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

She'd lost two more pounds. A picture of the models she'd cut out of the magazine flashed through Kessa's mind. And the winner is... seventy-three!

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.

She lay on her back and walked her fingers down her ribs, skipped them over her abdomen, and landed on her pelvic bones. She tapped them with her Knuckles. [. . .] I can hear my bones, she thought. Her fingers moved up from her pelvic bones to her waist. The elastic of her underpants barely touched the center of her abdomen. The bridge is almost finished, she thought. The elastic hung loosely around each thigh. More progress. She put her knees together and raised them in the air. No matter how tightly she pressed them together, her thighs did not touch.

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.

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.