What Happened to Him?
Why We Get Trauma and Care So Wrong
A 19-year-old patient I’ll call Jamie is being treated for depression and substance use. From the outside, he's easy to dismiss. He misses appointments. He doesn't follow advice. Some days, he barely looks up.
People might say he's irresponsible. He's not trying hard enough.
That story is not just wrong — it's harmful.
Jamie grew up in a world where nothing felt stable. People left. Promises were broken. Some days there wasn't enough food, and most days there wasn't enough emotional support.
Those experiences shaped how his adult brain and body respond to the world. He is wired for survival — fight, flight, or freeze. What looks like withdrawal or anger is often survival. This is what trauma does.
But our systems still operate as if people like Jamie are the problem. Healthcare labels him "non-compliant." Schools label kids like him "disruptive." Public policy too often treats him as disposable. We punish what we don't understand.
Trauma is not rare — it is common, and often invisible. It can include abuse, neglect, violence, and chronic stress, and its effects can last a lifetime. In some cultures, it is taboo to even discuss it.
Without trust, walking into a clinic can feel like a threat.
Martene Geary Souza is a trauma survivor and expert on trauma-informed care.
"I can look back, and I was going to the doctor and reporting things that should be a red flag,” she says. “For example, I had recurrent vaginal infections as a child as a result of some of the abuse that I was suffering. This was extremely recurrent. I remember going into the doctors every few months, just complaining about these, and nobody ever thought to ask, 'Why is this seven or eight-year-old having this?’”
Trauma-informed care starts with a simple but radical shift: instead of asking, "What's wrong with you?" we ask, "What happened to you?"
"A good trauma-informed doctor is one who displays a lot of curiosity and asks you questions — it feels like they really do want to listen and get to know you,” says Souza.
So when Jamie misses an appointment, the question is not "Why doesn't he care?" The real question is: what barriers — biological, emotional, and social — are we refusing to see?
Too often, our response is stricter rules, more penalties, and less patience. That doesn't fix the problem. It deepens it.
Trauma-informed care offers a different path. It means creating safety instead of fear. Building trust instead of demanding compliance. Offering choice instead of control. Responding with curiosity instead of judgment.
When Jamie feels respected, he shows up. When he is given a voice, he participates. When he is not shamed, he begins to change.
We can continue to blame people. Or we can change how we respond. Because behind every behavior is a story — and whether that story leads to more harm or to healing depends on how we choose to treat one another.
— Dr. Michael Wilkes with a Second Opinion
Further Reading:
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