What Happened to You?

On page 23, Dr. Perry explains that “seemingly ‘senseless’ or confusing behavior makes more sense once you look at what is behind the behavior…why did they do that? What would make them act that way? Something happened that influenced how their brain works.” When was the last time you struggled to understand behavior from someone in your life? What were your reactions to the behavior? Did you get frustrated, annoyed or angry because the behavior made life harder for you? –or did you consider asking yourself what was behind the behavior? Please share an example.

Consider this quote from Dr. Perry on page 29, “All experience is processed from the bottom up, meaning, to get to the top, smart part of our brain, we have to go through the lower, not-so smart part. This sequential processing means that the most primitive, reactive part of the brain is the first part to interpret and act on the information coming in from our senses. Bottom line: Our brain is organized to act and feel before we think.” How does our knowledge of this way of processing information help us to better understand the responses of those close to us or even ourselves?

Reread Oprah’s reflection on her own heart rhythms on pages 45-47. Dr. Perry follows: “Rhythm is essential to a healthy body and a healthy mind. Every person in the world can probably think of something rhythmic that makes them feel better: walking, swimming, music, dance, the sound of waves breaking on a beach…” Share some practical examples of how you can use healthy rhythmic activity to help regulate yourself or those you interact with in your personal or professional life.

On page 50 in the book, Dr. Perry states, “A person’s capacity to connect, to be regulating and regulated, to reward and be rewarded, is the glue that keeps families and communities together.” Discuss how your connections with others have helped you to be more regulated and how you can offer to be that connection for others. If this is an area where you have struggled or lacked that important connection, how can you work to increase this important protective factor?

On page 61, Dr. Perry writes, “So often when we ask, ‘What happened?’ we find a history of developmental trauma. Most people with ‘developmental adversity’ are chronically dysregulated – they tend to be wound up, anxious.” Dr. Perry addresses this impact of being chronically dysregulated in Chapter 2: Seeking Balance. One of the maladaptive ways that people will seek balance is through risky behaviors such as substance misuse or abuse, sexual promiscuity, eating disorders. He ends chapter 2 by indicating that “the most powerful form of reward is relational”. He goes on to say, “Without connection to people who care for you, spend time with you, and support you, it is almost impossible to step away from any unhealthy form of reward and regulation…..Connectedness counters the pull of addictive behaviors.” The US has very high rates of substance abuse, suicide, teen pregnancies, opioid-related deaths and the results of other unhealthy self-regulating behaviors. The secondary cause of the majority of child abuse and neglect reports to child protective services is substance abuse. How have you seen this in your own life or the lives of those around you? How can we help to promote positive, healthy ways to self-regulate to prevent future harmful behaviors in ourselves or those we care about?

In chapter 3: How We Were Loved, both Oprah and Dr. Perry discuss the need for trauma-informed training among professionals who work with children, youth, or adults who have been traumatized. They specifically call for trauma-informed training for educators, juvenile justice and child welfare workers, law enforcement and coaches. As shown in Figure 6 on page 92, depending on which mental state someone is in and what adaptations they’ve created for themselves to regulate when stressed or fearful, behaviors may be seen as willful disobedience rather than a biological response to trauma. Dr. Perry states, “what is adaptive for children living in chaotic, violent, trauma-permeated environments becomes maladaptive in other environments, especially school…the pervasive misunderstanding of trauma-related behavior has a profound effect on our educational, mental health, and juvenile justice systems”. Oprah goes on to write, “and this is why we need trauma-informed systems.” Discuss which systems in your community you think would benefit from becoming trauma-informed. How can shifting our question from “what’s wrong with you?” to “what happened to you?” help to decrease rates of school suspensions and expulsions, for example?

The Adverse Childhood Experiences (ACEs) study has proven valuable in understanding some traumas we experience on a personal level. However, we are also aware of the role other community and structural traumas, like generational poverty, play in the lives of many young people, especially those most marginalized in our society. What are some other kinds of overwhelmingly stressful experiences that the young people you live or work with face?

Chapter 7: Post-Traumatic Wisdom introduces us to these thematic words: “the painful path of wisdom.” We are taught that resilience is learned over time, can’t be rushed, and can never be assumed. What mistakes are easy to make in traumatic situations when we don’t respect the painful path of wisdom? “The painful path of wisdom” is dependent on those we meet along the way, the relationships we foster as we navigate the thrive-survive continuum we all live on. Oprah discusses how growing up, her “church family” provided those connections. Her community “didn’t have a word for the kind of trauma so many African Americans endured, so we said we ‘weathered’. The church was a big part of how we got through. We weathered together.” Dr. Perry responds with, “you are identifying such a central aspect of building resilience. Your connectedness to other people is so key to buffering any current stressor….being with people who are present, supportive, and nurturing. Belonging.” Share some examples of who helped you “weather” in times of stress or trauma. Share some practical ideas on how community care can be built in your setting.

On pages 206-207, Dr. Perry discusses how our modern society has led to a decreased sense of connectedness which is counter to our species’ anthropology. Humans were conditioned historically to live together in tribes or clans, to support each other as hunters, gatherers, farmers. On page 206, Dr. Perry states that “it’s such an unfair expectation of our society. No other society in the history of this planet has ever asked a single adult to provide the physical, social, emotional, and material needs of multiple children by themselves.” The US has a high rate of single parents, many of whom are teenagers. Discuss how communities could do a better job in supporting parents who may be raising children in isolation.

At the end of Chapter 8, “Our Brains, Our Biases, Our Systems,” Dr. Perry and Oprah discuss whether trauma is “causing humanity to move backward.” Dr. Perry writes that “I’m hopeful that by teaching about trauma and the power of connectedness, things will improve. We could invest in building neighborhoods, trauma-informed services….building spaces where people would create community.” How do you see awareness about trauma, healing, brain development, and resilience as ways to help create nurturing communities? How can we work toward making this a reality?

On page 257, Dr. Perry shares wisdom from his friend and colleague, Dr. Ed Tronick, who teaches us the power of “rupture and repair.” Think about some conditions necessary for “repair” to occur. How can the concept of “rupture and repair” align with how we interact with others in our families or in our lives? How can we incorporate those “safe ruptures and repairs” like family dinner arguments into our daily lives when many of us are living in a very isolated environment in our current societal environment?

Dr. Perry: “If we truly want to understand ourselves, we need to understand our history – our true history. Because the emotional residue of our past follows us.” Oprah: “but that can’t happen until there is a tipping point of awareness.” Discuss why knowing our society’s history is crucial to the healing of our society as a whole. How can we take advantage of the struggles we’ve faced that have provided this “tipping point of awareness” for all of us?

Dr. Perry talks throughout What Happened to You? about relational health and the importance of feeling a sense of belonging or connection in your community. In Chapter 9: Relational Hunger in the Modern World, Dr. Perry and Oprah discuss the impact of modern society’s social isolation and overdependence on social media for “connectedness.” On page 266, Dr. Perry introduces the concept of “relational poverty – lack of connectedness – as an adversity. Poverty of relationship can disrupt normal development, influence how the brain works, put you at risk for physical and mental health problems,” he writes. 6 How can we help to promote social connection and prevent isolation, especially during the pandemic, to provide greater relational health for those in our communities?