Skip to main content

“What Happened to You?” by Bruce Perry and Oprah Winfrey: a book that resonates with us in the PACEs world


What do PACEs Connection and “What Happened to You?”, the new book by Oprah Winfrey and Bruce Perry, have in common?

Almost everything. That’s my conclusion after I finished listening to the book on Audible and re-reading parts of it on Kindle.

In the book, Winfrey, a wScreen Shot 2021-06-08 at 12.22.24 PMorld-class connector, journalist, entertainer, author, thought leader, actor, and philanthropist, teams up with her longtime friend Perry, a child psychiatrist, neuroscientist and principal of the neurosequential model of brain-based therapy. They engage in a series of conversations about trauma, resilience, the power of relationships and community, healing, what they call post-traumatic wisdom, and  what we need now.

With warmth and their easy familiarity with each other, they take us through an education about trauma that I believe the world is hungry for, explaining the science of adverse childhood experiences (ACEs) and why and how traumas have affected us. Perry does a masterful job of explaining that how we are loved as infants and children is likely to determine how we are able to loveor not love as adults, with Winfrey giving pointed and moving examples. They truly ring almost all of the bells we at PACEs Connection hope to ring in our vision to create a world where all people thrive, and in our mission to prevent and heal trauma, and help individuals, families and communities create and build on the positive experiences that lead to strength and resilience.

Winfrey stuns us over and over with personal accounts of intensely painful personal traumas, and leaves us, throughout the book and especially at the powerful ending, with the hope that our traumas can help us become wise and powerful.

I honestly believed we would see a book or a series of O Network specials from Perry and Winfrey three years ago, not long after the “60 Minutes” interview when she and Perry talked about adverse childhood experiences and trauma-informed approaches. In previewing the interview, Winfrey told long-time friend and fellow journalist Gayle King of CBS that learning about ACEs Science and trauma-informed care “changes everything,” and that she’d “dance on tabletops” if that’s what it took to get people to pay attention to it.

Whatever moved them to share this life-changing work, this is my truth about it: “What Happened to You?” is a book that humanity desperately needs to help us remember, and understand, deep in our bones and DNA, that we are wired for connection and empathy, despite the economic and technological forces that can sometimes make them seem so far out of reach. It is a book I love and want to share widely, especially with parents, policymakers, educators, faith leaders, coaches, law enforcement, the medical community—actually, anyone and everyone—even young students, as I believe our knowing this information early on in life could help prevent many traumas to self and others.

Perhaps I am projecting as I listen to Perry talk about the unrealistic expectations with which society has burdened single mothers. Or I am connecting dots that aren’t there when I think that perhaps Perry and Winfrey could normalize the belief—even among the most hardened anti-welfare politicians—that reducing the overwhelm and stress of poverty, oppression, and multi-generational addiction and abuse is the right thing to do, because withholding support damages the brains of our nation’s children.

What do we, as a nation, love? What collectively inspires consensus?

I believe it is love for our children, and this book will help us remember that. It explains the importance of giving our children the best start possible—especially in the first two months of life—and could help spark healing relationships.


In "What Happened to You?" the two long-time friends advocate for nurturing brain development, and for the mental health, trauma education, and well being of their fellow Americans, the world. I believe that what they advocate for—community, acceptance, and a common understanding of the need to prevent trauma, promote regulation, relationships and reasoning—is vital to restoring and saving our collective humanity. They want us to ask, "What happened to you?" instead of "What's wrong with you?" because asking the second question can traumatize already traumatized people with the implication that there is something bad or wrong with them, as opposed to there being something bad or wrong that happened to them.

That Perry and Winfrey are a powerful team is indisputable. When she focuses her attention on something, change happens. I believe her decades of work as a trusted Black journalist, daily coming into the homes of all kinds of people with intimate, often hard-to-hear stories of childhood abuse and uplifting stories of people who’ve overcome obstacles, helped set the stage for Barack Obama’s presidency, the Me Too Movement, and some Americans being more willing to have some difficult conversations.

But even as brilliant and straightforward as Perry and Winfrey are, it likely took a lot of work to make the book as approachable as it is. Its conversational style belies the volumes of information many readers are likely to absorb.

Help for even the most broken children

It is fascinating to hear Perry share, with the utmost respect, stories of people who’ve endured unimaginable trauma. He discusses his calm, easy way of relating with children by getting on the floor to color with them, by having very brief but frequent connections, by building trust, by observing and asking just the right slightly probing question at just the right moment. It’s clear that he knows exactly what amount and weight a relationship can take and when. With the help of Perry and his team, children who would seem too broken to mend are brought back to functioning by patiently following his brilliant neurosequential model of therapy.


Equally compelling, Winfrey reveals vulnerabilities that are searingly sad. Because I listened to the book, her velvety, deep voice was so warm and rich it cannot leave my mind. It  haunts me as I recall revelations that were so painful, I needed to pull my car off the road or stop walking and sit down to catch my breath.

Among her most personal revelations were her grandmother’s intense beatings and her mother’s ongoing abandonment. She recalled standing with her mother at the age of six and feeling crushed by her mother’s agreement with her landlady to let “that dark-skinned-nappy-headed child” sleep outside on the porch on Winfrey’s first night in Milwaukee. That Winfrey knows the truth then—that she is absolutely alone—evokes feelings of empathy, anger, grief, fear.

Winfrey later reveals how she learned she’d never truly been “tucked into bed”. It was during the making of a movie when the director asked her to tuck a child into bed, and she realized she didn’t know that tucking in also means sharing affection instead of just arranging blankets, because no one ever tucked her in at night. I again had to stop the car to handle the shock and grief I felt for her.

In the final chapter of the book, Winfrey’s honesty, humility, and compassion are breathtaking and gave me chills, repeatedly, as she shared how she and her mother finally connected prior to her mother’s death. Have some tissues ready and know you are likely to be a stronger, better human for the privilege of hearing this account.

Hearing their easy conversation as Perry and Winfrey talk back and forth about the importance of community, relationships, regulation and education buffers the pain of the stories they share. They definitely found a rhythm in sharing concepts, examples, solutions.

944045D8-B6CF-44C2-95FA-634B44FE03E2Hearing Perry explain, through vivid and moving examples, how the body reacts to trauma, will hopefully open people up to be more compassionate about children who are dysregulated, people who are dysregulated, themselves  when they are dysregulated.

Perry’s stories illustrate beautifully how we are wired for love—or not—and that how we are wired is projected onto the world. That he has figured out ways to help people heal, and that this takes years of healing work, is hopeful, daunting, and instructive. Don’t write off children who’ve suffered abuse.

A constant source of reassurance for me is that Oprah survives the abuse she shares, and that we know she’s oftentimes enjoying life after having done such a heroic and remarkable job of overcoming, thriving, and helping others.

First two months of life are critical

Which leads me to a couple of many profound moments in the book. First, about developmental trauma and the importance of the first two months of life, of mothers and babies developing a secure attachment.

Perry writes, “The basic finding is that the experiences of the first two months of life have a disproportionately important impact on your long-term health and development. This has to do with the remarkably rapid growth of the brain early in life, and the organization of those all-important core regulatory networks.

“If, in the first two months of life, a child experienced high adversity with minimal relational buffering but was then put into a healthier environment for the next twelve years, their outcomes were worse than the outcomes of children who had low adversity and healthy relational connection in the first two months but then spent the next twelve years with high adversity.

“Think of that: The child who has only two months of really bad experiences does worse than the child with almost twelve years of bad experiences, all because of the timing of the experiences.

“This sounds discouraging. But we believe that poor outcomes are not inevitable; in fact, we believe that this is a perfect example of why we need developmentally informed, trauma-aware systems.”

Perry invites readers to think back to conversations about how important attentive, responsive caregiving is in providing the organizing experiences for the infant’s stress-response systems.

“Remember that if the life experiences of the first two months include inconsistent or unpredictable stress, this pattern of activation creates a sensitized stress response. That leads to a cascade of problems—trauma related problems. And even when these children are no longer in high-risk settings, their problems have to be addressed by caregivers, pediatricians, mental health providers, and educators. But if these people misunderstand what’s going on, if these systems focus on “What is wrong with you?”—as unfortunately, they typically dothe children won’t get better. They will continue to struggle. Their emotional reactivity and behavior problems will be viewed without a developmental or trauma lens, which could lead to ineffective interventions.”

Racism and trauma


Another big aha is Perry’s take on racism and trauma. He says: "I believe that if you don't recognize the built-in biases in yourself and the structural biases in your systems—biases regarding race, gender, sexual orientation—you can't truly be trauma-informed. Marginalized peoples—excluded, minimized, shamed—are traumatized peoples, because as we've discussed, humans are fundamentally relational creatures. To be excluded or dehumanized in an organization, community, or society you are part of results in prolonged uncontrollable stress that is sensitizing. Marginalization is a fundamental trauma.

“This is why I believe that a truly trauma-informed system is an anti-racist system. The destructive effects of racial marginalizing are pervasive and severe. In North America, Australia, and New Zealand, for instance, Black, brown, and Indigenous children are more likely to be over diagnosed and overmedicated in mental health systems, removed from their homes to enter the child welfare system, suspended or expelled from school, and charged at school with truancy and 'assault,' with the result that they enter the juvenile-justice system in disproportionate ways."

If people could learn this and take to heart that each “micro-aggression” is actually damaging the brains of their co-workers, children in classrooms, grocery stores, buses, street corners, shops, schools—anywhere and everywhere that children, people of color are treated as less-than in even the slightest way—perhaps we would stop this invisible, persistent torture that is costing all of society by preventing children from reaching their full potential.

All this is why I think Winfrey and Perry would so connect with the work done at PACEs Connection to build community, to educate about trauma, to track the work being done, to engage people in sharing the science of positive and childhood experiences, and to celebrate that work. I believe they would help share the new science of positive childhood experiences—how important it is for children to experience and enjoy community traditions, feel supported at home and at school, have supportive friends and have at least two non-parent adults who genuinely care about them. Winfrey is living proof of the impact teachers can have in lifting a child up and helping them believe in themselves when no one else does. She readily credits a specific grammar school teacher for seeing something special in her, for nurturing her love of learning, and inspiring confidence when no one else did.

I urge you to borrow or buy and read this book, and if you are a member of one of the 400+ geographic or interest-based communities on PACEs Connection, entreat your community members to have a book group about “What Happened to You?”, post about it, and email the link to me at

And  for more, listen to Oprah’s recent interview with Bruce Perry.


Images (6)
  • Screen Shot 2021-06-08 at 12.22.24 PM
  • 99E9EED4-E2EB-47B1-A97A-2AC2EF832875: Figure 2
  • 12940CB2-E09E-45AF-98B2-F0428529D39B: Figure 3
  • 944045D8-B6CF-44C2-95FA-634B44FE03E2: Figure 8
  • A520C45A-14DD-43C7-92A3-EE91C1679AC1: Figure 5
  • Screen Shot 2021-06-07 at 1.39.39 PM: Oprah Winfrey photo by Chris Craymer; Bruce Perry photo by Jimmy Greene

Add Comment

Copyright © 2023, PACEsConnection. All rights reserved.
Link copied to your clipboard.