1st Edition

Psychoanalytic Treatment of Eating Disorders When Words Fail and Bodies Speak

Edited By Tom Wooldridge Copyright 2018
    304 Pages
    by Routledge

    304 Pages
    by Routledge

    Psychoanalytic Treatment of Eating Disorders: When Words Fail and Bodies Speak offers a compilation of some of the most innovative thinking on psychoanalytic approaches to the treatment of eating disorders available today. In its recognition of the multiple meanings of food, weight, and body shape, psychoanalytic thinking is uniquely positioned to illuminate the complexities of these often life-threatening conditions. And while clinicians regularly draw on psychoanalytic ideas in the treatment of eating disorders, many of the unique insights psychoanalysis provides have been neglected in the contemporary literature.

    This volume brings together some of the most respected clinicians in the field and speaks to the psychoanalytic conceptualization and treatment of eating disorders as well as contemporary issues, including social media, pro-anorexia forums, and larger cultural issues such as advertising, fashion, and even agribusiness. Drawing on new theoretical developments, several chapters propose novel models of treatment, whereas others delve into the complex convergence of culture and psychology in this patient population. 

    Psychoanalytic Treatment of Eating Disorders will be of interest to all psychoanalysts and psychotherapists working with this complex and multi-faceted phenomenon.


    Table of Contents




    Tom Wooldridge, PsyD, CEDS

    PART I. Conceptualization of eating disorders

    1. Psychodynamic improvement in eating disorders: welcoming ignored, unspoken, and neglected concerns in the patient to foster development and resiliency 

    Kathryn J. Zerbe, MD, FAED and Dana A. Satir, PhD, CEDS

    2. Invisibility and insubstantiality in an anorexic adolescent: phenomenology and dynamics

    Mary Brady, PhD

    3. Primary interactions and eating disorders: a psychoanalytic perspective

    Antonella Granieri, PhD

    4. An island entire of itself: narcissism in anorexia nervosa

    Anthony P. Winston, PhD

    5. The dead third in the treatment of an adolescent with anorexia nervosa

    Lorraine Caputo, LCSW

    PART II: Treatment of eating disorders

    6. From knowing to discovering: some suggestions for work with an anorexic patient

    Yael Kadish, PhD

    7. Heathen talk: psychoanalytic considerations of eating disorders and the dissociated self

    Judith Brisman, PhD

    8. To know another inside and out: linking psychic and somatic experience in eating disorders

    Danielle Novack, Ph.D.

    9. On targeting emotion regulation deficits in eating disorders through defense analysis

    Timothy Rice, M.D.

    10. Eating disorders, impaired mentalization, and attachment: implications for child and adolescent family treatment

    Starr Kelton-Locke, PhD

    PART III: Contemporary issues related to eating disorders

    11. The low spark of high-heeled 'girls': hyperdeadness and Hyperawareness with eating-disordered patients

    Jean Petrucelli, PhD

    12. Psychodynamic importance of "cyber" and "in the flesh" friends in psychotherapy with college-aged adolescents with eating disorders

    F. Diane Barth, LCSW

    13. The enigma of ana: a psychoanalytic exploration of pro-anorexia Internet forums

    Tom Wooldridge, PsyD, CEDS

    14. Towards social justice: the continuum of eating and body image problems: how social and psychological realities converge into an embodied epidemic

    Susan Gutwill, MSW, LCSW

    15. Enduring perfectionism: seeing through eating disorder recovery and America’s cultural complex

    Kim L. Grynick, LPC


    Tom Wooldridge, PsyD, CEDS, is Chair in the Department of Psychology at Golden Gate University, San Francisco, CA, and an Executive Director at the National Association for Males with Eating Disorders. He has published numerous journal articles and book chapters on topics such as eating disorders, masculinity, technology, and psychoanalytic treatment. His first book, Understanding Anorexia Nervosa in Males: An Integrative Approach, was published by Routledge in 2016. He is an advanced candidate at the Psychoanalytic Institute of Northern California and has a private practice in Berkeley, CA.

    "A report from the front; the unconscionable front, which has brought an assault on our bodies, with its devastating price on individuals and families. Here is the work of clinicians who engage with the troubled bodies and eating of our times as they theorise their understandings and learning. There is much to learn here."


    -- Susie Orbach is a psychoanalyst and psychotherapist, co-founder of The Women's Therapy Centre. Her books include Fat is a Feminist Issue, Hunger Strike, and the award winning Bodies. Her most recent is In Therapy, annotated sessions from her BBC Radio series of the same name. 


    "Tom Wooldridge has assembled an impressive array of contributors to offer a rich and valuable survey of the contemporary psychodynamic approach to eating disorders. New therapeutic conceptualizations, including mentalization- and emotion regulation-based strategies, are applied to the special circumstances involved in eating disorders. At the same time, the deep traditional analytic insights are included and updated: Freudian, Kleinian, newer Object Relational, Developmental Psychoanalytic, and Self Psychology. All of this is coordinated with an interest in the effects of contemporary culture on how eating disorders develop and present, including attention to the "pro-anorexia" groupings emerging on the Internet and the occurrence of eating disorders in boys and men.  This book will be invaluable to any practitioner working with such patients, and of significant interest to all."


    - Stephen Seligman, D.M.H.

    Clinical Professor of Psychiatry, University of California, San Francisco; author of Relationships in Development: Infancy, Intersubjectivity, and Attachment; Joint Editor-in-Chief, Psychoanalytic Dialogues; Training and Supervising Analyst, Psychoanalytic Institute of Northern California & San Francisco Center for Psychoanalysis


    "Psychoanalytic Treatment of Eating Disorders: When Words Fail and Bodies Speak is an indispensable volume of psychoanalytically informed contributions to the literature on eating disorders. This irresistible recipe combines one part theory with two parts clinical wisdom. I was especially drawn to the treatment of the roles of specific emotions, like shame and anxiety. Equally useful for the seasoned clinician and those at earlier stages of their careers, this is a worthy addition to any clinician's library. These 15 authors represent the best in the field."

    - Sandra Buechler, Ph.D. Author of Understanding and Treating Patients in Clinical Psychoanalysis: Lessons from Literature. Training and Supervising Analyst, the William A. White Institute, New York.


    "Wooldridge provides us with a valuable collection of papers on the conceptualization and treatment of eating disorders. He also presents us with several chapters on contemporary cultural issues, including social media, which impact patients with eating disorders. Wooldridge and the contributing authors are keenly aware that eating disordered patients are among the most difficult to treat.  These patients present clinicians with potentially life threatening crises and the possible need for substantial ancillary care. These assembled authors do not shy away from the thorny problem of combining psychoanalytic containment and understanding with the variations in frame needed to ensure safety, such as the potential necessity for a treatment team and hospitalization."

    - Mary Brady, Ph.D., Author of The Body in Adolescence: Psychic Isolation and Physical Symptoms


    "For too long there has been a divide between psychoanalytic thinking and the treatment of eating disorders. This vital collection of essays is a key step in bridging that gap. Through vivid clinical examples, new theoretical advances are illuminated in ways that promise to deepen our understanding of eating disorders. With impressive clarity, this collection is a vital addition to the field that will extend what we understand as psychoanalytic. It will be of real value to both students and seasoned clinicians."

    - Peter Carnochan, Ph.D., Author of Looking for Ground: Countertransference and the Problem of Value in Psychoanalysis (Relational Perspectives Book Series) ​

    "This anthology of papers offers its readers what a skillful psychoanalytic treatment can offer an eating disordered patient: it reintroduces meaning, metaphor, and substance into an otherwise concrete, impoverished, and symptom dominated existence. As editor, Wooldridge had brought together an impressive anthology of papers that integrates multiple psychoanalytic perspectives. Without minimizing the need for symptom management with eating disordered patients, Wooldridge's emphasis is on integrating classical psychoanalytic conceptualizations of eating disorders with contemporary psychoanalytic thinking, on development, phenomenology, affect regulation, dissociation, attachment, mentalization, and socio-cultural context. The individual chapters are theoretically and clinically rich, varied, thought provoking, and useful. They will nourish and hold both beginning and seasoned clinicians in their struggle to find words that can touch and transform those patients for whom words have perilously failed."

    - Sarah Schoen, PhD, Supervising Analyst and Faculty at the William Alanson White Institute; Faculty at NYU Postdoctoral Program in Psychotherapy and Psychoanalysis, and Co-Editor of Unknowable, Unspeakable, and Unsprung: Psychoanalytic Perspectives on Scandal, Truth, Secrets and Lies.