The Heimann-Bielschowsky phenomenon after optic neuritis.

A 32-year-old woman with relapsing-remitting multiple sclerosis and a right optic neuritis with incomplete remission presented with unique neuro-ophthalmologic abnormality consisting of a spontaneous, pendular, vertical movement of the right eye consistent with the Heimann-Bielschowsky phenomenon (HBP). This rare form of dissociated nystagmus probably reflects a "dual abnormality mechanism" comprising the coexistence of an asymmetric conduction delay in the optic nerve and a strategic network disruption in brainstem gaze holding centres. For the clinician it is important to recognize this rare neuro-ophthalmologic syndrome and be aware of its benign nature.

Racker and Heimann on Countertransference: Similarities and Differences.

Both Sigmund Freud and Melanie Klein recognized the existence of countertransference but distrusted its clinical use. This idea was the one that prevailed until the late 1940s, when Heinrich Racker in Buenos Aires and Paula Heimann in London played decisive roles in reinstating countertransference. More specifically, both Racker (in 1948) and Heimann (in 1949), independently of and without contact with each other, claimed the importance of countertransference for signifying the transference and unconscious processes that the patient re-enacts in the analytic relationship. The context in which their ideas were developed allows us to recognize differences within their common view of countertransference as a useful tool in psychoanalytic work. In this article, we present the development of both Racker's and Heimann's ideas on countertransference and attempt a comparison of similarities and differences of those ideas and put them into a historical and clinical-theoretical context.

Heimann-Bielschowsky phenomenon and hypotropic DVD in case of monocular vision loss: a case report.

BACKGROUND: The Heimann-Bielschowsky phenomenon (HBP) is an underrecognized condition characterized by slow, pendular, vertical oscillations of the eye accompanying monocular vision loss. Hypotropic dissociated vertical deviation (DVD) is another rare condition induced by asymmetric visual input. This report documents a rare case of HBP with hypotropic DVD. CASE PRESENTATION: This report describes a case of a 58-year-old woman with HBP and hypotropic DVD, having suffered monocular vision loss in the left eye due to blunt trauma at the age of 10. Preoperatively, she was orthophoric at near fixation and demonstrated an intermittent, slow hypotropia of the left eye upon distance fixation that never rose above the midline. She underwent a 7 mm recession of the inferior rectus muscle in the left eye. After surgery, intermittent, downward drifts became constant vertical oscillations at both distance and near fixation. CONCLUSIONS: This case describes the clinical manifestation of an eye movement disorder related to prolonged monocular vision loss.

Shared Features of the Heimann-Bielshowsky Phenomenon and Ocular Neuromyotonia.

We describe a case of unusual ocular movement with features of both the Heimann-Bielshowsky Phenomenon and Ocular Neuromyotonia that might suggest that they share some common pathophysiology or be on a spectrum of abnormal firing of ocular motor cranial nerves. We are the first to propose such a relationship.

RETHINKING THE ROLE OF SMALL-GROUP COLLABORATORS AND ADVERSARIES IN THE LONDON KLEINIAN DEVELOPMENT (1914-1968).

The authors historically situate the London Kleinian development in terms of the small-group collaborations and adversaries that arose during the course of Melanie Klein's career. Some collaborations later became personally adversarial (e.g., those Klein had with Glover and Schmideberg); other adversarial relationships forever remained that way (with A. Freud); while still other long-term collaborations became theoretically contentious (such as with Winnicott and Heimann). After the Controversial Discussions in 1944, Klein marginalized one group of supporters (Heimann, Winnicott, and Riviere) in favor of another group (Rosenfeld, Segal, and Bion). After Klein's death in 1960, Bion maintained loyalty to Klein's ideas while quietly distancing his work from the London Klein group, immigrating to the United States in 1968.

Sobre o conceito de contratransferência em Freud, Ferenczi e Heimann / On countertransference concept in Freud, Ferenczi and Heimann / Sobre el concepto de contratransferencia en Freud, Ferenczi y Heimann

Toda análise é trespassada, inevitavelmente, pela contratransferência. Esse fenômeno constitui-se numa das questões fundamentais e mais problemáticas da teoria e técnica psicanalíticas, pois afeta o analista no cotidiano de sua clínica e o remete à sua análise pessoal, supervisão e escrita clínica, tal a angústia em face da inquietante estranheza da transferência. Denotada sua importância, neste texto será trabalhada a construção do seu conceito em Sigmund Freud como experiência necessária, mas um problema a ser resolvido, em Sándor Ferenczi, que aproxima a contratransferência como parte inerente da relação transferencial e da técnica analítica, e em sua posterior releitura por Paula Heimann em 1950, que demarca a importante mudança na compreensão do termo como ferramenta essencial ao método analítico...

All analysis is inevitably pierced by the countertransference. This phenomenon is one of the key issues of psychoanalytic's theory and technique as it affects the analyst in his daily clinical and refers to his personal analysis, clinical supervision and writing, because of the anguish relative to the transference's disturbing strangeness. Denoted its importance in this text, we will investigate the construction of its concept in Sigmund Freud as a experience necessary, but also as a problem to be solved, in Sándor Ferenczi's work, when approaching the countertransference as an inherent part of the transference relationship and the analytical technique. We will also demonstrate its subsequent comprehension by Paula Heimann in 1950, who made a major shift at the understanding of the term as an essential tool for analytical method...

Todos los análisis están impregnados, inevitablemente, por la contratransferencia. Este fenómeno constituye una de las cuestiones y de los problemas de la teoría y de la técnica psicoanalíticas más fundamentales, ya que afecta al analista en su clínica diaria y se refiere a su análisis personal, su supervisión clínica y su escritura, tal es la angustia acerca de la extrañeza inquietante de la transferencia. Denotada su importancia, este texto se dedica a la construcción del concepto en Sigmund Freud como una experiencia necesaria, sino un problema que hay que resolver, en Sándor Ferenczi, quien demuestra ser la contratransferencia una parte inherente de la relación transferencial y de la técnica analítica, y en su posterior reinterpretación de Paula Heimann en 1950, lo que supone un cambio radical en la comprensión del término como una herramienta esencial para el método analítico...

Sobre o conceito de contratransferência em Freud, Ferenczi e Heimann / On countertransference concept in Freud, Ferenczi and Heimann / Sobre el concepto de contratransferencia en Freud, Ferenczi y Heimann

Toda análise é trespassada, inevitavelmente, pela contratransferência. Esse fenômeno constitui-se numa das questões fundamentais e mais problemáticas da teoria e técnica psicanalíticas, pois afeta o analista no cotidiano de sua clínica e o remete à sua análise pessoal, supervisão e escrita clínica, tal a angústia em face da inquietante estranheza da transferência. Denotada sua importância, neste texto será trabalhada a construção do seu conceito em Sigmund Freud como experiência necessária, mas um problema a ser resolvido, em Sándor Ferenczi, que aproxima a contratransferência como parte inerente da relação transferencial e da técnica analítica, e em sua posterior releitura por Paula Heimann em 1950, que demarca a importante mudança na compreensão do termo como ferramenta essencial ao método analítico.(AU)

All analysis is inevitably pierced by the countertransference. This phenomenon is one of the key issues of psychoanalytic's theory and technique as it affects the analyst in his daily clinical and refers to his personal analysis, clinical supervision and writing, because of the anguish relative to the transference's disturbing strangeness. Denoted its importance in this text, we will investigate the construction of its concept in Sigmund Freud as a experience necessary, but also as a problem to be solved, in Sándor Ferenczi's work, when approaching the countertransference as an inherent part of the transference relationship and the analytical technique. We will also demonstrate its subsequent comprehension by Paula Heimann in 1950, who made a major shift at the understanding of the term as an essential tool for analytical method.(AU)

Todos los análisis están impregnados, inevitablemente, por la contratransferencia. Este fenómeno constituye una de las cuestiones y de los problemas de la teoría y de la técnica psicoanalíticas más fundamentales, ya que afecta al analista en su clínica diaria y se refiere a su análisis personal, su supervisión clínica y su escritura, tal es la angustia acerca de la extrañeza inquietante de la transferencia. Denotada su importancia, este texto se dedica a la construcción del concepto en Sigmund Freud como una experiencia necesaria, sino un problema que hay que resolver, en Sándor Ferenczi, quien demuestra ser la contratransferencia una parte inherente de la relación transferencial y de la técnica analítica, y en su posterior reinterpretación de Paula Heimann en 1950, lo que supone un cambio radical en la comprensión del término como una herramienta esencial para el método analítico.(AU)

The Effect of Horizontal Extraocular Muscle Surgery on the Heimann-Bielschowsky Phenomenon.

We report the effect of horizontal extraocular muscle surgery of Heimann-Bielshowsky phenomenon. A 52-year-old woman complained of binocular diplopia for a few months. In 2000, she underwent extracapsular cataract extraction with intraocular lens implantation in the right eye. After surgery, the diplopia persisted and developed further. She showed an esodeviation of 60 prism dioptres at near fixation and distance fixation. Cortical opacity and nucleus sclerosis were observed in the left lens, and phacoemulsification with intraocular lens implantation was performed in the left eye in October 2011. After cataract surgery, the patient suffered from oscillopsia and diplopia. Examination revealed unilateral coarse, slow, pendular vertical oscillations in the right eye and an esodeviation of 45 prism dioptres and a right hypodeviation of 8 prism dioptres, which were observed before the surgery. We performed a medial rectus muscle 6 mm recession and lateral rectus muscle 7 mm resection surgery on the right eye. After the operation, the oscillations disappeared and diplopia greatly improved. Moreover, the patient no longer complained of oscillopsia. We conclude that surgery performed on horizontal extraocular muscles could be an effective treatment for Heimann-Bielschowsky phenomenon also.