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'What My Bones Know' is Stephanie Foo's memoir on living with complex PTSD

SARAH MCCAMMON, HOST:

Stephanie Foo grew up in California, the only child of immigrants who abused her for years and then abandoned her as a teenager. As an adult, Foo seemed to thrive. She graduated from college, landed a job at "This American Life," became an award-winning radio producer, was dating a lovely man, but she was also struggling. Years of trauma and violent abuse as a child had left her with a diagnosis - complex PTSD, a little-studied condition that Foo was determined to understand. The result is her new memoir, "What My Bones Know." And Stephanie Foo joins us now from New York City. Hello.

STEPHANIE FOO: Hi. Thank you so much for having me today.

MCCAMMON: I want to start with your diagnosis, because listeners have likely heard of post-traumatic stress disorder, or PTSD. But how is complex PTSD different?

FOO: Right. So you can get traditional PTSD from a single traumatic event, like, say, you were hit by a car. Complex PTSD is kind of like if you were hit by that car every week for years. It manifested in my life as anxiety, as depression. The difference between PTSD and complex PTSD is that complex PTSD sort of has the potential to have a constant fear sort of churning underneath the surface. And I think it always had me on edge, hypervigilant, made it really hard for me to trust people - and to sort of bury that with intense workaholism, drinking a lot, partying a lot, that kind of thing.

MCCAMMON: Something you come back to a lot in your memoir is the idea of inherited trauma. So I'm wondering if you could talk about your parents' histories a little bit and your family's immigration from Malaysia and how that shaped your childhood.

FOO: I think my parents being recent immigrants gave them fewer resources in some ways. We didn't have access to a lot of family. And my parents, I think, were pretty alone and isolated in their ability to take care of me and in terms of having other people be able to take care of them and the mental illnesses that they suffered from. My parents came from lines of - where their parents had suffered immense traumas. My grandparents and my great-grandparents suffered through World War II. They suffered from the Malayan Emergency. My grandfather was imprisoned by the British during the Malayan Emergency for five years. And when he got out of prison, he lost all of his teeth somehow, and he never talked about it. You know, there were real consequences to that culturally, in terms of the way that they were raised, but even more so in their literal DNA.

MCCAMMON: Yeah, that was one thing that really struck me. I mean, you did some research into how trauma literally can change our genes and how that gets passed down. I mean, what did you learn about how that works?

FOO: Well, there's a couple of really fascinating studies about how our genes can change by what we endure. There's one really famous one where scientists exposed rats to the smell of cherry blossoms and then shocked them. And so these rats came to associate the smell of cherry blossoms with shocks, with fear. And their offspring and then their offspring would have panic responses every time they smelled cherry blossoms, even if they had never been shocked before. So what happens is the epigenome is sort of a layer on top of our DNA that kind of decides what genes get turned off and on. And experiencing trauma can change that epigenome.

MCCAMMON: I want to talk about your therapist, Dr. Ham. He is basically my favorite person in this book.

FOO: (Laughter).

MCCAMMON: How did you find him? And, in short, how did he help you?

FOO: I found him in a very radio producer-y (ph) way. I found him through listening to a podcast (laughter). He was talking about complex PTSD as, like, being the Incredible Hulk, right? Because the Incredible Hulk was actually abused as a kid. His father was an alcoholic, and now he had a hard time controlling his emotions when he was angry. He would sort of literally not be able to speak well, and he would just focus on surviving. And that is exactly what having complex PTSD is like. But the Hulk is not a villain. The Hulk is a hero. And so I needed to know more about that. And so I went to interview him, and he started interviewing me in the middle of me interviewing him. And eventually, he asked me if he could treat me, and I agreed.

MCCAMMON: And you approached this in a very radio producer-y way.

FOO: Yeah.

MCCAMMON: I mean, you have all of your tapes of your sessions with him, right?

FOO: Correct. And after we got done with a session, I would immediately go to the cafe downstairs, and I would upload all of my audio and transcribe it and put it in a Google doc, as you are very familiar with.

MCCAMMON: All too familiar.

FOO: And then we would edit it. And it was like we were editing my trauma out of the scripts. There was a point at which - after our actual first session, I saw, like, a whole page of me ranting about, like, my husband's job, which seemed completely out of left field. And I commented, what is going on here? Where am I? And he said, ah, you are dissociated because you are triggered. And I was like, what triggered me? Why am I dissociated? And I scrolled up. And right before that rant, I had talked about my mom holding a knife to my neck. And I turned off my emotions and my brain to access that, and I needed to disappear in some way to say that. And I got lost on the way. And so that was so helpful for me to just understand, with true journalistic objectivity, I guess, what was happening in my brain.

MCCAMMON: I'm really curious, though. You know, in writing this book and even now in talking about it, you have to go revisit a lot of those traumas again. You're talking about them right now. You're thinking about them. You're writing about them. I mean, how was that? How is that?

FOO: Yeah, dissociation, baby. That's what allows me to be talking to you and saying these things to you right now. And I think the other thing, too, is that I really did prioritize healing before I focused on writing. So writing itself was not the catharsis. Healing was the catharsis. It made me feel like I just wanted to share what I had learned. It was coming from a place of hope, and I wanted to write something that would help other people feel hopeful to. And I don't think that you ever totally heal from complex PTSD. It's sort of something that you carry with you all the time. But I feel like if the burden, the weight of complex PTSD, is like a pack on my back, then the process of healing has made me stronger. Does that mean, of course, that sometimes the pack gets really, really heavy and I need to sit down and take a break and cry a little bit and figure some new stuff out? Of course. Of course. That's what life is. But now I feel like I can hold the sadness and the anger and the joy all together.

MCCAMMON: Stephanie Foo's memoir is "What My Bones Know." Thank you so much for talking with us.

FOO: Thank you so much for having me. I really appreciate this opportunity to shed some light on complex PTSD. Transcript provided by NPR, Copyright NPR.

Sarah McCammon is a National Correspondent covering the Mid-Atlantic and Southeast for NPR. Her work focuses on political, social and cultural divides in America, including abortion and reproductive rights, and the intersections of politics and religion. She's also a frequent guest host for NPR news magazines, podcasts and special coverage.