Book review

What happened to you? Conversations on trauma, resilience, and healing, by Bruce D. Perry and Oprah Winfrey

Flatiron, New York, 2021
ISBN: 978-1-250-22321-0

Reviewed by Nikki O’Connor (Ngāti Porou, Te Ati Awa)

What happened to you? Conversations on trauma, resilience, and healing is an engaging and illuminating book that examines the impact of trauma on the developing brain. It nimbly traverses neuroscience, case studies, theory and personal stories to explain how experience shapes the way we think, feel and act. The long-asked question “What’s wrong with you?” is challenged and reframed as “What happened to you?” This mirrors a shift away from pathology when working with trauma. Instead it focuses on past experiences, and understanding the role they play in our processing of the world. The book goes on to explore how the brain can recalibrate, and how it is possible to emerge from trauma with post-traumatic wisdom.

The book is presented as a conversation between Dr Bruce Perry and Oprah Winfrey. 

Perry is a renowned neuroscientist and child psychiatrist with over thirty years experience. His skills have seen him work across a number of high-profile traumatic incidents, such as the Branch Davidian siege in Waco, Texas, which he talks about in the book. He manages to effectively explain some complex theoretical ideas by carefully weaving stories and neuroscience together to make the content accessible. His manner of delivery is humble, respectful and unpretentious.

Winfrey shares some deeply personal stories from her own childhood, and she contributes thoughtful insights acquired though her television interviews and philanthropic work. She maintains a consistent, reassuring attitude of hope and growth throughout the book, reminding the reader that post-traumatic wisdom is attainable. Winfrey has a knack for asking some difficult questions that many readers may also be pondering. 

The authors state the book will help you better understand yourself and others. Self-reflection is unavoidable, and readers are cautioned about the challenging content they may encounter. They are advised to put the book down if painful feelings arise, until they are ready to continue exploring the content. Not surprisingly, this reflects one of the key messages of the book: having agency over exposure, and having many short exposures (sometimes only minutes or seconds) to revisit and rework traumatic experiences. I support the authors’ recommendation to put the book down from time to time, but I would extend this to also cater for cognitive percolation of content.

The book is organised into ten thematic chapters, which cover content such as “the spectrum of trauma”, “post-traumatic wisdom”, and “our brains, our biases, our systems”. The procession through the themes is logical, and each chapter builds on the previous content. Often stories re-emerge in later chapters with the perspective of the newly introduced ideas.

Perry talks us through concepts that are crucial to understanding the brain’s response to stress. He explains how the body uses neural networks to process and respond to stress. We learn that the structural and functional complexity levels of the brain have a direct correlation to the sequence in which people might best experience positive growth and healing after trauma. Dysregulation and maladaptive responses are explored in the context of trauma, resilience and healing. Perry’s Neurosequential Model introduces us to one way of addressing trauma, in sequence, and in response to the hierarchical levels of the brain.

Creative arts therapists will connect with this book. There are a number of places throughout the book where Perry emphasises the need for regulation, and he identifies rhythm as one of the primary regulating forces. Our movement/dance and sound/music therapies are particularly well positioned as regulating modalities. Perry also talks about learning occurring faster when moving, using art to help form relationships, and building positive experiences together. Creative arts therapists will know these capabilities of the arts already. However, there may be learnings that prompt a shift in the timing or order of various methods, activities or tools.

One special feature in the book is the recognition of Māori approaches to healing. Perry dedicates a chapter to what he learnt from Māori elders when seeking to better understand Indigenous perspectives on healing practices. The insights he gained were profound enough to inform his future work with children and families back in America. He champions whanaungatanga and the power of strong connections with people. “Relationships are the currency of change” (Perry & Winfrey, 2001, p.285). Perry describes how important these reciprocal relationships are and how kinship leads to a sense of belonging and connection.

Other moments throughout the book also echo sentiments of Māori wisdom. Although not always named, concepts and practices such as whakamana, mihimihi, pūrākau, wānanga, hauora, kotahitanga and kanohi ki te kanohi feature. However, it is the concept of whakapapa that speaks to the core of the question posed in the title of the book. “To best understand the here and now, we need to know where we came from and ‘what happened’ to us and our ancestors” (Perry & Winfrey, 2001, p.248). The transgenerational fallout from colonisation is not ignored here; Perry sees the value in connecting and reconnecting, in spite of Western tendencies to fragment and disconnect. He places disconnection at the heart of trauma.

Although Perry’s intentions are genuine, it does need to be acknowledged that there is a tension that exists when we learn about Indigenous concepts from someone not from that culture, especially when there may be financial reward for the publishing party. To provide some balance and to supplement the reading list found at the end of the book, I would like to recommend work by the following Māori practitioners and researchers: psychiatrist Mason Durie (Rangitāne, Ngāti Kauwhata, Ngāti Raukawa); professor of Indigenous education Linda Tuhiwai Smith (Ngāti Awa, Ngāti Porou, Tūhourangi); neuroscience educator Nathan Mikaere-Wallis (Ngāi Tahu, Tainui); and psychiatrist Hinemoa Elder (Ngāti Kuri, Te Aupouri, Te Rerewa, Ngāpuhi).

One aspect of the book that I do question is the regular talk of belonging to a church or a faith-based group. Although this is being suggested as a way to help people gain connection and support, using the term ‘church’ is somewhat short-sighted, especially because many Indigenous people see the church as a symbol of colonisation, which has resulted in intergenerational trauma. Christianity attempted to destroy, appropriate and claim concepts of Indigenous spirituality and it remains a critical site of resistance for some (Smith, 2021). 

Despite that, I still highly recommend this book. It is available as a 304-page hardcopy version or as an Audible audiobook. The hardcopy provides easier access to diagrams and tables, but the audiobook sets the tone. The inflections and general expression used in their conversation enhances the text, and it offers a ‘holding’ of sorts. The dialogue between Perry and Winfrey welcomes the reader into a mindset of curiosity and reflection.

If we want to understand the oak, it is back to the acorn we must go – Oprah Winfrey

Glossary of Māori terms

Hauora Holistic well-being
Kanohi ki te kanohi Face to face
Kotahitanga Unity, togetherness, collective action
Mihimihi Greetings, introductory speeches
Pūrākau Story
Wānanga To meet, discuss, deliberate, consider
Whakamana To empower
Whakapapa Genealogy, lineage, descent
Whanaungatanga Relationship, kinship, sense of family connection

References

Perry, B.D., & Winfrey, O. (2021). What happened to you? Conversations on trauma, resilience, and healing. Flatiron Books.

Smith, L.T. (2021). Decolonizing methodologies: Research and Indigenous people (3rd ed.). Zed Books.