《大西洋月刊》万一弗洛伊德是对的呢？| 看似过时的精神分析，
字幕摘录
| 时间 | 英文 | 中文 |
|---|---|---|
| 0:03 | You're listening to What If Freud Was Right? | 你在听弗洛伊德说的对吗? |
| 0:06 | A neuroscientist dares to argue | 一个神经科学家敢于争辩 |
| 0:08 | that old fashioned psychoanalysis | 那个老式的心理分析 |
| 0:10 | holds the key to curing mental illness. | 持有治疗精神疾病的关键。 |
| 0:13 | Written by Scott Stossel. | 由斯科特·斯托塞尔编写. |
| 0:15 | Published in the September issue of The Atlantic. | 发表于"大西洋"9月期. |
| 0:17 | Read by Ben Sawyer. | 由本·索伊尔阅读. |
| 0:19 | Produced by Hark Audio, a podcast curation app. | 由Hark Audio制作,一个播客解说应用. |
| 0:22 | You can find this and other narrated Atlantic articles | 你可以找到这篇 和其他描述的大西洋文章 |
| 0:25 | along with curated podcast moments on the Hark Audio app. | 以及哈克音频应用程序的播客时刻 |
展开字幕全文（534 条）
| 序号 | 英文 | 中文 |
|---|---|---|
| 1 | You're listening to What If Freud Was Right? | 你在听弗洛伊德说的对吗? |
| 2 | A neuroscientist dares to argue | 一个神经科学家敢于争辩 |
| 3 | that old fashioned psychoanalysis | 那个老式的心理分析 |
| 4 | holds the key to curing mental illness. | 持有治疗精神疾病的关键。 |
| 5 | Written by Scott Stossel. | 由斯科特·斯托塞尔编写. |
| 6 | Published in the September issue of The Atlantic. | 发表于"大西洋"9月期. |
| 7 | Read by Ben Sawyer. | 由本·索伊尔阅读. |
| 8 | Produced by Hark Audio, a podcast curation app. | 由Hark Audio制作,一个播客解说应用. |
| 9 | You can find this and other narrated Atlantic articles | 你可以找到这篇 和其他描述的大西洋文章 |
| 10 | along with curated podcast moments on the Hark Audio app. | 以及哈克音频应用程序的播客时刻 |
| 11 | To announce that you are embarking | 宣布你即将启程 |
| 12 | on a course of psychoanalytic training today | 今天的心理分析课程 |
| 13 | is tantamount in many quarters. | 在许多方面是等同的。 |
| 14 | To admitting that you plan to treat your patients | 承认你打算治疗你的病人 |
| 15 | using astrology or by parsing the entrails of a goat. | 利用占星术 或通过分析山羊的内脏 |
| 16 | To say that you are undergoing psychoanalysis as a patient | 说你正在接受心理分析 作为一个病人 |
| 17 | is to reveal that you are entrusting your mental health | 说明你正在委托你的精神健康 |
| 18 | to a witch doctor. | 给巫医 |
| 19 | So if I were to tell you that a respected neuroscientist | 所以如果我告诉你 一个受人尊敬的神经科学家 |
| 20 | has undertaken to exhume Sigmund Freud | 已经承诺挖掘西格蒙德·弗洛伊德 |
| 21 | and make a case for both his theory of mind | 并为自己的思想理论辩护 |
| 22 | and his psychoanalytic method as the best, | 他的精神分析方法是最好的, |
| 23 | indeed the only, approach that can cure emotional disorders, | 确实是唯一能治愈情绪紊乱的方法 |
| 24 | you would likely rate that as a quixotic project | 你可能会把它评为精品项目 |
| 25 | and it's author perhaps a candidate | 而作者也许是一个候选人 |
| 26 | for serious therapy himself. | 认真治疗自己。 |
| 27 | Freud's cultural and scientific influence | 弗洛伊德的文化和科学影响 |
| 28 | crested some 70 years ago. | 大约70年前的峰值。 |
| 29 | And much of psychiatry's history since then | 之后的精神病学史 |
| 30 | has consisted of a renunciation of the man, | 包括放弃此人, |
| 31 | his concepts and his therapeutic techniques | 他的思想和治疗技巧 |
| 32 | so comprehensive as to have an edge of savagery, | 如此全面以至于有 野蛮的边缘, |
| 33 | even vengeance to it. | 甚至报复它。 |
| 34 | He has been deemed a sexist, a misogynist, a bully, | 他被认为是性别歧视者,厌恶女性主义者,欺负者, |
| 35 | a narcissist, a homophobe, a pervert, an addict, | 一个自恋狂,一个同性恋,一个变态,一个瘾君子, |
| 36 | an opportunist, a plagiarist, a fabulist | 一个机会主义者,一个盗贼,一个流浪者 |
| 37 | and a scientific fraud, as well as a disloyal friend | 和不忠的朋友, |
| 38 | and a credit stealing protege, | 和偷钱者, |
| 39 | not to mention a bungling incompetent therapist. | 更别提一个笨拙的无能治疗师了 |
| 40 | Quote, a dogmatist who browbeat his patients | 引用一个教条主义者,他打他的病人 |
| 41 | and consistently failed to mark the crucial difference | 并且始终未能表明关键区别 |
| 42 | between their fantasies and his own. | 在他们的幻想和他自己之间 |
| 43 | End quote. | 终引文. |
| 44 | So sums up the flap copy on a collection | 所以总结一下收藏品上的片段 |
| 45 | of Freud filetting essays by 18 psychiatrists, | 佛洛伊德的论文 18个精神病医生, |
| 46 | philosophers, historians and others compiled in 1998 | 1998年编纂的哲学家,历史学家等. |
| 47 | by Frederick Cruz, a literary critic | 由文学评论家弗雷德里克·克鲁斯编剧 |
| 48 | and one time devout Freudian turned virulent heretic. | 有一次虔诚的弗洛伊德人 变成了邪恶的异教徒 |
| 49 | If coroners were to pin an actual time of death | 如果验尸官确定死亡时间 |
| 50 | on Freudianism, they might specify 1963. | 关于弗洛伊德主义,他们可能具体提到1963年。 |
| 51 | That year, the philosopher of science, Karl Popper | 当年,科学哲学家卡尔·波普 |
| 52 | held up psychoanalytic theory as the archetypal instance | 将心理分析理论作为典型案例 |
| 53 | of what he called, quote, pseudoscience. | 他所说的伪科学 |
| 54 | Worse than mere bad science, psychoanalysis was | 比单纯的糟糕科学更糟糕, 心理分析是 |
| 55 | and being untestable, simply not science. | 而且是无法检验的 根本不是科学 |
| 56 | Based in large part on the highly speculative interpretation | 主要基于高度投机性的解释 |
| 57 | of imperfectly recalled dreams of all things, | 那是不完全的梦境, |
| 58 | psychoanalytic theory was impervious | 心理分析理论不透气 |
| 59 | to real scientific inquiry. | 到真正的科学调查。 |
| 60 | And presuming to explain everything Popper pronounced, | 并假设解释一切 波普宣布, |
| 61 | psychoanalysis explained nothing at all. | 心理分析完全没有解释 |
| 62 | So who today would dare attempt a rehabilitation of Freud? | 那么今天谁敢试图让弗洛伊德康复? |
| 63 | And why? | 为什么? |
| 64 | To take the second question first, here's one reason. | 先问第二个问题,有一个原因。 |
| 65 | What has followed Freudianism has not been, | 佛洛伊德主义的后遗症不是 |
| 66 | by many reckonings, any better. | 以许多比这更好的清算。 |
| 67 | In the 1970s, the mental health profession fled | 1970年代,精神卫生专业逃离 |
| 68 | from such squishy psychological concepts | 从这种令人毛骨悚然的心理概念 |
| 69 | as transference and counter-transference, | 作为转移和反转移, |
| 70 | the death drive, and seduction theory, | 死亡的驱动力和诱惑理论, |
| 71 | as well as more outlandish ones like penis envy, | 以及像阴茎羡慕之类的野外人 |
| 72 | castration anxiety, and the Oedipal complex, | 阉割焦虑 和Oedipal综合体, |
| 73 | and leaned instead into biological psychiatry, | 转而从事生物学精神病学, |
| 74 | which had emerged from the drug discoveries | 从药物发现中发现的 |
| 75 | of the 1950s and 60s. | 20世纪50年代和60年代 |
| 76 | Physiological notions took hold, | 生理观念得到确立, |
| 77 | such as the catecholamine hypothesis of effective disorders, | 例如有效紊乱的丙胺假说, |
| 78 | which attributed anxiety and depression | 导致焦虑和抑郁 |
| 79 | to deficits of the neurotransmitters, | 至神经递质的不足, |
| 80 | such as norepinephrine and dopamine. | 比如新肾上腺素和多巴胺 |
| 81 | Three decades later, in the 1990s, | 三十年后,在1990年代, |
| 82 | the chemical imbalance theory of depression arrived, | 抑郁症的化学失衡理论已经到来, |
| 83 | tying depression and other mood disorders | 将抑郁症和其他情绪紊乱联系起来 |
| 84 | to dysregulation of another neurotransmitter, serotonin. | 对另一个神经递质 血清素的调节 |
| 85 | Psychoanalysts' highly subjective assessments gave way | 心理分析家的高度主观评价被放弃了 |
| 86 | to the ostensibly more objective measurements | 对表面上更客观的测量 |
| 87 | provided by neuroscientific instruments | 由神经科学仪器提供 |
| 88 | that can capture brain activity, | 可以捕捉大脑活动, |
| 89 | 例如EEGs,PET扫描和fMRIIs. | |
| 90 | Doctors turned to genetic testing | 医生转向基因测试 |
| 91 | to help identify various temperament types | 帮助识别各种脾气类型; |
| 92 | and emotional predispositions, | 和感情上的倾向, |
| 93 | and relied on standardized questionnaires | 并依赖标准化调查问卷 |
| 94 | assessed for their validity in diagnosing mental illness. | 评估其诊断精神病的有效性。 |
| 95 | In repudiating Freudianism | 拒绝弗洛伊德主义 |
| 96 | and touting the field's proper medical grounding, | 并展示球场 适当的医疗基础, |
| 97 | science-based psychiatry confidently predicted | 基于科学的精神病学有自信的预测 |
| 98 | that measurable success was soon to come. | 这一可衡量的成功很快就要来了。 |
| 99 | That's not what happened. | 事情不是这样的 |
| 100 | Biological psychiatry, quote, | 生物精神病学,引文: |
| 101 | overreached, overpromised, overdiagnosed, overmedicated, | 过度接触,过度承诺,过度诊断,过度用药, |
| 102 | end quote, as the Harvard medical historian Ann Harrington | 作为哈佛医学史学家安·哈灵顿的结尾 |
| 103 | put it in 2019, which raises the question | 写在2019年 这引起了一个问题 |
| 104 | of whether psychiatry has simply exchanged | 精神病学是否只是交换 |
| 105 | one form of witchcraft for another. | 一种巫术 另一种巫术。 |
| 106 | The champions of so-called anti-psychiatry | 所谓反精神病的冠军 |
| 107 | and critical psychiatry, | 和严重的精神病, |
| 108 | now emboldened by Secretary of Health and Human Services | 现在被卫生与公众服务部的 部长所壮大 |
| 109 | Robert F. Kennedy Jr. and the Maha Movement, | 小罗伯特·肯尼迪和马哈运动, |
| 110 | certainly think so. | 当然可以 |
| 111 | So do some leading figures in biological psychiatry. | 生物精神病学的一些主要人物也一样。 |
| 112 | As the head of the National Institute of Mental Health | 担任国家心理健康研究所所长 |
| 113 | from 2002 to 2015, Thomas Ensell tried to root America's | 从2002年到2015年,托马斯·恩塞尔试图根植美国 |
| 114 | approach to mental health care | 精神保健办法 |
| 115 | more firmly in brain physiology | 更坚定的大脑生理学 |
| 116 | and the emerging understanding of genetics | 遗传学的新认识 |
| 117 | than in the nebulous concepts of Freudianism. | 而不是佛洛伊德主义的模糊概念 |
| 118 | But in 2017, when he looked back on the $20 billion | 但是在2017年,当他回顾200亿美元时 |
| 119 | he'd spent on the endeavor, his verdict was bleak. | 他花在努力上, 他的判决是暗淡的。 |
| 120 | Quote, I don't think we moved the needle | 引用,我不认为我们移动了针 |
| 121 | in reducing suicide, reducing hospitalizations, | 减少自杀 减少住院 |
| 122 | improving recovery for the tens of millions of people | 改善数千万人的复苏 |
| 123 | who have mental illness, end quote. | 有精神病的人,最后引用。 |
| 124 | What biological psychiatry once promised | 曾经承诺过的生物精神病学 |
| 125 | seemed revolutionary. | 看起来是革命性的。 |
| 126 | From the suffering patient's perspective, | 从病人的角度看 |
| 127 | what is delivered has been marginal. | 所交付的东西是微不足道的。 |
| 128 | Still, reverting to the nostrums | 不过,回到鼻孔 |
| 129 | of a disgraced Victorian quack seems a little like saying | 维多利亚州一个丢脸的乡巴佬 似乎有点喜欢说 |
| 130 | this modern medical technique isn't working so well. | 这种现代医疗技术效果不太好 |
| 131 | Let's go back to using leeches. | 让我们回到使用水貂。 |
| 132 | Well, as it happens, leeches have become an important part | 水貂已经成为重要的一部分 |
| 133 | of the modern reconstructive surgeon's toolkit | 现代重建外科医生工具包 |
| 134 | for use in skin grafts after surgeries, among other things. | 用于手术后的皮肤移植,等等。 |
| 135 | Might Freudianism be psychiatry's leech | 可能弗洛伊德主义是精神病学的精液 |
| 136 | resurrected for the astonishing health benefits | 为了惊人的健康利益复活 |
| 137 | it contained all along? | 它一直包含着? |
| 138 | The platonic ideal of the person who might dare | 勇敢的人的柏拉图理想 |
| 139 | to make this case would look a lot like Mark Psalms, | 为了让这个案子看起来很像马克·萨尔姆斯 |
| 140 | the author of the new book, The Only Cure, | 这本新书的作者, |
| 141 | Freud and the Neuroscience of Mental Healing. | 弗洛伊德与精神治疗神经科学. |
| 142 | He is a South African neuroscientist | 他是南非神经科学家 |
| 143 | armored with a sturdy resume and hundreds of articles | 装有坚固的履历和数百篇文章 |
| 144 | in scientific journals, | 在科学期刊上, |
| 145 | along with half a dozen books and counting. | 与半打的书和计数。 |
| 146 | His lab discovered the specific pathway | 他的实验室发现了具体的路径 |
| 147 | in the forebrain responsible for stimulating dreams, | 以能刺激梦想的预产物发誓, |
| 148 | and he disproved the notion that dreaming | 他反驳了梦境 |
| 149 | is dependent on REM sleep. | 依赖REM睡眠。 |
| 150 | He's also done extensive research | 他也做了广泛的研究 |
| 151 | into the science of consciousness. | 进入意识的科学。 |
| 152 | Psalms is a practicing psychoanalyst as well. | 诗歌也是心理分析家 |
| 153 | He treats neurological disorders, | 他治疗神经疾病, |
| 154 | stroke, Parkinson's dementia, | 中风,帕金森的痴呆, |
| 155 | in addition to psychiatric disorders, | 除了精神疾病之外, |
| 156 | anxiety, depression, psychosis. | 焦虑,抑郁,精神病。 |
| 157 | He's coined a term, neuropsychoanalysis, | 他发明了一个术语,神经心理分析, |
| 158 | to describe his clinical work | 描述他的临床工作 |
| 159 | because he buttresses traditional psychoanalytic techniques, | 因为他支持 传统的心理分析技术, |
| 160 | free association and dream interpretation, | 自由结社和梦想的诠释, |
| 161 | among other methods of probing the unconscious, | 除了其他调查无意识者的方法之外, |
| 162 | with the more recent findings of neuroscience. | 与神经科学的最新发现。 |
| 163 | Much of his research has involved trying | 他的研究大多涉及尝试 |
| 164 | to use modern technology to demonstrate | 使用现代技术进行演示 |
| 165 | the scientific underpinning | 科学基础 |
| 166 | of certain Freudian concepts and theories. | 某些弗洛伊德的概念和理论。 |
| 167 | For instance, Psalms says that the pleasure-seeking drive, | 例如,"诗经"说,追求快乐的驱动器, |
| 168 | the source of Freud's pleasure principle, | 弗洛伊德的快乐原则的来源, |
| 169 | is located in the brain networks | 位于大脑网络中 |
| 170 | that communicate via dopamine, | 通过多巴胺进行交流, |
| 171 | and he has mapped the superego | 他画了超能力 |
| 172 | onto a region of the prefrontal cortex | 进入前额皮层的区域 |
| 173 | involved in emotional regulation. | 参与情绪调控。 |
| 174 | A neuroscientist who is also a practicing psychoanalyst | 神经科学家,他同时也是心理分析家 |
| 175 | is a rare bird, but Psalms is rarer still, | 是一种稀有的鸟 但诗歌还是比较稀有 |
| 176 | having spent the past 29 years | 过去29年 |
| 177 | completing a revised translation | 完成订正翻译 |
| 178 | of the complete works of Freud. | 佛洛伊德的完整作品。 |
| 179 | 24 volumes were published in 2024, | 2024年出版了24卷, |
| 180 | and an additional four | 和另外四个 |
| 181 | consisting of his writings on neuroscience, | 包括他的神经科学著作 |
| 182 | including some that have never previously | 包括以前从未有过的 |
| 183 | been published in English, are due out in 2028. | 以英文出版,2028年到期。 |
| 184 | Making available previously overlooked writing | 提供先前被忽略的文字 |
| 185 | has given Psalms a chance to correct the misimpression | 给了诗歌一个纠正错误印象的机会 |
| 186 | that Freud was homophobic. | 弗洛伊德是同性恋者。 |
| 187 | In a letter to a woman who had asked him to, quote, | 在给一个女人的信中 他曾要求他引用 |
| 188 | cure her son's homosexuality, | 治愈她儿子的同性恋 |
| 189 | Freud writes that being gay, quote, | 弗洛伊德写道,同性恋,引用 |
| 190 | is nothing to be ashamed of, no vice, no degradation. | 没有什么可羞愧的, 没有恶习, 没有退化。 |
| 191 | It cannot be classified as an illness, end quote. | 它不能归类为疾病,最后引文。 |
| 192 | This last bit is ironic | 这最后一点很讽刺 |
| 193 | in light of the American Psychiatric Association's | 鉴于美国精神病学协会 |
| 194 | official classification of homosexuality | 同性恋的官方分类 |
| 195 | as a sociopathic personality disturbance, | 作为一个反社会人格的干扰, |
| 196 | or sexual deviation, until 1973. | 或性偏差,直到1973年。 |
| 197 | Freud goes on to note | 弗洛伊德接着说 |
| 198 | that some of the most accomplished figures in history, | 历史上最有成就的数字, |
| 199 | Plato, Michelangelo, Leonardo da Vinci, were gay, | 柏拉图 米开朗基罗 莱昂纳多·达芬奇 是同性恋 |
| 200 | and ends by saying that although psychoanalysis | 最后说 虽然心理分析 |
| 201 | can help her son become happier, | 可以帮助她的儿子变得更快乐, |
| 202 | less neurotic, and more productive, | 神经质更弱 生产力更强 |
| 203 | none of that will have anything to do | 这些都没什么可做的 |
| 204 | with his sexual orientation. | 他的性倾向。 |
| 205 | I suspect more than a few Freud detractors | 我怀疑不止几个弗洛伊德诽谤者 |
| 206 | will be surprised to read this. | 读这个会很惊讶 |
| 207 | By Psalms' own estimation, there might be, | 根据萨尔姆斯自己的估计,也许, |
| 208 | quote, nobody alive who has spent more time | 引用,没有人活着 谁花了更多的时间 |
| 209 | with Freud than I have, | 与弗洛伊德比我有, |
| 210 | but Psalms is no doctrinaire acolyte | 但"诗经"不是理论学说 |
| 211 | as guardians of the Freudian flame have tended to be. | 作为佛洛伊德火焰的守护者 |
| 212 | Ernest Jones, an influential early director | 欧内斯特·琼斯,一位有影响力的早期导演 |
| 213 | of the International Psychoanalytical Association, | 国际心理分析协会, |
| 214 | believed his role was to create a secret committee, | 相信他的作用是建立一个秘密委员会 |
| 215 | 引用,就像Charlemagne的古板, 结尾引用, | |
| 216 | to protect Freudian theory against heresy. | 保护弗洛伊德理论 对抗异端。 |
| 217 | Psalms, in contrast, embraces some major criticisms | 与此相反,诗歌中包含了一些重大的批评 |
| 218 | of Freud, calling the death drive, for example, | 例如,弗洛伊德的死亡之声 |
| 219 | quote, an egregious error, end quote. | 引用,一个惊人的错误,结尾引用。 |
| 220 | As for Freud's rather idiosyncratic theories about sex, | 至于弗洛伊德比较典型的性理论, |
| 221 | Psalms writes, quote, I don't think there's any | "诗经"写道,引用,我不认为有 |
| 222 | getting around the conclusion that Freud had this stuff | 得到一个结论 弗洛伊德有这种东西 |
| 223 | seriously muddled, end quote. | 严重的泥, 结尾引用。 |
| 224 | Part of Psalms' premise in this book | 本书中诗篇的部分前提 |
| 225 | is implicit and inarguable. | 是隐含和不可辩驳的。 |
| 226 | Despite the attempts to purge Freudianism from psychiatry, | 尽管试图从精神病学中清除弗洛伊德主义, |
| 227 | its tropes, terms, and concepts, | 其词条、术语和概念, |
| 228 | the unconscious, the id, ego, and superego, | 失去知觉 身份 自我 和超能力 |
| 229 | sublimation, defense mechanisms, the obsession with sex, | 潜伏 防御机制 对性痴迷 |
| 230 | the importance of early childhood experiences, | 幼儿期经历的重要性, |
| 231 | have seeped so deeply into our cultural limbic system | 已经深深渗入我们的文化边缘系统 |
| 232 | that they live on in the shared metaphors and terminology | 他们生活在共同的比喻和术语中 |
| 233 | we use to discuss personality and mental health. | 我们经常讨论个性和精神健康 |
| 234 | Frank is anal. | 弗兰克是肛门。 |
| 235 | Mary is repressed. | 玛丽被压抑了 |
| 236 | Donald Trump is a narcissist and an egomaniac. | 唐纳德·特朗普(Donald Trump)是一个自恋者和自大狂. |
| 237 | Jill Biden was in denial. | 吉尔・拜登在否认。 |
| 238 | When Freud died in 1939, | 1939年弗洛伊德去世时, |
| 239 | W.H. | (原始内容存档于2018-09-21). W.H. |
| 240 | Auden wrote that he had become, quote, | 奥登写道,他已经成为,引用, |
| 241 | a whole climate of opinion | 整个舆论气氛 |
| 242 | under whom we conduct our different lives. | 我们在谁的领导下过着不同的生活 |
| 243 | But the two explicit arguments Psalms makes | 但两个明确的论点 诗篇提出 |
| 244 | on Freud's behalf in The Only Cure | 代表弗洛伊德在"唯一的库尔" |
| 245 | are astonishingly ambitious and contentious. | 令人惊讶的是雄心勃勃和有争议的。 |
| 246 | In The Only Cure are astonishingly ambitious. | 在"唯一库尔"中,令人惊奇的雄心勃勃。 |
| 247 | In The Only Cure are astonishingly ambitious | 在"唯一库尔"中,令人惊奇的雄心壮志 |
| 248 | and contentious. | 和争议。 |
| 249 | The first is that Freud deserves credit | 第一,弗洛伊德值得称赞 |
| 250 | for neuroscientific prescience. | 用于神经科学前科学. |
| 251 | A recent history of neuroscience states baldly | 神经科学的近代史 发光了 |
| 252 | Freud had nothing novel or insightful to say | 弗洛伊德没有什么新颖的 或深刻的说 |
| 253 | about how the brain worked, end quote. | 关于大脑是如何工作的,最后引文。 |
| 254 | On the contrary, according to Psalms, | 相反,根据"诗经", |
| 255 | many prevailing theories about how the brain functions | 许多关于大脑如何运作的主要理论 |
| 256 | were first worked out by Freud. | 最初由弗洛伊德设计 |
| 257 | For instance, Psalms writes, | 例如,诗人写道, |
| 258 | Freud effectively identified the way | 弗洛伊德有效地确定了道路 |
| 259 | that short-term memories get consolidated | 短期记忆得到巩固 |
| 260 | into long-term ones, | 变成长期的, |
| 261 | and did so more than half a century | 半个多世纪以来 |
| 262 | before the neurochemical mechanism for this was discovered. | 在发现神经化学机制之前 |
| 263 | To bolster his case here, | 为了巩固他的案子 |
| 264 | Psalms marshals the very man | 诗歌唤醒了这个人 |
| 265 | who identified that particular mechanism, | 确定了这一特定机制, |
| 266 | Eric Kandel, who won the Nobel Prize in Physiology | 获诺贝尔生理学奖的埃里克·坎德尔 |
| 267 | or Medicine for doing so, | 或为此提供的药品, |
| 268 | and who agrees with Psalms that psychoanalysis | 他们同意《诗经》的精神分析 |
| 269 | is, quote, the most coherent | 是,引用,最一致的 |
| 270 | and intellectually satisfying view of the mind, | 和智力上令人满意的观点 心灵, |
| 271 | end quote, we have, | 结尾引用,我们有, |
| 272 | and that neuroscience is the, quote, | 而神经科学是,引用, |
| 273 | new intellectual framework, end quote, | 新的知识框架,最后引文, |
| 274 | that can reinvigorate psychiatry. | 它可以重振精神病学。 |
| 275 | Or consider Freudianism's key concept, the unconscious. | 或者考虑弗洛伊德主义的关键概念,即无意识. |
| 276 | Freud argued that our personalities and behaviors | 弗洛伊德认为我们的个性和行为 |
| 277 | are governed by a maelstrom of hidden drives | 由隐藏的驱动器控制 |
| 278 | and motivations mostly unknown to our conscious selves. | 以及我们自己所不知道的动机 |
| 279 | What we experience as our conscious life | 我们作为有意识的生活所经历的 |
| 280 | is in fact only a post hoc rationalization | 事实上,这只是一个事后的合理化 |
| 281 | of things we are doing for other reasons, | 我们所做的其他事情, |
| 282 | a devastating blow against not just human rationality, | 对人理性的毁灭性打击, |
| 283 | but even free will. | 但即使是自由意志。 |
| 284 | For years, evidence of the unconscious | 多年来,无意识的证据 |
| 285 | seemed inaccessible to objective science. | 似乎无法以科学为目标 |
| 286 | How can you prove the existence of something | 你怎么能证明有什么东西存在 |
| 287 | that none of us, by definition, | 根据定义,我们没有人 |
| 288 | can be subjectively aware of? | 可以主观上知道吗? |
| 289 | But technologies unavailable to Freud | 但弗洛伊德没有技术 |
| 290 | have demonstrated that much of what happens in the brain | 证明了大脑中发生的很多事情 |
| 291 | is in fact unconscious. | 事实上是无意识的。 |
| 292 | Studies using fMRI machines have revealed | 使用fMRI机的研究显示 |
| 293 | that when frightening images or angry faces | 当恐怖的影像或愤怒的面孔的时候, |
| 294 | are shown to people too fast for them | 被显示在人们面前太快了 |
| 295 | to consciously perceive them, | 以便他们觉悟, |
| 296 | their brains nevertheless register the fear stimuli. | 然而他们的大脑却记录了恐惧的刺激。 |
| 297 | The machines detect a flare of activity in the amygdala, | 机器在阿米格达拉探测到活动信号 |
| 298 | which is followed by a surge in heart rate, | 随之而来的是心率的暴涨, |
| 299 | blood pressure, and stress hormones, among other responses. | 血压和应激激素等反应. |
| 300 | The feeling of fear in the body | 体内的恐惧感 |
| 301 | then breaks into consciousness, | 然后觉悟, |
| 302 | and the brain makes decisions in response to that. | 而大脑会做出相应的决定 |
| 303 | It has become hard to deny that, | 很难否认 |
| 304 | at least in basic outline, | 至少在基本大纲中, |
| 305 | Freud was right about the unconscious. | 弗洛伊德对失去知觉的看法是对的 |
| 306 | Psalms's second explicit claim is, if anything, | 萨尔姆斯的第二项明确主张是,如果有的话, |
| 307 | even more provocative. | 更挑衅。 |
| 308 | There is abundant evidence, he writes, | 他说:有许多迹象, |
| 309 | that psychoanalysis and its offshoots | 心理分析及其结论 |
| 310 | are astoundingly effective. | 令人惊叹的是, |
| 311 | In some cases, he argues, quote, | 在某些情况下,他辩称, |
| 312 | as dependable as, say, insulin is | 就像胰岛素一样可靠 |
| 313 | at managing type 1 diabetes, | 管理1型糖尿病, |
| 314 | or as the HPV vaccine is at preventing cervical cancer. | 或作为HPV疫苗用于预防宫颈癌。 |
| 315 | These treatments are so well proven | 这些治疗方法已经证明 |
| 316 | that it would strike most doctors as, | 大部分医生认为 |
| 317 | to use a technical term, | 使用技术术语, |
| 318 | crazy not to deploy them by default, end quote. | 疯狂的不部署 默认,句号。 |
| 319 | Psalms's unqualified endorsement of psychoanalysis | 诗人无条件认可心理分析 |
| 320 | is startling after decades of criticism. | 在几十年的批评之后,令人吃惊。 |
| 321 | In support, Psalms cites a number of studies and papers | 作为佐证,Psalms引用了一些研究报告和论文 |
| 322 | from the past 40 years to show | 从过去40年到现在 |
| 323 | that psychoanalytic-style talk therapy | 心理分析式的谈话疗法 |
| 324 | is more effective than antidepressants | 比抗抑郁药更有效 |
| 325 | or electroconvulsive therapy for depression, | 或抑郁症的电休克疗法, |
| 326 | or than antipsychotics for schizophrenia. | 或是精神分裂症的抗精神病药物 |
| 327 | He also cites research demonstrating | 他还引用了证明 |
| 328 | that psychoanalysis has a robust sleeper effect. | 心理分析有很强的潜伏效应 |
| 329 | That is, symptoms continue to improve | 也就是说,症状继续改善 |
| 330 | long after the treatment has ended. | 在治疗结束很久之后 |
| 331 | These results are so striking | 这些结果太惊人了 |
| 332 | that I decided to look at the underlying studies | 我决定看看基础研究 |
| 333 | and some other relevant ones. | 和其他一些相关的。 |
| 334 | I found that Psalms is highly selective in what he cites | 我发现"诗经"在引用中很有选择性 |
| 335 | and elides a lot of nuance, | 和许多细微的, |
| 336 | and sometimes directly contradictory evidence, | 和有时直接矛盾的证据, |
| 337 | in service of his case for psychoanalytic-style therapy | 为他治疗精神分析型的病案服务 |
| 338 | and against other forms of therapy, | 和反对其他形式的治疗, |
| 339 | especially pharmacotherapy. | 特别是药物疗法 |
| 340 | Cherry-picking is not unusual, | 摘樱桃不是不寻常的 |
| 341 | especially when dealing with studies | 特别是在研究方面 |
| 342 | that are hard to compare, | 那是难以比拟的, |
| 343 | but the conclusions that flow from it | 但由此产生的结论 |
| 344 | are usually accompanied by a degree of circumspection. | 通常伴随着某种程度的谨慎。 |
| 345 | Psalms's verdicts are categorically blunt. | "诗经"的判决断然直截了当. |
| 346 | Quote, nearly every psychiatric disorder | 引用,几乎每一个精神障碍 |
| 347 | listed and defined in the standard diagnostic manuals | 标准诊断手册列出和定义 |
| 348 | is best understood and treated, | 得到最好的理解和待遇, |
| 349 | not pharmacologically, but psychologically, end quote. | 不是药学上的 而是心理上的 最后引言 |
| 350 | And quote, there are, as things stand, | 并引用,有, 目前的情况, |
| 351 | no physiological cures in psychiatry, end quote. | 在精神病学里没有生理治疗方法,最后引文。 |
| 352 | And perhaps most bracing, quote, | 也许最有说服力的话 |
| 353 | the mainstay of modern psychiatry, psychopharmacology, | 现代精神病学、精神药品学、 |
| 354 | is for the most part a defense against facing the facts | 大部分是面对事实的辩护 |
| 355 | about what our patients really need. | 我们的病人真正需要什么 |
| 356 | It is a way of suppressing symptoms | 这是抑制症状的方法 |
| 357 | instead of asking what they mean and fixing that, end quote. | 而不是问他们是什么意思 和修复,结尾引文。 |
| 358 | Psalms's position aligns him, probably unintentionally, | 诗人的立场与他一致 可能是无意的 |
| 359 | with the public pronouncements that RFK Jr. has issued | 小RFK发表的公开声明 |
| 360 | about SSRI antidepressants and his role as HHS secretary, | 关于SSRI抗抑郁药和他作为HHS秘书的角色, |
| 361 | which made the American Psychiatric Association Convention | 使《美国精神病学协会公约》 |
| 362 | in May jangly with tension. | 5月,局势紧张。 |
| 363 | Antidepressants are useless, | 抗抑郁药是没用的 |
| 364 | Kennedy has said at various times. | 肯尼迪在不同时间说过 |
| 365 | They are more addictive than heroin, | 他们比海洛因更上瘾 |
| 366 | result in brain damage, | 导致脑损伤, |
| 367 | and could be partially responsible for school shootings. | 并且可能对学校枪击事件负部分责任。 |
| 368 | None of this is true, | 这一切都不是真的 |
| 369 | but one reason demagoguing against medication has been easy | 但有一个理由 贬低药物是容易的 |
| 370 | is that the biological model of psychiatry, | 精神病学的生物学模型 |
| 371 | although filling the coffers of pharmaceutical companies, | 虽然填补了制药公司的国库, |
| 372 | has delivered no panaceas, | 他们没有施舍任何灵丹, |
| 373 | instead fueling cycles of disenchanted overreaction. | 反而助长了幻觉过度的循环 |
| 374 | Today, one in six Americans takes an antidepressant. | 今天,六分之一的美国人服用抗抑郁药. |
| 375 | No wonder APA attendees were on edge. | 难怪APA的参与者们都陷入了困境。 |
| 376 | Psalms does concede that while no physiological cures | "诗经"确实承认,虽然没有生理治疗方法 |
| 377 | exist in psychiatry, | 在精神病学中, |
| 378 | physiological treatments can remediate symptoms. | 生理治疗可以补救症状. |
| 379 | That Advil doesn't cure pain doesn't stop people | 阿德维尔治不好疼痛 也阻止不了人 |
| 380 | from taking the drug to alleviate it. | 从服用药物来缓解它。 |
| 381 | Still, his broadside against pharmacology seems over-brawled. | 不过,他反对药理学的侧面似乎过于粗糙。 |
| 382 | Although it is surely true that many of those | 虽说其中很多 |
| 383 | who take SSRI antidepressants do not need | 服用SSRI抗抑郁药的人不需要 |
| 384 | and should not be on them, | 绝不然, |
| 385 | it is also true that many others would be debilitated | 还有很多人也会被削弱 |
| 386 | if not dead without them. | 如果没有他们就不会死 |
| 387 | Before Freud became a psychiatrist, | 在弗洛伊德成为心理医生之前 |
| 388 | he himself was a neuroanatomist. | 他本人是神经麻醉师 |
| 389 | Some of his early research was on the gonads of eels | 他早期的一些研究 是关于鳗鱼的 |
| 390 | and the nervous systems of crayfish. | 还有龙虾的神经系统 |
| 391 | But given the tools available to him in the 1890s, | 但考虑到1890年代他掌握的工具 |
| 392 | he kept bumping up against the limits | 他不断撞到极限 |
| 393 | of what the physical brain could reveal | 身体大脑能揭示什么 |
| 394 | about the functioning of the mind. | 关于心灵的功能。 |
| 395 | Frustrated and in need of money, | 失望和需要钱, |
| 396 | he put aside the microscope, | 他把显微镜放在一边, |
| 397 | opened a private practice, | 开一门私塾, |
| 398 | and began focusing instead on clinical observation | 开始专注于临床观察 |
| 399 | of patients and of his own mind. | 和他自己的心灵。 |
| 400 | Study in consciousness | 意识学习 |
| 401 | and the unconscious brain that lay beneath it, | 和潜伏在脑下的无意识的大脑, |
| 402 | from the inside was how Freud constructed | 佛洛伊德是怎样构建的 |
| 403 | psychoanalytic theory. | 心理分析理论. |
| 404 | He sometimes expressed embarrassment at this approach. | 他有时对这种做法表示尴尬。 |
| 405 | Quote, it still strikes me myself as strange | 引用一下,我还是觉得奇怪 |
| 406 | that the case histories I write | 我写的案件记录 |
| 407 | should read like short stories and that, as one might say, | 读起来应该像短篇小说一样 正如人们可能说过的 |
| 408 | they lack the serious stamp of science, end quote. | 他们缺乏科学的严肃的印记,最后引文。 |
| 409 | He reflected in his foundational studies on hysteria in 1895. | 他在1895年对歇斯底里症的奠基研究中有所反映. |
| 410 | Freud never abandoned his quest | 弗洛伊德从未放弃他的追求 |
| 411 | to link physiology and psychology. | 将生理学和心理学联系起来。 |
| 412 | Quote, we must recollect that all our provisional ideas | 引用一下,我们必须记住我们所有的临时想法 |
| 413 | in psychology will presumably someday be based | 在心理学中,大概总有一天会得到 |
| 414 | on an organic substructure, end quote. | 在有机亚结构, 结尾引文。 |
| 415 | He wrote in 1914. | 他在1914年写作. |
| 416 | In 1938, not long before his death, | 1938年,在他去世前不久, |
| 417 | Freud was still at it. | 弗洛伊德还在做 |
| 418 | Quote, the future may teach us | 引文,未来可能告诉我们 |
| 419 | to exercise a direct influence | 直接施加影响 |
| 420 | by means of particular chemical substances | 使用特定化学物质 |
| 421 | on the amounts of energy and their distribution | 能源数量及其分配 |
| 422 | in the mental apparatus. | 在精神机构。 |
| 423 | Psalms has picked up the baton, | 诗人拿起警棍 |
| 424 | but he is adamant that we have not reached the future | 但他坚持我们没有到达未来 |
| 425 | that Freud was forecasting. | 弗洛伊德在预测 |
| 426 | Rather, his view is that we need to go back | 相反,他认为我们需要回去 |
| 427 | to Freud's true aim, to treat the soul, | 为了弗洛伊德的真正目的 对待灵魂 |
| 428 | not by ministering to the brain | 不是通过管理大脑 |
| 429 | as modern biological psychiatry does, | 就像现代生物精神病学那样 |
| 430 | but, quote, by accepting that the soul, | 但是,引用一下,通过接受灵魂, |
| 431 | construed as the experiencing, active, living eye, | 被理解为 体验,活跃,活眼, |
| 432 | is a part of nature, end quote. | 是自然的一部分,最后引文。 |
| 433 | And he has company even among clinicians who came of age | 而且他也有伴 即使是临床医生 来岁 |
| 434 | during the rise of biological psychiatry. | 在生物精神病学兴起期间 |
| 435 | Patients with psychosis are, quote, | 精神病患者是,引文: |
| 436 | too fascinating and complex to be reduced | 太迷人和复杂 无法减少 |
| 437 | to the blockade of dopamine receptors, end quote. | 封锁多巴胺受体,最后引文。 |
| 438 | 精神科医生,Lichtenberg, | |
| 439 | wrote in the 2023 book, Psychopharmacology Reconsidered. | 写在2023年的书"精神药品学重新思考"中. |
| 440 | So, what kind of map does Psalms provide? | 那么,"诗经"提供了什么样的地图? |
| 441 | You know Chekhov's famous stipulation | 你知道契诃夫的著名规定 |
| 442 | that if you introduce a gun in the first act, | 如果你在第一幕中引入枪, |
| 443 | it must be fired in the third? | 3号必须发射吗? |
| 444 | Well, here's a corollary. | 嗯,这是必然的。 |
| 445 | If you introduce a penis on the first page | 如果你在第一页引入阴茎 |
| 446 | of a book about psychoanalysis, | 一本关于心理分析的书 |
| 447 | it will go off, or fail to, or both, very soon. | 它会爆炸,或失败,或两者,很快。 |
| 448 | In his second paragraph, | 在他的第二段中, |
| 449 | Psalms ushers in a depressed physician named Teddy P, | 诗歌引来了一位叫泰迪·P的抑郁医师 |
| 450 | who gets dumped by his girlfriend after struggling | 被女友甩了 挣扎后 |
| 451 | with both premature ejaculation and erectile dysfunction, | 包括过早射精和勃起功能障碍, |
| 452 | perhaps a bit on the nose for a book about Sigmund Freud. | 也许有本关于西格蒙德·弗洛伊德的书 |
| 453 | When Teddy's case becomes acute, | 当泰迪的案子变得尖锐时 |
| 454 | in addition to depression and sexual dysfunction, | 除了抑郁症和性功能障碍, |
| 455 | he develops insomnia, headaches, brain fog, seizures, | 他有失眠、头痛、脑雾、癫痫 |
| 456 | and evidence of possible dementia. | 以及可能患有痴呆症的证据 |
| 457 | Psalms takes him on as a patient. | "诗经"以他为病人. |
| 458 | He determines that Teddy's underlying disease | 他确定泰迪的内在疾病 |
| 459 | is psychological, not neurological. | 是心理的 不是神经的 |
| 460 | The seizures had made that an open question. | 扣押令对此提出了疑问。 |
| 461 | It attributes much of what ails Teddy | 泰迪的病很严重 |
| 462 | to the cascading effects of drugs and treatments | 药物和治疗的连带效应 |
| 463 | he's been given for his depression, | 他因为抑郁症而受赐 |
| 464 | anxiety, insomnia, and pain. | 焦虑、失眠和痛苦 |
| 465 | Psalms weans him off his medications | 诗句让他戒掉药 |
| 466 | and embarks with him on a course of psychoanalysis. | 和他一起开始精神分析 |
| 467 | Then he puts Teddy aside, leaving the reader in suspense | 然后他把Teddy放在一边 给读者留下悬念 |
| 468 | for 258 pages before resuming the account of his fate. | 258页,然后恢复叙述他的命运。 |
| 469 | For all his extensive neuromedical training, | 在他广泛的神经医学训练中 |
| 470 | Psalms makes a point of describing the work | "诗经"对作品的描述 |
| 471 | of psychoanalysis as, quote, | 心理分析,如,引文: |
| 472 | less like science and more like a practical trade, | 更像科学 更像实际交易 |
| 473 | long experience leads to familiarity | 长期经验导致熟悉 |
| 474 | with many different kinds of glitch | 有很多不同种类的故障 |
| 475 | and suggests many different kinds of fix, end quote. | 并提出许多不同种类的固定, 结尾引用。 |
| 476 | Some people, and by some people I might mean me, | 有些人,有些人 我可能是指我, |
| 477 | derive a certain solace from understanding | 从理解中获得一定的安慰 |
| 478 | their anxiety and depression as, in effect, | 他们的焦虑和抑郁,实际上, |
| 479 | mechanical failures, not moral ones, | 机械故障,而不是道德故障 |
| 480 | a snag in the temperamental wiring here, | 这里有股温带的阻力 |
| 481 | an unfortunate genetic variant there, | 一个不幸的基因变体, |
| 482 | a dysregulation of neurotransmitters | 神经递质的阻塞 |
| 483 | not unlike the problems with insulin regulation | 和胰岛素调节的问题不一样 |
| 484 | in a diabetic's pancreas. | 在糖尿病患者的胰腺。 |
| 485 | But Psalms's contention, drawing from Freud, | 但"诗经"的论点,从弗洛伊德引申, |
| 486 | is that those mechanical problems can be fixed | 机械问题可以解决 |
| 487 | only as part of a wholesome realignment | 只是作为健康调整的一部分 |
| 488 | of unconscious drives and emotional needs. | 失去知觉的驱动器和情感需求 |
| 489 | That worked for Psalms. | 这对诗歌很有用 |
| 490 | He had been plagued by a severe death anxiety | 他被严重的死亡焦虑困扰着 |
| 491 | since he was a little boy when his older brother | 自从他哥哥小时候 |
| 492 | suffered brain damage in a freak accident | 在一次怪胎事故中脑部受损 |
| 493 | but was cured by a course of analysis | 但经过分析后痊愈了 |
| 494 | on the couch of Clifford York, | 在克利福德·约克的沙发上, |
| 495 | a British World War II veteran who had helped care | 曾帮助护理的英国二战老兵 |
| 496 | for survivors after the liberation of Bergen-Belsen. | 伯根-贝尔森解放后的幸存者。 |
| 497 | Teddy recovers. | 泰迪恢复过来了 |
| 498 | This is no spoiler. | 这不是破坏者。 |
| 499 | Readers could hardly have been expecting otherwise. | 读者几乎无法预料到其他情况。 |
| 500 | After four years of arduous work with Psalms, | 在与"诗经"合作四年的艰苦工作之后, |
| 501 | revisiting early childhood experiences | 重新审视幼儿期经历 |
| 502 | and his relationship with his mother, | 他和他的母亲的关系, |
| 503 | his depression and anxiety lift, | 他的忧郁和焦虑, |
| 504 | his sexual and romantic attachment issues abate, | 他的性爱和浪漫的恋情 问题缓解, |
| 505 | his growing conscious awareness frees him | 他意识的提高让他解脱 |
| 506 | from damaging unconscious compulsions. | 从破坏无意识的强迫。 |
| 507 | He becomes an outstanding doctor. | 他成为一个杰出的医生。 |
| 508 | The treatment involves all kinds | 治疗包括各种各样的 |
| 509 | of unexpected twists and turns, | 以明显的曲折和转折盟誓, |
| 510 | and Psalms deploys a lot of Freudian tools, | 和诗集部署 很多弗洛伊德工具, |
| 511 | dream analysis, free association, | 梦想分析 自由联合 |
| 512 | breaking down defense mechanisms, | 破坏防御机制, |
| 513 | recovering buried memories, | 恢复被埋葬的记忆 |
| 514 | transference and counter-transference, | 转让和反转让; |
| 515 | and elaborate, too elaborate if you ask me, | 说得更详细 说得更详细 |
| 516 | feats of interpretation by the analysts. | 分析家的翻译功绩。 |
| 517 | To someone with my firmly materialist leanings, | 对我坚定的唯物主义者倾斜的人来说 |
| 518 | it all seems a bit much. | 这似乎有点多。 |
| 519 | But I was struck by two things Psalms writes | 但我被诗篇写的两件事震撼 |
| 520 | in different places earlier in the book. | 在不同的地方 在书的早期。 |
| 521 | One is that the aim of psychotherapy at its core | 其一,心理治疗的核心目标 |
| 522 | is simply, quote, | 仅仅是,引用, |
| 523 | to help our patients find better ways | 帮助病人找到更好的方法 |
| 524 | of meeting their emotional needs, end quote. | 满足他们的情感需求,最后引文。 |
| 525 | Whatever you think | 无论你怎么想 |
| 526 | of the whole complicated Freudian edifice, | 整个复杂的佛洛伊德大厦, |
| 527 | who could take issue with that? | 谁能反对呢? |
| 528 | The other is, quote, | 另一个是,引用, |
| 529 | psychoanalysis is a cure wrought | 心理分析是一种治疗方法 |
| 530 | by loving your neighbor as yourself, end quote. | 通过爱你的邻居 像你一样,最后引言。 |
| 531 | Psalms has set out to complete the Freudian project | 诗篇开始完成弗洛伊德计划 |
| 532 | by giving it a neuroscientific basis, | 以此为神经科学基础, |
| 533 | but maybe the more important accomplishment | 但也许更重要的成就 |
| 534 | is to have restored to psychiatry its humanity. | 已经恢复了精神 人类。 |
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