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Psychoanalysis On and Off the Couch

Nov 10, 2019

“The experience and feeling that another person who is close to you is really curious about you and who really wonders who this person is - someone who is interested in asking the question: ‘Who are you?’ I think it is through that type of curiosity and the relationship which stems from that, that we develop a lot of our sense of self and who we are.”


Description: Harvey Schwartz welcomes Dr. David Clinton from Stockholm, Sweden. He is originally from Scotland but is now based in Sweden where he has been working in the eating disorders field for over 30 years. He is a member of the Swedish Psychoanalytical Association and an associate member of medical psychology at the Karolinska Institute in Stockholm and the Director of Research at the Institute for Eating Disorders in Oslo. David is involved with research and training in eating disorders professionals at the Karolinska Institute and has a private practice in psychoanalysis, psychodynamic psychotherapy, and clinical supervision, working in both English and Swedish. For 10 years, Dr. Clinton has worked closely with the eating disorders advocacy group called Healthy and Free which is part of the National Association against Eating Disorders. Together with this group, he has been actively exploring new ways of stimulating closer collaboration between clinicians, researchers, patients, and families. Outside of the eating disorder field, Dr. Clinton has been engaged in psychotherapeutic work at the Swedish Association for Sexuality Education which runs a public-funded clinic for psychosexual health. He has worked with eating disorder patients who struggled with pervasive problems linked to sexual self-destructiveness and trauma.


As you will hear in my conversation with David, he has taken up the challenge that a patient posed him many years ago, when he was working just with symptom alleviation - the patient said: “You helped me to survive, but now you have to help me learn to live.”


Key takeaways:

[4:44] The interference of eating disorders with intimacy.

[5:39] The morbidity of eating disorders.

[7:09] Going beyond the symptoms.

[7:37] The role of trauma in patients with eating disorders.

[9:34] The trauma caused by not being seen.

[10:56] The feeling of lack of presence in the other person’s mind.

[12:09] The curiosity of the patient regarding the therapist.

[15:30] From the concrete to the metaphorical.

[15:47] Dr. Clinton shares a case example.

[20:36] Patients working to be seen and loved for who they are.

[22:25] When the patient becomes aware that the therapist does not think about them as an object but as a subject.

[23:35] Discovering a new inner self.

[24:15] Dr. Clinton talks about his work with the patient advocacy group.


Mentioned in this episode:

IPA Off the Couch


Recommended Readings:


Bruch, H. (1973). Eating disorders: Obesity, anorexia nervosa and the person within. New York: Basic Books.


Clinton, D. (2006). Affect regulation, object relations and the central symptoms of eating disorders. European Eating Disorders Review, 14: 203-211.


Forsén Mantilla, E., Clinton, D. & Birgegård, A. (2018). The unsafe haven: Eating disorders as attachment relationships. Psychology and Psychotherapy: Theory, Research and Practice, 92: 379-393.


Robinson, P., Skårderud, F., Sommerfeldt, B. (2019). Hunger: Mentalization-based treatments for eating disorders. Cham, Switzerland: Springer.