This book has been written for women, with an invitation to take a heroine’s journey to overcome a disease the authors refer to as Human Giver Syndrome. The authors, Emily & Amelia Nagoski, open their book by stating that for women, the game is rigged by the patriarchy and that by understanding this, we can start to make our own rules.

Reading Notes from a Therapist

I was excited by this book. The belief of not being ‘enough’ is relatable for many and so the book’s callout to women who think this was enticing. The claim that this book holds the secret to solving the stress cycle was also appealing and I really wanted this book to deliver. I was disappointed in finding it didn’t quite follow through. More on this at the end of this book review. First up are a few concepts and takeaways I found interesting and worth sharing with you.

Human Giver Syndrome

The authors describe this as where we give to others at the cost of our own needs. They outline the symptoms of this (non-clinical) syndrome as:

Believing you have a moral obligation to be pretty, happy, calm, generous & attentive to the needs of others and that this forms our sense of meaning in life.
Believing any failure to be the above makes you a failure overall as a person.
Believing this failure means you deserve punishment.
Believing the above needs to be achieved at the expense of your own needs.
Believing all of the above to be normal, that all women should be this way, and so feeling outraged by other women who do not conform to this.

I think a lot of women will find themselves nodding along to this list. In this way, it is validating and provides a sense of collective unity in this experience. Its sets the scene for our problematic beliefs and how they are harming us. I read on with the assumption that we’d get to some pointers on how to challenge or chip away at these but was disappointed that we never seemed to get there.

Body Image and BMI

The authors bring attention to the existence of a hundred-billion-dollar global beauty industry that is dependent on us being insecure and dissatisfied with our body image in order to make money from us. While we may not give this much thought, most of us know it exists. However, the authors call out supposedly medical measures that they say are also part of this problem. They refer to BMI as ‘a nonsense measure of personal health.’ They state that this measure was created by a panel of 9 individuals, 7 of whom were employed by weight-loss companies.

They raise an interesting point – that BMI doesn’t account for what makes up our weight. So, somebody with low fat but high muscle mass may still be classed as overweight on this scale and therefore encouraged to lose weight if this additional information is not taken into context. They talk about how being categorised as healthy or unhealthy based on the BMI scale alone puts undue pressure on us, particularly women, to achieve unrealistic body goals. They highlight that this pressure can result in illness, with eating disorders having the highest mortality rate of all mental illnesses.

Their recommendation is to reframe insecurities (eg. Scars, acne) as ‘the new hotness.’ I like this idea but to really shift our thinking, we have buy into our new beliefs and I’m not sure that’s enough of a strategy to challenge our views on the physical aspects of ourselves that we feel most insecure about.

Sleep is Medicine

The book includes some interesting research about sleep that outlines that even one night’s sleep deprivation has a similar effect on our functioning as being drunk. To manage this, our body triggers the stress response to increase adrenaline and cortisol. This masks tiredness and the effects of sleep deprivation, resulting in us feeling able to manage tasks better than we can. The authors liken this to the increased confidence we can tend to feel in our abilities when we are drunk.

They summarise this by stating: “Anything you wouldn’t do drunk – drive, lead a work meeting, raise a child – don’t try it if you’ve been awake for nineteen hours, slept only four hours the previous night, or slept fewer than six hours every night for two weeks.”

While I appreciate the rationale here, I’m not sure how helpful or achievable these instructions are for say, a sleep-deprived new mother or for people working long and changing shift patterns. The takeaway message is to get enough sleep, and if this is a struggle seek medical advice or attend a sleep clinic. I fully advocate the importance and necessity of sleep, but from my experience in healthcare, attending a sleep clinic is not something that tends to be readily available. I would have liked a few more pointers on what we can do to improve our sleep ourselves.

A Therapist’s Book Review

The book very clearly explains the many reasons why women are so hard on themselves and so helps us make sense of why we do some of the things we do – like prioritising the needs of others, being self-critical and depriving ourselves of rest. Of course these things will be vulnerability factors for us eventually burning out. It helps us see burnout not as a personal failing but as a reflection of a bigger problem with the system around us. However, I didn’t find the book delivered in its promise to tell us how to solve the stress cycle other than broadly telling us to sleep, exercise, be kind to ourselves, listen to our bodies, and generically find a way to have an outlet for stress. These outlets may include belly laughing, hugs, breathing, creative expression, social connection or crying.

I found there to be an undertone of anger towards the patriarchy throughout this book, with bonus points awarded for actions that both help oneself and also ‘smash the patriarchy.’ I can see the intention for this to empower women, but I would personally prefer an approach centred on broader human solidarity and compassion rather than ‘us against them.’

The authors state that the cure for burnout isn’t ‘self care’ but all of us caring for each other. If ‘all of us’ is meant literally, then my view is that rather than focusing on the divide between women and the patriarchy, involving the patriarchy and finding ways to come together would be a more helpful approach.

Don’t ask me how – I didn’t write the book, I’m just sharing my view! Interestingly, the authors write about how women, in the eyes of the patriarchy, are not supposed to be angry or have big emotions so perhaps they may argue that I’m part of the problem for perceiving and disliking this undertone!

For an overview of factors increasing risk of burnout for women, this book covers some useful topics and is validating in that way. There is also a pretty impressive reference list which enables a deeper dive into the research if you’re interested. However, if you’re looking for strategies to prevent or manage burnout, I don’t think this book provides this.

A Final Thought

The information we take in is filtered by our own experiences, knowledge and beliefs. These are my views as a CBT therapist, as someone who focuses very much on finding solutions and taking practical strategies to update unhelpful patterns of thinking and believing. I also have a clinical understanding of burnout, low self esteem, perfectionism and help women with these challenges every day using evidence-based approaches. My expectations of this book, were high! I know others who have loved this book. Perhaps without my professional experience, I could have found this book quite revelatory. I don’t know, but I’m all for being open-minded and there’s certainly no harm in reading this and forming your own opinion!