Although the words "mental illness" are never used in "Holding My Breath," several members of Beth’s family have suffered at least one nervous breakdown. However, in Canada in the 1950s and ‘60s, those words would not have been used in polite company. The family never verbalizes what happens when, for example, someone behaves in an inappropriate manner. Instead, the incident is discussed in hushed tones and the person treated as an invalid. Anxious to learn the true reason behind her mother’s and her aunts’ behavior, Beth works to uncover these family secrets: "I feel as if I’ve spent my life piecing things together – stories I have heard, conversations I shouldn’t have. I have become my family’s narrator; I take everything I know, and I make this framework of a puzzle that when completed is my family’s story." This includes the reason why her mother seems so sad and why her one aunt remains unmarried.

During the course of the novel, Beth’s mother and aunts fight over the type of woman she should become. What’s very clear is her mother’s definition of success: Beth should marry a successful Jewish man, join a synagogue and participate in Jewish women’s groups. This is the life her mother longed for, although to achieve these heights takes money: "In our community, if you had money and were seen to spend it well (that included offering your fair share of tzedakah to support the community), then you were looked up to by your neighbours. You sat on committee. You were asked to chair synagogue boards. You led groups building community centres, headed symphony fund-raisers, and organized money-making activities, like trips to the art gallery and Sunday afternoon teas at the local Jewish school." Without money, you were an object of pity.

Yet, Beth isn’t sure these goals suit her nature. Her Aunt Carrie encourages her to follow in the footsteps of her late Uncle Phil, who died during World War II. He loved the stars and hoped to be an astronaut. The young Beth is enamored with his legacy, reading his notebooks and spending hours viewing the nighttime sky. Yet, as she enters her teens, her attraction to her Aunt Sarah, a sexy young woman who seems the epitome of cool, grows, creating even more conflict between Beth and her mother. As Beth tries to decide which woman she should please, she learns that following your dreams may have unexpected consequences.

Although Ludwig writes well and does an excellent job letting readers inside Beth’s mind, the novel wasn’t as gripping as it could have been. Perhaps this is because the characters’ lives are filtered through Beth’s experience. I would have liked to learn how they felt in their own words, rather than hearing it second-hand through an inexperienced young woman who admits that she doesn’t know the complete story of her parents’ and aunts’ lives.

While Beth fears that "I would grow up and have no say about the woman I would become," Ruby very early recognizes the need to gain control over her life. Unfortunately, this leads her "to distance herself [from those around her], to make two Rubys: the Ruby at home and the Ruby elsewhere; the Ruby who saw sad things and the Ruby whom the world saw."

After a cliff-hanging prologue, "The Cure for Grief" opens with a vision of a happy American family: the young Ruby, her three older brothers and her parents are on vacation in Maine during the late 1980s. Over the next few years, though, Ruby’s life begins to fall apart: Her older brother becomes ill and is committed to a mental hospital. Her father then develops a terminal brain tumor, something which is only the start of the disintegration of Ruby’s family life.

In addition to dealing with the problems her family faces, Ruby also struggles with her feelings about Judaism and the place of religion in her life. Although her father, a Holocaust survivor, was proud that she was bat mitzvahed and was committed to being Jewish, there was no spirituality in his life: "There was little talk of God, or really any belief at all" in her family. Her father’s heritage was important enough for him to ask Ruby’s mother, who was born Catholic, to convert before they married and the family does practice Jewish rituals, such as a Shabbat family dinner, at home. However, Ruby still struggles with what it means to be a Jew, particularly in light of the Holocaust and the tragedies her family faces.

At the same time, Ruby tries to pretend she is living a normal life, that nothing has changed, at times not mentioning her family problems even to her closest friend or her boyfriend. What happens at home, she feels, should stay at home, and her emotions are carefully kept in check. Ruby’s stoic demeanor so disturbs her mother that she encourages Ruby to talk to a therapist, something Ruby rejects since she realizes that if she truly reveals her feelings, she might never be able to control them again.

Hermann’s portrait of Ruby is impressive. She does a wonderful job letting readers inside Ruby’s head, allowing them to experience her emotions. While the author’s third-person narrative focuses on Ruby, the other characters, particularly the members of Ruby’s family, are also well drawn and three-dimensional.

Beth and Ruby are both members of unhappy families. Yet, the pleasure in reading their stories is in seeing not only how they struggle to overcome the problems that face their families, but the ways they find themselves in the process. Each young woman learns different lessons, but both discover that the past cannot be ignored because doing so endangers the future. Readers can only hope that the optimistic note on which both books end will be sustained in the future.