Book Review: What Happened to You?
I’ve been learning so much from all the books I have reviewed this year, and this book has been just as enlightening, if no more so than the ones I reviewed before it. It is also one of the more newly-published books I’ve been able to get ahold of.
“What Happened to You?” is a collaboration between Oprah Winfrey and Dr. Bruce Perry. The two have apparently been working together for years, with Dr. Perry serving as a consultant for Oprah’s shows and her South African girls school, the Oprah Winfrey Leadership Academy for Girls. The book can be purchased as an audio book, in digital format, or in hardcover. (#Ad)
The book is a great introduction to a developing area of study: trauma. And, this area covers a spectrum of trauma, from Adverse Childhood Experiences to Post-Traumatic Stress Disorder. Although the most widely thought of variety, PSTD, is limited to a specific set of diagnostic criteria, this book reveals there is a range of trauma that affects a far greater percentage of the population.
Working in criminal law, I have long thought that trauma has played a role in the histories of many people who come into contact with the criminal justice system. The first reason for my theory is that I am one of those sappy people who just can’t believe that the world is filled with bad people who do bad things simply because they have some evil intent.
The second reason is that through working with my clients, I have learned that nearly every one of them experienced some trauma that had a link to their decision to commit a crime. Trauma seems to be the reason why most folks I work with have developed addictions or turned to violence as a means of solving their problems.
I found this book to be helpful, not only because it helps me to talk about trauma in a more informed way in my work, but also because it encourages me to see folks more compassionately. If most people suffer from some form of trauma, I should probably be more gentle and understanding as I never know whether the reason for their behavior might be the result of something in their past.
As with all of my book reviews, in this post you’ll find a brief overview of the book. I’ll also include my personal takeaways along with any likes/dislikes.
Table of Contents
Overview of “What Happened to You?”
I’m guessing that most folks are familiar with one of the authors of this book, Oprah Winfrey. She has been more than a talk-show host and has become somewhat of a self-help guru. Dr. Bruce Perry is an American psychiatrist who focuses on childhood trauma and teaches at the Feinberg School of Medicine in Chicago.
The book they have created is part science, part anecdote, and lots of conversation. I have both read the book (on Kindle) and have listed to the audiobook, and I can tell you that it is helpful to both read and listen to it if you can.
The book has a back and forth conversation, with Oprah and Dr. Perry each writing in their own voices and responding to each other’s statements. In that way, it helps to listen to the book if you find reading conversations to be more tedious than listening to them.
That said, the book is laden with anecdotes. Oprah draws from her own life experiences to provide examples of her own traumas, while Dr. Perry offers examples from his psychiatry practice. These stories help to illustrate and bring to life some of the more complicated concepts in the book. The approach they take makes the scientific models and medical terms far more relatable to us lay readers.
Book Format
The book is formatted with a dedication, note from each of the authors and an introduction before getting into the chapters and epilogue. The book ends with a list of resources, as well as the usual credits and acknowledgments.
Chapters
The book has only 10 chapters, but they are chock full of stories and information about trauma and childhood development. Here they are in order:
- Making Sense of the World
- Seeking Balance
- How We Were Loved
- The Spectrum of Trauma
- Connecting the Dots
- From Coping to Healing
- Post-Traumatic Wisdom
- Our Brains, Our Biases, Our Systems
- Relational Hunger in the Modern World
- What We Need Now
My Takeaways
As a fan of storytelling, I feel like there’s almost too much information to share in this book. But, I do feel there were some general takeaways that really resonated with me.
Asking the better question. The authors note from the beginning that one of the main reasons they wrote this book was to help shift people’s perspectives. We often ask, “what is wrong with you?” when someone acts in a baffling or negative way. Oprah and Dr. Perry want us to ask a different question- one they think is more accurate and compassionate: “what happened to you?” It took me several years of practicing criminal law to come to that conclusion myself, although I didn’t phrase it as simply. I stopped looking for defects in my clients and instead found life experiences that shaped them in a way that often led them to act out. This book has helped me understand that I need to apply this in all my relationships.
A triangular model of the brain. Dr. Perry has created a really interesting model of the brain that looks like an upside down triangle. He titles it a “hierarchical organization of the human brain,” and it can only be viewed in the book. At the top and widest part of the triangle, is the cortex, which he notes is the center of “creativity, thinking, language, values, time, and hope.” The next section of the triangle is made up of the limbic system, which houses our rewards, memory, bonding, and emotions. After that is the diencephalon, which controls arousal, sleep, appetite, and movement. And, at the bottom, smallest part of the triangle is the brain stem, which is basically our autonomic system and controls our heartbeat, temperature, and breathing. The main takeaway from this model is as follows: when we have undergone a trauma, that information gets stored in the lower part of our brain, which means our thinking mind or cortex, is not involved. When we are triggered into having a trauma response, the thinking part of our mind is bypassed entirely, and we are ruled instead by the less evolved, more primitive parts of our minds. This leads to fight or flight responses rather than reasoned decision-making during times of stress.
Early childhood plays a huge role. This takeaway seems like a no-brainer. We have all learned about how important those early minutes, days, weeks, and months of brain development are. Interestingly, when babies are provided the things they need (their cries are immediately answered) by loving caregivers, these acts stimulate responses in the diencephalon and brain stem that the child associates with pleasure and safety. This is how adults can promote healthy regulation (which is another way of saying promoting balance in stressful situations) for young children. Dr. Perry introduces a “Tree of Regulation,” which shows how regulation affects the brain within the upside down triangular mode. However, when little ones experience frightening or abusive conduct or their needs are not met (cries go unanswered) by dysregulated adults, the children themselves are dysregulated and may adopt unhelpful coping mechanisms (or find balance in stressful situations) to stressful situations (overeating or abusing substances) as they grow up.
Trauma is subjective. One of the things I found most interesting in this book is the section on trauma as a spectrum. Basically, what one person finds traumatizing another may find exhilarating (Dr. Perry gives an example of a school fire drill where a young child might be scared while a firefighter might find the same situation thrilling). This has made it difficult for experts to define trauma. As such, trauma can stem from major stress-inducing events (like a war) or more subtle ones (like being embarrassed in front of others). Other factors that play into trauma are a person’s genetics, and the role of trauma in the person’s family or community. As such, Dr. Perry brought up the concept of Adverse Childhood Experiences, which were originally studied for their impact on long-term health (such as being a predictor for heart disease). At the other end of the spectrum is PTSD and its four diagnostic criteria.
Down time is necessary. Dr. Perry speaks about the role of dissociation– that state we enter when we retreat within ourselves. This can sometimes become maladaptive such as when a child who is severely abused becomes numb and cannot form proper emotional attachments. It may also be temporary, like when we experience a sad situation and simply go through the motions of our life in a state of grief. However, we also dissociate any time we get “in the zone” in an artistic or athletic performance or when we enter into a state of deep meditation. In fact, Dr. Perry suggests that offering breaks (periods of rest or play) for a stressed person is a way to help them disengage from stressful feelings.
We are all capable of change. One of the more hopeful aspects of the book is that it talks about the brain’s malleability. If the brain is capable of change, then even those who are suffering from the effects of trauma, and who have developed poor coping skills as a result, can change for the better. So, as much as we are never the same after experiencing a trauma, we are not destined to stay in that post-traumatic state. Dr. Perry notes that our capacity to recover from trauma is resilience. This section made me feel better about my own gut instinct to not give up on people.
We need more trauma-informed systems. As Dr. Perry points out, the term “trauma-informed” is so loosely defined as to be unhelpful. But, for someone working in a trauma-blind system that involves so many traumatized people, I think it’s at least a place to start. My hope is that others will read this book and start thinking about others in a more compassionate light. Perhaps if we invest as much of our resources into helping people identify their past traumas and make changes to recovery from them as we spend on punishing or locking them up, we might start to address the overall trauma experienced by whole communities. I know I may be oversimplifying things and am extremely optimistic, but even a little bit of compassion may go a long way in healing our neighbors and ourselves. Whether it be in the criminal justice system, our schools, or addiction treatment centers, the new frontier in addressing our troubled community members will be in making these systems more trauma informed.
Likes and Dislikes
I have to admit, I have very few dislikes about this book. I thought it was a great introduction to the evolving topic of trauma, and it ends on a hopeful note. Of course, if you already have a good grasp of the topic, this book may seem a little fluffy to you. It has some statistics and refers to a few scientific studies, but it mostly reads like a series of anecdotes. While I found that the storytelling format was an effective way of teaching the material to someone new to the subject, others who are looking for a more serious read may think it’s too wordy and not academic enough.
This is a great read for anyone looking to understand themselves and others a bit better. It has certainly deepened my compassion for others. Have you read this book? Do you have a different take on it? Please share in the comments!
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