498：与 Hiral 一起现场工作，第 1 部分（共 2 部分）

大家好，欢迎收听《感觉良好》播客，这里教你掌握一些高效的方法，改变你的情绪状态。

Hello, and welcome to the Feeling Good Podcast, where you can learn powerful techniques to change the way you feel.

我是你们的主持人，巴罗夫斯基医生。

I am your host, Doctor.

罗nda 巴罗夫斯基，今天在穆里埃塔演播室里，和我一起的是伯恩斯医生。

Rhonda Barovsky, and joining me here in the Murrieta Studio is Doctor.

伯恩斯。

David Burns.

伯恩斯医生。

Doctor.

他是认知行为疗法的先驱，也是全新TEAM疗法的创始人。

Burns is a pioneer in the development of cognitive behavioral therapy and the creator of the new TEAM therapy.

他撰写的《感觉良好》一书，在美国销量超过五百万册，已被翻译成三十多种语言。

He is the author of Feeling Good, which has sold over 5,000,000 copies in The United States and has been translated into over 30 languages.

他最新出版的《感觉极佳》一书，包含了全新的高效技巧，能帮助许多饱受抑郁和焦虑困扰的人快速恢复。

His latest book, Feeling Great, contains powerful new techniques that make rapid recovery possible for many people struggling with depression and anxiety.

伯恩斯博士

Doctor.

伯恩斯博士目前是斯坦福大学医学院临床精神病学的荣誉兼职教授。

Burns is currently an emeritus adjunct professor of clinical psychiatry at Stanford University School of Medicine.

罗达，我可能没几次机会这样说了，所以我想趁现在好好表达一下。

Rhonda, I won't get a chance to do that too many more times, so I thought I'd probably get the most out of it.

你好，大卫。

Hello, David.

见到你真高兴，也欢迎世界各地、甚至银河系各处的听众收听《感觉良好》播客第498期。

It's really great to see you, and we wanna welcome all of our listeners from across the world, across the galaxies to the Feeling Good Podcast, episode four ninety eight.

你说话的时候，声音听起来像是从歌剧明星切换到了百老汇音乐剧明星。

And it seems like your voice goes from opera star to Broadway musical star when you say

谢谢。

the Thank you.

我都老糊涂了，根本分不清了。

I'm so old and demented, I can't tell the difference.

我从来不接受任何夸奖，不管是认真的还是开玩笑的。

I don't take any kind of compliment, sincere or joke.

太好了。

Great.

给我们的听众介绍一下今天会听到什么内容吧。

Well, tell our listeners what they're going to hear today.

这可以说是你第500期播客的压轴之作，就在后天就到了。

Well, this is going to be kind of the grand finale of your, you know, five hundredth podcast, which is coming up in the third one from today.

这是最后两期了。

These are the last two.

当然，第500期我们会好好回忆一下过往。

And of course, we'll reminisce a lot on number 500.

但这一期是我们最精彩的一次教学，现场辅导一位来自印度的年轻女性希拉尔，她聪明又善良。

But this is our best teaching ever, which is live work, in this case with Hiral, a lovely, bright young woman from India.

她遇到的问题，我们每个人都感同身受。

And she had problems that we can all identify with.

主题当然就是‘我不够好’。

The theme, of course, being I'm not good enough.

她有个四岁的儿子，每次带他打疫苗时，孩子都会发脾气。

In her case, she has a four year old son and he sometimes throws a temper tantrum in particular when she took him for a vaccination.

我觉得她当时自己也崩溃了，接着就开始责怪自己。

And I think she kind of had a meltdown herself and then is beating up on herself.

这期节目分两部分，专门讲这个问题，特别精彩。

And it's a great two part podcast on that specific issue.

最后的结果，你们到结尾就能看到——尤其是看了我们精心准备的节目笔记后，会发现效果简直不可思议，彻底改变了。

And the outcome, you'll see toward the end, especially if you look at the fantastic show notes we've got for you, you'll see that it was just another unbelievable total blow away.

我们接下来还会和她做第三期内容。

We're going to have an upcoming part three with her.

不确定会不会做成播客，但我们会安排一次防复发训练，看看她课后的情况如何。

I don't know if it'll be a podcast or not, but we'll do a relapse prevention training and see how she's doing after the session.

她还提到很多和家人之间的相处问题，还有文化方面的困扰，但这次节目时间有限，我们没来得及深入讨论。

She also had mentioned a lot of interpersonal issues with family and, you know, cultural issues that we chose not to deal with in this podcast just due to the shortness of time.

不过我们可能会在第三期里也聊聊这些内容。

But we might do a part three on some of them, include some of those on the part three as well.

今天这一期，我们只聚焦在共情、测试和共情这部分。

One other unique feature, today we'll do just the empathy, the testing and the empathy part of the session.

下个月四月，正好是第500期，我们会做阻力评估，也就是所谓的悖论式目标设定，那个环节特别精彩，还有那些方法，简直太棒了。

And then next week in April, coming right up to number 500, we'll do the assessment of resistance, the so called paradoxical agenda setting, which was pretty fantastic, and the methods, which were ultra fantastic.

另外，这个播客还有一个特别的地方，虽然节目笔记里没怎么提，我现在先提醒你们一下，你们听第一期快结束的时候，我们会请每位患者给我们三个方面的共情表现打分。

But another thing that is unique in this podcast, and it's not so much emphasized in the show notes, I'm going to just mention it now so you can listen for it, is that in the part one that you're going to hear, you know, the end we ask for three letter grades at the end of empathy with every patient.

你觉得我们在认知共情上表现如何？

How do you rate us in thought empathy?

你觉得我们在情感共情上表现如何？

How do you rate us in feeling empathy?

你觉得我们在温暖与接纳上表现如何？

And how do you rate us in warmth and acceptance?

这三点是共情最关键的三个维度。

Those are the three crucial dimensions of empathy.

她给了我们一个A或者A+，在思维共情这一项上。

And she gave us, as you'll hear, an A or an A plus something like that on thought empathy.

我们完全理解了她的想法。

We understood exactly how she's been thinking.

我们在情感共情上也拿到了A或A+，但她拒绝给我们温暖和关怀这一项打分。

We got an A or an A plus on feeling empathy, But she refused to grade us on warmth and compassion and the relationship.

这其实说明了两件事。

And that meant two things.

第一，她不仅没觉得和我们亲近，也没感受到那种你期待的接纳感。

Number one, not only were we not was she not feeling close to us, and that warm kind of acceptance that you're looking for.

她甚至都不够信任我们，不愿意给我们打分。

She didn't even trust us enough to give us a grade.

很多治疗师会觉得这是失败。

And a lot of therapists would think that's a failure.

但我们的理念是，你最大的失败，往往正是伪装成失败的最大成功。

But our philosophy is that your greatest failures are your greatest successes in disguise.

事实上，我当时很难和她拉近距离。

And I was, in fact, having trouble feeling close to her.

我不知道这会不会彻底毁了整个咨询，但我确实从没见她之前就有这种感觉。

And I didn't know if it would entirely sabotage the session, but I'd never met her before and I actually felt that way.

我第一次见到她，就在咨询开始前半小时，就觉得她把我推开了，好像根本不想敞开心扉。

When I first met her, thirty minutes before the session began, I felt pushed away and like she wasn't going to open up.

我当时就想，天啊，如果这个问题不解决，这次咨询肯定要黄。

I thought, wow, if this isn't addressed, this session is going to be screwed.

接下来你们会听到事情是怎么发展的。

And so you'll hear that unfolding.

到了下周的第二部分开头，你们会听到我是怎么处理这件事的，以及最终这场咨询竟然变得如此出色。

And then at the start of part two, which will be next week, you'll hear how I attempted to deal with it and how this turned out to be a most phenomenal session unfolded.

我这里有没有漏掉什么重要的，罗达？

Is anything I'm leaving out here, Rhonda?

这次和她主要的对话内容，大家下个月四月才会听到。

Well, the bulk of this discussion with her, people are going to hear next week in April.

而且

And

你知道，

know,

你真的很大胆，我说不出具体怎么说，但你确实是个很有魄力的治疗师。

you're pretty I don't know what the I mean, you're a very bold therapist.

是的，没错。

Yeah, that's right.

这种风格我是从心理剧中学来的。

And I got that from psychodrama.

就我个人而言，我可没你这么大胆。

And just speaking from my own experience, I am much more timid than you are.

比如，你之前说，第一次见到她的时候，你根本感觉不到和她亲近——这个细节大家下个月就能听到。

So for example, when you said to her, which people are going to hear next week, that when you first met her you didn't feel that close to her.

我当时一听就完全被吸引住了，心想：天啊，这怎么做到的？

I was riveted to that and I thought, oh my God, how is this?

他怎么会这么说？

What did he say that?

你知道吗，接下来会发生什么？

You know, what's going to happen next?

比如，她会被听到吗？

Like what's, is she going to be heard?

我知道个人工作还在继续，但我一直在想，她会不会突然沉默？

Is the feed is, you know, I know that the personal work continued, but I thought, is she going to clam up?

你说治疗师都会害怕，可我明明只是在听，也觉得紧张又忐忑。

And I was, you know, you say that therapists are scared to be And I was feeling kind of nervous and scared, even though I was just listening.

所以我特别专注地听着这段对话是怎么展开的。

And so I felt very riveted to listening to how that dialogue unfolded.

后来你们三个人真的展开了一场深刻的交流，帮她完成了很有成效的个人成长。

And it did turn into a very meaningful exchange between the three of you, which led to a very successful personal work for her.

我觉得这正是你和她工作中的关键时刻。

And I think that was that's the key moment in your work with her.

就像我之前说的，真的特别吸引人。

And it is, like I said, very riveting.

谢谢。

Thank you.

你刚才说的，我特别喜欢。

I love what you were saying.

我完全同意。

And I agree 200%.

没错。

Absolutely.

不妨听一听，一定会觉得很有意思。

So give it a listen and enjoy it.

另外，虽然你可能不太会看节目笔记，但这次吉尔第一次和AI合作撰写了这些内容。

And then make sure you might not tend to read the show notes, but Jill wrote them in collaboration with AI for the first time.

她俩的合作成果真是非常出色。

And so the two of them are pretty brilliant.

吉尔的智商是176。

And Jill has an IQ of 176.

天哪。

Oh gosh.

他们俩的智商加起来有376。

And they also have an IQ of three seventy six.

两个人合起来，智商差不多快到五六百了。

So together they're up around 500 or 600.

真厉害。

Wow.

那些节目笔记简直像艺术品，美得像诗一样。

And the show notes, they're just a work of art, like poetry.

它们能帮你更深入地理解内容。

And so they'll enrich your understanding of what's going on.

在这期节目中，我和吉尔讲得特别简单，但其实我们做的事非常复杂，涉及多个层面同时进行。

In this session, we make it seem very simple, Jill and I do, but it's actually pretty complex what we're doing and it exists on multiple levels simultaneously.

但在开始之前，我话说得有点多了，马上闭嘴。不过我们得感谢希拉尔，不仅因为她带给我们激动、情感、泪水，还有这段我们都将铭记的深刻个人体验，更重要的是，她为我们展示了什么是最好的教学方式——让你亲眼看到治疗可以是什么样子，也是我心目中治疗应该有的样子。

But before we start, and I'm talking too much, and so I'm about to shut up, but we want to thank Hiral, not only for giving us excitement and emotion and tears and a powerful personal experience we'll all share, but also she's giving us what is, to my way of thinking, the best teaching possible, showing you what therapy can be and what I believe therapy should be.

不是这样的。

It's not this way.

我说的‘治疗应该有的样子’，是指一个两小时的单次疗程，你几乎就能完成整个治疗过程，就像希拉尔那样，从满眼泪水、绝望，一下子变成无比的喜悦。

By what therapy should be, I mean a single two hour session where you pretty much complete the treatment and people go from tears and despair as Hiral did to overwhelming joy.

而且这整个过程，就发生在短短两小时里。

And that's in one, you know, in this case, two hours session.

如果你对这个感兴趣，一定要认真听，我们会一步步告诉你，我们是怎么做到的。

And if that interests you, make sure you pay close attention because we'll show you exactly how we made that happen.

太好了。

Great.

欢迎各位来到《治疗室现场》，我是大卫·伯恩斯的节目。

Welcome everyone to Inside the Therapy Room Live with David Burns.

我是吉尔·莱维特，非常兴奋能和大卫一起主持这个半天的工作坊。

I'm Jill Levitt, and I'm really excited to be presenting this half day workshop alongside David.

今天早上能和大卫一起，作为他的助手来配合这位志愿者，这真是难得的机会。

It's really a unique opportunity to see David and myself as a humble sidekick working with our volunteer this morning.

希望大家能从中收获很多，不仅被触动，也能作为治疗师和普通人，真正产生共鸣、学到东西。

We hope that you'll learn a lot and that it will touch your heart and that you'll be able to relate and connect and learn a lot as a therapist and a human being today.

首先，让我为大家介绍一下大卫，他可能根本不需要介绍。

First, let me introduce you all to David, who maybe needs no introduction.

大卫·伯恩斯是世界知名的 psychiatrist、认知行为疗法的泰斗、畅销书作者，也是《感觉很棒》这款应用的创始人，稍后大卫会跟我们多分享一些关于这个应用的内容。

David Burns is a world renowned psychiatrist, CBT legend, bestselling author, and the creator of the Feeling Great app, which David is gonna share a little bit more with us about at the end of the presentation.

除了作为临床医生和作者极具创造力，大卫多年来一直是我们这些致力于学习 TEAM CBT 技法的人的良师益友。

And in addition to being incredibly creative as a clinician and an author, David is just an amazing mentor and supporter of all of us who've been working with him and striving to learn these TEAM CBT tools for many years.

能和你一起主持，我一直感到无比荣幸和开心，大卫。

So it's always a total honor and pleasure to present with you, David.

接下来，我要为大家介绍今天我们要合作的志愿者。

And now to introduce you to the volunteer that we're gonna be working with today.

她叫希拉尔。

Her name is Hiral.

大卫和我以前从没和希拉尔合作过。

And David and I have never worked with Hiral before.

我们其实今天早上九点前十五分钟才第一次见到她，之前都没见过面。

We've actually never met Hiral before, before about fifteen minutes before 09:00 this morning when we had a chance to talk with her.

不过我们有她的每日情绪记录。

We have her daily mood log though.

我们请她填了一份不完整的每日情绪记录，主要是想让她描述一件让她感到困扰的事情。

We asked her to complete a partially complete a daily mood log just to articulate kind of an event that was distressing to her.

大卫，我们先看一下希拉尔的简短情绪问卷，然后再请她自己说说她是谁，最近遇到了什么困扰，你觉得怎么样？

So David, should we just go over Hiral's brief mood survey first and then we can ask Hiral to tell us a little bit about herself and what she's been struggling with.

首先，希拉尔，非常感谢你愿意参与我们这次活动。

Well, first of all, Hiral, thank you so much for joining us.

你现在感觉怎么样？

And how are you feeling at this moment?

我有点紧张。

I'm feeling very nervous.

谢谢你告诉我们这些。

Thank you for telling us that.

能说说你现在感到紧张的具体情况吗？

And tell us about that nervousness that you're feeling right now.

这种紧张感有多强？

How strong is it?

当时你心里在想些什么？

What are the thoughts associated with that?

我担心自己在这么多来学习的人面前出丑。

I think I'm feeling that, I I hope I don't make fool out of myself in front of so many people who are here to learn.

你怎么会觉得你会出丑呢？

And and how how would I make a fool of myself?

我觉得是因为会犯错。

I think by making mistakes.

听起来你心里有个声音特别追求完美，一直在提醒你不能出错。

So it sounds like there's a voice inside of you that's a little bit perfectionistic and and telling you you you you mustn't make mistakes.

我能想象，这现在一定让你感到特别焦虑。

And and I I can imagine that that creates a lot of anxiety right now.

但我很好奇，这种压力会不会也让你觉得孤单？你看，我们两个人都真心想关心你，吉尔也一样。

But I'm I'm I'm wondering if it also creates a feeling of, of loneliness that that that here here we are two people, and I would like to care about you, and Jill would like to care about you.

但我想知道，你对自己施加的这种压力，是不是也让你觉得特别孤立？

But I'm wondering if that pressure that you're putting under yourself also leads to feeling alone.

是的，确实如此。

Yes, it does.

你能说说，此刻你感受到的孤单或寂寞是什么样的吗？

And can you tell us about feeling alone or lonely right at this moment?

对。

Yeah.

我说的不只是现在，这种感觉已经持续很久了。当你总是担心别人会怎么想，就会不知不觉觉得自己迷失了，跟所有人都脱节了，也感受不到当下正在发生的事。

I mean, not only this moment, think it's been forever because I think when you're thinking so much, about what others will think, I think, you just end up feeling, lost and disconnected from everybody and what's happening right now.

而且你根本没法专心做任何事。

And you're not able to focus also on anything.

如果我理解得没错的话，你刚才说的这些，我有时候可能没完全听懂，你要是发现我理解错了，一定要告诉我——但听起来，这种感觉已经伴随你很久了，孤独和疏离感似乎一直缠着你，挥之不去。

If I understand correctly what you're saying and I don't always get it right so let me know when I when I don't, But that that's been a long time in your life that this feeling is something that's with you a lot, and maybe the feeling of alone and disconnection is something that's that's with you an awful lot.

当我意识到这些的时候，我心里真的很难过，因为我知道你是个温柔又敏感的人，却把这么多心事都藏在心里。我希望我们能慢慢靠近你，让你感受到支持。

And and and when I realize that about you, I I just wanna assure that I I I feel a kind of sadness, because I know that you're a beautiful, vulnerable person, but that you're, you know, holding, holding a lot in and hopefully we can, we can, you know, connect with you.

我现在特别喜欢你的笑容。

And I love your smile right now.

你此刻在想什么？

What are you thinking just at this moment?

是的，我其实就在想，你们说得都对，只是我现在不太能像自己希望的那样多说几句话。

Yeah, I'm just thinking that, yeah, you're just getting things right, that I'm not able to speak as much as I would want to right now.

对。

Yeah.

没错，就是这样。

Yes, exactly.

我们会试着，我也一定会想办法，帮你克服这种想说却说不出来的犹豫。

And, we'll we'll try to I'll try to get you to to to speak, in spite of, that that that that reluctance.

如果我们真的做了，那道堤坝一定会崩塌，洪水肯定会涌出来，我确信。

And and and and if we do, the the dam will will break open and the waters will will flow, I'm I'm sure.

不过咱们还是先办正事吧。

But let's do our our our our business.

谢谢你刚才说的那些话。

But thank you for for that.

Hiral，你刚才说的那番话，我特别喜欢。

I loved what you just said, Hiral.

这个短暂情绪量表，大部分评分都是从0到20分。

The, the Brief Mood Survey, these most of the scores go from zero to 20.

今天早上开始前，你在抑郁测试中的得分是11分。

And on the depression test, your your score this morning just before starting was was 11.

这属于中等程度的抑郁。

And and that's a moderate level of depression.

其中两个表现特别明显：总是感到难过、情绪低落、沮丧，甚至觉得毫无希望。

And the two of the symptoms were a lot and that's sad and down in the dumps and discouraged and hopeless.

其他一些症状，比如自尊心低、动力丧失，还有对生活中的乐趣和满足感减退，虽然也有升高，但没那么严重。

And then some of the other symptoms, low self esteem and loss of motivation and loss of, you know, pleasure and satisfaction in life were elevated but not quite so severely.

但这些抑郁症状已经足够让你失去生活的乐趣了，尽管你身边有那么多快乐的源泉——那么可爱、聪明的小男孩，那么活泼的小家伙，还有你即将迎来的培训和认证考试，想想看，一旦摆脱这些负担，那个光彩照人的你，那个被层层阴霾遮住的你，该有多耀眼。

But that's way more than enough depression to take the joy out out of life in spite of the fact that there's a lot of potential sources of joy with a beautiful little smart little boy, spunky little guy, and, you know, your training and your certification exam coming up, and how great it would be to unleash that beautiful Hiral who's who's hiding behind all of this stuff.

这正是我们所期待的奇迹。

And, that's the kind of miracle we're hoping for.

没有自杀的念头。

No suicidal urges.

焦虑的程度甚至比抑郁还高一点，14分出20分，这明显属于中度，快要进入重度了，五项焦虑症状里有四项都很明显，比如紧张、担忧、不安、神经质等等。

The anxiety, was, slightly stronger even than the depression, fourteen out of twenty, that would be certainly moderate heading and into the severe and, four of the five, anxiety symptoms were a lot like anxiety and worrying and tense and nervous and so forth.

所以你现在同时承受着相当严重的抑郁和焦虑。

So you're experiencing, you know, depression and and anxiety both in pretty big doses.

还有另一点，吉尔，你提到过，愤怒的情绪也很强烈，我觉得这是我们今天要重点处理的部分。

And then another thing that, Jill, you you pointed out is that the anger is is is quite strong also and will be an important part, I think, of what we do deal with this morning.

愤怒的程度和焦虑一样，也是14分出20分。

It's it's as strong as the anxiety, and it's, four 14, out of twenty twenty.

所以你的愤怒程度属于中到重度。

So that you're that's, you know, a moderate to severe level of anger.

如果我们没做这个测试，可能根本不会意识到你有这些情绪，更不会清楚它们有多强烈。

And, and if we didn't do this test, we wouldn't be aware of that you're having these feelings and exactly how strong they are.

我们不能保证一定有效，但我们的目标是，根据你的期望，看看今天能不能带来一些改变。

And we can't guarantee anything, but our our goal, depending on what your goals are, would be to see if we can cause some shifts in in today's session.

幸福量表也是从0到20分，你的得分是8分。

Now the happiness, there version of the happiness scale also goes from zero to 20, and your score was eight.

在这个量表上，20分代表最大的幸福感。

Now on this one, a 20 would be the greatest happiness.

所以8分说明你感受到的快乐和喜悦非常少，只是有一点点，希望也只算中等程度。

And so the eight shows very little happiness, in terms of feeling, you know, happy and joyful only somewhat and hopeful only moderately.

这里没有哪一项是强烈或极度的。

There's nothing here that's a lot or extremely.

这当然和你正在经历的抑郁有关——你感觉低落，缺乏快乐和成就感。

So, that that that, of course, relates to to the to the depression that, you know, that you know, you're feeling down and you're not feeling a lot of joy and reward.

另外，关于你和丈夫的关系，关系满意度量表满分是30分，你的得分是10分，说明在关系的五个方面都存在一定程度的不满，这肯定也对你现在的情况有影响。

And then another thing that came up here is with with your husband, the relationship satisfaction scale goes from zero to 30 and, your score was was 10 and indicating, some level of dissatisfaction with all five areas of the relationship, and I'm sure that will will play a role as well in in what's going on.

如果觉得合适的话，吉尔，我这就把话筒交还给你，我们可以先做一点共情练习，然后再填每日情绪记录表。

And then if if if it makes sense to you, Jill, I'll turn it back over to you and we can do a little empathy, and then we we can do the daily mood log.

我们最好早点开始，让用户先有个直观感受。你翻到手册第四页，能看到这份每日情绪记录表，里面充满了自我批评的想法。

We should probably do it early to give users a feel and if you look at that page in your handout four, you can see here all's daily mood log with a lot of self self critical thoughts.

那不如你从头开始，一步步带我们走一遍，吉尔？

But can why don't you take us from, first base to second base here, Jill?

好的。

Yeah.

听起来不错。

That sounds great.

而且，我更希望先让希拉尔自己说说，用开放的方式聊聊她的处境，让我们能更了解她这个人，以及她背后的故事。

And, yeah, I'd rather I'd like to just hear a little bit in an open ended way from Hiral so that we feel like we know who she is and a little bit about the context in kind of an open ended fashion.

在共情环节，我们也可以看看她的每日情绪记录表，希拉尔花了一些时间，试着梳理那些引发这些情绪的想法。

And then as part of empathy, we can also turn to the daily mood log where Hiral took a few minutes to try to think through what some of the thoughts are that are driving these feelings.

不过，跟我们说说你自己吧，Hiral。

But yeah, tell us about you, Hiral.

你之前回复了我发的志愿者招募邮件，说很想得到一些帮助。

Sent out an email requesting a volunteer and you sent me an email saying you'd love to get some help.

能跟我们讲讲，你具体需要哪方面的帮助？背后有些什么情况？

So tell us a little bit about what you're looking for help with and some of the context.

我觉得最需要的是，不管做什么事，我都想能真正放松下来。

So I think the biggest help is that I really want to feel relaxed while I'm doing whatever.

就算是在扮演妈妈这个角色的时候，我也只想轻松愉快地待着，而不是整天担心他的未来、他的行为。哪怕是在准备三级考试，或者去上课的时候，我也希望自己能相信‘我能行’，而不是总觉得自己落后了——因为其他同事的孩子更小，他们都能兼顾，我却因为全身心扑在儿子身上，觉得自己远远落后了。

I mean, even if it's playing the role of a mother I want to just feel relaxed and happy and not just worry about his future or his behaviors and even if I'm you know preparing for my Level three or you know attending some classes I just want to feel as if, know, I can do it instead of thinking that, oh, you know, I'm just way behind, other colleagues of mine just because, know, my entire focus is on my son and, like nurturing him up because I also feel, you know, so behind in this race when I come across colleagues who have younger kids, than me and I feel, my god, if they can do it, why can't I do it?

就算我陪着儿子的时候，我也开心不起来；可要是我做点自己的事，又会觉得对不起儿子，没为他做得够多。

And, so I don't feel happy even like, you know, while I'm, attending to my son and I, if I'm, you know, doing something for myself, I feel that, you know, I'm not, doing enough for my son.

所以不管怎么选，我都快乐不起来。

So either ways I'm not happy.

是的。

Yeah.

所以，我很想再多听听你刚才说的，还有你提到你有个小男孩，对吧？

So then again, happy to hear more about what I'm hearing you say so far and what you shared with us a little bit as you have a little boy, right?

你儿子快四岁了，你觉得自己必须当个完美的妈妈，要把他照顾好、培养好，压力特别大。

Almost four year old son and you're feeling just a lot of pressure to be an excellent mother and to do a really good job nurturing him and caring for him and raising him well.

所以你经常觉得自己不够好，对吧？

And so you're often feeling not good enough, right?

你不断怀疑自己，甚至没法好好享受和他在一起的时光，因为你总觉得必须当个完美的妈妈，把他养得无可挑剔。

You're questioning yourself and you're not able to enjoy your time with him because you're feeling so much pressure to be an excellent mother and to raise him perfectly.

这种压力还蔓延到了你的工作上，比如你正在学习TEAM CBT这个模型，准备三级认证考试，但你也觉得自己在这上面不够好。

And then that bleeds a little bit into your professional work as well, where it sounds like you're training and learning this model, the TEAM CBT model, you're getting ready for a Level three certification exam, and you're also not feeling good enough there.

你好像总在和同事比较，觉得他们干得比你多。

You're comparing yourself to your colleagues, it sounds like, and thinking I'm not doing as much work as they are.

他们准备得比你充分。

I'm not as prepared as they are.

育儿方面也是这样。

And the same thing in the parenting realm.

我比那些孩子和我儿子一样大的朋友都落后了。

I'm behind my friends who have children this age.

我不如他们当父母当得好。

I'm not as good of a parent as they are.

这真的让你失去了很多快乐。

And that's really zapping a lot of kind of joy out of your life.

我理解得对吗？也想多听听你这方面的心声。

Is that am I getting you and happy to hear more of that too?

是的，确实如此。

Yeah, that's true.

我说，我整天都累得要命，其实也没干多少体力活，就是精神上特别耗人。

I mean, yeah, I think I feel so tired the whole day despite not doing anything physically, so much engaging.

所以我总是觉得累，然后感觉自己一直在原地打转，事情却一点都没推进。

So, yeah, I just feel tired and then yeah, I just feel I'm just moving in some kind of a circle or a loop and the loop is not getting done.

就是这么一直转啊转，没完没了。

Mean it's on it's it's just going on and on.

我想好好睡觉，可就算拼命想放松，也根本睡不着。

Can I'm not able to sleep well, even if I try so hard to just relax it is very difficult.

就连星期天都很难真正放松下来，可能我对自己太苛刻了，你也懂的。

Mean it's not that easy to even relax on Sundays as if you know I'm just being too harsh on myself or you know yeah.

你刚才说一整天都特别累，睡不好，也放松不了，能再详细说说吗？当然我们可以看你的每日情绪记录，但我想听听你自己的感受，为什么会这样。

Yeah I was gonna ask you when you said you feel so tired the whole day and you're not able to sleep very well, you're not able to relax, tell us more and again, we can look to your daily mood log for sure, but tell us more about why that is.

最后你说，你对自己要求太高了。

Ended by saying I'm just so hard on myself.

所以，你是陷入了一种自我批评的循环里吗？

So is that it feels like you're in this kind of loop of self criticism?

我觉得吧，我这个人特别希望家里井井有条、平和安宁。可看到长辈们根本不明白家里到底该做什么，我就特别焦虑。我本身是个年轻妈妈，情绪管理已经够难了，还要忍着不被孩子的行为激怒，再加上家人又不支持，真的太累了。

Yeah, I think see, I'm a kind of a person who likes, you know, to have peace and harmony and some kind of order in the house and when I see that, people elder to be, they are not understanding that what exactly is needed to be done in the house and you know I'm also being a young mother I'm also struggling so much, you know to, like to manage my own emotions, overwhelming emotions and you know to also to not get triggered by his behavior and, you know, also then, you know, the, unsupportive family environment.

所以我才觉得这么疲惫——好像不管怎么努力，总顾此失彼。我要是顾着自己和孩子，就顾不上整个家；可我要是顾家，又觉得对不起自己和孩子。我知道我得先照顾好自己和孩子，因为他完全依赖我，可同时，我们又离不开父母的帮助，这种矛盾让一切都变得特别难。

So I think that is why I feel so tired that, you know, it's it seems like, you know, if I try to lose if I try to save one boat I think I'm missing the other two ones and if I'm taking care of the if I'm taking care of myself and my son then I think I'm not able to take care of the family and I also really think that it's very important for me to take care of myself first and my son because he's dependent on me but at the same time, it also seems that, we are also dependent on our parents So that is is making things very difficult for us.

你能再详细说说吗，希拉尔？

Can you tell us more more about that, Hiral?

听起来你一直得当个完美的妈妈、妻子、家庭支柱，还得应付职场上的各种要求，一想到这些，我真的心疼。所有社会对女性的压力都太大了。

It sounds like you like, and and this kills me when I think about, you know, all the pressures on on women, and and in all societies, really, that that you've gotta be this perfect mother and then, you know, wife and family and and then, you know, the the the professional demands.

你拼命想把每件事都做到极致，却总在责备自己，连一点喘息和享受的机会都没有。

You're trying to do all of these things, you know, in a in a really high level way and and just constantly beating up on yourself and never getting a chance to to enjoy anything.

你能再多说说吗？尤其是那种愤怒，你心里积压了太多对亲人的不满。

And can you tell us more about that and especially the anger because you're you're carrying a lot of anger, you know, kind of toward toward loved ones and and so forth.

你能不能跟我们和观众分享一下你来自哪里？还有你的文化背景，我觉得这点特别重要，不能忽略。

And you might want to share with us and the audience just where you're located and a little bit of that kind of cultural background as well, just because I think it would be we would be remiss to not acknowledge that too.

是的，我来自印度的古吉拉特邦。

Yeah, so I'm from India and there's this state called Gujarat.

我来自古吉拉特，我们家还是传统的大家庭。我丈夫是独生子，我们自己经营生意，但即便他工作上很独立，经济上还是得依赖我公公。

So I'm from Gujarat basically and like we still live in a joint family where I have my husband who's an only child and we have our own family business but still you know my husband is very I mean despite being so independent at work we still have to you know be dependent on, my father-in-law for the finances and everything.

除此之外，我们还面临巨大的代际差异。他家特别传统，根本不愿意接受新观念，也不承认别人可以有不同想法、不同生活方式。这让我特别累，既要迁就他们的要求，又要照顾我儿子的需求。

Apart from even that, I think, there is this huge, generation gap also which we are dealing with and also, I mean, we come from a background where, you know, not exactly background, but his family is such that it's very rigid when it comes to adapting to new things or, you know, even acknowledging the fact that you know someone can have different know thoughts and opinions and approaches and perspective towards life so I think it becomes more challenging, frustrating and irritating for me to, you know, accommodate their needs and at the same time to, you know, accommodate my son's needs.

还有，我家也不在城里。

So and yeah, so and plus also, like, my my own house is not in the city.

所以我总觉得这么孤单，有时候连跟父母敞开心扉说说话的空间都没有，跟朋友也难联系，因为我现在没上班，很少出门。

So, you know, the the reason why I feel so lonely is because there is sometimes there is just no space for me to even, you know talk to my parents, openly or you know talk to my friends because I'm not working right now, so I don't get to go out so much often.

我出门就只是接送儿子，最近我才开始健身。

Only time I go out is to pick up and drop my son or I have started working out recently.

所以只有这时候，我才能有点属于自己的时间，跟朋友或父母聊聊天。

So it is that only that is the time when you know I, get some time for myself where I can connect to my friends or connect to my parents.

是啊，这么多事堆在一起，真的让人招架不住。

Yeah, so it just feels too much to handle at the same time.

这不仅影响我的心理健康，身体也跟着出问题。

And it is also affecting my mental well-being and physically also.

我激素失调，身体上一堆状况。

I mean, I have like hormonal imbalance and a lot of things going physically.

Hiral，我有个问题之前没太弄明白，想再跟你确认一下，也好好想想你刚才说的。

So Hiral, I had one question that I did, it wasn't clear on and then I can reflect a little more on what you said.

你、你丈夫和儿子，是跟公婆住在一起的吗？

So are you and your husband and your son living in the house with your in laws as well?

是的。

Yes.

对。

Yes.

好的。

Okay.

但不是你自己的父母，对吧？

But not your parents, correct?

不是。

No.

没错。

Right.

所以你的意思是，你得同时照顾丈夫、公婆，还有儿子的需求。

And so you're saying like, it feels like you're having to address the needs of your husband and your husband's parents and your son.

你一直在为家里很多人付出，操心着他们的各种需求。

And so there's just a lot that you're really very much giving to a lot of people and trying to take care of the needs of a lot of people in the home.

你现在正在带孩子，还没回去上班，也没重新开始执业，不过你一直在学习，已经走在复出的路上了。

And at this point, you're raising your son and not yet back to work or not yet practicing, though you've been studying and you're kind of on that road.

但我觉得，如果你能和父母、朋友聊一聊，可能会让你感觉好多了，也能更安心一些。

But it feels like even maybe it would be really helpful and connecting to be able to talk to your parents and talk to your friends.

可你现在几乎一直待在家里照顾孩子，感觉像被困住了。

But right now you've been really stuck at home caring for your son and just feeling a bit trapped.

不过听起来你已经在慢慢好转了——刚开始去健身房锻炼，更关注自己的健康，也试着带孩子出门办事，找一些小机会和外界联系。

And it sounds like you're making a bit of progress on that, that you've just started going to the gym, working out, taking care of yourself more, getting out of the house to drop your son places and finding small pockets of places to connect.

但你明显觉得这些还不够，这种不足让你情绪更低落，压力也更大了。

But you're definitely feeling that you need more of that and that's kind of making you feel more down and stressed as well.

另外还有一件事，你提到你公公，我不是要批评他或者他妻子，只是觉得他们有点固执，不太容易接受新观念。

And to add one more little thing, you mentioned that your father-in-law, not to be critical of him or his wife, but that they're a little rigid and slow to capture on to new perspectives.

我记得当年我和妻子从费城搬回加州，也就是我们现在住的地方，那时我们离我公公和继婆婆很近，本来是挺好的。

And I I can recall when my wife and I moved back to California where we now live after twenty years in in Philadelphia, that, we we were it was great because we were close to my my, you know, my in laws, father-in-law and my step mother-in-law.

我们喜欢和他们一起看电影、逛逛，但他们的价值观和对生活的理解，跟我们差别实在太大了。

But we were we liked to hang out with them and go to movies and stuff, but their values, and understanding of life was so radically different.

就连谈情绪这件事，对他们来说都特别陌生。

Even the thing of emotions and talking about emotions was something they they they, you know, it seemed kind of alien to to them.

我岳母和继母根本没法理解，一个人怎么会感到抑郁。

And, you know, my mother-in-law, stepmother-in-law, you know, couldn't imagine how a human being would ever be depressed.

她们觉得看医生就是乖乖听医生的，根本不需要自己动脑筋。

And so the so it was the, and they thought when you go to the doctor, you do what the doctor tells you, you know, you're, there's no critical thinking.

这完全是两种完全不同的处世哲学。

And it was just a completely different philosophy.

但我们还是很喜欢和她们待在一起，当然也不是天天在一起。不过我能想象，要是真住在一个屋檐下，肯定特别压抑。

But we loved being, being with them and we, you know, we weren't with them all the time, but I can imagine very well if we were trapped living with them in the same house, it would have been enormously uncomfortable.

我想她们可能也希望我们过她们那样的生活，但这根本不公平。她们的生活就是家里四堵墙，或者办公室四堵墙，而我天生爱探索，喜欢冒险。我以前住的城市朋友很多，生活特别热闹。现在我搬到这座城，结婚八年了，当妈妈也四年了。

Yeah, I guess I think they are also expecting us to live the way they are living, which is absolutely, not fair and so like their life is like you know only the four walls of the house or the four walls of the office and I'm someone who loves exploring, you know, I love adventure but then and plus the city from where I come I had like a lot of friends and, you know my life was very happening So now that you know I have come to another city, I have been married since eight years now and, I have been, I have I am mother since four years.

对我来说，这同样是个巨大的转变。

So like, like for me also it's a huge adjustment.

所以我经常生气，是因为我一直在迁就别人，可轮到他们体谅我、理解我的需求时，却一点动静都没有。连最亲近的人都不考虑我的感受，那我还能去哪儿找理解呢？

So, one of the reasons why I also feel angry so much is that you know when others when like I am trying to accommodate to someone else's needs and when it's their time to reciprocate and understand that, you know, even my needs are supposed to be, taken into consideration or, you know, even I have to be taken care of, I think when that understanding doesn't come from, very closed ones, I think then you feel then, you know, I mean, where do you go?

就是这样。

So it's like that.

你得照顾他们的需求，但他们却很少有人关心你的感受。

So you're expected to take care of their needs, but you don't see a lot of people trying to take care of your needs.

是的。

Yeah.

对吧？

Is that right?

对，没错。

Yeah, that's right.

而且，你原来的生活方式——你喜欢冒险，

And then in addition, your life as you know it, want to know it, is you love adventure.

喜欢热闹，喜欢充满活力的氛围。

You love things that are happening, excitement.

你以前朋友很多。

You have a lot of friends.

而现在，你几乎失去了所有这些。

And now almost all of that's kind of cut off for you.

所以你差不多就像被关进了牢笼。

So you're almost in kind of a prison.

是的。

Yes.

看到你笑真好，但我能想象这一定特别痛苦。

Yeah, it's good to see you smile, but I can imagine it's a very painful thing.

我真的希望我们至少能找到第一步，帮你缓解一下，因为听上去对你来说实在太难了，希拉尔。

And I sure hope we can find at least a step one in getting some relief on this thing because it sounds just awful for you, Hiral.

是的。

Yes.

确实如此。

It is.

你甚至都没有属于自己的时间。

You don't even have time with yourself.

是的，没那么多。

Yeah, not as much.

所以我总觉得自己抽出时间照顾自己，有点过意不去。

So I just feel guilty of, you know, taking some time out for myself.

直到我意识到，如果我不好好照顾自己，很可能会因为月经周期相关的问题引发严重疾病，我才开始真正锻炼身体、关注健康。

It's now that I've started working out or taking care of my health is only since the time I've gotten to know that you know okay if I don't take care of myself I might end up getting, you know getting into a severe, illness related to, my menstrual cycle and all of that.

正因如此，我才开始考虑要好好对待自己，因为我知道，不管我为公婆做多少，他们永远都不会满意。

So only that is something which is you know, making me think of taking care of myself because I know as it's never going to be enough, you know no matter how much I do for my in laws because they are never satisfied with whatever I do.

我为他们做事，他们从不感激；我不做，他们又满腹抱怨，脸上和行为里全是失望。

So it's like even if I do something for them they will never appreciate and acknowledge and even if I, don't do something for them of course then there is this lot of criticism and there is this lot of disappointment that I see, on their faces and in their behavior.

这听起来就像单行道。

That sounds like a one way street.

一味付出、一味付出，亚伦·贝克管这叫付出与回报的失衡。

Give, give, give, give, Aaron Beck used to call that a give, get imbalance.

不断付出，却从得不到任何回报。

Giving, giving, giving, and never getting anything in return.

真的吗？

Is that right?

是的，没错。

Yeah, that's right.

听起来真暖心。

Sounds really sounds warm.

我把它还给你，吉尔。

I'll give it back to you, Jill.

是的，我正想提两点，大卫，我觉得我们现在可以做一下。

Yeah, I was going to ask, I mean, two things that I think would be helpful for us to do at this point, David.

第一，我们可以问问希拉尔，看看我们在共情方面做得怎么样，请她给我们打个分。

One is we could check with Hiral and ask how we were doing on Empathy and ask her to give us a grade.

第二，也许在那之前或之后，最好先和她一起看看她每天的情绪记录。

And the other thing is that perhaps before or after that, maybe it makes sense to do it before it is to go over her daily mood log with her.

我听到希拉尔现在有两个方面的困扰，一个是这种我们通常说的个人情绪问题，对吧？

I'm kind of hearing two areas of work or two areas of distress that Hiral is having right now and one is this kind of what we think of as an individual mood difficulty, right?

对自己要求太严，总是自我批评，觉得自己当妈妈不够好，在工作和学业上也不够出色，甚至当儿媳也做得不够。

Being really hard on yourself and self critical, feeling not good enough as a mom and in your work and as a student, even as a daughter-in-law.

这部分我觉得我们可以深入探讨一下，结合你的每日情绪记录，一起把它更具体地呈现出来。

So there's kind of that piece, which I think we could explore a lot more and maybe bring to life more looking at your daily mood log together.

另外还有一个相对独立但又有点关联的话题，我觉得更适合单独处理，就是她和公婆、丈夫之间的人际关系问题，以及由此产生的愤怒、怨恨、挫败和孤独感。

And then there's kind of a separate topic that might be related a bit, but that I think actually would be a separate focus, which has more to do with relationships and some of the anger and resentment and frustration and loneliness she's feeling as related to her in laws and husband and kind of situation in life.

我的看法是，这两方面确实可以分成两类，我觉得我们首先应该准确理解她的情况，但不妨先从她个人情绪和自我苛责入手，结合每日情绪记录，把这部分更生动地展开。

So my guess is, yeah, hear it in these kind of two different categories and my guess is that, well, we should make understanding her correctly, but maybe go down the road more of the individual mood and the being hard on herself and turn to her daily mood log, to bring that to life more.

你觉得呢，大卫？

What do you think, David?

是的，我觉得这就像要打两场仗，一场是个人内心的，另一场是人际之间的。

Yeah, I see it as like two battles to be won here, the individual, and the interpersonal.

没错。

Exactly.

这两方面都有解决办法，也有很多可以做的积极事情。

And they both, have solutions and a lot of great things that can be done.

但我觉得我们可以先从你的每日情绪记录开始，看看你是怎么苛责自己的

But I think if we start with the the daily mood log and and the way you're criticizing yourself

对

Yeah.

这会是一个非常重要的第一步，同时我们也清楚，你和丈夫、家人之间的关系问题也需要用合适的方式去处理

That that would be a a tremendous first step, all the while acknowledging that there's still some relationships and husband and family issues that need to be dealt with in a skillful way.

所以

So

Hiral，你觉得这样安排怎么样？

how does that sound to you, Hiral?

我们能不能带着听众一起看看你的每日情绪记录，和你一起梳理那些想法和感受，重点放在自我批评和对自己要求太高的部分？

Can we maybe walk the audience through your daily mood log and have you look at your thoughts and feelings with us and kind of focus more on that aspect of it, that kind of self criticism and being hard on yourself?

好的

Yes.

是的

Yeah.

那

So

我们先做每日情绪记录，然后再谈共情。

Let's do the daily mood log first and then we can do the empathy.

没错。

Exactly.

同意。

Agree.

好的。

Yeah.

大卫，你来主导这个部分好吗？

Do you want to take the lead on that, David?

好的。

Yeah.

随时可以补充。

Feel free to chime in.

请观众翻到手册的第四页。

Let me just tell the audience to turn to page four in the handout packet.

那里是Hiral的每日情绪记录表。

That is actually where you have Hiral's daily mood log.

我们根本没见到她，只是让她回想一个特定时刻，写在最上面，圈出当时浮现的情绪，并记录下伴随这些情绪出现的负面想法。

And without seeing her at all, we just asked her to think of a moment in time and put that at the top and circle the feelings that were coming up for her and write down the negative thoughts that she was having as she was feeling them.

这是她跟我们分享的内容。

This is kind of what she shared with us.

David，你来给大家讲一下吧。

So David, maybe you can walk us through it.

好的。

Yeah.

我们总是聚焦于一个具体的时刻，因为所有问题都藏在你情绪低落的那一刻里。

The upsetting moment, and we always try to focus on one moment because all of your problems will be embedded in any one moment when when you're upset.

通过每日情绪记录，我们不仅能看清状况，还能引发一些深刻的变化。

And so we can use the daily mood log to understand what's going on as well as to trigger some hopefully fairly profound changes.

但当我读到这一条时，我的心真的揪了一下，Hiral，因为我们家刚添了个小宝宝。

But, you know, my heart went out to you, Hiral, when I read this one because we have a new baby in our family.

我儿子和儿媳生了个可爱的男孩，才九个月大。

My my son and his wife have a a beautiful little boy who's just nine months old.

但他突然生病了。

But he came down.

他们住得离这儿大概一小时车程，那天把孩子送来，让我们帮忙照看几个小时，好让他们俩去SPA放松一下。

They live about an hour from here and they brought him to have us babysit for a few hours while the two of them went to a spa and took a little break.

结果孩子一见妈妈不在就崩溃了，大哭大闹，整整一个半小时都没停，我完全不知道该怎么哄、该怎么想这件事，特别难受。

And he had kind of a meltdown because mommy was gone and he just screamed and it was, it was, you know, and it went on for a good hour and a half and it was uncomfortable, to try to figure out what what to do or how to think about it.

你和婆婆带儿子去打疫苗，那天是1月3号，他也闹得厉害，你当时特别受打击。

But you you and your mother-in-law took your son for a vaccination And, this was on January 3, and he had a meltdown, and you were really affected by it.

你当时感觉低落、不开心，100%焦虑，100%内疚和羞愧，100%觉得自己无能、有缺陷，80%孤独，100%尴尬和自我意识强烈，100%绝望，100%沮丧，80%烦躁不安。

And and you were feeling, down and unhappy, a 100%, anxious, a 100%, guilty and ashamed, 100%, inferior and defective, 100%, lonely, 80, embarrassed and self conscious, 100, hopeless, a 100, frustrated, 100, and annoyed and irritated, 80%.

我想特别说明一点，能准确记录下这些情绪指标其实一点都不简单——如果你去斯坦福的精神科住院部测试任何一位病人，他们的分数都不会比这更高。

And I just want to point out that again getting these measures is not a trivial thing at all because if you went to the Stanford psychiatric inpatient unit and tested any of the patients there, they would not have scores higher than this.

这意味着，你当时感受到的痛苦，现在可能依然经常袭来，程度之深，除非别人也经历过类似的情况，否则真的很难想象。

And that means that the distress that you were feeling at that time and probably still feel a lot of the time is so severe as to be almost hard for people to imagine, you know, if they haven't haven't experienced something similar.

这么说你能明白吗，Hiral？

Does does does that make sense, Hiral?

是的。

Yeah.

这简直就像身处情感的炼狱一样。

That is it's really like like being in an emotional hell.

那是什么样的想法在引发这种痛苦呢？

And then what are the thoughts that are triggering it?

首先，你提到这一点，Hiral，真的让我特别震撼。

And and number one, you were tell and this is so, eye opening here, Hiral.

这既反映出你的痛苦，也展现了你身上真正美好而了不起的地方。

It speaks to your pain as well as what's really beautiful and awesome about you.

你一直在对自己说：我不是个好妈妈，这一点毫无疑问。

You're telling yourself, I'm I'm not a good mother, and that's 100%.