Julie Holland (1) (1965–)

Holy cow. This was the most disgusting book I have ever read. The fact that someone as abusive, sadistic, narcissistic, and offensive as Julie Holland decided to write a memoir BRAGGING about these qualities astounds me. I knew I was in for a terrible ride when the first sentence talked about being surrounded by "insanity" and the next page thanked the NYPD. I highlighted everything that was offensive which ended up being around 60% of the book. I have 130 highlights and they were exclusively things that I found especially disgusting.

She spent the entirety the book doing any of the following:
- Laughing at people's worst days and sharing their trauma with the world
- Smugly kicking people out of the ER who she unreasonably deemed shelter-seeking and "not actually sick" (AKA not white, middle-class, employed people)
- Unnecessarily drugging patients for her own convenience and to get on cops' good sides
- Talking about how "butch" she is for being a heartless piece of crap
- Making massive generalizations based on diagnoses (schizophrenia, bipolar disorder, and sociopathy for the most part)
- Laughing at sexual harassment in the workplace
- Abusing her patients, going to therapy to try and figure out why she's so sadistic, blaming it on her non-existent daddy issues, and then deciding she's done with therapy even though she's still a sadist
- Equating mentally ill people with animals and talking about "T&Rs" or "zookeeper's guilt"
- Using words like the r-slur
- Seducing patients to get information from them

The lack of respect with which she discusses homeless people, incarcerated people, transgender people, and-- get this-- mentally ill people, is disturbing, especially as she details her interactions with said groups. She describes a transgender woman as "one humongous she-male!" and misgenders her throughout the entire story.

These were just a few of the things that stood out to me, but I could talk for hours about how disgusting this book was. I am furious that this was ever written or published and that someone like this worked in a psychiatric institution for so long. She deserves to have her medical license stripped and her name tarnished for life. I don't generally hate authors for writing bad books, but I hate her for being a bad person.

HORRENDOUS. If I could give this zero stars, I would.… (más)

Dr. Julie Holland is a psychiatrist and psychopharmacologist who worked in the psychiatric ER at New York's Bellevue Hospital from 1996 through 2005.

This memoir wasn't exactly the collection of wild stories the cover blurb seemed to promise, and it also wasn't quite the nuanced and thoughtful exploration of the treatment of mental illness that I was hoping for (although it does certainly have some of the latter). What it was, mostly, was, well, a memoir. Holland spends a lot of time talking about herself, her relationships of various kinds with other doctors, her own psychological issues, and the insights about herself she's taken from psychotherapy. Part of me can't help but find some of that a little self-absorbed or over-share-y, although I do appreciate her ability to be honest about her own faults, and those personal ruminations do both tie into the larger issues of mental health support and illuminate some of what it's like to do this particular job.

Whether it's quite what I expected/wanted to read or not, I did at least find this interesting as a glimpse into this world, with all its medical and emotional complexities. But, perhaps unsurprisingly, it's also pretty depressing, since it's crystal clear throughout that the systems we have in place for dealing with mental health crises and substance abuse problems are pathetically, horrifically inadequate (something Dr. Holland definitely appreciates, even if she's mostly fairly low-key about addressing it).… (más)

One of my doctors recommended this, and Christiane Northrup is quoted on the cover, so this book seemed totally up my alley. But after finishing it and sitting with the information for a couple of days, I can't decide whether to recommend it.

The book is split into three parts. The second part covers dating, long term relationships, motherhood, and perimenopause. (Full disclosure: I did not read the chapters on motherhood and perimenopause.) The third part is a guide to using this information in areas like daily nutrition, sleep, and exercise.

Positives:

Any book that teaches women more about their bodies and cites research heavily in order to do so is a valuable tool of empowerment. Holland tells us that women's bodies are cyclical, and that fluctuations, especially in mood, are tied to that cycle and have a biological and evolutionary basis. She tells us that being "moody" is normal, and more than that, it is "the source of our power (1)." I was silently cheering at a lot of what she wrote in part 1, and I really learned a lot that I did not know.

Holland talks extensively about the effects of birth control and anti-depressants on our hormones, and she gives a lot of specifics. She made me think differently about the value of marijuana as a more natural option than other drugs. The chapters on dating and long term relationships were really interesting, and informed a lot of experiences I had previously found confusing. The information on how our mood and body changes throughout our cycle is something I only started learning about with Toni Weschler when I tried FAM a couple of months back, so it's something I still know very little about. This book really increased my knowledge.

Overall, this book communicates a message of "You are totally okay and enough as you are," and it does so with a lot of research backing it up. That's a powerful message, and one that women can't hear enough. There's a lot of "women are x way and men are y way," and while that may be a problematic message (for reasons I explain below), it's also a reassuring one. Holland talks a lot about how understudied women are in medical research (most human and animal subjects are male), going as far to say, "Women are still, very simply, second-class citizens in the world of medicine (32)." Did you know that women's pain sensitivity fluctuates with where we are in our menstrual cycle? That eight of ten drugs removed between 1997 and 2001 were removed because they posed greater health risks for men than women, but they had only ever been tested on men in experiments (32)?

At the end of the first chapter, Holland says the following: "We are not men. We are women. We feel more deeply, express our emotions more frequently, and get moody monthly. It's normal. It's nature's way. And we don't necessarily have to medicate away the essence of who we are to make others more comfortable. In fact, once we better understand our bodies and our own moods, we will realize that as women we have many natural tools, for tackling all of the challenges of our busy, complex lives (33)."

Negatives:

This book fell into all three of the traps I was hoping it wouldn't. I fully acknowledge that the second negative is subjective, but the other two are pretty concrete absences for a book addressing the influence of the patriarchy on women's wellness.

1. If women are like this and men are like this, what do you mean by "woman"?
2. If the science is simple enough that I can understand it, I question its accuracy.
3. Fat shaming in the exercise chapter

1. What do you mean by "woman"?

In any book that says "women are like biologically and evolutionarily this," I need a definition of what women are. Are you talking gender, which is as least partially, if not completely, sociological? Sex, which was once believed to be a true dichotomy? Is a woman a person who has certain sex organs, like a uterus? Who menstruates from menarche to menopause? Who has secondary sexual characteristics like breasts? Who has more estrogen than testosterone? This isn't just semantics - this book is meant to inform and empower women, and it's important to define who the group "women" includes and excludes. Also, as a book like this would know, people who believe in complementary gender roles will use information about "women are biologically and evolutionarily like this" to support anti-women agendas and a false gender binary. The audience needs to know that this information won't be used to further disempower us.

I am sympathetic to the difficulty of defining a term like "women," especially since each of the research articles cited may define it differently. But I need the author to acknowledge that difficulty and try to give the best definition possible.

Holland addresses this on page 23, and to my memory, it is the only time she does.

"Obviously, we must be cautious in discussing differences between the sexes because there is large variation within each gender, and nurture and culture factor in nearly as much as nature does. There is interplay between our natural abilities and how we are molded to behave that is impossible to fully tease apart. Case studies of children with ambiguous genitalia who are raised to be male or female even though they possess the opposite genetic material are rare, but they do help to teach us one thing: the influence of biology cannot be underestimated. Often, our own balance of testosterone and estrogen levels dictates how aggressive we'll be in a pickup game of basketball (or if we'd ever be caught dead in a pickup game of basketball) more than anything our parents ever taught us (23)."

I'm glad this passage exists, but I expect more. Also, the problematic interchangeability of "gender" and "sex" in this passage is continued throughout the book. It wasn't a dealbreaker for me, but I can definitely understand how that would be enough of a reason for someone not to pick up this book.

2. The scientific catch-22

"Add to the cocainelike mix of dopamine and norepinephrine a healthy shot of endorphins, our naturally circulating opiates, nature's painkillers and stress relievers. So falling in love is pharmacologcally a bit like a speedball. But there's more, because experiencing intense infatuation, and especially love at first sight, is like taking a psychadelic drug, too (61)."

This is a really fun passage and the word choice is evocative and memorable. In contrast, interactions of hormones are really complex, and I know that the actual description of what happens with love at first sight would be dull and impenetrable. But I also know that this is far too simplified, so I have trouble knowing how much to trust it as true. This was the problem I had with most of the book. It was eminently readable, so I didn't know how much I could believe the science.

I don't really know how to resolve that problem, but it does help that Holland cites heavily.

3. Fat shaming

Fortunately, fat shaming was mostly limited to the exercise/body image chapter, with a little in the nutrition chapter. I understand that obesity has health risks, but the harm that fat-shaming causes to mental health (and to physical health, with things like doctor bias) seems like it far outweighs the benefit of constantly telling people those health risks. There is a way to talk about having a healthy level of activity without focusing on the size of people's waists, and this book did NOT strike that balance. If you have triggers around body image, I would skip this chapter.

The exercise chapter includes a section on body positivity and acceptance, and another section around accepting secondary female sex characteristics (hips and breasts) as normal. Yay! But it would also be great to not have fat shaming at all, or, if you're going to talk extensively about obesity, to address the concept of fat shaming and try and separate it from the scientific terminology and research.

Overall:

I'd recommend to treat the book as a reference, and to read in chapter-long sittings. I'd recommend being aware of the three negatives I mentioned, and reading critically. But every book is an interaction between the reader and the author, and I would say that if you read sparingly and critically, there is a lot to get from this book, both in terms of empowerment and information.
… (más)