Stephanie Foo on Gaining Agency From C-PTSD

Photo: Bryan Derballa

In her new memoir, What My Bones Know, author and radio journalist Stephanie Foo details her painful experiences with childhood physical abuse — and the long, indirect path she took to healing in her adulthood. Foo has C-PTSD, or complex post-traumatic stress disorder, a diagnosis first established in 1988 by Judith Herman, who argued the effects of long-term trauma required a term distinct from ordinary PTSD. Though many mental-health organizations and professionals make use of this distinction, C-PTSD is not recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

C-PTSD is characterized by prolonged, repeated trauma, as Foo says she experienced throughout her childhood. “If I had traditional PTSD,” she writes, “if, let’s say, getting hit by a car was the one foundational traumatic moment of my life, I could learn to isolate and resolve the triggers from it … but unfortunately, I do not have one foundational trauma. I have thousands.”

Because Foo was a well-behaved student, and later a successful journalist, she was able to hide her illness from others — and, to an extent, from herself — for many years. When she was finally diagnosed, Foo applied her journalistic rigor to researching C-PTSD and its treatments, many of which provided only temporary relief. Still, as Foo tells readers early on, though her journey was long and painful, the book has a happy ending.

The Cut recently spoke to Foo about writing and reliving her childhood experiences, trauma as reason versus excuse (particularly in the case of Joss Whedon), and the benefits of found family.

You write that you struggled with the decision to detail your abusive childhood in this book, as it could be triggering to other survivors. What was that decision-making process like for you? 

Writing the childhood-abuse section was definitely the most difficult part of the book. In my first draft, it was actually really, really brief. I kind of skimmed over the details. I really wanted to focus on the adult-healing aspect, and there are so many stories and memoirs that focus on the childhood aspect. I think it’s really important to normalize that, but I also really wanted to show what it feels like to actually heal. But my editor was like, “Look, nobody’s gonna buy into your healing story if they don’t understand what you’re healing from in the first place.” I probably wrote those first 50 pages something like 30 times, just trying to get the tone right. I tried to be matter-of-fact but accessible. It was a really tricky thing.

You write about not wanting to repeat your abusers’ behaviors, and we often frame abuse as a “cycle” that repeats. How does your experience with trauma make you think about the “nature versus nurture” debate?  

Late into writing the book, I came across this old Chinese saying: A third of the world is under the control of heaven, a third is under the control of the environment, and a third is in your hands. I think there’s a lot more wisdom to that than I previously thought. I feel like I have less agency than I previously thought. I am a product of my genes and of literally generations of trauma, war, and global conflict. I feel like my genes know something about fear, and they have a lot to be afraid of. Those genes built some resilience in me and taught me how to survive.

You tweeted about Joss Whedon after the Vulture story came out. It seemed there was an understandable desire to distance yourself, your diagnosis, from him there. What do you make of people like him who might call on past traumas to excuse bad behavior? 

We do have some agency, and the healing process gives us more agency. And I think that if you haven’t gone through that healing process, that’s sort of a dangerous thing. I think the healing process is what keeps us from taking those past events that we may or may not have had control over and hurting other people in our lives.

I think it’s okay to use that trauma as a reason to say, “Look, I may have behaved poorly for x, y, and z reasons.” I don’t think it’s okay to use it as an excuse going forward. I think we still have the responsibility to take that trauma and create something beautiful from it, to try to be a better person. I don’t think you can do that if you’re constantly excusing it: That’s not my fault, I have no control over the things that I do. That’s what the entire book is about — me trying to get agency from my trauma. And it’s excruciatingly difficult and painful.

You write really compassionately about wanting to heal in order to be a better friend and partner and person, and that’s so admirable — but also, after reading the first part, I felt as a reader like you of all people deserve to be angry and negative. How do you reckon with that resentment? 

I feel lucky that I wasn’t fixing it on my own. I had the support of people around me. And I think it’s absolutely okay to feel resentment and anger. Just this week, I had kind of a meltdown where I was just like, This is so unfair. But the important thing is to have that balance. I don’t think being mentally healthy means feeling good and happy all the time. It’s being able to feel that balance of anger and sadness and happiness, and to hold all of those things. In the beginning, certainly, I wasn’t able to feel as much joy and happiness and gratitude because I was mostly caught up in the negativity and the anger and fear. I still have those now, but I have a more diverse spectrum of emotion.

You’re a self-described workaholic — where do you think the desire to treat trauma and other mental-health issues with productivity and ambition comes from?

We’re Americans in a capitalist society — proud, good Protestant Americans. Everything can be erased by work. Productivity is valued over everything else. Success is valued over everything else. And I think part of it for me was an immigrant thing. Our parents came to America thinking past traumas or negativity could be erased by us as immigrant kids succeeding. That’s what they came here for. They wanted to give us opportunities, and if we were able to take them and run with them, and become doctors or lawyers or productive members of society, all of that could be painted over and whitewashed by our success.

In your accounts of experiences with various therapists and specialists, I got such a strong journalist vibe — you’re skeptical of most treatments. Do you think it has been harder to find and accept treatment as a reporter by trade? 

The skepticism probably didn’t help. There was also a workaholism aspect to it. I just wanted it to be fixed. I wanted to treat my diagnosis like a story, and for it to have a deadline, so I would just do the work and then I would be better. I think I tried to get too much information about the diagnosis at first — I needed to know all the science. I needed to know all these studies, many of which did not make me feel better and instead made me feel a lot worse. But in the end, I think I have a much fuller understanding of C-PTSD. And I’m really grateful that I have that fuller understanding, and that I was able to find the right experts in this field to frame it in a healthier way.

Respect for authority figures of all kinds is one of our strongest cultural norms, and stories like yours are a powerful counterargument to that, in a way. I wondered whether you might now conceive of the maxim to “respect one’s elders” differently, having experienced what you did.

I have “parents” in my life that are bosses, that are in-laws, that are mentors. I definitely have an appreciation of found family. In some ways, I’m able to be more grateful for the family that I found, because these people chose to be my family. They care so strongly about me, not because of blood ties but because they love me. There’s a lot of gratitude and appreciation there.

Stephanie Foo on Gaining Agency From C-PTSD