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

“The difference between regular PTSD and complex PTSD is that traditional PTSD is often associated with a moment of trauma. Sufferers of complex PTSD have undergone continual abuse—trauma that has occurred over a long period of time, over the course of years. Child abuse is a common cause of complex PTSD.”

Samantha, Foo’s therapist, provides the work’s first definition of C-PTSD upon divulging Foo’s diagnosis. As of the book’s publishing, the Diagnostic and Statistical Manual of Mental Disorders (DSM) in America did not recognize C-PTSD as a diagnosis, making it ineligible for coverage by most health insurance. C-PTSD is the main topic of the memoir, and Foo’s goal is to share her experience dealing with its complex symptoms in the hopes of providing more resources for others.

“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.”

Abuse and neglect have led Foo to consider suicide many times throughout her life. One thing that motivates her to keep living is her passion for journalism. When she becomes editor in chief of her high school newspaper, the responsibility and work prevent her from focusing on her feelings of loss and abandonment. Her early foothold in the field later blossoms into a successful career.

“In my line of work, I had learned a great many things about interviews and story structure, politics, and people. But I still had not learned how to be kind.”

Foo remembers her high school and college days as periods of great emotional upheaval and social distance. Having never been taught kindness and having lived in constant fear, Foo felt incapable of forging deep and long-lasting social relationships with her peers. Defiant and reactive, she first realized her shortcomings when a good friend broke all ties with her, calling her self-centered. Foo realized she was not equipped to offer others adequate emotional support due to her own trauma.

“Samantha helped me see that the loop kept happening because I was repeating behaviors taught to me by my mother—that her voice remained inside my head.”

Foo describes how the consequences of childhood abuse remain even after the abuser leaves the picture—an example of How Trauma Shapes Identity. Foo initially believes herself to fundamentally lack the necessary tools to forge lasting relationships because she repeats the abusive behaviors taught to her by her mother. To break the vicious cycle of abuse, Foo decides to work on finding ways to manage her anger and better connect with others.

“Lacey said the road would be long and difficult. That sounded about right, considering I was endeavoring the relearn how to be a person. I wanted to learn to be happy and strong and independent so I could support others instead of letting my own depression always take center stage.”

Lacey, a journalist who also deals with C-PTSD, gives Foo hope that her condition might one day become manageable. Through their discussions, Foo realizes that to better forge social relationships, she first needs to work on treating herself kindly. This is one impetus for Foo’s decision to quit her job at This American Life, which has become too stressful to manage. The positive example of healing that Lacey provides implicitly informs Foo’s choice to share her own story with others.

“Being my parents’ caretaker imbued me with an illusion of control—a belief that I could prevent disaster if only I was vigilant enough. But these health outcomes proved I was wrong. If anything, it was vigilance itself that destroyed me.”

After delving deeper into scientific research on C-PTSD, Foo concludes that survivors of abuse see their very biology changed by the trauma. Recent findings demonstrate that childhood abuse can reduce the thickness of the prefrontal cortex, a region of the brain associated with regulating emotions, complex thought, decision-making, and reasoning. Foo is afraid that her vigilance, born out of necessity in a household where her life was repeatedly threatened, has become the core factor preventing her from forging long-lasting relationships with others.

“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.”

EMDR therapy allows Foo to revisit her past trauma and understand it from an adult perspective. As an adult looking onto a scene from her childhood where she was beaten by her mother yet afraid to leave, Foo realizes the distance she has gained and the growth she has undergone over the years.

“The term ‘grounded’ started making sense. Being utterly and completely present allowed me to focus on the immense, full-body pleasure of simply being alive.”

Much of Foo’s trauma stems from having grown up in a volatile and dangerous environment where her life was constantly threatened. As a result, she lives with anxiety and frequent bouts of depression. Grounding exercises allow her to let go of her fears, embrace her own body, and focus on the immediate present. They are also an example of The Brain–Body Connection, as reconnecting with her physicality allows Foo to cope with her thoughts and feelings.

“Gratitude lifted my baseline mood up from being constantly seared by the pain of existence to living a largely satisfying life.”

This line evinces a change in Foo’s perspective on life, a crucial step in her road toward healing from complex trauma. She realizes that expressing gratitude to others as part of honest communication is deeply rewarding. Similarly, focusing on being grateful for the small things in life encourages her to focus on the present.

“You have a community of immigrants and refugees who survived extreme violence—but they don’t believe in mental illness, don’t talk about trauma, don’t allow for feelings or failure, and everyone is just fucking fine?”

Foo finds the Trauma and Silence in Asian American Communities deeply unsettling. The impulse to ignore trauma is only exacerbated by the widespread stereotype of the Asian American as a “model” immigrant who is successful and hardworking. Foo is convinced the secrecy is both deliberate and counterproductive.

“I also spoke to dozens of Asian children of immigrants […] In these conversations, everyone always wanted me to know that their parents were good people. They came here with nothing; they overcame so much. They’re just, you know. Stoic. Anxious. Quiet.”

This quote explains why second-generation Asian American immigrants are also quiet on the topic of trauma and mental health, despite growing up in America’s “melting pot.” Although they do not know the particulars of their parents’ trauma, they feel indebted to the earlier generation for their sacrifice; therefore, they find it appropriate to excuse and endure their parents’ abuse.

“If it weren’t for all the secrets. If we had simply said things, stated what was happening out in the open, then maybe someone could have stepped in to prevent my parents from ruining [my life].”

Foo resents her parents’ habit of burying the past and silencing their trauma—a habit she recognizes as endemic, though not exclusive, to Asian American communities. She believes that trauma cannot simply be ignored or erased and that violence will beget violence. Her abuse is partly the result of her parents’ unprocessed and untreated trauma. For her own sake and for the sake of other young Asian Americans, she wishes that the subject of mental health were not so taboo in her community.

“This was the lesson, then—a lesson Auntie repeated to me over and over throughout the years: that my great-grandmother’s history was worth our remembrance and our respect because of her hard work, her sacrifices, and, most of all, her unfathomable endurance. It made perfect sense to me later in life when I discovered that the Chinese word for endurance is simply the word knife on top of the word heart.”

Throughout the entire memoir, Foo highlights the tremendous resilience and strength needed to survive traumatic experiences. Her family’s history—and recent Asian history in general—are characterized by colonization, poverty, and extreme violence. Endurance means finding ways to overcome hardships, and this knowledge helps Foo cope with her own C-PTSD.

“Beyond that, every cell in my body is filled with the code of generations of trauma, of death, of birth, of migration, of history that I cannot understand. Just piecemeal moments I collected from Auntie over the years. My family tried to erase this history. But my body remembers.”

This passage embodies the core message of Foo’s memoir. Trauma is not simply a surface-level illness that can be cured; rather, it can be coded into DNA and passed down to later generations. In other words, it affects people beyond the individual, making it all the more counterproductive to attempt to hide it.

“My father and I had always seemed to struggle with what our relationship was to each other. I felt as if I had to take care of him growing up, even as I looked to him for food, shelter, advice on math homework. As adults, we could not find a middle ground. Were we strangers? Acquaintances? But, of course, there was that pesky genetic tie of obligation.”

What My Bones Know gives readers a clear sense of Foo’s feelings toward her mother, a profoundly abusive parent whose departure came as a relief to her daughter. Though less overtly abusive, Foo’s relationship to her father did not resemble that of a typical parent and child because she had to parent him through his bouts of depression, even when she was only a teenager. As a result, she finds herself unable to understand the nature of their relationship.

“I am blood and sin. I am the sum total of my parents’ regrets. I am their greatest shame.”

This quote expresses Foo’s deep grief at never having been loved by either of her parents. She comes to this conclusion when she realizes her father hid her presence from his new family, despite living only 45 minutes away from her. Though it causes her grief, the realization also helps Foo understand the importance of finding a new family and community that will support her.

“Removing my parents from my life protected me, but it did not fix me.”

Foo decides to become estranged from her immediate family because she realizes the distance is necessary for her survival. However, cutting them off does not magically heal her from her traumatic past, nor does it make her happy. As it is for most people who make this choice, choosing estrangement is simply a necessity.

“That sadness—the sadness of loss—is a different flavor than the sadness of reckoning. The sadness of reckoning feels visceral and angry and tinged with violence. It feels healable, somehow, with revenge or justice. But the sadness of a lost childhood feels like yearning, impossible desire. It feels like a hollow, insatiable hunger.”

Foo mourns the happy childhood she never had. She spent most of her adolescence feeling angry and combative, but she understands now that retribution cannot heal every type of wound. The sadness of loss cannot be mended with anger or vengeance.

“It is a great, sexist irony that in our society, PTSD is generally considered a male condition.”

Foo wrote this memoir partly to offer her own story as a resource for other people with complex PTSD. This quote exemplifies why she feels this is necessary: PTSD is associated with men, especially soldiers, when in fact it affects women more frequently. The literature on complex PTSD—and most importantly, treating C-PTSD—is even scarcer.

“The essence of what trauma does to a person is it makes them feel like they don’t deserve love.”

This is a struggle that Foo overcomes only through many years of therapy. Having been verbally abused as a child, she finds it difficult to see herself in a positive light. Her mother highlighted and punished her flaws, and Foo had to apologize for them, no matter how insignificant, to stay alive. In other words, self-love is a skill Foo has to learn over the course of her healing.

“I’d spent so much time pathologizing my flaws, seeing them in grand, thematically untackleable ways—I am a bad listener—that I’d sit in terror, unable to see how I was failing at listening from moment to moment in a conversation.”

Foo is adept at thinking of the big picture, but she finds it difficult see details accurately. This applies to her own actions as well: She cannot easily discern where her interactions with others veer off course, and therefore she struggles to correct her behavior. Instead, she finds herself growing anxious when a conversation takes an unexpected turn, and she berates herself in an attempt to mitigate the situation. Recording her therapy sessions with Dr. Ham allows her to revisit her conversations and find patterns she wishes to correct.

“In order to become a better person, I had to do something utterly unintuitive. I had to reject the idea that punishing myself would solve the problem. I had to find the love.”

Foo realizes that her drive for perfection affects her road toward healing from C-PTSD, as she berates herself for every little setback and bout of sadness. After speaking with Dr. Ham, she realizes she is “tiger-childing” her own recovery and decides she must practice greater self-care and self-love.

“Being healed isn’t about feeling nothing. Being healed is about feeling the appropriate emotions at the appropriate times and still being able to come back to yourself. That’s just life.”

Having lived in a constant state of anxiety for so long, Foo did not immediately intuit that a healthy life could include negative feelings as well as positive ones. Healing from C-PTSD does not mean being constantly happy. She concludes that being mentally healthy is about having a balanced emotional response to the situation at hand.