“…interoceptive confusion and body image distortions are forms of impaired embodied mentalizing and expressions of pre-mentalistic thinking. For example, psychic equivalence demonstrates how patients’ painful self and affect states are expressed though extreme body hatred and the mistaken belief that being “skinny” will bring them self-acceptance, "confidence," and agency. The teleological stance explains the obsessive drive for thinness as a method to obtain self-acceptance and the approval of others. In short, subjugation of the body is a confused attempt to gain mastery and control over feelings of ineffectiveness and lack of self-worth.”