Even though I’m not living in the US, I have been a fan of Oprah for years (especially when there was a false rumor that she was running for presidency). During the earlier time of my Adjustment Disorder, I ran into this book What Happened to You at Kinokuniya. I was drawn to it because of Oprah and the title. However, as I researched on the book a bit more, I was not so sure that I wanted to read the book because the main focus was on childhood trauma – and I’m certainly not a child (in a childish tone). I eventually bought it anyway because I wanted to read a book by Oprah more than anything else.
To my surprise, while the book revolves around the childhood trauma, it touches a lot on PTSD as well. I found the discussion eye-opening in many ways – especially the discussion around the definition of trauma and how PTSD surfaces.
The broadly defined
The book defined trauma very broadly as any moment that you are severely dysregulated and not able to address the dysregulation / regulate yourself back. A child relies on adult or caretaker to regulate him or her. When the child is de-regulated and no one address that, he or she will experience trauma. Another situation is when the caretaker is the one dysregulating the child him/herself. This includes hitting or punishing, which are very prevalent in Thailand, at least when I was young. I wonder how many children in Thailand are traumatized and have PTSD because of this?
The core theme of the book is the symptoms of PTSD that resulted from childhood traumas. Whereas a war veteran may get jumpy at explosive sounds – a more explainable responses to bomb-like sounds, a PTSD patient with childhood trauma may react to completely random cues such as a scent of perfume, a locked door, darkness, or random environmental cues.
The randomness results from the fact the cortex, which processes time and logics, is the last part of the brain to be developed. The trauma at the early part of childhood result in the association of sensory inputs, excluding time and logical story, to pain and fear. As such, random sensory inputs at the time of trauma are associated with pain. Even when the child grew up, the exposure to those environmental triggers will result in aggression and fear because the brain disregard timeline and logics.
The new world
Upon discovering these nature of trauma, Dr Perry, the co-author of this book, developed a new school of treatment for trauma. This school of treatment is very similar to multi-disciplinary approach in physical medical treatment. The only difference is that this is focusing on first addressing the trauma and the related cues. Only when the patient is stabilized, other forms of psychotherapy may follow.
My only question is, even in the US, this form of treatment is still not very popular. What is happening in the rest of the world? As the book outlined the potential problems caused by ignorance of the psychologist to the trauma, which is the root causes, how many children and patients are and will be harmed by the ignorance?
The furthering gap
Oprah talks about how she feels bad for single parents, who will have to regulate the child while juggling many other things at the same time. The single-parent set up is described almost as “setting up for failure”. This got me to really think back on developing countries, where people will have to work and care for children at the same time. How could the parents take care of the children while working hard at the same time? This is yet another aspect of the effect of income inequality. The rich will continue to have mentally healthy children while the poor will continue to face with struggling children.
One part I really love and appreciate is the ending of the book. Oprah said:
Because what I know for sure is that everything that has happened to you was also happening for you. And all that time, in all those moments, you were building strength. Strength times strength time strength equal power. What happened to you can be your power
While the beginning and the journey through the book is quite gloomy as it talks mostly about the problems of trauma, the parting thoughts by Oprah is very empowering. The post-trauma wisdom is real, and I have experienced that myself.