Thursday, December 19, 2019

Why "What Happened to You?" Isn't Trauma-informed

I just finished up my first run of my Trauma-Informed Care: An Introduction for Libraries course.

I hope to run it again next year, but something came up that I felt I should clear up.

There are a lot of different training opportunities lately coming at trauma in the library at different angles.

Quite a few of them start attempting to shift thinking about trauma with the notion that trauma-informed care "seeks to shift the clinical perspective from 'what’s wrong with you' to 'what happened to you'". I can't pinpoint the origin of this quote, but it's been used by such respected organizations as SAMHSA.

This phrase, quite deliberately, does not appear in any of my training materials. That's because I don't believe it's true.

title text in black on a blue and green background

At its most basic, I can understand what this is trying to do: make people who have not experienced trauma that has reshaped their brains start to blame circumstance rather than the people themselves when they have a frustrating interaction. Apparently, wondering what happened to someone is supposed to build empathy so we can act more compassionately.

I humbly submit that thinking this way can have the opposite impact, and instead can inspire pity and possibly resentment. I also contend that asking this question isn't trauma-informed, and is potentially harmful. It also assumes that library staff do not have backgrounds in trauma, which is not universally true.

To demonstrate how this framing might be problematic: here's how a person whose brain has been rewired to expect stress might answer these questions, speaking from experience:

What is wrong with you?
"I'm frustrated", "I'm confused", "I'm pissed" or similar.

What happened to you?
Too much or too little for the shape I'm in, depending on the day.
But to be honest? It's none of your damn business.

Now, I completely understand that these questions aren't supposed to be asked directly to the other person-- though, I'm unsure how much some trainings make that clear.

First of all, framing trauma-informed care through the lens of  "what happened to you?" plays into the lies the abled narrative tells us. Basically, it can frame neurodivergent people, like those with PTSD and other brain-related disabilities, as curious objects, "abnormal" medical oddities. It plays into that lie that people with disabilities need to be prepared to educate at all times and put their past traumatic experiences on front street in order to be believed.

Now: I GET IT, AGAIN, that these questions aren't intended to be asked of people, and are intended to inspire empathy; however, I assert that it can inspire pity, regardless. "Putting yourself in another person's shoes" when it comes to disability doesn't work to cultivate empathy; but it CAN cultivate fear, discomfort, and doubt.  That's what the research says.

I also KIND OF feel like framing trauma-informed care in this way works in opposition to a core foundational aspect of trauma-informed care, at least as I understand it: We cannot know who we encounter every day has experienced trauma. Trauma can affect anyone; and done right, trauma-informed care helps everyone.

So what can we ask instead?
I propose that Trauma-Informed Care, instead, compels us to ask:
"How can we succeed, together?"
It could look something like this:
-What do you have in place, in your environment and in interactions, that can keep a stress response from being activated?
-What supports are in place for staff and patrons who have backgrounds in trauma?
-What does a successful [interaction, recruitment/retention, display, environment, program, partnership] look like, and how can a trauma-informed approach help us get there?

I get that the question "what happened to you?" attempts to add the context of trauma; but I propose that "how can we succeed together?" can help us be mindful of all aspects that could influence an interaction/event (power/perceived power, "flipped lids", historical trauma, institutional oppression, bias, etc) in the context of the reality that we're currently experiencing.

As they say at Trauma-Informed Oregon: Every interaction has the opportunity to be retraumatizing or healing; we may as well try to be healing!


  1. I'm so sad your class didn't end up on my radar in time to sign up! Are you going to be teaching it again?

  2. Hi there. It looks like I might be teaching it again in Fall 2020. Stay tuned!

  3. This is a good read about trauma-informed care. "How can we succeed, together?" This question is so much better to ask, it promote a culture of safety, empowerment, and healing to those who experience trauma.

  4. Thank you for sharing this link today. I really appreciate your thoughts here and have some thinking to do. Thanks for the inspriation!

  5. I think you have totally misunderstood what those statements mean. People with Trauma (i speak from experience) often feel there is something deeply defective about themselves. It's a question I used to ask myself all the time "what's wrong with you" in addition to saying that I hated myself. When you hear it's not what's wrong with you but what happened to you to cause the way one behaves...its a game changer. It eases the self hatred and helps someone with trauma realize that they are not broken. These are statements that someone applies to themselves...not something you ask someone who has trauma. The fact that you completely misconstrued the meaning of the statements concerns me. You probably are not qualified to treat people with trauma.

    1. Hi!You're right, I'm not qualified to treat people with trauma. I'm a librarian with a brain rewired to expect stress, trying to make libraries more trauma-informed places. I understand what you're saying in this question can helpful *for the survivor* if they are able to process their trauma in a safe way. My criticism of the phrased is its use in training non-health-providers to work with people who have lived through trauma. Thanks for your comment.