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Book Review-What Happened to You?: Conversations on Trauma, Resilience, and Healing

It’s easy to assume that people who are famous and wealthy have had it good their entire lives, including now.  It’s harder to realize some of the awful tragedies that were wrought in their childhoods.  It’s harder to consider that they’re still humans who grew up with trauma that left scars.  What Happened to You?: Conversations on Trauma, Resilience, and Healing is a collection of writings and interactions between Oprah Winfrey and Bruce Perry.  It’s about increasing the understanding about the trauma that others have encountered to be able to understand their curious behaviors.

Oprah Winfrey

Born in Kosciusko, Mississippi, Oprah Winfrey has come a long way from the child of a one-time hookup between her mother and father.  She spent much of her formative years with her grandmother until her death, when she alternated between her mother and father.  From this unstable upbringing, she recalls the pervasive feeling of loneliness.

Though not addressed directly in the book, Oprah has spoken repeatedly about the sexual abuse and rape she experienced growing up and has worked tirelessly to prevent the harm to other children.  In addition to her personal experience with trauma, Oprah covered the issue of sexual abuse 217 times on her show.

Learning to Love

Children’s brains don’t create linear narrative memory before the age of about three, when the brain prunes connections and develops this capacity.  In theories about trauma, it’s believed that traumas encountered before this time can’t be recalled but are still somehow encoded in the child.  Conversely, it’s believed that supportive environments change the way that people experience the world.

Much has been made of attachment styles and the way that they change how people respond to different situations, including the “strange situation” test developed by Mary Ainsworth to test the theories of her mentor, John Bowlby.  (See Attached.)  There’s strong research indicating that children develop a greater ability to explore the world when they routinely encounter others that respond to their needs.  Those who encounter neglect or negative outcomes when they share their needs are classified with insecure attachment styles, which hold them back in their relationships for life.

The good news is that attachment styles, while initially set as an infant, are malleable.  If children encounter supportive, responsive relationships later in their life, their attachment style can shift towards more security and better outcomes.  (See Attachment in Adulthood.)

In essence, when children encounter love, they learn to love.  That love should come from parents but doesn’t always.

Repeating Patterns

One of the recurring tragedies of trauma is that, often, the person who was traumatized as a child replicates the pattern of abuse and trauma as an adult.  Because a child can’t see the difference between their experience and healthy or normal, they unwittingly replicate it.  Unconsciously, they may be trying to find a better outcome, like the son who became a doctor.  It wasn’t until much later that he would realize his mother was always kind to the doctor in ways she wasn’t kind to him.  He wondered if, unconsciously, he had chosen to become a doctor with the idea that he could finally get his mother to be nice to him.

Others aren’t so lucky in the way that they try to replicate what they experienced as children.  Women find mates who are controlling and abusive instead of supporting and caring.  Perhaps, at some level, they hope they can change their mates when they couldn’t change their situation as a child.

Reality is the Problem

Oprah recounts an interaction with Russell Brand, who wrote Recovery, when he said, “Reality is my problem, drugs and alcohol are my solution.”  If you’ve been abused or neglected as a child, your perspective of reality might be that it’s a painful place with nothing for you.  Instead, it’s a place where you can expect only to be hurt.  In these cases, like Brand’s, it makes sense that reality is a problem.  If you’re not hurting now, the perception is that you could be hurting at any moment.

There is a stigma about substance use disorder (SUD).  It’s believed that people who become addicted are bad.  Someone did something wrong.  However, as Dreamland, The Globalization of Addiction, and Chasing the Scream all explain, it’s not that.  It’s that they found life unlivable and sought an escape.  As Judith Harris Rich explains in No Two Alike and The Nurture Assumption, you can’t protect your children from everything.  They may experience hurts that you can’t protect them from.

Robert Putnam, in Our Kids, explains that some neighborhoods have better protections.  Some don’t support their children in ways that lead them to the greatest success.  It’s not about the kids.  It’s that the odds are better sometimes – and that there are no guarantees even with the best parents or in the best neighborhoods.

Stressing Growth

If too much stress is trauma and it’s not good for you, then one might think that no stress is the goal.  However, Nassim Taleb makes the point in Antifragile that we need stress.  Anders Ericsson makes the same point in Peak as he speaks about professionals at the peak if their profession.  Quiet Leadership speaks more generally about the need to have struggles for our growth.  While the idea of a stress-free life sounds good, a complete lack of stress leads to apathy, and that’s not good.

Event, Experience, and Effects

Trauma is defined by three Es: event, experience, and effects.  The event itself is easy to identify.  It’s the thing that happened from an objective point of view.

Experience is a bit different than the objective experience.  It includes how you initially assessed the event, including how it’s related to previous experiences, as well as what it felt like.  Effects are the down-stream impacts of the event.  If you’re in a car accident, there may be surgeries, physical therapy, or even permanent changes to your state of being.

Each of these plays a part in the impact of an event and whether it will be overwhelming and thus a trauma.  (See Trauma and Recovery.)

The ACE You Can’t Keep

It’s hard to not have heard about the adverse childhood experiences (ACEs) study.  The spooky results showed that there were lifelong effects to having experienced more traumatic events in childhood.  The more events, the worse your adult health.  Why Zebras Don’t Get Ulcers discusses it, as does Trauma: The Invisible Epidemic and It’s Not You, It’s What Happened to You.  Even How Children Succeed spoke of how ACEs impact children’s success (beyond health measures).

As a population health tool, the ACEs survey is useful.  As a clinical tool or to predict individual outcomes it’s not that useful.  It suffers from many of the same problems that Craig Bryan explains in Rethinking Suicide.  You just can’t make the statistics work like that.

Finding Flow

Perry explains that “flow” and being “in the zone” are partial dissociative states – that is, you start to disconnect from the reality around you.  The concept of flow was developed by Mihaly Csikszentmihalyi and is the subject of his books, Flow and Finding Flow.  Many have spoken about the power of flow, including Steven Kotler in The Rise of Superman.  Flow, in addition to its dissociative aspects, is a highly productive state and, that may be why Perry explains that people who can control when they go into flow have a gift.

I struggle with Perry’s focus on unescapable distress and pain as a trigger for flow, because it feels as if he’s speaking of dissociation but not the same state that Csikszentmihalyi is speaking of.  Csikszentmihalyi speaks of flow as a delicate balance between skills and challenge – a situation that isn’t present in the traumatic situations Perry is describing.

Loss of Innocence

I was doing a publisher-sponsored review of a book to provide feedback to the author about what could be improved upon.  One of the big flags for me was the continued use of the phrase and concept of “loss of innocence.”  The point I made is that only our first trauma deprives us of innocence.  The second through the thousandth still impacts us without necessarily displacing innocence.  After trauma, we’re different – but not just in the loss of innocence.

One of the words that I struggle with is “resilience”  At a literal level, it means a return to a prior state.  The thing is that, with humans, every trauma changes us.  Heracles said, “No man enters the same river twice.  He’s not the same man and it’s not the same river.”  It is the same with trauma.  Even when you’ve processed and recovered from the trauma, you’re still not the same.

Knowing

Oprah, as an adult, encountered a time when her mother was dying.  It was then that she wondered if the millions of television viewers knew her better than her own mother did.  The past loneliness that was endemic in her childhood hadn’t fully left her.  Instead, she still wondered if, even at the end of her life, her mother really knew her.

As people share their experiences today, for better or worse, we should continue to wonder What Happened to You?