She began to be reassured by these pains, tangible symbols of her success in becoming thinner than anyone else. Her only identity was being “the skinniest.” She had to feel it.

If you’re told what you should be but not helped to become it, you don’t get there. And it makes you ashamed for failing to. When a person you depend on keeps telling you that it’s time to ‘move on,’ ‘to grow up,’ it makes you feel that who you are now is inadequate or uninteresting.

Kessa began to cut her meat into tiny pieces. As a whole it was unmanageable, frightening; but divided and arranged, the meat could be controlled. She cut four pieces. She’d count to four between each bite.

If you want your daughter to change in a profound way – to change from only trusting herself and her own behaviors to trusting others, you, her family – you will have to bring a new energy to your relation with Kessa. If she has to overcome this all by herself, it will take longer, and she may never be close to you.

From the newsstands a dozen models smiled up at her from a dozen magazine covers, smiled in thin-faced, high-cheekboned agreement to Kessa’s new discovery. They knew the secret too. They knew thin was good, thin was strong; thin was safe.

Self-mutilation is a frightening barrier that keeps us from seeing a person who is lost, in pain, and in desperate need of help.

Repetition brings familiarity, and familiarity is the opposite of the unknown.

How silly people were to eat. They thought they needed food for energy, but they didn’t. Energy came from will, from self-control.

Soon I’ll be thinner than all of you, she swore to herself. And then I’ll be the winner. The thinner is the winner.

The nerves of the skin send pain signals to the brain to warn us of the danger from and impending injury. In the case of self-inflicted wounding, this pain acts as the body's own defense mechanism to stop one from proceeding in the effort at physical injury. If a person proceeds despite the pain, that means that he or she is motivated by something stronger than the pain, something that makes him or her capable of ignoring or enduring it.