As the demands of modern life continue to rise, with soaring living costs and relentless career pressures, many of us struggle to find time to care for ourselves. We’re often left feeling overwhelmed and unsure of how to meet our own needs, which becomes even more concerning when it’s time to raise children or care for others. Kids, whether our own or those we interact with, rely on us to guide them through the world. Yet, weighed down by personal and generational trauma, and often distracted by work or mindlessly scrolling through social media, many adults find it hard to be fully present—even when they want to be. What’s worse is that many don’t fully understand what being “present” truly means, and even fewer know how to engage meaningfully with children. The loss of community support only makes this struggle harder, leaving many of us stretched thin. All of this leaves the next generation vulnerable to trauma.
In What Happened to You?, Dr. Bruce Perry and Oprah Winfrey discuss a tragic cycle that’s often overlooked—people who have experienced trauma are frequently blamed or misunderstood. In reality, they are victims of the difficult experiences that shaped them. As I read about how these circumstances affect people’s behavior, I couldn’t help but feel a deep sadness. Instead of asking what someone has been through, society tends to focus on what’s “wrong” with them. This only leads to harsh judgment and mistreatment, particularly for those who are already hurting.
Children, in particular, enter a world that often doesn’t recognize or support them, many already carrying the burden of unaddressed trauma. Even worse, their struggles are frequently misinterpreted or punished. Perry and Winfrey reveal how our systems fail these innocent children—parents are overwhelmed, communities are broken, and kids are left emotionally adrift.
Perry and Winfrey explain that this issue extends far beyond individual parenting—it’s a systemic problem. We live in a world that prioritizes productivity and competition, leaving little space for genuine human connection. Many people are opting not to have children, recognizing that society is not structured to support families. For those who do, the lack of societal and financial support, combined with a poor understanding of mental health, creates an overwhelming burden.
Another topic that really struck me is the concept of loneliness, or what the book calls “relational poverty.” It made me reflect on how isolated we’ve become in modern life. Imagine going through life’s challenges without any support system—every hardship feels so much heavier when you’re facing it alone. For those experiencing relational poverty, the lack of meaningful connections makes stress overwhelming, taking a serious toll on both mental and physical health. Perry and Winfrey emphasize that this is the reality for many today, especially for children. Without enough care and presence from adults, kids are left vulnerable to trauma, even though society claims to understand its impact.
What makes this book ever more powerful is its focus on trauma’s broader implications, especially in marginalized communities. Perry and Winfrey highlight the fact that our systems are built on biases—whether related to race, gender, or sexual orientation—that make it impossible to be fully trauma-informed. Marginalized people, who face exclusion and dehumanization, endure prolonged, uncontrollable stress, which Perry defines as a core trauma. This realization that marginalization itself is traumatic is eye-opening, and it forces us to rethink how we approach trauma as a society.
One of the book’s strongest messages is that while resilience is a natural human trait, our ability to cope with stress depends heavily on the relationships we have. In today’s fast-paced, those crucial connections are harder to maintain. We’re becoming more reactive and less empathetic, with our stress-response systems on constant high alert from the relentless pressures of modern life.
Perry and Winfrey present all of those complex ideas in a conversational style that makes the science of trauma easier to grasp. Their guiding question, “What happened to you?” shifts the focus from blame to understanding. It’s a powerful reminder that our personal histories—our experiences and relationships—are key to understanding how we think and function.
By the end of the book, I was left with a profound sense of empathy for those struggling under the weight of unrecognized trauma. It’s heartbreaking to think about the children born into environments that don’t support them, burdened by trauma that society often overlooks. Perry and Winfrey’s message is clear: we need systemic change. We need to create a society that values presence over productivity, that supports parents, and that helps rebuild the communities where children can truly thrive.
I can’t think of another book that explores trauma and the human experience as powerfully as What Happened to You?. It’s a must-read for everyone, at least once in their lifetime. This book reminds us to rethink how our environments shape who we are, and it calls for collective action to build a more supportive world for future generations.
Summary
The Brain’s Structure: From Primitive to Complex
Our brain can be thought of as a hierarchy. At the top is the cortex, the most uniquely human part of the brain. This is where we process speech, language, thinking, and planning. It’s also where we store our values and beliefs, and it’s the part of the brain that can understand time—allowing us to reflect on the past and plan for the future.
On the other end, at the bottom of the brain, lies the brain stem, often called the “reptilian brain.” This part doesn’t think or plan; it’s focused on the present moment, regulating basic functions like breathing and heart rate. Unlike the cortex, it has no sense of time.
How the Brain Processes Information and Experience
When we encounter the world, sensory input from all around us is first processed by the lower brain areas, such as the brain stem. Because these lower areas don’t understand time, they trigger stress responses as if the threat is happening right now. Only when the signal reaches the cortex can we begin to analyze what’s really going on. But here’s the catch: once stress kicks in, the cortex’s ability to process information, including telling time, shuts down.
Our brains are designed to act before they think. The primitive parts of the brain handle the immediate response, and only afterward do the higher parts of the brain come into play. This bottom-up processing explains why our actions and emotions often come before our thoughts. It’s also how the brain develops: an infant first acts and feels before learning to think, gradually organizing how they understand the world.
The Developing Brain: Shaped by Early Experiences
Brain development starts before birth, influenced by everything from the mother’s stress to environmental factors. The first nine months of life see explosive growth, with the brain rapidly building connections that help the newborn make sense of the world. Our senses—both external (like sight and sound) and internal (like hunger and thirst)—send continuous feedback to the brain. This helps it activate the proper systems to keep us safe and healthy.
As the brain grows, it starts to store memories. But what those memories mean depends entirely on experience. For one child, eye contact might signal care and love; for another, it could mean an impending scolding. Our brain organizes these experiences, creating a personal codebook that shapes how we interpret the world. Early on, children filter the world through the adults around them.
The brain develops from the bottom up, starting with the basic functions in the brain stem and building toward the complex reasoning in the cortex. While the cortex isn’t fully developed in young children, other parts of the brain are already forming associations that will affect behavior for years to come. If a child experiences abuse, for example, their brain may associate certain features of the abuser with fear, influencing their behavior far into adulthood.
The Power of Love and Belonging
What happens to us in infancy has a profound effect on our capacity to love and be loved. When caregivers respond to an infant’s needs, they are building the child’s resilience. The brain begins to associate those caregivers with warmth, safety, and sustenance. These early interactions shape the child’s worldview and influence their ability to form healthy, loving relationships in the future.
Being loved early in life helps grow the brain networks responsible for empathy and nurturing. If you are loved, you learn to love. This capacity for love is at the heart of human survival, as it allows us to form strong, supportive groups.
Finding Balance: The Importance of Rhythm
Rhythm is crucial to a healthy mind and body. Whether it’s walking, swimming, or dancing, these activities help regulate us. Think of how rocking a baby can calm them—and in turn, calm us as well. As adults, we find our own set of rhythms to regulate ourselves, and rhythm continues to play a key role in helping us stay balanced. Stress, after all, occurs when we’re thrown out of balance.
Caregiving adults also provide external regulation for children. Responsive caregivers help build a child’s self-regulation over time, using rhythm as one of the most powerful tools. From the womb, a mother’s heartbeat creates rhythmic input that organizes the developing brain. After birth, rhythms—whether through rocking or soothing words—become associated with safety and comfort. A child’s brain begins to build a foundation of regulation through these early, rhythmic experiences.
Understanding Trauma: The 3 E’s
Trauma is best understood through the lens of the “3 E’s”: the event, the experience, and the effects. These three components shape how trauma impacts an individual. It’s important to note that not every stressful event leads to trauma. For some, what may seem traumatic is simply a stressful experience that they can process and recover from. However, the inequities and flaws in our public systems often mean that those who have the least are more likely to suffer lasting trauma.
Generational trauma is also a crucial concept to grasp. Trauma can be passed from one generation to the next, influencing not only the person who experienced it but also their children and grandchildren. If we better understand how trauma is inherited, we have a chance to break the cycle and prevent it from continuing.
What we expose our children to matters immensely. The experiences of our ancestors—both their struggles and their joys—shape the way we think, feel, and behave. Becoming aware of these influences allows us to be more intentional about the future. What we do now doesn’t just affect us; it will echo into the lives of future generations. By acknowledging this, we can make better choices for the well-being of those who come after us.
Trauma and the Impact of Inadequate Support
One of the central problems in our society is that many parents are left to care for children without enough support. An overwhelmed, dysregulated parent struggles to consistently and predictably regulate their child, and this has profound effects. The child’s stress-response systems can become overactive and overly reactive, especially when faced with inconsistent caregiving.
In cases of prolonged trauma, a child’s regulatory networks adapt, but in ways that leave lasting marks. For example, a child living in a chaotic home environment might constantly scan for signs of danger, a behavior that is adaptive at home but becomes problematic in a classroom setting, where the child may struggle to focus and is labeled with ADHD.
Trauma also affects how children form connections about relationships. If a caregiver is unpredictable, absent, or rough, a child’s worldview is shaped by these experiences, often leading to a sense of mistrust and insecurity in future relationships.
Building Resilience Through Relationships
Human beings are inherently social creatures. Relationships—whether with family, friends, or community—help regulate our stress and reward us with a sense of belonging. When we lack these connections, we become more vulnerable to stress, reacting intensely to even minor challenges. Our modern world, with its diminishing connectedness, is making it harder for us to build the resilience we need to face life’s difficulties.
Resilience is built through challenge and support. Children who feel loved and safe are more likely to step out of their comfort zones and take on new challenges, which helps them grow. Safe and stable environments create curious, resilient children who are better equipped to handle stress in the future.
The Roots of Trauma and Resilience
Adversity in childhood—especially during the first two months of life—can have lasting effects on brain development. Whether through neglect, inconsistent caregiving, or other forms of stress, early trauma sensitizes the stress-response systems, leading to challenges later in life. But equally important is the role of relational health: connectedness to family, friends, and community can buffer against these effects and promote resilience.
Dissociation: An Escape from Stress
For young children, dissociation is a common coping strategy. It allows them to retreat into their inner world, escaping from external stress or pain. Over time, this ability to mentally withdraw becomes a key tool for managing overwhelming situations. Dissociation can even manifest as people-pleasing behavior, where a child complies with others to avoid conflict.
Dissociation exists on a spectrum, from mild daydreaming to deeper states of retreat. While often seen as negative, it can also be beneficial in certain situations, like creative thinking or high-pressure performances. However, when dissociation becomes a primary method of coping with stress, it can lead to more destructive behaviors, such as self-harm.
Developmental Adversity
Three types of developmental adversity can significantly alter the brain’s core regulatory networks (CRNs), leading to long-term problems:
- Prenatal disruption: Any stress or disruption that happens before birth, such as exposure to harmful substances or maternal stress, can influence a child’s brain development.
- Disruption of early caregiver interactions: If the interactions between an infant and their caregiver are chaotic, inconsistent, or rough, the child’s stress-response system can develop abnormally. This can happen in homes where parents are overwhelmed, aggressive, or absent, leaving the child’s brain in a constant state of stress.
- Prolonged stress: Any consistent, unpredictable, or extreme stress that a child faces can cause their stress-response system to become overactive and overly reactive, making it difficult for them to manage challenges later in life.
One powerful takeaway is that human interactions—especially those in early childhood—are often brief but incredibly impactful. You can spend hours with someone, but if you’re not fully present and attentive, those hours don’t carry the same weight as a few moments of genuine connection. In many cases, trauma and neglect go hand in hand. Neglect is particularly destructive in early life, as the brain is growing rapidly and relies on consistent stimulation for normal development.
Neglect can take several forms:
- Chaotic neglect: When caregiving is fragmented and disorganized, critical brain systems develop in a similarly disorganized way, leading to functional problems.
- Splinter neglect: In some cases, certain aspects of a child’s development may seem normal, but one or more key systems are neglected, leading to gaps in areas like emotional or social development.
Children need patterned, consistent experiences to develop these key systems. The best foundation for healthy relationships later in life is having just a few stable, nurturing relationships in the first year of life. These early connections provide the repetitions needed to build the basic relational architecture that supports future emotional health.
However, in households where love is “outsourced” or inconsistent, children can develop underdeveloped or stunted relational capacities. This brings us to a major issue in modern society: we’re not very good at being truly present. The ability to empathize and nurture depends on the quality and frequency of loving interactions early in life. When caregiving is dismissive or disengaged, it doesn’t build the foundation for a loving, connected person. Instead, it creates emotionally hungry individuals who long for belonging but don’t have the neurobiological capacity to form meaningful connections. Dismissive caregiving can leave a person with an unquenchable thirst for love.
PTSD, The Lingering Effects of Trauma
Post-Traumatic Stress Disorder (PTSD) can develop at any age in response to a traumatic event. According to the 3 E’s of trauma—the event, the experience, and the effects—PTSD is primarily about the lasting effects of trauma. It is a specific syndrome recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM), with four main symptom clusters that emerge after a traumatic event:
- Intrusive symptoms: These include recurring, unwanted images or thoughts about the traumatic event, as well as nightmares. Trauma often leaves a person feeling shipwrecked, forced to rebuild their inner world. Healing becomes a process of sifting through the wreckage, searching for what remains and seeking a way to piece their worldview back together.
- Avoidant behaviors: These symptoms arise when someone experiences distress upon being reexposed to people, places, or reminders of the original trauma. The individual may try to avoid situations that trigger these memories as an attempt to regain control. In cases where the trauma occurred during early caregiving relationships, the person may develop an aversion to intimacy in future relationships, often without realizing the connection to their past trauma. This avoidant behavior is one of the lesser-known effects of developmental trauma.
- Changes in mood and thinking: This category includes depressive symptoms, where a person’s overall emotional state becomes impacted by the trauma, often leading to a persistent low mood or hopelessness.
- Alterations in arousal and reactivity: These symptoms are linked to an overactive stress-response system. They include heightened anxiety, hypervigilance, an exaggerated startle response, irregular heart rate, and sleep disturbances. The body remains in a heightened state of alert, constantly on edge and ready to respond to perceived threats.
When a person displays symptoms in each of these four categories, they may be diagnosed with PTSD. It’s important to remember, though, that PTSD is just one of the many ways trauma can impact a person’s mental and physical health.
Bias and Racism, The Complexity of Beliefs and Behavior
One of the hardest things to grasp about bias and racism is that your beliefs and values don’t always drive your behavior. These beliefs are stored in the highest, most complex part of your brain—the cortex. However, other parts of the brain can form associations that lead to distorted, inaccurate, or even racist behaviors, despite your sincere anti-racist beliefs. This is where implicit bias comes into play.
Everyone has some form of implicit bias, shaped by how and where we grew up. These biases are based on early experiences, often loaded into the lower parts of our brain, and they create a default worldview. For instance, it’s nearly impossible to have every culture and ethnicity represented in your life’s early years, meaning we all have blind spots or biases we aren’t fully aware of.
There is an important distinction between implicit bias and racism:
- Implicit bias refers to biases that are present but not always overtly expressed. These biases are embedded in the lower parts of the brain. Even when someone sincerely believes that racism is wrong, they may still express biased behaviors because those associations are stored in parts of the brain that operate below conscious awareness. Addressing implicit bias starts with recognizing that you have it. Reflect on situations where your biases may have shown up, and work to create meaningful relationships with people who challenge those biases. This helps reshape your understanding of individuals beyond their categories.
- Racism, on the other hand, is an overt set of beliefs about the superiority of one race over others. Racist beliefs are embedded in the cortex, the rational part of the brain that is malleable and capable of change. While these beliefs can be unlearned or altered through conscious effort, the underlying implicit biases stored in the lower brain often require deeper reflection and more intentional work to change.
The Role of Therapy and Healing
Therapy is a process of building new associations and pathways in the brain, helping individuals create healthier responses to stress. It’s like building a new, well-paved road alongside an old, worn-down one. With enough repetition and support, the new path becomes the brain’s preferred route, allowing individuals to heal from trauma.
Healing isn’t just about therapy, though. It’s about connection—finding a community of supportive people who can help you revisit and process trauma in manageable doses. Together, we can transform stress responses and move toward resilience.
Healing from Trauma
One key principle of trauma recovery is allowing the traumatized person to control when and how much they talk about their experiences. Forcing someone to share before they are ready can be retraumatizing rather than healing. The goal is to create an environment where trauma memories and stress-response systems can be activated in a predictable, controllable way. When this happens, the individual can begin to heal their sensitized system.
Given love, the unloved can become loving.
Bruce D Perry, What Happened to You: Conversations on Trauma, Resilience, and Healing
Having a support network of friends, family, and healthy relationships provides a natural healing environment. We heal best in community. This network gives opportunities to revisit trauma in manageable doses, helping to regulate the stress-response system. Over time, a person with a sensitized stress response can become “neurotypical”—less reactive and more resilient. The journey from trauma to resilience often leads to a unique strength and perspective, known as post-traumatic wisdom.
Traditional healing practices have long recognized the importance of rhythm, connection, and storytelling in trauma recovery. The pillars of traditional healing include:
- Connection to community and nature
- Regulating rhythms through activities like dance, drumming, and song
- Beliefs and stories that bring meaning to trauma
- Occasionally, plant-based substances used under the guidance of a healer to facilitate healing
Modern medical models often overemphasize psychopharmacology and cognitive-behavioral approaches, while undervaluing the power of connectedness and rhythm. However, a truly trauma-aware clinical team will use a wide range of tools, such as:
- Occupational therapy
- Physical therapy
- Speech and language supports
- School liaisons
- Psychoeducation for the family and child
- Techniques like Trauma-Focused Cognitive Behavioral Therapy (TFCBT), Eye Movement Desensitization and Reprocessing (EMDR), somatosensory interventions, and animal-assisted therapies
If professional therapy isn’t accessible, traditional practices offer cognitive, relational, and sensory elements. These include storytelling, physical touch (like massage), dancing, and singing—activities that help individuals reconnect with loved ones and their community. Aboriginal healing traditions emphasize repetitive, rhythmic, and relational practices known to effectively alter neural systems involved in the stress response.
Post-Traumatic Wisdom
Real wisdom often comes from facing hardship. It’s impossible to develop post-traumatic wisdom without going through difficult experiences and, most importantly, weathering them together with others. Social connection builds resilience, which in turn helps create post-traumatic wisdom. This wisdom leads to hope—not just for the individual, but for the community that participates in their healing process.
Changing the System, The Challenge of Addressing Trauma and Bias
Changing individuals is difficult, but changing systems takes even longer. To be truly trauma-informed, it’s essential to recognize both personal and structural biases—those related to race, gender, and sexual orientation. Marginalized people, who are excluded, minimized, or shamed, are often traumatized by these systemic issues. As fundamentally relational creatures, humans experience prolonged stress when excluded or dehumanized, and this creates a form of trauma.
It takes a long time to change people—and even longer to change systems.
Bruce D. Perry, What Happened To You?: Conversations on Trauma, Resilience, and Healing
Unfortunately, many schools are not trauma-aware and often discourage regulatory activities that can help, such as walking, rocking, or listening to music while working. Somatosensory regulation—the use of rhythmic activities to engage the brain—opens up the cortex and enhances learning. However, schools tend to minimize activities like sports, music, and art, viewing them as electives rather than recognizing their critical role in regulating the brain and building resilience.
Sports, music, and the arts engage the brain from top to bottom, synchronizing brain activity and promoting overall health. These activities are essential for learning and growth.
Overall Recommendation
The roots of health lie in rhythm and regulation. A well-regulated brain depends on a balance of relationships, regulation, and reward. Our connections to others help regulate our stress and bring us the emotional rewards we need to thrive.
- Belonging and love are fundamental to the human experience. A sense of safety and stability lays the groundwork for healthy development.
- Regulate, relate, reason—this simple principle is key to understanding trauma and fostering healing.
- By teaching about trauma and the power of connectedness, we can unlock unexpressed potential and improve society as a whole.
One of the most important principles of trauma-informed approaches is supporting the frontline adults who work with children and youth. When we create environments that help people listen, regulate, and reflect, we take important steps toward a healthier and more connected world.
Author: Bruce D. Perry, Oprah Winfrey
Publication date: 27 April 2021
Number of pages: 304 pages
