5 Variation: No variation of this Publication Agreement shall be effective unless it is in writing and signed by the parties (or their duly authorized representatives).
\n\n7.6 Severance: If any provision or part-provision of this Publication Agreement is or becomes invalid, illegal or unenforceable, it shall be deemed modified to the minimum extent necessary to make it valid, legal and enforceable. If such modification is not possible, the relevant provision or part-provision shall be deemed deleted.
\n\nAny modification to or deletion of a provision or part-provision under this clause shall not affect the validity and enforceability of the rest of this Publication Agreement.
\n\n7.7 No partnership: Nothing in this Publication Agreement is intended to, or shall be deemed to, establish or create any partnership or joint venture or the relationship of principal and agent or employer and employee between IntechOpen and the Corresponding Author or any Co-Author, nor authorize any party to make or enter into any commitments for or on behalf of any other party.
\n\n7.8 Governing law: This Publication Agreement and any dispute or claim (including non-contractual disputes or claims) arising out of or in connection with it or its subject matter or formation shall be governed by and construed in accordance with the law of England and Wales. The parties submit to the exclusive jurisdiction of the English courts to settle any dispute or claim arising out of or in connection with this Publication Agreement (including any non-contractual disputes or claims).
\n\nLast updated: 2020-11-27
\n\n\n\n
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I am also a member of the team in charge for the supervision of Ph.D. students in the fields of development of silicon based planar waveguide sensor devices, study of inelastic electron tunnelling in planar tunnelling nanostructures for sensing applications and development of organotellurium(IV) compounds for semiconductor applications. I am a specialist in data analysis techniques and nanosurface structure. I have served as the editor for many books, been a member of the editorial board in science journals, have published many papers and hold many patents.",institutionString:null,institution:{name:"Sheffield Hallam University",country:{name:"United Kingdom"}}},{id:"54525",title:"Prof.",name:"Abdul Latif",middleName:null,surname:"Ahmad",slug:"abdul-latif-ahmad",fullName:"Abdul Latif Ahmad",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"20567",title:"Prof.",name:"Ado",middleName:null,surname:"Jorio",slug:"ado-jorio",fullName:"Ado Jorio",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universidade Federal de Minas Gerais",country:{name:"Brazil"}}},{id:"47940",title:"Dr.",name:"Alberto",middleName:null,surname:"Mantovani",slug:"alberto-mantovani",fullName:"Alberto Mantovani",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"12392",title:"Mr.",name:"Alex",middleName:null,surname:"Lazinica",slug:"alex-lazinica",fullName:"Alex Lazinica",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/12392/images/7282_n.png",biography:"Alex Lazinica is the founder and CEO of IntechOpen. After obtaining a Master's degree in Mechanical Engineering, he continued his PhD studies in Robotics at the Vienna University of Technology. Here he worked as a robotic researcher with the university's Intelligent Manufacturing Systems Group as well as a guest researcher at various European universities, including the Swiss Federal Institute of Technology Lausanne (EPFL). During this time he published more than 20 scientific papers, gave presentations, served as a reviewer for major robotic journals and conferences and most importantly he co-founded and built the International Journal of Advanced Robotic Systems- world's first Open Access journal in the field of robotics. Starting this journal was a pivotal point in his career, since it was a pathway to founding IntechOpen - Open Access publisher focused on addressing academic researchers needs. Alex is a personification of IntechOpen key values being trusted, open and entrepreneurial. Today his focus is on defining the growth and development strategy for the company.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"19816",title:"Prof.",name:"Alexander",middleName:null,surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/19816/images/1607_n.jpg",biography:"Alexander I. Kokorin: born: 1947, Moscow; DSc., PhD; Principal Research Fellow (Research Professor) of Department of Kinetics and Catalysis, N. Semenov Institute of Chemical Physics, Russian Academy of Sciences, Moscow.\r\nArea of research interests: physical chemistry of complex-organized molecular and nanosized systems, including polymer-metal complexes; the surface of doped oxide semiconductors. He is an expert in structural, absorptive, catalytic and photocatalytic properties, in structural organization and dynamic features of ionic liquids, in magnetic interactions between paramagnetic centers. The author or co-author of 3 books, over 200 articles and reviews in scientific journals and books. He is an actual member of the International EPR/ESR Society, European Society on Quantum Solar Energy Conversion, Moscow House of Scientists, of the Board of Moscow Physical Society.",institutionString:null,institution:{name:"Semenov Institute of Chemical Physics",country:{name:"Russia"}}},{id:"62389",title:"PhD.",name:"Ali Demir",middleName:null,surname:"Sezer",slug:"ali-demir-sezer",fullName:"Ali Demir Sezer",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62389/images/3413_n.jpg",biography:"Dr. Ali Demir Sezer has a Ph.D. from Pharmaceutical Biotechnology at the Faculty of Pharmacy, University of Marmara (Turkey). He is the member of many Pharmaceutical Associations and acts as a reviewer of scientific journals and European projects under different research areas such as: drug delivery systems, nanotechnology and pharmaceutical biotechnology. Dr. Sezer is the author of many scientific publications in peer-reviewed journals and poster communications. Focus of his research activity is drug delivery, physico-chemical characterization and biological evaluation of biopolymers micro and nanoparticles as modified drug delivery system, and colloidal drug carriers (liposomes, nanoparticles etc.).",institutionString:null,institution:{name:"Marmara University",country:{name:"Turkey"}}},{id:"61051",title:"Prof.",name:"Andrea",middleName:null,surname:"Natale",slug:"andrea-natale",fullName:"Andrea Natale",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"100762",title:"Prof.",name:"Andrea",middleName:null,surname:"Natale",slug:"andrea-natale",fullName:"Andrea Natale",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"St David's Medical Center",country:{name:"United States of America"}}},{id:"107416",title:"Dr.",name:"Andrea",middleName:null,surname:"Natale",slug:"andrea-natale",fullName:"Andrea Natale",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Texas Cardiac Arrhythmia",country:{name:"United States of America"}}},{id:"64434",title:"Dr.",name:"Angkoon",middleName:null,surname:"Phinyomark",slug:"angkoon-phinyomark",fullName:"Angkoon Phinyomark",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/64434/images/2619_n.jpg",biography:"My name is Angkoon Phinyomark. I received a B.Eng. degree in Computer Engineering with First Class Honors in 2008 from Prince of Songkla University, Songkhla, Thailand, where I received a Ph.D. degree in Electrical Engineering. My research interests are primarily in the area of biomedical signal processing and classification notably EMG (electromyography signal), EOG (electrooculography signal), and EEG (electroencephalography signal), image analysis notably breast cancer analysis and optical coherence tomography, and rehabilitation engineering. I became a student member of IEEE in 2008. During October 2011-March 2012, I had worked at School of Computer Science and Electronic Engineering, University of Essex, Colchester, Essex, United Kingdom. In addition, during a B.Eng. I had been a visiting research student at Faculty of Computer Science, University of Murcia, Murcia, Spain for three months.\n\nI have published over 40 papers during 5 years in refereed journals, books, and conference proceedings in the areas of electro-physiological signals processing and classification, notably EMG and EOG signals, fractal analysis, wavelet analysis, texture analysis, feature extraction and machine learning algorithms, and assistive and rehabilitative devices. I have several computer programming language certificates, i.e. Sun Certified Programmer for the Java 2 Platform 1.4 (SCJP), Microsoft Certified Professional Developer, Web Developer (MCPD), Microsoft Certified Technology Specialist, .NET Framework 2.0 Web (MCTS). 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