When someone is caught in the throes of a panic attack, is too depressed to get out of bed, or is otherwise grappling with mental illness, it’s common for others to ask (or at least think), What’s wrong with you?

But media mogul Oprah Winfrey and her longtime colleague the renowned brain-development and trauma expert Dr. Bruce D. Perry believe that question needs to be reframed. Instead of looking at someone’s behavior as an act in and of itself, we should focus on the roots of such behavior, particularly as it relates to trauma, and ask, What happened to you?

That’s the name of their new number-one New York Times best-selling book, What Happened to You?: Conversations on Trauma, Resilience, and Healing. In it, Winfrey and Perry have a dialogue about the lasting impacts of childhood trauma and how adults can rewire their brains to change the often self-destructive behavior patterns that result from said trauma.

Winfrey reveals her most vulnerable side in the book, opening up about childhood physical abuse she suffered at the hands of her grandmother and, later, the sexual abuse inflicted upon her by other family members and friends. But she shows remarkable clarity and insight about her own traumatic experiences — thanks, in part, to following the healing and rebuilding process that Perry outlines in the book.

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

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

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

$27 at Bookshop
Credit: Flatiron Books: An Oprah Book

“Through this lens, we can build a renewed sense of personal self-worth and ultimately recalibrate our responses to circumstances, situations, and relationships,” Winfrey says in the book. “It is, in other words, the key to reshaping our very lives.”

Shondaland sat down with Perry, a senior fellow of the Child Trauma Academy in Houston, to talk about what our society gets wrong about trauma, what today’s parents can do, and how Winfrey has developed “post-traumatic wisdom.”


CHELSEA GREENWOOD: How has this project evolved? You’ve known Oprah for quite a long time, right?

BRUCE PERRY: Yes. It’s over 30 years that Oprah and I have known each other in a couple of different contexts. Originally, it was as somebody who was helping her understand the impact of abuse and neglect in the context of her show. And then, over time, it did evolve into a relationship where I was part of helping her address some of the problems that evolved at her school [the Oprah Winfrey Leadership Academy for Girls in South Africa] and other things.

This specific project actually grew out of an email exchange with Bob Miller, the publisher of Flatiron. After I was on a 60 Minutes segment with Oprah, he wrote an email and said, “Hey, would Bruce consider writing a book for us?” So, Oprah approached me, and I said, “You know, the reason people watched that segment wasn’t because of me. They watched it because of you. So, I’ll write a book if you write it with me.” So, we kind of talked about that, and, obviously, she didn’t feel comfortable with writing a book about all of this science stuff. I said, “Well, let’s just make it a conversation like we always do; we talk about this all the time.”

I went out to her home in Hawaii and spent four days there. We sat down every day and talked for hours, and that was all recorded. And then that transcript was edited, and I added some stories and some science. Then she added some of her stories, and that’s how the book came about.

instagramView full post on Instagram

CG: Could you explain the meaning of the title and its importance?

BP: Yes, the title What Happened to You? actually evolved from a phrase that was originally popularized by a colleague of mine, Sandra Bloom, who was a pioneer in the field of trauma. At one of her team meetings many years ago, somebody on her team was trying to capture the shift in perspective that was taking place because of the new understanding of the impact of trauma on behavior. She said, “Listen. Instead of asking what’s wrong with you when somebody comes in” — which is sort of what happens in a mental-health setting. You sit around and go, “What’s wrong with you?” People say, “I have attention problems and depression and don’t get along with people,” or whatever.

The real question should be: “What happened to you?” What brought you to this point? And it really shifts you from being focused on the problem in the moment to understanding the pathway to the problem — because that’s where the solutions really reside. If you understand how something got to this point, you have a better chance of unraveling it and helping people.

So, that’s really what the shift in perspective was. And it’s interesting. I mean, I’m embarrassed by this, but I’ve been talking to Oprah for 30 years about all of this stuff. And when I finally used that phrase, it was almost as if all the stuff that I had explained to her, she was able to finally connect, and she had this aha moment. For her, that phrase helped her make that connection, and that’s why she wanted the title to be What Happened to You?

CG: What are some of the key takeaways you want readers to remember from the book?

BP: The most important thing I hope people can take away from the book is how important it is that we pay attention to the time we have with other people. That we recognize that — in the way that we listen to somebody, in the way that we want to get to know somebody, in the way that we interact with people, in positive ways or even or in negative ways — that has impact on how they function, how they walk away from that moment.

And this is particularly true with children. Because of the sponge-like quality of their brain, these moments can have a really powerful impact on their developmental trajectory. So, just remember how important you are and how important moments are. And take the time to be truly present with other people. I think I want that to be the main takeaway.

CG: So, in the healing process you discuss in the book — when people are processing their trauma — what would you say is the most challenging part?

BP: One of the most challenging parts is that, for most people, when they revisit any emotional experience, it stirs up emotions. And then, once you get anxious or fearful or upset, that clouds your ability to stay in that moment. And so, that’s the complication: The very act of helping somebody heal involves dysregulation and pain. The key is how to dose that in tiny, little bits so somebody doesn’t get so overwhelmed that they can’t carry on with their everyday work or they can’t even carry on with their interaction with you.

This is a problem that our mental-health field has. We dictate to everybody else when they should talk about these things and how long they should talk about these things. Every Friday at 4, you’re going to come and see me for therapy — as opposed to appreciating that, literally, for most people, dealing with trauma or grief or loss or all kinds of other pain, we only want to stay there for a millisecond, and we want to do it in the presence of somebody who’s going to be patient and understanding.

If you understand how something got to this point, you have a better chance of unraveling it and helping people.

And then we don’t want to talk about it, but we may want to talk about it in four more minutes. But the whole issue of giving people permission to have the control over that painful process is important. And we’ve not been very good at that in the mental-health field.

CG: What are some tips you would offer to someone who has a close loved one, such as a spouse, who’s experiencing difficulties rooted in childhood trauma?

BP: That’s a bit of a challenge because, many times, as a partner, for example, you may see it, and you may see the connection, but your partner may not. And one of the most important things about healing is when there’s what we refer to as insight. When you finally make the connection that Wow, this thing that I do with us, when I sabotage us all the time, that comes from somewhere. And it’s eerily similar to what happened to me or to the way I responded to something in the past. So, I think that’s the hard part.

And that’s one of the reasons, honestly, we wrote this book. We want people to have some way to be aware of these things and help facilitate a whole range of potential healing experiences. It might be that you are able to now talk about this with somebody in your life. It might be that you realize: Wow, maybe I should talk to somebody professionally. It might be that you are motivated to go learn more about it and go read another book. I think everybody has a slightly different journey to this insight, but that’s one of the first steps. If people don’t see it, then there’s really very little you can say that will make them see it.

This is sort of one of the traps that we get into: Frequently, we know something, and we can see something that other people can’t see as clearly. And the irony is just telling them that frequently drives them away. It doesn’t make people go: Oh, I’m so glad that your insight about my behavior is really going to make me change. Most people are pretty defensive about it. They’re like, What the hell do you know about me? But that’s one of the big dilemmas. And this happens all the time, particularly if some of the maladaptive coping mechanisms like drinking or drugs or other things get mixed in there. Then you’ve got so much complexity that it’s hard to unravel unless you have some professional help.

CG: How can today’s parents address childhood trauma in their kids in a way that could help yield a positive overall change?

BP: One of the most important things that both parents and educators and everybody can do is to learn more about this. Just the fundamentals of how our brain works under stress — that will make you a better parent, a better coach, a better teacher. It’ll help you be a better supervisor at work. So, becoming more science literate about the brain and the stress response will literally give you this foundation to then understand trauma. That’s why a lot of what we put into this book is framed around the way everybody responds — not just focusing on the effects of trauma. I think that’s a really important thing.

CG: It seems like Oprah’s now doing some of the most important work of her career, increasingly focusing on mental health, including The Me You Can’t See docuseries with Prince Harry. What are your thoughts on that?

BP: I think you’re right. She said a couple of times that this is the most important work that she’s ever done. I think she’s going to continue to try to improve the public’s broad understanding about mental-health issues and trauma. And I think she recognizes that this is a way in which she can be part of making the world a lot different and a lot better.


Chelsea Greenwood is an award-winning lifestyle writer and editor whose work has been featured in InStyle, Teen Vogue, SELF, Racked, Vulture, Brit + Co, SheKnows and Vice. Follow her on Twitter @cpgreenwood.

Get Shondaland directly in your inbox: SUBSCRIBE TODAY