What My Bones Know: A Memoir of Healing from Complex Trauma

by Stephanie Foo

I knew none of the other girls in the troop were being screamed at right now. I thought of the ease with which the girls had leaned into their mothers during that song, how they expected to be held. How they expected to be safe.

This was how I discovered the power of journalism—not just as a force to right wrongs and change the world, but as a force that turned my anguished brain into a functioning machine. I liked many things about journalism. I liked that it was one thing people thought I was good at. I liked that it gave me a reason to go out into the world, like an explorer heading into the jungle to collect specimens. And I liked that journalism was a puzzle. You lay out your evidence and order it from most important to least, the inverted pyramid a force against woeful attention spans and chaos. I could take feelings and injustices and even tragedies and figure out a way to shape them all into something purposeful. Something controlled.

Achievement was my constant. My comfort. In college, I edited the humor paper, freelanced and interned for national magazines before I turned nineteen, taught classes on gender and religion as a junior, then graduated in only two and a half years, decorated with honors.

It was only then, in the wake of so much I had demolished, that I realized I had done this to myself, and I had done it because it had been done to me. My anger was a reflection of two people who had self-immolated with their own anger.

The next time I was at a taqueria, some drunk guy cut in front of me, demanded food, then meandered away, oblivious. My whole body burned with the desire to yell, to call him pathetic, rude, bald. Not doing so felt like leaving a chunk of rice at the bottom of the bowl, like dipping out without paying the bill—unfinished business, a miscarriage of justice. And yet. What would it accomplish? I let it go. I strong-armed myself into normalcy.

Several months after my decision to let go of my anger, I started seeing Samantha, my therapist, to learn to love better. Slowly, she taught me the basics of healthy communication. To listen more than yell. To assert myself in calm, measured tones. Armed with her techniques, I practiced punching down my anger like a ball of dough, flattening it out. After a couple hundred times, it became a reflex—my eyes unfocused, my voice went flat, and I floated somewhere near the ceiling, far away from the conflict. I let it go.

Resilience, according to the establishment, is not a degree of some indeterminable measure of inner peace. Resilience is instead synonymous with success. Which of course made me resilient as fuck. Like a good Protestant American, I continued to save myself through work.

It’s okay to have some things you never get over. In the span of half an hour, this man whom I had known for less than a season did what nobody in my life ever had: He took all of my sins and simply forgave them. He didn’t demand relentless improvement. There were no ultimatums. He asserted that I was enough, as is. The gravity of it stunned me into silence. Joey was the opposite of the dread.

I clicked on the Wikipedia page, then the Veterans Affairs website, and saw the list of symptoms: People with complex PTSD have trouble holding down jobs and maintaining relationships. People with complex PTSD are needy. People with complex PTSD see threats everywhere and are aggressive. They are more likely to be alcoholics, addicts, violent, impulsive, unpredictable.

But it was the hyper-specific ones that freaked me out, like the idea that C-PTSD patients spend their lives in “relentless search for a savior.” How could they have known about that?

In March, I read parts of the book Complex PTSD: From Surviving to Thriving by author and psychotherapist Pete Walker. He frequently writes about what he calls the obsessive/compulsive flight type: “When [she] is not doing, she is worrying and planning about doing…. These types are also as susceptible to stimulating substance addictions, as they are to their favorite process addictions: workaholism and busyholism. Severely traumatized flight types may devolve into severe anxiety and panic disorders.”[1] Maybe work was not salvation. Maybe it was a symptom.

There was no reason to add a “C,” no need for a distinction between the two. It’s worth mentioning, however, that the U.S. Department for Veterans Affairs and the United Kingdom National Health Service both recognize C-PTSD as a legitimate diagnosis.

The books taught me that when we live through traumatic experiences, our brains take in the things around us that are causing the greatest threat, and they encode these things deep into our subconscious as sources of danger.

This reflex might manifest in a big way, like a panic attack. Or it might manifest in a smaller way, like suddenly feeling very grumpy. You might decide that you’re irritated at your girlfriend for a mildly stupid thing she said that morning and text her to say so. None of this, of course, is reasonable or rational. But your brain is not trying to be reasonable. It’s trying to save your life.

What we might think of as emotional outbursts—anxiety, depression, lashing out in anger—aren’t always just petty, emotional failings. They may be reflexes designed to protect us from things our brain has encoded as threats. And these threatening inputs are what many people call triggers.

And here’s what makes complex PTSD uniquely miserable in the world of trauma diagnoses: It occurs when someone is exposed to a traumatic event over and over and over again—hundreds, even thousands of times—over the course of years.

When you are traumatized that many times, the number of conscious and subconscious triggers bloats, becomes infinite and inexplicable. If you are beaten for hundreds of mistakes, then every mistake becomes dangerous. If dozens of people let you down, all people become untrustworthy. The world itself becomes a threat.

My freak-outs are more or less constant, a fixed state of being. Ah. The dread. That infinite plethora of triggers makes complex PTSD more difficult to heal from than traditional PTSD. And the way the books seem to think about it, our fixed state of being also makes us more problematic.

“The adults who had been abused as children often had trouble concentrating, complained of always being on edge, and were filled with self-loathing. They had enormous trouble negotiating intimate relationships,” van der Kolk writes. “They also had large gaps in their memories, often engaged in self-destructive behaviors, and had a host of medical problems. These symptoms were relatively rare in the survivors of natural disasters.”

I embarked on this research in 2018. It’s important to understand that two years later, in 2020, Robert F. Anda, the co–principal investigator of the initial ACE study, came out with an article and a YouTube video stating that ACEs were a relatively crude way of measuring childhood trauma.[6] The scores are remarkably helpful epidemiologically—for people to understand the overall significance of childhood trauma on public health.

Traumatized brains tend to have an enlarged amygdala—a part of the brain that is generally associated with producing feelings of fear. Which makes sense. But it goes further than that: For survivors of emotional abuse, the part of their brain that is associated with self-awareness and self-evaluation is shrunken and thin.

Victims who were screamed at might have an altered response to sound. Trauma can result in reductions in the parts of the brain that process semantics, emotion and memory retrieval, perceiving emotions in others, and attention and speech.

And the scariest factoid, for me anyway: Child abuse is often associated with reduced thickness in the prefrontal cortex, the part of the brain associated with moderation, decision-making, complex thought, and logical reasoning.

Exercise boosted my mood temporarily. But my psychic energy was supremely lacking. I could leap up subway stairs with a load of groceries, but I often still couldn’t get myself up off the couch to send an email.

In Gretchen Schmelzer’s excellent, gentle book, Journey Through Trauma, she insists on the fifth page: “Some of you may choose a therapist: a psychiatrist, psychologist, social worker, counselor, or member of the clergy. Some of you may choose some form of group therapy. But I am telling you up front, at the beginning: in order to heal, you will need to get help. I know you will try to look for the loophole in this argument—try to find a way that you can do this on your own—but you need to trust me on this. If there were a way to do it on your own I would have found it. No one looked harder for that loophole than I did.”[1] After my diagnosis, I looked for that loophole, too, for a while.

Finding a person to declare your craziest, most profound insecurities to is not exactly a picnic. But the bureaucratic idiocy of America’s healthcare system turns what should be a chore into torture.

You learn on the internet that insurance companies haven’t updated reimbursement rates for therapists in up to twenty years, despite rising rates for office rent and other administrative costs. If therapists were to rely on reimbursement rates from insurance alone, they’d wind up making about $50,000 a year on average,[5] which is fine, but like, not great if you’re an actual doctor.

In The Body Keeps the Score, Bessel van der Kolk writes about how talk therapy can be useless for those for whom “traumatic events are almost impossible to put into words.” Some people are too dissociated and distanced from these traumatic experiences for talk therapy to work well.

They might not be able to access their feelings, let alone convey them. For others, they’re in such an activated state that they have a hard time reaching into difficult memories, and the very act of recalling them could be retraumatizing.

Then again, he said that EMDR was far more effective for adult-onset trauma, and it cured only 9 percent of childhood trauma survivors. But at this point, 9 percent was better than nothing. Nine percent was a beacon I couldn’t afford to ignore.

She reported that subjects who received EMDR therapy had “significant decreases in ratings of subjective distress and significant increases in ratings of confidence in a positive belief.”[1]

Talking gives us knowledge about why we are the way we are, but that knowledge isn’t enough. Processing, on the other hand, allows us to truly come to terms with our trauma and resolve it—to rewrite the memories in our brains with a healthier narrative.

“It’s interesting you say that you aren’t dissociated,” Eleanor said carefully. “When you describe some terrible things being done to you, you have a remarkably flat affect when talking about them.”

That’s why many trauma therapists try to set up a strong framework of coping mechanisms before people launch into their foundational traumas. So if you find Pennywise in the cellar of your brain, you can have some solid techniques for how to handle him.

I’ve always said there are forest people and desert people. Forest people are nurturing and fertile, but they have a tendency to hide behind their branches. I’m a desert person. Hard and acerbic and difficult to endure, but honest. You always know what you’re getting in the desert because there isn’t anywhere to hide. In that dry air, you can see a storm coming from ten miles away.

“It’s true,” I yell, and now I’m loud. “They both abandon you in a few years. All the hard work that you put in to save them, all the mediation, the effort, none of it pays off. They don’t appreciate it at all. They never thank you.”

“I just want you to know that you haven’t actually done anything wrong. Just remember that eventually you will be loved, I promise,” I say. “And…I want you to know how powerful you are. Your vigilance. Your diplomacy. You are only a small child, but you are the nucleus that keeps this family together. With or without you, these two toxic adults would be fundamentally unhappy. But you make them less unhappy, if anything. Their grief is not your fault.”

Those little buzzers had worked some kind of electronic Robin Williams magic. I didn’t just understand the weight of my abuse logically. I felt it, like a blade through flesh, like a bone popping out of place. I felt it like a lover saying it’s not going to work: sharp, immediate, and terrifying. I actually felt, with searing clarity, the horror of what happened to me—maybe for the first time ever. I felt how tremendously sad it was that I was forced to make my parents feel loved at such a young age. I felt how courageous I must have been to endure that torture, day after day for so many years, by the people I trusted most in this world. I felt a sense of love and adoration for my childhood self that I’d never been able to summon before.

There is a difference between knowing and understanding. I had known that this wasn’t my fault. EMDR unlocked the gate to the next realm, toward understanding. The difference is one between rote memorization and true learning. Between hypothesis and belief. Between prayer and faith. It seems obvious now—how can there be love without faith?

I learned two critical things that day. First: Just because the wound doesn’t hurt doesn’t mean it’s healed. If it looks good and it feels good, it should be all good, right? But over the years I’d smoothed perfect white layers of spackle over gaping structural holes. And the second thing I learned was: My parents didn’t love me.

When all of these terrible things keep happening, everything should have fallen apart, but it didn’t. It was like I was watching it all through a glass. It was a movie. A movie. I had used the same exact phrasing Eleanor used when she’d questioned me from her worksheet, the same language clinicians and psychiatrists use to diagnose people with dissociation, the language I denied in her office.

Dissociation exists for a reason. For millennia, our brains and bodies have removed us from our pain so we can keep moving forward. A tiger just ate your wife? Bummer, but breaking down or freezing up is not an option. You better go out hunting today or your kids will starve. Your house was just destroyed in an air raid? Okay, but you have to pack up what’s left and find new shelter, now. Feelings are a privilege.

Now I had nothing but time, the excruciating expanse of leisure. And without my armor, I was raw, the elements scraping against exposed muscle. What’s behind the veil? Pain. A lot of fucking pain.

The literature says this is normal for traumatized people. Experts say it’s all part of the three P’s: We think our sadness is personal, pervasive, and permanent. Personal, in that we have caused all the problems we face. Pervasive, in that our entire life is defined by our failings. And permanent, in that the sadness will last forever.

There is overwhelming evidence that meditation can increase focus and decrease anxiety, depression, and cortisol flooding.[1] There is evidence that it decreases activation in the amygdala, one epicenter of fear in the brain, and increases activity in the prefrontal cortex.[2] People who meditate are able to unstick themselves from cyclical, dangerous thinking and see things from a calmer, more positive perspective.

Meditation activates the parasympathetic nervous system.[3] It’s literally the antidote to stress.

Then there is the more achievable exercise of “grounding.” Grounding sounds like meditation lite—an act of mindfulness but briefer than meditation and more focused on concentrating on small things in the world around you.

One of the more helpful C-PTSD resources I found is a website called Beauty After Bruises, which describes grounding this way: “Being grounded refers to a state of mental awareness where you’re fully present with the here and now. You know who and where you are, the current time and year, and what’s happening all around you. It is the opposite of dissociating. The act of ‘getting grounded’ means taking deliberate steps to bring one’s self out of flashbacks, dissociation, and/or other distress…. This is a vital skill for trauma patients.”[4]

But I soon learned that in trauma lingo, people often aren’t talking about the movie version of flashbacks. They’re talking about emotional flashbacks.

Even though consciously I was completely in the present, my emotions were back in 1997, back when I was a little kid and making a mistake on a spelling test could literally be a matter of life and death. This return was an emotional flashback.