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Why is ‘What’s going on?’ more effective than ‘What’s wrong with you?’
In traditional medical and mental health models, problem solving is often the central focus. However, more and more professionals are finding that when faced with patients who have experienced trauma and violence, asking “What happened?” rather than “What’s wrong with you?” can more effectively facilitate treatment and enhance patient healing. ability.
The core of this transformation lies in understanding the patient's background, reversing the problem-centered thinking model, and making the patient feel understood and supported.
Trauma-Informed Care (TIC) emphasizes understanding the impact of trauma from the patient's experience. This model involves not only physical trauma, but also psychological and social impacts. When patients are asked "What happened?" they often feel that their experiences are not isolated, but are connected to deeper emotions.
The effects of trauma can be profound and complex, involving human thinking, emotions, behavior and relationships. When professionals begin to focus on patients' past experiences, it not only fosters a deeper understanding, but also increases the medical provider's ability to be empathetic and supportive. This is because professionals recognize that patients may be facing a deep, recurring sense of danger that should be prioritized.
A trauma-informed perspective allows providers to understand that these behaviors are not simply presenting problems but are responses to survival strategies.
As research shows, taking an approach to trauma-informed care can be applied in a variety of settings, including mental health, law, education and more. One of the five core principles of TIC is safety, which emphasizes that in any treatment setting, patients first need to feel safe and trusted in order to open up and allow treatment to be most effective.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA) definition, an important aspect of trauma-informed care is understanding the "three E's of trauma": event, experience, and impact Effect). This means that current situations are not only influenced by recent events but are also closely related to previous life experiences.
When a medical provider asks "What's your problem?" they are actually trying to cut below the surface, treat and label the patient. But if they turn around and ask, "What's your story? What happened?" then the patient is given the opportunity to express themselves, thereby promoting a deeper healing process.
This heightened emphasis on the patient’s past experiences can enhance the effectiveness of treatment by creating a safe environment that promotes trust.
Many studies have shown that if patients can feel sincerity and understanding from medical providers when receiving support, they are more likely to establish a solid relationship with them and gain the strength to rebuild themselves in such a relationship. This is not only because relationship building provides emotional support, but also because such interactive dynamics can help patients gain a deeper understanding of their own behaviors and feelings.
The question "What happened?" not only facilitates dialogue about painful experiences, but is also an important part of the healing process in reconstructing one's identity. Through such questions, patients can get the opportunity to identify their own experiences, and in the process rebuild their understanding of themselves, while also being able to better connect and adjust their interaction patterns with others.
Therefore, we need to ask ourselves: When facing the pain of others, can we also promote more meaningful communication and understanding through deeper questioning, thereby promoting their healing journey?
As a medical or mental health professional, in addition to learning to listen, you also need to learn how to ask the right questions so that patients feel safe, valued, and willing to share their stories. Through trauma-informed care models like this, we not only better serve our patients, but we also allow these experiences to be the beginning of healing. Can we, in every conversation, choose another way to understand and support those dealing with trauma?
