In this episode, I speak with Tom Wooldridge, Psy.D, A.B.P.P., a psychologist and psychoanalysist who works with adolescents, adults, and families with eating disorders, about integrating family-based and psychodynamic approaches. Tom shares his career journey, beginning with his training at the Family Institute of Pinole, where he first encountered a young person and his family struggling with an eating disorder and how family based interventions were so helpful. Later, he began seeing clients who had improved with Family Based Therapy for Anorexia in adolescence, but relapsed during major life changes, which led him to explore the personality-level factors that can make people vulnerable. We discussed how the DSM’s focus on observable symptoms can miss important differences between people with the same diagnosis, such as the perfectionistic, high-achieving presentation of anorexia versus a more under-regulated, borderline presentation. We also talked about binge eating disorder, its link to trauma history, impulsivity, and uncomfortable feelings. Tom shared his work with males, including anorexia in men and muscle dysmorphia, and how obsessive-compulsive features can narrow a person’s focus on their body. We discussed the three stages of FBT and the importance of building a treatment team that includes a physician trained in eating disorders, since weight alone can’t show medical severity. Tom described the need to address refeeding from the start while also doing deeper therapeutic work, and the way therapists can swing between worry about safety and focus on the psychotherapy. We explored the Minnesota starvation experiment and how restriction can act as a numbing agent for hard emotions, and how therapy can help clients turn towards relationships for regulation instead. Tom also discussed working with families from a psychodynamic lens, including transference and countertransference. Finally, he described the framework in his book for parents, which moves from control to connection through three pillars: emotional regulation, emotional attunement, and reflective function, drawn from mentalization and attachment theory. We also touched briefly on ARFID and how different underlying causes require different treatment approaches. Tom Wooldridge, PsyD, ABPP, CEDS-S, is a psychoanalyst and board-certified, licensed psychologist who is the Vice Provost of Digital Innovation and founding Dean of the school of Psychology at Golden Gate University. He has treated children, adolescents, and adults with eating disorders, including working with parents navigating a child’s treatment. He is a Personal and Supervising Analyst at the Psychoanalytic Institute of Northern California and a Training Analyst at the San Francisco Center for Psychoanalysis, and he serves on the faculty of several psychoanalytic training programs, including the William Alanson White Institute's Eating Disorders, Compulsions, and Addictions program. He has served on the advisory council for the National Eating Disorders Association and has been interviewed by outlets including Newsweek, Slate, and WebMD. His books include Understanding Anorexia Nervosa in Males, the edited volume Psychoanalytic Treatment of Eating Disorders, and Eating Disorders: A Contemporary Introduction. He has also written a novel about the process of psychotherapy, Ghosts of the Unremembered Past. His newest book, End the Food Fight: Replacing Control with Connection to Help Your Child Heal from an Eating Disorder, with a foreword by Susie Orbach, is written for parentsand clinicians. He has a private practice in Berkeley, CA.