What’s it about?

What Happened to You? (2021) is an in-depth exploration of trauma and how it affects the brain. Long before we can make rational sense of traumatic experiences, they become etched into our neural circuits. They influence how we respond to stress, form relationships, and make meaning. Unfortunately, trauma is often misunderstood. By understanding trauma as both a brain issue and a societal issue, we can start to support trauma survivors with the tools they need to heal. 

About the author:

Dr. Bruce D. Perry is a neuroscientist and child psychiatrist. He’s also the principal of the Neurosequential Network and senior fellow of the Child Trauma Academy. His previous best-selling books include The Boy Who Was Raised as a Dog and Born For Love.

Oprah Winfrey is the renowned host and supervising producer of The Oprah Winfrey Show. As an activist and philanthropist, she’s worked tirelessly to bring attention to experiences of trauma and sexual abuse, and advocate for survivors. 


Our individual experience in childhood shapes our brains.

The strongest memory of Oprah Winfrey’s youth is a feeling – a sense of extreme loneliness. She knew she was undesired, even as a young child. Her mother, a teenager, was quite young. She had no money to look after her daughter or emotional resources. Thus, Oprah spent her childhood being taken care of by various family members, bouncing between homes. These relatives only worsened things. Oprah wasn’t only ignored; often, she was physically beaten.

All these encounters shaped Oprah’s worldview. The people around her influenced her expectations. They shaped her own vision. And the formation of her brain was literally impacted.

It takes years to grow the reasoning section of a child’s brain – the cortex. To be exact, about three years. Sometimes people think it does not mean that young kids absorb so much – that a two-year-old, for instance, does not count maltreatment or trauma. That’s the contrary. Actually, the younger a child, the more harmful brain damage is. At a staggering rate, a baby’s brain develops 20,000 new neurons each second. And each event is recorded in a personal brain “codebook.” 

Later, traumatic experiences can be seen as complex memories which cannot be rationally understood.

Take Samuel’s instance. As a child, his dad abused him physically. The abuse halted only after Child Protective Services withdrew him from the custody of his father. Sam moved to a group house after a difficult few years on his way through foster families. There, he received the help he needed and was making good progress. But he got a new instructor and, suddenly, began to act out in school, he became aggressive, and he got departed. Until he observed Sam’s dad visit, Dr. Perry became perplexed by this behavior. The man – Old Spice, wore a strong cologne. Perry noticed in one flash that Sam’s professor was also wearing Old Spice. 

Suddenly, Sam’s conduct was meaningful. The smell triggered awful sensory recollections and made him act as if he had been attacked. Finally, it was easy to resolve Sam’s difficulty. He altered his teacher’s perfume, and Sam’s behavior changed as well.


There’s one fundamental thing to ask when we try to understand trauma:

 What happened to you? And, particularly when you were very little, what happened to you? It’s a question that was fundamental to the life of Oprah while she fought to heal her trauma in her youth. Creating your own codebook helps you understand seemingly unexplained emotions and strategies for survival that have evolved so that you can remain secure.

Unless you understand how the brain works, you cannot cure trauma.

War veteran Mike Roseman was out on a date when he was suddenly in total terror hiding on the ground. His girlfriend was trying to help him, but he stupidly hit her. It took him ten minutes to get out of it and begin to think coherently.

What happened?  A vehicle had shot back, and a loud tone had been emitted with its exhaust pipe. The sound was like a firing, which aroused a horrific memory of Roseman 30 years before the Korean War. He immediately overruns his survival reactions and dives into the dirt as if he In both brain stem and cortex, traumatic memories lodge. The stem of the brain initially stimulates. Then it fed the “higher” and more developed portions of the brain — the regions related to connections, beliefs, and meaning.   

However, if people are traumatized, they are vulnerable to stress, and their survival systems are activated extremely fast. That’s how Roseman came about. He recognized there was no threat to a backing car in rational terms and that he no longer lived in a war zone. But since the weapon-like sound-activated his survival system quickly, he had no opportunity to reach the reasoning portion of his brain. He was sheltering from a sniper.

Only then could Roseman really access the cortex: the region of the brain in charge of logical thinking and reasonable logic.


To deal with trauma, learning constructive techniques for regulation is crucial.

When she started out as a journalist, Oprah worked 100 hours a day and did her best at her job. She was exhausted and agitated, but she ignored all the indications her body sent about all this. She was trained to be a qualified pleasant person by the abuse she faced. She neglected her own limits totally, preferring instead to meet the requirements of everyone else. And with her favorite drug, she numbed her feelings: food.

Whenever we are uncomfortable or anxious, we’re unbalanced. However, many survivors of trauma, like Oprah, are conditioned to ignore signals. And when they are stressed, they have not acquired positive techniques to regulate and restore equilibrium.

The fundamental message is this: Positive tactics for regulation are critical in the management of trauma.

The brain of everybody has an embedded system of self-regulation. This system consists of key regulatory networks or short CRNs. The networks are designed to maintain a balance between us. One network monitors “fight and flight” stress reactions. Another is connections and relationships. Another one controls the reward circuitry of the brain. These networks together create the so-called Tree of Regulation of Dr. Perry.

When the baby’s caregivers always respond with sensitivity and care to their basic needs, their CRNs are resilient, and the youngster gets essential abilities to regulate himself while growing up. However, if your carers are inconsistent or harsh, the Tree of Regulation of a youngster will get compromised. Dysregulation is the technical word for this. If a child’s Regulation Tree is dysregulated, its stress reactions become hypersensitive. It easily becomes hypervigilant about hazards and panics in its environment. Since her caregivers were so irresponsible, she will involve people with danger and disappointment and fight to develop human relationships.

It is challenging to identify constructive ways in which she grows up to govern herself. She’s more subject to dependence like Oprah. Drugs, alcohol, autodestructive habits such as cutting and food disorders might alleviate distress from time to time. The comfort feels good and illuminates reward pathways in the brain, enhancing the chance of repeating the relief-giving conduct.

Oprah learned to detect her body’s stress cues as she worked on healing from trauma. She began to build healthy limits and learned to say no if something didn’t work for her. Most importantly, when she was distressed, she found beneficial techniques to calm her down. You can also find constructive approaches to go back in balance even if you haven’t developed a good strategy for regulating.


Working with our natural cycles is crucial to trauma healing.

Put your hand for a time over your heart and be still. You’re going to feel your chest-thumping constantly.

The first primary rhythm that we hear is a heartbeat in the womb of the mother. The rest of the heart rate of our mothers 60, to 80 beats per minute, is the basis for safety and continuity. There’s. Therefore, a rhythmic rocking movement immediately comforts newborns. And as we grow up, our mental health is always influenced by rhythm.

The important message is: working with our natural cycles is crucial to trauma healing.

For thousands of years, people have been organizing their lives in natural cycles. However, That changed. The rising and setting of the sun no longer structure our days. We can eat anything at any time rather than consuming food in the season. And the cacophony of noises we cannot turn away today comprises our sound landscapes. Such loud and rhythmic settings might be particularly harsh for those with sensitive survival systems.

Of course, Oprah fought. She always felt on the verge of her violent, abusive background. It was particularly difficult to be alone at night. Oprah was worried that someone would break in and attack her even though she lived in a building with a doorman and security. She was unable to sleep, and with every sound, she would startle. Oprah finally recognized that her survival systems had become so hypersensitive that they would not switch off even in her sleep. Over time, therefore, she learned how to quiet her brain by returning to her own natural rhythms.

All rhythmical activities are walking, dancing, and singing, enabling us to manage the day’s tension. In particular, the rhythmic strokes of a massage help cure survivors of trauma. And, naturally, out of Oprah’s book, we could take a leaf and head outside. The world of nature contains rhythms that can anchor our times. As we walk, we adapt to our own natural rhythms and stop the hectic life’s noise and stimulus.


Learning how positive relationships are created is essential to the cure of trauma.

How can you love someone? How can you know? It would sound like an odd question if you grew up with dotting carers—the ability to love looks as natural as the ability to breathe. But, actually, from our youngest days, this is what we must learn. You won’t know how to do it if you were never loved.

But fortunately, the story of Gloria has taken a unique turn. She was supported by social professionals and therapists who realized how her careless behavior was motivated. They treat her with love and respect, not punishing her or shaming her. She finally arrived at a stage when she could take care of her daughter again.

The most crucial skills you can develop to deal with trauma are to learn how to build meaningful relationships. The author’s team has collated data from 70,000 trauma cases in 25 countries. They discovered relational wellness to be a greater mental health indicator than a trauma history. In other words, the impacts of trauma are mitigated by personal connections.

But the neediest people cannot typically create social ties. Think of a child in a school looking for attention when acting out or somebody whose experiences were so unpleasant that in social environments, they disconnect. The good news is that anybody can learn how to build relationships like Gloria. We can learn to connect just like we may learn to play the piano. Our brains are neuroplastic: through practice, they can learn new things.


Stress can contribute to creating resilience at the correct doses.

Every day we read frightening stories about the impact of stress on our physical and mental condition. But did you know it is a crucial aspect of human development to experience stress in small doses?

We face tension every time we have a new encounter or a professional endeavor that expands our skills. Successfully managing stress is like lifting weights; we are stronger, more resilient afterward.

Children who grow up in stable, caring households might be stressed. You continuously explore, experience new things, and then go back to your familiar home. Only when it is chronic or intense does stress become a concern. And when it is inconsistent or predictable, it is more challenging to deal with.

Dr. Perry got the chance to work with a group of kids who had been saved from a violent cult. They were filled with confusion and dread in their everyday lives. Moreover, from a young age, they had been indoctrinated that everybody would get them out of the cult. He knew quickly that the imposition of intense therapy only would enhance the feelings of impotence and increase tension.

Therefore, his team built a predictable and safe atmosphere. The youngsters could choose what they should eat and what they should do in their leisure time and connect with the personnel as they felt like it. The children slowly began to open up to the staff with this safe baseline, reviving their painful memories over short meetings, which they controlled. They have gained resilience throughout time and have been able to handle stress for themselves.

The experience may aggravate their trauma by forcing traumatized- youngsters to perform in classrooms and therapeutic rooms such as neurotypical children. Children with trauma often have a developmental age much younger than their current age. They cannot always speak with words or adhere to an extended class day. They have no emotional resources to connect. They end up being distressed and frustrated. Or they distance themselves and finally check the issue. Such conduct can lead to errors in diagnosis. For example, when the valid reason for its distress is trauma, a child may be diagnosed with ADHD.

The challenge must match the kid to build resilience. This should be a healthy, not impossible, stretch.


Trauma is carried through generations of institutionalized racism.

Imagine that you’re passing across the street with your mother and you find a big dog. You can feel your mother rigid next to you, so you feel terrified suddenly.

Emotions, particularly for youngsters, are contagious. They absorb the thoughts and sentiments of their parents like a sponge. Trauma can thus be transmitted throughout generations. Therefore, what happened to you? Mustn’t we ask? We also need to understand what happened to them — what happened and what did you inherit from your parents?

Let’s return to the dog’s example. Because of a poor encounter, your mum might have behaved frightened. However, her terror is further enhanced by decades of legacy trauma. Dogs trained hunting and attacking enslaved persons. Dogs were used as weapons against civilian rights activists in the South of America several decades later. And now the cops, who employ disproportionate force against Black people, are using dogs. Thus, your fear of dogs is partly inherited if you are Black. It’s been a long time.

Trauma is transmitted through stories and gestures, and emotional contagion. However, it also can influence our genes themselves. Somebody born in slavery has been confronted by horrific systemic cruelty. His system of survival was vigilant and formed its entire regulatory networks. Early study has demonstrated that these changes can really be genetically transferred to future generations, even if their habitats are not subject to the same challenges.

Understanding these trauma stories might provide us insight into our parents’ experiences and grandparents’ experiences and into our seemingly minor anxieties. It is also an essential part of trauma-informed treatment. In a sociopolitical vacuum, trauma for non-White individuals is not present. It takes place during hundreds of years of horrific colonization, slavery and bigotry. Race nowadays impacts the violence experienced every day by Black, brown, and indigenous people. It also influences the way public institutions treat them. Colored people’s children will be removed, overmedicated, institutionalized, or classified as ‘problem children by their family considerably more probable.

Whether school, hospital, or support organizations, any institution can only fully serve trauma survivors if they are also involved in anti-racist activities. This includes asking how they sustain racial behavior and analyzing their structures. Trauma-informed care can only be effective when trauma is viewed more as a social problem than an individual problem – an issue we must deal with jointly.


With the correct help, we can manage terrible situations.

Nearly half of the children in the USA have experienced severe trauma. And 60 percent of adults state that there has been at least one traumatic experience.

Given what we now know about the effects of trauma on the brain, just imagine how these events influence our broader communities and the whole country. When so many individuals are attuned to stress, is it surprising that so many are attacked by violence or intolerance of difference? Is it surprising that adults are not in a position to support their children themselves?

Trauma leaves a scar every time. People love to talk about how robust children are. They prefer to assume that children do not absorb violence in the manner adults do, that they can innately rebuild against horror and abuse. It’s totally untrue; we now know. The minds of children are moving. Even though you can’t see it outside, you will be affected by the trauma.

Maybe at school, they still do well, but it takes a lot more energy than before. Or their physical condition will worsen. Stress, for example, can impact the neuroendocrine systems of children and increase their risk of diseases like diabetes.

Survivors of trauma require support — not only for days and weeks after the occurrence but throughout adulthood. Providers who appreciate the specific problems of working with a traumatized brain will need adequate treatment.

But, as crucial as that, their communities will require continual assistance.

It’s no coincidence that Oprah was also involved in building a community on her journey to heal her trauma. The little girl, who was so lonely and isolated, has been working out of connection throughout the past few decades. She’s interviewed tens of thousands of people and taught millions more that they’re not alone in their experiences of trauma and abuse. In a sense, the community she never had was created.

We all need support from our communities to heal from therapists or our families and from our schools and workplaces and justice systems and places of worship. We may all learn with correct help how to live with trauma and rely on our experiences of post-traumatic knowledge.