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

This book gives language to an injury most sufferers can't name. Complex PTSD isn't in the DSM-5, so millions walk around misdiagnosed or just told they're 'difficult.' Foo combines hard science — ACE scores, cortisol studies, polyvagal theory — with a raw personal account of abuse and recovery. Read it if you survived childhood trauma, love someone who did, or work in mental health.

1. 1Part I, Chapters 1-2

   The diagnosis that isn't in the book of disorders

   Stephanie Foo is twenty-five, producing stories at This American Life, when her boyfriend Joey ends the relationship in their Brooklyn apartment. 'You have C-PTSD,' he tells her. 'You have complex trauma.' She has never heard the term. After he leaves, she calls her mother in San Jose and asks, point blank, whether she was abused as a child. Her mother answers: 'I don't remember anything. I don't remember anything from my childhood. I don't remember anything from your childhood. I don't remember anything.' Then she hangs up. Foo eventually lands in the office of Dr. Ham at Columbia University Medical Center. After a two-hour intake, he gives it a name: complex PTSD, a condition born from prolonged, repeated trauma, usually in childhood, where escape is impossible. It isn't even in the DSM-5. 'You have a very severe case,' he tells her. 'You have all the symptoms. You have a lot of work to do.' When she asks if she'll ever get better, he pauses. 'I don't know. I think you can learn to manage it.'

   The idea

   Complex PTSD was first proposed by psychiatrist Judith Herman in 1992, in her book Trauma and Recovery — and three decades later it still hasn't made it into the DSM-5. That gap matters: it means people with the condition are often diagnosed with plain PTSD, or depression, or nothing at all. Herman's definition of recovery reframes the whole project. 'Recovery is not about never having symptoms again,' she tells Foo. 'Recovery is about having a life that is worth living, even with the symptoms.' The goal isn't erasure. It's building a life big enough that the symptoms no longer run it.

   Try this: If therapy hasn't worked for you, ask a clinician specifically about complex trauma — not just PTSD — and see whether the prolonged, repeated kind fits your history better.

2. 2Part I, Chapter 3

   Your childhood gets scored like a test

   Foo fills out a questionnaire that asks about her childhood — and scores high. The questionnaire comes from the landmark 1998 CDC-Kaiser Permanente study on Adverse Childhood Experiences, run by Dr. Vincent Felitti and Dr. Robert Anda, which surveyed over 17,000 adults. The finding that changed medicine: the more categories of childhood adversity a person reported, the higher their risk of chronic disease and the leading causes of death. Foo's own score is high. The abuse she survived isn't just memory — it's a measurable predictor of what her body will do decades later.

   The idea

   The ACE study turned 'rough childhood' from a vague complaint into a public-health variable. Over 17,000 adults answered questions about what happened to them before eighteen, and the pattern held across the board: higher scores tracked with more chronic disease and earlier death. What surprises people is the dose-response shape — it's not one bad event, it's accumulation. Foo scores high, which means her panic attacks and body-locking aren't character flaws. They're the expected output of a body that spent years in survival mode.

   Try this: Take the ten-question ACE questionnaire online this week. Knowing your number won't fix anything, but it turns self-blame into data.

3. 3Part I, Chapter 4

   The freeze: when your body won't let you speak

   In a work meeting at This American Life, a colleague criticizes Foo. Nothing dangerous is happening — just words in a conference room. But her body locks up completely. She cannot speak. She cannot move. Several minutes pass before she comes back online. She calls it 'the freeze,' and it recurs throughout her life: conflict triggers a shutdown she can't override with willpower. The woman who can run a radio show can't say 'excuse me' when someone criticizes her, because her nervous system has decided she's back in danger.

   The idea

   The freeze response explains something sufferers know and everyone else finds baffling: intelligence has nothing to do with it. Foo isn't choosing silence. Her nervous system is running a program installed during years when speaking up meant punishment. The response fires on cue, in safe rooms, in front of colleagues, without her consent. Once you understand that shutdown is automatic, not cowardly, the shame around it loosens — and so does the judgment of partners and friends who wondered why someone so capable just 'went blank.'

   Try this: Next time you freeze in a conversation, don't force words. Notice the lock-up, name it silently — 'this is the freeze' — and give yourself permission to return to the conversation later.

4. 4Part I, Chapter 5

   The trauma is not in the event. It's in the body.

   Foo sits down with psychiatrist Bessel van der Kolk, author of The Body Keeps the Score, and gets a biology lesson. Trauma, he explains, physically reshapes the brain: it shrinks the hippocampus — the structure that files memories and tells time — by up to 25 percent. Meanwhile the amygdala, the alarm system, stays in a constant state of hyperarousal. 'The trauma is not in the event,' van der Kolk tells her. 'The trauma is in the body.' For Foo, this lands like a key turning. Her panic, her freeze, her racing heart — these aren't leftover feelings about the past. They're present-tense physiology.

   The idea

   This is the idea that separates trauma from memory. An event ends; the body's response to it doesn't, because the brain structures that should mark it as 'over' are the very ones damaged. A shrunken hippocampus can't file the past as past, and a hyperarousal-stuck amygdala reads every doorway as a threat. That's why Foo can be criticized in a meeting and lose the ability to speak — her alarm system doesn't check dates. Talk therapy addresses thoughts; the body keeps its own record and needs its own treatment.

   Try this: When you're triggered, put a hand on your chest and name five things you can see. You're giving your amygdala present-tense evidence that the danger has passed.

5. 5Part I, Chapter 6

   Rewinding a memory with a moving light

   Foo tries EMDR — Eye Movement Desensitization and Reprocessing — with Dr. Marylene Cloitre. In a session, she brings up one of her worst memories: her mother choking her. The therapist waves a light bar back and forth while Foo holds the image. It sounds absurd, waving a light at someone's worst moment. But after eight sessions, something shifts. The memory feels 'fuzzy.' It still exists, but it has lost its voltage — it no longer detonates on contact. The scene is the same; Foo's body responds to it differently.

   The idea

   EMDR looks like the least plausible therapy ever invented — follow a light with your eyes and your worst memory loses its sting. Foo's result after eight sessions with Dr. Marylene Cloitre shows why it survives: the memory of her mother choking her didn't disappear, it went 'fuzzy.' The content stayed; the charge dropped. That distinction matters for anyone who fears that healing means forgetting. Desensitization isn't erasure. It's turning a live wire into a wire you can touch.

   Try this: If a specific memory keeps ambushing you, look for an EMDR-certified therapist and ask directly how many sessions they typically need for a single target memory.

6. 6Part II, Chapter 7

   Sold at eight: the grandmother who started it

   Foo flies to Malaysia to dig into her family's past. Her aunt tells her about Foo's grandmother: sold into servitude at age eight, beaten regularly, later abandoning her own children. 'Your grandmother was crazy,' the aunt says. 'She beat us every day.' Foo travels to the village where her grandmother lived and finds the house gone, replaced by a palm oil plantation. A neighbor fills in the picture: 'Your grandmother used to wander the streets at night, screaming. The children called her a ghost.' Foo stands in a plantation where a home should be, holding the story of a woman who was sold as a child, beaten, and left screaming in the dark.

   The idea

   Foo's grandmother was sold into servitude at eight and beaten regularly — a child treated as property. She grew up to abandon her own children and, by her neighbors' account, wander the streets at night screaming until children called her a ghost. Foo's parents then raised her with beatings and abandonment. Nobody in this chain invented their cruelty; they inherited it like a family heirloom nobody wanted. Standing in the palm oil plantation where the house once stood, Foo sees the relay clearly: unhealed trauma doesn't die with its owner. It gets handed down.

   Try this: Ask your oldest living relative what your grandparents' childhoods were actually like. You're not assigning blame — you're mapping where your patterns came from.

7. 7Part II, Chapter 8

   A grandfather who screamed in his sleep

   Foo learns what her grandfather lived through as a child during the Japanese occupation of Malaysia in World War II. He watched Japanese soldiers bayonet his neighbors. He was forced to bury bodies. He never spoke about any of it — but for decades, he screamed in his sleep. A man who never told his story told it every night, involuntarily, in the next room while his family tried to sleep. His body kept the record his mouth refused to open.

   The idea

   A child watches soldiers bayonet his neighbors and is forced to bury the bodies. He grows up, raises a family, says nothing — and screams in his sleep for decades. Foo's grandfather demonstrates the body-keeps-the-score principle across a generation: silence is not absence. The unprocessed horror found its way out nightly, in a bedroom, where children could hear it. Families don't just pass down genes. They pass down the sound of what was never spoken.

   Try this: Ask whether anyone in your family had nightmares, night terrors, or screamed in their sleep. Sleep symptoms often carry history that daytime stories never mention.

8. 8Part II, Chapter 9

   The cortisol evidence: trauma in the bloodline

   Foo discovers the research of Rachel Yehuda, who studied children of Holocaust survivors. She measured their cortisol — the stress hormone — and found something strange: the offspring had lower baseline cortisol levels than expected. Lower, not higher. Their stress systems were calibrated differently, a biological marker of trauma transmission. Foo reads this and does the math on her own family: a grandmother sold at eight, a grandfather burying bodies, parents who beat her. The chemistry of survival may have arrived in her bloodstream before she ever took a breath.

   The idea

   Rachel Yehuda's finding upends intuition: children of Holocaust survivors had lower baseline cortisol, not more. The stress hormone system appears recalibrated in the next generation — a biological fingerprint of what parents endured. For Foo, whose grandmother was sold into servitude and whose grandfather buried bodies under occupation, this reframes her own diagnosis. Her nervous system may have been primed before her first memory. That doesn't make healing hopeless; it makes the starting line different from where everyone assumes it is.

   Try this: Stop asking 'what's wrong with me?' and start asking 'what happened to the people who raised me?' Write down one thing you know about each grandparent's early life.

9. 9Part II, Chapter 10

   Ten days of silence, seven days to a breakdown

   Foo signs up for a ten-day silent meditation retreat at Spirit Rock Meditation Center in California — the kind of place healing is supposed to happen. By day three, the silence strips away her defenses and intrusive memories of abuse start surfacing. By day seven, she has a panic attack so severe she cannot breathe and has to leave the meditation hall. The retreat that was supposed to calm her nervous system instead floods it, because stillness leaves nowhere for the stored trauma to hide.

   The idea

   Meditation is sold as universally calming. Foo's ten days at Spirit Rock show the fine print: for someone with complex trauma, silence and stillness can be a trigger delivery system. By day three, intrusive memories of abuse surfaced; by day seven, she couldn't breathe and had to leave the hall. When your nervous system's whole strategy is staying busy enough not to feel, removing the busyness removes the shield. Intensive retreats aren't neutral — for trauma survivors, dose matters, and ten silent days can be an overdose.

   Try this: If you're trauma-exposed, start with ten minutes of guided meditation, not ten days of silence. Build tolerance before you sign up for anything residential.

10. 10Part II, Chapter 11

    Learning to read your own heartbeat

    Foo begins somatic experiencing with Dr. Peter Levine. Instead of talking through her past, he has her sit with physical sensations during flashbacks — the tight chest, the heat, the shaking. In one session she notices her heart racing at 120 beats per minute. Then she practices slowing it down through breathwork. It's the opposite of avoidance: instead of fleeing the feeling, she stays inside it long enough to learn its edges, and discovers she can nudge her own physiology rather than being ridden by it.

    The idea

    Somatic experiencing flips the usual therapy script. Dr. Peter Levine doesn't ask Foo to narrate her history; he asks her to track sensation while it happens — a heart at 120 beats per minute, then breathwork to bring it down. The skill being built is interoception: reading your own body's signals in real time. For someone whose freeze response ambushes her mid-meeting, that's not a luxury. It's the difference between being hijacked and noticing the hijacking start — which is the only moment you can do anything about it.

    Try this: Once a day, when stressed, take your pulse. Just noticing the number starts building the muscle of tracking your body instead of being blindsided by it.

11. 11Part II, Chapter 12

    'Okay. What do you need from me?'

    Foo meets a man named Joey through a dating app. On their third date, she takes a risk and discloses her C-PTSD diagnosis. He doesn't flinch or flee. 'Okay,' he says. 'What do you need from me?' They begin a relationship, and she practices something entirely new: telling him her triggers as she recognizes them, instead of hiding them or exploding. Around the same time, she's learning from researchers — using Dr. Stephen Porges's polyvagal theory, which explains the nervous system's shutdown response — that healing runs through co-regulation: other people's calm nervous systems helping settle yours. She starts deliberately building a chosen family of friends to support her recovery.

    The idea

    Polyvagal theory, developed by Dr. Stephen Porges, gives Foo a map of her shutdown response — and points to a cure that no clinic offers: co-regulation, nervous systems steadying each other. That's why Joey's third-date response matters so much. 'Okay. What do you need from me?' is a regulated nervous system offering a hand to a dysregulated one. Foo's answer is to build a chosen family on purpose. For trauma survivors whose biological families were the source of harm, friendship isn't a consolation prize. It's the treatment.

    Try this: Tell one safe person about one of your triggers this week — before it fires, not after. Naming it in advance turns them into an ally instead of a bystander.

12. 12Part III, Chapter 14

    The dish in the sink and the plate on the wall

    Joey leaves a dish in the sink. Foo screams at him and throws a plate against the wall. In the aftermath, sitting in the wreckage of a minor household event, she traces the rage to its source: her father used to beat her for minor household infractions. A dish in a sink isn't a dish in a sink to her nervous system — it's the exact trigger that once preceded violence. The realization doesn't excuse the plate, but it explains it, and points at what actually needs treating.

    The idea

    A plate against the wall over a dish in the sink looks like a temper problem. Foo's insight is that it's a time-travel problem: her father beat her for minor household infractions, so her body reads a neglected dish as the opening bars of a beating. The rage arrives before thought, aimed at a partner who left a dish, powered by a man who has been dead to her life for years. Naming the pattern doesn't undo the plate. It does create the gap between trigger and response where change becomes possible.

    Try this: After your next disproportionate reaction, ask one question in writing: 'What did this remind my body of?' Don't analyze it in the moment — the answer comes later.

13. 13Part III, Chapter 13

    A wedding, a bathroom stall, and thirty minutes of grounding

    Foo and Joey marry in a small ceremony in New York City. Then, at the reception, a family member makes a comment — and Foo's nervous system betrays her on her own wedding day. She has a dissociative episode and retreats to a bathroom stall, where she spends thirty minutes running the grounding techniques she learned in therapy until she comes back to herself. Healing, it turns out, doesn't exempt you from your worst days. It just gives you tools for them.

    The idea

    Foo gets the wedding, and her dissociation comes anyway — triggered by a family member's comment at the reception. Thirty minutes in a bathroom stall, running grounding techniques, on the day she's supposed to be purely happy. This is what recovery actually looks like: not a finish line where symptoms forfeit, but a life where you know what to do when they show up uninvited. The win isn't that she didn't dissociate. The win is that she knew she had, and knew exactly what to do next.

    Try this: Pick one grounding technique — feet flat, name five sounds you hear — and practice it daily while calm, so it's automatic when you need it at a wedding, a funeral, or a work party.

14. 14Part III, Chapter 16

    Six hours of psilocybin, forty percent lighter

    Foo undergoes a guided psilocybin session with a therapist in a clinical trial at NYU. For six hours, under supervision, she meets her childhood self in her mind and says what she's never managed to say: 'I'm sorry I hated you. I'm sorry I blamed you. You were just a kid.' The results outlast the trip — she reports a 40 percent reduction in PTSD symptoms on the CAPS scale, holding for six months afterward. She also carries a line from psychiatrist Gabor Maté: 'Trauma is not what happens to you. Trauma is what happens inside you as a result of what happens to you.'

    The idea

    Gabor Maté's line — trauma is what happens inside you, not what happens to you — explains why two siblings can live through the same house and only one develops C-PTSD. The event is shared; the internal wound is individual. Foo's psilocybin session at NYU works directly on that inside: six hours in a clinical trial, apologizing to her childhood self, produced a 40 percent symptom reduction on the CAPS scale that held for six months. The apology she never got from her parents, she gave herself — and her symptom score moved.

    Try this: Write a letter of apology to yourself at the age your hardest memory happened. Read it aloud. You're the only adult who was ever going to say it.

15. 15Part III, Chapter 17

    'I remember everything.'

    Foo returns to San Jose to see her mother for the first time in five years. The denial hasn't moved an inch: her mother still insists no abuse occurred. But Foo has stopped needing her confirmation. 'I remember everything,' she tells her. 'I'm not asking you to confirm it. I'm telling you it happened.' It's the sentence the little girl on the mattress on the floor could never say, delivered by the woman she became — no longer negotiating with the person who hurt her, just stating the record.

    The idea

    Foo's mother still denies everything, and Foo stops waiting for the apology that isn't coming. 'I remember everything. I'm not asking you to confirm it. I'm telling you it happened.' This is the exit from an unwinnable game: survivors often stay stuck hoping a parent will finally validate the past, granting the person who caused the harm power over whether the harm is real. Foo reclaims the verdict. Reality doesn't require a co-signature — not from her mother, not from anyone.

    Try this: If someone denies your past, write your account down for yourself — dated, specific. Your memory doesn't need their agreement to be true.

16. 16Part III, Chapters 18-19

    Breaking the cycle before the baby arrives

    Foo becomes pregnant, and the old fear surfaces: will she pass this down? Her therapist cuts through it: 'The fact that you're worried about being a good mother means you're already breaking the cycle.' Then comes the delivery room — and her body, of all places and moments, flashes back to her own childhood abandonment. She holds her newborn daughter and whispers: 'I will never leave you. I will never hurt you. You are safe.' The chain that ran from a grandmother sold at eight, through beatings and abandonment, stops here, in a hospital room, spoken out loud.

    The idea

    The generational chain in this family ran unbroken: a grandmother sold into servitude who beat her children, parents who beat and abandoned Foo. Foo's generation could have been the next link. Instead, the cycle-breaker's paradox holds: the abusers never worried; the worrier breaks the cycle. Her therapist names it — worrying about being a good mother is itself evidence the transmission has already been interrupted. And in the delivery room, mid-flashback, Foo says the words no one in her family's history ever said to a child: you are safe.

    Try this: If you fear repeating your parents' mistakes, write down three concrete things you will do differently. Specific intentions beat vague anxiety every time.

17. 17Epilogue

    Not cured. Better. And still healing.

    Foo and Joe marry, and she describes the wedding as a celebration of her healing and her new chosen family. In her vows she says: 'I promise to choose us, every day.' In the epilogue, she takes stock honestly: she is not cured. She is significantly better. She defines healing not as a cure, but as 'the ability to hold all the parts of myself, even the painful ones, with compassion.' The woman who once couldn't speak in a meeting now has a marriage, a daughter, a community — and symptoms that no longer get the final word.

    The idea

    Foo's final definition of healing refuses the fantasy ending: not cured, significantly better, and healing defined as 'the ability to hold all the parts of myself, even the painful ones, with compassion.' The painful parts don't get evicted; they get held. Her wedding vow — 'I promise to choose us, every day' — applies the same logic to love: not a feeling that happens to you, a choice renewed daily, including on the days the symptoms show up. Recovery, as Judith Herman told her, is a life worth living even with the symptoms.

    Try this: List the parts of yourself you're most ashamed of, and write one compassionate sentence to each. Healing starts with including them, not deleting them.

Anyone who survived childhood abuse or neglect and still can't find the right diagnosis — and the partners, friends, and therapists trying to help them. Also essential for anyone skeptical that trauma is 'all in your head': Foo brings the biology.

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