The fatal flaw of the work is that it is absolutely apolitical. The drug recovery memoir is the modern version of the exorcism narrative: A person is taken over by an unknown and unknowable force, a demon of addiction-as-disease, forced to commit unspeakable acts and led into the underworld until, through a series of rites, the foreign invader is expelled and the person is returned to their community. The story of the exorcism contains no explication of the demon. After hundreds of pages spent in Kate’s skin, the reader feels compassion for her, but not necessarily for other sex workers and drug users. Holden differentiates herself from others in her predicament in elitist terms: They’re “jailheads,” “hollow creatures” who have “given up all their dignity,” whereas Holden can play “a swaggering junkie in dark streets,” but at heart she’s still the “nice, polite, middle-class girl” she is when she’s at home with her parents.
Holden does not impel the reader to find a solution in terms of bettering the lives of other drug users and sex workers. Like the exorcism narrative, In My Skin ultimately blames no one but the narrator for her plight.”