Episode Overview

Podcast: New Books Network
Episode: Tom Wooldridge, "Eating Disorders: A Contemporary Introduction" (Routledge, 2022)
Host: Helena Wiesing
Guest: Tom Wooldridge
Release Date: September 5, 2025

This episode explores Tom Wooldridge’s latest book, Eating Disorders: A Contemporary Introduction. The conversation traverses Wooldridge’s motivation for writing the book, the complexity and heterogeneity of eating disorders, the value of psychoanalytic and psychodynamic approaches, relational and familial dynamics, and the profound struggles both clients and clinicians face in the realm of eating disorders. Wooldridge also discusses his conceptual contributions, such as the "entropic body," the role of online forums, and previews his new projects dedicated to parents.

Key Discussion Points & Insights

1. Motivation and Book Context

• Personal & Professional Motivation (02:03)

  • Wooldridge’s background as an athlete sensitized him to issues of body image and fitness.

  • Early clinical work with young people revealed the limitations of symptom-focused treatment and sparked his interest in psychoanalytic approaches.

  • He sought to integrate deeper psychodynamic theory to address underlying dynamics beyond surface symptoms.

    "At that time I was exposed to some of the more symptom focused, manualized responses to eating disorders and while I found them helpful...they didn't really get to the deeper dynamics at play." — Tom Wooldridge (02:40)

• Book Series and Structure (03:52)

  • Part of Routledge's "New Introductions to Contemporary Psychoanalysis."

  • Focuses on the idea of structural diagnosis: understanding the underlying ways a person is structured, not just the descriptive symptoms.

  • Goal: support more complete, sustainable recovery.

    "With that structural diagnosis in hand, you can really address the whole complexity of the person in treatment..." — Tom Wooldridge (04:34)

2. Heterogeneity of Eating Disorders

• Diversity Within Diagnoses (05:55)

  • Eating disorders are not monolithic; even within anorexia, patients show widely different personality styles and underlying structural issues.

  • Examples: Highly perfectionistic, high-functioning prototypes vs. undercontrolled, trauma-impacted individuals.

    "...what's needed for one person is not necessarily what's needed for the other." — Tom Wooldridge (07:12)

3. Psychoanalytic Perspective & Family Dynamics

• Recovery as Development (07:35)

  • Full recovery is understood as "the growth and development of personality" — a concept rooted in psychoanalytic thinking.
  • Treatment is both intrapsychic and relational, often requiring engagement with family systems.

• Team Approach & Complexity (09:48)

  • Emphasizes the need for multidisciplinary teams: physicians, nutritionists, psychiatrists, family therapists.

  • Psychoanalysis offers depth, but symptom stabilization (e.g., weight restoration) often requires coordinated care.

  • Complexity rises when parents resist or are unable to participate in healing; recovery trajectories are unpredictable, especially with adolescents.

    "You can't always say ahead of time what's possible for any individual." — Tom Wooldridge (12:21)

4. Stigma, Blame, and Parental Involvement

• Historical Stigma vs. New Extremes (14:45, 18:55)

  • Previous eras (e.g., Hilda Bruch) overemphasized family blame, alienating parents.

  • Current trends sometimes swing to agnosticism, portraying eating disorders as if they arise in a vacuum—another imbalance.

  • Parents’ own histories, attachment styles, and vulnerabilities must be acknowledged thoughtfully, without blame or denial.

    "Parents, I think, really need help developing the capacity for emotional attunement, the capacity to reflect on their own states of mind, their child's states of mind. They need help moving through and out of self-blame, through grief..." — Tom Wooldridge (16:30)

5. Body Image, Affect Regulation, and Relational Context

• Body Image Is Relational (20:54)

  • The experience of one's body is dynamic, shifting with relational and emotional contexts—not merely an objective or culturally influenced phenomenon.

    "Body image may vary, our self states vary with each self state bringing to the foreground relational identifications that in turn shape the way that the body is experienced." — Helena Wiesing quoting Wooldridge (21:15)

• Symbolic Growth and Alexithymia (42:12)

  • Many with eating disorders initially express strictly concrete beliefs about their bodies ("my body is fat. There’s nothing else to say about it").
  • Treatment invites expansion into symbolic, emotional registers—fostering reflection and growth.

6. Concept of the Entropic Body & Survival Function of Symptoms

• "Entropic Body" Concept (26:38)

  • Developed from Jean Petrucelli's idea of "body states."

  • The "entropic body" describes starvation as an emotional regulation strategy—serving as a substitute for reliable attunement from others.

  • Starvation can provide a perverse sense of calm and control, especially in the face of annihilating anxiety.

    "...for her, starvation was a way of achieving a state of calm. It could mute the intensity of affect for her. And...it came to be a kind of stand in for a reliable, attuned other..." — Tom Wooldridge (28:12)

7. Clinical Challenges: Dissociation, Intensity, and Consultation

• Working with Severe States (31:20, 35:07)

  • Clinical work can encounter profound dissociation, patient indifference, and walling off.

  • Not all treatments succeed in reaching the vulnerable parts of the client.

  • Therapist vulnerability is key; supervision and consultation are vital, particularly given the existential stakes.

    "You have to find ways to stay in touch with your own vulnerability...much more about staying kind of soft and receptive in yourself and knowing that inevitably you're going to lose touch with that...and how do you refine to that, again and again and again?" — Tom Wooldridge (35:44)

    "Enactment...is almost inevitable. Susan Sands has a lovely paper...she talks about the therapist's kind of oscillation between worry and neglect..." — Tom Wooldridge (36:28)

8. Cultural Milieu: Control, Self-Optimization, and Dependency

• Culture of Control (39:30)

  • Contemporary culture valorizes self-control, autonomy, and bodily mastery, amplifying tension for those with eating disorders.

  • This culture undermines the kinds of vulnerability and receptivity needed for healing, for clients and clinicians alike.

    "We live in a culture that really prioritizes self control...control is highly, highly valued in our culture. That is true." — Tom Wooldridge (40:36)

9. Digital Spaces and Eating Disorders

• Pro-Anorexia Forums (44:42)

  • Wooldridge’s research found both danger and moments of connection/support within pro-anorexia online communities.

  • Social media’s evolution (from text to image-based platforms) has potentially reduced opportunities for genuine connection and reflection.

  • Clinicians must grapple with the limits of their influence when adolescents are involved in these spaces.

    "...part of what I guess I'd say, looking back at that article, is that those sites are not one thing. There are many, many different kinds..." — Tom Wooldridge (46:00)

10. Looking Ahead: New Work for Parents

• Upcoming Projects (48:55)

  • Wooldridge has a new paper in progress on the dynamics of control in eating disorders.

  • He’s authored a forthcoming book (expected 2026) aimed at parents, centered not on treatment logistics, but on the emotional work parents must undertake—reflection, grief, and developing themselves as emotional resources for their children.

    "This is a book that's about the emotional work that parents need to do. So how do you reflect on your experience, your own states of mind as you engage with your child? How do you address your own grief and try to move through it?" — Tom Wooldridge (49:40)

Notable Quotes & Memorable Moments

• On Symptom-focused vs. Structural Approach:

  "I found again and again that [manualized treatments] didn't really get to the deeper dynamics at play." – Tom Wooldridge (02:40)

• On Family Dynamics:

  "...it's a hard conversation to have because you don't want to fall into, on the one hand, stigma and blame, and you also don't want to fall into kind of denial." – Tom Wooldridge (17:13)

• On the Entropic Body:

  "...starvation was a way of achieving a state of calm. It could mute the intensity of affect for her. And...it came to be a kind of stand in for a reliable, attuned other..." – Tom Wooldridge (28:12)

• On Clinician Vulnerability:

  "You have to find ways to stay in touch with your own vulnerability...knowing that inevitably you're going to lose touch with that...and how do you refine to that, again and again and again?" – Tom Wooldridge (35:44)

• On the Work Ahead for Parents:

  "...it's really about the parent as an emotional resource for the child, as the child goes through treatment and as the family goes through treatment." – Tom Wooldridge (50:18)

Timestamps for Important Segments

• 00:01:28 — Host’s introduction and opening question
• 00:02:03 – 04:57 — Author’s motivation and framework
• 00:05:55 – 07:35 — Heterogeneity within eating disorders
• 00:07:35 – 12:53 — Depth and complexity of psychoanalytic treatment; family system
• 00:14:45 – 17:27 — Stigma, blame, and refining the role of parents
• 00:18:55 – 20:54 — Agnostic positions & shifting family involvement
• 00:20:54 – 26:38 — Relational context of body image and the symbolic registers
• 00:26:38 – 29:50 — The "entropic body" and symptom as survival
• 00:31:20 – 37:40 — Clinical difficulties, dissociation, transference, and practitioner vulnerability
• 00:39:30 – 42:12 — Cultural context: control and dependency
• 00:42:12 – 43:55 — Moving from concrete to symbolic understanding and expression
• 00:44:42 – 47:55 — Digital forums and their changing impact
• 00:48:55 – 50:38 — Upcoming projects, especially a book for parents

Summary & Takeaways

• Tom Wooldridge’s work emphasizes the profound complexity, heterogeneity, and deeply relational nature of eating disorders.
• He advocates a structural, psychoanalytic understanding—complemented by multidisciplinary teamwork—as a path toward comprehensive and sustainable healing.
• Family systems play a central but nuanced role, requiring clinicians to balance sensitivity, non-blaming attitudes, and an invitation to reflective work for all parties involved.
• Concepts such as the “entropic body” offer clinicians tools for understanding why starvation and other symptoms can be so subjectively adaptive—while also challenging and potentially dangerous.
• The cultural climate of control and self-optimization, along with the rise of digital communities, adds layers of complexity to both symptoms and treatment.
• Wooldridge’s forthcoming book for parents aims to fill a crucial gap by supporting the parent’s emotional journey—enriching the efficacy of family-based care.

This summary captures the episode’s key content and discourse, highlighting the reflective, nuanced, and deeply humane tone of both guest and host throughout.