Gabby Falzone translates the study of trauma

When she was 12, Gabby Falzone and her family became homeless in New York. At 15, she ran away. She moved between squats and stints with her family, but said she suffered too much abuse from them to stay for long. At 17, she moved to Boston, where she said she survived by exchanging sex for rent. At 19, she got into a friend’s car and drove to San Francisco. Within a month, she said, she was shooting heroin. “I kept thinking that if I escaped where I had just been, it would get better, not really understanding that that’s not how you get away from trauma,” she said.

Now she stands before some 50 people in a dimly-lit room, sketching out the hypothalamic–pituitary–adrenal axis on a small rolling whiteboard. The audience members watch intently from rows of worn chairs, and some carefully copy her drawing on their own paper.

Falzone is giving a talk entitled “Enduring Oppression: Chronic Childhood Trauma,” hosted by the Community Democracy Project, an Oakland organization that promotes community learning and direct democracy. The makeshift lecture hall is actually the ballroom of Omni Oakland Commons, a collaborative work and social space run by several Bay Area collectives.

At age 31, Falzone graduated Summa Cum Laude and Phi Beta Kappa from San Francisco State University, with a major in psychology and a minor in classics. Today, nearly 15 years later, Falzone is a doctoral candidate in the Social and Cultural Studies department at UC Berkeley’s School of Education, studying how to improve information about the biological effects of oppression. Falzone includes structural oppression, like racism and poverty, in her work, as opposed to focusing solely on more tangible individual traumatic experiences, like childhood abuse and homelessness. She refers to both as “trauma.”

In her PhD department, Falzone said, she stands out. “My knowledge first comes from my direct experience with intergenerational trauma. My secondary knowledge comes from academia,” she said. “I notice in academia that there are not very many people that I have met whose knowledge comes first from their own experience and then secondarily from what they learn.”

A 2014 data report by the Center for Youth Wellness, a San Francisco health organization, classifies what they call Adverse Childhood Experiences or toxic stress—and what others including Falzone refer to as early trauma—into three categories: abuse, neglect and household dysfunction. This last category includes mental illness, having an incarcerated relative, having a mother who is treated violently, witnessing substance abuse and experiencing divorce.

The report states, “Left unaddressed, toxic stress can cause fundamental changes to a child’s basic brain architecture as well as her developing immune and hormonal systems. These changes can dramatically alter her ability to learn and interact with others and can fundamentally affect her physical and mental health.”

The consequences of that stress can be severe to both emotional and physical health. According to the report, adults who have experienced four or more traumas are more than 12 times as likely to attempt suicide, more than 10 times as likely to use injection drugs, and over seven times as likely to be an alcoholic. These individuals are also more than two times as likely to have ischemic heart disease, more than twice as likely to have a stroke, and nearly twice as likely to have cancer.

The report states that 61.7 percent of adults in California have experienced at least one trauma, and one in six California adults have experienced four or more traumas.

 As a child, Falzone was a straight-A student, and even started to take part-time courses at SUNY Stony Brook at age 16. Her success at school didn’t change when her family became homeless or when she ran away from them. She lived with friends, but realized that she was putting their families in jeopardy for harboring a runaway. She had to disguise her runaway status at school, because runaway minors were not allowed to enroll. She begged her parents to emancipate her so that she could continue to live on her own and stay in school, but, she said, her parents refused. “So,” she said, “I moved back home. And then I tried to kill myself. I felt really trapped.”

Falzone navigated ways to spend as little time at home as possible and focused on graduating, which she did at 17, before moving to Boston. She worked minimum wage day jobs, but as a minor, she could never make enough money to pay rent. Falzone said she turned to sex work. “I engaged in a lot of survival sex to pay rent. I exchanged sex for money to do nothing but be a responsible adult and pay my rent,” she said.

A friend, a Harvard PhD graduate, encouraged her to leave Boston and drive across the country with him as he moved to Stanford. So she headed west and found a group of punk rockers to move in with in San Francisco. “We are a community of traumatized people who found each other, usually on the streets,” she said.

“I had been dabbling in drugs when I was in Boston, but I came here, and …” She paused. “It was the only way I could cope. And actually, for a while my life got better. I started working full-time and going to community college.”

At first, she said, she could manage her drug use as a way to self-medicate her trauma symptoms: chronic anxiety and depression. “But then eventually heroin addiction becomes a whole different thing,” she said.

She said that many of her friends who were most severely addicted to drugs have overdosed, but that there’s a misconception about decisions made on the streets. “It’s not like people become drug addicts and then they become homeless,” she said. “It’s more common that people become drug addicts because they’re homeless.”

From ages 19 to 25, Falzone said, she struggled with her addiction and with the emotional consequences of exchanging sex for a place to live. She moved to a rehab facility for a year. When she left, she was homeless again.

“I was thinking that if I just stopped doing drugs, my life would get better, but I wasn’t feeling better. Because all those feelings were coming back, and I didn’t have anything to medicate with,” she said. She suffered from physical health symptoms, as well, and was diagnosed with an autoimmune hepatitis. “It was a very lonely and difficult time,” she said. “The choice was to kill myself, to go back to shooting drugs which would eventually kill myself, or to just hang on. For the most part, I didn’t think anything was going to get better.”

Navigating this period, she said, “was a combination of perseverance and community support.”

“I know how to advocate for myself, so I was able to reap the benefits of community services,” she said. “If I had been suffering symptoms any more than I already suffered, I would still be on the streets or dead.” She said that support from people in recovery for drugs, fellow activists, and the punk rock community got her through the first few years at SF State. During her final year of undergraduate classes, The New Leader Scholarship out of San Francisco, which supports marginalized first-generation college students attending Bay Area public universities, helped sponsor and mentor Falzone through the rest of her education. Falzone also worked part-time, and volunteered with youth homeless outreach organizations and at the San Francisco Zoo.

Yet Falzone wasn’t always sure how to fit into the world of academia that she’d worked so hard to reach. She has a big, youthful smile and bright turquoise eyes. Her short hair is dyed black and green and her ears are fully ornamented with silver rings. She wears thin rectangular glasses and has a colorful tattoo across her chest.

When she first started her PhD program, Falzone said, she woke up early every morning to scrutinize her appearance. “What would a normal person wear?” she’d ask herself. Then she began to challenge her own thinking that there was a uniform for intelligent people. She gestures to her piercings, to her faded sweatshirt and loose black jeans. “Now I go to conferences and I dress like this. I refuse to dress up. I got more tattoos,” she said.

Marginalized communities have a tenuous relationship to academia, Falzone said, as even well-intentioned intervention from research experts can do more harm than good. “There’s harm in having experts think they know what the problem is,” she said. “They can misdiagnose the problem and their solution may be worse than what the community is going through.”

“I am more ashamed of being in certain circles and telling people that I’m getting my PhD than I am in being in certain circles and telling people that I used to be a homeless drug addict,” she said. This is why Falzone chooses participatory action research, to work with a specific community to understand the problems they face. This is also why she’s chosen to host community talks, to present information rather than impose solutions.

“Sometimes the tool of the oppressor can be helpful. Sometimes hard science research on trauma is helpful for communities suffering from trauma,” she said. “I’m sharing this really complicated science but not sharing it as if it is the truth but just a truth.”

One of those tools is the biology behind changes to what seem like hard and fast structures, like DNA.

 In 1957, C.H. Waddington, a professor of animal genetics at the University of Edinburgh coined the term epigenesis to describe a mechanism that he determined must exist above the DNA code to control the output of a cell. Something in the environment of the cell influences its DNA, he concluded.

Epigenetics is often cited as an explanation when identical twins grow up in different environments and one twin remains healthy while the other develops a chronic illness. In the early 2000s, scientists began noting that peoples’ epigenetic outcomes are connected to their life experience. Not all epigenetic changes are negative ones. The Roadmap Epigenomics Project at the National Institute of Health has mapped the epigenome of over 100 types of cells in the body, meaning that all of those tissues can change and adapt based on their environments.

One process by which the epigenetic changes happen is methylation, in which a small molecule attaches to segments of the DNA and codes for a completely new product. Recently, scientists have studied methylation’s impact on behavioral and mental health. One paper written by researchers from the University of British Columbia and published in 2007 by the American Psychological Association states that methylation from stress impacts how bodies regulate cortisol, a hormone that plays a key role in the nervous system: in learning, memory, and emotion.

In community health research, a field called “structural competency” promotes the understanding of the health effects of chronic stress. Dr. Kelly Knight, associate professor of anthropology at UCSF, has incorporated this kind of curriculum at UCSF’s medical school where, she said, “we use a self-to-society framework, looking at ways in which the environment people are living in their everyday life in, accessing food in, taking care of basic needs, as having impact on their health, and that can be seen on a cellular level.”

Knight said UCSF students school-wide learn to add these extra layers to their diagnoses. For example, she said, students give a “mental health diagnosis as a bio-psycho-social phenomenon rather than only biological.” That means students lay out the biological issue, the psychological issue, and the social issue that contributes to how a patient is feeling. “Anybody who does any kind of health research or any work with any vulnerable groups probably has a structural analysis and could benefit from adding the skills framework of structural competency,” she said. “We need to have it be the air we breathe.”

Falzone’s model of how individuals are affected by traumatic environments is similar, but she said that she finds teaching practices like Knight’s a bit problematic because they are expert-driven and often don’t involve traumatized individuals themselves.

Falzone’s model focuses on understanding several kinds of trauma that can affect a person: structural, community and individual. For example, a structural problem like sexism can give rise to a community culture in which sexual violence is normalized, which can lead to an individual trauma for a person who is raped.

As a society, Falzone said, we tend to look at ill people’s symptoms in isolation and out of context. But anxiety, depression or anger issues are often a product of repeat trauma, such as dealing with the effects of racism. “Whenever I see people who are unhoused and who manifest mental health symptoms, that is chronic trauma. Chronic trauma drives you mad. I’ve been there,” she said.

“Sometimes that is really healing,” for a person to realize that their health problems are related to broader social injustices, she said. But, she added, “until the oppression stops happening there can really not be true healing. But it’s a step because it takes the blame away from the individual as being defective and puts the issues in context of where to place the blame.”

In the Omni Commons ballroom, in front of her Oakland audience, Falzone is upbeat and magnetic. She explains biology in analogies that click with her listeners. She says she thinks of DNA as a blueprint for a house. That blueprint would tell you where to place a light switch on a wall. But whether the light turns on or off depends on the cell’s reaction to the environment. “The light switch is DNA; whether it goes on or off is epigenetics,” she says.

She punctuates her sentences with cuss words that make her audience laugh: “I only know fancy adjectives or using the word fuck as an adjective.” She playfully rants about her frustration with the scientific euphemism “Adverse Childhood Experiences,” which she says reduces trauma to things that happen in the house and makes trauma sound like just a bad time. She gives another euphemism: “I used to work at the San Francisco Zoo, the insect zoo, and we used to have to kill the bugs. We had to put them in the freezer, which we called the ‘euthanizer,’” she said.

Falzone says that society glorifies the grit and resilience of oppressed people, but often isn’t aware of trauma’s deeper biological effects. Those who go through trauma adapt to it, she says: “We adapt the best we can but there’s going to be consequences. There’s always consequences to resilience.”

Falzone tells the audience that she struggles regularly with symptoms of trauma, and that over the summer she was in intensive therapy. “I don’t want to perpetuate that narrative that people love to hear about poor peoples’ horrible lives, that they’ve overcome and are now stronger for it. That’s a bunch of crap. It’s the feel-good narrative,” she said. “I am still affected by things that happened to me.”

As her time in the ballroom runs out, Falzone throws out an offer to hold more community talks, as long as food as involved. The audience laughs and murmurs approval, and hands spring up from the crowd with questions.

Today, Falzone lives in an Oakland apartment with two black cats: one friendly and one prickly. She takes the train into San Francisco to visit one of her three now-adult foster children. She took the three in when they were teenagers after their mother, a friend of Falzone’s, became ill and could no longer care for them. Falzone moved into Section 8 housing and raised them for the next five years, putting off graduate school to work as a middle school teacher. Two of her foster children are now living on their own, but she said that one, now age 26, has schizophrenia and is currently homeless. He’s been awaiting government housing for over a year and a half, and every few months he comes to Oakland to stay with Falzone.

She also works with students who have been involved in the juvenile justice system. On a cold Wednesday night, Falzone lugs four Little Caesar’s boxes into the basement of UC Berkeley’s student union. She leads a weekly writing workshop for Underground Scholars Initiative, a Berkeley group that supports students who have been incarcerated or whose family members have been in prison.

Emilio Lecon is at Underground Scholars for the first time. He’s a freshman, and said he was in the juvenile justice system as a middle schooler. He points out that his background differentiates him from other Berkeley students and says that the education he’s getting in class is extremely tailored to middle class students and how they see the world. His feels that his community—poor Latinos—is analyzed in sociology class discussions, rather than included in the conversation. It’s hard to be different, he says, but he’s here, and Underground Scholars is a comfortable place for him.

“We’re so blind. We don’t learn the truth,” Lecon says. “We need to be educated about our history and the policies that oppress us so we can get fired up. We already hate the government, but we need to learn why they do it and how they do it in order to change it. Learning the truth helps.”

Falzone sketches a hamburger on a whiteboard, representing the five-paragraph essay structure. She explains that even her 40-page dissertation proposal follows the same structure as the very first essays they all learned to write in fifth grade. “It doesn’t matter whether you’re writing a five-to-seven page paper or a book,” she tells them. “Everything follows the same basic outline as in middle school. My dissertation proposal is a glorified hamburger.” The students smile.

Falzone says that she wants to use her access to academic information, and her ability to translate it for non-academics, to encourage communities to disrupt  the effects of trauma they’ve experienced. “I’m very invested in doing the opposite of what academia has done for centuries, where they went into communities and stole knowledge and kept it for themselves. I would like to steal some of that knowledge and bring it back to communities,” she said.

Her dissertation involves working with a group of young people in the juvenile justice system in the Bay Area doing youth participatory action research. She hopes to train them to conduct their own research, develop their own definition of a problem, and write their own action plan. “The idea of developing trauma curriculum based in lived experience and with western science and other science, that’s applicable everywhere,” she said. But she added that the problems and solutions the young people come up with in those session are context-specific, based on the type of racism, violence, poverty and personal histories within each community. “One of my dissertation questions is: Is this trauma curriculum going to help with this population?” she asks.

Falzone says she also she hopes to hold more free community education talks. “There is a desire to have more conversations about trauma,” she said. “Since Trump got elected, a lot of my friends have been organizing grief and trauma sessions.”

She said those organic conversations are just as valid as any lecture series. “There are many ways to have those trauma conversations,” she said.