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Using a training programme developed by Heimlich. we have aitempled to train swallowing in a 78-year-old man who had been fed by a nasogastric tube for 3 years after a stroke. The training was successful and. during a follow-up of I year, the patient was eating normal food. The training process is analysed as a two-level communication between the patient and his trainer; the therapeutic relationship and the training programme. The development of the patient's attitudes during training is interpreted with reference to Erikson's theory of ‘eight stages of man’.