周日精选：专访：社交隔离对大脑有何影响？与维韦克·默西博士对话

大家好，欢迎收听TED每日演讲。

Hey, TED Talks Daily listeners.

我是伊莉丝·胡。

I'm Elise Hu.

今天，我们为大家精选了一期来自TED音频合集的其他播客节目。

Today, we have an episode of another podcast from the TED Audio Collective handpicked by us for you.

每个人都需要一些独处的时间，宁静的独处有助于缓解压力。

Everyone needs some time to themselves, and peaceful solitude has stress relieving benefits.

但当独处是被迫的，其负面影响可能会广泛而深远地影响你生活的方方面面。

But when being alone is forced upon you, the negative effects can be extensive and surprisingly pervasive in all areas of your life.

在本期TED Health节目中，主持人索珊娜·乌恩格莱特采访了美国前外科医生维韦克·穆尔蒂，探讨孤独症流行现象，以及当我们缺乏社交接触时，大脑会发生什么变化。

In this episode from TED Health, host Shoshana Ungerleiter interviews doctor Vivek Murthy, the former surgeon general of The United States, on the loneliness epidemic and what happens to our brains when we lack social contact.

对话结束后，她分享了一段由教育家特里·库珀斯制作的TED Ed课程，探讨独处究竟如何影响我们的身体和大脑。

After the conversation, she shares a TED Ed lesson from educator Terry Coopers who investigates the question, how exactly does isolation affect your body and brain?

你可以在你收听播客的任何平台收听更多这一特别系列节目。

You can listen to more of this special series on TED Health wherever you get your podcasts.

了解更多关于TED音频合集的信息，请访问audiocollective.ted.com。

Learn more about the TED Audio Collective at audiocollective.ted.com.

现在进入本期节目。

Now on to the episode.

享受吧。

Enjoy.

这是来自TED的TED健康播客，我是您的主持人Shoshana Ungerleiter医生。

This is TED Health, a podcast from TED, and I'm your host, doctor Shoshana Ungerleiter.

最近我一直在思考，要度过一整天却没有任何真正对话是多么容易的事。

I've been thinking a lot lately about how easy it is to go through an entire day without a real conversation.

我说的这种对话，不是仅仅发个简短短信或打个招呼说‘嗨’。

You know the kind I mean, not just a quick text or a passing like, hey.

你好吗？

How are you?

我是说，真正建立连接的时刻，有人真正看见了你。

I mean, an actual moment of connection where someone really sees you.

我们是在一月份录制这一集的，我注意到这种趋势在冬季越来越明显。

We're recording this episode in January, and I see this trend happen more and more in the wintertime.

随着天气变冷，我们许多人待在室内的时间更长了，而节日期间，那些远离家人或正经历困难时期的人，孤独感有时会加剧。

Many of us are spending more time indoors as the weather gets colder, and sometimes the holiday season can leave us with amplified feelings of loneliness for those who are far from family or going through a difficult time.

如果你正是这样，请知道你并不孤单。

If that's you, know that you're not alone.

因为专家指出，我们许多人其实比自己愿意承认的更缺少这种深层次的连接。

Because according to experts, it turns out many of us are missing this kind of deeper connection a lot more than we'd like to admit.

从健康的角度来看，社交孤立对我们真的非常不利。

And from a health perspective, social isolation really, really isn't good for us.

在本周的节目中，我很高兴为您带来与美国第十九任和第二十一任外科医生维韦克·穆尔西的对话。

In this week's episode, I'm excited to bring you a conversation with doctor Vivek Murthy, the nineteenth and twenty first surgeon general of The United States.

穆尔西医生是一位医生和公共卫生领袖。

Doctor Murthy is a physician and public health leader.

多年来，他一直在警示美国正在面临的所谓孤独流行病。

He's also been sounding the alarm about what he calls the loneliness epidemic in The US for years now.

他认为社会孤立是一种公共卫生危机，其致命性不亚于重度吸烟，我们将探讨我们是如何走到这一步的。

He sees social isolation as a public health crisis that can be just as deadly as heavy tobacco use, and we're gonna talk about how we got here.

穆尔西医生和我将讨论社交媒体，以及我们的数字生活如何重塑线下的人际关系。

Doctor Murthy and I are gonna talk about social media and how our digital lives are reshaping our relationships offline.

我们还将探讨一些简单而实用的建议，帮助大家从今天开始，在新的一年里重建联系，增强身心健康。

We'll also explore some small and practical tips we can all take to rebuild connection and strengthen our well-being this new year starting today.

采访结束后，请继续收听一段TED Ed课程，了解没有社交接触时大脑会发生什么。

Then after the interview, stick around for a TED Ed lesson on what happens to your brain without any social contact.

但在深入之前，先让我们花点时间听听赞助商的广告。

But before we dive in, a quick break to hear from our sponsors.

医生。

Doctor.

穆尔西医生，非常感谢您来到《TED健康》节目。

Morthy, thank you so much for being here with us on TED Health.

谢谢你邀请我，莎莎娜。

Thanks so much for inviting me, Shoshana.

今天我们要深入探讨一个我知道你非常熟悉的话题：社交联系与孤独。

So today we are digging into a topic that I know that you know well, social connection and loneliness.

我们现在经常随意地使用‘孤独’这个词。

We use the word lonely pretty casually now.

但从公共卫生的角度来看，孤独到底意味着什么？它和单纯独处有什么不同？

But from a public health standpoint, what does loneliness actually mean, and how is it different from simply being alone?

我们大多数人一生中都曾感到过孤独。

Most of us have felt lonely at some point in our lives.

也许是在我们离家上大学的时候。

Maybe that's when we moved away to college.

也许是在我们换了一份新工作，离开了旧同事的时候。

Maybe it's when we moved to a new job and left old colleagues behind.

还记得吗？也许是在我们小时候，因为父母的工作调动而搬家，不得不在一个新城镇从头开始的时候。

Remember, maybe it's when we were kids and we moved because of our parents' job and had to just start all over in a new town.

当你进一步思考时，我们就可以进入定义层面了：孤独本身是一个主观的概念。

When you think about going beyond that then, we can get into definitions, which is that loneliness itself is a subjective term.

它描述的是一种感受：我生活中所需的连接关系，比我实际拥有的要多。

It describes the experience of feeling like the connections I need in life are more than the connections that I actually have.

在这种差距中，我体验到了孤独。

And in that gap, I experience loneliness.

但它与客观意义上的孤立不同，孤立更多是指你周围有多少人。

But it is distinct from the objective term isolation, which is more a descriptor of the number of people you have around you.

这一点之所以重要，是因为你可能根本一点都不孤立。

And the reason this is important is because it turns out that you can be not isolated at all.

你可能被成百上千人包围着，就像大学生在校园里那样，但如果你感觉不到与这些人有联系，觉得自己无法做真实的自己，或者在危机时找不到可以求助的人，你依然会感到非常孤独。

You can be surrounded by hundreds or thousands of other people, way college students are in campuses, but you can feel very lonely if you don't feel connected to those other people, if you don't feel you can be yourself or don't feel like there's anybody you can reach out to in a crisis.

而这正是当今世界上人们普遍的经历。

And this turns out is the common experience that people have in the world today.

我们身边有很多人，但往往是因为缺乏关系中的安全感，缺乏能够做自己、敞开心扉、展现脆弱的感觉，才让许多人即使身处人群，也感到孤独。

We're surrounded by lots of folks, but often it's the lack of comfort in our connection, the lack of feeling like we can be ourselves, be open, be vulnerable that leads many of us to feel lonely in a crowd.

是的。

Yeah.

我认为这种表述真的能帮助我们更好地理解。

I think that framing really helps to ground us.

你把孤独称为一种流行病，有些人听到可能会想：一种情绪怎么就成了公共卫生问题？

And you've called loneliness an epidemic for people who might hear that and think, how does something emotional turn into a public health issue?

科学实际上揭示了它对身体的影响，比如对我们的心脏、大脑甚至免疫系统？

What does the science actually show about its impact on the body, like our heart and our brain and even the immune system?

我在上医学院的时候，记得那时我们非常关注身体健康，但逐渐意识到，我们的心理也会影响身体。

When I was going through medical school, I remember it was a time where we had so much focus on physical health, but there was this growing recognition that, hey, our mind influences our body as well.

如今，时间又过去了几年，这种认识不仅没有减弱，反而更加深入了。

And now fast forward a number of years, and we see that understanding has only grown.

作为临床医生，我们在医院里经常清楚地看到，患者的感受——他们是否焦虑、抑郁、乐观或担忧——实际上会显著影响他们的身体健康。

And we see now just often very clearly ourselves as clinicians in the hospital that how a patient feels, how they're doing, are they anxious, are they depressed, are they optimistic, are they feeling worried, that actually has an impact often on their physical health.

我们可以通过心率来观察这一点，对吧？

We can see that in the form of your heart rate, right?

当你感到焦虑时，有时心率会升高，血压也会升高。

When you get anxious, sometimes your heart rate goes up, sometimes your blood pressure goes up.

所以我们知道身心之间存在着联系。

So we know there's a connection between body and mind.

像孤独这样的状态带来的挑战在于，它们是慢性应激状态，而短期压力可能有益，能激励你行动、思维更敏锐或集中注意力。

The challenge with states like loneliness is that they're chronic stress states and stress while in the short term may be beneficial, motivating you to act or to think more sharply or to focus.

当长期处于压力之下时，实际上会对身体产生损害，导致体内炎症水平升高。

When you have long term stress, that can actually start to become detrimental to the body, lead to increased levels of inflammation in our body.

这就是为什么我们发现，那些长期与社会脱节的人，实际上似乎面临更高的身心健康不良后果风险。

It's why we see actually that people who struggle with a chronic sense of social disconnection that they actually appear to have a higher risk of poor physical and mental health outcomes.

因此我们看到，不仅抑郁症风险翻倍，焦虑和自杀风险增加，而且心血管疾病和中风的风险也显著上升了约百分之三十。

So we see not only a doubling in the risk of depression, increased risk of anxiety and suicide, but we also see a market increase in their risk of cardiovascular disease and stroke around thirty percent, for example.

我们看到老年人患痴呆症的风险增加了百分之五十，而社会孤立带来的总体死亡率影响，与肥胖和吸烟造成的影响相当。

We see a fifty percent increase in the risk of dementia among older people and an overall mortality impact associated with social disconnection that's comparable to what we see with obesity and with smoking.

我这么说可能很直白，但多年前看到这些数据时，这对我来说确实相当具有启示性。

And so I say that plainly, but that was quite revelatory to me when I saw this data years ago.

这让我明白了，尤其作为当时担任卫生局局长、身处一个传统上致力于解决吸烟和肥胖等问题的机构的人，它让我认识到社会孤立同样是一个重要的公共卫生问题，需要我们给予更多关注。

And it helped me understand, especially as somebody who was serving as surgeon general at the time and who was part of an office whose tradition was to work on issues like smoking and obesity, it helped me understand that social disconnection is as important a public health issue and one that we need to pay more attention to.

我确实感到欣慰，因为我们现在正在建立这些联系，分享这些至关重要的数据。

I am certainly heartened by the fact that we're now making these connections, sharing this critically important data.

这真的深深触动了我。

It really certainly hits home for me.

维韦克，你能分享一个你在担任外科医生总长期间，或者你个人生活中，改变你对社交联系与健康看法的故事吗？

Vivek, can you share a story either from your time as Surgeon General or maybe from your own life that changed the way that you think about social connection and health?

是的。

Yeah.

在我第一个任期内巡访各地时遇到的那些故事，让我开始关注这个问题。

The stories I encountered on the road during my first term as surgeon general that made me pay attention to this issue.

我刚上任时，并没有认为孤独是一种公共卫生问题，或任何形式的危机。

I didn't actually come into office thinking loneliness was a public health issue or that it was a crisis in any way, shape, or form.

我知道那不是一种好受的感觉。

I knew that it wasn't a good feeling.

我小时候，尤其是在小学时，因为非常害羞和内向，很难交到朋友，经历过很多孤独。

I had experienced a lot of loneliness as a kid who struggled in elementary school in particular with making friends because I was very shy and very introverted.

作为一名医生，我见过我的病人经历孤独，尽管我在医学院从未学过这一点。

I had seen loneliness in my patients as a doctor, even though I never learned about it in medical school.

这种孤独就体现在我收治入院和在诊所接诊的病人们的故事中。

There it was in the stories of the patients that I was admitting to the hospital and seeing in clinic.

但尽管如此，我仍然觉得这或许只是我个人经历中的特例。

But despite all of that, I kept thinking somehow that maybe that was just peculiar to my own experience.

但当我开始担任外科医生总长的第一任期并展开倾听之旅时，我开始在全国各地遇到许多人，他们向我倾诉孤独的感受。

But then I began my first term as surgeon general with the listening tour and started encountering people all across the country who were telling me about loneliness.

顺便说一句，千万别用这个词。

See, by the way, never use that term.

他们很少主动走过来对我说：嗨。

Rarely do they come up to me and say, hi.

我是特里珊。

I'm Trishan.

我是维韦克。

I'm Vivek.

我感到孤独。

I'm lonely.

但相反，他们会说：我觉得自己一个人承担着生活中所有的重担。

But instead, they would say things like, I feel like I'm carrying all these burdens in life by myself.

如果有个人可以分担一下，或者依靠一下，那就太好了。

It'd be really nice if there's somebody to share this with or to lean on.

大学生会告诉我：我身边有很多同学，但我感觉无法做真实的自己。

College students would tell me, I'm surrounded by lots of other students, but I don't feel like I can really be myself.

没人真正了解我。

Nobody really knows me.

所以我感觉自己完全是孤身一人。

So I feel like I'm just on my own.

我会听到来自各个年龄段的人——父母、祖父母、年轻人——令人心碎的故事，他们说：‘如果我明天消失了，恐怕都没人会注意到。’

And I would hear these heartbreaking stories from people of all ages, parents, grandparents, young people who would say, I feel like if I just disappear tomorrow, nobody would even notice.

我觉得自己无人看见。

I feel invisible.

对我来说，这些都体现了一种相似的孤独感。

And to me, these all spoke of a similar thread of loneliness.

但后来，作为成年人，我也多次亲身经历过这种情况。

But then I saw it many times in my life as an adult as well.

我特别记得，在我首次担任卫生局局长的确认过程中，那段经历非常艰难和具有挑战性，因为我关于枪支暴力的言论卷入了政治漩涡。

I remember in particular the time where I was going through my confirmation process, my first time serving as surgeon general, and it ended up being a very difficult challenging confirmation process because it caught in this swarm of politics around statements that I had made around gun violence.

我曾表示枪支暴力是国家的公共卫生问题，我认为这只是一个不言而喻的事实，而非有争议的言论。

I had said gun violence was a public health issue for the nation, and and I saw that as a truism, not as a controversial statement.

但在我们所处的政治世界里，对一些人来说，这却成了一种政治表态。

But in the political world we live in, it turned out that was a political statement to some people.

我记得那几个月一直在努力理解这一切。

And I remember those many months of trying to figure this out.

我当时对华盛顿和政府的整个体系还非常陌生。

I was very new to this whole world of DC and government.

我之前从未在政府工作过。

I'd never worked in government before.

我从未与参议院打过交道，更不用说这种政治斗争了。

I'd never dealt with the senate, much less that kind of politics.

我只记得自己感到辜负了家人和朋友，因为我陷入了这个问题。

And I just remember feeling like I had failed my family and my friends because I had run into this problem.

孤独的奇妙之处在于，对局外人来说，它往往没有道理。

The thing about loneliness is it doesn't always make sense to someone on the outside.

但在那段危机时刻，我却越来越退缩，而实际上我需要做的恰恰是更多地主动联系他人，依靠别人。

But in that time of crisis, found myself withdrawing more and more at exactly the time what I needed to do was actually to reach out more and to lean on other people.

所以我记得那些日子非常黑暗。

So I remember those days were very dark.

多亏了我的妻子爱丽丝、我的父母和妹妹，他们在我最艰难的时刻团结在我身边，给予我支持，还有那些围绕在我身边的朋友们。

And thank goodness for my wife, Alice, and for my mother and father and my sister who really came together around me and lifted me up during some extraordinarily hard, hard moments, and to friends who rallied around me.

你可能会以为，我当时就该吸取教训，说：嘿。

And you would think that I would have learned my lesson at that point and said, hey.

好吧。

Okay.

你就是一场危机。

You're a crisis.

你感觉很糟糕。

You're feeling bad.

主动联系其他人。

Reach out to other people.

但自从那时起，我意识到智慧并不是我们总能保持的东西。

But what I've realized since then is that wisdom is not something that we always retain.

它需要我们不断被提醒。

It's something we have to be reminded of.

在我人生的其他阶段，尤其是在我完成第一任期的卫生总监职务后，我再次陷入孤独的深渊，感觉自己失去了工作圈。

And at other points in my life, especially, like, after my first term, finished as surgeon general, once again in this pit of loneliness and feeling like I had just lost my work community.

我部分失去了朋友圈，因为我第一任期内未能与人保持联系，总是把工作放在与所爱之人维系关系之上，这在事后看来是个错误，但我必须面对由此带来的后果。

I had lost my friend community in part because I had failed to stay in touch with people during my first term and consistently had put work ahead of staying in touch with the people I loved, which was a mistake in retrospect, but I had to deal with the consequences of that.

我当时在波士顿处理一些工作事务，偶然遇见了一位多年未见的老朋友。

And I was up in Boston for something work related, and I saw an old friend there who I hadn't seen in years.

我会向她坦白自己的感受，比如感到非常孤独和孤立。

And I would just sort of confess to her how I was feeling, like pretty lonely and isolated.

她只是对我说，你的问题不是没有朋友。

And she just said to me, your problem is not that you don't have friends.

你的问题是你没有真正体验友谊。

Your problem is you're not experiencing friendship.

你生活中有那些人，只要你主动联系，他们都会在你身边。

You have people in your life who would be there for you if you reached out to them.

如果你能放下那些疑虑、担忧或焦虑，不再担心他们会不会因为你没保持联系而生气，只是简单地说：嘿。

If you swallowed the misgivings or worry or anxiety you have about how they might be mad at you for not staying in touch and just said, hey.

我在这儿。

I'm here.

我需要你作为朋友。

I need you as a friend.

对不起，以前我没有在你身边，但现在我在这里了。

I'm sorry for not being there before, but I'm here.

是的。

Yeah.

人们会回应的。

And people will respond.

他们会在那里支持你。

They will they'll be there for you.

她说得对。

And she was right.

是我主动联系别人，才重新体验到了这种联结。

And it took me reaching out to people proactively to experience that connection again.

所以我认为，我们每个人在生活中都经历过孤独。

So I think all of us in our lives have experiences of loneliness.

我想提醒自己、也建议他人记住的是，从外表很难看出谁正在经历孤独。

And the thing I think that I try to remember that I would urge others to perhaps keep in mind as well is that it is very hard to tell who is lonely from the outside.

但如果你了解这些数据，知道每三个成年人中就有一个在与孤独作斗争，你就会意识到，我们身边的许多人实际上都是孤独的。

But if you understand the numbers and understand that one in three adults are struggling with loneliness, then you realize many of the people around us are actually lonely.

当你主动联系他们，只是想关心一下、打个招呼、说句温暖的话，或者顺便去陪陪他们时，你永远不知道这可能会成为某位感到极度孤独的人的生命线。

And you never know when you're reaching out to them just to check-in and say hello, to offer a kind word, to stop by and offer your company.

你永远不知道，这样的举动可能会成为某个感到无比孤独的人的重要支持。

You never know when that can be a vital lifeline to somebody who's feeling very alone.

我想很多人都会在其中看到自己的影子。

I think a lot of people will recognize themselves in that.

我当然能认出自己。

I certainly see myself.

从你的角度来看，日常生活中健康的社会生活究竟是什么样的？

From your perspective, what does a healthy social life really look like in day to day life?

我认为，健康的社会生活意味着你身边有少数几个人，你可以对他们做真实的自己。

I think a healthy social life looks like a life where we have a few people around us who we can be real with.

这意味着要坦诚地表达你的感受。

That means being honest about how you feel.

这意味着要敞开心扉，分享你正在经历的困难。

It's being open about what you're struggling with.

这意味着能够寻求帮助。

It means being able to ask for help.

这也意味着能够回馈，主动提供帮助，而不是等待别人邀请，而是在有人需要时主动伸出援手。

It also means being able to reciprocate that, being able to offer help to others, not waiting for an invitation to help, but stepping up and showing up when there are people who are in need.

但你不需要对很多人这样做。

But you don't need to do that with a lot of people.

你不需要几百个最好的朋友。

You don't need hundreds of best friends.

你生活中可能只需要两三个、四个人就够了。

You might be two, three, four people, like, in your life.

他们不一定都住在你身边，但知道这些人存在于你的生活中，知道你可以依靠他们，他们也能依靠你，这就能带来天壤之别。

Not all of them may be physically around you, but to know that those people exist in your life, to know you can lean on them and that they can lean on you, that can make all the difference in the world.

我认为这一点非常重要，因为过去十五到二十年，尤其是社交媒体兴起以来，我们看到人际关系的重点从质量转向了数量。

And I think this is important to underscore because what we have seen in the last fifteen to twenty years, particularly with the advent of social media, is that there has been a shift from a focus on quality of relationships to quantity of connections.

对吧？

Right?

我们用关注者取代了朋友，用联系人取代了知己。

We've replaced friends with followers and confidants with contacts.

但事实是，当凌晨三点你遭遇危机时，社交媒体上一个随机的关注者或联系人并不会出现在你身边。

The truth is though that when you have a crisis at 03:00 in the morning, a random follower or contact on social media is not the one who's showing up for you.

真正会出现在你身边的是了解你、关心你、爱你的朋友，这就是为什么我们每个人的生命中都需要这种关系。

It's a friend who knows you, who cares about you, who loves you, and that's why we all have a need for that in our life.

我认为，社会健康这一概念对我们每个人思考自己的生活、对我们关心他人的人思考他们的生活、对我们这些从事医疗工作的人思考患者的生活都至关重要。

I think this concept of social health is an incredibly important one for us to think about in our own lives and for those of us who have others we care about to think about in their lives and for those of us who are in healthcare to think about in the lives of our patients.

我在接受医学培训时从未真正学过如何评估社会健康，但我清楚的是，只需向患者敞开心扉，问一句：‘你对你的友谊感觉如何？’

Like I was never really taught about how to assess social health when I went through medical training, but what I do know is that simply by opening up a conversation with the patient and saying, how do you feel, you know, about your friendships?

你有可以依靠的人吗？

Do you have people you can lean on?

还是你生活中有时会感到孤独？

Or do you have times where you feel lonely in your life?

你能跟我谈谈吗？

Can you tell me about that?

这对许多背负着孤独重担、常伴有羞耻感的患者和个体来说，可能是一种极大的解脱，而这种负担确实很沉重。

This can be incredibly liberating for many patients, for many individuals who carry the weight of loneliness often with a sense of shame, and that's a heavy burden to bear.

天哪。

Gosh.

这在当下尤其相关。

That feels especially relevant right now.

社交媒体，对吧，将全球数以亿计的人连接在一起。

Social media, right, connects millions and millions of us around the world.

但与此同时，它显然与孤独感的上升有关，尤其是在年轻人、青少年中——他们是最孤独的一代。

And at the same time, it's, of course, linked to rising loneliness, especially among young people, teenagers, the loneliest generation.

你认为这里发生了什么？

What do you think is happening there?

我认为社交媒体最初承诺的是建立联系和社群。

I think social media began with the promise of creating connection and community.

但在某个时刻，它偏离了轨道。

And somewhere along the way, it went off the rails.

我认为这背后是一种以广告为核心的商业模式。

And I think that was driven by a business model that, at its heart, was about advertising.

它依赖第三方广告收入，这意味着参与度成为收入的关键驱动因素。

It's about third party ad revenue, which meant that engagement became a critical driver of revenue.

如果你的目标是让用户留在你的平台上并保持他们的参与度，那么你就会使用各种工具和手段来留住他们，即使这对他们的心理健康和身体健康有害。

And if your goal is to keep people on your platform and keep them engaged, then you can employ all kinds of tools and tactics to keep them on even if it's not good for their mental and physical health and well-being.

我认为，令人遗憾的是，我们确实看到了这种情况。

And I think sadly that's what we have seen.

当我担任外科医生总长，走遍全国和世界各地时，我经常听到这些说法。

And I heard this all the time when I was traveling the country and the world as surgeon general.

许多人实际上表示他们曾尝试戒除或停止使用社交媒体。

So many people have actually said that they have tried to detox or quit social media.

但其中很多人并没有成功。

A lot of them have not succeeded.

但我认为这是因为我们需要认真思考这个问题。

But I think it's because we have think about this.

世界上一些顶尖的科技公司，汇聚了最杰出的产品工程师，利用前沿的神经科学，研究如何让你在平台上停留得越来越久。

Some of the best resource companies in the world with some of the most talented product engineers in the world using cutting edge neuroscience to figure out how to get you to stay on for longer and longer.

尤其是当你想到那些13岁的年轻人，他们使用社交媒体却难以控制使用时间，而我们却对他们说：嘿。

And especially when you think about young people, 13 year old, who might be using social media and struggling to limit their usage, and we say to them, hey.

你只需要更有意志力，更自律一点。

You just gotta find more willpower, be more disciplined.

面对这种情况，这简直是一场不公平的较量。

In the face of that, that is a definition of an unfair fight.

因此，我不怀疑许多平台的创建者在多年前最初是怀着建立社区的愿望的。

So I don't doubt that many people who built these platforms began many years ago with the desire to create community.

但如今数据清晰地告诉我们，对许多人来说，这种体验并没有转化为真正的社区感。

But what the data is actually telling us very clearly now is that for many people, that experience is not translating to community.

事实上，年轻人经常告诉我，社交媒体如何让他们对自己感觉更糟。

In fact, it's young people would tell me all the time about how social media would make them feel worse about themselves.

多年来，已有许多研究证实了这一点。

And there are a number of studies that have backed this up over the years.

其中一些内容被我纳入了我本人发布的关于社交媒体与青少年心理健康的公共卫生顾问报告中。

Some of them I included in my own surgeon general's advisory on social media and youth mental health.

但年轻人告诉我们，使用社交媒体也会让他们对自己的身材形象感到更差。

But as young people tell us that using social media makes them feel worse about their body image as well.

许多青少年表示他们对社交媒体上瘾。

Many adolescents say they feel addicted to social media.

它也影响了他们的睡眠。

It's impacting their sleep as well.

因此，当你把这些因素综合起来，你就不得不问自己一个我们在医学领域经常自问的问题：如何平衡风险与收益？

And so you put all of this together, and you have to ask yourself the same question I think in medicine we ask ourselves all the time, which is how do you balance risk and benefit?

我认为，我们目前看到的是，社交媒体的风险被严重低估了，对年轻人而言，甚至对成年人而言，其风险远比我们认识到的要大得多。

And I think what we're seeing is that the risks of social media have been dramatically underplayed, and they're far more significant for young people, and I would say even for adults, than we have recognized.

而我们原本期望的社交媒体带来的更紧密友谊和更紧密社群的好处，则被严重高估了。

And the benefits we hoped for in terms of closer friendships and tighter communities have been dramatically overstated.

这并不是说对某些人来说完全没有好处，但我们必须自问：这在我们的生活中是净收益吗？

It's not to say again that there are no benefits at all to some people, but we've gotta ask ourselves, is it a net benefit in our lives?

我们是否还在使用社交媒体，只是因为担心如果不使用就会被排除在外？

Are we still on social media because we are worried that maybe we'll be left out if we're not?

最后，我只想告诉你们这一点。

I'll lastly just tell you this.

我遇到过许多尝试戒掉社交媒体的人。

I have encountered many people who have tried to quit social media.

那些已经戒掉的人中，我几乎想不出有谁后悔过这个决定。

Those who have, it's extremely hard for me to think of a single person who has regretted that decision.

再次强调，这并不是说任何人都不该使用社交媒体，但我觉得，尤其是涉及到我们的孩子时，我们必须问自己一个问题：我们真的了解这些风险吗？这些风险是否值得我们可能看到的任何好处？

Again, it's not to say that no one should ever be on social media, but I think especially when it comes to our kids, I think we have to ask ourselves a question, do we really understand the risks and are those risks worth any benefits that we may see?

对于我的孩子，以及根据我所审查的数据——自我们的报告发布以来，越来越多的数据不断涌现——我建议所有家长都这样做：在没有建立确保公司充分披露其平台对儿童健康影响的完整数据和安全标准之前，我不认为在13岁就给孩子使用社交媒体是个好主意。

And I'll tell you that for my kids and what I advise parents across the board to do based on the data that I've examined and more and more data has continued to come out since our report, is I don't think that giving your kids access to social media at the age of 13 is a good idea until there are safety standards that are put in place that actually ensure that companies are disclosing the full effects and data they have on the health impacts of their platforms on kids.

特别是对于我的孩子来说，他们对使用这些平台感到不舒服。

For my kids, in particular, they don't feel comfortable with them being on these platforms.

因此，对于儿童使用的许多物品，比如食品、玩具等，我们都要求公司披露安全数据。

So we require companies to disclose safety data on a lot of things that kids use, food, toys, etcetera.

然而，在一个超过95%的年轻人表示使用过社交媒体的平台上，我们的立法者却未能要求任何合理的安全标准。

Yet on a platform that is relatively ubiquitous among young people with 95% plus saying they've used social media, Somehow our lawmakers have failed to require any type of reasonable safety standards.

对我来说，作为一名家长，这无疑是一个警示信号。

And to me, that's a red flag as a parent.

而且，这不仅仅是青少年或孩子的问题，对于那些深陷刷屏循环中的人来说也是如此。

And because, of course, this isn't just a a teen issue issue for kids, for someone who feels stuck in the scroll Yeah.

就像我们许多人一样，尤其是当感觉别人都完全生活在网络上时，我们如何才能现实地进行一次社交媒体重启，又不至于感到彻底被孤立？

Like so many of us, especially when it feels like everyone else is living their lives completely online, what's a realistic way for us to do a social media reset without feeling totally cut off?

所以，我想分享一些我们可以采取的措施。

So here are a couple of things that I think that we can do.

第一，我们可以尝试在生活中设立无科技区域。

Number one is we can take the first step of trying to create tech free zones in our life.

对吧？

Right?

比如，我们可以规定，用餐时间、与家人共处的时光、和朋友聚会的时候，都禁止使用社交媒体。

So we could say, for example, that our time at dinner, our time with our family when we're having meals, our time when we're hanging out with friends, that's gonna be time that's free of social media.

我们不会用它。

We're not gonna be on it.

这听起来可能显而易见，但我敢保证，每个听这期节目的人都有过这样的经历：当你和某人在一起时，你们中至少有一方在刷社交媒体。

And that might seem obvious, but the number of people who are I guarantee you everybody who is listening to this episode has had an experience in their life where some while they've been hanging out with somebody, they've been on social media, they or the other person.

我们可以做的第二件事是，选定一周中的某一天作为远离社交媒体的‘假日’。

The second thing that we can do, we can move to having a particular day of the week that we take as a as a holiday, if you will, from social media.

我们可以决定，比如，周六我不查社交媒体，或者周五我不查。

We might decide, okay, on Saturdays, I'm not gonna check, or on Fridays, I'm not gonna check.

但我建议的第三件事是，不要独自这么做，而是找一个朋友，和他达成约定，一起承诺在日常中设立无科技时段，或每周抽出一天不使用社交媒体。

But the third thing I would suggest is that we not do this alone, that we find a friend, somebody that we can make a pact with, that we're going to make this commitment to create a tech free zone in our day or take a day off in the week from using social media.

这之所以如此重要，是因为这些平台具有成瘾性。

And the reason that's so important is because these platforms are addictive.

这无可否认。

There's no other way to put it.

它们的设计本就如此。

They're designed to be so.

因此，很容易故态复萌。

And as a result, it's very easy to backslide.

很容易就会说，让我 just 打开一下应用。

It's very easy to say, let me just open the app.

让我 just 快速看一下有没有新通知，但我不会真的去刷屏。

Let me just see quickly if there are any notifications, but I won't really go and scroll.

但十五分钟后，你已经开始不停地刷了。

But then fifteen minutes in, you're scrolling, scrolling.

所以我们需要一个可以相互监督的人，我自己其实也需要这样的人。

So we need somebody that we're accountable to, and I actually needed this too.

在我的生活中，我曾经有一段时间用得太频繁了。

Like in my life, I was at a point where I was on it too much.

2022年我做手部手术时，需要休养几天，不能打字太多。

I had this particular moment in 2022 when I was having hand surgery and I needed to recover for a couple of days, meant I couldn't type as much.

于是我的两位密友给我打了电话，说：嘿，这正是你人生中做出改变的绝佳时机。

And so two of my very close friends called me and they said, hey, look, This is gonna be a perfect time for you to make some sort of shift in your life.

你一直想做但一直没能做到的是什么？

What have you been wanting to do that you haven't been able to do?

我说，说实话，戒掉社交媒体就是其中之一。

And I said, you know, honestly, getting off social media is one of those things.

于是他们说，好吧。

So they said, okay.

我们来做吧。

Let's do it.

我们做个承诺吧。

Let's make a commitment.

我太喜欢了。

I love it.

你的朋友们对你进行了一次干预，真的有效。

Your friends did an intervention with Yeah.

这真是太及时了。

And it was so welcome.

但正因为如此，每当我想要点击查看什么时，就会想到：哦，不行。

But because of that, every time I, like, went to potentially click and check something, you know, I would oh, no.

我得在周五向他们汇报进展，不然他们就会突然给我发消息，问我过得怎么样。

I gotta check-in with them on Friday and tell them how it's going, or they're gonna just text me out of the blue and ask me how I'm doing.

这实际上让我坚持了下来。

So that actually kept me on it.

我得说，这对我产生了真正的影响。

And I'll tell you that had a real impact on me.

你会意识到自己在这些平台上花了多少时间。

You realize how much time you're spending on these platforms.

这些时间加起来一整天就过去了。

It adds up the course of the day.

但另一点是，它对你的心理产生的影响。

But the other thing is the impact it has on your mind.

对吧？

Right?

我们的注意力被社交媒体搞得支离破碎。

Like, our attention gets so fractioned and shattered, if you will, by social media.

能够把它们放下，有时深呼吸一下，专心读点东西，或者好好聊个天，而不被这样打断，这是一次重要而不同的体验。

Being able to put that aside and sometimes just take a deep breath, read something and focus on it, or have a conversation and not be pulled aside like that.

那是一种重要而独特的体验。

That was an important and a different experience.

听好了。

Look.

我们并不是一夜之间就陷入对社交媒体上瘾、并看到它对我们造成的种种负面影响的。

We didn't get into this challenge overnight of being addicted to social media and seeing all the negative effects it has on us.

我们可能也不会一夜之间就摆脱它，但我们可以从今天开始采取一些小步骤。

And we may not get out of it overnight, but there are small steps we can start to take today.

这样做的重要原因，不仅是为了我们自己，更是为了那些有孩子或孙辈的人，要为他们树立一个与科技健康相处的榜样。

And the important reason to do that is not just for us, but for those of us who have kids or grandkids, it's to role model for them how to have a healthy relationship with technology.

当我旅行时，年轻人最常向我抱怨的一点是：我的父母总是盯着手机，总是刷社交媒体，我不知道怎么让他们放下。

Because one of the most common complaints I would get from young people on when I would travel was they would say, my parents are always on their phones and always on social media and I don't know how to get them off.

所以这个问题是一个跨代际的问题。

So this problem is a cross generational problem.

确实如此。

It really is.

好吧，我想稍微退一步来看这个问题。

Well, I want to zoom out for a moment here.

你提到过，公众对医学和科学的信任已经减弱。

You have talked about how public trust in medicine and science has eroded.

这确实也是我非常关注的一个话题。

It's certainly a topic that I am focused a lot on myself.

你认为我们对信任有什么误解吗？

What do you think that we've misunderstood about trust?

我认为最重要的一点，人们往往忽略了：信任本质上是一种关系。

I think perhaps the most important thing nobody should remember about trust is that fundamentally, it's relational.

人们通常不会仅仅因为无名的品牌或机构就建立信任。

People don't typically just build trust in faceless brands or institutions.

我们通常信任的是人，或者与这些机构有关联的人。

We tend to build trust in people or the people we associate with those institutions.

因此，我们在新冠疫情期间看到，即使在机构信任度下降的高峰期，人们也并非完全不信任任何人。

And so one thing we saw during COVID is even during the throes of COVID when trust in institutions is declining, it's not like people didn't trust anyone, period.

他们仍然信任他人。

They still trusted people.

许多人仍然信任他们的医生。

Many people still trusted their doctor.

他们信任护士，那些照顾他们和他们家人的人。

They trusted the nurse, so this who took care of their them and their families.

他们信任自己的朋友。

They trusted their friends.

如果他们认识当地公共卫生部门的人，这些人曾帮助他们解决问题或来到他们的社区提供援助，他们就信任这些人。

If they knew somebody at their local department of public health who had helped them on an issue or come to their community to help, they trusted them.

但最终归结为：我真正认识的是谁？

But it came down to who do I actually know?

我认为我们必须记住，在公共卫生和医学中，要以人际关系为基础重建信任。

And I think we have to remember that in public health medicine and use that to rebuild trust on a platform of relationships.

例如，这意味着，如果我们正在培训未来的护士、医生和公共卫生领导者，那么培训的一部分必须包括：我该如何真正走进社区，倾听并理解人们的需求，与他们沟通我们正在做的事情，并倾听他们的反馈？

For example, that means to me that if we're training nurses, doctors, public health leaders for the future, part of that training has to be in how do I actually go into a community and listen and understand what people need, talk to them about what we're doing, and listen to their reactions to that?

我该如何在社区中建立长期的关系？这样，即使我是公共卫生部门的一员，我的工作的一部分也是直接将信息带到社区，无论是在教堂、社区会议、学校集会，还是确保我有开放的政策，让人们知道他们随时可以进来提问。

How do I build longer term relationships in a community so that I might be a department of public health, but part of my job is in bringing, like, my information to communities directly, whether that's in church town halls or school gatherings or community town halls or whether that's making sure that I have an open door policy and people know they can come in at any time and ask questions.

我们必须想办法让健康、公共卫生和医学变得有血有肉，同时也要赋予、培训和支持公共卫生和医疗从业者去实现这一点。

We have to figure out how to put a face to health, to public health and medicine, and we have to empower and train and enable public health and medical practitioners to do that.

这当然不是要再给医生、医疗和公共卫生从业者本已冗长的任务清单上增加一项新内容。

And this is not to be clear about adding one more thing to the long list of things that we ask doctors and medical and public health practitioners to do.

更准确地说，作为一个系统，我们该如何支持他们，让他们能花更多时间与他们想要服务的人群在一起？

It's more about saying as a system, how can we support them in spending more of their time with the people that they are seeking to serve?

我认识的医生中，几乎没有谁是因为想多填几张表格、多做些行政工作，或者花更多时间打电话跟保险公司争辩预授权问题，才选择从医的。

There are very few doctors I know who there are no doctors I know, let me put it this way, who got into medicine and were inspired to become a healer so that they could chart more or do more administrative work or spend more time on the phone with an insurance company fighting over a prior authorization.

人们之所以这么做，是因为他们不得不如此。

Like, people do that because they have to.

他们被迫这样做，因为他们正在努力为患者争取所需的东西。

They're forced to because they are fighting to get their patients what they need.

但这种行政负担正是我们需要逐步从系统中根除的。

But this is the kind of administrative burden that we need to start increasingly root out of the system.

这也是我认为人工智能如果被良好地使用和设计时，可以在医学和公共卫生领域发挥作用的地方——减轻一些行政负担，从而为我们腾出更多时间去做真正需要的人性化工作，不仅在诊所和医院里，也在我们的社区中。

This is one of the places also where I think AI, if used and designed well, can be helpful in medicine and in public health to reducing some of that administrative burden and helping instead free up some of that time for us to do the human work that needs to be done, not just in our clinics and hospitals, but out in our communities as well.

在我们结束之前，我很好奇。

Well, before we wrap up here, I'm curious.

我很想想象一下，事情可能会有什么不同。

I'd love to imagine what could be different.

所以，在你看来，如果学校、我们的工作场所，甚至城市，都是以人际关系为核心来设计的，那会是什么样子？

So from your perspective, what would it look like if schools, if our workplaces, maybe even cities, were actually designed with human connection in mind?

我想，让我描述一个超越社会连接的愿景。

I think let me describe a vision that goes even beyond social connection.

我们迫切需要一场关于我们想要生活在怎样一个世界中的对话，以及这个世界应该以什么为中心。

I think what we are in desperate need of is a conversation about what kind of world we want to live in, what we want it to be centered around.

我们希望它以传统的成就模式为中心吗？

Do we want it to be centered around traditional models of achievement?

我们希望它以财富和名望的积累为中心，还是以人为核心？

Do we want it to be centered around acquisition of wealth and fame, or do we want it to be centered around people?

你看，我认为我们今天面临的许多全球性挑战——不仅限于健康领域，还包括政治极化和经济困境——在某种程度上都源于我们正在经历的一种更深层的精神危机，这不仅是国家层面的，也是全球社会的危机。

See, I think that many of the challenges that we're facing in the world today, not just in health in terms of political polarization, economic challenges we're facing, I think many of these trace themselves in part back to a deeper spiritual crisis that we are going through, not just as a country, but as a global community.

这是一种危机：我们建立了一种以名望、金钱和权力为根基的成功模式，它现在正驱动着社会，塑造着世界，也迫使年轻人不仅要去走，甚至要奔跑在一条他们认为必须追随的路上。

This is a crisis where we have created a model of success rooted in fame, money, and power that is now driving society, that is shaping the world and the path that young people feel they need to not just walk, but run down.

但现实是，金钱、名望和那种传统意义上的成功——如果你愿意这么说的话——本身并没有错，但它们并不能内在地带给我们幸福。

But the reality is that money, fame, and success in that traditional way, money, fame, and power, if you will, there's nothing wrong with them inherently, but they don't intrinsically make us happy.

因此，问题来了：究竟缺少了什么？

And so this is the question is what has been missing?

在这种现代的成功范式中，我们生活中日益缺失的是什么？

What is increasingly missing in many of our lives in this modern paradigm of success.

缺失的是那些带来满足感的因素，而这些因素就是人际关系、服务和使命感。

What's missing are the factors that drive fulfillment, and those factors are relationships, service, and purpose.

我把这三者视为幸福的三位一体，而这三者都需要他人参与。

I think of those three as a triad of fulfillment, and all three of those require other people.

我们需要与他人建立关系。

We need to build relationships with others.

我们需要服务他人。

We need to serve others.

我们需要通过相互扶持、改善彼此的生活来找到人生的意义。

We need to find purpose in lifting each other up and improving each other's lives.

这并不意味着生活会变得轻松。

It doesn't mean life is easy.

这并不意味着没有逆境。

It doesn't mean there's no adversity.

但这意味着我们能够找到并触及内心深处的平静与满足，而这正是所有人作为人类所渴望的。

But it does mean that we find and access a deeper well of peace and fulfillment that we all crave as human beings.

因此，当我思考我希望我的孩子们继承的世界，以及我希望我们所有人共同拥有的世界时，我想到的是一个以人为本的世界，在这个世界里，我们个人在生活中所做出的行动、关于如何分配时间、注意力和精力的选择、关于如何养育孩子的选择，都围绕着如何优化人际关系、服务和人生意义展开。

And so when I think about the world that I want my children to inherit, the world that I want all of us to claim as our own, I think about a people centered world where our individual actions in our lives, the choices we make about where we put our time and attention and energy, choices we make about how we raise our kids are oriented around how to optimize relationships, service, and purpose in their life.

我想象的世界是，我们的孩子上学时，会学习那些将人生建立在关系、目标和服务上的人。

I think about a world in which our kids, when they go to school, they learn about people who have built their lives around relationships, purpose, and service.

他们能理解这些要素的价值。

They learn the value of those elements.

他们共同合作，真正创造生活，参与服务项目，从事能带来满足感的工作。

They work together to actually create lives, engage in service projects, do the kind of work that'll help create fulfillment.

我想象的职场也强调同样的理念，政策制定者认识到，构建人际关系的社会基础设施，是我们必须投资的。

I think about workplaces that emphasize the same about policymakers who recognize that the infrastructure for building relationships, social infrastructure, if you will, is something that we've gotta invest in.

他们之所以推动这一点，是因为他们意识到，这是建设任何健康社区基础的重要部分。

And they put that forward because they realize that's an important part of building the foundation for any healthy community.

这就是我所梦想的，我们希望朝着这个方向前进。

So that is my dream of what I hope that we can move toward.

对我来说，这不仅仅是一个项目。

And to me, it's more than a single program.

这不仅仅是一个单一的问题。

It's more than a single issue.

我认为，归根结底，当我们想象自己坐在摇椅上，回望一生，希望那时能感受到充实的人生，我们所回忆的，很可能也是我多年来在照顾的人临终前常常回忆的：那些他们深爱的人、他们服务过的人、那些赋予他们生命意义的人。

And I think at the end of the day, when we think about that moment where we're sitting on our rocking chair, hopefully looking back on a fulfilled life, when we're reflecting about what made that life so fulfilling, what we will likely reflect on is what many of the people who I've cared for over the course of their lives at the end of their life reflect on as well, is they reflect on the people, the people they loved, the people they served, the people who gave meaning to their lives.

我希望，我们所有的孩子都不必等到生命尽头，才明白我们的目标最直接地存在于彼此之间。

And my hope is that all of our children don't have to wait until the end of their lives to realize that our purpose is most readily found in each other.

天哪。

My goodness.

我没想到这场对话会让我如此感动。

I was not expecting to be so moved during this conversation.

谢谢你。

Thank you.

非常感谢你，维韦克。

Thank you so much, Vivek.

你太棒了。

You're amazing.

我非常感激你抽出时间，与我们分享你的观点和内心。

I I so appreciate you taking the time to share your your perspective and your heart with us.

谢谢你，莎莎娜。

Well, thank you, Shoshana.

感谢你给我这个机会进行这次对话。

I thank you for the chance to have this conversation.

你知道，这对我来说也非常个人化，因为像世界上很多人一样，我担心这个世界正在发生的事情。

And, you know, this means this is very personal for me too because like a lot of people in the world, like, I'm worried about what's happening in the world.

我担心我孩子们的未来。

I'm worried about the future for my kids.

但我也知道，我们可以创造一个更好的世界，我们不仅有能力，而且有本能去实现它。

But I also know that there is a better world we can create, and we have not just the ability, but the instincts to actually do it.

因为我认为我们所谈论的这个彼此紧密相连、根植于彼此的世界，实际上是我们人类在数千年进化过程中适应的生活方式。

Because I think the world we're talking about where we're anchored and rooted in each other, this is actually the kind of world that we have evolved to live in over thousands of years.

我们作为社会性生物进化而来，彼此合作、互相帮助，在扶持他人中找到意义。

Like, we evolved to be together as social creatures, to collaborate, to help each other, to find purpose in lifting each other up.

因此，我所谈论的这个世界，并不是一种与人类经验完全陌生的激进新世界。

And so the world I'm talking about is not so much a radical new world that's foreign to the human experience.

这在某种程度上是我们一直以来本质的回归。

It's a return to who we always have been at some level.

真美。

Beautiful.

谢谢。

Thank you.

我和医生的对话。

My conversation with Doctor.

莫蒂博士的分享让我深刻意识到，连接如何深刻地塑造我们的健康。

Morthy really puts into perspective how deeply connection shapes our health.

我们的人际关系能缓冲压力，缓解压力。

Our relationships buffer stress, stress.

它们支持心理健康，甚至影响我们身体的康复与恢复。

They support mental well-being and even influence how our bodies heal and recover.

但这同时也让我思考极端情况。

But it also makes me wonder on the extremes.