After Suffering from Severe Abuse, Journalist Stephanie Foo Is Building Awareness around Complex PTSD

Stephanie Foo grew up in San Jose, California surrounded by manicured landscapes and high-achieving immigrant families. From the outside, Foo’s youth seemed to epitomize the “American dream.” But Foo was the victim of extreme abuse. Her parents regularly beat and emotionally abused her—and they ultimately abandoned Foo when she was 16.

In 2018, Foo was diagnosed with Complex PTSD, a little-understood form of PTSD that occurs from repeated, long-term trauma. An award-winning producer for This American Life, Foo used her journalistic skills to research her unusual diagnosis and dig into her past. “I told myself that when I finally healed, I would write the book I so wanted to read when I was first diagnosed — a stigma-busting, kind, first-person account with real science and solutions,” says Foo.

That book is What My Bones Know: A Memoir of Healing From Complex Trauma, which ignites a much-needed conversation on C-PTSD and its wider role on building greater mental health awareness and support.

A Conversation with Stephanie Foo

You start your book with a disclaimer assuring the reader a happy ending. Why did you feel the need to include this?

I had just read so many trauma books that were so dismal throughout the entire book and just really hard to read. I always was searching for a happy ending and it wasn't something that I was finding. The literature on Complex PTSD is sparse — everything was pathologizing. There were some really depressing stories. One book said people with C-PTSD are a burden and should be avoided. When I was first diagnosed, I just wanted to feel normal, like a good person, like I had some hope. And I wanted to write a gentle book that focused on healing.  

How does Complex PTSD differ from the more widely known PTSD?

Let's say you're hit by a car: You can absolutely get PTSD from that one traumatic incident, and you might get afraid when you're crossing the street and you see a car coming at you, or you might get afraid while driving. C-PTSD is different, in that it's kind of like if you were hit by a car every day for many years. Mine comes from child abuse. It could be survivors of domestic abuse, or living in a war zone or anything that involves repeated traumatic events. Symptoms include:

• Trouble regulating one’s emotions
• Difficulty trusting others
• Bouts of aggression
• Self-loathing, anxiety, and depression

I had all of that.  

C-PTSD is not yet recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM), a guidebook widely used by mental health professionals. What does this say about our mental health care system?

There is immense cruelty and injustices in our society in which someone can't get help for that because mental illness is the same as physical illness. And so to let somebody suffer in this way, without being able to provide them with the mental health care that they need is really just like letting someone walk on a broken leg forever without treating them.

C-PTSD needs to be legitimized professionally. It needs to be accepted by doctors. Our mental health care system is backward right now. There's a focus on chemical imbalances and medicating those away without really digging for what the core trauma might be for people.

Of course, there might be a chemical imbalance in your head, but it's a chicken and egg issue. Like where does that chemical imbalance come from? Could it be because you were abused as a child?

You write about your years of horrific physical abuse and abandonment by your parents. Does someone need to have physical abuse to be diagnosed with C-PTSD?

I had a conversation with someone recently who said to me, “My parents clearly didn't love me. I was unwanted, I felt unwanted, but you know, I didn't have to go through all of the levels of abuse that you did.” I told her the physical abuse does affect me. And I have triggers: There are certain movies. I can't watch certain games. [There are] certain scenarios I can't put myself into. But the fundamental loss, the fundamental trauma that affects me every single day is that of a lack of love that I wasn't loved by my parents.

So I'm not going to minimize other people's trauma who might not have experienced physical abuse, but did have neglect or emotional or verbal abuse. That is truly the most painful thing for a child to experience.

The lessons in this book are applicable not to just people with C-PTSD, but all of us, because honestly, all of us have some form of trauma. You can't get through this life without experiencing trauma, it’s like that Buddhist tenet “life is suffering.” Life is inherently going to be comprised of loss and whether it's your grandma dying and you being triggered by the sound of a ventilator, or being triggered by a horrible breakup. Trauma is, in essence, your brain teaching you what is dangerous, what to fear in life. Basically, you have to learn what is dangerous in order to keep yourself safe and survive. Fear is a very legitimate emotion. It's just when fear overtakes other emotions that it starts to become problematic.

A lot of C-PTSD symptoms and damage is caused by difficulty in relationships. And, healing means learning how to have healthy relationships.

I still hear my mom's voices in my head telling me I'm a terrible person because my mom spent all this time telling me I was a terrible person. C-PTSD often means someone you were in a relationship with, who was supposed to love and care for you, did not. This causes you to sort of lose your faith in humanity and other people. If your brain taught you that other people are dangerous, you have to rewire it. The only way to really rewire that is through relationships, through being with other people and learning to trust them, and having the skills to be able to listen and receive. And, to have ruptures with them, have conflict with them, and be able to repair. And understand that just because someone's mad at you doesn't mean it's the end of the relationship or doesn't mean they're out to get you. There are ways to work together to be on the same page.

You say that practicing self-compassion is an important step in healing. How has it helped you?

When you don't have a great model for love, for being loved, it makes it really difficult to understand why. And I really used to struggle with loving myself because I was like, okay, I feel love for a partner, but I can't feel love for myself and I don't understand that.

I just used to think maybe loving myself meant not hating myself, literally just forgiving myself for messing up things. And that is actually a huge part of it. Just having more forgiveness for ourselves. So we're not constantly shaming ourselves. Robin Wall Kimmerer has this beautiful quote, "despair is paralysis". I think when you despair, when you hate yourself, when you're full of self-loathing, that paralyzes you from growing and being curious about how you can actually do better. And when you actually really do care for yourself, you have self-compassion. It's like, How do I nurture this? How do I nurture myself? How do I take a cue? How do I feed myself? How do I comfort myself when I'm going through something really difficult? And then when you mess up, it's less lambasted, it's more curiosity, there's more movement and freedom and investigating.

This isn't unique to people with Complex PTSD — being able to look at yourself through this lens of kindness is really important because I think before, when I was really triggered, when I was really self-loathing, I might self-harm, I might try to dissociate by drinking or working way too much. And when I was able to comfort myself, sit with myself and just be like, Hey, Hey kid, you're okay. You might've messed that one up, but it doesn't mean you're the worst person in the world. This has been healing to me.

How does having C-PTSD affect you on a daily basis?

Day-to-day it's up and down. Healing is not a straight line. It's more like a spiral. You're feeling a little bit better one day. And then one day you're feeling like, oh my God, I'm the worst, I'm in the dumps. But you keep getting closer and closer to the place where you need to be. And the closer you get, the ups and downs are less grandiose. C-PTSD is something that I will be healing from for the rest of my life. I still mess up in relationships, but we all do, and now I'm able to calm, and then forgive myself for messing up and be able to repair that relationship with the person that I messed up with. That's what we can all do. That's the most we can all do.

Stephanie Foo is an Emmy award-winning writer and radio producer. Her work has aired on This American Life, Snap Judgment, Reply All, 99% Invisible, and Radiolab. She lives in New York City with her husband. You can order her book, What My Bones Know, here.