Book Summary: What Happened to You? Conversations on Trauma, Resilience, and Healing by Bruce Perry and Oprah Winfrey

What Happened to You? Conversations on Trauma, Resilience, and Healing by Bruce Perry and Oprah Winfrey is a book I often recommend to others.  These are my personal notes from the book.  These are not all direct quotes, but also paraphrases and added commentary from me.  A 📌 or ❤️ designates a note-worthy point.  If any of these notes spark interest or curiosity, lean in and learn more.  As always, reading the book for yourself is suggested. 

• Making sense of the world
  

The work begins by excavating the roots that were put down long before we had the words to articulate what was happening to us.

What was once adaptive has now become maladaptive. 

📌Our brain is organized to act and feel before we think. This is called sequential processing. Bottom to top.

As we grow up, we are all trying to make sense of what’s happening around us. 

📌The younger you are, the more sensitive you are to your emotional climate.

Many people react by burying their feelings and becoming people pleasers or sabotagers.

As we make our way through the world, countless sounds, smells, and images can tap into the memories we created earlier in life. 

Our brain catalogs a vast amount of input. 

We make sense of the world by creating associations and making memories.

• Seeking balance
  

The emotions of people around us are contagious. 

As we grow up, we find our own set of regulating rhythms and activities.

Regulation is about being in balance.

The brain is a meaning making machine, always trying to make sense of the world. 

The tree of regulation (see figure 2)  is comprised of a set of neural networks Our body uses to help us process and respond to stress.

Pattern of stress—> unpredictable, extreme, prolonged—> sensitization (vulnerability)

Pattern of stress—> predictable, moderate, controllable—> tolerance (Resiliance)

📌We elicit from the world what we project into the world, but what you project is based upon what happened to you as a child.

Adaptation: dissociation, escaping to inner world, complying, avoiding conflict 

How we fill our bucket is crucial to regulation— food, beliefs, rhythm, relationships, sex… alcohol, drugs…

• How we were loved
  

all of us want to know that what we do what we say, and who we are matters.

Belonging and being loved are core to the human experience. We are a social species, we are meant to be in community, emotionally, socially, and physically interconnected with others.

Children know from birth whether their caregivers eyes light up when they enter a room. They sense and respond to tenderness, playfulness, compassion, and patience. They know the true feeling of quality time and they know when they are loved.

Isolated and disconnected, we are vulnerable. In community we can protect one another.

Three types of developmental adversity that cause widespread problems:

1– the disruption that happens before birth, such as prenatal exposure to drugs and alcohol or maternal stress. 

2–the disruption of early interactions between infant and caregiver, such as absence, chaos, and inconsistency.

3–the sensitizing patterns of stress, when prolonged activations of the stress response result in overactive and overly reactivestress responses.

📌Childhood experiences impact the biology of the brain. It can affect how you function for the rest of your life.

The fetal brain is developing so rapidly it’s like putting in the foundation of a building. The first couple of months after you’re born is like putting up the framing. The first year is like adding the wiring and plumbing. Early construction issues will lead to problems later on.

Stress is not something to be afraid of or avoided, it’s the controllability, pattern and intensity of stress that can cause problems.

When we encounter a potential threat, our initial default behavior is to flock. We look to others to help determine what’s going on. We looked at other people, especially their facial expressions for clues about how to interpret the situation.

The more threatened or stressed we are, the less access we have to our cortex.

Dissociation is a complex mental capability that we use in every day life, it involves disengaging from the external world, and focusing on our inner world. Daydreaming is a form of dissociation. Whereas the physiology of the arousal response is to optimize fighter flight, the physiology of dissociation is to help us rest, to replenish, survive injury, and tolerate pain.

State dependent functioning:

Calm state— cortex dominance, reflective, abstract, iq 120-100

Alert state— lower cortex, flock/hypervigilant arousal option,  avoidant dissociative option, concrete thinking, iq 110-90

Alarm state— limbic brain, freeze arousal option, compliance dissociative option, emotional cognition, iq 100-80

Fear state— (can get stuck here), brainstem dominance, flight/defiance arousal option, dissociation/paralysis dissociative option, reactive cognition, iq 90-70

Terror state— brainstem, fight arousal option, faint/collapse dissociative adaptive option, reflexive cognition, iq 80-60

[Figure 6]

• The spectrum of trauma
  

it’s normal to not know what is wrong, but knowing that you’re viewing the world through a prism of pain.

Almost 50% of the children in the US have had at least one significant traumatic experience. 

The word trauma typically means a really bad event or experience and usually one that sticks, that you don’t forget, and that can have an enduring impact on you.

📌Because the internal experience of a given event varies from person to person, so does the long-term impact.

The 3E definition of trauma: the event, the experience, and the effects. All need to be considered.

Trauma can arise from quieter less obvious experiences, such as humiliation, shaming, emotional abuse or marginalization.

📌You can only stand the emotional intensity of visiting the wreckage of your trauma fractured Life for only a few seconds before your brain starts to do things to protect you from the pain.

It is regulating to be seen. 

PTSD is specific to the effects of your trauma. (3E)

Trauma leaves you shipwrecked. As you revisit the shipwreck, piece by piece, you find a fragment and move it to your new safer place to look at. It takes time and many visits to the wreckage. Again and again you revisit, look through, take something and move it to a safe haven. This is the healing process.

• Connecting the dots
  

Understanding both the cause and affect is a game changer.

📌Every family has patterns and pathologies of thought, beliefs, and behaviors that are passed on from one generation to another in the same way that a physical characteristic is passed on.

There are multiple pathways we used to pass down these characteristics. Genetic, epigenetic, intrauterine, perinatal, and postnatal.

children are very contagious to the emotions of the people around them. 

Experiences changes us at a cellular level, in an instant. 

Transmissibility: emotional contagion. The ability of a trait, skill, belief, etc. to be passed on from one person to another.

📌Everything matters. Everything that’s ever happened to you, ever happened to your mother, ever happened to the mother before her, and to the father, and so on, everything matters.

Interconnectedness: nothing is separate, physical well-being and emotional health are deeply connected, they are the same.

Getting to the cortex: getting to the place where you can communicate rationally with someone. If they are dysregulated, nothing you say will really get to their cortex, and nothing already in their cortex will be easy for them to access. This concept is critical if you are a parent, teacher, or counselor.

Regulation is the key to creating a safe connection. Being connected is the most efficient and effective way to get information up to the cortex.

📌In therapy it often takes 10 to 20 sessions before the client begins to feel safe nough to share some of the most emotionally difficult experiences. 

To get to the cortex, you have to regulate, relate and reason. 3R (in that order)

📌Whispers can be heard as shouts.

📌In order to communicate rationally and successfully with anyone, you have to make sure they are regulated, make sure they feel a relationship with you, and only then try to reason with them.

• From  coping to healing
  

📌Neglect is as toxic as trauma.

Neglect causes a very different biological experience than trauma, and can have very different affects on the brain and the developing child. If key experiences are absent, or if their timing, patterns or nature’s are abnormal, key capabilities do not develop. There are many different ways to neglect a child.

Total neglect is rare, the most common form of neglect is fragmented patternless caregiving. There’s also splinter neglect, which occurs when many aspects of development are normal and some key systems receive appropriate experiences, but one or more does not, leading to the absence of a critical aspect of healthy development.

Not being seen, not feeling scene is neglect. Outsourcing parenting or love can be neglect.

Being too busy can be neglect.

Constantly engaging with a screen rather than your child can be neglect.

Even a baby can tell when you are there or not. They want safety and they want eye Contact. They want full engagement and you to be present. 

The inability to be really present has a toxic impact on healthy development.

Sense of belonging: I matter, I am one of you, I am important.

Neglect feels like: I am not important enough to hold your attention. ( I’m not enough )

A cold or disengaged partially attentive Caregiver can have immediate and lifelong toxic affects on a developing child. The child can grow up feeling inadequate and unlovable.

When we are stressed, there is a graded response,  gradually activating the systems in the brain and body that can help us. Calm —> alert —> fear…

The dissociative response is used when there is inescapable or unavoidable distress and pain. Because you cannot physically flee and fighting is futile, you psychologically flee to your inner world.

Daydreaming, mind wandering, being in the flow, or in the zone, getting lost in a book are all partial dissociative states. This can be healthy in certain situations.

Very young children can’t fight or flee, they have to stay. 

📌If you’ve ever ask yourself why you can’t stay in the game when things get challenging, it’s because your brain has been trained to dissociate when things become uncomfortable or feel like a threat to you. 

For individuals who tend to have a dissociative response to stress, the first stage in the continuum is avoidance. These people don’t want conflict, they want to be invisible. They provide hollow compliance. 

People pleasing is a classic coping mechanism that is part of the compliant behavior seen with dissociation.

The power of intention: an intention precedes every thought and every action and the outcome of your experiences is determined by your intention going in. There is nothing I do that doesn’t start with me asking myself: What is my intention in doing this.

If, as a child, you experience chaos, threat, neglect, or trauma, your brain organizes according to a view that the world is not safe and people cannot be trusted. 

The most destabilizing thing for anyone is to have their core beliefs challenged.

📌The brain is malleable all through life. We can change but we don’t randomly change.  we can intentionally change if we know what needs to be addressed. The key is to recognize the patterns. You start by connecting the dots.

You naturally want what is familiar. If Chaos is familiar, you will want chaos.

You can’t get rid of the past. You cannot delete it or get a blank slate. 

Therapy is more about building new associations, making new healthier default pathways. It is building a better alternative, a new default. That takes repetition and time.

• Post traumatic wisdom
  

The emotional bottom does not come in the first weeks following the traumatic event. Statistically after about six months, you start hitting bottom.

To feel better, we create an other. Us and them is deeply ingrained in our neurobiology, is what makes connectedness at a ledge.sword. We are strongly connected to our clan, but not so much to other plans, we compete with them for resources. 

To make ourselves feel better, we use our belief in another persons resilience or strength as an emotional shield to protect ourselves from discomfort. It’s a kind of looking away, letting our worldview go unchallenged, and let our life continue with minimal disruption.

📌The impact of trauma doesn’t simply fade away.

(Makes sense as to why we can’t forget/drop it after an apology is made.)

Children are not born resilient, they are born malleable. It’s not an automatic property of childhood. 

It’s wishful thinking that a child could experience a traumatic stress and somehow be unaffected. 

We change from all of our experiences, good and bad. 

A Nerf ball (resilient) versus a metal hanger (malleable). 

You can demonstrate resilience, and you can build resilience. 

The capacity to get back to baseline after a trauma is influenced by many factors, primarily your connectedness.

It’s impossible to go back to being the same once a trauma has occurred. 

Changes from trauma will be there, even if they don’t result in any apparent real life problems for the person, or if they demonstrate resilience. 

The ability to cope with stress, distress and trauma is changeable. You can make your coping machinery stronger and more effective. 

Fear shuts down parts of the cortex, the thinking part of the brain.

Sensitized stress response: our brain processes incoming sensory input from the bottom up so someone that has had a chaotic, stressful life is more likely to act before thinking. Their cortex is not as active and reactivity in the lower areas of the brain becomes more dominant. 

📌It’s very difficult to meaningfully connect with or get through to someone who is not regulated. It’s nearly impossible to reason with them. 

📌This is why telling someone who is disregulated to calm down never works. 

📌When someone is very upset, words themselves are not effective. 

📌Tone and rhythm of the voice has more impact than words.

📌 The best thing to do is simply be present. 

You can’t talk someone out of feeling angry, sad or frustrated, but you can be a sponge and absorb their emotional intensity. 

If you stay regulated, ultimately they will catch your calm. 

Let the dysregulated person have control over when and how much they’re going to talk about what’s upsetting them. If you give a person that control and help them feel safe, in their own time, they will be more capable of talking. 

Walking can be very regulating and so can nature.

Sensitization is essentially the opposite of resilience. 

You can heal a sensitive person by offering control-ability and predictability. Healing takes place when there are dozens of therapeutic moments available each day for the person to control, revisiting and reworking their traumatic experience. (Remember the shipwreck analogy)

The journey from traumatized to typical to resilient helps create a unique strength and perspective. It can create post traumatic wisdom. 

The pillars of traditional healing are connection to clan (community) and the natural world, regulating rhythm through various means, a set of beliefs or values that bring meaning and on occasion, natural hallucinogens or other plant derived substances, used to facilitate healing with the guidance of a healer. 

Today’s best practices are versions of these four things. Only a few modern approaches use all four of the options well. The medical model over focuses on 2- psychopharmacology and cognitive behavioral approaches. 

📌It is impossible to be truly wise without some real life hardship. 

Children need different kinds of therapeutic interactions at different times. 

In prior generations, No single person was expected to provide all of the emotional, social, physical or cognitive needs of a developing child. This is incredibly unlike our modern world.

Relational poverty

• Our brains, our biases, our systems
  

Choose  to find your light.

❤️ Your past is not an excuse, but it is an explanation, offering insight into the question so many of us ask ourselves: 

why do I behave the way I behave? 

Why do I feel the way I do? 

There is no doubt that our strengths,  vulnerabilities, and unique responses are an expression of what happened to us. 

Very often what happened takes years to reveal itself. It takes courage to confront our actions, peel back the layers of trauma in our lives, and expose the real truth of our past. 

But this is where healing begins. -Oprah

School to prison pipeline

Struggling students most likely have no idea what the underlying cause for their struggles is, they end up adopting the worlds view of them which is dumb, slow or crazy.

The word snapped is often used when we don’t know where a burst of anger is coming from or why someone is having a violent reaction. What actually happened was that something happened in the moment that triggered one of the brains trauma memories.

We all must change how we try to understand behavior.

Sequence of engagement: Regulate, relate, then reason. In that order. 

We learn faster when we’re moving and interacting with others. 

Our mental health system tends to be crisis focused.

📌Having access to a number of invested caring people is actually a better predictor of good outcomes following trauma than having access to a therapist.

your beliefs and values do not always drive your behavior. Beliefs and values are stored in the highest most complex part of your brain the cortex. Other parts of your brain can make associations, distorted inaccurate or racist associations. Understanding sequential processing in the brain is essential to grasping this.

The cortex is the most malleable and changeable part of the brain. Beliefs and values can change. 

Addressing implicit bias is first recognizing that you have it. 

Moderate, predictable, controllable stress can build resilience. 

Create new associations and have new experiences. Spend time with people who are different than you. Create real relationships so that you get to know individuals based on their unique qualities not in categories.

• Relational hunger in the modern world
  

Don’t simply chase symptoms, heal people.

Don’t be overly focused on what is wrong with you or others, such as what problems, symptoms, and Failures need addressing. Too often our approach to treatment isn’t getting to the heart of healing.

We need a therapeutic Web of positive relationships, these are the relationships needed for healing. Are you experiencing relationship poverty?

Our world is relationally impoverished. 

We live in environments where we see fewer people, and even when we do see people and engage in conversation, we’re not really listening to each other or being fully present. 

This disconnection is making us more vulnerable. Even though we live in an amazing country, filled with good people, collectively were less resilient. 

Our ability as a people to tolerate stressors is diminishing, because our connectedness is diminishing.

This relational poverty means less buffering capacity when we do experience stress. 

We are becoming more sensitized to anything that feels potentially threatening, such as a person with a different political opinion. 

Many people are overly reactive to relatively minor challenges. 

📌And when we’re overly sensitive as a result of state dependent functioning, we quickly shift to a less rational and more emotional style of thinking and acting. 

We’re losing the ability to calmly consider someone else’s opinion, reflect, and attempt to see things from their point of you. 

No one wants to listen to each other. 

Interpersonal rupture and repair is good for building resilience. These ruptures are perfect doses of moderate and controllable stress. 

📌Conversation for example promotes resilience; discussions and arguments as long as there is repair, is resilient building and empathy growing experiences. 

We shouldn’t be walking away from a conversation in  a rage, we should regulate ourselves. 

Repair the ruptures. 

Reconnect and grow. 

When you walk away, everybody loses. 

📌We all need to get better at listening, regulating, and reflecting. 

This requires the capacity to forgive, and to be patient. 

Mature human interactions involve efforts to understand people who are different from you. 

We need to create positive healthy back-and-forth patterns of human connection. 

📌True growth comes from tougher moments and more difficult conversations.

📌 If you approach an interaction with an empathic stance, you’re much less likely to have a negative perspective on whatever is going on. 

When somebody is being rude, our typical response is to get caught up in the contagion of their emotions. We get dysregulated, and then we mirror their rude behaviors. If you can approach the interaction from a regulated empathic stance, your response changes.  

📌The human brain is really not designed for the modern world. 

Through almost the entire day of our existence as humans, our social network was small, we only knew 60 to 100 people. 

📌Science is gathering knowledge faster than society gathers wisdom. 

Human beings have been human beings in this genetic form for about 250,000 years. For 99.9% of that time, we lived in hunter gatherer bands of relatively small multi family groups. 

Our brain is suited for the social attributes and complexities of  smaller groups. 

Today we live very differently than we did thousands of years ago. 

We have invented our modern world. 

📌Whenever this world and its inventions start to stretch us away from our genetic capabilities and preferences, we run into problems. 

Our current challenge is that the rate of invention is now exceeding the rate at which we can problem solve. 

Every time you see someone you on the street, your brain asks: is the safe and familiar? Friend or foe? Trustworthy or not? 

Over and over again. 

You scan the attributes of each person and compare them to your internal catalog of safe and familiar. 

This constant monitoring of the social environment can consume a significant portion of our bandwidth. 

📌The best predictor of your current mental health is your current relational health, or connectedness. 

Disconnectedness is fueled by two things: the basic capabilities you’ve developed to form and maintain relationships and the relational opportunities you have in your family neighborhood, school, and so forth.

📌 Modern life provides fewer opportunities for relational interactions.  

📌we spend hours and hours in front of a screen, on average over 11 hours per day. 

We have fewer family meals and our conversational skills are fading. 

The art of storytelling and the capacity to listen are on the decline.

📌 The result is a more self-absorbed, more anxious, and more depressed and less resilient population. 

The typical college aged adult is 30% less empathic and more self-absorbed than 20 years ago. 

One study documented a 40% increase in psychopathology in American college students over the last 30 years. 

📌This is related to cultural shifts toward extrinsic goals such as materialism and status, and away from intrinsic goals, such as community, meeting in life and affiliation. 

Disconnection and loneliness in our society are playing a major role in increased anxiety, sleep problems, substance use, and depression we’re seeing. 

A recent study at Harvard found that of all the factors involved in depression, the most powerful were related to connectedness.  

📌All pain is the same, we just choose different ways to express it. 

We are all here to learn from one another’s pain. 

the loss of community and the social isolation we all feel is a source of great collective pain. 

📌So many people feel empty and are seeking connection and often seeking it in really unhealthy ways. 

❤️ A common thread in our culture: we are reactive, we prioritize convenience and short term solutions, we are risk-averse, and we use material things rather than relationships as rewards.

The speed with which we are inventing our world is outpacing our ability to understand the impact of our inventions. 

TV, video games, phones and computers are all pretty new. 

We don’t quite know the full impact of these devices on a developing brain, on how our children will think and process experience. 

We are beginning to understand the disruptive impact that 11 hours in front of a screen can have on social development. 

Techno hygiene: a social practice of rules about when and how to use  technologies.

No phone zones and no phone times, proper dosing, and spacing of screen time… 

• What we need now
  

Regulate, relate, then reason.

Ask: is this person in a state where they can effectively hear what I’m trying to say or teach? 

📌If the person is too dysregulated then they will not be open to any new learning or experience. Back away from teaching, coaching or reasoning when the persons state is such that they cannot learn. 

Focus on being present and regulate yourself when you start to feel frustrated, disrespected, or angry because they have not listened to you. 

No matter what has happened, you get a chance to rewrite your script. 

It really is never too late. Healing is possible. 

📌Learn the way you are organized by knowing what happened to you. 

Prioritize self-care. It is not selfish. It is essential. 

📌Find ways to use your experience to service to others. 

📌 Until you heal the wounds of your past, you will continue to bleed. 

As an adult, learn to see your parents through a different lens. 

Forgiveness is giving up the hope that the past could have been any different. 

We cannot move forward if we’re still holding onto the pain of the past. 

All of us who have been broken and scarred by trauma have the chance to turn those experiences into post traumatic wisdom. 

Forgive yourself, forgive others. 

Step out of your history and into the path of your future. 

Stop clinging to what should or could have been, and turn to what is and what could be. 

❤️ What happened to you can be your power. 

About Kristi | View Profile

Kristi Schwegman is a psychotherapist specializing in helping couples develop healthy relationships, whether dating, engaged, or married. She also draws from her Christian-based approach to lead individuals in becoming aware of the limiting beliefs that can get them stuck.