嘉宾系列 | 保罗·康蒂博士：如何提升心理健康

在第一集中，我们探讨了理解自我与朝着健康或最健康版本的自我迈进之间的某些相似之处，其中自主性和感恩是正在表达的状态。

During episode one, we touched on some of the similarities between understanding the self and building towards a healthy or healthiest version of self where agency and gratitude are these states that are being expressed.

当时的一个主题是，人们或许希望健康是为了长寿，但 presumably 他们也希望健康到能爬楼梯、抱起孩子、搬动物品、避免受伤，甚至能从事运动；当然，也有一些人是为了审美原因而追求健康。

And one of the themes there was this idea, people perhaps want to be healthy so that they live a long time, but presumably they also want to be healthy so that they can walk up flights of stairs, pick up their kids and move objects, not get injured, perhaps even do sport or and of course, some people want to be healthy for aesthetic reasons as well.

如果我们讨论身体健康，我们可以探讨其中的主要支柱，也就是橱柜里的那些项目。

And if we were having a discussion about physical health, we could address the sort of major pillars there, which were items within the cupboard.

比如，大多数人希望拥有一定的耐力或体力，能够走一段路，甚至跑一段距离。

Like, you know, most people want some ability to have endurance or stamina to walk some distance, or maybe even run some distance.

正如我之前提到的，能爬楼梯、具备一定的力量、一定程度的柔韧性，当然还有活动能力，甚至动态活动能力等等。

As I mentioned before, walk up a flight of stairs, have some strength, some degree of flexibility, certainly some mobility, maybe even dynamic mobility, etcetera.

为了应对或改善这些方面，他们可以查看这些‘橱柜’，思考：我每周进行多少跑步、游泳或长时间的有氧运动？

And in order to address those or improve upon those, they could look in those covers and say, well, how much running, swimming, long form cardiovascular exercise am I doing per week?

我每天走多少步？

How many steps am I taking per day?

我每周有多少次举起比自己舒适承受力稍重的物体？

How many times a week do I lift objects that are slightly heavier than is comfortable for me to lift, etcetera?

这是具体的，非常实在的。

It's tangible, very concrete.

在这里，你以某种类似的方式，将心理、自我和心理健康变得非常具体，提到有十个方面可以去审视。

Here you're making the psyche and the self and mental health very much concrete in some of the same way, saying there are 10 covers that one can look in.

这些驱动力，正如你所称的生成驱动力、攻击驱动力和愉悦驱动力，你稍后可能会告诉我们，它们在不同人身上表现的程度不同，以及具体表现形式是什么。

And these drives, as you refer to them as generative drive, aggressive drive, and pleasure drive, you'll probably tell us in a few minutes, can be expressed to varying degrees in different people and how that shows up and what that looks like.

我只是想让大家明白，这与判断一个人是否能跑很长距离，但总是感到酸痛、虚弱或无力，是非常相似的。

And I just want to frame this in people's minds as very similar to addressing whether or not, okay, if somebody can run very long distances, but they're always having aches and pains or they they feel weak or they are weak.

你知道吗？

You know?

这背后是有充分原因的。

There are good reasons for that.

他们过度强调了某一种锻炼方式。

They're overemphasizing one form of exercise.

这种表现更偏向于耐力和持久力，而不是力量；或者反过来，力量举运动员能从地上举起七百五十磅的重量，但爬两层楼梯时却气喘吁吁，到楼梯顶上不得不停下来。

The expression is more along the lines of endurance and stamina, not strength, Or vice versa, the power lifter who can, you know, lift seven fifty pounds from the floor in a deadlift, but walks up two flights of stairs and is, you know, belly breathing and has to stop at the top of the stairs.

你知道的，这在物理层面是很明显的。

You know, it's obvious in the physical realm.

而在心理层面则稍微更隐晦或更难以捉摸，

It's slightly more cryptic or more cryptic in the psychological realm,

但在这里它对我们来说变得具体了。

but here it's becoming concrete for us.

所以我觉得这非常有趣且颇具讽刺意味，对吧？

So I think it's very interesting and very ironic, right?

所以我所在的领域，精神病学领域，历史上一直希望成为医学其他部分的一部分，或者像医学的其他分支一样，而我认为它最终做的是美化一种分类法，对吧，美化一种理解人类的分类机制。

So the field that I'm in, the field of psychiatry, has historically wanted to be sort of part of the rest of medicine or like the rest of medicine, and what I believe it's ended up doing is glorifying a taxonomy, right, glorifying a category mechanism of understanding human beings.

就像这样，如果，好吧，如果我在从事普通医学，你来看病，你鼻塞，我判断，哦，你得了细菌性鼻窦炎，对吧？

So in the way that if, okay, if I'm practicing general medicine and you come in and you're congested and I determine like, oh, you have bacterial sinusitis, right?

那么现在我做出了诊断，现在我知道该怎么处理了，对吧？

So now I've made a diagnosis, and now I know what I'm going to do about that, right?

所以，好吧，我会开抗生素。

So, okay, I'm going to prescribe an antibiotic.

现在，问题来了，比如该用哪种抗生素，对吧？

Now, the thought comes in of like what antibiotic, right?

但是，确诊鼻窦炎后就需要抗生素，这大致就是医学的运作方式。

But the identify sinusitis, now you need an antibiotic, is, like, kind of how medicine works.

对吧？

Right?

所以，精神病学原本的想法是要将一切分类。

So the thought was psychiatry is gonna categorize everything.

对吧？

Right?

所以我们会说，好的。

So we'd say, okay.

我一直在听你说。

I've listened to you.

就像，啊，我知道你的套路或者说你的那些数字了。

Like, ah, I know your number or your numbers.

对吧？

Right?

一旦我给了你这些数字，我就知道该做什么了。

And then once I've given you the numbers, now I know what to do.

我会开这种药、那种药，以及一定次数的某种心理治疗。

I prescribe this medicine, that medicine, these many sessions of a certain kind of psychotherapy.

但这种方式行不通，对吧？

And like that doesn't work, right?

在心理健康领域，这行不通。

It doesn't work in mental health.

也许我感到焦虑，但这并不是说它完全无效。

It may I'm anxious, it's not that it never works.

但如果你想真正理解一个人，那就不同了。

But if you're gonna try and understand people, like, it's different.

自我这个问题，比如我在生活的某个方面缺乏自信，而在其他方面却没有，这可是个大问题。

The problem of self, like, if I have a lack of confidence in one area of life and not in others, right, that's a significant issue.

这不像细菌性鼻窦炎那样，你知道，好吧，箭头指向开抗生素。

It is not like bacterial sinusitis where then, you know, okay, arrow goes to prescribe antibiotic.

我认为具有讽刺意味的是，这种处理方式实际上确实让精神病学或心理健康与医学的其他部分保持一致，这就是为什么你能进行这种类比。

And I think what is ironic is that this route of approach, right, actually does bring psychiatry or mental health into line with the rest of medicine, right, which is why you can make that parallel.

而且，你知道，它很契合，对吧，当你将其与身体健康以及'我想保持健康'进行类比时。

And, you know, it fits well, right, when you're making the parallel to physical health and to, I want to be healthy.

好的。

Okay.

它的组成部分是什么？

What are the components of that?

我要怎么做才能实现这个目标？

What am I doing to achieve that?

如果事情不如我所愿，我就回头审视那些组成部分。

If something's not the way I want, let me go back and look at those components.

我的意思是，这可能是因为它更具体，本质上更容易理解。

I mean, it may be because it's more tangible, it's sort of essentially easier to comprehend.

对吧？

Right?

因为它是具体的。

Because it's concrete.

但在我看来，这并不神秘，只是不那么明显。

But I don't, in a sense, see it as cryptic, just less obvious.

对吧？

Right?

但如果我们去观察它，会发现这确实很有道理。

But if we go and we look at it and we say, oh, that really makes sense.

对吧？

Right?

从某种意义上说，它之所以合理，是因为它合乎逻辑。

And in a sense, it makes sense that it makes sense.

对吧？

Right?

如果有一种理解机制适用于许许多多更具体的事物，那么为什么一种类似的机制——比如理解组成部分是什么，理解建立在它们之上的东西——不能适用呢？

If there's a mechanism of understanding that applies to lots and lots of things that are more concrete, why would a similar kind of mechanism, like, understand what the components are, understand what's built on top of them?

就像这样，我相信，精神病学实际上正是通过这种方式与医学的其他部分相契合，不是通过美化分类法，而是通过理解的视角。

Like, this, I believe, is how psychiatry actually fits with the rest of medicine, not by glorifying a taxonomy, but by coming through the lens of understanding.

是的。

Yeah.

我完全同意。

I couldn't agree more.

而且我认为，最令人安心的是，无论是在创造身体健康方面——涵盖心脏健康、肺部健康、耐力、力量等各个领域，还是认知健康以及心理健康，其核心都是动词。

And I I think that what's so reassuring is that both in terms of creating physical health across the various domains of heart health, lung health, endurance strength, etcetera, cognitive health, as well as mental health is verbs.

要知道，这最终都归结为我们每个人和所有人都应该参与的行动项，以达到我们都希望达到的状态和存在方式，对吧？

Know, it comes back to action items that we each and all should engage in in order to arrive at the states and ways of being that we all want to be in, right?

我们希望感觉健康，看起来健康，等等。

We want to feel healthy, look healthy, etcetera.

我们想要快乐，对吧？

We want to be happy, right?

我几乎没遇到过不想快乐的人。

I know very few people who don't want to be happy.

当然，确实有人会选择放弃，但今天我们也会讨论这个问题以及摆脱困境的途径。

I mean, certainly there are people who give up, but we'll talk about that today and routes out of that.

但归根结底，关键在于审视这些分类、提出具体问题，然后通过具体行动来达到赋权、谦逊、能动性、感恩、平和、满足、愉悦等状态，而不是仅仅使用言语和理解来获得洞见后就停滞不前，指望一切会自动改变。

But at the end of the day, it's all about looking in those bins, asking specific questions, and then moving forward in specific actions to get to the place of empowerment, humility, agency, gratitude, peace, contentment, delight, etcetera, as opposed to simply using words and understanding to arrive at insight and then stopping there and expecting everything to change.

我认为这正是许多人对心理学、治疗和精神病学感到困惑的地方。

And I think that's where a lot of people are confused about psychology, therapy, and psychiatry.

正如你所提到的，精神病学内部也有其自身的阴影，可以说，药物的使用虽然肯定非常有用，甚至能挽救生命——确实如此。

And as you mentioned, psychiatry has its own shadows, if you will, within it where the use of drugs, which certainly can be very useful, even lifesaving- Absolutely.

但很多时候，它被视为一种万能解决方案，似乎能重新整理橱柜里的一切，让食谱变得完美，而实际上，正如我们今天要讨论的，这通常并非最佳途径。

Oftentimes is seen as a fix all that somehow could reorder everything within the cupboards and make the recipe just right, when in fact, as we'll talk about today, that that is generally not the best route.

但再次强调，我们需要理解药物可以非常强大。

But again, with the understanding that drugs can be very powerful

它可以发挥作用，对吧？

It can play a role, right?

但重要的是我们要明白它们合适的角色是什么，而我们常常在这方面走偏。

But it's important we understand what role is appropriate for them, and that's where we often go astray.

我想短暂休息一下，感谢我们的赞助商AG1。

I'd like to take a brief break and acknowledge one of our sponsors, AG1.

AG1是一种含有维生素、矿物质和益生菌的饮品，能满足你所有的基础营养需求。

AG1 is a vitamin mineral probiotic drink that meets all of your foundational nutrition needs.

我从2012年就开始服用AG1，因此很高兴他们能赞助这个播客。

I started taking AG1 way back in 2012, so I'm delighted that they're sponsoring the podcast.

我开始服用AG1，以及至今仍每天服用一次或两次的原因是，这是确保我摄入所需全部维生素、矿物质、益生菌和纤维的最简便方式。

The reason I started taking AG1 and the reason I still take AG1 once or generally twice per day is that it's the easiest way for me to ensure that I'm getting all of the vitamins, minerals, probiotics, and fiber that I need in my diet.

当然，从天然食物中获取充足营养至关重要，但大多数人，包括我自己，都很难每天摄入足够的水果和蔬菜，尤其难以获得足够的益生元和益生菌来维持肠道健康。

Now, of course, it's essential to get proper nutrition from whole foods, but most people, including myself, find it hard to get enough servings of fruits and vegetables each day, and especially to get enough prebiotics and probiotics to ensure gut health.

正如你所知，你的肠道中含有数万亿的微生物，即所谓的肠道菌群，它们与身体其他器官建立关键联系，以促进大脑健康，并支持免疫系统以及其他与身心健康的方面。

As you may know, your gut contains trillions of little microbiota, the so called gut microbiome, which establishes critical connections with other organs of your body to enhance brain health, as well as to support your immune system and other aspects that relate to mental and physical health.

我最常被问到的问题之一是：如果你只能选一种补充剂，你会选哪一种？

One of the most common questions I get is if you were to take just one supplement, which supplement would that be?

我的答案始终是AG1，因为服用AG1能让我确保摄入所有提升心理健康、身体健康和表现所需的维生素、矿物质和益生菌。

And my answer is always AG1 because by taking AG1, I'm able to ensure that I'm getting all of the vitamins, minerals, and probiotics that I need to enhance my mental health, physical health, and performance.

如果你想尝试AG1，请前往drinkag1.com/huberman领取特别优惠。

If you'd like to try AG1, go to drinkag1.comhuberman to claim a special offer.

他们会送你五份免费的旅行装，并赠送你一整年的维生素D3K2。

They'll give you five free travel packs and they'll give you a year supply of vitamin D3K2.

再次提醒，前往drinkag1.com/huberman领取这项特别优惠。

Again, that's drinkag1.com/huberman to claim this special offer.

因此，在我们继续探讨如何帮助人们获得——姑且这么说——对自身心理健康、自我认知的掌控力，并明确他们该采取哪些行动时，我想向你请教一些我在这个世界观察到、尤其是从本播客听众那里经常听到的话题。

So as we move forward here in defining and helping people gain, for lack of a better word, agency over their own mental health and self understanding and defining for them what action items to take, I'd like to ask you about some of the things that I observe in the world and hear a lot about, in particular from the audience of this podcast.

很明显，人们在攻击性驱动力、愉悦驱动力，以及 presumably 生成性驱动力方面存在差异。

It's obvious to me that people vary in terms of their level of aggressive drive, pleasure drive, and presumably generative drive as well.

一个常见问题是：我该如何变得更积极主动？

One common question is how do I become more motivated?

对吧？

Right?

你知道的。

You know?

当然，这引出了许多其他问题，比如人们是否因为害怕失败而缺乏动力？

And of course, that opens up a bunch of other questions like are people afraid of failure and that's why they're not motivated?

人们害怕成功吗？

People afraid of success?

那是他们缺乏动力的原因吗？

Is that why they're not motivated?

是否存在某种潜在的童年创伤或无意识过程在驱动这种恐惧，等等？

Is there some underlying childhood trauma or unconscious process that's driving that fear and so on?

但如果我们从精神科医生的角度，也就是你的角度来看，如果有人来找你，说：‘我真的不想努力了。’

But if we were to take the psychiatrist's perspective, your perspective, if someone comes to you and says, You know, I just don't really feel like trying.

学业很难，学生贷款负担太重，这确实是事实。

School's hard, school loans are excessive, which is true, by the way.

你知道，即使有了学位，也不确定能有什么作为，或者你在工作或感情领域经历了一系列失败，你感到压力沉重，觉得努力也没意义。

You know, it's not even clear that with a degree I can do much, you know, or I had a series of failures in the work domain or in the relationship domain, and they're just feeling weighed down as if it's not worth trying.

这告诉你应该从哪里入手？

What does that tell you in terms of where to look?

这又说明了他们的驱动力是什么？

And what does that tell you in terms of their drives?

我的意思是，我们能对他们内在的攻击性驱动力、愉悦驱动力或创造性驱动力做出什么判断？

I mean, we conclude something about their innate level of aggressive drive or their pleasure drive or their generative drive?

我的意思是，世界上有很多这样的人，接下来我们会考虑一些其他类型的表型例子。

I mean, I think there are many such people out there, and then we'll consider some other kind of phenotypic examples.

对。

Right.

所以这是一个

So it's a

这是一个很好的例子，因为任何优秀的临床医生听到这个故事后，都可能产生一些想法，这些想法可能会有所帮助，而无需一定引用驱动力的概念。

great example because sort of any good clinician, right, could hear that story and have thoughts about it that could and would hopefully be helpful without necessarily referring to drives.

所以我认为，你可以将任何评估、任何分析、任何试图理解的过程都建立在驱动力的基础上，但并不非得如此。

So I think you can anchor any set of assessments, any evaluation, any attempted understanding to drives, but it doesn't have to be that way.

所以，例如，你可以向这个人多问一些关于他们正在做什么、如何安排时间的问题，因为你告诉我，这个人从任何事情中都得不到乐趣或满足感。

So, for example, you might ask that person more questions about what they're doing, how they spend their time, because you're telling me about someone who's not getting enjoyment or gratification out of anything.

对吧？

Right?

这对我来说就变得有意思了。

And that then becomes of interest to me.

对吧？

Right?

这个人有没有做什么事情是真正享受的？

Is there something this person does enjoy?

对吧？

Right?

有没有什么事情是他们更想做的？

Something they'd rather be doing.

比如，他们上大学时借了很多贷款，是因为他们觉得那样更好，以为自己将来会做某件事，但现在其实并不想做？

Like, did they did they go to college and take on a bunch of loans because they thought that was better because they thought they were gonna do something that now they actually don't wanna do?

对吗？

Right?

或者机会不存在了，现在他们很沮丧。

Or that opportunity isn't there and now they're frustrated.

比如，这个人内心有什么可能看起来不同的东西？

Like, what is inside this person that might seem different than that?

再说一次，答案可能很复杂。

And again, the answers could be complicated.

也许那个人其实喜欢他们正在做的事情，但所在地区的生活成本太高，以至于他们仍然感到痛苦。

It could be maybe that person enjoys what they're doing, but the cost of living where they are is so high that they still feel miserable.

有一种匮乏感，然后这又被映射回一种想法，比如，我从任何事情中都得不到乐趣。

There's a sense of privation, and then that gets back mapped to like, I don't I'm not getting any pleasure out of anything.

对吗？

Right?

所以答案可能很简单，比如你和那个人一起制定策略，例如，那样的人是否应该搬家？

So the answer could be as simple as you strategize with the person of, you know, for example, does a person like that move?

你知道的，搬到另一个地方。

You know, move to a different area.

所以，有很多方式来看待这个问题，也有很多方式去理解它，但你向我描述的这个人，似乎一直在抱怨什么都不觉得好。

So, like, there's so many ways of looking at this and so many ways of understanding this, but you're describing someone to me who who is kind of really complaining that nothing is feeling good.

对吧？

Right?

没有什么能带来愉悦或快乐的感觉。

Nothing's providing a sense of of enjoyment or of pleasure.

对吧？

Right?

所以我可能会先关注这一点，想想可能是愉悦驱动力比当前得到的满足要更高。

So I I would probably be interested in that first and think maybe the the pleasure drive is higher than what's being fulfilled.

对吧？

Right?

也许愉悦驱动力本身就很低，这本身就是个问题。

Maybe the pleasure drive is is low, and that's an issue in and of itself.

我们某种程度上是学会这些事情的。

We sort of learn those things.

对吧？

Right?

也许进取心不足，而且，你知道，如果那个人能多投入一点精力，对吧，就像，他们可能会处于不同的境地。

Maybe the aggressive drive is low, and, you know, if that person just put a little more energy into it, right, like, they could be in a different place.

对吧？

Right?

所以你是想帮助这个人理解他们自己，以便能够做出改变。

So you're trying to help the person understand themselves so that you can make change.

而且，再次强调，这种理解不一定非要锚定在驱动力上，但我确实相信驱动力是所有理解的根源。

And, again, that understanding doesn't have to be anchored to to the drives, but I do believe the drives are at the root of all understanding.

因为如果你和那个人坐在一起交谈，你就能理解是什么失衡了，对吧，要么是驱动力本身的排列出了问题，要么是它们被体验的方式有问题。

Because if you sit with that person and you talk to that person, then you're gonna be able to understand what is out of balance, right, either in the the actual array of the drives or in how they're being experienced.

因为再举个例子，如果你有很高的享乐驱动力，但它没有得到满足，对吧，那这就代表了一个问题。

Because again, if you have a high pleasure drive, for example, and it's not gratified, right, like that represents a problem.

对吧？

Right?

是的。

Yeah.

关于那些能体验到一些快乐或能让自己保持忙碌的人，比如说，在社交媒体上或玩电子游戏？

About people who can experience some pleasure or can keep busy, say for instance, on social media or playing video games?

或许我还应该说，这正将他们带向一个平和、满足和愉悦的境地。

And I should also say perhaps it's bringing them to a place of peace, contentment, and delight.

但从某种意义上说，这并不真正具有创造性，对吧？

But in some sense, it's not really generative, right?

我不会妄下判断，说电子游戏和社交媒体都是在浪费时间。

I'm not going to cast judgment and say that video games and social media are all a waste of time.

我的意思是，我也在社交媒体上努力为人们提供价值和知识，同时也从其他账号那里获取价值和知识。

I mean, I'm on social media trying to provide value to people and learnings, and I derive value and learnings from other accounts as well.

但人生中确实存在这些里程碑，如果你愿意这么说的话。

But there are these milestones, if you will, in life.

我的意思是，并不是每个人都必须上大学、结婚、组建家庭，我认为生活中有很多不同的路径都可以被视为成功。

I mean, not that everyone has to go to college and get married and have a family, I mean, there are a lot of different paths through life that I would consider successful.

但在某种意义上，确实存在一些里程碑。

But in some sense, there are milestones.

就像我们都希望向前迈进。

Like we want to move forward.

如今有一种现象，很多年轻人出现所谓的‘无法起飞’（难以独立）的情况。

There's this phenomenon nowadays of a lot of young people and so called failure to launch.

比如他们不离开家，或者没有找到职业方向。

Like they're not leaving home or they're not finding a vocation.

他们不觉得自己擅长任何事情，他们认为除非你能成为某个领域的顶尖1%，否则就不值得尝试。

They're not feeling as if they're good at anything, they have the sense that unless you're going to be like top 1% in something, it's not worth trying.

但他们仍然能找到，你知道，大多数人称之为乐趣的东西。

But they can still find, you know, what most people would describe as pleasures.

比如他们可能享受美食，也许有点过头了。

Like they might enjoy food, maybe a little too much.

他们喜欢喝酒，可能有点过头了。

They enjoy alcohol, maybe a little too much.

他们喜欢社交媒体或电子游戏，可能有点过头了。

They enjoy social media or video games, maybe a little too much.

我说‘有点过分’是因为这或多或少成为了他们侵略性和享乐欲望的蓄水池，却没有推动他们在标准的人生里程碑上前进。

And I say a little too much because it's providing more or less a sink or a reservoir for their aggressive and pleasure drives that's not moving them forward in the standard milestones of life.

嗯哼。

Mhmm.

我经常听到这种情况。

I hear about that a lot.

我经常看到这种现象。

I see that a lot.

你明白吗？

You know?

所以，这比之前描述的单纯缺乏动力或无动力的类型要稍微复杂一些。

So it's a slightly more complex phenotype than described before as just simply the amotivated or non motivated person.

但你对刚才我描述的这种表型有什么看法？

But what do you think of the phenotype I just described?

因为我们每个人都是独特的，对吧？

Because we're unique, right?

每个人都是独特的，尽管我们属于某些类别，对吧？

Each person is unique, although we fit categories, right?

所以可能存在一些类别，个体可以归入其中，但这些类别可能和我说的不一样，对吧？

So there are categories a person there could fit that could be different from what I'm saying, right?

但我认为大多数人会说，总体来看，对吧？

But I think most people, they say on balance, right?

什么是最突出的特征，对吧？

What is most prominent, right?

我认为在这种情况下最突出的是，生成性驱动力出现了失衡，对吧？

And I think what is most prominent in that situation is there's something out of balance in the generative drive, right?

你经常看到的情况是，一个人的生成性驱动力强于他实现这种驱动力的能力。

And what you see a lot of times is the person has a generative drive in them that's higher than their ability to realize that drive.

那么生成性驱动力就会受挫。

The generative drive then is frustrated.

所以，我来举个例子。

So, I'll give an example.

所以，这是一个真实的故事：有个人非常非常努力，上了很长时间的学，最终获得了一份高薪工作。

And so, a real true story of a person who had worked very, very hard, gone to school for a long time, and had achieved a very high paying job.

这就是目标，对吧？

And that was the goal, right?

这是一份很有声望的工作。

It's a prestigious job.

这是一份高薪的工作。

It's a high paying job.

而且这个人曾经一度做得相当不错。

And the person for a while was doing quite well at it.

然后，你知道，事情很快就朝着负面方向发展了。

And, you know, things went relatively rapidly in a negative direction.

所以，也许这个人短时间内还过得不错。

So maybe for a little while the person's doing okay.

然后，当他们不在工作时，就对自己的身心健康和生活环境变得非常疏忽。

Then the person becomes very negligent of themselves and their environment when they're not at the job.

所以，家里乱七八糟，东西脏兮兮的，这个人还浪费时间在各种事情上。

So, you know, the house is a mess, things are dirty, the person is wasting time with things.

所以，这个人喜欢的并不是电子游戏这类东西。

So this is a person who enjoys it wasn't exactly video games.

我们不妨假设它可能是电子游戏。

Let's say it could have been.

对吧？

Right?

嗯，他确实会从中获得一定程度的享受，能从中得到快乐，觉得时间花得值。

Well, it enjoys them to a certain degree and can really gain pleasure and feel good about the time spent.

对吧？

Right?

但开始花太多时间。

But start spending too much time.

对吧？

Right?

现在，原本令人愉快的事情开始变成一种逃避机制。

Now what was pleasurable starts becoming a distraction mechanism.

对吧？

Right?

然后这种状况演变成了酒精滥用。

And then what that transitioned to was overuse of alcohol.

对吧？

Right?

所以现在你面对的是一种真正具有破坏性、对工作表现和这个人本身都产生负面影响的行为，对吧？

So now you have either something that is actually destructive and was negative to job performance, right, towards the person.

这人以前并不常喝酒，而他在喝酒时感到痛苦，或者只是在虚度光阴。

This wasn't a person who was drinking a lot before, and this is a person who was miserable when they were drinking or they were sort of wasting their time.

对吧？

Right?

而我们对这一切都心知肚明。

And we're aware of all of this.

嗯，这里有一个非常明显的问题，那就是那个人对他们所做的事情毫无兴趣。

Well, there's a very clear problem, which is that that person had no interest in what they were doing.

一点都没有。

None whatsoever.

感觉大部分清醒时间都像自动机器一样度过，但又清醒地意识到其中的单调乏味和挫败感。

It felt like the majority of waking hours were spent in an automaton like way, but being awake and aware of the tedium of it, the frustration of it.

职业方面。

The professional side.

所以他们本质上对这份他们做得很成功的工作缺乏内在的好奇心或渴望，对吧，

So they essentially had little intrinsic curiosity or desire to do the job that they were successfully Right,

这一点只有在深入探究后才会显现，因为看起来像是，嗯，这个人到底怎么了？

Which comes out only after exploration because it seems like, Well, what's going on with this person?

这个人有一份好工作，生活过得非常非常顺利，经济状况也很好，那么这个人现在是不是在过度放纵自己呢？

This this person has a good job, and their life was going really, really well, and they're doing well financially, and, you know, is this person trying to now, you know, overly indulge themselves?

对吧？

Right?

比如，这就是他们喝酒的原因吗？

Like, is that why they're drinking?

到底是怎么回事？

What's going on?

对吗？

Right?

而你的感觉是，这个人有强烈的创造驱动力，但他所做的工作一点都没有满足这种驱动力，这在他内心造成了巨大的挫败感，以至于这个人要么沉迷网络，要么做一些惩罚性和自我伤害的事情。

And what you feel is that this person had a strong generative drive, and it wasn't met one little bit by what he was doing, which was creating such frustration inside that the person was either taking himself online or doing something that was punitive and self injurious.

而且，这是一个真实的故事。

And like, this is a real story.

这个人后来换了一份工作，薪水只有之前工作的十分之一。

The person exchanged that job for a job that paid a tenth of what the job they had paid.

这个人的生活发生了惊人的变化。

And the change in the person's life was amazing.

比如，我都不知道这家伙会笑，对吧？

Like, I didn't know this guy could smile, Right?

他变得快乐了。

He became happy.

他热爱自己所做的事情。

He loved what he was doing.

他卖掉了大房子，买了一个小房子，并且把它打理得很漂亮。

He sold the larger house, bought a smaller house, kept it beautifully.

比如，他很开心。

Like, he was happy.

对吧？

Right?

这就是他需要获得快乐的原因，因为这样一来，他内在的创造驱力——他热爱自己所做的事情，在那里得以施展和表达，然后其他事情才能随之理顺，对吧？

That's what he needed to be happy because then the generative drive in him, he loved what he was doing, where it gets enacted, it gets expressed, And then other things can come then into line, right?

他不再对自己过度苛责、酗酒过度，你知道，因为他不再对周围世界、对自己说‘去你的’，对吧？

He's not being overaggressive towards himself and drinking too much, you know, because he's saying, Oh, to hell with you, to the world around him, and to himself, right?

他不再把生活中那些有实际用途的东西当作负担。

He's not taking something that serves a purpose in his life.

再举个例子，如果是电子游戏的话，那就像是，是的，很棒。

Like, again, if the example had been video games, would be like, Yeah, great.

你享受花一定时间做那件事，然后去做并获得满足感，而不是过度依赖它，以至于它不再提供满足感，反而变成一种干扰。

You enjoy doing that X amount of time, and like, go do that and get gratification from it, as opposed to then over relying on it, and then it's not providing gratification, it becomes a distraction.

所以那些事情在他的生活中重新恢复了平衡，但前提是必须有这种理解。

So those things came back into balance in his life, but there had to be the understanding.

而且我认为，很多内心有创造驱动力的人都会遇到这种情况，他们感觉这种驱动力被周围不配合的世界所挫败。

And I think there's a lot of that in people who have a generative drive in them that they feel is frustrated by a world around them that isn't cooperating.

那么，我们能否理解这一点，并改变大多数处于那种境地的人呢？

Now do I think we can understand that and change that in the vast majority of people who are in that place?

是的。

Yes.

但首先必须正视这一点。

But it has to be looked at first.

对吧？

Right?

因为情况并非总是如此。

Because when it's not always that.

只是很多时候是这样。

It's just that a lot of the time.

对吧？

Right?

所以必须理解这一点。

So it has to be understood.

这个人身上到底有什么问题？

What is it in that person?

然后你如何回到那些核心原则，审视这个人为何会陷入那种境地？

And then how do you go back to those pillars and look at what's going on that the person is in that place?

因为这个世界会给我们带来很多困难。

Because the world can bring us a lot of difficulties.

对吧？

Right?

而那个人现在背负的贷款比他们预期的要多得多，比如，我对此怀有极大的同情和怜悯。

And that person who now is saddled with a lot more loans than they expect, like, I have tremendous compassion for that and sympathy for that.

比如，那是真实的。

Like, that's real.

对吗？

Right?

所以人们可能会面临很多事情，这只是其中之一。

So people can be up against a lot of things, and that's just one of them.

对吧？

Right?

但这并不意味着生活就不能好起来。

But it doesn't mean that life can't be okay.

对吧？

Right?

这并不意味着。

It doesn't mean that.

但这个人必须感受到有某种出路，他们需要足够了解自己：好吧，这就是现状，我大致明白这是什么、为什么会这样、我为何身处此处，从这里开始，我就能规划一条通往更好生活的道路，因为没错，我们确实会遇到困难，而且可能很多。

But the person has to feel that there's some way, they have to understand enough about themselves, okay, this is what this is, and I kind of see what this is and why and how I'm here, and from there, I can start to plot a route to something that is better because, yes, we have our difficulties, and we can have a lot of them.

对吧？

Right?

但对我们绝大多数人来说，这些困难并不是无法克服的。

But it's for the vast majority of us, it's not like they're not surmountable.

我们只需要理解它们。

We have to just understand them.

假设这个人决定去寻求帮助。

And let's say if that person goes and say, I'm going to get some help.

然后他们去找人，对方说：哦，好的。

And they go and someone says, Oh, okay.

等一下。

Wait.

你有十次认知行为疗法的疗程。

You get 10 sessions of cognitive behavioral therapy.

你试着想想，这个人怎么能用不同的方式思考？

And you try and like, how can that person think differently?

然后他们就会有不同的情绪感受。

Then they'll feel differently.

听好了，认知行为疗法有它的作用。

Look, cognitive behavioral therapy has its place.

对吧？

Right?

但它解决不了这个问题。

But it's not gonna solve that.

对吧？

Right?

比如，那个人需要了解一些关于自己的事情，而不是把他们的想法引导到更好的地方。

Like, that person needs to understand something about themselves, not redirect their thoughts to better places.

对吧？

Right?

所以，如果这个人产生了一种反射，因为这种反射对这个系统很有效，对吧？

So if the person gets a reflex because that reflex works well for the system, right?

这种反射对治疗这个人的系统很有效，对医疗系统、保险系统很有效。

A reflex works well for the system that's treating that person, for the medical system, the insurance system.

那个人一点帮助都得不到。

That person isn't helped one bit.

对吧？

Right?

也许药物能有所帮助。

And maybe a medicine can help.

对吗？

Right?

也许药物能帮助减轻这个人的焦虑和紧张，然后这个人就能更好地思考这个问题了。

Maybe a medicine helps to just take down the anxiety and the tension in the person, then the person can sort of think more about it.

而且确实，药物确实帮助了这个人，因为要放弃工作、放弃声望、放弃金钱的想法——这样做真的可以吗？

And and truly, medicine did help this person because the idea of leaving the job, I'm leaving the prestige, I'm leaving the money, is that okay to do?

比如，它引发了大量焦虑，但有助于稍微降低那种紧张感，让他能够思考这个问题，参与治疗，最终达到他想要的状态，然后我们就可以逐渐停止用药。

Like, it generated a lot of anxiety, and it helped to kind of bring the temperature down a little bit of that so that he could think about it, engage in therapy, ultimately navigate to where he wanted to be, then we could back away from the medicine.

所以，药物是有其作用的。

So, like, medicine has a role.

但如果他只是吃药，我的意思是，药物帮助的可能性有多大？

But if he just got medicine, I mean, what are the possibility what are the odds of that helping?

几乎为零，对吧？

Like zero, right?

因为它不会给出答案，除非这个人自己感觉好一点并自己想明白。

Because it's not gonna make the answers unless somehow the person feels a little bit better and figures it out on their own.

我的意思是，事情不是这样运作的，对吧？

I mean, it's not how it works, right?

所以药物有其作用，但我们需要的是一种能够认识到药物在大多数情况下的局限性、并真正帮助人们理解自身的疗法。

So medicine has its place, but a kind of therapy that recognizes the limitations of medicine in most situations and is designed to really help the person understand, like, that's what we need.

你举的例子非常出色，因为正如你所说，药物有其作用，某种程度上思维的引导也有其作用。因为据我回忆，在自我功能的支柱中，关键点之一是显著性，即我们对内或对外的关注点，以及我们的内在叙事。

The example you gave is a spectacular one because as you mentioned, medication had its place, perhaps even redirection of thought in some sense had its Because as I recall, under the pillar of function of self, one of the key items is salience, what we pay attention to internally or externally, what our internal narratives are.

但继续以这个个体为例，作为供所有人学习的表型范例，真正促成理解的，是对自己提出更好的问题。

But in staying with the example of this individual, again, as a phenotypic example for everybody to learn something from, The asking of better questions about oneself is really what leads to the understanding.

所以，更好的提问方式，对吧？

So like better forms of inquiry, right?

在我看来，这些更好的提问方式，就像身体健康的有氧运动、力量训练、柔韧性训练、活动能力训练和协调性训练一样，同样适用于心理健康。

To me, these better forms of inquiry, better questions are really the cardiovascular exercise, the strength training, the flexibility training, the mobility training, coordination training of physical health just translate to mental health,

这真的很有趣，对吧？

It's so interesting, right?

因为如果你仔细想想，在我举的例子中，通过系统进行的心理治疗，比如认知行为疗法，也有其作用，对吧？

Because if you think about it, in the example I gave, both the therapy part through the system, right, the CBT has a place, right?

而药物部分也同样有其作用。

And the medicine part also had a place.

所以这两者都有其作用，但如果我们构建一个完整的故事，说‘这就是一切，你会通过这些方式得到帮助’，其实根本帮不到这个人。

So both of those things have their role, but if we build the whole story of like, this is what this is, and this is how you're going to be helped around those things, we don't help that person at all.

事实上，如果我们从整体来看，包容所有情况，最终反而会造成伤害。

In fact, we ultimately, if you take on balance, you take all comers, we end up doing harm.

从某种程度上说，如果我们继续用身体健康作类比，这就像是一个人想健身，然后买了一辆——我不是针对Peloton这个品牌，只是举个静态自行车的例子。

Well, in some ways, if we stay with the analogy of physical health, it would be like the person who wants to get in shape and then they get a, I'm not picking on Peloton as a brand, but just a stationary bike.

他们每天早上骑车，减掉了体重，血压下降了，状态变好了。

And they pedal every morning and they lose weight, their blood pressure goes down, they're doing better.

但到了某个阶段，你必须清楚地知道，如果你一直重复同样的运动方式，迟早会因为过度使用而受伤。

But then at some point, know with certainty that if you just do the same form of exercise over and over again, like sooner or later, you're going to get overuse injuries.

于是，你的下背部出了问题，身体其他部分也失衡了，对吧？

So then there's like the lower back piece and another piece you become out of balance, right?

只是我觉得，这其实借鉴了兰斯·阿姆斯特朗的思路，但关键根本不在自行车上，对吧？

There's just But I guess this is stealing from the Lance Armstrong book, but it's not about the bike, right?

我的意思是，重点不在自行车，而在于心率的提升。

Mean, it's not about the bike, it's about the elevation of heart rate.

关键在于清晨锻炼时伴随的其他健康活动，以及由于早晨锻炼而未能做的所有事情。

It's about the whatever other healthy activities go along with exercising first thing in the morning and all the things that you're not doing as a consequence of exercising in the morning.

因此在我看来，这些更佳的探究路径——作为通往更佳心理健康、更美好生活的途径——它们建立在自我结构、自我功能这些支柱之下，才是真正的关键。

So it seems to me that these better lines of inquiry as the path to better mental health, a better life, that sit under these pillars of structure of self, function of self are really the key.

所以在这个例子中，对吧，你做的类比甚至更加戏剧化，对吧？

So in this example, right, the parallel that you made is even more dramatic, right?

那就不会是动感单车了，对吧？

It wouldn't be the stationary bike, right?

因为固定自行车正在实现

Because the stationary bike is achieving a

很多目标，对吧？

lot of ends, right?

这更像是告诉那个人，你知道，上楼的时候应该走得更快一些，对吧？

It would be more like telling the person, you know, you should walk more briskly when you're going upstairs, right?

就像，这是个好主意，但这并不会带来真正的改变，对吧？

Like, that's a good idea, but that's not going to make the change, right?

所以，认为某些认知行为疗法、某些药物有道理，这种想法更像是那样，对吧？

So the idea that some CBT, some medicine makes sense, it's more like that, right?

并不是说上楼梯走得更快不是件好事。

It's not that walking more briskly up the stairs isn't a good thing.

问题在于，我们不能围绕'你的整体健康将因此改变'来构建整个故事。

It's that we can't build the story around your whole health is going to change based upon that.

那么，如果那个人认为'只要上楼梯走得更快，你就会更健康'，这就会成为一个问题，因为当它不起作用时，他们就觉得自己失败了，对吧？

And then that's a problem then if the person thinks, Just walk more briskly up the stairs and you'll be healthier, because when it doesn't work, now they've failed, right?

这在心理健康领域经常被用到。

And this gets used a lot in mental health.

那个人这种疗法失败了，那种药物也无效，对吧？

That person failed this therapy, failed that medicine, right?

而且我觉得这也很讽刺，因为那往往就是当事人内化的想法。

And I think it's so also ironic because that's often what the person internalizes.

嗯，他们失败是因为我们100%地设定了他们必然失败，对吧？因为我们把那些本有其作用（至少可能有其作用）的东西，围绕它们构建了整个叙事，因为这个叙事对提供护理的体系来说很方便。

Well, they failed because we set them up 100% for failure, right, because we took things that have their role, at least potentially have their role, and we built the whole story around them because that story is convenient for the systems that are providing the care.

这对医疗系统来说很方便。

It's it's convenient for the health care systems.

这对保险公司来说也很方便。

It's convenient for the insurers.

认知行为疗法（CBT）很容易打包，你可以看到，当你开始改变想法以及它们如何影响你的感受时，表面上似乎能看到一些进展，即使深层并没有变化。

CBT packages very nicely, and you could see how, you know, if you start changing thoughts and how they make you feel like, you know, you can get some movement on the surface even if there's no movement underneath.

对吧？

Right?

而且，我并不是说认知行为疗法不好，但把它当作唯一答案，在很多情况下注定会失败。

And, again, I'm not saying CBT is bad, but to see it as the whole answer guarantees failure in so many situations.

药物也是如此。

Same thing with the medicine.

如果你仅仅因为方便就构建整个叙事，而总的来说，药物比人力便宜得多。

If you build the whole story just because it's convenient and and by and large, medicines are cheaper than people.

对吧？

Right?

所以你可以非常随意地开药。

So so you can prescribe medicines very reflexively.

精神科医生每次只花十五分钟见病人，之后可能几个月都再也见不到他们。

Psychiatrists with fifteen minutes with a patient that they can't then see back for a couple of months.

这怎么可能做好呢？

Like, how does that go well?

答案是，这就像一只坏掉的钟，一天只有两次是对的。

The answer is it only goes well the way a broken clock is right a couple of times, you know, twice a twice a day.

对吧？

Right?

我的意思是，你看。

I mean, so look.

有时候确实能奏效，病人在十五分钟内做一点治疗，选对了药物，一切就恰巧顺利了。

Sometimes it goes well where it just somehow it works out, and that person could do a little bit of therapy in fifteen minutes and choose the right medicines.

但总的来说，我们这么做只是因为对系统来说方便，而这也正是人们并没有像我们预期的那样康复的原因。

But by and large, we do those things because they're convenient for the systems even though that's why, like, people don't get better like like we think they would.

这就是他们一直留在系统里的原因。

That's why they stay in systems.

这就是他们反复进出急诊室的原因。

That's why they come in and out of emergency rooms.

这就是他们无法停止那些药物的原因——这些药物往往只有在患者去世时才会被停用。

That's why they're not able to stop the drugs that end up, you know, only being stopped when the person dies.

这种事情经常发生，而我们却不去阻止它，因为我们所持的视角太过局限。

Like, this happens all the time, and we don't stop it because we're coming from a perspective that is so limited.

我们是否应该退一步想想：我们真的能帮助到这个人吗？

It's not saying, let's take a step back and look, Can we really, like, help someone?

我们真的能帮助这个人理解吗？

Can we really help that person understand?

我们能帮助这个人做出改变吗？

Can we help that person make change?

这最终对个人、对社会都会好得多，但即使只从经济成本来看，也显然更划算。

Which ultimately would be, of course, so much better for the person and so much better for society, but is also better if we just look at bottom line dollars and cents.

对吧？

Right?

因为从短期来看，让精神科医生在十五分钟的就诊中随意开药，今天看起来更便宜。

Because the short term view of it is cheaper today to have a psychiatrist at a fifteen minute appointment reflexively prescribe a medicine, that is cheaper today.

但从长远来看，当这个人消耗了更多资源，或频繁出入急诊室时，这还更便宜吗？

Is that cheaper across time when that person is utilizing more resources or they're in and out of emergency rooms?

这种短视的做法与我们社会的许多运作方式相符，对吧？我们想要即时的满足，而且要快速得到满足。

It's so shortsighted with which fits with many ways in how our society works, right, that we want gratification, and we want gratification rapidly.

这就是为什么一个人会认为他们的问题是可以通过药物解决的，对吧？

That's why a person would accept that their problems could be changed by medicine, right?

我们已经被这样塑造了。

We're kind of conditioned that way.

当然，还有我们看不到的成本，那就是这个人失去了表达创造驱动力的机会，其后果是无法估量的。

Well, and then, of course, there's the cost we don't see, which is that person doesn't get the opportunity to express their generative drive, and the consequence of that is incalculable.

对。

Right.

是的。

Yes.

如果我们退后一步来看待这个问题，我认为我们会发现，我们并非完全把自己逼入了绝境，而是像这样——你知道，就像一幅覆盖整面墙的美丽挂毯，只有站远一些才能看清全貌，对吧？

And if we take a step back and we look at that, I think that what we will see is that we have, it's not quite like painted ourselves into a corner, it's like, you know, the idea that if there's a beautiful tapestry that's the size of the wall, right, that you can see that only standing back from it, right?

我的意思是，这可以追溯到几千年前，对吧，这种思想和理念，但如果你靠得太近，就再也看不清它的意义了。

I mean, this goes back, you know, I think a couple thousand years, right, this sort of thought and idea, but if you come up too close to it, then you can't see what it means anymore.

而我们离得太近了，以至于我们在想，好吧，一个参数怎么可能改变呢？

And we're up so close to it that we're thinking, well, okay, how could one parameter change?

而且，你知道，这个人能否尽快安排一个十五分钟的诊疗？

And, you know, can this person get a fifteen minute visit sooner rather than later?

或者换这种药而不是那种怎么样？

Or how about this medicine instead of that?

然后这就好像我们的鼻子紧贴着挂毯，我们看不到很多时候我们没有善待个体，也没有善待社会，而如果你停下来想一想，我们也没有善待自己，因为我们任何一个人都可能处于那种境地，我们很多人都曾处于那种境地，站在事情的另一面，真正需要帮助和理解。

And then it's like our noses are right up against the tapestry, and we don't see that we're not doing right by individual people a lot of the time, and we're not doing right by society, which then if you stop and think about it, we're not doing right by us is any one of us could be in that position, and many of us have been in that position being on the other side of things and really needing help and needing to understand.

所以我们任何人都可能处于那种情况。

So any of us can be there.

如果我们让很多个体失败，也让社会失败，那么无论谁在听这些，最终我们都是在让自己失败。

So if we're failing a lot of individual people and we're failing the society, it doesn't matter who we are listening to this, like ultimately we're failing ourselves.

我想短暂休息一下，感谢我们的赞助商Eight Sleep。

I'd like to take a brief break and acknowledge our sponsor, Eight Sleep.

Eight Sleep生产智能床垫罩，具备制冷、加热和睡眠追踪功能。

Eight Sleep makes smart mattress covers with cooling, heating, and sleep tracking capacity.

我之前在这档播客和其他场合多次提到，规律地获得高质量睡眠是心理健康、身体健康和表现的基础。

I've spoken many times before on this podcast and elsewhere about the fact that getting a quality night's sleep on a regular basis is the foundation of mental health, physical health, and performance.

当我们睡得好时，一切都会变得更好。

When we're sleeping well, everything goes better.

而当我们睡眠不足或质量差时，心理健康、身体健康和表现都会迅速恶化。

Or when we are not sleeping well or enough, everything in terms of mental health, physical health, and performance gets far worse very quickly.

获得优质睡眠的关键之一是控制睡眠环境的温度。

One of the key things to getting a great night's sleep is to control the temperature of your sleeping environment.

这是因为，要入睡并保持深度睡眠，你需要让核心体温下降大约一到三摄氏度。

And that's because in order to fall and stay deeply asleep, you need your core body temperature to drop by about one to three degrees.

为了醒来时感觉神清气爽，你需要核心体温上升大约一到三摄氏度。

And in order to wake up feeling refreshed, you need your core body temperature to increase by about one to three degrees.

使用Eight Sleep的智能床垫罩后，这一切都变得非常简单，因为它允许你在夜间开始、中间以及即将醒来时，提前设定好睡眠环境的温度。

That all becomes very easy when using an Eight Sleep mattress cover, because it allows you to program the temperature of your sleeping environment at the beginning, middle, and towards the end of your night when you wake up.

我两年前开始使用Eight Sleep的床垫罩，它立刻且持续地提升了我睡眠的质量和深度。

I started sleeping on an Eight Sleep mattress cover over two years ago, and it immediately and persistently improved the quality and depth of my sleep.

因此，我醒来时感觉更加精力充沛。

And as a consequence, I wake up feeling far more refreshed.

我白天的情绪、专注力和警觉性都得到了提升。

I have enhanced mood focus and alertness throughout the day.

如果你想尝试Eight Sleep，可以访问eightsleep.com/huberman，最多可节省150美元的Pod Three床垫罩费用。

If you'd like to try Eight Sleep, you can go to eightsleep.com/huberman to save up to $150 off their pod three cover.

Eight Sleep目前在美国、加拿大、英国、部分欧盟国家以及澳大利亚发货。

Eight Sleep currently ships in The USA, Canada, UK select countries in The EU and Australia.

再次提醒，网址是eightsleep.com/huberman。

Again, that's eightsleep.com/huberman.

那么我们来谈谈哪些方法是有效的。

Let's therefore talk about what does work.

再次强调，虽然药物和认知行为疗法（CBT）确实有帮助，但它们只是整个大图景中的两个组成部分。

And again, placing on the shelf the fact that medications can help and CBT cognitive behavioral therapy can help, but they are just but two components of a much larger picture.

我们在本期节目开头简要描述过的那张地图——顺便说一句，如果观众想直观查看，可以在节目说明中找到可下载的PDF版本——并且在第一期节目中进行了详细讲解。我希望大家能抽空收听，因为内容非常丰富深刻。

The map that we described briefly at the beginning of today's episode, and that is, by the way, available as a downloadable PDF in the show note captions if people want to look at it visually, and that was described in a lot of detail in episode one, which I hope people will take the time to listen to because it's so rich with depth of understanding.

我相信每个人只需聆听您的讲述，就能对自己和他人有极大的了解。

And I'm certain everyone will learn a ton about themselves and others simply by listening to your words.

我对此非常确定。

I'm absolutely certain of that.

这张地图基本上提供了一个描述，告诉你该去哪些‘抽屉’里寻找更好的答案，甚至包括你可能要问的各种问题。

That map provides essentially a description of the bins, the cupboards to look in to arrive at better answers and even the sorts of questions that one might ask.

我们能否就你之前提到的那个例子来谈谈，那个人做出了非常了不起的选择，离开了那份高薪工作。

If we could just talk about that in the context of the example that you gave of this person who made this really incredible choice to move away from this higher paying job.

他们当时过度沉溺于某些适应不良的行为中。

They were overindulging in certain maladaptive behaviors.

我们再次使用这个例子，但这个例子只是无数个正在挣扎的人的案例中的一个，对吧？

And again, we will use this example, but this example is but one of an infinite number of examples that we could use of a person who's in a struggle, right?

他们在做一些对自己无益的事情，同时也没有去做那些他们知道应该做的事情，明白吗？

They're doing something that's not working for them, and they're also not doing things that they know they ought to be doing, okay?

这一点对人们来说很重要，因为会有一些人想：‘哦，这个可怜的家伙，他赚了这么多钱，真可怜。’

This is important for people to understand because there are going to be people out there that are thinking, Oh, like this poor guy, like he's making tons of money, poor him.

但他正经历着深深的

But he was experiencing deep

他很痛苦。

He's miserable.

缺乏满足感。

Lack of satisfaction.

也可能是相反的情况。

It So could have been the reverse example.

比如，一个人的工作收入不足以让他过上富足的生活，对吧？因为生活中确实存在经济现实。

Like, the person isn't in a job that brings about enough wealth for them to thrive, right, because there are financial realities to life.

所以这只是一个例子。

So it's just one example.

对吧？

Right?

没错。

Right.

但我认为这是个好例子，因为这个人放弃了金钱。

But it's a good one, I think, because the person left the money.

对。

Right.

对吧？

Right?

那么，是什么让你放弃这些呢？

So it's like, what would make you leave that?

对吧？

Right?

而让你做出这种选择的原因是，当你身处那种情境时感到痛苦，而离开那种情境后却感到快乐。

And this is, well, what would make you leave that is if you're miserable in the situation with that, and you're happy in the situation without it.

对。

Right.

所以这关乎摆脱痛苦，寻找幸福。

So it's about leaving misery and finding happiness.

所以，如果你愿意和我们分享一下你在那些对话中的心态，比如你问他哪些关于他自我结构的问题，来揭示他的自我结构和功能，从而帮助你们最终引导他走上一条好得多的道路。

So if you'd be willing to share with us a little bit of your mindset during those sessions, meaning the sorts of questions you asked him about the structure of his self or to reveal the structure of his self and the function of his self that allowed the both of you to eventually set him down this far better course.

还有什么比摆脱挫败感、过度放纵和适应不良的行为，转而获得深刻的满足、平静、安宁和喜悦，成为一个富有创造力的人更好呢？

What's better than moving away from frustration and overindulgence and maladaptive behavior to deep satisfaction, peace, contentment, and delight, and to become a generative human being?

对。

Right.

所以，我们可以逐一查看这十个抽屉，对吧？

So we can look in each of those 10 cabinets, right?

比如说，我们来看看无意识心灵这个抽屉。

So let's say we look in the unconscious mind cabinet.

那里没什么东西，对吧？

There's not much there, right?

当这个人成长时，拥有更多钱和一份让人羡慕的工作显然是很重要的事。

When the person was growing up, it was very clear that having more money and having a job that impressed people was an important thing.

他内化了一些东西。

He internalizes some of it.

所以其中一部分是无意识的，但总体而言，他是有意识的。

So some of it's unconscious, but by and large, he's aware of it.

你是通过问他关于成长经历的问题来发现这一点的，比如：谈谈你的成长背景。

Then that was revealed to you how you would ask him a question about, Tell me about your upbringing.

他会说，是的，钱对我家来说很重要，但我一直觉得我们足够了。

And he would say, Yeah, like, money was important to my family, but I always felt like we had enough.

不算特别富有，但够用了。

Wasn't super wealthy, but it had enough.

所以当你说到那里没什么东西时，你是想说，没有那种明显的标志，也没有闪烁的红灯，比如：哇，他的潜意识里有什么东西在阻碍他。

And so when you say there wasn't a lot there, do you mean that there was no kind of like X marks the spot or like blinking red light, like, Woah, there's something really in his unconscious mind that's in his way.

我理解得对吗？

Do I have that right?

嗯，更多是因为这是有意识的，对吧？

Well, more because it was conscious, right?

所以他很清楚这几乎是被灌输给他的，对吧？

So he was aware that it was very much like beat into him, right?

就像这是唯一能让人安心的方式，对吧？就是要有一份高薪体面的工作，对吧？

Like this is the only way to be okay, right, is to have a prestigious job that makes a lot of money, right?

但他意识到了这一点。

But he's aware of it.

如果他没有意识到，那我们就需要把它揭示出来，对吧？

If he weren't aware of it, then we have to bring that to light, right?

但他意识到了。

But he was aware.

他说，你看，这对我影响很大。

He's like, Look, it has a big impact on me.

这让我很难抽身离开。

It makes it hard to step away.

就是，我知道自己其实没那么在乎钱，但某种程度上又确实在乎，你懂我的意思吧？

Like, I know I don't really care that much about the money, but I also kind of do, you know?

当然，金钱，

Sure, money,

我常说金钱买不来幸福，但它确实能缓冲生活中的某些压力源。

I always say money can't buy happiness, but it certainly can buffer certain stressors in life.

对。

Right.

我的意思是，没有人，你知道，有时候你会听到很多有钱人说，金钱买不到幸福，因为，你知道，有很多痛苦的有钱人。

I mean, nobody, you know, sometimes you hear people who have a lot of money saying like, Money can't buy happiness because, you know, there are lot of miserable, rich people.

但这就像是，你知道的，雇两个夜班护士照顾宝宝，和必须自己熬夜照顾孩子的人相比，情况完全不同；或者单身母亲与有伴侣愿意分担的母亲相比也是如此。

But it's like, you know, it's very different to have two night nurses to take care of a baby than to be the person who has to stay up all night taking care of a kid, or a single mother versus a mother that has a partner who's willing to pitch in.

你知道，这根本没法比。

You know, you just can't compare.

虽然这完全正确，但在这个情况下，我们只是把钱当作钱来看，也就是作为一个终点，对吧？

And while that's absolutely true, in this case, we're just looking at money as money, like as an endpoint, right?

意思是，不管怎样，更安全、更有保障，钱越多就越好吗？

The idea that no matter what, right, how secure and safe, like, is more money better, right?

而他对这一点有着内在的高估，对吧？

And he had an intrinsic overvalue of that, right?

因此，这让他更难抽身，因为他高估了它。

So it made it harder to step away from it because he was overvaluing it.

他知道自己高估了它，仅仅因为它本身，而不是因为它能带来什么，对吧？而是因为它所承载的心理意义，对吧？

He knew he was overvaluing it just in and of itself, not even for what it gets you, right, but for the psychological meaning of it, right?

然后我们来看看他的防御机制。

Then we look at his defensive structures.

如果我们看看那个橱柜，你会发现它们真的已经发生了变化。

If we look in that cupboard, you see that they've they've really shifted.

对吧？

Right?

它们从健康的状态发生了转变。

They shifted from healthy places.

现在它们有些扭曲变形，他做了很多否认、很多回避、很多合理化。

Now they're sort of twisted and distorted, and he's doing a lot of denial, a lot of avoidance, a lot of rationalization.

对吧？

Right?

他对自身施加了很多攻击性，并且做了很多投射，对吧？

He's enacting a lot of aggression towards himself, and he's doing a lot of projecting, right?

他正在用酒精伤害自己。

He's harming himself with the alcohol.

他正在惩罚自己。

He's punishing himself.

所以他的防御结构，它可以是健康的。

So his defensive structure, it can be healthy.

我们知道这一点，因为它曾经更健康。

We know that because it was healthier.

对吗？

Right?

但后来我们看到它是如此扭曲。

But then we see that it is so twisted.

所以我们从中学到了很多。

So we learn a lot from that.

对吧？

Right?

这个人有很多意识层面的东西。

A lot is conscious in this person.

防御机制可以是健康的，因为它曾经是健康的，但最终，它确实是健康的。

The defensive structure can be healthy because it was healthy, but it's Eventually, it was healthy.

嗯，它以前是健康的。

Well, it was healthy before.

我明白了。

I see.

它以前是健康的。

It was healthy before.

所以你知道它可以再次变得健康，对吧？

So you know that it can be healthy again, right?

他内心具备拥有健康防御机制的能力。

He has it in him to have healthy defenses.

只是随着他对工作越来越不满意，对自己越来越愤怒，越来越痛苦，这些防御机制开始逐渐脱离他的掌控。

They just started getting away from him as he felt less and less satisfied with his job and more and more angry with himself and more and more miserable.

这对我来说以及对我们所有人来说都是一个非常关键的点。

This is a really key point for me and everyone else to understand.

在高中和大学这些年，以及和朋友相处这类事情上，我经常会听到这样的话，比如我以前健身很厉害，或者我以前——你知道吗，要是每次有人说‘你真该看看我高中的样子’我就能得到一美元就好了。你知道，那些放任自己的人，可以说是因为忙于工作和家庭责任。

Throughout the years of high school and college and friends and things of that sort, I would hear this like, I used to be really good at fitness, or I used to, you know, if I had a dollar for every time someone said, you know, you should have seen me in high school, you know, the person who lets themself go, arguably is very busy with professional duties and family duties.

而且你知道，你可以理解为什么他们的时间比高中时期更加紧迫。

And you know, you can understand why their time is more compressed than it was when they were in high school.

但尽管如此，你知道，你总是会听到这类事情。

But nonetheless, you know, you hear these sorts of things all the time.

就像我曾经有一种感觉，觉得自己能做成事情，或者事情会顺利解决，但后来仿佛他们以前的那个自己完全萎缩了，而现在的或后来的自己却再也无法触及那种状态了。

Like I used to have this sense of like I could do things or that like things could work out or that And then it's as if there was a previous version of themselves that is completely atrophied and the new version of themself or the later version of themselves rather just simply like doesn't have access to that anymore.

对。

Right.

这就是创伤的影响。

And that's the impact of trauma.

是的。

Yeah.

对吧？

Right?

好吧。

Okay.

无论是重大创伤，还是一些重大事件，或者是一连串的小事，比如‘这个世界并没有回报我’。

Whether it's big trauma or it's, you know, a big event or it's multiple things like, oh, the world isn't rewarding me.

我一直在努力。

I'm trying.

这个世界并不奖励我。

The world's not rewarding me.

我在努力。

I'm trying.

这个世界并不奖励我。

The world's not rewarding me.

然后人们就会变得灰心丧气，对吧？士气低落，对吧？

Then people become dispirited, right, demoralized, right?

正是这种创伤剥夺了人的自我感和能动性。

So it's the trauma of that that takes away the sense of self, the sense of agency.

我以前觉得自己能做成事情。

Like, I thought I could do things before.

现在我觉得自己什么都做不了，对吧？

Now I don't think I can do things, right?

但其实我本身并没有什么改变。

But nothing has really changed in me.

我是说，这是个问题，对吧？

I mean, that's a problem, right?

而且这个问题绝大多数时候源于创伤。

And it's a problem the vast majority of times it's born of trauma.

这一定意味着是童年早期的创伤吗？还是说也可能是人生后期的创伤？

Does that necessarily mean early childhood trauma, or I suppose it could be later life trauma?

我的意思是，你所说的让我非常欣赏的一点是，你作为一位精神科医生，听到病人说‘我过去能把某件事做得很好’或者‘我曾经感觉……’，这听起来像是一个信号，一个真正健康的灯塔，它仍然存在于这个人身上，只是他们与之失去了联系。

I mean, one of the things that I like about what you're saying so much is that, you know, you, the psychiatrist, hears, I used to be able to do something well or And feel that's like, it sounds like is a signal, it's really a beacon of health that still exists in the person, but that they're out of touch with.

我认为对大多数人来说，当他们思考自己或他人谈论曾经在某个领域如何能干，如今却不再胜任时，听起来就像是某些东西从根本上坏掉了。

I think for most people, when they think about themselves or people who talk about how they used to be functional in some domain and they're no longer functional in that domain any longer, it sounds as if like things are fundamentally broken.

就好像他们曾经正常运转的一部分脱离身体飘走了，对吗？

Like is this of a piece of them that was functioning like drifted out of their body and left, right?

但我很喜欢这种乐观的态度，对吧？

But I love the optimism, right?

因为我认为我们今天要讨论的很多内容，不仅仅是哪些方面出了问题及其原因，还包括哪些方面运作良好及其原因，以及过去哪些方法有效及其原因。

Because I think so much of what we're interested in covering today is not just what's not working and why, but also what's working and why, and what used to work and why.

而且，这些柜子里可能隐藏着问题的线索。

And the idea that, you know, within these cupboards, there can be the discovery of problems.

显然，这正是我们打开柜子的原因，正如我们所定义的那样。

Clearly, that's why one goes to the cupboards, right, as we're defining it.

但里面也有很多答案。

But that there are a lot of answers.

成功的要素其实早已存在于我们自身。

The ingredients for success already exist within us.

对。

Right.

尤其是当我们知道自己曾经拥有这种能力的时候，对吧？

Especially if we know we've had that ability before, right?

因为我们知道，我们以前确实拥有过。

Because we know that we had it before.

所以想想这个男人，他觉得自己无法做出改变。

So think about in this man, he felt that he couldn't make change.