身体创伤专家：药物治疗可能损害儿童大脑发育！修复创伤的眼动技巧！EMDR疗法的秘密！——贝塞尔·范德科尔克

但你提到的可预测性这一点非常重要。

But what you talk about, that things were predictable is very important.

我的父母也是可预测的，这对你至少能有所预期、知道该做什么等等都极其有帮助。

My parents also were predictable, which is enormously helpful for at least for you to anticipate, to know what you are supposed to do, etcetera, etcetera.

混乱是件可怕的事。

Chaos is a terrible thing.

我觉得这个观点很有意思，因为虽然我经常受到体罚，是的。

I think that point is really interesting because although there was I was physically punished a lot Yeah.

但这是可预测的。

It was predictable.

是的。

Yeah.

所以我知道如果...而且我理解为什么受罚。

So I knew that if I and I understood why I was being punished.

比如我在屋里踢足球打碎了装饰品

So I kicked I was playing football in the house and broke ornaments

是的。

Yeah.

或者类似的事情。

Or something like that.

从来都不是不可预测的。

It was never unpredictable.

没错。

Right.

但你说话时我突然想到，我父母最终来访时也是类似的情况。

But something comes to my mind as you're talking is that same visits that my parents finally came.

那时我有一个三岁的女儿。

I had a three year old daughter at the time.

我们住在一栋房子里，把我父母安排在一楼紧邻主浴室的位置。

We're staying at a house and put my parents on the 1st Floor right next to the main bathroom.

然后我三岁的女儿去了那个紧邻我父母卧室的浴室。

And then my three year old daughter went to that bathroom that was next to my parents' bedroom.

我母亲出来冲我大喊，说她怎么敢用我们的洗手间？

And my mother came out and yelled at me and said, how dare she use our bathroom?

你应该惩罚她。

You should punish her.

我差点就照做了。

And I almost did.

我当时就有种立刻行动的冲动。

I had an immediate impulse.

我在说我应该惩罚我三岁的孩子。

I'm saying I should punish my my three year old.

我开始朝她走去，然后突然意识到，天啊，我快要哭出来了。

And I started to walk towards and go like, oh my god, I'm about I feel like crying.

天啊，我感觉我正要重演我父母对我做过的事。

My god, I feel I'm about to reenact what my parents did to me.

我做了个决定，不，妈妈。

And I made a physician, no, mom.

她可以使用卫生间。

She is allowed to use the bathroom.

而我为母亲设定了界限，这对我来说是一次转变性的体验，让我真正意识到自己即将重蹈覆辙——重复那些人们习以为常的行为。

And I set the limits on my mom, which is why a transformative experience for me to actually realize that I'm about to repeat what was done to me, which people do routinely.

而我当时差点要打我的女儿。

And I was about to beat my daughter.

然后我说，故事到此为止。

And I said, that's the end of the story.

是的。

Yeah.

这件事仍然让你情绪激动。

It still causes you a lot of emotion.

实际上我很惊讶，谈论这件事会引发如此强烈的情绪。

It's actually I'm surprised how much emotion comes up talking about it.

是的。

Yeah.

是啊。

Yeah.

为什么你觉得一谈起这件事就会有这么多情绪涌上来？

Why do you think it's so much emotion comes up when you talk about that?

好问题。

Good question.

敏锐的问题。

Sensing question.

因为它让我获得了新生。

Because it allowed me to have a life.

听着，生活中大部分事情都是自动发生的，但当你能选择以不同方式行事时，你就开始真正掌握自己的人生。

Look, much of life is automatic, but when you can make a choice to do things differently, you start owning yourself.

那正是我开始真正掌握自己人生的时刻。

And that's the moment I started to own.

我要对我的孩子们负责。

I'm responsible for my kids.

我会继续跟进，但我认为这是正确的。

I'm going to do follow-up, but I think it's right.

这确实是解放的时刻，同时也是分离的时刻。

It's really a moment of liberation, but also a moment of separation.

比如，不会变得像你一样。

Like, will not be like you.

这么做极其困难，因为这是违背你的

It's tremendously hard to do that because it's going against your

人生轨迹。

your life.

我认为这对我们所有人来说都很重要，我们都渴望归属感。

And I think that's a big thing for all of us, we want to belong.

我们必须成为群体的一员。

We have to be a member of a tribe.

而如果你选择不同的道路，你就会失去你的群体，成为一个孤独的旅人。

And if you do things differently, you lose your tribe and you become a lonely traveler.

所以这非常复杂，因为人们渴望归属于

So this is incredibly complex because people want to be part of

一个群体。

a tribe.

我们不能没有群体。

We cannot do without a tribe.

因此真正离开你的群体实际上是一次非常非常重要的精神旅程。

And so the act of actually leaving your tribe is very, very major pilgrimage to make.

是的。

Yeah.

我身上有些特质有时会显现出来，我明白这是我习得的行为模式。

There's parts of me that manifest sometimes, and I understand that this is the behavior that I learnt.

没错。

Yeah.

而且我觉得我其实有点担心，因为我成长的家庭里，你知道，体罚是对大多数不良行为的反应方式，我担心如果我当了父亲，这可能会成为我的本能反应。

And I I think there's a part of me that's worried actually because I learned I grew up in a home where physic, you know, physical discipline was the response to most kind of forms of unwanted behavior, that I'm worried that if I become a dad, that will be my natural.

很可能会这样。

Probably will be.

是的，我不希望这样

Yeah, I don't want it

发生。

to be.

但你不必遵循它。

But you don't have to follow it.

是啊。

Yeah.

你的孩子会让你发疯，因为孩子就是这样的。

Your kids will drive you crazy because kids do.

没错。

Yeah.

我认为在那一刻，养育孩子会成为人生中一次宝贵的学习经历。

And at that point, I think having kids has found a great learning experience in life.

你知道吗？

You know?

嗯哼。

Mhmm.

我们每个人都以为自己知道该怎么做，但实际上是孩子们教会了我们如何成为重要的老师——教会我们如何应对这些极具挑战性的事情。

We all of us knows what we're doing, and then the kids teach us how to to be very important teachers for how do you deal with this because it's very challenging.

是啊。

Yeah.

你从

What did

孩子身上学到了什么？

you learn from your children?

噢，我学到了很多

Oh, I learned a lot

从我的孩子们那里。

from my kids.

首先，我的长子是个——曾经是个非常乖巧、充满爱心、光彩照人、漂亮又女性化的孩子。

For one thing, so my my firstborn was a is a was just easy and loving and luminous and pretty and girly.

而她现在性别模糊，刚刚与丈夫离婚，选择与一位女性在一起。

And she now is gender ambiguous and just divorced her husband to be with a woman.

所以在她身上发生了彻底的转变。

So that was completely transformed in her case.

陪伴她走过这段旅程时，我的感受就是：哇，哇，哇，真是不可思议。

And to see go through that journey with her like, wow, wow, wow, wow.

而我儿子是个神经多样性的孩子，经常失控，有很多肢体反应，非常聪明但易冲动，整天躺在床上只玩电脑游戏。

And my son was a neuro atypical child, very out of control much of the time, many physical reactions, very bright but reactive, staying in bed, only playing computer games.

如今他已成长为最富有爱心、最体贴的成年父母之一，能够帮助他人。

And he's grown up to be one of the most loving, thoughtful adult parents he can help to meet.

所以我的两个孩子都变成了与儿时截然不同的人，但我与他们保持着非常好的关系，

So both my kids have become become very different people who I saw they were, but I have a very good relationship with both of

尽管我其实并不完全理解他们中的任何一个。

them, even though I really don't quite understand either of them.

当我们看到孩子出现功能失调行为时，我认为一种自然反应就是给他们某种药物治疗，或者给他们贴上某种标签，说他们在这方面有问题。

When we see dysfunctional behavior in children, I think one of the natural reactions is to give them some kind of medication or to attach some label to them and say that they're broken in this way.

你对此有何看法？

How do you feel about that?

嗯，那正是拯救了我儿子的方法。

Well, that is what saved my son.

因为我是一名精神科医生，我明白这些标签就像小拐杖，永远无法准确描述一个人正在经历的痛苦。

Because I am a psychiatrist, and I know about how these labels are little crutches that never quite capture what somebody is suffering from.

当时人们开始想给我儿子用药，但我是个精神药理学家。

And people started wanting to put my son on medications because but I was a psychopharmacologist.

我深入研究过药物及其功效与局限。

I really studied drugs and what they can and cannot do.

很明显这些药物对他没有帮助。

And it was very clear that they were not helping him.

我不必像大多数家长那样屈从权威，说什么'医生建议这样那样'。

And I didn't have to submit to authority as most parents would do and say, oh, my doctor says this and this and this.

我说，我是医生。

I say, I'm a doctor.

我了解大脑也了解孩子。

I know about brains and I know about kids.

虽然我不清楚我的孩子到底出了什么问题，但他没有双相情感障碍，也不会对锂盐产生反应。

And I don't know what the hell is going on with my kids, but he doesn't have bipolar disorder and he is not gonna respond to lithium.

所以我的两个孩子都成为了我探索什么对他们真正有益的主要动力。

And so my both my kids were major inspirations for really exploring what was good for them.

我特别感激我的儿子，他在很多方面都是个非常令人害怕的孩子，而我现已离婚的妻子在探索可能有效的方案上也表现得非常出色。

And I'm particularly grateful for my son who was such a really very scary kid in many ways that my wife, whom I'm now divorced from, she was really great also in terms of exploring what might be helpful.

另外他们真正需要意识到的是特权问题，我收入足够让我们花大量时间寻找能帮助我儿子的方法。

And so what they're really good to also be aware of is the issue of privilege, that I made enough money that we could spend a lot of time trying to find things that would help my son.

如果我们住在廉租房里，我儿子就会成为严重的不适应者。

If we had lived in a housing project, my son would have been a terrible misfit.

但因为我们能够通过不断探索给予他大量支持和关怀，他最终找到了重构心理状态的方法。

But because we had we're able to give him so much support and care by exploration that he actually found a way of rearranging his his mental state.

我

I

我的意思是，就这一点而言，我读到过一个统计数据：低收入家庭的儿童接受抗精神病药物治疗的可能性是拥有私人保险儿童的四倍。

mean, just on that point, there's a stat I read that children from low income families are four times more likely as the privately insured to receive antipsychotic medicines.

确实如此。

That's true.

接受抗精神病药物治疗的可能性高出400%，如果你想这么表述的话。

400% more likely to receive antipsychotic medications, if you want.

是的，这是个非常严重的问题。

Yeah, that's a very big issue.

这确实不是我的专业领域。

It's not really my area of expertise.

但你知道，给孩子用药可能非常危险，因为这会干扰大脑发育的自然过程。

But, you know, giving drugs to kids is potentially very dangerous because you interfere with natural processes of brain growth.

大脑发育。

Brain growth.

是的。

Yeah.

所以如果在发育阶段给人服用改变大脑中某些化学物质的药物，实际上可能会改变大脑的形成方式，可能无法像发生在我儿子身上的那样——他能够弥补许多缺陷，他的大脑学会了如何以不同的方式做出反应。

So if you give people medication that changes certain chemicals in the brain at the developmental phase, it may actually change the way that the brain gets formed and may not allow, as happened to my son, who was able to compensate for many things and his brain was able to learn how to react differently.

如果抑制所有这些，你的大脑可能无法学会这些新的适应方式。

If you suppress all of that, your brain may not learn these new adaptations.

你认为我们应该先关注社会条件，然后再考虑

You think we should be looking at social conditions before we look at

社会环境、物理环境、运动、触觉、同步性、音乐。

Social conditions, physical conditions, movement, touch, synchrony, music.

所以在我们的世界里，西方人被允许做某些事情。

So in our world, we got stuck in Western people are allowed to do things.

他们能做的一件事就是，我称之为‘猛灌一口’。

They can do one thing, is they can, what I call, take a swig.

如果你感觉不好，就喝点酒，这会让你感觉好些。

If you feel bad, you take alcohol and that makes you feel better.

因此，服用化学物质来改变情绪是我们受尊重的传统的一部分。

So that's part of our respected tradition is taking a chemical to change the way you feel.

如果有人建议你服用这种化学物质，没人会说你疯了。

And anybody who says you should take that chemical, nobody ever say you're crazy.

西方人还非常擅长的一件事就是喋喋不休。

And the other thing that Western people are very good at is yakking.

所以我们不停地谈、谈、谈、谈、谈、谈、谈，试图理解事物。

So let's talk, talk, talk, talk, talk, talk, talk, and understand things.

我想给大家讲个故事：1992年我们第一次去北京时，中国还很贫穷匮乏，刚从文革中恢复过来，人们什么话题都不敢谈。

And then I'd like to tell people a story that the first time we went to Beijing in 1992 and China was still very poor and deprived and miserable and coming back from this cultural revolution and nobody could talk about anything.

不，地图上什么都没发生过。

No, nothing happened on the map.

不，什么都没发生过。

No, nothing happened.

不，天安门事件不存在。

No, Tiananmen Square didn't happen.

那件事没有发生。

It didn't happen.

那时的中国和现在一样，每个公园都挤满了练气功和打太极的人。

And China was filled with every park then as now is filled with people doing qigong and tai chi.

我走进公园和中国人一起练气功。

And I go down into the park and do qigong with the Chinese.

那是什么？

What's that?

气功。

Qigong.

他说，中国舞蹈。

He said, the the Chinese dancing.

中国动作。

Chinese movements.

他们最擅长这个，然后他们会发出'天啊'的惊叹。

They do that best, and they go like, oh my god.

他们就是通过这种气功太极动作来生存的，但如果你在波士顿这么做，人们会说你疯了。

That's how they survive by making these chi gong tai chi movements, which if you use it in Boston, you people say you're crazy.

但在中国，你不能随便议论这些。

But in China, you cannot talk.

通过特定的动作方式，你能让身体平静下来。

You calm that body down by the way you move.

我开始对世界各地文化如何用截然不同的方式帮助人们调节生理机能和同步性产生了浓厚兴趣。

And I became very interested in how cultures around the world actually have very different ways of helping people to regulate their physiology and their synchronicity.

我想详细探讨这些，特别是运动的概念及其在疗愈中的作用。

I want to talk about all of that, specifically this idea of movement and the role it plays in healing.

先简单收尾关于童年创伤的部分。

Just to close off on the part about childhood trauma.

为什么孩子与照顾者建立安全依恋关系如此重要？

Why is it so important for a child to grow up with a secure attachment to a caregiver?

你会逐渐变成别人眼中的模样。

You become how people see you.

你会成为别人眼中的样子。

You become how people see you.

是的。

Yeah.

所以如果你是个孩子，大多数孩子，他们的父母觉得你很可爱，或者你有侄女或祖父母，他们会说，哦，你看起来真可爱。

So if you're a kid, and most people, most kids, their parents find being cute or you have a niece or grandparent, they say, oh, you look cute.

你真讨人喜欢。

You're lovely.

你真好。

You're so sweet.

没有孩子能说，我只是个普通人。

And no kid is able to say, I'm just average.

要知道，看看世界上数十亿的孩子，我并不比其他人更特别。

Know, look at the billion kids in the world and I'm not any cure than anybody else.

不。

No.

当孩子们被告知他们很可爱时，这就成为了他们的现实。

When the kids get told you're really cute, that is your reality.

而如果孩子们被告知他们很丑陋、讨厌且刻薄，这就会成为他们的身份认同。

And if the kids get told you're really ugly and nasty and mean, that is becomes identity.

所以你确实会变成小时候别人对待你的样子。

And so you really become how people treat you early on in your life.

作为一个治疗师，我处理的一个重大课题就是这些早期经历留下的印记，它们非常难以改变。

And there's a very big legacy that I, as a a therapist, deal with is these imprints of early experience, which are very difficult to change.

早期经历的印记。

Imprints of early experience.

这些印记可以改变吗？

Are they changeable?

可以。

Yes.

这是个好消息。

That is the great news.

还有另一个令人惊喜的消息是，尽管我们知道如何做到其中一些，但我们不会深入探讨。

And also the amazing news that even though we know how to do some of that, we're not going there.

所以你能从童年创伤中痊愈吗？

So you can heal from your childhood trauma?

绝对可以。

Absolutely.

每个人都能吗？

Everyone?

这是我面对人们时的基本假设。

That's my assumption when I see people.

以你的经验来看，你一生都在与患者打交道，整个职业生涯都是如此。

In your experience, you've dealt with patients your whole life, your whole professional life.

你认为其中有多少患者是可治愈的？

How many of those patients do you think were healable?

我真心认为，只要给予机会和资源，你几乎可以为每个人做些什么。

I really think that if given a chance and given the resources, you can pretty much do something for everybody.

但问题在于，再次回到我们在麦克风开启前讨论的起点，如今我们的关注点都放在了生产力和行为改变上，而非探索如何真正帮助人们。

One of the other But the problem is, again, go back to where we started before the microphone was on, is that our focus these days is on productivity and behavioral change and not in how do we find out how to help you.

我在书中描述的几乎所有有益方法——那已是十年前的内容，之后我又了解到更多——都是主流心理学或精神病学中未被采用的非常规疗法。

All the things that I describe in my book, almost most of the things that I describe in my book as being helpful, and that was ten years ago, know some other things since that time, are unconventional methods that do not get practiced in mainstream psychology or psychiatry.

因为这些方法需要既高效又低成本。

Because they need to be productive and they need to be cheap.

而你是否真正康复并不重要。

And whether you get better or not doesn't matter.

你够便宜吗？

Were you cheap?

这才是主要动机。

It's the main motivation.

我认为利润导向正在扼杀良好的诊疗实践。

I think the profit point of is killing good practice.

你的书很有趣，因为当我读到封面介绍，又看了你讲解体内六种治疗体系的视频时——比如瑜伽这类方法。

Your your book was very interesting because when I read the cover, and then I watched a video you'd made talking about the sort of six sort of treatments and stuff that exist within the body, things like yoga.

你谈到戏剧和表演如何帮助你走出创伤。

You talk about theater and acting and how that helps you to to get out of your trauma.

身体从未忘记。

The body keeps the score.

这是一种相当激进的思考创伤的方式。

This was a pretty radical approach to thinking through trauma.

它变成了一个流行梗，这现象很有趣。

And it became a meme, which is an interesting thing to see.

嗯，我在日常生活中和伴侣交流时也会用这个说法。

Well, I use it in my everyday language with my partner.

我经常听人们说'身体从未忘记'，当我们讨论身体如何承载那些...是的。

And I've heard people say, the body keeps the score, the body keeps the score, when we're talking about how our body is holding on to those Yeah.

创伤记忆，发生在我们身上的创伤性事件。

Traumatic memories, traumatic things that have happened to us.

对于从未读过你书的人，甚至不理解这个基本前提的读者，这个标题想表达什么核心观点？

For someone who has never read your book and doesn't even understand the, like, base premise here, what is the, like, base premise of your of the title there?

创伤确实是一种切身体验。

It's really that trauma is a visceral experience.

visceral 是什么意思？

What does the visceral mean?

它存在于你的身体里。

It's in your body.

心碎和肠断。

Heartbreak and gut wrench.

你会变得僵硬。

You stiffen up.

你会屈服。

You surrender.

你会失去力量。

You lose your power.

你会紧绷起来。

You tighten up.

创伤确实是在这些地方体现的。

That's really where trauma is lived.

我大致看到了两种处理方式。

I kinda see it as two approaches.

你可以选择先尝试改变思维，从而间接影响身体。

You can either go, let's try and change the mind, which will then change the body downstream.

或者你也可以选择先改变身体，进而影响思维。

Or you can say, let's change the body, which will then change the mind.

对。

Right.

确实可以。

You could.

不过我经常和妻子一起做认知行为治疗，我们

But I do a lot of CBT with my wife, let's

说吧。

say.

是啊。

Yeah.

我会指出她不理智的行为，说她应该换个角度看问题，而我自己其实也不见得看得多正确。

I point out her irrational behavior and that she should really see things from a different angle and that I shouldn't really see things correctly.

但这么做基本没什么效果。

And I barely have much success with that.

我有点惊讶心理学居然能把大多数夫妻都搞不定的问题处理得这么好。

And I'm a bit surprised that psychology does things that most spouses have failed in using very well.

这种躯体疗法。

This somatic approach.

我也是最近才从我伴侣那里听说这个术语，她说效果非常神奇。

I've only recently had this term from my partner, and she says it's amazing.

她还特意让我在播客里跟你聊聊这个，说你能真正改变她对这个疗法的看法。

And she's told me she told me to speak to you on this podcast because she says, you know, you'll really help to change her opinion on this.

这种躯体疗法到底是什么？

What is this somatic approach to healing?

躯体疗法是真正体验身体的感受，并允许身体去做那些它曾害怕做的事情，以某种方式探索身体如何与世界互动。

Somatic approach is to really experience what your body feels and also allowing your body to do things that it has been afraid to do and to explore how your body moves to the world in some ways.

为什么女性在这方面似乎比男性强这么多？

Why are women just to seem to be so much better than at this stuff than men?

因为她们确实在做普拉提之类的运动。

Because they're doing like Pilates sure.

普拉提、瑜伽。

Pilates, yoga.

这些都是，还有舞蹈。

These are all things, dancing.

这些通常是女性比男性参与更多的活动。

These are things typically women do more than men.

是啊。

Yeah.

没错。

Yeah.

是啊。

Yeah.

是啊。

Yeah.

而且它

And it

似乎女性在这方面更敏感。

seems women are just more in touch with it.

没错。

Yeah.

我觉得这是个有趣的问题，因为这并非女性专属。

I think it's an intriguing question because it's not exclusively women.

当然，男性在军队和新兵训练中一直都有这类训练。

Of course, men have always done it in armies and basic training and the military.

让我觉得有趣的是，当人们参军时，他们通常并不是很自律的人，但经过新兵训练后，他们会一起行军、合唱、翻越障碍，与他人共同经历综合体能训练。

And what's intriguing to me is that, you know, when people join the military, they oftentimes they're not very well put together people and they go through basic training and they really march together and they sing with people and they climb barricades and they go through composite physical experience with other people.

经过十二周的训练后，他们不仅感到能力提升，还建立了深厚的情谊，找到了生死与共的战友。

At the end of twelve weeks, they feel competent and they feel connected and they have found a band of brothers.

他们是怎么做到的？

How do they do it?

不是靠空谈，而是通过共同经历深刻的体能挑战。

Not by yakking, but by having very deep shared physical experiences.

你在书中提到一个特别有趣的观点——我发现自己在那些描述中看到了些许影子——你说：'我发现患者背景中的创伤越多，他们往往越有创造力且越容易成功。'

One of the interesting things that you write about, which I found particularly interesting because I saw little flashes of myself in the words, is you said, I found that the more traumas your patients have in their backgrounds, the more creative and successful they often become.

往往如此。

Often.

虽然我们不清楚具体概率，但这类人我确实见过不少。

And we don't know how often that is, but I get to meet quite a few of them.

是啊。

Yeah.

正是那些被迫挣扎求生的人，往往能看见新的可能性，并不得不开辟新的出路。

It's the people who have had to struggle who often see new possibilities and have no choice but to discover new options.

确实如此。

That's true.

确实如此。

That's true.

是的。

Yeah.

但你知道，那些能来我诊所的人都是成功应对了困境的人。

But, you know, but those are the people who manage to get into my practice.

而那些找不到解决办法的人，既没有资源也没有能力来接受我的治疗。

And the people who don't find their solutions don't have the wherewithal and the capacity to make it into therapy with me.

他们可能在外面吸毒成瘾。

They might be outside with a drug addiction.

在街头买毒品、露宿等等。

Getting drugs, lying on the streets, etcetera, etcetera.

在很大程度上，我认为这是个偶然性问题。

And to to a large degree, I see that as as an issue of accident.

你知道吗，去年我参观了洛杉矶一个名为'家业男孩'的项目。

You know, this past year, I visited a program in Los Angeles called Homeboy Industries.

这是一个为曾经被监禁、大多是没有父亲的拉丁裔男性罪犯设立的项目。

It's a program for formerly incarcerated, largely Latin men who had no fathers, who had been criminals.

这个项目非常出色，他们秉持的理念是：你需要什么？

And it's a spectacular program where they honor they say, what do you need?

我们怎样才能照顾好你？

How we can we take care of you?

我们如何为你创造一个安全的环境？

How can we make a safe place for you?

在那里我看到了真正的治疗。

And I saw real treatment there.

圣。

St.

昆廷医院，圣。

Quentin Hospital, St.

圣昆廷监狱，加利福尼亚著名的监狱，现在采用创伤治疗模式。

Quentin Prison, famous prison in California, It's now trauma based.

他们把我的书作为那里的教材使用。

They use my book as a portrait text there.

他们通过承认囚犯经历的现实来改变人们的生活，帮助人们成为治愈系统的一部分，通过小组活动和运动疗法。

And they're transforming people's lives by acknowledging the reality of what they dealt with, helping people to be part of the healing system, working in groups, working with movement.

比如在昆廷监狱，他们甚至开设了草裙舞课程。

Like it's in Quentin, they have hula dancing classes.

我当时就说，这太棒了。

I go like, yeah.

与他人共同舞动能让你获得联结感和愉悦感。

Moving together with other people gives you a sense of connection, a sense of pleasure.

他们开始真正明白这是可以实现的。

They're really beginning to understand you can do it.

在哈佛医院，你绝不会这样大规模地与人互动治疗。

At the Harvard Hospital, you wouldn't do the whole lot with people.

你会接触到很多人。

You would do lots of people.

投资圈有个玩笑说，如果你投资的对象——无论是创业者还是创始人——曾经历过一些创伤，往往能获得更好的回报。

I think there's a bit of a joke in the investment community that says you'll get better returns if you invest in someone, an entrepreneur or a founder, that is a little bit traumatized.

其实我觉得...我不想错误引用她的话，但芭芭拉·柯克兰，就是美国《鲨鱼坦克》节目里的那位投资人。

And I actually think I if I I don't want misquote her, but Barbara Cochrane, who's a shark on Shark Tank in The USA here on the show.

她曾告诉我，在她所有投资中，表现最好的往往是那些过去有些创伤经历的人。

And one of the things she said to me was, with all of her investments, the ones that tend to do the best are those that have a little bit of a trauma in their past.

她说因为当他们打电话向我求助时...

And she says, because when they call me with a problem Yeah.

他们总是带着解决方案来找我。

They call me with the solution attached.

而那些从未经历过创伤的人，打电话时只会告诉我问题本身。

Versus people who have never had trauma, they call me and just tell me the problem.

所以他们会打电话说：听着芭芭拉，发生了这件事，而我们的应对方案是这样的。

So they'll call me and say, listen, Barbara, this has happened, and this is what we're gonna do about it.

她用一种略带幽默的方式说的这话，但我想知道你是否认为这种观点有一定道理

And that was her you know, she said it in a slightly humorous way, but I wondered if you thought there's any truth in this idea that

是的。

Yeah.

我认为这又是她合作对象的选择偏差问题。

I think that's again a selection bias of people she worked with.

我确实认识很多人——包括为我工作的一些人——他们在面对挑战时会完全不知所措，既没有解决方案，又变得非常依赖别人告诉他们该怎么做。

I know certainly plenty of people have had plenty of people working for me who who really get paralyzed in the face of of challenges and who don't have a solution and who become very dependent on giving getting them action.

所以我认为她的样本实际上有点不寻常。

So I think she has a bit of an unusual sample actually.

因为我好奇你是否有一个异常的早期成长经历。

Because I wondered if if you've had an an anomalous early upbringing Yeah.

这是否会让你成为一个异于常人的成年人？

Does that make you an anomalous adult?

这是否增加了你成为一个异常、略微不同的成年人的概率？

Is it does it increase the probability that you become an anomalous, slightly different adult?

哦，绝对是的。

Oh, absolutely.

好的。

Okay.

而且这种情况可能无处不在。

And that can go everywhere.

你会发展出适应那种特定情境的思维和大脑。

You develop a mind and brain to fit with that particular situation.

如果那种特定情境没有帮助，你就需要寻找新的解决方案。

And if that particular situation doesn't help, you need to find new solutions.

因此，创伤和虐待确实会迫使你去尝试寻找那些解决方案。

And so trauma and abuse really forces you to find try to find those solutions.

但其中许多并不成功。

But many of them are not successful.

创伤是你大脑中的一个故事吗？

Is trauma a story in your brain?

不是。

No.

创伤是你大脑中的一种感知。

Trauma is a perception in your brain.

一种感知。

A perception.

那么

What's So the

问题是当某些事情发生时，你的大脑和心智会接收它，然后针对那个特定事件做出适应调整。

the issue is something happens, and your brain and mind takes it in and then makes an adaptation to that particular event.

这取决于你当时的年龄和环境。

That depends on how old you are in the circumstances.

而且对不同的人来说差异很大。

And it's very different for different people.

给我举个感知的例子。

Give me an example of a perception.

如果

If

如果你现在打我，我会觉得这人疯了。

you would beat me up right now, I'd go, this guy is crazy.

我可以叫人过来，毁掉你的名声等等。

And I can call people and ruin your reputation, etcetera.

如果你三岁，而我三岁时你开始打我这个小孩，我根本不知道该怎么办。

If you're three if I'm three years old and you start hitting me as a kid, I don't know what the hell to do about it.

我很可能会认为一定是我做错了什么才导致别人打我，我是个糟糕的人。

And I'll likely think it's probably I did something wrong that I caused the guy to beat me up, and I'm a terrible person.

难怪他会打我，因为我就是个糟糕的人。

And no wonder that he beat me up because I'm a horrible creature.

这就是几乎所有我认识的童年挨打的人。

And that's what almost everybody who I know who was beaten as a child.

内心对此的理解。

Has the internal understanding of it.

不是在你八岁或十五岁时，而是在你非常年幼的时候，这就成为了你的经历。

Not when you're eight years old or 15 years old, but when you're very young, that becomes your experience.

因为你还在形成对世界的认知。

Because you're still forming your perception of the world.

是的。

Yeah.

没错。

Yeah.

就是这样。

That's it.

你的大脑会以非常深刻的方式绘制世界地图。

Your your brain creates a map of the world very, in very deep ways.

因此你的经历会形成内在的世界图景，让你在特定时刻预期某些事情。

And so your experiences form an internal vaster of the world that makes you expect certain things at certain times.

所以如果我走进房间，看到一个长得像我老叔叔的人要和我玩耍，我就会开始对你产生好感，因为在深层意识里，你可能会像我曾经那个非常好的叔叔。

So if I walk into a room and I see a person who looks like my old uncle who he has to play with, I start signing up to you because you're on the deep level, you might be of that very nice uncle that I once had.

我并不知道这一点，但我的大脑已设定好以特定方式解读世界。

I don't know that, but my brain is set to interpret the world in a particular way.

因此，我经历过最深刻的研究体验之一纯属偶然。

So one of the things, most profound research experience I had was purely accidental.

我们开始对人们进行罗夏墨迹测试。

We started to do Rorschach tests on people.

那是什么？

What's that?

墨迹测试。

Inkblot tests.

就是展示一些无定形的墨迹图案，我们把它展示给受试者。

So you show some formless ink picture and we showed it to people.

我们发现人们对这些墨迹测试的投射内容有着完全不同的解读。

And we saw that people had completely different interpretations of what they projected on that inkblot test.

这让我真切意识到：我们都生活在不同的世界里。

And that really brought home to me that we all are living in different worlds.

就像我见过的许多越战老兵一样，他们在那些卡片上看到的是血淋淋的尸体或残缺的肢体。

And that our like a lot of the Vietnam veterans I saw saw bloody corpses or mutilated bodies in those cards.

从未经历过战斗的人则看不到这些。

People who had never been in combat didn't see that.

强奸受害者看到的是撕裂的阴道和残破的身体。

Rape victims saw torn vaginas and torn bodies.

其他人则看不到这些。

Other people didn't see this.

一旦这种认知模式根植于你的感知系统，你就会继续以这种特定方式解读世界——与你过去的经历息息相关。

So once that becomes lodged into your perceptual system, you continue to interpret the world in that particular way having to do with what you have the answer in the past.

对于不了解的人，墨迹测验其实就是一张沾着随机墨迹的纸

And an inkblot test, for anyone that doesn't know, is basically just a piece of paper with random ink

仅此而已。

As all it is.

是的。

Yeah.

但多年来已有约10万人接受过这项测试的分析。

But it's been analyzed on about 100,000 people over the years.

因此你能从中检测出某些特定模式。

So there's certain patterns you can detect in it.

是的。

Yeah.

没错。

Yeah.

我从未做过墨迹测试。

I've never done an inkblot test.

我觉得自己应该尝试一次。

I feel like I should do one.

要知道，我从墨迹测试中学到的东西不亚于脑部成像给我的启示。

You know, I learned as much from my inkblot test as I learned from my brain imaging.

不过脑部成像技术更受认可，而心智研究似乎已逐渐式微。

But the brain imaging is respectable and the mind has sort of disappeared.

但举例来说，在我们的致幻剂研究中，我仍然非常希望能进行墨迹测试，因为正如迈克尔·波伦所说，我们如何改变心智呢？

But for example, in our psychedelic research, I still very much hope to do Inglot test because as Michael Pollan says, how do you change your minds?

但我们并不是在测量人们如何改变想法。

But we're not measuring how people change their minds.

你觉得有多少人——这可能是个荒谬的问题——你认为有多少比例的人经历过某种形式的创伤？

How many people do you think I mean, is maybe a ridiculous question, but how many people what percentage of people do you think have trauma in some form?

这取决于你如何定义它。

How you define it.

要知道，数据显示有四分之一的人遭受过身体虐待。

You know, the figures are a quarter of people get physically abused.

五分之一的人遭受过性虐待。

One out of five people get sexually abused.

八分之一的儿童目睹过父母间的暴力行为，等等。

One of eight kids witnesses violence being their parents, etcetera, etcetera.

所以你看，如果我坐在房间里，这不是一个非黑即白的问题。

So, you know, if I sit in a room, you know, it's not a binary issue.

这并不是非此即彼的问题——要么你受过创伤，要么没有。

It's not either you were traumatized, you didn't get traumatized.

但当我与一屋子的专业人士交谈时（我经常这样做），我假设至少半数人从本能上理解创伤意味着什么。

But when I talk to a room of professionals, which I do a lot, I assume that at least half the group viscerally knows what trauma means.

那么创伤对我的大脑造成了什么影响？

And what is trauma doing to my brain?

你说过你做过很多神经影像扫描。

You said you've done a lot of neuroimaging scans.

如果我受过创伤，而你扫描了我的大脑，你能看出什么异常吗？

If you if I was traumatized and you scanned my brain, is there something you could see?

不一定。

Not necessarily.

我能看出你的大脑可能与他人有何不同。

I can see how your brain may be different from other people's brains.

我可能会选取特定人群进行研究。

I may take a particular population.

你可以取平均值然后说，哦，导水管周围灰质的激活稍微多了一点，而亮胰岛素的激活稍微少了一点。

You can average it out and you can say, oh, there's a little more activation of the periaqueductal gray, a little bit less of the bright insulin.

所以你会看到大脑中特定的连接模式。

So you see certain patterns of connectivity in the brain.

但在某种程度上，你知道，我认为我们对大脑了解很多，但我们对其了解仍然有限。

But to some degree, you know, I think we learn a lot about the brain, but we don't know much about the brain.

而且我认为人们往往夸大了脑部图像能教会我们的东西。

And I think people tend to overstate how much the brain pictures can teach us.

你知道，就像我喜欢哈勃望远镜或韦伯望远镜一样。

You know, it's a I love the Hubble's telescope or the Webb telescope.

你知道，我们的大脑就像一个宇宙，而我们的技术还远远不足以真正了解大脑中那些难以置信的复杂连接。

You know, it's our brain is like a universe and our technology is very inadequate to really know about all the unbelievably complex connections the brain has.

但在过去二十年里，我们还是学到了一些东西。

But we have learned a few things in the last twenty years.

那么创伤是如何影响大脑的呢？

So how does trauma affect the brain?

它会影响大脑，使你倾向于...大脑中有一个部分我称之为'蟑螂中心'，即位于杏仁核下方的导水管周围灰质，这部分会自行激活。

It affects the brain that you tend to There's one part of your brain that I call the cockroach center of your brain, the periakial gray that lights up itself underneath the amygdala.

现在人人都知道杏仁核这个词了。

Everybody knows the word amygdala these days.

好的。

Okay.

所以这是大脑中告诉你处于危险中的那部分。

So The part of your brain that tells you that you're in danger.

当你遭受创伤时，很可能大脑深处脑干中的这个小部分会持续处于激活状态。

When you're traumatized, you're likely that that little part of your brain, way back in the brainstem is firing all the time.

你会一直觉得'我有危险'。

All the time you go like, I'm in danger.

我有危险。

I'm in danger.

我有危险。

I'm in danger.

因此，这一切始于非常基础的感官层面。

And so that's where it starts in a very elementary sensory level.

你不知道危险是什么，但你就是感到害怕。

You don't know what the danger is, but you just feel that you should be scared.

然后大脑中某些部分，比如岛叶，负责连接你的身体感觉和身体意识。

And then there's certain parts, other parts of your brain, for example, insula, which makes the connection with your physical sensations and your body awareness.

对许多人来说，这些功能会因创伤而关闭，因为创伤体验是一种心碎和肠绞痛的内脏体验。

And for many people get shut down because trauma, the experience of trauma is a visceral experience of heartbreak and gutvenge.

如果你经历了很多这样的体验，你可能会学会关闭大脑的那部分功能，这样你就不会那么强烈地感受身体了。

And if you have a lot of that, you can learn to shut that part of your brain down so you don't feel your body so much anymore.

或者说你不会那么强烈地感受身体。

Or you don't feel your body so much.

你也不会感到自己很有活力。

You don't feel very alive either.

你也不会一直感到那么害怕了。

You don't feel so scared all the time.

但很可能你有时会想服用一些药物让自己感觉活着。

But it's likely that you will want to take some drugs to make yourself feel alive sometimes.

诸如此类的事情。

Stuff like that.

是的。

Yeah.

所以你提到我大脑的那个部位，就在杏仁核下方

So the part of my brain, you said just under the amygdala Below

杏仁核。

the amygdala.

在杏仁核下方。

Below the amygdala.

受过创伤的人，他们那个部位通常会出现某种功能障碍吗？

People that are traumatized, they have some kind of dysfunction in that typically?

嗯，功能障碍就是它会持续激活。

Well, dysfunction is that it keeps firing.

持续激活。

Keeps firing.

这让你感觉如何？

And how does that make

你感觉如何？

you feel?

然后杏仁核就会持续产生一种潜意识的恐惧感。

And then the amygdala so so there's a constant sense of of subliminal dread.

那就是焦虑吗？

Is that anxiety?

焦虑已经是较高层次的心理活动了。

Anxiety is already too high of mental functioning.

明白。

Okay.

它是更基础的本能反应。

It's more elementary.

就像你的狗在发抖一样。

It's like your dog shaking.

是的，我女儿收养了一只狗。

Yeah, my daughter has adopted a dog.

她是个。

She was a.

两年后，那只狗仍然在我家里走动。

And two years later, the dog still walks through my house.

你收养了一只狗，它在你家里还是会发抖。

You've adopted a dog and it shakes in your house still.

是的。

Yeah.

是的。

Yeah.

但始终没有完全适应。

But still never quite comfortable.

这就是为什么你们多次见面却始终不太自在。

And that's how many times you meet are never quite comfortable.

所以当有人说他们被触发时？

So when someone says they're triggered?

不是。

No.

触发属于更高层次的概念。

Trigger is in the higher level thing.

好的。

Okay.

那么下一层级确实是由杏仁核部分介导的触发机制。

So then the next level is indeed the trigger that is in part mediated by the amygdala.

如果你的杏仁核，你的烟雾探测器变得过度敏感，就会把小问题无限放大。

If your amygdala, if your smoke detector, that tends to become hypersensitive so that minor things get blown up.

你可能对我说的小事，我会当成世界上最侮辱人的话。

And a minor thing that you may say to me, I take as the most insulting thing in the world.

所以你总是被各种事情触发，让你觉得好像对我做了很糟糕的事。

And so you're constantly triggered by things and that makes you feel like you are doing terrible things to me.

而且并不是我过于敏感。

And it's not like I'm hypersensitive.

当你状态不佳时，那是你的问题，不是我的问题。

And when you have an off day, that is your issue and not my issue.

不。

No.

当你状态不佳时，我能感受到你的情绪，然后我们就会一起陷入麻烦。

When you have an off day, I feel your off day, and then we start getting into trouble together.

我这里有一张图，展示大脑烟雾探测器运作时的大脑状态

I've got a picture here of what the brain looks like when the brain smoke detector

嗯。

Yeah.

对。

Yeah.

警报响起。

Goes off.

这是大脑在那种情况下的样子吗

Is that what it looks like on the brain when it's

那只是某个特定的人，每个人都是独一无二的。

That is one particular guy, and nobody is exactly the same as everybody else.

你能给我解释一下吗？

Can you explain this to me?

但基本上，你在这里看到的是一个正在重温他遭遇的可怕车祸的人。

But basically, what what you see here is this is a guy who is reliving a terrible car accident he was involved with.

你在这里看到的是大脑右后侧部分，大脑右侧的颞顶交界区在活动，那是你大脑的恐惧区域。

What you see here is that the right posterior part of the brain, the temporal parietal junction on the right side of the brain fires, and that's the feeding part of your brain.

于是你会说，天啊天啊，我吓坏了。

So you go, oh my god, oh my god, I'm terrified.

但这没有认知过程。

But there's no cognition.

基本上，大脑左侧会停止运作。

Basically, the left side of the brain shuts down.

当你处于创伤中时，你会变得不再理智。

So when you're in your trauma, you don't become you're not a reasonable person.

实际上你会变得有点像个语无伦次的傻瓜。

You actually become a little bit of a blubbering idiot.

我们所有人都会变得愤怒、沮丧、表达不清，但情绪却非常强烈。

All of us, we really are angry, upset, and not very articulate, but we have a lot of feelings.

我展示这段内容的关键在于，当这个人重温创伤时，大脑这两个部分会停止活动。

And then the the piece that I where I showed this is that as he is guy is reliving his trauma, these two parts of the brain go offline.

这是背外侧前额叶皮层。

This is the dorsolateral prefrontal cortex.

这是大脑中负责计时功能的部分。

That's the part of the brain that's the timekeeper of your brain.

所以如果我们之间发生不愉快的事，我会想，再过半小时我就没事了。

And so if something unpleasant happens between us, let's say, I'll go, oh, it's another half hour and I'll be okay.

让我先把这个问题放一放。

So let me just sort of put off with this.

但当你遭受创伤时，时间感知功能会消失，只剩下当下的感受。

But when you get traumatized, the timekeeper disappears and this is all there is.

你会失去对时间尺度的感知。

You lose your sense of perspective.

这就是当你处于创伤状态时发生的事。

And that is what happens when you're in your trauma.

你无法区分过去和现在，因为大脑的时间感知功能下线了，此刻的感受就是全部真实——而非记忆。

You don't know the difference between the past and the present because the timekeeper of your brain goes offline and whatever is you're feeling is real as opposed to be feeling like a memory.

明白了吗？

If get it?

嗯。

Yeah.

对于看不到脑部扫描的人，我简单说明下：现在看到的右侧大脑处于极度活跃状态。

So for people that can't see it in this brain scan, what I'm basically seeing is the right side is extremely activated.

左侧看起来是关闭状态。

The left side looks like it's off.

关闭。

Off.

对。

Yeah.

然后还有这两个未被激活的空白区域，称为门。

And then there's these two blanks empty spaces that aren't activated called the doors.

背外侧前额叶皮层。

Dorsolateral prefrontal cortex.

前额叶

So there's prefrontal

这是大脑中让你有时间感的系统部分。

part of the system in the brain that give you a sense of time.

好的。

Okay.

只要你有时间感，就像小婴儿也没有时间概念一样。

And as long as you have a sense it's like little babies don't have a sense of time either.

无论发生什么，都是完全沉浸式的体验。

It's like whatever happens, it happens totally.

你会看到孩子慢慢成长，逐渐获得时间观念。

And you see a child slowly grow, and they get a sense of perspective.

虽然现在正在发生，但明天就会不同。

It's happening right now, but tomorrow it will be different.

好的。

Okay.

所以你的意思是，焦虑通常就是在这个时候产生的对吧？当你开始思考未来的时候？

So that's when I mean, presumably, that's when you get anxiety, right, when you start thinking about the future?

关键在于保持'这只是当下正在发生'的视角。

It is about having the perspective of this is happening right now.

此刻，我真的非常害怕。

Right now, I'm really scared.

但当我回到家，给朋友打个电话，我就会感觉好一些。

But the moment I go home, the moment I call my friend, I'll feel better.

因此你需要具备这种视角能力，而当你处于创伤中时这种视角就会消失，你就会变成一个受创伤的人。

And so that you need to have the capacity for perspective, and that perspective goes offline when you're in your trauma, and you become a traumatized person.

所以这个特定的人，我手头的这份脑部扫描，这家伙遭遇过车祸。

So this particular person, this brain scan that I have here, this guy was in a car accident.

对。

Yeah.

而我正在查看的这个被触发的脑部扫描显示，他基本上是被放进了一台fMRI扫描仪里。

And the triggered brain that I'm looking at here is he was basically put in a an m f m r I scanner.

没错。

Yeah.

然后他被故意触发创伤，以观察他大脑会发生什么变化。

And he was intentionally triggered to see what would happen in his brain.

正是这样。

Exactly.

所以他可能被展示了一场车祸之类的东西。

So he was shown maybe a car accident or something.

不。

No.

不。

No.

具体来说，是他自己的那场车祸。

Specifically, his car accident.

哦，你们给他看了他自己那场

Oh, you showed him a picture of his

你看到了什么？

What did you see?

他听到了什么？

What did he hear?

你闻到了什么？

What did you smell?

我们当时在想什么？

What we were thinking?

非常具体的感官细节。

Very specific sensory details.

好的。

Okay.

所以你是

So you're

不是别人的感官。

Not somebody else's sensory.

你自己的感官细节。

Your sensory details.

他大脑的右侧被照亮了吗？

And the right side of his brain was illuminated?

是的。

Yeah.

他大脑的光明面变得非常活跃。

Light side of his brain became very active.

是的。

Yeah.

但被抑制的是他大脑中的时间感知区域。

But what got inactivated was the timekeeper of his brain.

所以他无法躺在那里说，哦，我在回忆昨天发生的事。

So he could not lie there and say, oh, I'm remembering what happened to me yesterday.

他正在重新经历昨天发生的事。

He's reliving what happened yesterday.

瞬间。

Instantly.

你会感觉它正在此刻发生。

You feel like it's happening right now.

这就是创伤的本质。

And that's the nature of trauma.

创伤不是记忆。

Trauma is not a memory.

而是一种重新经历。

It's a reliving.

你是意识清醒地重新经历，还是潜意识在重新经历？

Are you consciously reliving it, or is your subconscious reliving it?

感觉就像此刻正在发生。

Feel like it's happening right now.

所有类型的创伤都是这样吗？

With all forms of trauma?

但并非

But not

事件正在此刻发生，但我的感受是此刻正在发生。

it's happening right now, but my feeling is happening right now.

在我的身体里？

In my body?