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我们必须停止仅通过症状或特征来解释多动症。
We have to stop explaining ADHD by symptoms or traits.
我们必须问：时间盲区对你来说意味着什么？
We have to say, what does time blindness mean to you?
执行功能障碍对你来说意味着什么？
Does executive function challenges mean to you?
这会对他人产生什么影响？
How does that impact someone else?
你需要什么样的支持才能帮助你？
And what's the support you might need that could help you?
随着我们越来越多地关注女性——这是完全合理的——我认为这种对话至关重要。
As we get more focus on women, rightly so, I think it's really important that conversation is there.
对我来说，同样重要的是，我们要为男性提供一个空间，让他们可以说：这并不是关于你是否‘正确地’患有多动症。
For me, it's equally as important that we can give men as well a space to say, this isn't about whether you think you did ADHD right.
而是关于它对你意味着什么，以及现在它又意味着什么？
It's about what did it mean to you, and what does it mean now?
你现在和未来需要什么？
What do you need now and going forward?
马特·古普韦尔是一位全球公认的ADHD导师。
Matt Gupwell is a globally recognized ADHD mentor.
他的工作帮助了数百万人理解自己非典型的大脑。
Whose work has helped millions of people understand their neurodivergent brains.
他是ADHD和自闭症领域最具影响力的声音。
He's the most powerful voice in the ADHD and autism space.
他也是ADHD各方面问题的专家。
And an expert in all things ADHD.
帮助你在各个领域优化你的ADHD。
Helping you optimize your ADHD in all sectors.
我也认识一些在人生后期才得知自己情况的年轻人。
I also know young people who have found out later in life.
实际上，他们的父母在他们很小的时候就已为他们确诊了自闭症或ADHD，但从未告诉过他们。
Actually their parents did get them diagnosed with autism or ADHD when they were very young, the parents never told them.
然后他们在上大学时崩溃了，这才被诊断出患有自闭症。
And then their autism was picked up when they were at university and they were falling apart.
这真让人心痛。
That's painful.
你认为人们有时会不会把所谓的中年危机误认为是未被诊断的多动症？
Do you think there's confusion sometimes between what someone might describe as someone having a midlife crisis, how that might be confused with actually undiagnosed ADHD?
但我得先谨慎地说明一下。
But I'm gonna preface this very carefully.
我想让大家非常清楚。
I want people to be very clear.
这只是我的个人观点。
This is my opinion.
忠实的听众和观众们。
Loyal listeners and viewers.
我非常感谢大家收看《多动症闲谈》，我们邀请世界顶尖的多动症专家回答那些尖锐的问题，为你提供最前沿的多动症资讯。
I can't thank you enough for tuning in to ADHD Chatter, where we ask world leading ADHD experts the hard questions to give you access to the most cutting edge information on the topic.
如果你曾经感到破碎或与众不同，我希望这些内容能帮助你寻找信息、答案和归属感。
If you've ever felt broken or different, I hope this helps in your search for information, answers, and community.
你知道吗？有什么能真正帮助到我呢？
And do you know what would really help me in return?
请在你收听的平台点击关注或订阅按钮。
By clicking the follow or subscribe button wherever you're listening.
这看起来可能微不足道，但在ADHD Chatter，这意义非凡。
It might not seem like much, but at ADHD Chatter, it means a huge deal.
有了它，我就能邀请更多精彩的嘉宾，持续点燃我们所有人——包括我自己——的自我探索之火。
And with this, I can book more incredible guests and keep the self discovery fire alive for all of us, including myself.
只需轻轻一点，其影响远超你的想象。
Just one click of a button goes a lot further than you think.
我们承诺会认真听取你的反馈，并邀请你希望听到的嘉宾，探讨对你重要的议题。
We'll promise to listen to your feedback and book the guests you want on topics that matter to you.
请记住，你并不破碎，只是与众不同，而你一直都很足够。
And remember, you're not broken, just different, and you have always been enough.
马特，欢迎再次回到ADHD聊天室。
Matt, welcome back to the ADHD Chatter studio.
再次。
Again.
谢谢。
Thank you.
是是
Is it is
这是第四次、第五次了吗？
it fourth, fifth time?
第五次。
Fifth.
第五次了。
Fifth time.
是的。
Yes.
你怎么
How do you
感觉又回来了？
feel big back again?
能有你在这里真的是一种荣幸
It's such a privilege to have
你在这里。
you here.
我仍然像上次一样困惑，当时你说过，老实说你会回来的。
I I I'm still as confused as I was last time that you was like, I'd be back if I'm honest annex.
你知道吗？
You know?
在节目播出前，我就一直把这内容发给人们，但不过，这真的很棒，能回来真的很开心，能再见到你也很高兴，而且能被纳入这个平台，拥有一个讨论ADHD真正含义的机会，这真的很棒。
I've been sending this to people before it came, but but, no, it's it's really nice, and it's it's it's nice to be back and nice to see you again, but it's it's nice to be sort of included and to have a platform and to hopefully have a really good discussion about, you know, what ADHD means.
所以，我真的很感激。
So, yeah, I'm really grateful.
很激动，谢谢。
Exciting, thanks.
上次我们就回避敏感性情绪障碍进行了一次精彩的对话，是的。
Last time we did a brilliant conversation on rejection sensitive dysphoria Yes.
那场对话非常出色，广受好评。
Which was brilliant and very well received.
而我认为今天，我们希望能更深入地探讨ADHD和自闭症。
And I think today, we're hoping to explore a little bit more about ADHD and autism.
所以，如果任何ADHD频道的听众不认识你——我想这应该很少见——你觉得自己在ADHD或自闭症领域的主要专长和优势是什么？
So I suppose if any of the ADHD chatter listeners don't recognize you, which I suspect will be very few people, what would you say are your specialties and your strengths within the ADHD or the autism space?
这很有趣。
So it's interesting.
我觉得这让我有些困扰，因为我并不是专家。
I think that for me challenges something in me, because I'm not a specialist.
我不是心理学家、精神科医生、医生或研究人员，什么都不算。
So I'm not a psychologist or a psychiatrist or a doctor or a researcher or in anything.
所以，说我有专长，其实是夸大了我自己。
So for me to say I have a speciality would be overstating who I am.
我只是在理解ADHD的道路上走了十年的人，对基于证据的研究与亲身经历相结合，并帮助人们理解他们在这个领域中有自己的位置，充满热情。
I am just somebody who's ten years down the road of my own understanding of ADHD, who is incredibly passionate about evidence based research being combined with lived experience and and helping people understand there's a space for them both.
但我并不认为我有什么专长。
But I don't think I have a speciality.
我所定义的是，我对自己的做事方式、处理方式和表达方式充满热情，因此我将自己 professionally 定义为ADHD教育者或神经多样性领域的教育者，尽管这么说听起来确实很宏大，因为我除了亲身经历外没有任何资质，但我所说的一切都建立在人们的真实体验和已有研究证据的基础上，我对此很有信心。
I have what I define is I I have a passion for the way I do things and approach things and say things, and so I define myself professionally as an ADHD educator or an educator in the neurodiversity space, which again feels really lofty to say, you know, I have no qualifications other than my lived experience in this, but I only say things that I'm confident can be backed up by what people have experienced and also what's seen in the evidence and the research.
所以，我认为这就是我对自己的定义。
So I think that's how I would define myself.
其他人可能会有不同的说法。
Others may say different things.
你可能没有任何资质，但作为这个领域两年的观察者，我认为你在各个在线平台上是最有激情的声音，而且你还有自己的亲身经历。
Well, you may not have any qualifications, but having been an observer of the landscape myself for for only two years, I would say you are the most passionate voice in the space on various platforms online, and you've got your own lived experience.
这份热情是从哪里来的？
Where does that passion come from?
你希望在这个领域实现什么？
What are you hoping to achieve in the in the space?
这份热情源于最初的那个初衷：如果我能帮助创造一个更包容、更理解、更有同理心、更有知识的世界，让我的两个儿子——现在分别是19岁和20岁——拥有比我直到近几年之前更好的人生，那就是我做这一切的原因，一直以来都是如此。
It it comes from exactly the same place it did originally, which is if I can help make the world a more welcoming, understanding, empathetic, knowledgeable even place so that my sons, who are now 19 and 20, have a far better life than I had up until very recent years, then that's why I do what I do, it always has been, it always was.
他们都在2009年和2010年，四岁时被诊断为自闭症。从那天起，直到今天，以及未来的每一天，我所做的一切都是为了他们。
They were diagnosed autistic when they were both four, 2,000 and nine, 2,010, respectively, And from that day until today and every day going forwards, everything I do is for them.
他们现在始终是我心中的首要牵挂。
They're at the front of my mind now.
无论我做什么工作，他们都会是我心中最重要的部分。
They'll be at the front of my mind whenever I do my work.
如果通过这样做、通过这份热情，也能帮助其他人理解自己，明白这一切意味着什么，那对我来说就是一种无比谦卑的额外馈赠。
If by doing that and being that passionate, it also helps other people make sense of themselves and what all these things mean, then that's just an incredibly humbling added bonus, I think.
是的，你说得对。
And, yeah, you're right.
我充满热情、声音响亮、富有争议性，而这一切源于我曾经的挣扎——我清楚自己曾多么艰难，却没有工具、语言、理解与知识去为自己发声；当我看到我的儿子们在学校里挣扎时，我却因当时不懂得如何支持他们而深感无力。
I am passionate and vociferous and argumentative, and I think that comes from a place of having struggled, known I've struggled, and not had the tools and the language and the understanding and the knowledge to advocate for myself, having seen my sons struggle when they were at school because I didn't know what I needed to know to support them back then.
这种热情源于我不希望任何人再经历这样的挑战，无论是他们还是其他人。
That passion is about I I don't want anyone else to have to experience that level of challenge, not them or anyone else.
考虑到所有这些，你对ADHD和自闭症的哪个细分领域最感兴趣？
I suppose taking all of that into account, is there a subsection of ADHD and autism that you're most passionate about?
不。
No.
而且，我觉得这一点很有趣。
And, again, I think this is interesting.
我一直在认真思考这个问题。
I've been giving this a lot of thought.
我不太认同这种在讨论时把人分成子类别的想法。我的意思是，过去几年，尤其是，我看到越来越多拥有相同状况或标签的人彼此聚集在一起。
I'm not I'm not comfortable with this idea, I think of subsections when we have conversations like that, and what I mean is over the past few years particularly, I've seen more division of people who share the same conditions or labels that I have coming together.
我当然有自己的关注点和兴趣，或者说是我的特殊兴趣，但我热衷于让更多人更好地理解ADHD和自闭症，尤其是它们对人们意味着什么。
So I have focuses and things that are my interest, if you like, my special interest, but I am passionate about the understanding being better of ADHD and autism and particularly what they mean to people.
不是它们是什么，而是它们意味着什么，以及这些理解能如何帮助人们。
Not what they are, but what they mean, and what that can do to help people.
所以，这确实是我的重点，如果这么说能让你明白的话。
So that's really my focus, if that makes sense.
这并不是说只关乎女性或只关乎男性。
It's not to say it's only women or it's only men.
是的，我非常关注晚年诊断，甚至是极晚年的诊断，但我想这是因为我自己就是如此——我51岁了，你知道，这很自然，但无论你是四岁刚得到诊断，还是84岁才确诊，对我来说最重要的都是人们能够获得信息、找到社群和支持，帮助他们理解这些经历。
Yes, I'm very invested in late life diagnosis or very late life diagnosis, but I think that's because that's me, I'm 51, you know, it makes sense that it would be, but it doesn't matter whether you're four years old and you've just got a diagnosis or 84 years old, to me the most important thing is that people are able to find information and community and support that helps them make sense of these things.
所以，这就是为什么我会做这么多不同的事情：我参与了一个名为Divergent Works的慈善机构或社区利益公司，我们已经运营了一个社区好几年，现在刚刚从WhatsApp迁移到了一个应用程序上。令人欣慰的是，参与其中的人背景非常多元，但他们告诉我们的共同点是：他们找到了一个能分享经历的社群，这帮助他们理解了这些经历对自己的意义。
So you know, that's why I do so many different things, I'm involved in a charity, or a CIC called Divergent Works, and we have a community that we've run for a couple of years now that's just moved off WhatsApp onto an app, and what's so nice about that is there's such a wide range of people who contribute to it, but what they've all got from it that they tell us is they've found that sense of community of people who can help share their experience, that helps them make sense of what it means to them.
最重要的，就是弄清楚这一切意味着什么。
That's the most important thing, is making sense of it.
这是你的书吗？
Is that your book?
是的。
Yeah.
我想，这正是大多数人收听这个播客、你的播客以及其他类似节目的原因——他们希望理解那些多年来一直无法理解的事情。
Well, I think that's why most people listen to this podcast, and your podcast and other podcasts is they wanna make sense of so many years of it not making sense.
你说你51岁，而回顾这个播客的听众群体，其实涵盖了各个年龄段，但主要集中在40到60岁之间，很多人因为各种原因尚未确诊，但他们怀疑如果去评估，很可能会得到诊断，或者最近刚刚确诊。
And you said you're 51 and looking at the back end of this podcast, there's sort of it's a whole spectrum of age groups, the concentration is 40 60 year olds, many of whom don't have a diagnosis for various reasons, but they suspect they would if they went for assessment or they've recently got a diagnosis.
而这部分人中有85%是女性。
And eighty five percent of those people are female.
你认为，一个人在成年后才被诊断出注意力缺陷多动障碍，与从小就知道自己有ADHD的人，所经历的过程会有所不同吗？
Do you think there's a different process someone goes through when they get a diagnosis of ADHD later in life compared to someone who knows that they have had ADHD from a very young age?
是的，这个话题其实有很多细微的差别。
I do, and and there's there's a lot of nuance to this conversation.
有很多不同的子类型体验。
There's lots of different sort of sub experiences.
比如，我可以谈谈我的孩子们。
So I can, you know, I can talk about my sons.
我提到过，他们当时分别是四岁的时候被诊断出自闭症。
I mentioned they were they were four, respectively, when they were diagnosed with autism.
现在他们已经19岁和20岁了。
So they're now 19 and 20.
他们从很小的时候就知道了。
They've known for most of their lives.
当他们被诊断时，我的妻子凯瑟琳和我下定决心，尽管当时我们对自闭症一无所知，也要尽可能多地学习，以便帮助我们理解它，帮助他们和他们的老师理解它。
Now when they were diagnosed, Catherine, my wife, and I made it our mission, knowing nothing at that point about autism, nothing at all, to learn as much as we could in order to help us understand it, and to help them and their teachers understand it.
我们一直跟孩子们谈论他们的自闭症。
And we always spoke to the boys about their autism.
自从被诊断以来，他们就知道自己是自闭症患者。
They have known they were autistic since they had their diagnosis.
因此，他们非常幸运，对自闭症对自己的意义有着深刻而丰富的理解，他们也有很多自闭症朋友，所以他们的经历非常不同。
So they're very fortunate that they have a really deep and rich understanding about what autism means to them, and they have lots of friends who are autistic, and so their experience is very different.
这并不意味着他们的生活没有困难，他们曾被欺凌，被排斥，从未收到过派对邀请，我们最终在家教育了他们五年，因为学校环境太糟糕了。
Now it doesn't mean that's not been difficult for them, they've been bullied, they were excluded from things, they were never invited parties, we we ended up home educating them for five years because school was so bad.
你知道，他们的生活并不容易，但至少他们对自闭症如何影响自己有了一个清晰的框架。
You know, life has not been easy for them, but at least they've got a framework for their autism of how that may have impacted.
他们俩也都被诊断出患有注意力缺陷多动障碍，我小儿子在封锁期间14岁时被确诊，我大儿子去年才确诊，因此观察他们如何将ADHD融入自我认知并加以应对，非常有意思。
They are both also diagnosed with ADHD, my youngest was diagnosed at 14 during lockdown, my oldest was only diagnosed last year, so it's been interesting seeing their process of now adding ADHD to themselves and how they manage that.
而且，这并不是说他们经历药物调整和上大学的过程没有挑战，确实有挑战，但他们很幸运，我们能坦诚地谈论这些。
And again, it's not to say that's not been challenging for them and going through titration and being on medication and college, it has, but they're lucky that we talk about it.
他们很幸运，我们愿意谈论这些。
They're very fortunate that we talk about it.
我也认识一些年轻人，他们到了二十多岁才得知，其实父母在他们很小的时候——大约四到八岁之间——就已经为他们确诊了自闭症或注意力缺陷多动障碍，但父母从未告诉过他们。
I also know young people who have found out later in life, few in their mid twenties, that actually their parents did get them diagnosed with autism or ADHD when they were very young, sort of somewhere between four and eight years old, but their parents never told them.
出于某种原因，通常是担心被贴上标签，父母没有告诉孩子，结果直到上大学时，他们才被发现有自闭症，那时他们已经濒临崩溃。
For whatever reason, typically because it's this frame of girth, we don't want them to be labeled, they didn't tell their kids, and then their autism was picked up when they were at university, and they were falling apart.
这显然也是一种完全不同的经历。
Now that's inherently a different experience as well.
这很痛苦，因为这意味着要重新梳理和理解一大堆过去被掩盖的问题，他们该如何理解这一切？
That's painful, because then there's a whole different layer of stuff to unpick, and how do they make sense of that?
我另一个特别感兴趣的问题，是你刚刚提到的播客听众的年龄分布，对吧？
The other bit that I'm really interested in, and you just mentioned the demographic of the podcast, right?
确实如此，出于很多原因，如果你在四十岁之后才获得理解，并且有幸选择去确诊ADHD、自闭症或两者兼有，那么理解这些诊断意味着要重新梳理你的一生。
It absolutely is true for for lots of reasons that if you receive the understanding and you're fortunate enough where you choose to get diagnosed with ADHD or autism or both, once you get past 40 years old, the process of making sense of what that means means unpacking your entire life.
对吧？
Right?
你不能把这和一个23岁才得到同样诊断的人相提并论。
You can't compare that to, say, somebody at 23 years old who receives the same diagnosis.
这没关系，不同很正常，也不是说哪个更难，但我的热情在于帮助这些年长者理清这些信息，理解如何回顾自己的一生——无论他们是否成功，并在此基础上继续前行。
And that's okay, it's okay that it's different, and it's not to say it's harder, but I think my passion lies in trying to help those people who are older make sense of how to unpick all of that information and make sense of how to do all that retrospective looking at their entire life, whether they've thrived or not, and then moving forwards.
我认为，让他们接触到真正合适、来自同样经历过这些的人所提供的信息非常重要，这样他们才能明白：原来你经历过这么多份工作、当过父母、关系破裂，或者，我老是想到我妻子。
And I think it's really important that they have really good, if you like, age appropriate information from people who've lived it as well that they can look to and go, I understand how you can talk about the experience of having lots of jobs or being a parent or or failed relationships or or or you know, I keep thinking of my wife here.
她今年一月开始攻读开放大学的心理学与咨询学位，就是因为这些事，对吧？
She started an open university degree this January, studying psychology and counseling because all this stuff, right?
这是她第三次尝试完成学位了。
This is attempt three at a degree.
她在50岁重新开始，却因之前两次失败而感到羞愧和尴尬，这种感受是年轻人无法比拟的，因为它更沉重；但这也帮助她以自己的方式去消化这一切，同时也在帮助更年轻的人以他们的方式去理解。
The the shame and and embarrassment she feels about not being able to do it twice and having to start again at 50 is completely incomparable to somebody who's younger because it hits harder, but it's helping her process it in her way, and helping somebody else who's younger process it in their way.
所以关键是要确保人们能接触到能与他们产生共鸣的信息，而不是看到年轻人谈论如何与ADHD共处时，却引用的是年长者的生活经验，这真的很困难。
So it's about just making sure people have the information that they can connect to and feel speaks to them, rather than, you know, it's very hard when I see really young people talking about how to live your life with ADHD and talking about the experience of people who are older or anything.
你怎么知道的？
How do you know?
我23岁的时候，整天忙着为英国航空公司飞遍世界，喝得烂醉，每天抽40到60支烟，却根本不知道自己有成瘾问题，还以为自己什么都知道。
When I was 23, I was too busy flying around the world with British Airways getting spectacularly drunk, smoking 40 to 60 cigarettes a day, not knowing I had problems with addiction, and I thought I knew everything.
我觉得自己特别了不起。
I thought I was the man.
对吧？
Right?
我以为自己把人生安排得明明白白，而我对40岁、50岁、60岁的人的看法完全不是这样——他们根本不懂我，我又怎么可能懂他们呢？对吧？
I I thought I had life sorted, and what I thought about people who were 40 or 50 or 60 was nothing like me, they don't understand me, and how could I understand them, right?
这种‘我们必须为所有人代言’的叙事，我们必须小心。
And it's that narrative of we've got to be careful of speaking for everyone.
我们必须确保提供的信息能帮助人们解答这些问题。
We've got to make sure that the information supports people to answer those questions.
你觉得，马特，对于你所专注的40岁左右人群来说，是否存在这样的风险：他们正经历压力、焦虑，甚至抑郁，却不知道自己可能患有未被诊断的注意力缺陷多动障碍或其他神经多样性状况？而一旦他们意识到这一点，会不会成为打开他们理解自我的关键，帮助他们走上更理解自己、更善待自己的道路？
Do you think there's a risk, Matt, of someone who is in the age group that you're specializing in, people 40, experiencing stress, anxiety, maybe even depression, but because they don't know that they perhaps are living with undiagnosed ADHD or other neurodivergent conditions, that that could be the the sort of key that unlocks their understanding and part paves that path for them to live a more understanding and self compassionate life?
毫无疑问，你知道，我不能从临床角度发言，但我可以根据我所运营的支持小组以及辅导他人所获得的信息和经验来谈，我也曾与多位临床医生交流过，他们完全证实了这一点，你留意一下自己的评论就会明白，对吧？
There is absolutely no doubt, you know, again, I can't speak from a clinical perspective here, I can speak from the information and the experience I've gained from the support group I run and from mentoring people, but I also have spoken to clinicians who confirm this absolutely, you watch your comments lighter, right?
如果你现在正在听这段话，刚听到这个问题，有多少人曾经一生都活在压力和肾上腺素中，被告诉你患有抑郁或焦虑，却始终怀疑这是否只是表象，后来才意识到这可能是或可能是ADHD，这为你的理解增添了完全不同的层面？
Literally, if you are listening to this now and you've just heard that question, just how many of you went through your lives living on stress and adrenaline and being told you were depressed or had anxiety, but always wondered if it was just that, and then have since realized that it is or could be ADHD, and that's added a completely different layer of understanding to it.
对吧？
Right?
百分之百，确实如此。
A 100% it does.
不过，我认为对我而言非常重要的一点是，尽管在我们尚未知晓之前可能有过这样的经历，但人们必须清楚地认识到，诊断本身并不能让这些感受消失。
I think what's really important, though, for me to say is, whilst that may be the experience before we know, it's really, really, really important people realize the diagnosis doesn't make that go away.
它或许能帮助你理解为什么你会以这种方式体验这些情绪，也可能帮助你明白为什么你的体验与其他人的不同，但它并不一定意味着这些感受会就此停止。
It helps you understand perhaps why you've experienced it the way you have, it maybe helps you understand why you experience it differently, but it doesn't necessarily mean it will stop.
你知道，今年我经历了近三年来最严重的一次抑郁。
And you know, this year I have had the worst period of depression I've had in probably three years.
我是说，那种令人瘫痪的抑郁，想放弃一切，看不到生活的意义，我已经好几年没这样过了，但即便我非常了解自己的ADHD，已经走过十年，我依然会遭遇焦虑，依然会陷入抑郁，依然会感到极度压力，对吧？
I mean, debilitating depression, wanting to just give up everything, I couldn't see the point in life, and I've not felt like that in years, and yet I know a lot about my ADHD, I'm ten years down the line, and I still get hit by anxiety, and I still get hit by depression, and I am still incredibly stressed, right?
我幸运的是，现在我更好地理解了多动症和自闭症对这些事情意味着什么，这让我能够选择不同的工具来支持自己，对吧？
What I'm fortunate to have is now a better understanding of what my ADHD means and autism means in relation to those things, which means I can choose different tools to support me, right?
所以我认为这非常重要，因为确实有些人以前一直在挣扎，现在可能仍在挣扎，尤其是刚被诊断出来的时候，对吧？帮助他们理解这没关系，你并没有失败，这只是过程的一部分，但它能帮你理清这个过程，也可能帮助你理解如何支持自己、为自己发声。
So I think that's really important, because yes, there are people that struggled before, who may still be struggling, particularly when they're newly diagnosed, right, and it's helping them understand that's okay, you're not failing, it's part of the process, but but it helps you make sense of the process now, and it helps you potentially understand how to support you and advocate for you.
我想，这段漫长的历史中，伴随着许多失败的关系，或许还有你开始后又放弃的工作，因为你感觉上司对你不满，你在家庭聚会中对批评和拒绝的反应，这些累积多年，会造就一个极度焦虑的人，我想。
Well, I suppose there's quite a lot of shame associated with this huge history of failed relationships, perhaps jobs that you've started and abandoned because you've sensed that your boss is annoyed with you, how you've reacted to criticisms and rejections at family events, that can compound over so many years to create this incredibly anxious person, I imagine.
而你在四十几岁或更晚才得到诊断。
And and you get a diagnosis in your forties or later.
马特，你在性别方面有没有发现差异？男性和女性在面对和处理这个诊断时有什么不同？
Have you, Matt, experienced a difference in the sexes, how sexes, how men and women go on and process that diagnosis?
是的。
Yeah.
而且最近这种情况也发生了变化，我认为。
And it's changed more recently as well, I think.
是的，我有这种体验。
So, yes, I have.
首先我要说的是，现在关于女性也被识别为患有注意力缺陷多动障碍和自闭症的讨论，比以往任何时候都更加响亮和一致，这真是太好了。
And and the the first thing to say, and I have to start with this, is what's really good and really important is that the conversation around women being recognized as having ADHD and autism as well is louder and more consistent than it's ever been, and that's phenomenal.
对吧？
Right?
这真的非常好。
It's it's it's so, so good.
我认为男性和女性在经历上的主要区别在于，尽管我们所有人都面临ADHD的污名，但很多人仍然认为ADHD就是那个调皮的小男孩，或者觉得如果一个男性在成年后才被诊断，那他小时候一定就是那个调皮捣蛋的孩子，总是惹麻烦。
I think the difference that I see between men and women particularly is because there's still a stigma attached for all of us who ADHD, that ADHD, a lot of people still think it's the naughty little boy, or they perceive that if a man's diagnosed later in life, they were that naughty little boy, right, and they were always getting in trouble.
但现在我遇到的很多男性——我自己也是其中之一——并不符合这种经历：我从来不是总在惹麻烦，没有被罚过留校，从未被开除，也没有和法律打过交道，我确实冲动、愚蠢，做过很多糟糕的决定，但我不是那种人。
Now I meet so many men, and I'm one of them, who that isn't the experience of, I wasn't always in trouble, I didn't get detentions, I was never excluded, you know, I never had run ins with the law, I was impulsive and stupid and made very bad decisions, but I wasn't that.
所以我听到的男性对ADHD的体验是，他们觉得无法公开谈论，因为别人会评判说：‘你小时候就是那样，那你现在不还是那样吗？’
So what I hear from men in the way they experience it is they feel that they can't talk about it as openly, because they'll be judged that, oh well you must have been like that, and therefore are you that now?
这就让他们很难知道：我该怎么向别人描述这件事呢？
And so it makes it very hard for them to know, well how do I describe this to people?
我该怎么解释ADHD对我而言意味着什么，以及现在它对我意味着什么？
How do I explain what ADHD was to me and is to me?
所以这就是挑战，但我认为这种挑战迟早都会出现。
So that's the challenge, but it's one that I think was always going to happen for a while.
随着我们越来越关注女性——这是完全正确的——再加上现在女性经历围绝经期和绝经期，以及我们目前获得的这些认知，我认为这种对话至关重要。
As we get more focused on women, rightly so, and now with women going through perimenopause and menopause, and that knowledge that we're gaining now, I think it's really important that that conversation is there.
对我来说，同样重要的是，我们要为男性提供一个空间，让他们可以说：这并不是关于你是否‘正确地’患有多动症。
For me, it's equally as important that we can give men as well a space to say, this isn't about whether you think you did ADHD right.
而是关于它对你意味着什么，以及现在它又意味着什么？
It's about what did it mean to you, and and what does it mean now?
你现在和未来需要什么？
What do you need now and going forward?
所以最终，总会存在差异。
So ultimately, there is always going to be a difference.
关键是给人们提供工具，去解释这些差异意味着什么。
It's giving people the tools to explain what that means.
我认为，正如你刚才所说，许多男性对谈论神经多样性状况，甚至对谈论心理健康本身，都感到不自在。
I think for the reasons you've just said, many men don't feel comfortable speaking openly about, let alone neurodivergent conditions, but mental health in general.
你认为神经多样性会伴随着孤独吗？
Do you think being neurodivergent goes hand in hand with loneliness?
毫无疑问。
There's no doubt.
我不需要声称自己拥有任何临床知识，这纯粹是基于我们所看到的一切。
And I don't have to say that claiming any sort of clinical knowledge, that's just based on everything we see.
你在活动中与人交谈时，或者在那些主动联系你的人身上，一定也见过这种情况。
You'll have seen it in the people that you speak to at events and in, you know, who reach out to you.
孤独是我们经常听到的问题，我认为这真的很有挑战性，因为如果你从小不知道为什么事情总是那么困难，为什么你交不到朋友或留不住朋友，或者你觉得自己在任何地方——学校、大学、工作，甚至生活中——都格格不入，这确实会让你感到孤独，让你觉得自己连自己的身体都容不下，更别提融入他人了。
Loneliness is something we hear all too often, and I think I think it's really challenging because if you grow up not knowing why things have been difficult, why maybe you don't make friends or keep friends, or you don't feel you fit in anywhere, school, university, jobs, life even, it does make you feel lonely, it does make you feel like you don't fit in in your own skin, let alone with anyone else.
我认为挑战在于——虽然这么说听起来有点奇怪，但确诊为ADHD并不会消除那种痛苦，它并不意味着那种痛苦会消失，它只是让你或许能部分理解原因。
I think the challenge is, and again, it sounds strange to say this, but a diagnosis, knowing it's ADHD, doesn't change that pain, if you like, it doesn't mean that that goes away, it just gives you maybe a part of a reason for it.
我认为这就是为什么我们仍然会见到那些刚确诊的人，他们依然感到如此强烈、如此孤立和孤独，甚至在自己的家、自己的关系中也感到孤独，这完全是另一回事，但问题在于，他们仍然深深投入于理解这个诊断意味着什么，而可悲的是，他们的家人往往并不如此。
And I think that's why we still see people when they're newly diagnosed who feel that so much, they still feel so isolated and so lonely, and they often will feel lonely in their own homes, in their own relationships, which is a whole different thing, but that then is about they're still so invested in what this means, and sadly very often their families aren't.
你已经被确诊了，对吧？
Well you've been diagnosed, done that?
那为什么你对它不像我这么感兴趣呢？
And now why aren't you so interested in it as I am?
这让我们感到孤独。
And that makes us feel lonely.
所以社群才如此重要，找到能够分享并认同你的人，这一点至关重要。
So that's why community is so important, that's why finding people to connect with who can share that and validate, that's so important.
但确实，对我而言，这两者密不可分，而且承认这一点真的很难。
But, yeah, they are, for me, inextricably linked and really difficult to admit.
你知道，一直觉得自己格格不入，这种感觉真的很艰难。
You know, it can be really hard to feel like you've never fitted in.
我认为，要承认为什么会这样，以及承认自己究竟有多格格不入，需要极大的心理力量。
And I think it takes a lot of mental strength to admit why that may have been, and to admit maybe just how much you've never fitted in.
你知道那句话吗？人越多的地方，你反而越孤独。
You know, it's that phrase, you've never been so lonely in a crowd.
我一生中的大部分时间，身边总是围着很多人。
Most of my life, was always around lots of people.
我当时很社交，别人觉得我非常外向，但我却一直感到孤独。
I was, you know, very social, I was seen as very outgoing, and yet I was perpetually feeling lonely.
对吧？
Right?
一直感到孤独。
Perpetually lonely.
友谊也是如此。
And it's the same with friendships.
你知道，你常听说有些人说他们没有朋友，从来就没有朋友。
You know, you hear people say they've got no friends, they've never had any friends.
我也说过这样的话。
I've done that.
我曾抱着妻子痛哭，说我一个朋友都没有。
I have sobbed with my wife saying that I've got no friends.
但那并不是真的。
Now that's not true.
我有朋友。
I've got friends.
我认识一些人，如果出了问题，我可以打电话给他们，他们会在我身边。
There are people I know, if things went wrong, I could pick up the phone, and they would be there for me.
但那种孤独的感觉却挥之不去。
But it's the feeling of being that lonely.
有时候，要理清这一切实在太复杂、太令人困惑了，你觉得自己是别人的负担，觉得没人打电话给你，也没人主动联系你。
There are times where it's just so complicated and confusing making sense of all of this that you feel like you're a burden to anyone else, and you feel like nobody's calling or nobody's reaching out.
所以是的，你会感到孤独、孤立和格格不入，而帮助人们找到这种联结很重要。
So yeah, you feel lonely and isolated and different, and it's just helping people find that connection.
你知道，就是这句话，对吧？
You know, is that phrase, isn't it?
联结是孤独的反面，对吧？
Connection's the opposite of loneliness?
嗯，确实是，但我们必须找到自己的群体才能做到这一点。
Well, is, but we have to find our tribe to do that.
你认为，比如在四十岁或之后才得到诊断，会不会引发孤独感？因为在那之前，你可能一直应对得很好，拥有朋友群体，有一个版本的你表现得正常、社交活跃，能参加各种活动。但当你得到诊断后，开始质疑：这真的是真实的我吗？
Do you think a late diagnosis, say, in your forties or later, could a diagnosis of ADHD or other neurodivergent conditions trigger loneliness in in the sense that you might have up until that point in your life been coping so well, that you've got a group of friends, and there's a version of you that has been functioning and is social and does get by and does go to events, and you get this diagnosis and you start questioning, is that a true representation of me?
而你诊断后意识到的真正自我，却逐渐与你过去四十年向外界展示的自我分离开来，变得孤立。
And your sort of your sort of true self that you've come to realize post diagnosis becomes a bit of an island, separates from this version of yourself that you've been presenting to the world for forty years.
嗯。
Mhmm.
对于这样一个人，诊断后的真正自我，会不会突然感到孤独，而在此之前并没有这种感觉？
Is it possible for that person, that sort of your true self post diagnosis to suddenly feel lonely when they didn't before?
是的，绝对会，我觉得你解释得非常好。
Yeah, absolutely, and I think you've explained that really well.
我们可以发展出应对机制，过着看似正确、符合期待的生活，但当我们获得许可去审视自己的生活，意识到自己有注意力缺陷多动障碍、自闭症或其他相关情况时，就会开始质疑：我真的一点都不喜欢那些事吗？
We can develop systems of coping, and we can go through life doing things that feel right, and we feel are expected, but then when we get the permission to look at our life and understand that there's ADHD or there's autism or something else connected, it can make us question, Did I ever actually really enjoy that?
我真的想做那些事吗？
Do I really want to do that?
这可能会非常艰难。
And that can be really difficult.
我知道有些人，包括我自己，在确诊后，就不再与一些群体来往了，因为我感觉那样并不对劲。
I know of people, and me as well, post diagnosis I lost or stopped interacting with complete groups of people because I just felt that it wasn't right.
我再也无法继续那样做，而且尝试去做的时候，反而让我更不舒服。
I couldn't do it anymore, and I felt more uncomfortable trying to than not.
虽然没有那些群体、不被邀请参加活动仍让我感到难过，但到了某个阶段，我必须接受：我现在只做让自己感到自在的事情，并且我身边有了接受真实我的人。
And then it still makes me sad to not have those groups and to not be invited to things, but there's a point where I have to accept I now do the things that make me feel comfortable in my own skin, and I now have people who accept me for that.
但这需要时间，对吧？
But that's taken time, right?
所以是的，我认为确诊之后——我会一再提到这一点——确诊只是开始，而不是终点。
So yeah, I think post diagnosis, again, I'll keep coming back to this, diagnosis is the beginning, it's not the end.
它并不能让一切变得更好。
And it doesn't make everything better.
在很多方面，包括孤独感在内，它甚至可能让情况变得更糟，这或许就是为什么很多人后来开始否定或质疑自己的诊断。
And in a lot of ways, loneliness included, it can actually feel like it makes it worse, Which I think is why you see a lot of people then start to reject their diagnosis or question their diagnosis.
这样对吗？
Is this right?
也许我并没有那么严重的多动症，因为我喜欢去酒吧，或者喜欢做这些事。
Maybe I'm not that ADHD, because I like going to the pub, or I like doing this.
实际上，他们想说的是，我怀念那种感觉，但我并不愿意承认这种不适感，但这是过程的一部分。
Actually, what they're saying is, I miss that, and I'm not comfortable with maybe acknowledging that I that doesn't feel right, but it is part of the process.
让我们用一小段来自赞助商的话来谈谈一个常见的多动症误区——笔记本谬误。
A quick word from our sponsors to address a big ADHD issue, the notebook fallacy.
我们都说服自己，只要买一本神奇的笔记本，就能解决所有问题，但事实从来不是这样。
We all convince ourselves that buying that one magic notebook will solve all of our problems, but it never does.
第二本、第三本，甚至第十本笔记本也一样无效。
Nor does the second one, or the third, or the tenth.
Tiimo 应用比拥有全世界所有的笔记本都更有用。
Well, Tiimo app is more useful than having all the notebooks in the world.
如果你连笔都总是丢，那笔记本又有什么用呢？
And what use are notebooks if you keep losing your pen anyway?
Tiimo 应用通过提供最用户友好的界面，极大地帮助我整理了混乱的生活。
Tiimo app has hugely helped me organize my chaotic life by offering the most user friendly interface an organizational app has to offer.
不同之处在于，它是为神经多样性人群设计的，你一眼就能看出来。
The difference is it's designed by neurodiverse brains for neurodiverse brains, and you can tell.
它专为适应你的神经多样性思维模式和灵活的规划方式而打造。
It's built to adapt to your neurodiverse way of thinking and be flexible to your way of planning.
现在，有了AI规划助手，它变得更加简单了。
And now it's even more simple with the AI planning assistant.
Tiimo现在提供了一项出色的全新语音转录服务，让使用更加便捷。
Tiimo now offers an incredible new voice transcribing service, making it even easier to use.
当你需要规划某事，或有什么想法突然冒出来时，只需简单地说一句，全新的AI规划助手就会立即听到并将其转录成一份清晰易懂的指令列表，帮你记住。
A simple voice prompt when you have to plan something or something pops into your mind, and the new AI planning assistant hears it and transcribes it instantly into an easily digestible list of instructions for you to remember.
Tiimo旨在帮助你简化规划、提升专注力，让生活顺利进行。
Tiimo is here to help you simplify planning, build focus, and make life happen.
不再有决策瘫痪，新的AI规划助手让你能快速轻松地添加信息，甚至在你忘记或分心之前就能完成。
No more decision paralysis, the new AI planning assistant makes it so quick and easy to insert information, you can do it before you've forgotten or been distracted.
试试看吧，点击我简介中的链接可享受30%折扣。
Give it a go, and use the link in my bio for 30% off.
不过要注意，这段代码仅适用于网页浏览器，不适用于智能手机。
Just a note though, this code is only applicable on the web browser, not on the smartphone.
当Tiimo帮你解决所有问题后，就可以把笔记本拿去做些有用的事了，比如垫平摇晃的桌腿，或者擦干洒出的咖啡。
Then when Tiimo solves all of your problems, go ahead and use your notebooks for something useful, like propping up a wobbly table leg or mopping up a spilt coffee.
回到本期节目。
Back to the episode.
考虑到节目主要聚焦四十多岁的男女，马特，你认为人们有时会不会把所谓的‘中年危机’与未被诊断的多动症混淆？
With the sort of focus on men and women in their forties, Matt, do you think there's a confusion sometimes between what someone might describe as someone having a midlife crisis, how that might be confused with actually undiagnosed ADHD?
我确实这么认为，但我要先谨慎说明一下，因为我希望人们能非常清楚地理解。
I do, but I'm gonna preface this very carefully because I'm aware that I want people to be very clear.
这只是我的个人观点。
This is my opinion.
对吧？
Right?
这是基于我脑海中反复思考的问题，以及我向那些我在研究和临床领域非常敬重的人请教后得出的看法，但确实，我之所以有这种想法，是因为我成长于八十年代，当时我大约十到十一岁。
This is my opinion based on things that have rattled around my head, and I've asked questions about this to people I really sort of rate in the research and the clinical world, but yeah, and where this comes from for me is, you know, I was a sort of 10, 11 year old of the eighties.
对吧？
Right?
现在，如果我们回想一下当年男性中年危机的刻板印象，那通常是某个男人到了四十多岁，突然间似乎否定了自己迄今为止的一切生活。
Now if we think of what, particularly a male midlife crisis, what the stereotype of that was back then, it was the guy who maybe reached his forties, mid forties, and out of nowhere seemed to reject his life up to that point.
于是他们辞掉工作，或者开始穿一些极其年轻化的衣服——不管那意味着什么——或者结束长期的婚姻或关系，带着一个更年轻的伴侣远走高飞，或者毫无征兆地买一辆跑车，对吧？
So we quit the job or we start dressing really, really in, you know, these clothes that are way too youthful, whatever that means, or, you know, leaving long time marriages or relationships, and taking off with a new younger partner, or buying the sports car out of nowhere, right?
但当时，所有这些行为都被视为刻板印象：‘他正在经历中年危机’，‘他崩溃了’，‘他不对劲’。而长期以来，我一直质疑：有多少这样的男人其实正在经历自我认知的根本性转变？你可能会想到睾酮水平的变化，就像我们讨论女性荷尔蒙那样，有多少男人其实极度困惑，他们所做的一切，只是在表达：‘突然间，这一切都不对劲了’。
Now all of those things back then were the stereotypes, oh he's having a midlife crisis, that one right, he's falling apart, oh he's not right, And for the longest time I've questioned, I wonder how many of those men were actually going through fundamental changes in their sense of self, and you know, you could question testosterone maybe coming into it in the same way we talk about hormones with women, how many of those men were actually so confused that what they were doing was a demonstration of, actually, all of a sudden, none of this feels right.
回到孤独感这个框架。
Go go back to that framework of loneliness.
突然间，这不再是真正的我。
All of a sudden, that isn't me.
但因为他们不知道‘真正的我’是谁，于是他们走向另一个极端，试图做些截然不同的事情。
But because they don't know what me is, they go to another extreme and they try and do something vastly different.
这会不会是未被诊断的注意力缺陷多动障碍？
Could that have been undiagnosed ADHD?
那会不会是冲动行为的表现呢？
Could that have been presentations of impulsivity, right?
或者是亢奋的大脑从不休息，反而拖了他们的后腿？
Or of sort of hyperactive brains never resting and not helping them?
也许吧，我不知道，我不是临床医生，不能下定论。
Maybe, I don't know, I'm not a clinician, can't say.
我知道的是，目前关于睾酮的研究还没有从这个角度去探讨，但我相信已经开始有人关注了：当男性的睾酮水平发生变化时，会发生什么？
What I know is the research that's out there on testosterone hasn't looked at it from that point of view yet, but I believe it's starting to happen about, hold on, what happens when a man's testosterone changes?
但最多也只是相关性。
But at the best it's correlation.
绝对不是因果关系，我认为ADHD不能被定义为导致中年危机的原因，但我确实对此感到好奇，当我看到人们步入中年时，我不禁想，有多少人会有一种紧迫的念头：‘这就是全部了吗？’
Certainly not a cause, I think ADHD could be ever defined as a cause for a midlife crisis, but I do wonder about it, and I do wonder when we see people get to this midlife, I wonder how many of those people have got that sense of impending, is this it?
我正在变老，难道生活就永远这样不变了吗？
I'm getting old Does it never get any different to this?
一切开始变得平庸，一切开始变得——恕我直言——无聊。
And it all starts to feel mundane, and it all starts to feel, dare I say, boring.
我能理解，有些冲动控制力差的人可能会突然做出一些完全不像他们平时风格的事情。
And I can really understand how some people, with poor impulse control might suddenly start doing things that just seems out of character.
在那个时候，如果周围的人能够有足够的信心说：‘你有没有想过，我们是不是该探索一下你为什么会这样感觉，而不是仅仅对行为做出反应？’这会有帮助吗？
Now at that point, would it be useful if the people around them maybe felt confident enough to say, do you think we might need to explore some different avenues for why you feel this way rather than reacting to the behaviors?
我知道这很难，对吧？
Now I know that's hard, right?
我知道很难不去做出反应，但这样做会不会有助于挽救婚姻、事业、人际关系等等？
I know it's hard not to react, but would that help and maybe save marriages, careers, relationships, etcetera?
也许吧。
Maybe.
所以，我忍不住会想这个问题，但我认为这很难量化。
So yeah, I can't help but wonder about that, but it's very hard to quantify, I think.
因为还存在一个问题：究竟有谁会真正承认呢？
Because there's also an element of who's really gonna admit that?
有谁会真正承认，其实他们并不想要那辆跑车，或者并不想做那件事，但那只是对其他事情的反应，或者天啊，其实是ADHD造成的？
Who's really gonna admit that actually they didn't want that sports car, or they didn't wanna do that thing, but it was a reaction to something else, or oh God, it was ADHD.
所以，是的，我想我们或许永远无法真正知道，我不确定。
So yeah, I think possibly how we ever know, I don't know.
但我认为，如果现在有某些人正挣扎于‘我是谁，我在哪’这样的感受，那么开始探究还有哪些其他因素在影响这种状态就很重要了。
But I think if there are people out there now who are struggling with this sense of, ah, who am I, where am I, that's where starting to look at what else could be contributing to that is important.
这并不意味着事实就是如此，但问问自己这些问题，并寻求专业人士的意见。
It doesn't mean it is, but asking yourself questions and and and asking professionals.
是的。
Yeah.
我觉得这是个非常明智的做法。
I think that's a really smart move.
马特，我最喜欢的一句歌词来自一支叫Plus Forty Four的乐队，‘过去只是亮着灯的未来。’
One of my favorite lines, Matt, is in a song from a band called Plus forty four, and it's the past is only the future but with the lights turned on.
当你到了一定年纪，积累了足够多的人生经验和证据，你就能准确预测未来的发展，除非你做出重大改变。
And you can get to an age where you've accumulated enough life experience, enough evidence to be able to accurately predict how the future's gonna go unless you make significant changes.
所以，要给一个四十多岁、拥有这些证据却仍不愿做出重大改变的人贴上标签，这容易吗？
So is it easy to label someone in their forties who has that evidence making significant changes, I.
呃。
E.
买跑车、移民、改变外貌，是中年危机的表现，还是他们实际上在采取行动，以避免一条注定重复过去的道路？
Buying the sports car, moving country, changing their appearance as having a midlife crisis or are they actually taking action to divert an otherwise inevitable path that will replicate their past?
要轻易断定这是
Is it easy to say it's
中年危机吗？
a midlife crisis?
对任何外人来说，是的。
For anyone else on the outside, yes.
因为我们就是这样看待的。
Because that's what we we look at.
这又回到了框架和偏见的问题。
It goes back to the frameworks and the stigma.
是的。
Yeah.
从外部的其他人来看，是的。
From anyone else outside, yeah.
我肯定这很容易。
I'm sure it is easy.
如果你是正在经历这一切的人，关键在于有能力问自己一些非常艰难的问题。
If you're the person going through that, it's about having the ability to ask yourself some really hard questions.
我为什么会有这种感觉？
Why do I feel like this?
我究竟在逃避什么，或者是在追求什么，对吧？
What am I running from, or towards even, right?
尤其是，为什么是现在？
And particularly, why now?
为什么我在三十岁时没有那样做？
Why wasn't I doing that in my thirties?
为什么我在二十岁时不想那样做？
Why didn't I wanna do that in my twenties?
这说得通吗？
Does that make sense?
我认为，正是我们提问的方式，才引导我们找到需要寻找答案的方向。
I think it's how we we ask ourselves the questions that may lead us to where we need to look for the answers.
我听说过
I've heard
你过去曾把注意力缺陷多动障碍的应对策略描述为笼子。
you describe ADHD coping strategies in the past as cages.
你能解释一下你所说的‘笼子’是什么意思，以及它可能如何产生负面影响吗？
Could you describe what you mean by cages and how this could manifest negatively?
我用‘笼子’这个隐喻想表达的是这个意思。
So what I mean by the this metaphor of cages is this.
当我们未被诊断时，我们中的许多人，我相信在观看和聆听的观众中也有很多人，都会依赖那些他们认为对自己有帮助的事物。
When we are undiagnosed, lots of us and lots of people watching and listening, I'm sure, will have lent into things that they would say were helping them.
对吧？
Right?
他们会做那些他们声称自己必须做的事。
They would have done things that they said they needed to do.
所以，你可以先从负面的例子说起。
So you know, you can start with maybe the negatives.
比如那个总是在下班后第一个冲到酒吧的人，或者那个社交达人，但我觉得我需要这么做来放松，这是我需要的。
So the person that is always first to the bar after work, and you know, the social butterfly, but I need to do that to decompress, I to do that for me.
或者那个每个周末都外出的人，又或者是群体中最吵闹、最外向的那个人。
Or the person that is out every weekend, or, you know, the person that is the loudest in the group or the most sort of gregarious.
有些人知道，自己在家独饮几瓶啤酒可能被视为社会可接受的行为，但当你一个人喝完一整箱科罗娜时，或许就不对了，不过没关系，我没问题，这没什么大不了的，对吧？
The person who maybe knows that when they're drinking on their own at home, having a couple of beers might be seen as socially acceptable, but when you've done your own carton of corona to yourself, maybe that's not right, but it's okay, I don't have a problem, it's alright, it's not a problem, right?
所以，我们可以看看这些负面表现，对吧？
And so we can look at the negative, right?
我们也可以看看正面的例子，比如那些全身心投入工作、锻炼，或者沉迷于正念、呼吸练习或其他类似活动的人。
We can also look at the positive, those people who throw themselves into work, they throw themselves into exercise, they throw themselves into, you know, they become obsessed with the mindfulness or the breath work or the whatever.
我认为，如果你问这些人为什么这么做，他们通常会说，这对我有帮助，它让我感受到一些东西。
I think very often if you ask those people why do you do that, they say, well it helps me, you know, it makes me feel something.
我越来越注意到，无论是我指导的人还是我交谈过的人，如果你接着问他们：那么，不做这些事对你有什么好处？
What I've started to notice more and more with people I've mentored and with people I've spoken to is if you then ask them, okay, what doesn't doing that do for you?
我的意思是，当你真正静下心来思考时，你真的对自己这样生活感到快乐和安心吗？
I mean, when you really sit with it, are you really, really happy and comfortable with that?
很多时候，人们会开始敞开心扉说：不，但我不知道如果不这么做，我该怎么生活。
A lot of the time people will start to open up and say, no, but I don't know how to be if I don't I don't know how not to do that.
而这正是它们变成牢笼的时候，因为当我们不够自信时，就会回到你之前说的——也许我其实并不想每晚都出去社交。
And that's when they become cages, because when we don't feel confident enough, goes back to what you said about maybe saying, actually I don't want to go out and be social every night.
那种如果我不去，我会不会感到孤独的恐惧？
That fear of what if I don't, will I be lonely?
对很多人来说，这种恐惧让我们即使不情愿，也一次次地回头。
For a lot of people keeps us going back even when we don't want to.
这是一种牢笼。
It's a cage.
这是一种很难摆脱的牢笼，因为我们不确定自己是谁，需要什么，什么才是真正对自己好的。
It's a cage that's very hard to shake because we're not sure who we are, what we need, what is good for us.
所以是的，我看到很多情况下，这些行为变成了牢笼。
So yeah, I see a lot where they become cages.
我的意思是，这确实和成瘾模式有某种松散的关联，而且确实，我们看到一些人因为可能缺乏自控力，会说：‘没关系，就这一次，就这一次’，而其他人已经开始注意到，这其实不对，这太过分了。
Mean, look, yes, it's a very loosely connected metaphor to the addiction pattern as well, and yeah, we see examples of people who, again, due to maybe a lack of impulse control, would say, It's okay, it's just that, it's just that, and then other people have now started to notice that actually this is not right, this is too much.
但最难的是意识到这一点。
But it's the recognition of it that's hard.
我第一次意识到这个问题，第一次将这联系起来作为问题，是在多年前我上一份工作的时候，那时公司有一辆小型货车。
And where I first realized this, where I first started to connect this as a problem was years ago now with a previous job, had a sort of transit van thing, right, for work.
自从有了这辆货车后，几乎每个周末，每周好几个晚上，我都在帮别人跑腿。
Now as soon as I got that van, literally every weekend, several nights a week, I was out helping somebody.
你能过来一下吗？
Can can you come around?
我能借一下车吗？
Can I borrow the van?
你能帮我们搬一下这个吗？
Can we can you move this?
你能把这个挪一下吗？
Can you shift this?
我无法拒绝。
And I could not say no.
我无法拒绝，因为我觉得这样才是善良、是好朋友、乐于助人，而且这样做是对的。
And I couldn't say no because I felt that that was me being nice and being a good friend and being helpful, and and it was a good thing to do.
对吧？
Right?
我会对我妻子说，她一个人带孩子、忙这忙那，但我就得去帮别人，因为这本来就是好事，对吧？
And I would say to my wife who was struggling with the kids and doing things on her own, yeah, but I just need to do this because, you know, because it's good to do, isn't it?
对吧？
Right?
我没能意识到，对他们在家来说，这并不好——她独自一人挣扎，而我也没意识到，这意味着我没有休息，我总是疲惫不堪，我这么做不是为了自己，也得不到任何回报，但我害怕不去做。
I wasn't able to recognize that for them, at home, it wasn't good, that she was left on her own struggling, and I wasn't able to recognize that what it meant was I wasn't resting, I was perpetually tired, and I wasn't doing it for me, and I wasn't getting really anything from it, but I was scared not to.
那就是我的牢笼。
That was my cage.
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那就是我第一次意识到这对我的影响有多消极。
That's that's when I first realized how negative that was for me.
像这样的事情，表面上看似乎无害，但如果我们真正坐下来面对它们，就会发现它们确实是个问题，而且对我们没有任何帮助。
And it's things like that that I think can seem so innocuous, but actually if we really sit down and face them, they are a problem, and they're not serving us.
但这又回到了那些高度的焦虑、压力和对被拒绝、不合群的恐惧，我们之所以维持这些牢笼，是因为如果我不再这样做了，会发生什么？
But it goes back to those high levels of anxiety and stress and fear of rejection and not fitting in that we keep these things as cages that we do, because what happens if I don't anymore?
正是这种‘如果怎样’的恐惧，我认为才让这种情况持续发生。
And it's that fear of what if that I think keeps that happening.
我认为，在确诊之前，我一生中被困住的牢笼，总是与负面的过度专注有关，可以用三个D来概括：我会用酒精来淹没这些负面想法，嗯。
I think for most of my life pre diagnosis, the cage I was stuck in was always dealing with negative hyperfocuses with, I guess, three d's, like I would either drown the negative thoughts out with alcohol Mhmm.
但我现在不能再这样做了，因为和你一样，我相信如果我。
Which I can't do anymore because I like yourself I believe if I Yeah.
我是个酒鬼，喝酒对我而言非常危险，或者我会试图分散注意力。
I'm an alcoholic so drinking is very dangerous for me, or I would distract myself or at least try to.
如果前两种方法都做不到，我就会反复纠结于这些想法，那常常是极其可怕的。
And if I couldn't do those two, then I would dwell on the thought and that was often horrific.
我想，在诊断之后摆脱这个牢笼，就是意识到其中还有一个'C'，那就是沟通，找个人聊聊这件事。
I guess breaking out of that cage post diagnosis is realising that there's a C there which is communicate, find someone to talk to about it.
当你意识到这一点时，会觉得它如此显而易见，但内德·哈洛韦尔曾著名地说过：永远不要独自担忧，我认为这对所有这些问题都至关重要。
And you realise it and it's so obvious but Ned Hallowell famously said, never worry alone and I think it's so important with all of these things.
当你陷入思维漩涡，陷入反复思虑时——我们很多人都有这种倾向，它会轻易让你过度聚焦于可怕的事情——这时，就拿起电话吧。
When you get that spiral, when you get that ruminating the mind that so many of us have that make it so easy to hyper focus on something terrible when you're in that, pick up the phone.
是的。
Yeah.
我的意思是，这确实是康复的基本原则，对吧？
I mean, goes, yes, it's fundamental principle of recovery, isn't it?
你知道，如果你觉得自己有风险，就给某人打电话，但这里面也有一点微妙之处。
You know, if you think you're at risk, call someone, But there is a little nuance to that as well.
所以，如果你正处于反复纠结的阶段，有人对你说：亚历克斯，我觉得你一直在谈这件事，说得太多了，或者你这样下去会……
So if you were in that dwelling phase, and somebody said to you, Alex, I think you're talking about this too much, or you're gonna Right.
因为我们可能更容易遭受拒绝，更容易受到RSD（拒绝敏感性障碍）的影响，如果他们这么说，你很可能不会想：哦，谢谢你提醒我，这正是我需要听到的。
Because we might be a bit more prone to rejection, because we might be a bit more prone to RSD, the likelihood if they say that is you don't go, Oh, thank you for saying that, that's just what I needed to hear.
你会对他们的反应产生负面情绪，不，不，我不是，你错了，你猜怎么着？
It's that you then react negatively to them, no, no, I'm not no, you're wrong, and guess what?
然后你就又陷入了恶性循环。
Then you're back in the spiral again.
对吧？
Right?
所以这真的很难，因为你说得对，我们需要有能力拿起电话。
So it's really hard because you're right, it takes us having the ability to pick up the phone.
我们需要有能力意识到：我不该陷入这种模式。
It takes us having the ability to recognize, I don't think this is a pattern I should be in.
但要达成这一点很困难，因为它可能从根本上改变你对自己的看法。
But but that's difficult to come to because it can fundamentally change your opinion of who you are.
从那个笼子里挣脱出来可能会非常坎坷，因为正如你所说，如果你拿起电话，却感觉到对方没时间听你倾诉
It can be a really bumpy escape out of that cage, because like you said, if you pick up the phone and you just sense that that person doesn't have the time for
你，是的。
you Yeah.
或者他们给你一些心不在焉的建议，就像你说的，RSD就会被触发，是的。
Or they're giving you, like, half hearted advice, then like you said, RSD triggers Yeah.
然后，你就会被问题淹没，几乎产生一种强迫性的冲动，去面对那个极其危险的‘D’，它最终让很多像你我这样的人住进了医院，是的。
And suddenly, the drowning out of the problem, almost the compulsion to go towards that d, the really dangerous d that winds up a lot of people like you and me in hospital Yeah.
真的很难不去这么做。
Is really hard to to not do it.
所以，对我们很多人来说，逃离这个牢笼的过程几乎是一条极其危险的学习曲线。
So it's almost a very dangerous learning curve to get out of that cage for so many of us.
确实如此，但我觉得，如果你能理解并承认自己每天的状态，对吧？也就是说，承认这些状态——这才是最难的部分，你知道吗？
It is, but I think it's if you can understand what your days are, right, I mean, and admit of them, which is the hard bit, you know?
我们谈论的康复，就是跌到谷底的那一刻，那时人们才会承认：好吧，我撑不住了，我失去了控制，行吧。
We're talking recovery about hitting rock bottom, and that's the point where people admit, okay, I'm not coping and I'm not in control, fine.
如果你能做到这一点，你就更有可能感到自己能够拿起电话，而不陷入那种被淹没的感觉。
If you can do that, you have more chance, frequently of feeling like you can pick up the phone and not go into the drown particularly.
天啊，这太难了。
By heck, that's hard.
因为正如你所知道的，观看这个视频的其他人也知道，沉溺于其中非常有效。
Because as you will know, and other people watching this will know, the drowning is really effective.
我们学会了通过那些能淹没噪音、掩盖困难、让我们不必面对艰难事务的方式来应对，我们发现这真的很管用。
We learn that leaning into the stuff that drowns out the noise and drowns out the difficult and stops us having to face the hard, We learn that that works really well.
但我们不知道还有其他方法能同样有效，甚至更有效，而且我们害怕去尝试。
What we don't know is that there's anything else that will work as well, if not better, and we're terrified to try it.
因此，正是这种支持与教育的社群在说：试试看，打一次电话。
So it's that community of support and education that says, try it, pick up the phone once.
但确实，这非常困难，直到我们准备好承认那些牢笼就是牢笼，它们才会存在。
But yeah, it is very difficult, but those cages exist until we're ready to acknowledge that that's what they are.
马特，我听过你使用‘技能倒退’这个词。
Matt, I've heard you use the term skill regression.
在ADHD的世界里，这到底是什么意思？
What does that actually mean in in the sort of world of ADHD?
对。
Right.
所以要正确地看待这个问题，我实际上要说的是，技能倒退这个说法是错误的。
So to to go about this properly, what I actually say is skill regression is wrong.
我不认同‘技能倒退’这个术语，我坚信，当人们使用‘技能倒退’这个词时，往往是那些尚未真正理解如何解读自身状况的人在使用——这五个字背后，藏着巨大的误解。
I disagree with the term skill regression, and I I firmly believe that when people use the term skill regression, it's used by people that actually, and this will fight five words, don't yet understand what the process of making sense of their conditions is.
所以当人们谈论技能倒退时，通常发生在诊断或认知之后。
So when people talk about skill regression, typically it's something that happens after diagnosis or recognition.
他们说的，也呼应了我们之前讨论的内容：在职场中，我们经常听到，有人在同一份工作上干了三年，那是一份压力极大的工作，他们一直都能应付，但诊断之后，突然就做不到了。
And what they say, and it feeds back to what we were talking about, they say how all of a sudden they, you know, in the workplace we hear it a lot, they've had the same job for three years, and it's been a really high stress job, they've always coped, and then all of a sudden, post diagnosis, they can't do that anymore.
他们身体上做不到了，或者再也不能社交了，或者不能做这个、不能做那个，于是就把这一切归咎于ADHD和自闭症伪装导致的技能倒退。
They physically can't do it, or or they can't socialize anymore, or they can't this, or they can't that, and they term it as skill regression caused by ADHD and autistic masking.
其实并不是这样。
It's not.
绝对不是。
It's absolutely not.
这从根本上忽略了这件事最重要的核心。
Fundamentally, it misses the most important point of this.
那时真正发生的是信息处理。
What's actually going on at that point is processing.
你的大脑必须处理大量关于你是谁、你为何如此、你为何做出这些行为、你的人生为何如此的新信息。
Your brain is having to process an enormous amount of new information about who you are, why you are the way you are, why you've done the things you do, why your life has been the way it is.
在处理和理解这些信息的过程中，你的大脑必须过滤掉一些内容。
And as part of that processing and of making sense of that, your brain has to filter some things out.
它需要为这些新信息和新关注点腾出空间，因此有些东西会被挤出去。
It has to make space for all this new information and new focus so something will get pushed out.
这就是为什么人们会说：我只是没有足够的精力再做那件事了。
And that's why people say, I just I just haven't got the capacity to do that anymore.
我只是觉得我做不到。
I just I just don't feel I can.
这并不是负面的，这是正常的，也没关系。
It is not negative, it's normal, and it's okay.
感到这样是完全正常的。
It's absolutely okay to feel that.
我多次看到，无论是我指导过的人、共事过的人，还是注意力缺陷多动障碍（ADHD）群体中的人，当他们对这些状况的意义越来越适应时，那些曾被定义为能力退化的方面反而回来了。
What I've seen time and time again with people I've mentored, with people I've worked with, and the divergent ADHD community is, as people become more comfortable with what these things mean, some of the things they defined as skill regression come back.
他们之前能够做到的一些事情的能力会重新恢复，但可能会以不同的方式去做。
Their capacity to do some of the things they did before will return, but they may do them differently.
因此，他们可能会有选择地参加社交活动，而不是参加所有活动。
So they may choose the social events they go to rather than go to all of them.
他们可能会说：‘好吧，有个家庭生日派对，以前我毫无节制，会是最后一个在酒吧、喝得酩酊大醉的人，但现在我会去，但我会在十点离开。’
They may say, okay, there's a family birthday party, and whereas before I'd have no filter and I'd be the last person at the bar and be steaming drunk now, I'm gonna go, but I'm gonna leave at 10:00.
对吧？
Right?
这并不是能力退化。
That's not skill regression.
这是能力的提升。
That's skill acquisition.
这是学会应对。
That's learning how to cope.
对吧？
Right?
所以，我们认为能力丧失是由这种状况引起的，这种观点是不对的。
So this concept that we lose ability and it's caused by the condition is not right.
我们实际上是在为自己腾出空间，去处理一些非常困难、非常困惑、有时甚至令人不安的关于自我的信息，然后学习如何应对这些信息。
What we are doing is making space to process some really difficult, really confusing, sometimes really upsetting information about ourselves and also to then learn what to do with that.
本质上，总得有所取舍。
Inherently, something's got to give.
我不明白，为什么得了神经多样性诊断，就会失去技能。
I don't I don't understand how you can lose skills just because you've got a new diagnosis of a neurodivergent condition.
比如，如果我一生都在假装自己喜欢骑自行车，后来我得到了诊断，突然意识到，其实我并不喜欢骑自行车。
For example, if I was pretending that I like bike bicycle riding my whole life, and I got a diagnosis, and I suddenly realized that, actually, I don't like bicycle riding.
我只是为了融入而假装喜欢。
That I was just pretending to do that to fit in.
但我依然会骑自行车。
I still know how to ride a bike.
我并不会失去骑自行车或工作的能力。
I don't lose the ability to ride a bike or at work.
如果我以前假装喜欢会计或当医生，只是因为我觉得那是父母希望我做的，那么当我获得诊断后，我依然知道如何做心脏手术，依然知道如何使用Excel表格。
I don't if I was pretending to like accounting or a doctor because I thought that's what my parents wanted me to do, if I get a diagnosis, I still know how to do heart surgery or I still know how to use an Excel spreadsheet.
我并没有失去这些技能。
I'm not losing those skills.
难道这不是一个阶段，让人能够整合一生中所习得的所有技能——无论是否伪装过——然后以新的自我继续成长，基于已有的学习成果？
Surely, it's a stage where someone can consolidate all of the skills that they've acquired throughout their entire life, masking or not, and then take the new version of them selves onto the next version to to grow on what they've what they've already learned?
是的。
Yep.
我的意思是，没错，归根结底就是这样。
I I I mean, yeah, ultimately, it it's that.
这并不是所谓的技能倒退，这个词对我来说几乎是一种冒犯。
It's not and that's why the term skill regression is it's almost offensive to me.
我们并没有失去技能。
We don't lose skill.
对吧？
Right?
现在我给你一个很好的例子。
Now I'll give you I'll give you a real good example of this.
我上次买的杂技球在你身后。
The juggling balls I bought in last time are behind you.
对吧？
Right?
现在，杂技跟我生活紧密相连了十五年。
Now juggling was connected to my life for fifteen years.
我曾是一名表演者、小丑，教过八万人玩杂技，每周七天，这对我来说就是一切，对吧？
I was a performer, a jester, I taught 80,000 people to juggle, it was seven days a week, it was everything for me, right?
杂技和马戏团女孩对我来说就是一切。
And juggling and circus girls was just everything to me.
当我被诊断出来时，正处于一个极度不确定自我、对这一切意义感到迷茫的阶段，我根本不敢靠近杂技或马戏团女孩。
When I was diagnosed in the phase where I became so just uncertain who I was anymore and so unaware of what this all meant, I couldn't go near juggling or circus girls.
我身体上感受到了一种反应，因为那已经不是我了，我不确定它曾经真的是我，我不明白这意味着什么，这很痛苦，我就是无法再做下去。
I I physically felt a reaction to that because I was it's just not me anymore, and I'm not sure it ever was, and I don't know what that means, and it's painful, and I just couldn't do it.
对吧？
Right?
几乎让我感到厌恶。
Almost repulsed me.
我仍然能 juggler。
I could still juggle.
我仍然能教别人玩杂耍。
I could still teach people to juggle.
我只是无法靠近它，因为它与我当时对自己身份的认知不符。
I just couldn't go near it because it didn't fit with what I thought I or who I thought I was at that point.
直到今年，我才重新把杂耍融入我所有的主题演讲中，并用它来解释执行力之类的东西。
It's taken me until this year to now put juggling back into all of the keynote talks I deliver, and I use it to explain things like executive function.
对吧？
Right?
我用它来解释像过载或感官处理这样的问题，因为它非常有效。
And I use it to explain things like overwhelm or sensory processing because it works really well.
我之所以能做到这一点，是因为我已经完成了对诊断的消化。
The only reason I can do that is because I've done the processing of my diagnosis.
我已经理解了它对我意味着什么，以及我是谁。
I've made sense of what it means to me and who I am.
而现在，我实际上很喜欢杂耍。
And now, actually, I love juggling.
是的。
Mhmm.
我的包里现在有杂耍球。
I've got juggling balls in my bag.
对吧？
Right?
它依然像以前一样为我发挥作用。
It does what it always used to do for me.
如果我 juggles 几分钟，它就能让我大脑停下来。
If I juggle for a couple of minutes, it switches my brain off.
我减压了，但这是一种健康的放松方式。
I de stress, but it's a healthy decompress.
对吧？
Right?
所以这正是我要表达的要点。
So it's that's exactly that point.
我没有忘记怎么做，也没有倒退。
I didn't forget how to do it or regress.
我只是不能做，因为那不符合我的情况。
I just couldn't because it didn't fit.
所以，不幸的是，这种术语在社交媒体上被不断传播，有个人对我说过一句话，我觉得特别贴切。
So it's and unfortunately, this is terminology that gets perpetuated across social media, And there's a phrase somebody said to me that I really think this this fits into.
对吧？
Right?
所以，‘技能退化’这个说法现在被当作不可辩驳的事实。
So this term of skill regression is now taken as irrefutable fact.
对吧？
Right?
当观点开始被当作事实时，这就很危险，因为人们会以为自己必须按照那样去行为。
When opinions start to be taken as fact, it's dangerous because people then think that's what they have to behave like.
谁说这些是事实？
Who's saying they're fact?
哦，我明白了，我每刷到一个社交媒体短视频，只要有人谈论技能退化，说话的都是刚被诊断不久的人，他们只是重复看到的内容，因为这些说法符合他们的认知。
Oh, I see I see skill regression literally on every social media reel I watch when people talk about skill regression, and it's always by people who are incredibly newly diagnosed, and they're repeating what they've seen because it fits.
我能理解，你可能会对曾经擅长多年的事情感到厌恶，甚至不想再靠近，因为你把它和过去的自己联系在一起，而那个自己已经不再符合你现在的身份，但你其实依然会做。
I can I can understand how you might be repulsed or not wanna go near something that you've been skillful at for years because you dis you you associate it with a previous version of yourself that isn't aligned with your new self, but you still know how to do it?
比如，一位退伍军人可能因为创伤经历，再也不愿碰枪。
Like, war veteran might be so traumatized by his experience that he doesn't wanna ever go near a gun again.
但如果真的迫不得已，他依然知道如何装弹和开枪。
But he still knows how if push came to shove, he'll still know how to reload and fire a gun.
他并没有失去这项技能，
He hasn't lost that skill or
天啊。
shit.
这只是一个粗糙的术语，我认为没人认真思考过，而且同样地，也从未受到过质疑。
It's just a clunky term that I think wasn't thought through, and, again, hasn't been challenged.
人们都没有停下来想一想：不对。
People haven't stopped and go, no.
比如，我并没有忘记这个。
Like, I haven't forgotten this.
只是它不再适合我了。
It just doesn't fit.
这只是一个处理过程。
It's processing.
这里的基本概念是，你的大脑正在处理一些你不知道该如何应对的信息。
Like, fundamental concept here is your brain is processing information you don't know how to process.
你可能得不到处理这些信息所需的支持，总得有个突破口。
You're probably not getting the support you need to process, something's gotta give.
对吧？
Right?
总得有个东西突然崩掉，我实在没空间再容纳这个了。
Something has to suddenly go, I haven't got space for that.
这并不意味着你以后再也不会了。
Doesn't mean you never will again.
所以像这样的术语，你知道，当我们一再看到它们，姑且说‘伪装’吧，就会让人困惑，因为他们以为自己必须达到别人告诉他们的那些定义，但实际上并不需要。
So it's terminology like that, you know, when we see it repeated, and dare I say masking, that then confuses people because they think they have to live up to the definitions they're being told, and actually, they don't.
他们需要自己去弄清楚这些东西对他们而言究竟意味着什么，这才是关键。
They have to figure out what what these things actually mean to them, and that's the key.
我想换个话题，马特，简单聊聊哀悼。
I wanna move on, Matt, and talk about grieving briefly.
ADHD大脑是如何处理哀悼的？
How does the ADHD brain process grieving?
你觉得在亲人去世或关系结束时，情况会有所不同吗？
Do you think it is different, either in death, end of a relationship?
我想我们可以把这个延伸到任何事物的失去。
And I guess we can extend this to the loss of anything.
是的。
Yeah.
我的意思是，我不是临床医生。
I mean, again, so not a clinician.
我不能从临床角度谈论悲伤，但我可以说的是，尽管我妻子会对此提出异议。
I can't I can't talk clinically about grief, but what I can say is this, although my wife will challenge me on this.
这没关系。
That's fine.
长期以来，悲伤的黄金标准模型被称为库伯勒-罗斯模型，它认为当人们经历任何类型的悲伤时，都会经历某些阶段，我会误述这些阶段。
The sort of the gold standard model for grief for a long time was known as the Kubler Ross model, and it said that when people experience any kind of grief, they go through certain stages, and I'm gonna misquote these.
所以有愤怒、讨价还价、否认和接受。
So there is anger, bargaining, denial, and acceptance.
对吧？
Right?
现在，库布勒-罗斯模型认为，这些阶段可以在任何时间以任何顺序发生，甚至多次重复，直到我们能够理解并消化悲伤的过程。
Now what the Kubler and Ross Kubler Ross models said was those stages can occur at any time, in any order, and more than once until the process of grieving has become one that we are have able to make sense of.
我认为我们经常听到一句话：我们永远不会真正走出悲伤。
We never get over grief, I think it's something you hear a lot.
如果你把我们关于注意力缺陷多动障碍（ADHD）的所有信息——尤其是关于情绪失调、拒绝敏感性等方面——与一种极其创伤性的悲伤过程放在一起，难道不会觉得我们对悲伤的反应可能有所不同吗？
If you then take everything we hear about ADHD, particularly in terms of our emotional dysregulation, things like rejection sensitivity, and you put that next to a very traumatic process of grief, does it make sense that we might react differently to to to grief?
是的。
Yes.
确实如此。
It does.
我们可能会以某种方式做出反应，让别人觉得我们反应过度，或者对情境显得不切实际。
It it it makes sense that we may react in ways that seem to people over the top or sort of unrealistic to the situation.
某种程度上，我们常听说一些人——特别是当我们谈到自闭症时——表现得非常冷漠。
In some ways, we we hear of people, particularly, you know, when we talk autism, who are very cold.
你知道的。
You know?
说这话让我很难受。
Pains me to say this.
我知道我参加过葬礼，看到人们哭泣，却什么感觉都没有。
I know that I've attended funerals and seen people crying and felt nothing.
并不是我不难过。
Not that I wasn't sad.
我没有哭。
Didn't cry.
因为我的大脑以不同的方式处理所有这些情绪。
You know, because my brain is processing all of that emotion differently.
所以，是的，我认为我们确实如此。
So, yes, I think we do.
我认为真正重要的是这一点。
I think where it really is important is this.
当你得到诊断结果时，你就得到了一个答案。
When you get that diagnosis, you get an answer.
你得到了一个我们一直寻求的答案，对吧？我们想要的。
You get an answer that we've asked for, right, we wanted.
但当这个答案打开了一扇门，让你不得不面对一段可能包含困难、挑战、悲伤、不适、创伤，同时也包含快乐、喜悦和兴奋的过往时，我们的大脑就必须找到一种方式来处理这一切。
But when that answer then opens the door to having to look at a history that may include difficulty and challenge and sadness and discomfort and trauma and everything else, as well as happiness and joy and excitement, yes, our brain has to find a way to process that.
在我见过的几乎所有案例中，包括我自己刚被诊断出来的经历，我都看到了愤怒、讨价还价、否认和接受。
Now in almost everyone I've ever seen, including me who's newly diagnosed, I've seen anger, bargaining, denial, and acceptance.
有趣的是这个顺序。
What's fascinating is the order.
对于我接触和观察过的大多数人来说，最初通常都会遵循相同的顺序。
It tends to, for most people that I've worked with and I've seen, follow the same order initially.
令人惊讶的是，人们最先大声、强烈表达的往往是他们已经接受了这个事实。
And surprisingly, the first thing that people will very loudly, vociferously say is that they accept it.
哦，这真是一种解脱。
Oh, it's such a relief.
我拿到诊断结果了。
I've got the diagnosis.
是的。
Yeah.
百分之百。
100%.
哦，我一直都知道这很棒。
Oh, I always knew it's wonderful.
对吧？
Right?
九成情况下，前面比布莱顿更多。
That nine times out of 10 is more front than Brighton.
对吧？
Right?
我们之所以这么做，是因为如果我们不这样做，就得早早面对一个事实：天哪。
And we do it because if we don't do that, we've got to actually face very early on that, oh my god.
这太多了。
That's a lot.
对吧？
Right?
这就是为什么我们经常看到许多新确诊的人，突然想告诉所有人他们患有多动症，并与全世界分享。
That's why we see lots of very newly diagnosed people who suddenly wanna tell everyone about their ADHD and talk to the world about it.
对吧？
Right?
这是其中一部分，是的，我接受了，我要和你分享，因为如果我这样做，就不必停下来感受那种不适。
It's part of that, yeah, I accept this, and I'm gonna share it with you, because actually if I do that, I don't have to stop and feel the discomfort.
对吧？
Right?
但之后，我们总能看到一些人在初始阶段过后，进入一种看起来非常像否认的状态。
But then we always see people after that initial phase who will go through what looks very much like denial.
也许他们搞错了。
Maybe they're wrong.
我不是那种患有多动症的人。
Well, I'm not like that person who's got ADHD.
我不像他们，所以我觉得诊断并不对。
I'm not like them, so I don't think it was right.
也许医生的判断错了，你知道的。
Maybe the clinician wasn't right, you know.
我们看到讨价还价阶段，对吧？
We see the bargaining, right?
在人们决定是否服药时，这种情况经常出现，我经常看到这个讨价还价阶段浮现出来。
And that comes up a lot in people's decisions on not to take medication, that's where I see that bargaining phase come up a lot.
哦，我的多动症没那么严重，不需要吃药。
Oh, well my ADHD is not so bad that I need medication.
我不需要那个。
I don't need that.
通常这是因为人们不了解药物是什么、有什么作用，也没人向他们解释过，但他们正在为自己讨价还价，试图淡化多动症对自己的影响。
Now that typically is about they don't understand what medication is, what it does, they haven't had to explain, but they're trying to bargain for themselves about how ADHD impacts them.
对吧？
Right?
这个过程不断重复，我们会反复经历这些阶段，直到我们不再试图听别人告诉我们ADHD应该意味着什么，而是真正理解它对我们自己的意义。
And it goes over and over, and we repeat the cycles on these phases until we stop trying to hear what other people tell us our ADHD should mean, and we understand what it means to ourselves.
当我们第一次能够平静地坐下，说：我想我明白了。
When we can sit in peace for the first time and say, I think I get it.
我现在真的觉得，有了这些信息，我对自己是谁感到安心了，我也知道未来这意味着什么。
I I actually think now I'm comfortable with who I am with this information, and I think I know what it means going forwards.
那时，我们就不再看到那么多那样的情况了。
That's when we stop seeing so much of that.
再强调一下，我已经知道ADHD是我生命中的一部分长达十年了。
And and, again, to put that in context, I have known that ADHD was a piece of me for a decade.
我是2015年7月被告知的。
I was told July 2015.
对吧？
Right?
直到今年，我才能坦然地说：我可以坐下来，直视镜中的自己，接纳我是谁，接纳我的多动症和自闭症意味着什么，不再抗拒，不再否认，并对它对我的意义、我如何应对它以及如何表达它有了一些理解。
It has taken me until this year to be able to say I can sit down, I can look myself in the mirror, be comfortable with who I am, be comfortable with what my ADHD and my autism means, not fight it, not deny it, and have some sense of what it means to me and what I do with it and how I communicate it.
十年。
Ten years.
我不是说每个人都要花上十年。
I'm not saying it'll take a decade for everyone.
也许我只是比较慢。
Maybe I'm just slow.
但我想说的是，人们常常急于表现得好像已经完全懂了，结果反而延长了理解这个过程，而不是缩短它。
But what I'm saying is people are often in such a rush to seem like they've got it that actually they extend the process of making sense of it rather than shorten it.
你提到了药物？
You mentioned medication?
是的。
Yeah.
你对药物怎么看？它的效果如何？或者你觉得多动症的管理方案比药物更深一层？
What are your views on medication and the efficacy of it, or do you think the solution to ADHD management's deeper than meds?
是的
Yep.
我查阅了所有研究，拜访了所有临床专家，还去了在布拉格举办的全球注意力缺陷多动障碍联合会世界大会，与该领域最杰出的研究人员、科学家、药理学家和临床医生进行了交流。
All the research, all the clinicians, I went to the World Congress for World Federation of ADHD in Prague, spoke to the most prolific sort of researchers and scientists and pharmacologists and clinicians about this.
关于疗效，我们究竟知道些什么？
What do we know in terms of efficacy?
兴奋剂类药物，当适用于某人、以正确的方式逐步调整剂量并得到妥善管理时，是我们目前最有效的治疗方法，尤其在管理儿童和成人ADHD大部分症状方面，我们拥有确凿的循证依据。
Stimulant medication, when suitable, when when right for a person, titrated in the right way, managed properly is the single most effective treatment that we have, particularly that we have a conclusive evidence base for in managing the majority of symptoms of ADHD for children and adults.
对此，我找不到任何反驳的余地。
That that there is no argument to that that I can find.
有一篇论文，我不记得具体是何时发表的，大概是十一月吧，由一位名叫苏珊·杨格的杰出临床专家和该领域权威参与完成，这篇论文系统评估了所有可用的ADHD干预方法和治疗手段，分析了哪种最有效。
There was a paper, I can't remember when this came out, I want to say November, that was published by, well, contribution with a lady called Susan Younger, who's a phenomenal clinician and expert in this field, but she was part of the research, and what that paper did was it looked at all of the available, if you like, treatments, approaches for ADHD, and what was most effective.
那么，排在首位的是什么？
And again, what was at the top of the list?
药物治疗。
Medication.
每次都是药物治疗。
Every time, medication.
我在关于药物治疗的讨论中看到的问题是，当人们被告知药物可能是一个选择时，他们并没有获得正确的信息。
The problem that I see in the conversation about medication is that what people don't get at the point of being told that medication might be an option is the right information.
没有时间，对吧？
There isn't time, Right?
在临床就诊时，通常情况下，取决于你的医生是谁，由于对临床医生的压力，根本没有时间详细解释药物是什么、它如何起作用、意味着什么以及为什么需要它。
When we're in these in clinic appointments, very often, depending on who your provider is, there just isn't time because of the pressures on the clinicians to go into detail about what medication is, what it does, what it means, and why.
真的没有时间。
There just isn't.
对吧？
Right?
这就是为什么我与医生合作创办的播客《Deliberate with a Clinician》中，观看量最高的那一集，虽然远不及你们的数字，但仍然是我们至今观看量最高的一集。
It's why on the podcast that, you know, I started with Deliberate with a Clinician, our most viewed episode, nowhere near your numbers, but obviously, but the most viewed episode we've got still is the first one we did.
那是一期长达一小时五十六分钟的关于药物治疗的深度探讨。
It is an hour and fifty six sort of long deep dive into medication.
每一种药物。
Every medication.
它们的作用是什么？
What do they do?
它们是如何起作用的？
How do they do it?
为什么它们要这样起作用？
Why do they do it?
到底发生了什么？
What's going on?
对吧？
Right?
医生和临床人员在培训时都被推荐观看这段内容，以帮助他们解释清楚，对吧？
It's been recommended to physicians in training, it's been recommended to clinicians in training, saying you need to watch this to help you explain it, right?
我们一次又一次听到它是最受欢迎的，是因为这个播客里的信息，正是人们在被建议考虑用药时没能获得的信息。
And the reason it's the most viewed that we hear time and time again is because that information on that podcast is the information people didn't get at the point they were told, I think you might, you know, might want to consider medication.
所以因为人们不够了解，他们对此感到恐惧。
So because people don't understand it well enough, they're fearful of it.
对吧？
Right?
而且，哦，它会有副作用，如果它这样或那样怎么办？
And, oh, it's gonna have side effects, and what if it does this, what if it does that?
所有研究都已公开，明确告诉你具体的副作用、风险以及哪些不是风险。
All the research is out there to tell you exactly what the side effects are and what the risks are and what they're not.
对于儿童和成人，这些信息都已公开。
For children and adults, it's all out there.
我认为重要的是要说，药物是一种工具。
I think what's important to say is medication is tool.
对吧？
Right?
它是我们拥有的最有效的工具，但终究只是一种工具。
It's the most effective tool we've got, but it's a tool.
对吧？
Right?
它只做非常特定的事情。
And it does a very specific job.
对吧？
Right?
它直接作用于我们的大脑和神经递质，帮助我们集中注意力，从而有助于改善执行功能和情绪失调等问题。
It literally interacts with our brain, with our neurotransmitters, and helps us focus and concentrate, and by consequence then can help with things like executive function and emotional dysregulation.
它确实能做到这一点，而且在剂量合适的情况下效果非常好。
It does do that, and it does it really well if we're on the right dose.
这不是终身服用的。
It's not for life.
不是每天都要吃。
It's not daily.
需要时才用。
It's as and when.
它每天都在你的系统里。
It's at your system every day.
对吧？
Right?
所以我对它的看法是，我真心希望外界的信息能更完善，但我也非常开放地接受，我们还有其他可以支持和帮助自己的方法。
So my views on it passionately are I wish the information out there was better, but I am also very open to the fact that there are other things we can do that support us that can help.
对于那些不能服药的人，我们还有其他可以做的事情。
Now for people who can't take medication, there are other things we can do.
我们知道某些心理疗法，以及某些咨询方式，能真正帮助我们理解这种叫做注意力缺陷多动障碍（ADHD）的东西。
We know that certain psychological therapies, we know that certain sort of counseling approaches can really help us make sense of this thing called ADHD.
我们知道运动对ADHD有非常显著的影响，而且不同类型的运动还能改善ADHD的不同方面。
We know that exercise has a really interesting impact on ADHD, and that different types of exercise improve different parts of ADHD as well.
对吧？
Right?
我认为这对人们来说是很有趣的信息。
That's interesting for people, I think, to know.
我们知道，比如尽可能负担得起并能获得的最健康饮食。
We know things like, yes, being able to eat the healthiest diet that you can reasonably afford and have access to.
嗯，这很健康。
Well, it's healthy.
这很好。
It's good.
当然，它会有帮助，但不会起到同样的作用。
Of course, it will can help, but it it's not going to do the same thing.
所以对我来说，药物是金标准，因为有证据支持。
So it's it for me, medication is gold standard because there's evidence to it.
但NICE指南提倡多模式方法。
But the NICE guidelines talk about multimodal approach.
通常所说的这种方式是‘药物加技能’。
The the way that's often referred to is pills and skills.
如果其他方法能帮助我们培养技能，那当然很好，但相比不靠药物就能培养技能的人，更多人需要先靠药物才能发展出这些技能。
Now if other things help us develop skills, that's great, but there are more people that will need the pills in order to develop the skills than we'll be able to develop the skills without the pills.
对吧？
Right?
所以我们必须聪明一点。
So we have to be smart.
我们必须问自己，我害怕的是什么？
We have to be saying, what am I fearful?
当我听到‘药物’这个词时，我担心的是什么？
When I hear that word medication, what I worried about?
对吧？
Right?
但这些技能很重要，因为它们常常涉及这些问题：为什么我无法有条理？为什么我不能记日记或管理时间？
But the skills are important because they're they're very often the questions, so why aren't I organized, or why can't I keep a diary or management time?
我们可以学会应对这些的技能。
We can we can learn skills for those.
但，是的，这正是我一直以来的观点。
But, yeah, that's my point all the time.
说到循证医学，马特，你在这方面非常有名，有没有什么新的注意力缺陷多动障碍研究引起了你的注意，但目前公众还无法接触到？
And speaking of evidence based, Matt, something you're pretty synonymous with, is there any new ADHD research that has caught your eye that might not be accessible right now to the public?
是的。
Yeah.
有的。
There is.
我想说的是这一点。
I mean, the one thing I wanna say is this.
再说一遍，我不是临床医生，所以我发现的任何东西，其他人也都能找到。
Again, I'm not a clinician, so everything I find, anyone else could go and find.
任何东西。
Anything.
对吧？
Right?
你可以在PubMed或谷歌学术上找到，这些信息都公开可用。
You can find it on PubMed or Google Scholar or it's it's all out there.
关键是知道该搜索什么。
It's knowing what to search for.
然而，在布拉格举行的世界大会上，我参加了几场研讨会，我认为这些研究对公众了解 ADHD 领域的最新进展非常重要。
However, at the World Congress in Prague, there were a couple of seminars that I attended that I thought were really important for people to know the research was happening.
第一场研讨会专门探讨了睡眠障碍及其各种类型，以及 ADHD 如何影响这些睡眠障碍。
So the first one was specifically on sleep disorders and all different types of sleep disorders, and how having ADHD impacted those sleep disorders.
这非常有趣，因为这是第一次研究不再仅仅说：我们会关注睡眠——我们知道睡眠至关重要，高质量的睡眠非常重要，已有大量证据支持这一点。
That was really interesting, because it's the first time that that research has not just said, we'll look at sleep, which we know is vital, we know good quality sleep is really important, we've got lots of evidence that says that.
这项研究关注的是被诊断患有睡眠障碍的人群，以及他们同时经历的 ADHD，而这些影响因睡眠障碍的类型而异。
This looked at people with diagnosed sleep disorders and their experience of ADHD as well, and it is different, dependent on the sleep disorder.
不出所料，不同情况下的差异以及应对方式也各不相同，这很有趣。
Unsurprisingly, the difference and the way that people can manage it does vary, so that was interesting.
在那场研讨会结束时，我有机会提问：这项研究是否也包含了自闭症患者？
It was interesting that at the end of that I got to ask a question about did that include people with autism as well?
答案是否定的。
To which the answer was no.
所有参与者都是被诊断为注意力缺陷多动障碍（ADHD）的人。
The participants were all people who had a diagnosis of ADHD.
这就是研究的重点。
That was the focus.
他们并不确定这些参与者是否患有自闭症，但研究人员告诉我，这是一个有趣且重要的问题，因为确实，同时患有自闭症、ADHD和睡眠障碍的人可能会面临不同的挑战。
They didn't know for sure whether those people may be autistic or not, but what the researcher said to me was it is an interesting and important question because, yes, again, having autism plus ADHD plus a sleep disorder may well present again different challenges.
我觉得这非常有趣。
So that I thought was fascinating.
另一项研究更具全球性，不局限于英国，但我认为它很有意义。
The other research that was it's more global, less UK based, but I think it has a place.
另一项让我觉得特别有趣的研究是，现在已有大量关于不同地区、特别是不同国家的研究，探讨为何同一国家内不同地理区域的儿童ADHD诊断率存在差异。
The other research that I found really interesting was there are lots of studies that have been done now about different regions, countries particularly, looking at why there are different rates of diagnosis in children in different geographic areas in the same country.
所有儿童都符合ADHD的临床诊断标准，但在不同地区，诊断率却大相径庭。研究似乎指向一个原因——正如史蒂夫·法隆很好地解释的那样——这并不是说伦敦的ADHD儿童比切斯特的多。
So all children that would meet the clinical standard of ADHD, but in different areas there were very different rates of diagnosis, and what the research seemed to be pointing to, and again Steve Faron sort of really explained this well, was it's not to say that the children living in, you know, if we said it was in The UK, it's not to say that there are more children in London with ADHD than there are in Chester.
更可能的情况是，伦敦有更多了解诊断后能带来相应支持（如教育支持或其他资源）的临床医生，而在某些偏远地区，这种支持却很匮乏。那么，如果诊断不能带来药物以外的任何帮助，它对这些孩子究竟意味着什么？
What actually might point to more is that there are more clinicians in London that understand that if a child gets a diagnosis there, there is also the support that follows from that diagnosis, educational or whatever it may be, and that in certain regions, isolated regions for example, that support's not So what does the diagnosis then give that child if not medication?
我觉得这很有趣，因为它确实揭示了我们如何看待诊断对人们的意义以及背后的情况。
I think that was interesting because it does point to a way that we look at what a diagnosis means to people and what's going on.
虽然在会议上没有展示，但我想要分享的一件让我着迷的事情是这个。
But whilst not presenting it at the conference, the one thing I wanted to share that I found fascinating was this.
在我们采访史蒂夫·法隆时，他说了一些话，这帮助我重新思考了多动症的含义。
Steve Faron said something while we were interviewing him, and it sort of really helped me reframe what it means about ADHD.
他说，现在已经有很多人群研究在探讨所谓的‘多动症’与‘非多动症’之间的分界线在哪里。
And he said there have been lots of population studies now done to look at where the line, if you like, the cutoff for has ADHD, doesn't have ADHD is.
他说，例如，如果你写下多动症的症状描述，然后分别发给伯明翰、伦敦、爱丁堡和康沃尔的一千人，让他们根据自身情况打分，你会发现，并不是某些地方的人更多或更少符合标准。
What he said was, for example, if you did if you wrote up a description of ADHD symptoms, and you gave that to a thousand people in Birmingham, in London, in Edinburgh, in Cornwall, and you ask them to score themselves on how they think they fitted in, what you would find is not that there were more people who did or more people who didn't.
你会看到一种非常典型的、他们称之为‘自然的渐变分布’。
You would find a very, what they call, natural graded distribution.
没错，曲线两端平缓，更多人表现出部分症状或某些表现。
Right, a gentle curve towards the ends, more people that had some presentation, some of the symptoms.
他说，你也可以用基因测序的方式来做类似但不同的研究。
He said you could then take that and do that differently using genomic sequencing.
对吧？
Right?
所以我们现在可以抽取一滴血样。
So we can now take a blood sample.
我们可以分析你的DNA。
We can look at your DNA.
他说，如果我们用DNA样本来做，结果也会完全一样。
He said if we did it using DNA samples, right, you'd find exactly the same thing.
一千个人的基因都会被单独检测。
Thousand people all have their unique gene go sampled.
你会看到完全相同的结果。
You would find exactly the same thing.
不会有一端的人更多，另一端的人更少。
There's not more people with at one end and more people without at the other.
这是一种渐变的分布，这一点很重要，因为它也影响了工作组的中期报告，报告中也提到了这一点。
There's a graded distribution, and that's important because it feeds into the interim report for the task force as well because it was mentioned there.
对我来说，这一点很重要，因为它表明有些人如果接受评估，是不会达到诊断标准的。
For me, that's important, because what it says is there are people who, if they went for an assessment, would not meet the criteria.
但这可能意味着他们不是勾选了八个症状，而是只勾选了六个。
But that might mean that instead of ticking eight symptoms, they only tick six.
这是否意味着他们没有在挣扎？
Does that mean they're not struggling?
这是否意味着我们就不会支持他们？
Does that mean that then we don't support them?
不，不应该这样。
No, it shouldn't.
这意味着我们需要关注他们需要什么样的支持，因为他们可能和那些符合标准的人一样挣扎，甚至更艰难。
What it means is we need to look at what's the support they need, because they could be struggling just as much and just as hard as someone that meets the criteria.
对吧？
Right?
那我们该怎么做？
So what do we do?
这就是社会教育和社区教育发挥作用的地方，帮助人们理解如何自助至关重要，我认为这是最重要的事情，因为这正是我所有努力的核心。
That's where social education comes in, that's where community education comes in, that's where helping people understand how to support themselves is really important, and I think that's the most important thing, because that's everything I'm trying to do.
这回归到一个原则：如果我们能帮助更多人理解ADHD对他们意味着什么，再赋予他们工具，让他们能以他人能理解的方式解释这一点，人们就能获得更好的支持与理解，从而在生活中真正茁壮成长。
It goes back to the principle of if we can help more people learn how to understand what their ADHD means to them, and then give them tools to know how to explain that to other people in a way that they can understand, people are going to start to be able to get better support and better understanding and to actually then thrive more in life.
但要做到这一点，我们必须停止用近乎伪临床的术语——如症状或特质——来解释ADHD。
But to do that, we have to stop explaining ADHD in almost pseudo clinical terms by symptoms or traits.
时间盲区对你来说意味着什么？
We have to say, what does time blindness mean to you?
执行功能困难对你来说意味着什么？
What does executive function challenges mean to you?
这对你意味着什么，又如何影响他人？
What does it mean to you, and how does that impact someone else?
你需要什么样的支持来帮助你？
And what's the support you might need that could help you?
这正是我现在为所有企业客户开展每场培训的方式。
It's how I deliver every session I deliver with my corporate clients now.
我不谈论任何症状，也不告诉他们如何识别多动症或自闭症，这毫无意义。
I don't talk about any symptoms, I don't tell them how to spot ADHD or autism, it's of no relevance.
我告诉他们人们可能正在经历哪些困难，并提供一套不会引发威胁感或恐惧、却能促进相互理解的问题框架。
I tell them what they'll see that people might be struggling with, and I give them a framework of questions that they can then ask that isn't threatening, that doesn't spike fear, but that leads to a mutual understanding of her.
如果我们这样做，这对您有帮助吗？
So if we do that, does that help you?
而且你猜怎么着？十次中有九次，这种支持要么成本很低，要么免费。
And guess what, nine times out of 10, that support is either low cost or free.
这仅仅就是理解。
It just is understanding.
所以，我认为研究与亲身经历的部分至关重要。
So that's where I think the research and the lived experience piece is important.
如果现在观看这段视频的每个人都能记住一个信息，那就是这个。
If everyone watching you, watching this now, takes one message away, it's this.
已经完成的研究并不落后于时代。
The research that's been done isn't behind the curve.
它远远领先于当前水平。
It's well ahead of the curve.
只是还没有发表，因为进展缓慢。
It's just not published yet because it's slow.
这就是研究，对吧？
That's research, right?
研究的价值与亲身经历的价值同样重要。
There is as much value in the research as there is in the lived experience.
我们需要更多地将两者结合起来，这样我们就不会认为这一边是病理化，而另一边是完全整体的社会模型。
What we need is a coming together of the two more, right, so that we don't think that it's pathologizing on this side and a really holistic social model on this side.
我们认为，看看我们拥有的这些丰富信息，它们能帮助我们理解多动症是什么，以及如何更好地支持人们理解它对他们的意义。
What we think is, look at all this amazing information we've got that can help us understand what ADHD is, and how we can better support people to understand what it means to them.
如果我们能做到这一点，我认为我们将开始看到一种完全不同的对话。
If we can get there, I think we start to see a very different conversation.
真的非常引人入胜，马特。
Truly fascinating, Matt.
非常感谢。
Thank you so much.
不客气。
My pleasure.
我想以ADHD痛苦艺术环节结束，我觉得你对这个很熟悉。
I wanna finish with the ADHD agony art section, which I think you're familiar with.
是的。
Yes.
我们上次做过，就是‘烦恼洗衣机’，因为我的ADHD物品就是一台洗衣机，因为我总是把洗衣物留在机器里。
We did it last time, which is the washing machine of woes because my ADHD item is a washing machine because I always leave my laundry in the machine.
我之前问过你这个问题吗？
Did I ask you that before?
我是否这么做。
Whether I do.
你是否把洗衣物留在机器里。
Whether you leave your laundry in the machine.
我得说实话。
I've gotta be honest.
我几乎从来不洗衣服，因为我记不住。
I barely do the laundry because I don't remember.
我需要别人提醒我才能去做。
I have to be reminded to do it.
所以，没有，我不这么做。
So no, I don't.
但说实话，我们都这样。
We all do, if I'm honest.
衣服在机器里放好几天，还经常自动重启新循环，真吓人。
The washing stays in there for days, and it goes on a new cycle so often it's frightening.
那大家都应该用Tiimo这款应用，这是我们的赞助商，自从我开始用它之后，马特，我记事情的能力确实变好了。
Well, everyone should be using the Tiimo app, which is the sponsor, and since I've been using them, Matt, I'm actually getting pretty pretty good at remembering.
你看，这不就对了嘛？
There you go then, see?
这周，马特，洗衣机里有人问：作为一个患有注意力缺陷多动障碍和焦虑症的人，每当我向别人提起这件事——无论是伴侣还是同事——我都会莫名其妙地与他们失去联系，渐渐地，他们就从生活中把我排除了。
This week, Matt, in the washing machine, someone's asked, as someone with ADHD and anxiety, every time I tell someone about it, my partners or work, I magically lose touch with them somehow, and gradually, they fizzle me out of their lives.
你觉得这两者有关系吗？
Do Do you think the two things are connected?
有关系？
Connected?
是的。
Yes.
我认为这个问题的核心其实是，我会问那个人：当你每次跟别人说起你的注意力缺陷多动障碍时，你是想帮助他们理解这到底意味着什么，还是在用一种近乎临床的、假设对方已经了解ADHD含义的方式，跟你谈论症状和表现，期待他们因此能支持你？
What's actually, I think, at the heart of this is I would ask that person, when you say every time you talk to someone about your ADHD, are you trying to help them understand what it means, or are you talking to them about traits and symptoms with an understanding of ADHD that is almost more clinical and expecting them to know what that means and therefore to be able to support you?
因为现在普遍的叙事就是：我们被教导去谈论症状——注意力不集中和冲动行为，但我还是要重申这句话：没人像你一样关心这些症状意味着什么。
Cause that's the narrative out there, really, is we're taught to talk about the symptoms, and inattention and impulsivity, and I'll go back to this phrase, no one else is as interested in what that means as you are.
他们真的根本不关心，一点都不。
Literally they don't care, they don't.
所以与其谈论‘我的ADHD意味着什么’，不如想想该怎么表达，比如‘当我把衣服留在洗衣机里’这种情况。
So rather than talking about my ADHD means, it's about how can you say, when I leave the washing the washing in the washing machine, for example.
我这么做是因为我不太擅长管理时间，或者记不住流程。
I do that because I'm not very good at keeping track of time, or I'm not very good at remembering processes.
这让我感到非常尴尬。
That makes me feel really embarrassed.
当你接着问：‘你为什么又这么做了？’
And when you then say, Why have you done that again?
这让我觉得你在评判我，对吧？
It makes me feel like you're judging me, right?
真正能帮到我的是，你不要那样说，而是可以说：‘嘿，我注意到你把洗衣机里的衣服忘了拿出来，我已经晾好了，我们能做点什么来帮你？’
What would help me is if rather than saying that, you could say, Hey, I noticed you left the the washing inner machine, I've hung it out, what could we do that might help you?
这可能是提醒应用，也可能是便签，或者其他任何方式，但别跟我谈什么ADHD段子，要谈的是：当我这么做时，意味着什么，我有什么感受，我知道这影响了你，而我真的不想成为那样的人。
Now it could be a reminder app, it could be a post, you know, it could be anything, but don't talk about my ADHD memes, talk about when I do this, it means this, it feels like this, I know it impacts you, and I really don't wanna be that person.
如果我们能开始这样做，就会失去更少的人。
If we start doing that, we lose less people.
因为他们知道如何跟人对话，却不知道如何跟一个诊断标签对话，毕竟谁教过我们这个呢？
Because they know how to have a conversation with people, they don't know how to have a conversation with a diagnosis, because who was ever taught that?
这就是我会说的话。
That's what I would say.
我知道这个播客也帮助了很多人，因为我看到评论区里的反馈。
And I know the podcast as well helps people, because I see it in the comments section.
当哦，我
When Oh, I
去洗衣机的时候，看到评论说：你提醒了我该倒洗衣机里的衣服了，非常感谢。
go to washing machine, see comments saying, you just reminded me to empty my washing machine, so thank you very much.
是的。
Yeah.
它总是整整齐齐的。
It's always tidy.
但，没错，这又回到了社区这个事情上。
But, yeah, but but it goes back to that is the community thing.
如果有人听了之后留言，另一个人看到了，这就是我们提供帮助的方式。
If somebody listens and comments and somebody else sees it, that's how we help.
所以，是的，这就是我想说的。
So, yeah, that's what I would say.
马特，非常感谢你。
Matt, thank you so much.
马特，在我们结束之前，每位嘉宾都会写下三条生活准则，并把它们放在这个邮局里，我现在要递给你上一位嘉宾的信。
Matt, before we finish, every guest writes their three rules to live by, and they post it in this post office, and I'm gonna deliver to you the previous guest's letter.
你能为我们读一下这封信吗，马特。
And if you could kindly read it for us, Matt.
有三条生活准则。
There are three rules to live by.
第一，尊重自己的身体舒适。
Number one, treat your own physical comfort with respect.
你的感官体验很重要。
Your sensory experience matters.
是的。
Yeah.
我喜欢这个。
I like that.
第二，善待自己，这样你才能善待他人。
Number two, be kind to yourself so that you're able to be kind to others.
第三，不要因为享受或投资于自己的爱好和兴趣而感到内疚。
And three, never feel bad about enjoying or investing in your hobbies and interests.
非常好。
Very good.
不过，在24小时过去之前，别花太多钱。
Well, don't spend a fortune until twenty four hours has passed.
是的。
Yeah.
我的意思是，设置一个提醒回来。
I mean, set a reminder to return.
经典的技巧。
Classic hack.
是的。
Yeah.
马特，再次衷心感谢你分享的全部智慧。
Matt, once again, thank you so much for all your wisdom.
代表所有听众和观众，非常感谢。
On behalf of all the listeners and viewers, huge.
非常感谢你。
Thank you so much.
谢谢。
Thank you
感谢你再次邀请我，我真心希望我没有挑战太多人，但希望这些内容能有所帮助。
for having me back, and I I I genuinely hope I haven't challenged too many people, and I hope it helps.
你做得完美极了。
You've been perfect.
谢谢你，马特。
Thank you, Matt.
干杯。
Cheers.
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