What Happened To You? A Book Review

A book review by Darcia Narvaez, PhD, and Mary Tarsha. How the new book What Happened To You? reflects the science of our Evolved Nest.

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Dr. Darcia: Welcome to Evolved Nest.org book reviews! My name Dr. Darcia Narvaez and I’m here with Mary Tarsha. We are both at the University of Notre Dame’s Department of Psychology and the Kroc Institute for International Peace Studies.

In these book review podcasts, we discuss books aimed at parents and how they align or not with humanity’s evolved nest and with child-thriving. First, a quick review of the evolved nest. 

Humans evolved to be nested. Humanity’s nest for young children helps optimize children’s development, fostering thriving, flourishing and resilience capacities in children of all ages.  The evolved nest includes soothing gestation and birth, on-request extensive breastfeeding and positive moving touch (no negative touch), a welcoming social climate, self-directed play with multiple aged mates, warmly responsive nurturing from mother and others, Nature immersion and connection, and healing practices to repair miscommunication, hurts rebalance.

Child-thriving includes Physical health; Happiness and wellbeing, Self-acceptance and self-confidence; Self control; Emotional Intelligence; Sociality & social skills; Empathy; Perspective taking; Kindness; Active curiosity; and cooperative community participation.

The book that we are discussing today is called, What Happened to You: Conversations on Trauma, Resilience and Healing, which was written by Bruce Perry and Oprah Winfrey.

Mary: Let’s start by saying why we chose this book. We’re interested in this book because Bruce Perry is really a leader in the field, and has been for several decades, not only on child development, but also in trauma. He has been leading the field and helping us become more aware of the impact of experiences, positive and negative, and their impact in early life. He talks about that throughout the book, and about how timing is so important. He’s a specialist in the brain and so he’s always thinking about how life is influencing our brain and shaping our brain. He does an excellent job of describing that, as we’ll talk about, how the brain is very plastic and influenced by experiences. It helps us understand behavior and why people are the way they are. 

The title of the book, “what happened to you” is a shift from “what’s wrong with you.” And then, of course, Oprah Winfrey is very famous and has done tremendous work in interviewing people from all over the world. And together they have teamed up and written the book as a conversation back and forth between the two of them. Oprah provides stories from her own life, sharing how she has experienced numerous traumas and hardships and difficulties throughout her life from an early age. And she shares very vulnerably how those experiences have impacted her throughout her life. But the book is written in such a hopeful way because she’s such a tremendous person that has helped so many across the world and is such a success story in many ways. Those were some of the reasons why we chose the book.

D: Yes, the book provides some excellent insights into the brain effects of trauma, and promotes trauma-informed practice and how you deal with people who have been traumatized. There are several main points that can assist everybody.

First: to understand that developmental trauma is widespread now in, especially United States, the stresses on mothers and families undermine developmentally appropriate responsive care for care for babies young children and children in general children in general.

Visit the Evolved Nest Self-Directed Learning Center to learn more about the nine components of our evolved nest.

Too often, adults don’t understand how a child’s acting out is actually trauma-related, and instead they use force, such as restraint, isolation, punishment, that further traumatizes the child.

Developmentally appropriate care builds the brain’s capacities from the bottom up. Now in healthy family life, you would learn as a child to self-regulate and to relate cooperatively with others, and then use reason to guide behavior. But it happens in this kind of staged way, one after the other. You can’t start with a reason, and try to regulate a child who’s unregulated. You have to help them get back to regulation first.

D: These are all things that the book is pointing out across many stories and case studies of how Bruce Perry really has dealt with individuals who are in trouble in various ways. He uses the three R’s as the key to healing: regulation, relation, and reason.

And too often then, as I was saying, the adults start with reason, instead of realizing the child needs help with regulation first, because that’s part of the older parts of the brain that has to be established first.

M: And he makes these points, by putting in very simple terms decades of research, both empirically neuroscientific information, as well as psychological research and incorporating case studies—individuals that he’s worked with personally. These are great takeaways, but there’s also a great depth of evidence behind all of these. 

D: Yes, and it’s really a pleasurable book, well, apart from the topic itself. It’s a book that’s easy to read in terms of its writing style, in terms of the stories that are given. It is heart-wrenching to read about some of the stories., but it’s something that I think everybody can benefit from reading.

M:  What are some of the other takeaways?

D:  When there’s developmentally inappropriate experience, the child is often stuck at an earlier stage of development, because experiences were not appropriate to help them move along.

And so troubled children then become stuck in that early babyhood stage almost, unable to self-regulate. That impairs the development of relationships and reasoning, which are the other two Rs. When a person is unable to self-regulate, that’s a signal that there’s trauma that has been experienced, or some developmentally inappropriate experiences that occurred during sensitive periods when the brain was developing those systems that were related to that kind of regulation.

M:  In terms of self-regulate, maybe we need to define what that means, because it’s more of a technical word. Self-regulation is calming down, but also with an intentionality so you’re able to do that which you would like to do. You’re in a place of homeostasis of calmness, and at the same time, you’re able to use these other skills such as thinking and reasoning and relating to others. When you’re in that place you’re going to play some self-regulation.

D: Self-regulation is complicated. It involves multiple systems such as the vagus nerve, which we talk about regularly, the neuroendocrine system—e.g., the oxytocin system, the stress response, the habits you develop, the immune system. All these things have to be trained up, in effect, in early life to work well. And so developmentally inappropriate care is not going to help them develop well.

So, when a developmental trauma occurs it often snowballs across generations. Therapy to heal a troubled child really should involve the parents because the parents have been the context usually for why that child is dysregulated. And as we note in other books we review, the parent can be dysregulated and then create a dysregulated child so it’s really important to bring in the whole family, in effect, and that’s what Perry recommends.

M: And just a note about trauma, they do a great job discussing what is trauma. It’s a word that’s used in the vernacular and thrown around a lot. They spend some time discussing that. Dr. Perry talks about how trauma is an event, and based upon the experience of the event and the effects of the event; these three E’s determine if this is really a trauma, traumatic event or not.

They talk about the transmission of trauma across generations and they lay that out in a very nice figure of how this can take place prenatally or the transgenerational effect. But what also I think is valuable is they talk about these big cataclysmic events such as war, or some violation of the person in some very profound way, or even a natural disaster or something like that, but they also emphasize other experiences that are simply lacking emotional connection or something that is persistent is also traumatizing. I really liked that there is a lot of nuance within the book for what trauma means to each person.

D: I like this quote ‘relational glue keeps our species alive. And love is a relational super glue.’

We’re always looking for love, right? Especially if we didn’t get it when we were young, but when we do get it when we’re young – a loving context and the Evolved Nest that we feel safe, that we feel that the world is predictable and caring – it develops our worldview, how we address relationships and how we move through our life.

M: This unaddressed trauma can move through and across family generations. They talked about how we need to have this trauma-informed approach, and so that leads to the title of the book. So “what happened to you?” rather than “what’s wrong with you?”

D: Dr. Perry says a lesson for him was that we need to recognize a key aspect of trauma, the “What happened to you?” is also “What didn’t happen for you?” What attention, nurturing touch, reassurance, basically, what love didn’t you get? And that’s neglect. Neglect is as toxic as trauma. This is nest-related, because the nest is all about attention, nurturing touch, reassurance, and that loving nest of care. Did you receive the Evolved Nest?

M: So maybe we should go through the nest and see how the book supports or not different parts of components of the nest. So starting with perinatal experiences. They do point out the transmission of adversity, so there is a little bit of it, but in terms of how to support soothing perinatal. There’s not much there, but they do talk about how traumatic events during gestation or even before, can impact later generations. And breastfeeding?

D: Nothing there. Positive moving touch?

M: Yeah, so they do talk about the importance of moving, moving and rhythm and Perry emphasizes the neurobiology behind it and how powerful that is, and Oprah even talks about ways that she helps regulate herself by going in nature and going for walks and dancing, and just the rhythm behind different motions that really helped her have a positive climate.

D: How about positive climate?

M:  They talk about this throughout the entire book. They really emphasize the emotional tone—they use that word instead of climate, but they talked about the emotional tone throughout the book, in schools and communities in the home, and Oprah emphasizes this actually over and over again and then Perry helps explain how this gets picked up even from our earliest years. I do like how he talks about how infants are constantly sensing the emotional tone or the climate that they’re immersed in. He explains how these memories or these experiences shape our brain and so even if they’re not memories that we can comfortably pull out and point to it is more of an emotional experience that becomes deeply embedded within our brain and within ways that drive us to behave or react to certain things. And what about play?

D: They do mention it a little bit here and there. 

M: Yes, there’s some, there’s some mentioning of play and really connecting with others.

D: Yeah, I think it sort of goes with the touch and the rhythm and rocking and dancing, things that help you get reregulated. And how about allomothers?

M: I don’t think there’s much emphasis on alloparenting. They do talk about social connection and social support. But in terms of the specifics of alloparenting, there’s not so much in there. There are a few case studies that Perry points to of mothers who they themselves had been in foster care and then become mothers themselves. They benefit from a really caring nurturer, a mother figure in their life, who they never had. So there’s a couple of stories like that. We see that throughout the whole book, it’s really about how to provide warm responsive and nurturing parenting. And nature connection?

D: There’s only a few statements: to regulate take a walk, go outside.

M:  And what about healing practices? They emphasize regulate, relate and then reason, so that is their emphasis throughout the book. That is their way of helping to bring about healing. 

I think Perry also emphasizes a lot, the why—why parents do the things that they do. He sees it from a neural biological perspective that really helps parents understand the reasons why they’re doing certain things—because of the way their own brain has been shaped from their own experiences. By acknowledging that, there is a lot of power and freedom to then parent in different ways. That leads to the emphasis on the plasticity within the brain, that he emphasizes a lot, and how the brain changes in a use-dependent way, which I really loved that part of the book. He talks about just like an athlete needs to practice over and over again. Right. That is a great emphasis example of how the brain when you use it, the more and more you use it the more and more changes. So it’s through practice, over and over, that we can change behavior. And, you know, we have to do this in very specific ways if we want to change specific behaviors. He talks about that and connects it beautifully with what you can do if there has been a traumatic experience, or how you can help children who have had traumatic experiences and bring healing.

D: Yes, a number of case studies where he shows how he builds a relationship with the child. Over time, and generally takes at least twelve contacts with the person to build trust. So that’s why usually for therapy, it takes at least ten times of going to therapy sessions with the therapist to feel trust, so you can actually open up. But he has one case study where he had a young child he’s trying to connect to. And what he did was he would see them for five minutes, and then leave for a while and then come back for five minutes, and then made his 12 visits, very short, brief times with that child, and then over time the child then was able to trust him. And he points out—this is the nice quote I like: “in order to communicate rationally and successfully with anyone, you have to make sure they’re regulated.” And so he would make sure that for this child the mother was there, and they weren’t doing anything threatening, coloring next to him or whatever. Finally, the child started to feel safe enough to build the relationship and actually talked to him. And then you, then he could have the reasoning. Then they could have actual conversation about what had happened.

M: Yeah, so that is a big emphasis throughout the book. Both Perry and Oprah emphasize over and over the importance of connectedness and relationship. You know, that is one of the requirements when we review different books. Are they heart centered? Are they parenting from a heart centered approach? And I think both of us say absolutely. In this book they are parenting from a heart-centered, relational way and teach us how we can do that better by not trying to reason with the child, not trying to get them to change behavior before understanding if they are regulated or not. I think that’s a very important point.

D: Another quote from Perry: “Your connectedness to other people is so key to buffering any current stressor—and to healing from past trauma. Being with people who are present, supportive and nurturing. Belonging. That’s the key to current stress reduction and healing from trauma.”

M: Absolutely. And another quote that he gives: “Given love, the unloved can become loving.” The book is really about how we can understand those who have experienced trauma or understand ourselves if we’ve experienced trauma. ways that we can then practice love to others to help them experience love and be loving.

D: We loved it. Two thumbs up. 

M: Speaking of love. Yes, we loved it. Two thumbs up. It’s highly recommended.

D: Thanks everybody.

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