We (the treatment team for Sanctuary) were in a team meeting sometime around 1991 on our inpatient unit, trying to describe the change that had happened to us in recognizing and responding to the issue of trauma, especially what has become known now as childhood adversity - as a causal issue for the problems of most of the people we were treating and Joe Foderaro, LCSW, always good at pithy observations, said "it's that we have changed our fundamental question from "what's wrong with you" to "what happened to you" and we all thought it exactly captured our experience.
I think I first wrote it down in a chapter published in 1994 that was the first time I tried to articulate the enormous change that had happened to us. That citation is page 476 of Bloom, S. L. (1994). The Sanctuary Model: Developing Generic Inpatient Programs for the Treatment of Psychological Trauma. Handbook of Post-Traumatic Therapy, A Practical Guide to Intervention, Treatment, and Research. M. B. Williams and J. F. Sommer, Greenwood Publishing: 474-491.
From Ann Jennings, PhD, executive director of The Anna Institute:
I believe the source for this now widely used way of describing the paradigm shift that needs to happen in the mental health and other fields – is one of Dr. Sandy Bloom’s colleagues – Joe Foderaro. He said this around 30 years ago!
In Dr. Bloom’s book “Creating Sanctuary: Toward An Evolution Of Sane Societies” published in 1997, this is referred to on page 191 as follows: “Our program director (Joe Federaro) said it best when he observed that we (the Sanctuary program) had stopped asking the fundamental question “What’s wrong with you?’ and changed it to “What has happened to you?” (Foderaro, 1989).
In a recent keynote recorded March 2014 at the 2014 Jefferson Population Health Colloquium entitled “The Heart of Trauma Theory: Sickness vs Injury Model: Changing the Fundamental Question From “What’s Wrong with You” to “What Happened to You” - Dr. Bloom talked of being in a team meeting of a psych unit in 1985 when one of her colleagues said, “you know, we really need to change our fundamental question from what’s wrong with you – to what happened to you” and then spoke of how understanding what happened changed the way they thought, which changed everything. Link to her talk is https://www.youtube.com/watch?v=X9zEb1YCprg – its worth listening to!
In the attached article by Bloom dated 1995, in reference #14 to (on page 9) “we really need to change our fundamental question from what’s wrong with you – to what happened to you”, she says “Thanks to Joseph Foderaro for this succinct way of explaining a profound interactional shift”.