410. Why does everyone have a diagnosis these days?

它被归类为创伤和应激相关障碍。

It's a trauma and stressor related disorder.

症状群也做了调整。

It also changed the symptom clusters.

它取消了过去要求患者必须最初表现出强烈恐惧、无助或惊骇的规定，同时收紧了确诊PTSD所需接触的创伤类型标准。

It removed the old requirement that a person needed to respond with intense fear, helplessness or horror initially, and it narrowed the criteria around the kinds of trauma somebody had to be exposed to to get a diagnosis of PTSD.

也就是说，总体上变得更难确诊了。

So basically it made it more difficult.

有些方面放宽了，有些则收紧了。

Some aspects broadened, some narrowed.

但这并不意味着诊断标准一直在扩大，这才是唯一的变化。

And it's not again, it's not that criteria keep expanding and that's the only changes that are happening.

实际上，是我们对这些疾病的理解在更新，过去一些医学标准可能并不准确，把很多人挡在了门外。

It's just that our understanding is changing for conditions that previously were perhaps gatekept by medical standards that weren't accurate.

我们现在只是设定了一个更贴近现实的门槛。

We're just giving it a more realistic a more realistic kind of bar that needs to be jumped over.

而对于另一些人，我们其实是在说，过去我们的理解可能恰恰相反，是错的。

And then for others, we're kinda saying, well, perhaps, like, our understanding that was was incorrect in the opposite way.

我必须特别强调一下。

I really need to stress.

这完全不是因为公众压力。

This is not, like, because of public pressure.

一点都不是。

Not at all.

这真不是因为公众压力。

This is not because of public pressure.

也不是因为社会舆论变了。

This is not because the cultural conversation changed.

而是因为科学界的讨论先发生了变化。

It's because the scientific conversation changed first.

制定DSM修订标准的人，不是因为网上有人说‘现在人人都有ADHD’，就跟着改的。

The people who make these changes to the DSM are not just doing it because somebody online is making an argument that, you know, everybody has ADHD these days.

他们做出这些调整，不是因为外界的压力。

They're not just doing it because of outside pressure.

他们一直在认真讨论这些问题。

They are debating this routinely.

他们有意识地在不同人群中进行试验，只为更真实地反映人类的实际情况。

They are trialling this deliberately and across many different populations to be more truthful to the human experience.

我想快速回到我之前提到的一个例子，就是ADHD诊断标准从六个症状降到五个的那次调整。

I want to quickly return to something I mentioned before, and that is the example I gave of that change to the ADHD criteria from six lowered to five.

需要多少症状才算符合标准，这个阈值的设定是个艰难的决定。

And how many symptoms need to be present and the difficult decision of deciding on a threshold.

到目前为止，我们还没有达成共识：在诊断时，到底谁才算足够受影响，值得获得这个诊断？

Here is something we still don't have a consensus on: when it comes to a diagnosis, who is impacted enough to receive said diagnosis?

症状必须持续多久，才能做出诊断？

How long do symptoms have to be present before a diagnosis is given?

什么是人格？

What is personality?

什么是小习惯？

What is small quirks?

那什么才算一个问题？

And what is a problem?

你知道吗，网上经常争论这一点：我们每个人偶尔都会有点心不在焉。

You know, this is the debate that happens a lot online a lot, which is that all of us at times can can be a little bit idle minded.

我们每个人偶尔都会情绪低落，或者喜欢事物有条理、有逻辑。

All of us at times can have low mood or are people who want things organized or coherent.

什么是个性？

What is personality?

什么是环境？

What is environment?

什么只是单纯的怪癖行为？

What is just quirky behavior?

什么时候才严重到需要贴上标签？

And when does it get serious enough for a label?

我觉得这正是让一些人真正担忧的地方。

I think this is what is really worrying some people.

我们是不是把太多事情都病理化了，以至于每个人都能在某个诊断里看到自己的影子？

Have we overpathologized things so much to the point that everybody can see themselves represented in a diagnosis?

就像每个人都能在塔罗牌、星座或者性格测试里找到自己的影子一样。

Perhaps the same way that everybody can see themselves represented in tarot cards or astrology or personality tests.

我觉得不是这样。

I would say no.

要达到正式诊断的标准，所必须经历的困扰程度依然相当严重。

I would say the level of impairment you have to experience to get a formal diagnosis is still pretty significant.

但人们真正担心的，其实是自我诊断这个现象。

But self diagnosis is I think where people get concerned about this.

有一个叫‘概念扩张’的说法，是澳大利亚一位学者提出的，意思是过去几十年里，我们描述某些现象的用词不断扩展，慢慢超出了原本的范围，变得适用于越来越多的人。

There's a concept called concept creep that was created by an Australian academic that basically talks about how in the last couple of decades, our language for things that like, specific language for things has expanded and slowly creeped out of the bounds of what it meant such that it applies to more and more people.

这种扩展在很多方面其实是道德上的进步，因为它让我们开始正视那些过去被门槛压制或否定的伤害。

And that expansion in many ways is morally progressive because it lets us recognize the harms that used to be minimized or invalidated by gatekeeping something.

但这也让我们把正常的痛苦都当成病症，甚至明明没什么问题，也觉得一定有毛病，因为现在的表达太容易引起共鸣了，外人看下去，好像也没那么严重。

But it also has caused us to pathologise ordinary distress and essentially believe in the existence of a problem or a disorder even if maybe there isn't one because of how overly relatable our language has gotten, because of how essentially easier it is for people to see themselves represented in something because it looks less serious from the outside.

我给你举个例子。

Let me give you an example.

前几天我在TikTok上看到一个年轻女孩的视频。

I saw this video the other day on TikTok from this young woman.

她最多也就十七岁，正在讲什么是边缘型人格障碍的征兆。

She couldn't have been more than 17, and she was talking about the signs that you may have BPD.

其中一些征兆比如：你爱得特别深。

And some of the signs were like, you love really deeply.

别人拒绝你时，你会特别生气。

You get mad when people reject you.

你特别敏感。

You are very sensitive.

我问你个问题。

Let me ask you a quick question.

我们有谁不觉得这些话说到自己心坎里了？

Who of us cannot relate to that?

说实话，有谁被拒绝了不生气的？

Genuinely, who doesn't get upset when people reject them?

有谁不爱那种沉浸在爱里的感觉？

Who doesn't feel good about being in love?

没错。

Yes.

如果程度特别强烈，那可能就是边缘型人格障碍了。

On a very intense scale, this is BPD.

这些表现确实可能出现在边缘型人格障碍患者身上，也会造成明显困扰。

It may represent people with BPD and can cause impairment.

但这些表现其实也适用于几乎每个人。

But it can also this representation can represent pretty much everybody.

我相信大家都能想到一些例子，网上流传的那些信息太过笼统，根本和真正的术语、临床指南对不上号。

And I'm sure we can all think of a few examples of this where the information we are specifically seeing online is simply too general and doesn't actually represent what the terms, what the words, what the clinical guidelines actually are.

关于这类心理学和心理健康内容，还有另一点。

Here's the other thing about psychology and mental health content like that.

它确实很火。

It does really well.

因为人们拍的时候都用很笼统的方式，所以特别容易引发互动。

It gets really great engagement because people are filming them in a way that is generalised.

他们之所以这么拍，就是为了这个目的。

That's exactly why they do it this way.

他们希望观众能产生共鸣。

They want it to be relatable.

这类内容就是想让人觉得说的就是自己，然后转发给朋友、收藏、再传播出去等等。

This content wants people to see themselves and resonate with what they're saying and send to their friends and save it and forward it and whatever.

但结果很多人会深信不疑，觉得自己真有严重的问题，可实际情况未必如此。

But then people end up believing something deeply and very serious about themselves that may not be accurate.

未必。

May.

有时候确实是这样。

At times it is.

但即使内容没错，如果你只靠这些信息来理解自己，那也是基于一种过于简化的观点，而这种观点可能根本帮不上忙。

But even if it is accurate, if you're only going off of this content, it's gonna be based on a very simplified version of things that may actually not be helpful anyways.

这类内容之所以这么受欢迎，是因为我们人类总在寻找能帮我们理解自身经历的东西。

Another reason this content does really well is because as people, we are constantly looking for something that will help us make sense of our experiences.

尤其是年轻的时候，比如这个视频里的女孩才17岁。

Basically, when we're young, especially, you know, this girl in this video was like 17.

她的目标观众大概也是其他青少年。

Her target audience audience is probably other teenagers.

在十几岁、二十几岁、三十几岁，甚至整个人生都充满困惑的时候，有人给你一个笼统的标签，帮你解释自己的经历，尤其是以这种方式，真的会让人感到安心。

When we're in our teens, twenties, thirties, and life in general is very confusing, Someone giving you a general label to grasp onto that explains your experiences, especially in this way, is very reassuring.

问题是，你可能会反过来把自己塑造成那个标签的样子，而不是标签去匹配真实的你，这就成了自我实现的预言。

The issue is that that can actually become a self fulfilling prophecy as you mould yourself to fit the label, not the other way around.

而且如果你没有专业的临床支持作为补充，问题就更大了。

And when you don't have clinical help alongside it.

我有些朋友是心理医生、精神科医生、社工，他们越来越多地提到，有人来就诊时会自带两三个诊断标签。

I have some friends who are psychologists, psychiatrists, social workers, and more and more they're talking about how people will come into appointments or sessions essentially with two to three labels.

他们会说：我有边缘型人格障碍，我有双相情感障碍，我有强迫症，我有多动症。

They'll be like, I have BPD, I have bipolar, I have OCD, I have ADHD.

但经过一番深入了解，或者发现对方其实并不符合这些诊断标准后，医生才会追问，结果客户才坦白：哦，我是自己在网上查出来这些的。

And it's only after a little bit of investigating, or in fact, like some confusion that like this person doesn't actually seem to match the criteria that they will ask the client and the client will be like, oh, I diagnosed myself online.

有时候，他们的判断确实是对的。

Sometimes they're right.

问题就在这儿。

That's the thing.

有时候，自我诊断反而最了解自己，没人比你更清楚自己的感受。

Sometimes these self diagnosis, like, you know yourself better than probably anybody.

所以有时是对的，但有时也完全不对。

So sometimes they're correct, but sometimes they're just not.

真正让医生担心的是后一种情况——一旦你接受了某个标签，并且真的觉得它贴合自己，就很容易开始用这个标签来看待一切。

And those are the cases that they get really worried about because they're like, once you have that label, once you really do feel aligned with it, it can become very easy to start seeing everything through that lens.

风险就是确认偏误。

The risk is confirmation bias.

我们会特别留意那些支持诊断的证据，却忽略那些让情况变得复杂的线索。

Know, we notice the evidence that supports the diagnosis and we overlook the evidence that complicates it.

我们开始收集各种符合的案例——比如忘记的预约、尴尬的互动、糟糕的日子，却忽略了可能更准确的解释。

We start collecting examples that fit forgotten appointments, awkward interactions, bad days, and not examples of maybe a more accurate explanation.

这和过度认同的风险很相似。

This is similar to the risk of over identification.

你的诊断，尤其是这种基于简化信息、没有专业指导的自我诊断，很容易让人觉得它定义了你整个人，而不仅仅是你身份或经历中的一部分。

Your diagnosis, especially in this case where it's a self diagnosis made on simplified information, right, without clinical help, it can feel like in that isolated way it becomes your whole identity rather than just one part of the person that you are and one part of your experience.

问题在于，这种语言和术语被用得太过宽泛，仿佛能解释一切，结果变得随意、松散，甚至有点像一种潮流符号。

The problem with that is that it turns as well language and terminology into something that can explain everything and is therefore overly loose and overly casual or even at times aesthetic.

这会抹平病情严重程度和体验上的重要差异。

And that that can really flatten important differences in severity and important differences in experience.

如果每一个轻微的困扰都用描述深刻、改变人生、极度艰难的词汇来表达，那些真正需要帮助的人反而更难被看见了。

If every mildly relatable struggle is described in the same language as profound, life altering, incredibly difficult, then the people who do and who need the most help become a lot harder to see.

如果我只是有点分心，讨厌处理琐事，却被归到和严重的执行功能障碍一个类别里，那会让人觉得自己的真实经历被忽视了、不被看见。

If, you know, I'm a bit distracted and I hate admin gets put into the same category as profound difficulties with executive function, that can really make an individual's own experiences feel less seen and less visible.

重要的东西就这么丢了。

Something important gets lost.

我们不能否认，正因如此，这些问题才会有不同的表现、定义、标准和严重程度之分。

Like we cannot deny that there are variations and there are definitions and there are criteria and levels for this very reason.

如果普通的难过和重度抑郁用同样的词来形容，或者轻微的不适和创伤被混为一谈，那其中真正重要的含义就消失了，这对每个人都很关键。

You know, if ordinary sadness is described in the same breath as incapacitating depression or if discomfort is described in the same breath as trauma, there is meaning that is lost there that is important for literally everybody.

这时候你就会看到，有人感到自己的感受不被认可，觉得自己得不到理解，也得不到帮助。

That is when you start to see examples of people feeling invalidated, people feeling like they are missing out on understanding, they are missing out on on help.

因为原本他们用来描述自己经历的那些词，现在被泛化使用了，可能并不准确。

Because the language that they would typically use to describe their experience has now and is now used in very general ways that maybe aren't accurate.

可能并不准确，我得这么说。

Maybe aren't accurate, I will say.

有时候，人们又会说，这其实都值得讨论，毕竟每个人的情况都不一样。

Sometimes people again, this is all up for debate and obviously everybody's situation is different.

这只是一个我们看到的普遍趋势，就是问题被过度简化了。

This is just a general trend of what we're seeing with the oversimplification.

听我说，我觉得社交媒体的作用不能简单地说是好还是坏。

Listen, I think what I should say is like the role of social media is not simply good or bad.

它有可能减少羞耻感，但也可能传播困惑。

It has the potential to reduce shame, but it also has the potential to spread confusion.

这两方面都是事实，而且都是我们应该关注的地方。

Both things are true, and both things are things we should pay attention to.

这确实能帮到那些之前被忽视的人找到自我，特别是对于那些生活中或家庭里从未有过这类对话的人来说。

It really does help previously missed people find themselves, especially people for whom these conversations are not something that has had in their environment or in their families.

但这也可能意味着他们是在缺乏支持的情况下独自摸索。

But it can mean that that is done in an unsupported way.

我们必须认识到这种悖论效应，以及它对服务可及性、贴标签现象和其他人经历被稀释所产生的连锁影响。

We have to recognise the paradoxical effect and the flow on impact that this has on accessibility of services, on pigeonholing, and on the dilution of other people's experiences.

另外，那些面向大众、追求广泛参与的高度刻板化内容，无法像专业人士那样理解你的具体处境。

The other thing that general highly stereotyped content made for broad audiences and mass engagement doesn't do is it doesn't understand your context the way that a professional can.

每个人带着各自不同的经历和困扰来到社交媒体这个空间。

Everybody is coming into this space onto social media with so many different things going on.

其中一些经历其实比诊断更能解释他们的行为和处境。

And some of those things would actually explain their behavior and what they're going through better than a diagnosis.

但如果他们看到的唯一内容都在说：‘你只有得了这种病才会这样’，那就会让人特别困惑。

But if the only video or content they see is like, the only way you can be experiencing this is if you have this, that can become really confusing.

我前几天读到一篇文章，说人们总想给每一种人类行为贴标签，结果反而让一些真正需要改变的部分被忽略了——因为一切都被归咎于个人问题。

I read this piece the other day that talks about how a desire to label everything, every single human behavior is meaning that some parts of the human experience that probably need working on are not being changed because it's all coming down to a problem with the individual.

所以现在人人都说自己抑郁，却没人去深究：我们周围的系统正变得越来越让人压抑。

So basically, like, everybody is depressed and nobody is investigating the fact that the systems around us are becoming more depressing.

对吧？

Right?

人人都感到焦虑。

Everybody is anxious.

人人都可能被贴上焦虑症的标签，但没人去追问为什么：世界越来越不确定，经济压力越来越大，住房不稳定，情绪也愈发不可预测。

Everybody could have the label of having an anxiety disorder, but nobody is then focusing on why that is because the world is becoming more uncertain, because of financial pressures, because of pressures, because of unstable housing, emotional unpredictability.

你知道吗，人人都说有注意力缺陷，好像每个人都该贴上这个标签，可没人去想，等等，真正该问的是：为什么现代生活要求人们每天盯着屏幕十二个小时？

You know, everybody has ADHD and everybody, like, could have the label, but then we're not investigating the fact that, wait a second, maybe the real question is why does modern life ask people to stare at screens for twelve hours a day?

为什么现代生活总让人不停地切换任务？

Why does modern life ask people to switch tasks constantly?

为什么它逼着我们处理没完没了的通知，应付根本做不完的琐事，还要在人为的环境下保持专注？

Why does it ask us to process endless notifications and manage impossible admin and maintain sustained focus under artificial conditions?

这种例子我还能举出很多。

I could go on.

当然，这些都会严重影响人的注意力。

Of course, that is going to have an impact on human attention.

我觉得，任何人处在这种环境下都会有点精神涣散，而对有注意力缺陷的人来说，影响只会更严重。

I think that everybody would be slightly mentally fragmented under those conditions, but people with ADHD, so much more so.

有意思的是，大家只想着给他们贴标签、吃药、改变自己，却没人问一句：为什么我们的系统从不支持这样的人？

And what's interesting is that they are asking to, you know, be given a label, take medication, change all these things, and nobody's thinking like, wait, why do our systems not support these people?

为什么所有问题最后都归结为‘你有病，你有问题’，而不是去反思：我们这个社会的结构，到底哪里出了问题，才没法好好支持你？

Why does it all come back to here is a diagnosis, here is the thing that is wrong with you, and not the things that are wrong with how our society has been set up to support you?

前几天我听了一个特别棒的播客，讲的是现代社会如何把越来越多的人推到了一种状态——他们的行为和情绪成了问题，因为我们现在的系统根本跟不上人类真正的需求，也不符合大脑的自然设计。

I listened to this amazing podcast the other day that essentially talked about how modern society is pushing more people into a space where their behavior and their mood is of concern because of how little our current systems actually match what we need as humans or how our brains are designed.

所以，也不奇怪，当我们的身体、社交、经济和情感环境都这么混乱时，越来越多的人会在注意力缺陷、情绪障碍、焦虑或抑郁的症状里看到自己的影子。

And so, again, no wonder more people see themselves in the symptoms of ADHD or in the symptoms of mood disorders or anxiety or depression when our physical, social, financial, emotional environment is so disrupted.

我觉得真正让我纠结的是，现在总有人问‘为什么现在人人都有诊断’？可问题是，当你面对的现实这么糟糕，社交媒体又把这些问题简化得离谱，你为什么不会对这些症状和描述产生共鸣呢？生活有时真的会把人逼到一种状态，看起来就像得了真正的心理疾病。

I think the real issue I have with this discussion of like, why does everybody have a diagnosis these days is like, because why wouldn't you relate to these symptoms and why wouldn't you relate to these depictions of these conditions and sometimes these disorders when yes, asocial media is depicting them as so simplified, but also when life is so awful at times to people that it is actually pushing people into a state that does mimic symptoms of very real conditions and disorders.

当然，这事儿也不是全怪环境。

Obviously, like this isn't all about environment at all.

但我认为，把责任全推到个人身上，或者让这种讨论把锅甩给个人，是不公平的。

But I think it really does go to show that like the individual blame that we place on people or that this discussion would like to place on people is not fair.

不能动不动就怀疑别人是想博关注、装病，或者说什么突然爆发了大规模的生物性疫情——我们明明看得清清楚楚，是这些社会因素在推高人们对心理健康的讨论，也推高了诊断率。

Like, it is not fair to be like, to assume that everybody is trying to get attention or putting it on or whatever, like the idea is or that there's some huge biological epidemic when we can very clearly see all these factors that are really increasing our conversation around mental health and increasing diagnosis rates at times as well.

归根结底，我们真正绕来绕去的问题是：谁该被贴上诊断的标签，谁不该？

I think at the end of the day what we're really circling is like who deserves a diagnosis, deserves being in quotation marks, and who doesn't.

而一个标签，到底意味着什么？

And what does a label actually mean?

这当然有它的意义。

Obviously, it means something.

所以人们才这么珍视它。

That's why people are so protective over it.

因此临床指南才对它把得这么严。

That's why it's so closely guarded by clinical guidelines.

对普通人来说，这个标签到底意味着什么？

What does a label mean to people?

它为什么这么重要？

Why is it important?

为什么大家总在讨论它？

Why is it discussed?

为什么它会引发这么大的争议？

Why why is it controversial?

广告结束后，我们再深入聊聊这个话题。

We're gonna talk more about that after this short break.

你当然可以有自己的看法。

You can have opinions.

你可以持非常明确的立场。

You can have, like, a strong stance.

但你的身体自有它的运行方式。

And then there's your body having its own program.

我是医生。

I'm Doctor.

我是认知科学家玛雅·尚卡尔，播客《计划的小调整》的主持人，这档节目探讨的是当生活改道时，我们如何定义自己、如何蜕变。

Maya Shankar, a cognitive scientist and host of the podcast A Slight Change of Plans, a show about who we are and who we become when life makes other plans.

我们分享故事和科学洞见，帮助大家更好地应对生活中的动荡与转变。

We share stories and scientific insights to help us all better navigate these periods of turbulence and transformation.

有一项发现始终一致，那就是我们的韧性源于人际关系。

There is one finding that is consistent, and that is that our resilience rests on our relationships.

我真希望当初没有那么久地抗拒改变的必要。

I wish that I hadn't resisted for so long the need to change.

我们必须愿意接受一种谁都不喜欢的不确定性。

We have to be willing to live with a kind of uncertainty that none of us likes.

可以在 iHeartRadio 应用、Apple 播客，或者你常用的任何播客平台收听《计划的小调整》。

Listen to A Slight Change of Plans on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

基思·杰马恩卡看起来是个温和的郊区父亲，但暗地里，他变成了另一个人，一个擅长伪装、四处作案的高手。

Keith Jemmaanca seemed like a mild mannered suburban dad, but secretly, he became someone else, a master of disguise who went on a crime spree.

那时候，这听起来是不是很疯狂？

At the time, did it seem like a crazy idea?

确实疯狂透顶，但我太绝望了，觉得这是最快、最简单的出路。

It seemed very crazy, but I felt so desperate that I felt it was the quickest, easiest way out.

你有没有想过事情可能会搞砸，或者会变成什么样？

Did you allow yourself to think about how it could go wrong or what that might look like?

没有，我不想让那种情况成真。

No, I didn't want

去让它成真。

to manifest that.

我当时只想把成功吸引过来。

I was trying to manifest success.

每个家庭都有自己的秘密。

Every family has its secrets.

但当你发现父亲一直在过着双重生活时，会怎么样？

But what happens when you discover that your dad has been living a double life?

那根本不是无辜者该有的表情。

That is not the look of an innocent man.

这件事会永远改变我的人生和家庭关系，因为过去我所相信的一切，现在全都不成立了。

This is gonna change my life and my family dynamic forever because everything that had existed prior in my reality is now untrue.

收听《深潜：家庭男人》在 iHeartRadio 应用、Apple 播客，或你常用的任何播客平台。

Listen to deep cover the family man on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

主流媒体对无家可归者的描绘往往充满恶意，总是指责、羞辱，把他们当成一个毫无差别的群体。

Mainstream media is full of cruel depictions of the unhoused, stories that shame and blame and paint the unhoused as a monolith.

《我们，无家可归者》这个播客，正在改变这一切。

We The Unhoused is the podcast that's changing that.

我是西奥·亨德森，这个节目的创作者和主持人。多年来，我一直为无家可归者及其支持者提供一个讲述自己故事的平台。

I'm Theo Henderson, creator and host, and for years I've created a space where the unhoused and their advocates can tell their own stories.

仅在过去几个月里，我就采访了无家可归的父母、移民、互助组织者、退伍军人、LGBTQIA+群体，以及那些制定影响无家可归者生活的政策的决策者。

In the last few months alone, I've interviewed unhoused parents, immigrants, mutual aid organizers, veterans, the LGBQTIA plus community, and the policymakers who make the laws that impact the unhoused existence.

《梅里迪安之家》是两届威比奖和SIGNAL奖得主，接下来还会有更多精彩的嘉宾登场。

Meridian House is a two time Webby and SIGNAL award winning show with many exciting guests on the horizon.

本周别忘了收听我对吉尔·威彻里克医生的专访。

Tune in this week for my interview with Doctor.

吉尔·威彻里克原本是街头医生，现在成了网络红人，她为无家可归群体所做的工作在线上和本地社区都产生了巨大影响。

Jill Witcherick, a street doctor turned influencer whose work with the unhoused community has made a huge impact online and in her community.

收听《我们无家可归者》，请在iHeartRadio应用、苹果播客，或您常用的播客平台搜索。

Listen to We the Unhoused on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

如果你正在追《亚特兰大主妇》最新一季，那你一定知道这季有太多值得细聊的地方。

If you're watching the latest season of The Real Housewives of Atlanta, you already know there's a lot to break down.

波蒂娅指控凯莉与已婚男子有染。

Portia accusing Kelly of sleeping with a married man.

他们拦着凯·米歇尔，不让她跟德鲁闹起来。

They holding Kay Michelle back from fighting Drew.

平基现在经济上有困难。

Pinky has financial issues.

我喜欢《主妇》节目里那种奢华的风格。

I like the bougie style of Housewives show.

现在我觉得这事儿越来越有意思了。

Now I think it looks like it's gonna be interesting.

在播客《现实与国王》里，我是卡洛斯·金，专门复盘你最爱的真人秀里的重磅时刻——包括《主妇》系列的狗血、联盟和八卦。

On the podcast, Reality With The King, I, Carlos King, recap the biggest moments from your favorite reality shows, including the Real Housewives franchise, the drama, the alliances, and the tea.

大家都在热议的事儿。

Everybody's talking about.

作为真人秀的执行制片人，我可不只是在看热闹。

As an executive producer in reality television, I'm not just watching it.

我懂这里面的门道。

I understand the game.

作为制作节目的人，我甚至可以这么说。

As somebody who creates shows, I'll even say this.

归根结底，人们在家的时候，就想看点有意思的。

At the end of the day, when people are at home, they want entertainment.

想听更多这样的内容？请在 iHeartRadio 应用、Apple Podcast 或你常用的播客平台收听《Reality With The King》。

To hear this and more, listen to Reality With The King on the iHeartRadio app, Apple Podcast, or wherever you get your podcast.

我对自己关于爱情或关系的那些想法，会直接影响我的行为，甚至让我无意中破坏了建立联系的机会。

The story I've told myself about love or relationships can then shape my behavior, and that can lead me to sabotage the possibility of connection.

今年心理健康宣传月，欢迎收听 Debbie Brown 主持的《Deeply Well》播客，一起探索疗愈、自我发现和回归自我的旅程。

This mental health awareness month, tune into the podcast deeply well with Debbie Brown and explore the journey of healing, self discovery, and returning to yourself.

我们会探讨一些深层次的实践方法，帮你在这个令人窒息的世界里找到清晰、平静和内在的掌控力。

We explore higher practices that help you find clarity, peace and self mastery in a world that can feel overwhelming.

这个世界正变得越来越孤独。

The world is becoming lonelier.

我们并没有变得更善于社交，也没变得更紧密相连。

We're not becoming more social and connected.

我们越来越个人化，只顾着低头看手机，但实际上我们更需要与人建立联系。

We're becoming more individualized, eyes, but we actually need people in connection.

如果你一直在寻找一个温暖的港湾，来支撑你完成自我疗愈的旅程，这个播客就是为你准备的。

If you've been searching for a soft place to land while doing the work to become whole, this podcast is for you.

想了解更多内容，请在 iHeartRadio 应用、Apple Podcasts 或你常用的播客平台收听《Deeply Well》与 Debbie Brown，来自 Black Effect Podcast Network。

To hear more, listen to deeply well with Debbie Brown from the Black Effect Podcast Network on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

所以我们真正要探讨的是，为什么一个标签这么重要？

So what we're really getting to is like, why is a label important?

正式的诊断和标签之所以重要，是因为它能打开许多机会。

A formal diagnosis and a label is important because of the doors that it opens.

首先，它打开了自我理解的大门。

Firstly, it opens the door of self understanding.

不管是自我觉察还是专业诊断，我认为真正关键的，是那份理解。

And whether that's self diagnosis or a formal diagnosis, I think the understanding is the most crucial part.

研究一再表明，虽然对一些人来说，诊断可能带来复杂的情绪，但对大多数人而言，它带来的是释然、自我肯定，以及更深层次的理解。

Research continuously shows that although a diagnosis is a complicated feeling for some, for most it is a relief and it's self affirming and it provides much deeper understanding.

标签还能让人获得治疗、合理便利、教育支持、职场调整、法律保护、药物治疗等等，好处说不完。

A label then also provides access to treatment, relevant accommodations, educational support, workplace adjustments, legal protections, medication, you know, the list goes on.

之所以能带来这些，是因为我们生活在一个依赖体系的社会，而这些体系必须用简单明确的分类来判断谁该得到什么资源。

And the reason it provides that is because we live in a society that runs off of systems, and those systems need a clear reductionist way of categorizing people so they know who gets let in the door, so they know who gets access to what in society.

从政府和医疗部门的角度看，他们需要明确的分类和患病率数据，才能合理规划并提供相应的服务。

On a structural and service level, governments and health care boards need categories, need evidence around prevalence to be able to commission the services to support those people.

很多国家现在根本忙不过来，需求远远超过了供给能力。

A lot of countries, granted, are now in a position where they simply cannot keep up with the demand.

这其中有很多复杂原因，比如政府没有把心理健康和神经多样性支持服务放在优先位置。

And there are a lot of complicated factors where governments aren't prioritizing the funding for mental health and for neurodivergent support services and support systems.

但我担心的是，有些人反而把问题归咎于那些去确诊的人，而不是反思：这根本不是我们社会的优先事项。

The problem I have is that then people turn around and blame others who are getting a diagnosis for that problem and not the fact that this is not a prioritized thing in our society.

如果你真担心有人滥诊，那更该做的，是大力扩大心理健康服务，而不是质疑谁在申请诊断。

If we are truly worried about more people claiming a diagnosis, you should actually care more about expanding mental health services nonetheless.

不管你是觉得这些人是认真的，还是觉得他们只是受了Instagram或TikTok的影响，只要能接触专业人员，所有误解自然都会澄清。

Whether you think people are serious or not, whether you think people are just getting that from Instagram, TikTok or not, because having access to a professional will clear up any confusion in any direction.

我知道这听起来好像跟我之前那番关于社交媒体的抱怨有点自相矛盾。

I know that sounds kind of contradictory to, like, that whole rant I went on about social media before.

但简单总结一下我想表达的意思：人们对某些病症发病率上升感到困惑和怀疑，总想把这归咎于疫苗、环境变化，或者觉得是有人编造病情、过度病理化。

But, like, to do a mini summary of what I'm really saying here is that people are very confused and skeptical of of increasing rates of certain conditions, and they wanna put those rates and that rise down to theories about vaccines or changes in the environment or they wanna put that down to people making it up or people suddenly overpathologising.

我能理解这种担忧。

I get the fear.

看到这种情况，人们自然会害怕，觉得有什么地方出了问题。

It's very scary for people to see this and think that something's going wrong.

所以他们急着想找一个解释。

And so they're looking for an explanation.

但真相要复杂得多，也庞大得多。

It's just that the explanation is a lot bigger and is a lot more complicated.

真正的原因是，诊断率上升是因为诊断标准放宽了，更多人找到了描述自己的语言，更多人被心理健康系统识别出来，能够自我认同并获得帮助——这其实是好事。

The real explanation is that the reason we are seeing diagnosis rates increase is that criteria are broadening, more people are finding the language to describe themselves, more people are being identified by mental health systems and being able to self identify and then get help, which is a good thing.

当然，其中一小部分人确实因为概念泛化或社交媒体的影响而被误诊或自我误诊。

A small portion of those people are being misidentified and misidentifying themselves because of concept creep, because of social media.

其实这些人很难拿到正式诊断，毕竟诊断不是随便发的，像发糖果一样。

Often those people like it's very rare those people ever get a formal diagnosis anyways because it's not like they're just handing them out like candy.

那些被误诊的人，问题在于他们没法真正理解自己。

The problem with that small amount of people who are getting the wrong diagnosis is firstly that they actually don't get to understand themselves in the correct way.

而且，这种误诊带来的压力，最终都落在了医疗系统身上。

But also that, you know, the pressure that people are claiming to that puts on services.

我真正想说的是，如果我们能给医疗服务更多资金，这根本就不是问题。

What I'm really saying is like, if we actually had more funding for services, it wouldn't be a problem.

对吧？

Right?

不管有没有诊断，人们都能得到他们需要的帮助。

Because people would get the help they needed whether that was a diagnosis or not.

过度设限对谁都没好处。

Gatekeeping actually helps no one.

我们才能更准确地了解，到底有多少人正在经历心理问题。

We would have a more accurate idea of how many people are dealing with mental health concerns and disorders and conditions, whether that is more or less.

如果我们把重点放在扩大心理健康服务的投入上，而不是整天纠结于谁该算、谁不该算，就能帮助更多人，不管他们有没有诊断结果，不管他们具体面临什么情况。

We would be able to help more people regardless of whether they had a diagnosis or not, regardless of what was going on, if we concentrated on expanding mental health funding rather than focusing all of our attention on this larger debate about who counts and who doesn't.

这你明白吗？

Does that make sense?

我不想让人觉得我在说，第一，这根本不是问题；或者第二，自我诊断有问题。

Because I don't want this to come across as like, a, this isn't a problem or b, that self diagnosis is a problem.

我们现在看到需求激增，是因为各种因素叠加，政府根本应付不过来，而不是因为来找帮助的人多了，也不是因为人们本身有问题。

We're just seeing such an uptick in demand because of all these factors and our governments being able to cope with that, not because of the people, not because it's people seeking help.

这根本不是他们的错。

It's not their fault.

只是因为政府根本没把这事当回事。

It's because they just don't see it as a priority.

我觉得这才是核心问题所在——正因为如此，太多人只能自己去摸索术语、自己去寻找解释，结果得到的信息不准确，也更难获得真正需要的帮助，只能独自承受这一切，没人能帮他们更清楚地理解自己。

And I think that's where the big problem just where this all comes down to and why so many people are forced to go looking for the language and forced to go looking for the explanations by themselves that perhaps gives them a less accurate picture or less access to the help they really need and makes them deal with this, like, in solitude and without actually somebody there to give them a clearer understanding of themselves.

不幸的是，随着诊断需求激增，而政府系统又跟不上，我们还看到私营机构正趁机在这个空档里捞钱。

Unfortunately as well, with this huge increase in demand for diagnosis and government systems that can't or won't step up, what we're also seeing is that private industries are looking to make a buck in this gap in the market.

这些行业的角色怎么强调都不为过。

And the role of these industries cannot be overstated.

制药公司就是最典型的例子，很多人都会想到他们，因为他们希望尽可能多地让人确诊，这样就能让更多人成为他们的药品消费者。

Pharmaceutical companies are obviously the example a lot of us think of because they do want more people diagnosed by any means possible so that these people become consumers of their medications.

对吧？

Right?

有部纪录片，叫《焦虑的时代》，是2012年拍的。

There is this documentary, I think it's called The Age of Anxiety, and it was made in 2012.

它非常出色地揭示了大型药企如何利用人们对心理健康支持日益增长的需求，完全不顾个人真正需要什么。

And it does an amazing job at investigating how big pharma has exploited the increasing demand for mental health support regardless of what's best for the individual.

他们把这种需求纯粹看成了赚钱的机会。

Like, they've seen this increasing demand as a money making thing.

在上世纪七十年代以前，我不知道你们知不知道，当时医学上对需要药物治疗的临床抑郁症，和由环境因素引发的抑郁是有明确区分的，后者更需要谈话疗法、生活调整，或者两者结合。

Prior to the nineteen seventies, I don't know if you guys know this, there was a greater distinction between medical depression that required medication and depression caused by circumstances which required more talk therapy or more, you know, life intervention or a mixture of both.

但随着制药公司开始大力推广抗抑郁药——顺便说一句，我自己也在吃，我也很认可这些药，这可不是什么阴谋论——从那以后，很多人的治疗方式变得越来越单一，越来越偏向医学化，人人都被当成需要吃药的病人。

But as pharmaceutical companies began to market antidepressant drugs, which, by the way, I'm on, I'm a big fan of, this is not some conspiracy, but as they began to market these drugs, the focus of treatment for many people became more homogenous and it became more medical for everyone.

这显然让这些公司赚得盆满钵满，因为他们抹去了心理健康领域原本应有的那些重要区分。

And that obviously helped these companies make a lot of money because they were able to erase some of the distinctions that are required when it comes to mental health.

私人评估机构、治疗平台、自助品牌、健康类App、营养补剂公司、效率工具、教练产业，全都从这种文化中受益——越来越多的人被引导去认为自己需要被定义、被贴标签、被治疗、被优化、被管理，而真正接受专业训练的医疗人员所提供的临床服务，却越来越难触及。

Private assessments, private assessment clinics, therapy platforms, self help brands, wellness apps, supplement companies, productivity tools, coaching industries, all benefit from a culture where more and more people are encouraged to see themselves as needing an explanation, a label, treatment, optimisation, management, and less people have access to actual clinical services with people who are trained, with people who could seriously help them.

我看过一些报道，有人花了数百甚至上千英镑和美元去寻求ADHD诊断，结果却得不到正规医疗人员的正式认可。

I've seen articles about people being conned out of hundreds, if not thousands of pounds and dollars trying to seek an ADHD diagnosis only for it to not be formally recognised by a regulated healthcare professional.

结果他们连真正需要的支持和药物都拿不到。

So they actually couldn't even get access to the support and medication that they need anyways.

还有大量针对焦虑、ADHD、强迫症的课程，根本不是由持证专业人士开发的，因为有人看到了这个市场空缺，就冲了进来。

There's all these as well examples of courses for people with anxiety, with ADHD, with OCD that aren't even made by licensed professionals because people are like getting into this gap in the market.

我前几天还看过一门这样的课，内容错误百出，过度简化，简直荒谬。

And these courses, I actually was looking at one the other day, are just so inaccurate and simplified and just dumb.

这真的特别令人心酸，因为现在人人都在关注‘每个人都有问题’、‘诊断都是假的’这种说法。

And this is so incredibly sad because it's like everybody wants to focus on how everybody has a problem these days and diagnoses are fake.

但事实上，很多人内心极度渴望帮助，渴望被倾听、被理解。

But people are really desperate for help and are really desperate to be heard and supported.

当我们无法找到有效的方式去满足这种需求、帮助这些人——无论他们有没有诊断——就会有逐利的机构趁虚而入，从中牟利。

And when we do not find a good way to meet that demand and to help these people whether they have a diagnosis or not, there are money making machines that will capitalise on that lack of support.

用这种方式包装问题有利可图，通过贴标签来卖解决方案也是一门生意。

There is money in framing it this way and there is money in being able to sell people a solution to their problems through a label.

只要涉及金钱，我们就必须格外警惕。

I just think that when there is money involved, we need to be really, really cautious.

但这并不意味着所有寻求帮助的人都被操纵了。

Again, that does not mean everyone seeking help is being manipulated.

自我诊断就不准吗？

Is self diagnosing inaccurately?

完全不是。

Absolutely not.

这也不是说药物有问题，或者临床医生存心不良。

This doesn't mean that medication is bad or that clinicians are acting in bad faith.

当然不是。

No.

这仅仅意味着诊断系统并不是孤立存在的。

It just means that diagnostic systems don't exist in a vacuum.

它们是政治、经济和临床认知等更广泛因素的一部分。

They exist as part of all these wider factors to do with politics, to do with economics, to do with clinical understanding.

这些因素中有些伴随着利益驱动，我们必须意识到这一点，以免盲目行事。

And some of those factors come with incentives, and we need to be aware of that so that we're not acting blindly.

保持一定的怀疑态度是有益的——不是怀疑那些努力寻找解释、希望改善自己的人，而是怀疑那些系统：它们通过告诉越来越多的人，他们的痛苦本质上是内部问题，需要一个标签，并通过某种产品、服务或订阅来解决，而这些只有它们能提供。

Some scepticism is healthy, not towards the individuals who are trying to find an explanation and trying to better themselves, but towards any system that might profit from telling more and more people that their distress is best understood as an internal problem that has a label that can be serviced through a product, a service or a subscription that only they can sell you.

所以，这引出了我今天要讲的最后一点。

So this brings me to my final point of the day.

考虑到以上所有因素，是诊断过度好，还是诊断不足好？

With all of this in mind, is it better to over diagnose or under diagnose?

这是个很大的问题，但我想把它拆开来说。

It's a huge question to end on, but I want to break it down.

过去我们面临的是诊断不足的问题。

Under diagnosing is what we had in the past.

说实话，这其中有很多部分真的很令人心酸。

And honestly, think there are large parts of it that are quite tragic.

它让人被忽视、被抛弃，还被责怪为在承受着别人无法理解的痛苦。

It leaves people unseen, unsupported, and blamed for struggles others do not understand.

有些人花上好几年时间，以为自己懒惰、难搞、爱夸张、软弱、破碎，可实际上，他们只是在面对一种从未被承认、也从未有人帮他们命名的问题。

It means people can spend years of their life thinking that they are lazy, thinking that they are difficult, dramatic, weak, broken, when in reality they're just dealing with something that has simply never been recognized and that they were never able to have the language to understand.

这真的会带来严重的后果。

And that really has that has consequences.

当然，这点不用我多说——它影响着我们的自尊、人际关系、经济状况，还有生活质量。

Of course, I don't need to say that, but it impacts our self esteem, our relationships, our finances, the quality of life that we have.

我们绝不能回到过去那种状态。

We do not want to go back that way.

我们不能重走低估诊断的老路，让想寻求帮助的人更加举步维艰。

We do not want to go back to the underdiagnosis path and make it even harder for people to get help.

不过，过度诊断也有它自己的风险。

Overdiagnosis, though, has its own risks too.

它可能会无意中把正常的人类差异当成病症来看待。

It can pathologise ordinary human variation without meaning to.

它会让人忽视周围的环境因素，而这些因素其实更能解释为什么越来越多的人出现严重症状，有时还会引导人们接受那些并不完全符合他们整体情况的解释或治疗。

It can pull attention away from the context that we're in that may be describing why more people are having severe symptoms, and it can sometimes lead people towards explanations or treatments that don't actually fit the full picture of them as a person.

这样一来，轻微的困扰和深远的影响之间的界限就会变得模糊。

And that can really blur the line between mild difficulty and profound impact.

一旦出现这种情况，诊断用语就会逐渐失去它原本的意义。

And when that happens, diagnostic language can start to lose some of its meaning.

所以我觉得，无论是过度诊断还是诊断不足，都不一定更好。

So I don't think it's necessarily better to do either.

真正的目标应该是准确、谨慎、结合具体情境地进行诊断，留出空间去理解一个人不断变化的状况，而不仅仅贴个标签。

I think that the real goal here is to diagnose well and diagnose carefully, contextually, and with room for an evolving understanding of of a person, not just a label.

这个人究竟是谁？

Like, who is this person?

别只盯着他们有什么病，而是要问：他们到底是谁？

Rather than seeing them as having this or that, who are they?

他们正在经历什么？

What are they going through?

他们需要什么样的语言？是标签也好，其他表达也好。

What language do they need, label or otherwise?

但除此之外，他们还需要什么样的帮助？

But then what what help do they need as well?

记住，标签也好，诊断也好，都只是症状或行为模式的集合。

Remember, like labels, diagnoses are just clusters of symptoms or patterns of functioning.

它们并不能完整地描述一个人。

They do not describe a person entirely.

如果你见过一个患有多动症的人，一个患有自闭症、强迫症、边缘型人格障碍、焦虑或抑郁的人——不管是什么情况，你只是见到了一个正在经历这种状况的人。

If you have met one person who has ADHD, one person who has autism, OCD, BPD, anxiety, depression, whatever it may be, you have met one person who is experiencing that.

仅仅一个。

Just one.

因为每个人的情况都不一样。

Because it's always gonna be different.

标签之所以被简化，是因为它必须简化，才能把人归类。

A label is an oversimplification for a reason because it needs to oversimplify things so we can categorize people.

我们更应该关注的是这个人本身。

We need to instead be focusing on the person.

我知道这听起来可能像遥不可及的理想，毕竟现在资源和服务都压力巨大，但我觉得，这恰恰是我们真正该面对的问题。

And I'm I know that might seem like a faraway dream because of the strain that resources and services are currently under, but I think that is, like, really the problem that we are getting to.

整个体系出了问题。

The system is faulty.

这个体系没能充分服务任何人。

The system is under serving everybody.

所谓诊断不足还是过度，其实被转嫁成了个人要解决的问题。

I think what that means is that the problem with under versus overdiagnosis is being turned into an individual issue to deal with.

人们被迫靠自己，用有限的资源——比如社交媒体——去理解自己。

It's turned on to the individual to try and make sense of themselves using whatever resources they have, social media being one of them.

我们正越来越被迫独自应对一切，却没有专业人员的帮助。

And we are being increasingly forced to take care of ourselves without the help of somebody who is trained to do so.

再说一遍，不管你有没有诊断结果，压力都该落在系统身上。

And again, regardless of whether you have a diagnosis or not, the pressure should be on the system.

压力应该放在资金不足的医疗体系上。

It should be on underfunded healthcare systems.

压力应该放在那些仓促的评估上——这种事简直太常见了。

It should be on the fact that, you know, rush assessments take place all the time.

想做个评估，往往得等上好几年。

It takes years to get an assessment for something.

学校的支援体系根本没法有效制定医疗计划，也很难发现需要帮助的孩子。

Schools support systems are not good at putting in place health care plans or identifying children who could need help.

这种问题，说几天几夜都说不完。

Like, can just go on and on and on.

那些私营公司一进来，就想方设法让人觉得自己有病，根本不在乎谁真有病，只图赚钱。

Like, the private companies come in and are like, we can make a buck off of making everybody believe that they are not well without actually caring about anybody who is not well.

所以我觉得，这点真的值得我们特别留意。

So I just think that's like something to really be conscious of.

我打算用这段总结来结束这一集，虽然之前我做过几次总结，但这次是针对这个话题的正式总结。

I'm going to finish up this episode with a quick summary of which I've done several, but a proper summary for this topic.

为什么现在人人都好像有个诊断？

Why does everybody have a diagnosis these days?

第一，其实并不是每个人都有诊断。

Point one, not everybody has a diagnosis these days.

是的，诊断率在上升，但只是在追上那些一直存在却被忽视的真正患病比例。

Yes, rates are increasing, but they are just catching up to an underlying prevalence rate that has always been there.

像抑郁和焦虑这类问题，发病率非常高，这确实是个严重的问题。

For conditions like depression and anxiety, those rates are incredibly high, and that is a real concern.

这说明我们的社会正在发生某种变化，而且这种变化正在影响着每个人。

And that is showing that there is something changing in our society and happening in our society.

我们的社会里确实发生了很多事，深刻地影响着每一个人。

And there have been things happening in our society that are deeply, deeply impacting everybody, really.

至于其他一些病症，虽然诊断率也在上升，但大部分增长其实来自那些过去本该被诊断、却因诊断标准不完善、缺乏相应语言、未被看见，或表现方式不符合刻板印象而被漏掉的人。

When it comes to other conditions, though, rates do seem to be increasing, but a large majority of this rate increase is coming down to people who previously, historically should have been diagnosed, but they were not included by diagnostic criteria, they didn't have the language, they weren't seen, or their case or the way that they represented didn't match stereotypes.

有些人把正常的人格特点，用社交媒体和其他渠道传开的笼统又不准确的标签乱贴标签。

Some people are mislabeling normal human idiosyncrasies with catch all inaccurate terms that's coming from social media and other sources.

但我们没必要操心一个人怎么看待自己。

But it is not our job to be concerned with how an individual chooses to see themselves.

更重要的是，要确保这个人能顺利见到医生，获得帮助，而不是纠结于他们感受到的东西在我们眼里是不是‘真的’。

And we should be more focused on ensuring that that person can get in and see a clinician, that person can get help than we should be at trying to correct whether whatever they are experiencing is true or false in our eyes.

我们还得对身边很多系统保持警惕，它们总想让人觉得自身出了问题，尤其是当它们能从中赚钱，靠简化心理健康术语来获利的时候。

We also need to be skeptical of a lot of systems around us right now that are trying to make more people feel like something is wrong with them, especially when they can make money from it, especially when they seek to gain from the oversimplification of mental health language.

所以你要留心这一点。

So make sure that you are looking out for that.

要意识到那些可能在操纵你生活中痛苦或困扰的系统。

Make sure that you are aware of the systems in place that may be manipulating certain parts of of distress or impairment happening in your life.

但说到底，这事儿特别复杂。

But, again, it is a really complicated complicated thing.

在我们真正投入更多资金、更多研究，以及对心理健康和人性本身应有的关怀之前，这种争论只会越来越激烈，人们也还会继续承受本不该有的痛苦和挣扎。

And until we have more money and until we have more research and until we have the care towards this and just towards humanity that we actually need, like, we're gonna continue to see this debate, like, be very intense and continue to see people perhaps suffering and struggling in ways that they don't really need to.

那我就说到这儿了。

I'm gonna finish it there.

我们完成了。

We did it.

这是今年目前为止最长的一期。

This is the biggest episode of the year so far.

我觉得这是今年最长的一集。

I think it's the longest episode of this year.

如果你坚持听到了最后，谢谢你的陪伴。

If you've made it to the end, thank you.

希望这期内容能引发你的思考。

I hope it stirred up some thinking for you.

希望它让你学到了新东西，或者至少让你对整个情况有了更全面的理解。

I hope that it taught you something new or just gave you a better bird's eye view of the situation.

我知道不是所有人都会同意我所说的每一句话。

I know some of you won't agree with everything that I said.

非常欢迎你们的反馈。

Totally welcome feedback.

特别想听听你们的想法。

Would love to hear it.

如果你和朋友也像我和我的朋友一样在讨论这个话题，不妨转给他们。

If this is also something that you and your friends have been discussing, like me and my friends, send it to them.

这依然是一个正在发展的讨论。

It's still an evolving conversation.

我觉得这事儿吧，本来就没有标准答案。

And I feel like it's like, it's one of those things, like, just don't have answers to it.

说到底，唯一的解决办法就是更多钱和更多帮助，但那又不太现实。

Like, the only answer is like more money and more help, but that's kind of unrealistic.

除此之外，如果你和朋友还在聊这个，也把这期节目转给他们吧。

Besides that, though, if you and your friends again have been talking about it, send this episode to them.

也许你们可以继续聊聊这个话题。

Maybe you guys can keep chatting about it.

我和朋友们最近搞了个播客读书会。

Me and my friends have actually been doing this thing where we've been doing like a podcast book club.

其实就是个读书会，只不过读的是播客——每个月我们听五集，然后聚在一起聊聊感受。

So basically, it's like a book club, but for podcasts where we listen to, like, five podcast episodes a month and then get together and discuss them.

你们这期节目说不定就适合我们这个小组。

This could be one of your podcast episodes.

我很想听听你的看法。

I wanna hear your thoughts.

特别感谢我们的研究员莉比，她为这期节目做了大量扎实的研究工作。

I wanna thank our wonderful researcher, Libby, for her wonderful research contributions to this episode.

她真的太出色了，最近一直在研究这个话题，简直让人兴奋不已。

She is truly magnificent, and she's been doing some work on this very topic, which is just, like, so exciting.

如果你想看完整版内容，记得在Instagram和Substack上关注我们。

Make sure that you are following us on Instagram, on Substack if you wanna read the full version of this.

你也可以给我发私信。

You can also DM me.

你可以给我发邮件。

You can email me.

可以在下方留言。

You can leave a comment down below.

你可以在Netflix上观看完整剧集。

You can watch full episodes on Netflix.

关于这一集，你可以做的还有很多。

There's so much that you can do with this episode.

不过，希望你喜欢这一集，我真的希望它能引发你的共鸣和思考。

But, yeah, I hope you enjoyed it, and I just genuinely hope that it stirred up feelings and thoughts for you.

而且，相信它也会就此引发更多讨论。

And, yeah, it's gonna start some more conversations with that in mind.

一如既往，照顾好自己，善待他人，也对自己温柔一点。

As always, be safe, be kind, be gentle to yourself.

我们很快再聊。

We will talk very, very soon.

这一季《亲爱的切尔西》由我和切尔西·汉德勒主持，我们邀请了一些非常棒的嘉宾，比如艾米莉亚·克拉克。

This season on Dear Chelsea with me, Chelsea Handler, we have some fantastic guests like Amelia Clark.

每当年轻人跑过来跟我说他们想当演员之类的，我第一反应总是问，你还能想想别的什么方向吗？

When, like, young people come up to me and they wanna be an actor or whatever, my first thing is always, can you think of anything else

除了这个，你还有别的更想做的事情吗？

that you can do rather be?

毕竟，这是为了你好。

Because Point of end.

一定要这么做。

Do do that.

大卫·奥耶洛沃。

David Oyelowo.

我太喜欢这个播客了，不管是聊心理治疗、感情关系、宗教信仰、性、成瘾问题，还是直接直击灵魂深处。

I love this podcast, whether it's therapy or relationships or religion or sex or addiction or you just go straight for the guts.

丹尼斯·利瑞、《怪奇物语》的盖顿·马塔拉佐、塔娜·蒙戈、卡米拉·马罗内、凯莉·肯尼·西尔弗，还有更多嘉宾。

Dennis Leary, Gaten Matarazzo from stranger things, Tana Mongeau, Camilla Marone, Carrie Kenny Silver, and more.

在 iHeartRadio 应用、Apple 播客或者你常用的任何播客平台收听《亲爱的切尔西》这些节目。

Listen to these episodes of dear Chelsea on the iHeartRadio app, Apple Podcast, or wherever you get your podcasts.

嗨。

Hey.

我是埃德温·卡斯特罗，也叫卡斯特罗十点二一。

It's Edwin Castro, also known as Castro ten twenty one.

我是康基，他的好朋友兼经纪人。

And I'm Conky, his best friend and business manager.

我们新开了一档节目，叫《十点二一播客》。

And we've got a new show called the ten twenty one podcast.

我会带你们看看，我是怎么成为 Twitch 上最受欢迎的主播之一的。

I'm taking you behind the scenes on how I became one of Twitch's most popular streamers.

我们俩都很喜欢体育。

We also love sports.

世界杯马上就要来了，我们会提前剖析在美国举办的这场大赛最值得关注的几大话题。

And with the World Cup right around the corner, we'll be breaking down the biggest storylines ahead of the big tournament here in The USA.

收听《Ten Twenty One》播客，可以在 iHeartRadio 应用、Apple Podcasts，或者你常用的任何播客平台收听。

Listen to the ten twenty one podcast on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

我给自己编的故事，会直接影响我的行为，甚至让我无意中破坏了建立联系的机会。

The story I told myself can then shape my behavior, and that can lead me to sabotage the possibility of connection.

今年心理健康宣传月，快来收听黛比·布朗的《Deeply Well》播客。

This mental health awareness month, tune into the podcast deeply well with Debbie Brown.

如果你一直在寻找一个温柔的落脚点，帮助你慢慢走向完整，那这个播客就是为你准备的。

If you've been searching for a soft place to land while doing the work to become whole, this podcast is for you.

想听更多内容？请在 iHeartRadio 应用、Apple Podcasts，或你常用的任何播客平台收听黛比·布朗的《Deeply Well》，来自 Black Effect 播客网络。

To hear more, listen to deeply well with Debbie Brown from the Black Effect Podcast Network on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

为什么我们所有人都这么痴迷于爱情？

Why are we all so obsessed with romance?

在《Radio 831》播客里，和我们一起来听桑贾娜·巴斯克和泰勒·麦卡勒的分享。

On the Radio eight three one Podcast, join us Sanjana Basker.

我们将深入剖析那些最近大火的情感套路。

And Tyler McCall as we unpack all the trending tropes,

热门改编作品、读书圈的八卦纷争，

buzzy adaptations, book talk drama,

还有名人恋情，配上犀利观点和精彩嘉宾。

and celebrity love stories with hot takes and sharp guests.

每期节目都深入探讨这些故事揭示了当代人对欲望、幻想、身份认同以及爱的方式。

Each episode digs into what these stories reveal about desire, fantasy, identity, and how we love now.

收听Radio 831播客，请在iHeartRadio应用、Apple播客或您常用的播客平台收听。

Listen to the Radio eight three one podcast on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

我是乔伊·达丹诺。

I'm Joey Dardano.

在我的新播客《伪善者的希望》里，我会用有深度的方案去改变人生、帮助有需要的人。

And on my new podcast, Hope From a Hypocrite, I'll be changing lives, helping people in need with thoughtful solutions.

开玩笑的。

Psych.

我是个喜剧演员。

I'm a comedian.

我可没资格给人什么好建议。

I'm not qualified to give good advice.

来和我还有我的喜剧演员朋友们一起，瞎聊、吐槽，推荐一些人类能想到的最不靠谱的建议。

Join me and my comedian friends as we riff, rant, and recommend some of the most legally dubious advice known to man.

这就是来自伪君子的帮助，来自你认识的最蠢的人给出的最差的建议。

This is help from a hypocrite, the worst advice from the dumbest people you know.

每周三收听《来自伪君子的帮助》，在 iHeartRadio 应用、Apple 播客，或者你常用的任何播客平台都能找到。

Listen to help from a hypocrite Wednesdays on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

这是 iHeart 播客。

This is an iHeart podcast.

百分百真人制作。

Guaranteed human.