如何识别完全隐匿型抑郁症【TED演讲】
共 3 集
剧集目录
| 集 | 标题 | 时长 |
|---|---|---|
| P1 | 如何识别完全隐匿型抑郁症【TED演讲】 中英双语 | 15:36 |
| P2 | 如何识别完全隐匿型抑郁症【TED演讲】 英文字幕(注释+中文 | 15:36 |
| P3 | 如何识别完全隐匿型抑郁症【TED演讲】 无字幕(中英外挂) | 15:36 |
P1 · 如何识别完全隐匿型抑郁症【TED演讲】 p01 中英双语 (P1)
字幕摘录
| 时间 | 英文 | 中文 |
|---|---|---|
| 0:01 | Let me tell you about Natalie. | 让我告诉你娜塔莉的事 |
| 0:04 | Natalie came into therapy almost apologetically. | 娜塔莉几乎从波尔基学入院治疗 |
| 0:07 | She giggled as she told me about | 她笑得像她告诉我的那样 |
| 0:10 | what sounded like panic disorder, | 听起来像是恐慌症 |
| 0:13 | her heart racing, difficulty breathing. | 她的心跳,呼吸困难 |
| 0:16 | Maybe she wanted to run out of the room | 也许她想离开房间 |
| 0:17 | when she felt pressured. | 当她感到压力。 |
| 0:19 | Otherwise, she was very successful. | 否则,她非常成功。 |
| 0:21 | She had friends galore, a good marriage, | 她有朋友Galore, 一个很好的婚姻, |
| 0:24 | and she loved her kids. | 她爱她的孩子。 |
展开字幕全文（274 条）
| 序号 | 英文 | 中文 |
|---|---|---|
| 1 | Let me tell you about Natalie. | 让我告诉你娜塔莉的事 |
| 2 | Natalie came into therapy almost apologetically. | 娜塔莉几乎从波尔基学入院治疗 |
| 3 | She giggled as she told me about | 她笑得像她告诉我的那样 |
| 4 | what sounded like panic disorder, | 听起来像是恐慌症 |
| 5 | her heart racing, difficulty breathing. | 她的心跳,呼吸困难 |
| 6 | Maybe she wanted to run out of the room | 也许她想离开房间 |
| 7 | when she felt pressured. | 当她感到压力。 |
| 8 | Otherwise, she was very successful. | 否则,她非常成功。 |
| 9 | She had friends galore, a good marriage, | 她有朋友Galore, 一个很好的婚姻, |
| 10 | and she loved her kids. | 她爱她的孩子。 |
| 11 | She said, my life's almost perfect. | 她说,我的生活几乎完美。 |
| 12 | I just need to calm down. | 我只是需要冷静下来。 |
| 13 | I'd been a therapist for about eight years | 我当了八年的心理医生 |
| 14 | when I saw her, and I thought, you know, | 当我看到她, 我想,你知道, |
| 15 | this is a pretty common anxiety disorder. | 这是很常见的焦虑症 |
| 16 | I need to help her find out what's making her anxious | 我要帮她找出是什么让她着急 |
| 17 | and what she can do about it. | 还有她能做的 |
| 18 | But one afternoon, I got a call from her husband, Jeff, | 但是有一天下午 我接到她丈夫杰夫的电话 |
| 19 | and he said something's wrong. | 他说出了点问题 |
| 20 | I got this weird message from Natalie | 我从娜塔莉那里收到一个奇怪的消息 |
| 21 | asking me to pick up the kids when I get back into town | 叫我回来接孩子 |
| 22 | and take them to her mother's. | 带她们去她妈妈家 |
| 23 | I thought about our last session | 我想到了我们上次的会面 |
| 24 | and nothing really strange had happened. | 没有什么奇怪的事情发生。 |
| 25 | She'd even said therapy was helping. | 她甚至说治疗有帮助。 |
| 26 | But I heard Jeff's tone, and my gut said differently. | 但我听到杰夫的语气, 我的直觉说不同。 |
| 27 | So I listened to it, and I drove to their home | 于是我听了,开车到他们家 |
| 28 | and let myself in with the garage code | 让我用车库密码进去 |
| 29 | that Jeff had given me. | 是杰夫给我的 |
| 30 | I walk into the kitchen. | 我走进厨房 |
| 31 | I see recently washed dishes | 我看到最近洗过的盘子 |
| 32 | and towels neatly folded by the sink. | 毛巾在水槽边折叠 |
| 33 | There is no sound, just silence. | 没有声音,只是沉默。 |
| 34 | I started calling Natalie's name, | 我开始叫娜塔莉的名字, |
| 35 | hoping that she'd come around the corner, | 希望她能从角落过来 |
| 36 | being embarrassed that she'd have another panic attack, | 觉得尴尬,她会再次恐慌发作, |
| 37 | and wanting to know why and how I was getting in her house. | 想知道我为什么会进她家 |
| 38 | But instead, I found her lying in bed, | 但我却发现她躺在床上 |
| 39 | an empty vodka bottle, | 一个空伏特加酒瓶, |
| 40 | and several stray pills laying on the table. | 和数种迷幻药丸, |
| 41 | I called 911 with her saying, oh, don't call, I'm fine. | 我打911跟她说 别打电话 我没事 |
| 42 | When the paramedics rushed her out, | 当救护人员赶她出去时, |
| 43 | I just stood there, stunned. | 我只是站在那里,震惊。 |
| 44 | I'd had no idea that Natalie was suicidal, none. | 我不知道娜塔莉是自杀,没有。 |
| 45 | I felt to blame and not to blame. | 我感到责怪而不是责怪 |
| 46 | What had I missed? | 我错过了什么? |
| 47 | What if I hadn't listened to my gut? | 如果我没有听我的直觉呢? |
| 48 | What if I hadn't called Jeff back? | 如果我没有给杰夫回电话呢? |
| 49 | But the fact remained, | 但事实依然如此, |
| 50 | I diagnosed her with panic disorder and mild depression, | 我诊断她患有恐慌症和轻度抑郁症 |
| 51 | because that's what Natalie had allowed me to see. | 因为娜塔莉让我看到这些 |
| 52 | We all have secrets, | 我们都有秘密 |
| 53 | and it's not always the secrets themselves | 这并不总是秘密本身 |
| 54 | that get us into trouble, | 那会给我们带来麻烦, |
| 55 | but the feelings about the secrets | 但对于秘密的感受 |
| 56 | that can darken and deepen over time. | 它会逐渐变暗和加深 |
| 57 | Some of those feelings can be terror, fear, shame, | 有些感觉可以是恐怖 恐惧 羞耻 |
| 58 | self-loathing, and worse. | 自我厌恶,更糟糕的是。 |
| 59 | Unfortunately, many of us learn that it's not okay, | 不幸的是,我们很多人 都明白这不好, |
| 60 | or we're just never taught | 要么我们从不教书 |
| 61 | that it's okay to express those feelings, | 可以表达这些感情, |
| 62 | so we deny their existence. | 所以我们否认他们的存在。 |
| 63 | On the outside, we're fine, | 在外面,我们没事, |
| 64 | while on the inside there could be immense feelings | 内心可能充满巨大的感情 |
| 65 | of despair, loneliness, and hopelessness. | 绝望 孤独 绝望 |
| 66 | Natalie had secrets, | 纳塔莉有秘密 |
| 67 | but it was her secret feelings that nearly killed her. | 但正是她的秘密感觉 差点杀了她 |
| 68 | Can you imagine a world | 你能想象一个世界 |
| 69 | where talking about these secrets is not shameful? | 哪里谈论这些秘密不是可耻的? |
| 70 | Is it possible to create a culture | 能否创造一种文化 |
| 71 | where expressing those feelings is not shameful, | 在那里,表达这些感情并不可耻, |
| 72 | but actually can be seen as healthy self-acceptance | 但实际上可以被视为健康的自我接受 |
| 73 | and even personal strength? | 乃至个人力量? |
| 74 | 16 years and hundreds of patients later, | 16年和几百个病人之后, |
| 75 | I wrote a blog post. | 我写了一篇博客文章。 |
| 76 | I was describing people like Natalie | 我在描述像娜塔莉这样的人 |
| 77 | and what it might be like | 和它可能是什么样子 |
| 78 | to live their lives day in and day out. | 日复一日地生活着 |
| 79 | I just wrote about successful-looking people | 我刚刚写了些长得很成功的人 |
| 80 | who were hiding their struggles. | 他们隐藏着他们的斗争。 |
| 81 | I didn't think it was particularly profound, | 我不认为这是特别深刻的, |
| 82 | but that post went viral | 但那个帖子是病毒化的 |
| 83 | because I had called it and defined it, | 因为我叫它并定义它, |
| 84 | perfectly hidden depression. | 完全隐藏的抑郁症。 |
| 85 | My email was swamped with messages from people | 我的邮件充斥着人们的信息 |
| 86 | who said, I have these feelings and no one knows. | 谁说,我有这些感觉 没有人知道。 |
| 87 | It's like you're in my head. | 就像你在我的脑海里一样 |
| 88 | And the more I wrote and received feedback, | 我写和收到的反馈越多 |
| 89 | I began to understand how trapped people can feel | 我开始理解 被困在人们的感受 |
| 90 | in this cage of rigid emotional control | 在这个牢牢的情感控制笼子里 |
| 91 | with fear and shame, | 怀着恐惧和耻辱, |
| 92 | keeping them terrified of discovery. | 让他们害怕发现 |
| 93 | So I put two and two together and said, | 所以我把两个和两个一起说, |
| 94 | oh, a perfect seeming life can serve as camouflage. | 哦,一个完美的外观生活 可以作为伪装。 |
| 95 | But there's an obvious problem. | 但有一个明显的问题。 |
| 96 | How can we identify that someone needs help | 我们怎样才能确认有人需要帮助 |
| 97 | if they don't tell us, feel like they can't tell us, | 如果他们不告诉我们 觉得他们不能告诉我们 |
| 98 | or don't know how? | 还是不知道怎么做? |
| 99 | For example, let's say someone like Natalie | 比如说,像娜塔莉这样的人 |
| 100 | goes to, makes a tentative trip, | 去,做一个暂定旅行, |
| 101 | maybe goes to the doctor or a clinician's office. | 也许去医生或诊所 |
| 102 | The professional would do what they were taught to do, | 专业人士会做他们教他们做的事, |
| 103 | which would be to assess the presence of mental illness | 评估精神病的存在 |
| 104 | using the diagnostic and statistical manual | 使用诊断和统计手册 |
| 105 | of mental disorders. | 精神障碍。 |
| 106 | The DSM, as it's called, | DSM,它被称为, |
| 107 | offers internationally recognized | 国际承认的 |
| 108 | psychiatric symptom checklists, | 精神病症状核对表, |
| 109 | some of which are then required | 其中一些是当时需要的 |
| 110 | to earn a certain diagnosis. | 以获得某种诊断。 |
| 111 | This is based on the medical model of mental illness, | 这是基于精神病的医学模式, |
| 112 | which many believe overemphasizes | 许多人认为, |
| 113 | the biological aspects of depression. | 抑郁症的生物方面。 |
| 114 | But it becomes the lens through which | 但它变成了透镜 |
| 115 | that professional begins to see the problem | 那个专业的开始看到问题 |
| 116 | and certain questions are then asked | 然后问一些问题 |
| 117 | that reflect those symptoms and that lens. | 那些症状和镜头 |
| 118 | Does the patient report sleep and appetite disturbance? | 病人报告睡眠和食欲障碍吗? |
| 119 | Has the patient lost pleasure in things they used to enjoy? | 病人在自己喜欢的事物中失去了乐趣吗? |
| 120 | No. | 没有 |
| 121 | Does the patient have foggy thinking? | 病人有迷雾的想法吗? |
| 122 | No, not till right now. | 不,直到现在。 |
| 123 | Does the patient have suicidal thinking? | 病人有自杀的想法吗? |
| 124 | No. | 没有 |
| 125 | My life is far too full of grateful things. | 我的生活充满了感激之情 |
| 126 | The exact process I used with Natalie. | 我和娜塔莉一起用过的程序 |
| 127 | The problem is the lens. | 问题是镜头 |
| 128 | Your lens determines what you see. | 你的镜片决定你所看到的 |
| 129 | Combine the limitations of that professional's lens | 结合专业镜头的局限性 |
| 130 | with the patient's fear of revealing vulnerability | 与病人的恐惧 暴露脆弱 |
| 131 | and my friends, we have a problem. | 我的朋友,我们有一个问题。 |
| 132 | In 1993, the founder of the American Association | 1993年,美国协会创始人 |
| 133 | of Suicidology, Edwin Schneidman, | 爱德温·施奈德曼 |
| 134 | was a well-respected thought leader and researcher | 是个受人尊敬的思想领袖和研究员 |
| 135 | in the world of suicide and depression. | 在自杀和抑郁的世界。 |
| 136 | He coined a term called psychache, | 他发明了一个叫精神病的术语, |
| 137 | meaning intolerable emotional and psychological pain. | 意味着无法忍受的情感和心理痛苦。 |
| 138 | And his research upended common psychiatric thinking | 而他的研究 增加了常见的精神病思想 |
| 139 | at the time because he found that psychache | 当时他发现那个精神痛 |
| 140 | had more to do with suicide than depression. | 和自杀有关 而不是抑郁症 |
| 141 | Pain is at the core of suicide, he said. | 他说痛苦是自杀的核心 |
| 142 | Meaning that the answers to treating people | 意味着治疗的答案 |
| 143 | with suicidal feelings does not lie in the assignment | 与自杀的感情 不在任务中 |
| 144 | of a diagnosis, but by an acknowledgement | 诊断,但通过确认 |
| 145 | and working through of that pain. | 并努力克服这种痛苦。 |
| 146 | Two years later, Sidney Blatt, another renowned researcher, | 两年后,西德尼布拉特,另一位著名研究员, |
| 147 | warned that when perfectionism is found | 警告说,当发现完美主义时 |
| 148 | alongside depression, it can drastically change | 伴随着抑郁症,它会急剧改变 |
| 149 | depression's presentation and must not be assessed | 抑郁症的介绍,不得评估 |
| 150 | through diagnostic measures, but through understanding | 通过诊断措施,但通过了解 |
| 151 | the perception of that person of themselves and their world. | 他们对自己和他们世界的看法。 |
| 152 | But we are so governed by the medical model | 但是我们受医疗模式的支配 |
| 153 | of mental illness that unless someone's depression | 精神疾病,除非有人抑郁 |
| 154 | meets the criteria, the official DSM criteria for depression, | 符合标准 正式的DSM 抑郁症标准, |
| 155 | it is likely to be missed while suicide rates | 有可能在自杀率下降时被忽略 |
| 156 | are skyrocketing worldwide. | 全世界都在飙升 |
| 157 | I wager that it will not be long before every one of us, | 我敢打赌,它不会 很快,我们每一个人, |
| 158 | every single one of us, either knows someone personally | 我们每个人都认识一个人 |
| 159 | or has heard the story of someone whose life | 或曾听见一个人的故事, |
| 160 | was going great and they died by suicide. | 他们死在自杀中 |
| 161 | That person, your friend, your neighbor, | 那个人 你的朋友 邻居 |
| 162 | your kid's soccer coach, your pastor, your professor, | 你孩子的足球教练 你的牧师 你的教授 |
| 163 | your work buddy, and maybe even your child | 你的工作伙伴,甚至你的孩子 |
| 164 | is keeping their pain secret. | 他们的疼痛是保密的 |
| 165 | Now why? | 为什么? |
| 166 | Again, those who identify with what I term perfectly | 同样,那些认同我所说的 |
| 167 | hidden depression feel that they must protect themselves | 隐藏的抑郁感认为他们必须保护自己 |
| 168 | with this shield of silence. | 与这个屏蔽的沉默。 |
| 169 | They're not going to fit into the pre-assigned DSM criteria, | 他们不会符合预先指定的DSM标准, |
| 170 | and in fact, they are ashamed that anyone might think of them | 事实上,他们感到羞愧,因为任何人想他们, |
| 171 | or see them as depressed. | 或视其为忧郁。 |
| 172 | So what can we do? | 我们能怎么办? |
| 173 | How can we change or set the stage | 我们怎样才能改变或建立舞台 |
| 174 | for increased transparency? | 增加透明度? |
| 175 | I think, I know that we must recognize | 我想 我知道我们必须承认 |
| 176 | that suicidal feelings and the thoughts that accompany them | 自杀的感情和他们的思想 |
| 177 | are, believe it or not, normal. | 是,信不信由你,正常的。 |
| 178 | To be clear, I'm not saying that suicide is normal. | 说清楚 我不是说自杀是正常的 |
| 179 | I'm saying that thoughts about suicide | 我说的是关于自杀的想法 |
| 180 | are much more common than most of us know. | 比我们大多数人都知道的要普遍得多。 |
| 181 | I cannot count the number of people over the years | 这些年来,我无法计算人数 |
| 182 | who've revealed such feelings to me, | 谁向我揭示了这种感情, |
| 183 | sometimes hesitatingly, fearing that I'll do something | 有时犹豫不决,怕我会做点什么 |
| 184 | radical or take away their rights, | 或者剥夺他们的权利, |
| 185 | sometimes with great relief because they begin to let go | 有时他们很宽慰,因为他们开始放手 |
| 186 | of a shame that has literally seeped down | 令人羞愧的 已经渗出 |
| 187 | into the very core of their being, | 在他们的核心, |
| 188 | and sometimes with sadness because they realize | 有时因为意识到 |
| 189 | just how close they've come. | 他们离我们有多近 |
| 190 | Now, there are people who have the intent to die, | 现在,有人有 死的意图, |
| 191 | have the means to do it, and cannot tell you | 有办法,不能告诉你 |
| 192 | why they shouldn't. | 为什么他们不应该。 |
| 193 | Those people tell someone like me | 那些人告诉我这样的人 |
| 194 | because they want my help to keep them safe | 因为他们希望我帮助他们安全 |
| 195 | and they must be taken very seriously. | 必须认真对待它们。 |
| 196 | But so many suicidal feelings are natural, | 但是很多自杀的感觉是自然的 |
| 197 | human, normal responses to what has happened in your life. | 人类,正常的反应 在你的生活中发生的一切。 |
| 198 | So why don't we treat it as normal? | 那么我们为什么不把它当成正常的呢? |
| 199 | Why don't we talk about the feelings | 我们何不谈谈感情 |
| 200 | that we would talk about any other way? | 我们想谈别的方面吗? |
| 201 | Why don't we ask, well, when do you feel this? | 为什么我们不问,嗯,你什么时候觉得呢? |
| 202 | When do you not feel this? | 你什么时候没有感觉? |
| 203 | What's it like to talk to me about it? | 跟我谈这件事是什么感觉? |
| 204 | Have you ever wondered what would make it go away? | 你有没有想过它会消失? |
| 205 | Questions that we would ask about any other feelings | 我们想问的关于其他感情的问题 |
| 206 | that a person was trying to understand and cope with. | 一个人试图理解和应付。 |
| 207 | But these are not questions about symptom criteria. | 但这不是症状标准的问题。 |
| 208 | We are gonna go in the direction | 我们要往前走 |
| 209 | that John Summers Flanagan wants us to go, | 约翰·萨默斯·弗拉纳根希望我们离开 |
| 210 | which is working toward a strength-based | 它正致力于一个基于力量的 |
| 211 | assessment of suicide. | 对自杀的评估。 |
| 212 | Now, what does this have to do with you? | 这和你有什么关系? |
| 213 | You're probably not a clinician or a doctor. | 你可能不是临床医生或医生 |
| 214 | How would you respond if someone told you | 如果有人告诉你,你会怎样回应? |
| 215 | they were thinking about taking their own life? | 他们想自杀? |
| 216 | Sadly, the instinct is often, | 可悲的是,直觉常常是, |
| 217 | I can't believe you said that. | 真不敢相信你这么说 |
| 218 | You know you have people who love you. | 你知道你的人谁爱你。 |
| 219 | How can you be so selfish? | 你怎么能这么自私? |
| 220 | And the quickest way to end a conversation | 和最快的方式结束一个谈话 |
| 221 | is to blame someone for the way they're feeling | 就是责怪别人的感受 |
| 222 | or to suggest that no one that was literally loving | 或暗示没有真正爱的人 |
| 223 | and caring would ever have that feeling. | 关心会永远有那种感觉 |
| 224 | What if instead we could approach | 如果我们可以接近 |
| 225 | not with judgment, but with acceptance? | 不是判断,而是接受? |
| 226 | Many more conversations would take place. | 还将进行更多的对话。 |
| 227 | Let me tell you about Michael. | 让我告诉你有关迈克尔。 |
| 228 | Michael was an internationally prominent person | 迈克尔是国际知名人物 |
| 229 | in his field when he came to see me. | 当他来看我的时候 |
| 230 | And he was laughing because he said | 他笑是因为他说 |
| 231 | no one would ever imagine me going to therapy. | 没有人会想象我要去治疗。 |
| 232 | He'd grown up in a family where they didn't discuss feelings, | 他成长在一个家庭 他们没有讨论感情, |
| 233 | especially painful ones. | 特别痛苦的 |
| 234 | But his father had died suddenly. | 但他父亲突然去世了 |
| 235 | And Michael had never told his dad that he loved him | 迈克尔从未告诉他爸爸 他爱他 |
| 236 | despite the tumultuous relationship they'd had. | 尽管他们的关系很混乱 |
| 237 | And Michael couldn't forgive himself for that. | 迈克尔无法原谅自己 |
| 238 | As we talked about his childhood | 当我们谈论他的童年 |
| 239 | and current decisions he was trying to make, | 以及他试图做出的当前决定, |
| 240 | he began to see patterns. | 他开始看到规律。 |
| 241 | He could see how he'd covered up his horrific abuse | 他可以看到他是如何掩盖 他可怕的虐待 |
| 242 | as a child and tried to cover it up | 小时候还试图掩盖 |
| 243 | with greater and greater achievement | 取得更大成就 |
| 244 | to reach some sort of destination | 到达某个目的地 |
| 245 | that would blot out or blur the painful secrets | 那会抹去或模糊痛苦的秘密 |
| 246 | he kept hidden inside. | 他一直躲在里面 躲起来 |
| 247 | But it didn't work. | 但没成功 |
| 248 | He told me one day very painfully | 他告诉我有一天,很痛苦 |
| 249 | that he also had feelings of the intent to die. | 他也有死欲的感觉 |
| 250 | I told him those feelings were normal | 我告诉他这些感觉是正常的 |
| 251 | given the extent of his pain and how long he had felt it. | 鉴于他的痛苦程度 以及他感受了多久 |
| 252 | In our continuing work, | 在我们的继续工作, |
| 253 | he found that he could have compassion for himself | 他发现他可以同情自己 |
| 254 | without carrying the shame that was not his to carry. | 而不带着不是他的耻辱 |
| 255 | He could grieve without pummeling himself | 他可以悲伤而不自责 |
| 256 | with self-loathing and he could decide to live. | 与自我厌恶 他可以决定活下去。 |
| 257 | I truly will never forget the day | 我真的永远不会忘记那一天 |
| 258 | that Michael strolled into my office, | 迈克尔走进我的办公室, |
| 259 | laughing, big smile on his face and said, | 笑,大笑在他的脸上说, |
| 260 | hey doc, I gotta tell you something. | 嘿,医生,我得告诉你一件事。 |
| 261 | I was on this crowded airplane, | 我在飞机上, |
| 262 | journaling instead of working, | 日记而不是工作, |
| 263 | writing about my childhood and my father in public. | 在公众场合写我的童年和我父亲 |
| 264 | And when I felt a tear roll down my cheek, | 当我感觉到我的脸颊被撕裂时 |
| 265 | I didn't care. | 我不关心。 |
| 266 | We all have secrets. | 我们都有秘密 |
| 267 | But the cost that can accompany the feelings | 但与感情相关的费用 |
| 268 | of those secrets has never been more evident. | 这些秘密从未如此明显 |
| 269 | But you and I can realize we could have an impact | 但你和我可以意识到 我们可以有一个影响 |
| 270 | right now on our culture | 现在,我们的文化 |
| 271 | so that transparency is seen as strength. | 因此,透明度被视为力量。 |
| 272 | Now close to all but online. | 现在除了在线之外,都接近了 |
| 273 | Please feel free to leave it in the comments down below. | 请在下面的评论中留下它。 |
| 274 | What worried me most was Israel | 我最担心的是以色列 |
该视频共有字幕 274 条。解锁更多字幕为会员功能，请移动到 价格
P2 · 如何识别完全隐匿型抑郁症【TED演讲】 p02 英文字幕(注释+中文外挂) (P2)
字幕摘录
| 时间 | 英文 | 中文 |
|---|---|---|
| 0:01 | Let me tell you about Natalie. | 让我告诉你娜塔莉的事 |
| 0:04 | Natalie came into therapy almost apologetically. | 娜塔莉几乎从波尔基学入院治疗 |
| 0:07 | She giggled as she told me about | 她笑得像她告诉我的那样 |
| 0:10 | what sounded like panic disorder, | 听起来像是恐慌症 |
| 0:13 | her heart racing, difficulty breathing. | 她的心跳,呼吸困难 |
| 0:16 | Maybe she wanted to run out of the room | 也许她想离开房间 |
| 0:17 | when she felt pressured. | 当她感到压力。 |
| 0:19 | Otherwise, she was very successful. | 否则,她非常成功。 |
| 0:21 | She had friends galore, a good marriage, | 她有朋友Galore, 一个很好的婚姻, |
| 0:24 | and she loved her kids. | 她爱她的孩子。 |
展开字幕全文（269 条）
| 序号 | 英文 | 中文 |
|---|---|---|
| 1 | Let me tell you about Natalie. | 让我告诉你娜塔莉的事 |
| 2 | Natalie came into therapy almost apologetically. | 娜塔莉几乎从波尔基学入院治疗 |
| 3 | She giggled as she told me about | 她笑得像她告诉我的那样 |
| 4 | what sounded like panic disorder, | 听起来像是恐慌症 |
| 5 | her heart racing, difficulty breathing. | 她的心跳,呼吸困难 |
| 6 | Maybe she wanted to run out of the room | 也许她想离开房间 |
| 7 | when she felt pressured. | 当她感到压力。 |
| 8 | Otherwise, she was very successful. | 否则,她非常成功。 |
| 9 | She had friends galore, a good marriage, | 她有朋友Galore, 一个很好的婚姻, |
| 10 | and she loved her kids. | 她爱她的孩子。 |
| 11 | She said, my life's almost perfect. | 她说,我的生活几乎完美。 |
| 12 | I just need to calm down. | 我只是需要冷静下来。 |
| 13 | I'd been a therapist for about eight years | 我当了八年的心理医生 |
| 14 | when I saw her, and I thought, you know, | 当我看到她, 我想,你知道, |
| 15 | this is a pretty common anxiety disorder. | 这是很常见的焦虑症 |
| 16 | I need to help her find out what's making her anxious | 我要帮她找出是什么让她着急 |
| 17 | and what she can do about it. | 还有她能做的 |
| 18 | But one afternoon, I got a call from her husband, Jeff, | 但是有一天下午 我接到她丈夫杰夫的电话 |
| 19 | and he said something's wrong. | 他说出了点问题 |
| 20 | I got this weird message from Natalie | 我从娜塔莉那里收到一个奇怪的消息 |
| 21 | asking me to pick up the kids when I get back into town | 叫我回来接孩子 |
| 22 | and take them to her mother's. | 带她们去她妈妈家 |
| 23 | I thought about our last session | 我想到了我们上次的会面 |
| 24 | and nothing really strange had happened. | 没有什么奇怪的事情发生。 |
| 25 | She'd even said therapy was helping. | 她甚至说治疗有帮助。 |
| 26 | But I heard Jeff's tone, and my gut said differently. | 但我听到杰夫的语气, 我的直觉说不同。 |
| 27 | So I listened to it, and I drove to their home | 于是我听了,开车到他们家 |
| 28 | and let myself in with the garage code | 让我用车库密码进去 |
| 29 | that Jeff had given me. | 是杰夫给我的 |
| 30 | I walk into the kitchen. | 我走进厨房 |
| 31 | I see recently washed dishes | 我看到最近洗过的盘子 |
| 32 | and towels neatly folded by the sink. | 毛巾在水槽边折叠 |
| 33 | There is no sound, just silence. | 没有声音,只是沉默。 |
| 34 | I started calling Natalie's name, | 我开始叫娜塔莉的名字, |
| 35 | hoping that she'd come around the corner, | 希望她能从角落过来 |
| 36 | being embarrassed that she'd have another panic attack | 感到尴尬,她会再次惊慌失措 |
| 37 | and wanting to know why and how I was getting in her house. | 想知道我为什么会进她家 |
| 38 | But instead, I found her lying in bed, | 但我却发现她躺在床上 |
| 39 | an empty vodka bottle, and several stray pills | 一个空的伏特加瓶子, 和几个流浪的药丸 |
| 40 | laying on the table. | 摆在桌子上 |
| 41 | I called 911 with her saying, oh, don't call, I'm fine. | 我打911跟她说 别打电话 我没事 |
| 42 | When the paramedics rushed her out, | 当救护人员赶她出去时, |
| 43 | I just stood there, stunned. | 我只是站在那里,震惊。 |
| 44 | I'd had no idea that Natalie was suicidal, none. | 我不知道娜塔莉是自杀,没有。 |
| 45 | I felt to blame and not to blame. | 我感到责怪而不是责怪 |
| 46 | What had I missed? | 我错过了什么? |
| 47 | What if I hadn't listened to my gut? | 如果我没有听我的直觉呢? |
| 48 | What if I hadn't called Jeff back? | 如果我没有给杰夫回电话呢? |
| 49 | But the fact remained, I diagnosed her | 但事实依然如此,我确诊了她 |
| 50 | with panic disorder and mild depression, | 有惊慌失措和轻度抑郁症, |
| 51 | because that's what Natalie had allowed me to see. | 因为娜塔莉让我看到这些 |
| 52 | We all have secrets, | 我们都有秘密 |
| 53 | and it's not always the secrets themselves | 这并不总是秘密本身 |
| 54 | that get us into trouble, | 那会给我们带来麻烦, |
| 55 | but the feelings about the secrets | 但对于秘密的感受 |
| 56 | that can darken and deepen over time. | 它会逐渐变暗和加深 |
| 57 | Some of those feelings can be terror, fear, shame, | 有些感觉可以是恐怖 恐惧 羞耻 |
| 58 | self-loathing, and worse. | 自我厌恶,更糟糕的是。 |
| 59 | Unfortunately, many of us learn that it's not okay | 很不幸,我们很多人都明白,这不好 |
| 60 | or we're just never taught | 要么我们从不教书 |
| 61 | that it's okay to express those feelings, | 可以表达这些感情, |
| 62 | so we deny their existence. | 所以我们否认他们的存在。 |
| 63 | On the outside, we're fine, | 在外面,我们没事, |
| 64 | while on the inside there could be immense feelings | 内心可能充满巨大的感情 |
| 65 | of despair, loneliness, and hopelessness. | 绝望 孤独 绝望 |
| 66 | Natalie had secrets, | 纳塔莉有秘密 |
| 67 | but it was her secret feelings that nearly killed her. | 但正是她的秘密感觉 差点杀了她 |
| 68 | Can you imagine a world where talking about these secrets | 你能想象这个世界 谈论这些秘密 |
| 69 | is not shameful? | 不丢脸吗? |
| 70 | Is it possible to create a culture | 能否创造一种文化 |
| 71 | where expressing those feelings is not shameful, | 在那里,表达这些感情并不可耻, |
| 72 | but actually can be seen as healthy self-acceptance | 但实际上可以被视为健康的自我接受 |
| 73 | and even personal strength? | 乃至个人力量? |
| 74 | 16 years and hundreds of patients later, | 16年和几百个病人之后, |
| 75 | I wrote a blog post. | 我写了一篇博客文章。 |
| 76 | I was describing people like Natalie | 我在描述像娜塔莉这样的人 |
| 77 | and what it might be like to live their lives | 以及过着什么样的生活 |
| 78 | day in and day out. | 日复一日,日复一日。 |
| 79 | I just wrote about successful-looking people | 我刚刚写了些长得很成功的人 |
| 80 | who were hiding their struggles. | 他们隐藏着他们的斗争。 |
| 81 | I didn't think it was particularly profound, | 我不认为这是特别深刻的, |
| 82 | but that post went viral | 但那个帖子是病毒化的 |
| 83 | because I had called it and defined it, | 因为我叫它并定义它, |
| 84 | perfectly hidden depression. | 完全隐藏的抑郁症。 |
| 85 | My email was swamped with messages from people | 我的邮件充斥着人们的信息 |
| 86 | who said, I have these feelings and no one knows. | 谁说,我有这些感觉 没有人知道。 |
| 87 | It's like you're in my head. | 就像你在我的脑海里一样 |
| 88 | The more I wrote and received feedback, | 我写的和收到的反馈越多 |
| 89 | I began to understand how trapped people can feel | 我开始理解 被困在人们的感受 |
| 90 | in this cage of rigid emotional control | 在这个牢牢的情感控制笼子里 |
| 91 | with fear and shame, keeping them terrified of discovery. | 恐惧和羞耻 让他们害怕发现 |
| 92 | So I put two and two together and said, | 所以我把两个和两个一起说, |
| 93 | oh, a perfect seeming life can serve as camouflage, | 哦,一个完美的貌似生活 可以作为伪装, |
| 94 | but there's an obvious problem. | 但有一个明显的问题。 |
| 95 | How can we identify that someone needs help | 我们怎样才能确认有人需要帮助 |
| 96 | if they don't tell us, feel like they can't tell us | 如果他们不告诉我们, 感觉他们不能告诉我们 |
| 97 | or don't know how? | 还是不知道怎么做? |
| 98 | For example, let's say someone like Natalie | 比如说,像娜塔莉这样的人 |
| 99 | makes a tentative trip, maybe goes to the doctor | 做一个临时旅行, 也许去医生 |
| 100 | or a clinician's office. | 或诊所的办公室。 |
| 101 | The professional would do what they were taught to do, | 专业人士会做他们教他们做的事, |
| 102 | which would be to assess the presence of mental illness | 评估精神病的存在 |
| 103 | using the diagnostic and statistical manual | 使用诊断和统计手册 |
| 104 | of mental disorders. | 精神障碍。 |
| 105 | The DSM, as it's called, | DSM,它被称为, |
| 106 | offers internationally recognized | 国际承认的 |
| 107 | psychiatric symptom checklists, | 精神病症状核对表, |
| 108 | some of which are then required | 其中一些是当时需要的 |
| 109 | to earn a certain diagnosis. | 以获得某种诊断。 |
| 110 | This is based on the medical model of mental illness, | 这是基于精神病的医学模式, |
| 111 | which many believe overemphasizes | 许多人认为, |
| 112 | the biological aspects of depression, | 抑郁症的生物方面, |
| 113 | but it becomes the lens through which that professional | 但它变成了那个专业的镜头 |
| 114 | begins to see the problem | 开始看到问题 |
| 115 | and certain questions are then asked | 然后问一些问题 |
| 116 | that reflect those symptoms and that lens. | 那些症状和镜头 |
| 117 | Does the patient report sleep and appetite disturbance? | 病人报告睡眠和食欲障碍吗? |
| 118 | Has the patient lost pleasure in things they used to enjoy? | 病人在自己喜欢的事物中失去了乐趣吗? |
| 119 | No. | 没有 |
| 120 | Does the patient have foggy thinking? | 病人有迷雾的想法吗? |
| 121 | No, not till right now. | 不,直到现在。 |
| 122 | Does the patient have suicidal thinking? | 病人有自杀的想法吗? |
| 123 | No. | 没有 |
| 124 | My life is far too full of grateful things. | 我的生活充满了感激之情 |
| 125 | The exact process I used with Natalie. | 我和娜塔莉一起用过的程序 |
| 126 | The problem is the lens. | 问题是镜头 |
| 127 | Your lens determines what you see. | 你的镜片决定你所看到的 |
| 128 | Combine the limitations of that professional's lens | 结合专业镜头的局限性 |
| 129 | with the patient's fear of revealing vulnerability | 与病人的恐惧 暴露脆弱 |
| 130 | and my friends, we have a problem. | 我的朋友,我们有一个问题。 |
| 131 | In 1993, the founder of the American Association | 1993年,美国协会创始人 |
| 132 | of Suicidology, Edwin Schneidman, | 爱德温·施奈德曼 |
| 133 | was a well-respected thought leader and researcher | 是个受人尊敬的思想领袖和研究员 |
| 134 | in the world of suicide and depression. | 在自杀和抑郁的世界。 |
| 135 | He coined a term called psychache, | 他发明了一个叫精神病的术语, |
| 136 | meaning intolerable, emotional, and psychological pain. | 意思是无法忍受的 情感的 心理的痛苦 |
| 137 | And his research upended common psychiatric thinking | 而他的研究 增加了常见的精神病思想 |
| 138 | at the time because he found that psychache | 当时他发现那个精神痛 |
| 139 | had more to do with suicide than depression. | 和自杀有关 而不是抑郁症 |
| 140 | Pain is at the core of suicide, he said, | 他说痛苦是自杀的核心 |
| 141 | meaning that the answers to treating people | 意味着治疗的答案 |
| 142 | with suicidal feelings does not lie | 与自杀的感情是不会说谎的 |
| 143 | in the assignment of a diagnosis, | 在诊断中, |
| 144 | but by an acknowledgement and working through of that pain. | 但是通过承认 并努力克服这种痛苦。 |
| 145 | Two years later, Sidney Blatt, | 两年后 西德尼・布拉特 |
| 146 | another renowned researcher, warned | 另一位著名研究员,警告 |
| 147 | that when perfectionism is found alongside depression, | 当完美主义与抑郁同时出现的时候, |
| 148 | it can drastically change depression's presentation | 它能大大改变抑郁症的呈现 |
| 149 | and must not be assessed through diagnostic measures, | 不得通过诊断措施进行评估, |
| 150 | but through understanding the perception | 但通过理解感知 |
| 151 | of that person of themselves and their world. | 和他们的世界。 |
| 152 | But we are so governed by the medical model | 但是我们受医疗模式的支配 |
| 153 | of mental illness that unless someone's depression meets | 除非某人的抑郁症 |
| 154 | the criteria, the official DSM criteria for depression, | 标准 抑郁症的官方DSM标准 |
| 155 | it is likely to be missed, | 可能会错过 |
| 156 | while suicide rates are skyrocketing worldwide. | 自杀率在世界范围内急剧上升。 |
| 157 | I wager that it will not be long before every one of us, | 我敢打赌,它不会 很快,我们每一个人, |
| 158 | every single one of us, either knows someone personally | 我们每个人都认识一个人 |
| 159 | or has heard the story of someone | 或听见别人的故事, |
| 160 | whose life was going great and they died by suicide. | 他的生活是伟大的 他们死于自杀。 |
| 161 | That person, your friend, your neighbor, | 那个人 你的朋友 邻居 |
| 162 | your kid's soccer coach, your pastor, your professor, | 你孩子的足球教练 你的牧师 你的教授 |
| 163 | your work buddy, and maybe even your child | 你的工作伙伴,甚至你的孩子 |
| 164 | is keeping their pain secret. | 他们的疼痛是保密的 |
| 165 | Now why? | 为什么? |
| 166 | Again, those who identify with what I term | 那些认同我所说的 |
| 167 | perfectly hidden depression feel | 完全隐藏的抑郁感 |
| 168 | that they must protect themselves | 他们必须保护自己 |
| 169 | with this shield of silence. | 与这个屏蔽的沉默。 |
| 170 | They're not going to fit into the pre-assigned DSM criteria, | 他们不会符合预先指定的DSM标准, |
| 171 | and in fact, they are ashamed that anyone | 他们为任何人感到羞耻, |
| 172 | might think of them or see them as depressed. | 也许会想到他们 或者视他们为沮丧。 |
| 173 | So what can we do? | 我们能怎么办? |
| 174 | How can we change or set the stage | 我们怎样才能改变或建立舞台 |
| 175 | for increased transparency? | 增加透明度? |
| 176 | I think, I know, that we must recognize | 我想,我知道,我们必须承认 |
| 177 | that suicidal feelings and the thoughts | 自杀的感情和思想 |
| 178 | that accompany them are, believe it or not, normal. | 不管他们信不信,他们都是正常的 |
| 179 | To be clear, I'm not saying that suicide is normal. | 说清楚 我不是说自杀是正常的 |
| 180 | I'm saying that thoughts about suicide | 我说的是关于自杀的想法 |
| 181 | are much more common than most of us know. | 比我们大多数人都知道的要普遍得多。 |
| 182 | I cannot count the number of people over the years | 这些年来,我无法计算人数 |
| 183 | who've revealed such feelings to me, | 谁向我揭示了这种感情, |
| 184 | sometimes hesitatingly, fearing that I'll do | 有时犹豫不决,害怕我会这么做 |
| 185 | something radical or take away their rights, | 激进的东西 或剥夺他们的权利, |
| 186 | sometimes with great relief because they begin | 有时会很轻松 因为他们开始 |
| 187 | to let go of a shame that has literally seeped down | 以摆脱已经渗入的耻辱 |
| 188 | into the very core of their being, | 在他们的核心, |
| 189 | and sometimes with sadness because they realize | 有时因为意识到 |
| 190 | just how close they've come. | 他们离我们有多近 |
| 191 | Now, there are people who have the intent to die, | 现在,有人有 死的意图, |
| 192 | have the means to do it, and cannot tell you | 有办法,不能告诉你 |
| 193 | why they shouldn't. | 为什么他们不应该。 |
| 194 | Those people tell someone like me | 那些人告诉我这样的人 |
| 195 | because they want my help to keep them safe | 因为他们希望我帮助他们安全 |
| 196 | and they must be taken very seriously. | 必须认真对待它们。 |
| 197 | But so many suicidal feelings are natural, human, | 但很多自杀的感觉都是自然的,人性的, |
| 198 | normal responses to what has happened in your life. | 平时对你生活中发生的事的反应 |
| 199 | So why don't we treat it as normal? | 那么我们为什么不把它当成正常的呢? |
| 200 | Why don't we talk about the feelings | 我们何不谈谈感情 |
| 201 | that we would talk about any other way? | 我们想谈别的方面吗? |
| 202 | Why don't we ask, well, when do you feel this? | 为什么我们不问,嗯,你什么时候觉得呢? |
| 203 | When do you not feel this? | 你什么时候没有感觉? |
| 204 | What's it like to talk to me about it? | 跟我谈这件事是什么感觉? |
| 205 | Have you ever wondered what would make it go away? | 你有没有想过它会消失? |
| 206 | Questions that we would ask about any other feelings | 我们想问的关于其他感情的问题 |
| 207 | that a person was trying to understand and cope with. | 一个人试图理解和应付。 |
| 208 | But these are not questions about symptom criteria. | 但这不是症状标准的问题。 |
| 209 | We are gonna go in the direction | 我们要往前走 |
| 210 | that John Summers Flanagan wants us to go, | 约翰·萨默斯·弗拉纳根希望我们离开 |
| 211 | which is working toward a strength-based | 它正致力于一个基于力量的 |
| 212 | assessment of suicide. | 对自杀的评估。 |
| 213 | Now, what does this have to do with you? | 这和你有什么关系? |
| 214 | You're probably not a clinician or a doctor. | 你可能不是临床医生或医生 |
| 215 | How would you respond if someone told you | 如果有人告诉你,你会怎样回应? |
| 216 | they were thinking about taking their own life? | 他们想自杀? |
| 217 | Sadly, the instinct is often, I can't believe you said that. | 可悲的是,直觉常常是, 我不能相信你这么说。 |
| 218 | You know you have people who love you. | 你知道你的人谁爱你。 |
| 219 | How can you be so selfish? | 你怎么能这么自私? |
| 220 | And the quickest way to end a conversation | 和最快的方式结束一个谈话 |
| 221 | is to blame someone for the way they're feeling | 就是责怪别人的感受 |
| 222 | or to suggest that no one that was literally loving | 或暗示没有真正爱的人 |
| 223 | and caring would ever have that feeling. | 关心会永远有那种感觉 |
| 224 | What if instead we could approach not with judgment, | 如果我们不能做出判断, |
| 225 | but with acceptance? | 但接受吗? |
| 226 | Many more conversations would take place. | 还将进行更多的对话。 |
| 227 | Let me tell you about Michael. | 让我告诉你有关迈克尔。 |
| 228 | Michael was an internationally prominent person | 迈克尔是国际知名人物 |
| 229 | in his field when he came to see me, | 当他来看我的时候, |
| 230 | and he was laughing because he said | 他笑是因为他说 |
| 231 | no one would ever imagine me going to therapy. | 没有人会想象我要去治疗。 |
| 232 | He'd grown up in a family where they didn't discuss feelings, | 他成长在一个家庭 他们没有讨论感情, |
| 233 | especially painful ones. | 特别痛苦的 |
| 234 | But his father had died suddenly, | 但他父亲突然去世了 |
| 235 | and Michael had never told his dad that he loved him | 迈克尔从未告诉他的爸爸 他爱他 |
| 236 | despite the tumultuous relationship they'd had. | 尽管他们的关系很混乱 |
| 237 | And Michael couldn't forgive himself for that. | 迈克尔无法原谅自己 |
| 238 | As we talked about his childhood | 当我们谈论他的童年 |
| 239 | and current decisions he was trying to make, | 以及他试图做出的当前决定, |
| 240 | he began to see patterns. | 他开始看到规律。 |
| 241 | He could see how he covered up his horrific abuse as a child | 他可以看到他如何掩盖 他可怕的虐待 作为一个孩子 |
| 242 | and tried to cover it up with greater and greater achievement | 并试图以更大的成就掩盖它 |
| 243 | to reach some sort of destination that would blot out | 以达到某种会污染的目的地 |
| 244 | or blur the painful secrets he kept hidden inside. | 或模糊他所隐匿的痛苦的秘密。 |
| 245 | But it didn't work. | 但没成功 |
| 246 | He told me one day very painfully | 他告诉我有一天,很痛苦 |
| 247 | that he also had feelings of the intent to die. | 他也有死欲的感觉 |
| 248 | I told him those feelings were normal | 我告诉他这些感觉是正常的 |
| 249 | given the extent of his pain and how long he had felt it. | 鉴于他的痛苦程度 以及他感受了多久 |
| 250 | In our continuing work, | 在我们的继续工作, |
| 251 | he found that he could have compassion for himself | 他发现他可以同情自己 |
| 252 | without carrying the shame that was not his to carry. | 而不带着不是他的耻辱 |
| 253 | He could grieve without pummeling himself with self-loathing, | 他可以悲伤而不自责 |
| 254 | and he could decide to live. | 他可以决定活下去 |
| 255 | I truly will never forget the day | 我真的永远不会忘记那一天 |
| 256 | that Michael strolled into my office laughing, | 迈克尔走进我的办公室笑, |
| 257 | big smile on his face and said, | 他脸上笑着说: |
| 258 | hey doc, I gotta tell you something. | 嘿,医生,我得告诉你一件事。 |
| 259 | I was on this crowded airplane journaling instead of working, | 我当时在拥挤的飞机日记上 而不是工作 |
| 260 | writing about my childhood and my father in public. | 在公众场合写我的童年和我父亲 |
| 261 | And when I felt a tear roll down my cheek, I didn't care. | 而当我感觉到我的脸颊被撕裂时,我不在乎. |
| 262 | We all have secrets, | 我们都有秘密 |
| 263 | but the cost that can accompany the feelings | 但代价可以伴随感情 |
| 264 | of those secrets has never been more evident. | 这些秘密从未如此明显 |
| 265 | But you and I can realize we could have an impact | 但你和我可以意识到 我们可以有一个影响 |
| 266 | right now on our culture | 现在,我们的文化 |
| 267 | so that transparency is seen as strength. | 因此,透明度被视为力量。 |
| 268 | And that's the end of the story for today. | 况今之结. |
| 269 | Thank you for joining us for today's episode. | 感谢大家参加今天的节目 |
该视频共有字幕 269 条。解锁更多字幕为会员功能，请移动到 价格
P3 · 如何识别完全隐匿型抑郁症【TED演讲】 p03 无字幕(中英外挂) (P3)
字幕摘录
| 时间 | 英文 | 中文 |
|---|---|---|
| 0:01 | Let me tell you about Natalie. | 让我告诉你娜塔莉的事 |
| 0:04 | Natalie came into therapy almost apologetically. | 娜塔莉几乎从波尔基学入院治疗 |
| 0:07 | She giggled as she told me about | 她笑得像她告诉我的那样 |
| 0:10 | what sounded like panic disorder, | 听起来像是恐慌症 |
| 0:13 | her heart racing, difficulty breathing. | 她的心跳,呼吸困难 |
| 0:16 | Maybe she wanted to run out of the room | 也许她想离开房间 |
| 0:17 | when she felt pressured. | 当她感到压力。 |
| 0:19 | Otherwise, she was very successful. | 否则,她非常成功。 |
| 0:21 | She had friends galore, a good marriage, | 她有朋友Galore, 一个很好的婚姻, |
| 0:24 | and she loved her kids. | 她爱她的孩子。 |
展开字幕全文（272 条）
| 序号 | 英文 | 中文 |
|---|---|---|
| 1 | Let me tell you about Natalie. | 让我告诉你娜塔莉的事 |
| 2 | Natalie came into therapy almost apologetically. | 娜塔莉几乎从波尔基学入院治疗 |
| 3 | She giggled as she told me about | 她笑得像她告诉我的那样 |
| 4 | what sounded like panic disorder, | 听起来像是恐慌症 |
| 5 | her heart racing, difficulty breathing. | 她的心跳,呼吸困难 |
| 6 | Maybe she wanted to run out of the room | 也许她想离开房间 |
| 7 | when she felt pressured. | 当她感到压力。 |
| 8 | Otherwise, she was very successful. | 否则,她非常成功。 |
| 9 | She had friends galore, a good marriage, | 她有朋友Galore, 一个很好的婚姻, |
| 10 | and she loved her kids. | 她爱她的孩子。 |
| 11 | She said, my life's almost perfect. | 她说,我的生活几乎完美。 |
| 12 | I just need to calm down. | 我只是需要冷静下来。 |
| 13 | I'd been a therapist for about eight years | 我当了八年的心理医生 |
| 14 | when I saw her, and I thought, you know, | 当我看到她, 我想,你知道, |
| 15 | this is a pretty common anxiety disorder. | 这是很常见的焦虑症 |
| 16 | I need to help her find out what's making her anxious | 我要帮她找出是什么让她着急 |
| 17 | and what she can do about it. | 还有她能做的 |
| 18 | But one afternoon, I got a call from her husband, Jeff, | 但是有一天下午 我接到她丈夫杰夫的电话 |
| 19 | and he said something's wrong. | 他说出了点问题 |
| 20 | I got this weird message from Natalie | 我从娜塔莉那里收到一个奇怪的消息 |
| 21 | asking me to pick up the kids when I get back into town | 叫我回来接孩子 |
| 22 | and take them to her mother's. | 带她们去她妈妈家 |
| 23 | I thought about our last session | 我想到了我们上次的会面 |
| 24 | and nothing really strange had happened. | 没有什么奇怪的事情发生。 |
| 25 | She'd even said therapy was helping. | 她甚至说治疗有帮助。 |
| 26 | But I heard Jeff's tone, and my gut said differently. | 但我听到杰夫的语气, 我的直觉说不同。 |
| 27 | So I listened to it, and I drove to their home | 于是我听了,开车到他们家 |
| 28 | and let myself in with the garage code | 让我用车库密码进去 |
| 29 | that Jeff had given me. | 是杰夫给我的 |
| 30 | I walk into the kitchen. | 我走进厨房 |
| 31 | I see recently washed dishes | 我看到最近洗过的盘子 |
| 32 | and towels neatly folded by the sink. | 毛巾在水槽边折叠 |
| 33 | There is no sound, just silence. | 没有声音,只是沉默。 |
| 34 | I started calling Natalie's name, | 我开始叫娜塔莉的名字, |
| 35 | hoping that she'd come around the corner, | 希望她能从角落过来 |
| 36 | being embarrassed that she'd have another panic attack, | 觉得尴尬,她会再次恐慌发作, |
| 37 | and wanting to know why and how I was getting in her house. | 想知道我为什么会进她家 |
| 38 | But instead, I found her lying in bed, | 但我却发现她躺在床上 |
| 39 | an empty vodka bottle, | 一个空伏特加酒瓶, |
| 40 | and several stray pills laying on the table. | 和数种迷幻药丸, |
| 41 | I called 911 with her saying, oh, don't call, I'm fine. | 我打911跟她说 别打电话 我没事 |
| 42 | When the paramedics rushed her out, | 当救护人员赶她出去时, |
| 43 | I just stood there, stunned. | 我只是站在那里,震惊。 |
| 44 | I'd had no idea that Natalie was suicidal, none. | 我不知道娜塔莉是自杀,没有。 |
| 45 | I felt to blame and not to blame. | 我感到责怪而不是责怪 |
| 46 | What had I missed? | 我错过了什么? |
| 47 | What if I hadn't listened to my gut? | 如果我没有听我的直觉呢? |
| 48 | What if I hadn't called Jeff back? | 如果我没有给杰夫回电话呢? |
| 49 | But the fact remained, | 但事实依然如此, |
| 50 | I diagnosed her with panic disorder and mild depression, | 我诊断她患有恐慌症和轻度抑郁症 |
| 51 | because that's what Natalie had allowed me to see. | 因为娜塔莉让我看到这些 |
| 52 | We all have secrets, | 我们都有秘密 |
| 53 | and it's not always the secrets themselves | 这并不总是秘密本身 |
| 54 | that get us into trouble, | 那会给我们带来麻烦, |
| 55 | but the feelings about the secrets | 但对于秘密的感受 |
| 56 | that can darken and deepen over time. | 它会逐渐变暗和加深 |
| 57 | Some of those feelings can be terror, fear, shame, | 有些感觉可以是恐怖 恐惧 羞耻 |
| 58 | self-loathing, and worse. | 自我厌恶,更糟糕的是。 |
| 59 | Unfortunately, many of us learn that it's not okay, | 不幸的是,我们很多人 都明白这不好, |
| 60 | or we're just never taught | 要么我们从不教书 |
| 61 | that it's okay to express those feelings, | 可以表达这些感情, |
| 62 | so we deny their existence. | 所以我们否认他们的存在。 |
| 63 | On the outside, we're fine, | 在外面,我们没事, |
| 64 | while on the inside there could be immense feelings | 内心可能充满巨大的感情 |
| 65 | of despair, loneliness, and hopelessness. | 绝望 孤独 绝望 |
| 66 | Natalie had secrets, | 纳塔莉有秘密 |
| 67 | but it was her secret feelings that nearly killed her. | 但正是她的秘密感觉 差点杀了她 |
| 68 | Can you imagine a world | 你能想象一个世界 |
| 69 | where talking about these secrets is not shameful? | 哪里谈论这些秘密不是可耻的? |
| 70 | Is it possible to create a culture | 能否创造一种文化 |
| 71 | where expressing those feelings is not shameful, | 在那里,表达这些感情并不可耻, |
| 72 | but actually can be seen as healthy self-acceptance | 但实际上可以被视为健康的自我接受 |
| 73 | and even personal strength? | 乃至个人力量? |
| 74 | 16 years and hundreds of patients later, | 16年和几百个病人之后, |
| 75 | I wrote a blog post. | 我写了一篇博客文章。 |
| 76 | I was describing people like Natalie | 我在描述像娜塔莉这样的人 |
| 77 | and what it might be like | 和它可能是什么样子 |
| 78 | to live their lives day in and day out. | 日复一日地生活着 |
| 79 | I just wrote about successful-looking people | 我刚刚写了些长得很成功的人 |
| 80 | who were hiding their struggles. | 他们隐藏着他们的斗争。 |
| 81 | I didn't think it was particularly profound, | 我不认为这是特别深刻的, |
| 82 | but that post went viral | 但那个帖子是病毒化的 |
| 83 | because I had called it and defined it, | 因为我叫它并定义它, |
| 84 | perfectly hidden depression. | 完全隐藏的抑郁症。 |
| 85 | My email was swamped with messages from people | 我的邮件充斥着人们的信息 |
| 86 | who said, I have these feelings and no one knows. | 谁说,我有这些感觉 没有人知道。 |
| 87 | It's like you're in my head. | 就像你在我的脑海里一样 |
| 88 | And the more I wrote and received feedback, | 我写和收到的反馈越多 |
| 89 | I began to understand how trapped people can feel | 我开始理解 被困在人们的感受 |
| 90 | in this cage of rigid emotional control | 在这个牢牢的情感控制笼子里 |
| 91 | with fear and shame, | 怀着恐惧和耻辱, |
| 92 | keeping them terrified of discovery. | 让他们害怕发现 |
| 93 | So I put two and two together and said, | 所以我把两个和两个一起说, |
| 94 | oh, a perfect seeming life can serve as camouflage. | 哦,一个完美的外观生活 可以作为伪装。 |
| 95 | But there's an obvious problem. | 但有一个明显的问题。 |
| 96 | How can we identify that someone needs help | 我们怎样才能确认有人需要帮助 |
| 97 | if they don't tell us, feel like they can't tell us, | 如果他们不告诉我们 觉得他们不能告诉我们 |
| 98 | or don't know how? | 还是不知道怎么做? |
| 99 | For example, let's say someone like Natalie | 比如说,像娜塔莉这样的人 |
| 100 | goes to, makes a tentative trip, | 去,做一个暂定旅行, |
| 101 | maybe goes to the doctor or a clinician's office. | 也许去医生或诊所 |
| 102 | The professional would do what they were taught to do, | 专业人士会做他们教他们做的事, |
| 103 | which would be to assess the presence of mental illness | 评估精神病的存在 |
| 104 | using the diagnostic and statistical manual | 使用诊断和统计手册 |
| 105 | of mental disorders. | 精神障碍。 |
| 106 | The DSM, as it's called, | DSM,它被称为, |
| 107 | offers internationally recognized | 国际承认的 |
| 108 | psychiatric symptom checklists, | 精神病症状核对表, |
| 109 | some of which are then required | 其中一些是当时需要的 |
| 110 | to earn a certain diagnosis. | 以获得某种诊断。 |
| 111 | This is based on the medical model of mental illness, | 这是基于精神病的医学模式, |
| 112 | which many believe overemphasizes | 许多人认为, |
| 113 | the biological aspects of depression. | 抑郁症的生物方面。 |
| 114 | But it becomes the lens through which | 但它变成了透镜 |
| 115 | that professional begins to see the problem | 那个专业的开始看到问题 |
| 116 | and certain questions are then asked | 然后问一些问题 |
| 117 | that reflect those symptoms and that lens. | 那些症状和镜头 |
| 118 | Does the patient report sleep and appetite disturbance? | 病人报告睡眠和食欲障碍吗? |
| 119 | Has the patient lost pleasure in things they used to enjoy? | 病人在自己喜欢的事物中失去了乐趣吗? |
| 120 | No. | 没有 |
| 121 | Does the patient have foggy thinking? | 病人有迷雾的想法吗? |
| 122 | No, not till right now. | 不,直到现在。 |
| 123 | Does the patient have suicidal thinking? | 病人有自杀的想法吗? |
| 124 | No. | 没有 |
| 125 | My life is far too full of grateful things. | 我的生活充满了感激之情 |
| 126 | The exact process I used with Natalie. | 我和娜塔莉一起用过的程序 |
| 127 | The problem is the lens. | 问题是镜头 |
| 128 | Your lens determines what you see. | 你的镜片决定你所看到的 |
| 129 | Combine the limitations of that professional's lens | 结合专业镜头的局限性 |
| 130 | with the patient's fear of revealing vulnerability | 与病人的恐惧 暴露脆弱 |
| 131 | and my friends, we have a problem. | 我的朋友,我们有一个问题。 |
| 132 | In 1993, the founder of the American Association | 1993年,美国协会创始人 |
| 133 | of Suicidology, Edwin Schneidman, | 爱德温·施奈德曼 |
| 134 | was a well-respected thought leader and researcher | 是个受人尊敬的思想领袖和研究员 |
| 135 | in the world of suicide and depression. | 在自杀和抑郁的世界。 |
| 136 | He coined a term called psychache, | 他发明了一个叫精神病的术语, |
| 137 | meaning intolerable emotional and psychological pain. | 意味着无法忍受的情感和心理痛苦。 |
| 138 | And his research upended common psychiatric thinking | 而他的研究 增加了常见的精神病思想 |
| 139 | at the time because he found that psychache | 当时他发现那个精神痛 |
| 140 | had more to do with suicide than depression. | 和自杀有关 而不是抑郁症 |
| 141 | Pain is at the core of suicide, he said. | 他说痛苦是自杀的核心 |
| 142 | Meaning that the answers to treating people | 意味着治疗的答案 |
| 143 | with suicidal feelings does not lie in the assignment | 与自杀的感情 不在任务中 |
| 144 | of a diagnosis, but by an acknowledgement | 诊断,但通过确认 |
| 145 | and working through of that pain. | 并努力克服这种痛苦。 |
| 146 | Two years later, Sidney Blatt, another renowned researcher, | 两年后,西德尼布拉特,另一位著名研究员, |
| 147 | warned that when perfectionism is found | 警告说,当发现完美主义时 |
| 148 | alongside depression, it can drastically change | 伴随着抑郁症,它会急剧改变 |
| 149 | depression's presentation and must not be assessed | 抑郁症的介绍,不得评估 |
| 150 | through diagnostic measures, but through understanding | 通过诊断措施,但通过了解 |
| 151 | the perception of that person of themselves and their world. | 他们对自己和他们世界的看法。 |
| 152 | But we are so governed by the medical model | 但是我们受医疗模式的支配 |
| 153 | of mental illness that unless someone's depression | 精神疾病,除非有人抑郁 |
| 154 | meets the criteria, the official DSM criteria for depression, | 符合标准 正式的DSM 抑郁症标准, |
| 155 | it is likely to be missed while suicide rates | 有可能在自杀率下降时被忽略 |
| 156 | are skyrocketing worldwide. | 全世界都在飙升 |
| 157 | I wager that it will not be long before every one of us, | 我敢打赌,它不会 很快,我们每一个人, |
| 158 | every single one of us, either knows someone personally | 我们每个人都认识一个人 |
| 159 | or has heard the story of someone whose life | 或曾听见一个人的故事, |
| 160 | was going great and they died by suicide. | 他们死在自杀中 |
| 161 | That person, your friend, your neighbor, | 那个人 你的朋友 邻居 |
| 162 | your kid's soccer coach, your pastor, your professor, | 你孩子的足球教练 你的牧师 你的教授 |
| 163 | your work buddy, and maybe even your child | 你的工作伙伴,甚至你的孩子 |
| 164 | is keeping their pain secret. | 他们的疼痛是保密的 |
| 165 | Now why? | 为什么? |
| 166 | Again, those who identify with what I term perfectly | 同样,那些认同我所说的 |
| 167 | hidden depression feel that they must protect themselves | 隐藏的抑郁感认为他们必须保护自己 |
| 168 | with this shield of silence. | 与这个屏蔽的沉默。 |
| 169 | They're not going to fit into the pre-assigned DSM criteria, | 他们不会符合预先指定的DSM标准, |
| 170 | and in fact, they are ashamed that anyone might think of them | 事实上,他们感到羞愧,因为任何人想他们, |
| 171 | or see them as depressed. | 或视其为忧郁。 |
| 172 | So what can we do? | 我们能怎么办? |
| 173 | How can we change or set the stage | 我们怎样才能改变或建立舞台 |
| 174 | for increased transparency? | 增加透明度? |
| 175 | I think, I know that we must recognize | 我想 我知道我们必须承认 |
| 176 | that suicidal feelings and the thoughts that accompany them | 自杀的感情和他们的思想 |
| 177 | are, believe it or not, normal. | 是,信不信由你,正常的。 |
| 178 | To be clear, I'm not saying that suicide is normal. | 说清楚 我不是说自杀是正常的 |
| 179 | I'm saying that thoughts about suicide | 我说的是关于自杀的想法 |
| 180 | are much more common than most of us know. | 比我们大多数人都知道的要普遍得多。 |
| 181 | I cannot count the number of people over the years | 这些年来,我无法计算人数 |
| 182 | who've revealed such feelings to me, | 谁向我揭示了这种感情, |
| 183 | sometimes hesitatingly, fearing that I'll do something | 有时犹豫不决,怕我会做点什么 |
| 184 | radical or take away their rights, | 或者剥夺他们的权利, |
| 185 | sometimes with great relief because they begin to let go | 有时他们很宽慰,因为他们开始放手 |
| 186 | of a shame that has literally seeped down | 令人羞愧的 已经渗出 |
| 187 | into the very core of their being, | 在他们的核心, |
| 188 | and sometimes with sadness because they realize | 有时因为意识到 |
| 189 | just how close they've come. | 他们离我们有多近 |
| 190 | Now, there are people who have the intent to die, | 现在,有人有 死的意图, |
| 191 | have the means to do it, and cannot tell you | 有办法,不能告诉你 |
| 192 | why they shouldn't. | 为什么他们不应该。 |
| 193 | Those people tell someone like me | 那些人告诉我这样的人 |
| 194 | because they want my help to keep them safe | 因为他们希望我帮助他们安全 |
| 195 | and they must be taken very seriously. | 必须认真对待它们。 |
| 196 | But so many suicidal feelings are natural, | 但是很多自杀的感觉是自然的 |
| 197 | human, normal responses to what has happened in your life. | 人类,正常的反应 在你的生活中发生的一切。 |
| 198 | So why don't we treat it as normal? | 那么我们为什么不把它当成正常的呢? |
| 199 | Why don't we talk about the feelings | 我们何不谈谈感情 |
| 200 | that we would talk about any other way? | 我们想谈别的方面吗? |
| 201 | Why don't we ask, well, when do you feel this? | 为什么我们不问,嗯,你什么时候觉得呢? |
| 202 | When do you not feel this? | 你什么时候没有感觉? |
| 203 | What's it like to talk to me about it? | 跟我谈这件事是什么感觉? |
| 204 | Have you ever wondered what would make it go away? | 你有没有想过它会消失? |
| 205 | Questions that we would ask about any other feelings | 我们想问的关于其他感情的问题 |
| 206 | that a person was trying to understand and cope with. | 一个人试图理解和应付。 |
| 207 | But these are not questions about symptom criteria. | 但这不是症状标准的问题。 |
| 208 | We are gonna go in the direction | 我们要往前走 |
| 209 | that John Summers Flanagan wants us to go, | 约翰·萨默斯·弗拉纳根希望我们离开 |
| 210 | which is working toward a strength-based | 它正致力于一个基于力量的 |
| 211 | assessment of suicide. | 对自杀的评估。 |
| 212 | Now, what does this have to do with you? | 这和你有什么关系? |
| 213 | You're probably not a clinician or a doctor. | 你可能不是临床医生或医生 |
| 214 | How would you respond if someone told you | 如果有人告诉你,你会怎样回应? |
| 215 | they were thinking about taking their own life? | 他们想自杀? |
| 216 | Sadly, the instinct is often, | 可悲的是,直觉常常是, |
| 217 | I can't believe you said that. | 真不敢相信你这么说 |
| 218 | You know you have people who love you. | 你知道你的人谁爱你。 |
| 219 | How can you be so selfish? | 你怎么能这么自私? |
| 220 | And the quickest way to end a conversation | 和最快的方式结束一个谈话 |
| 221 | is to blame someone for the way they're feeling | 就是责怪别人的感受 |
| 222 | or to suggest that no one that was literally loving | 或暗示没有真正爱的人 |
| 223 | and caring would ever have that feeling. | 关心会永远有那种感觉 |
| 224 | What if instead we could approach | 如果我们可以接近 |
| 225 | not with judgment, but with acceptance? | 不是判断,而是接受? |
| 226 | Many more conversations would take place. | 还将进行更多的对话。 |
| 227 | Let me tell you about Michael. | 让我告诉你有关迈克尔。 |
| 228 | Michael was an internationally prominent person | 迈克尔是国际知名人物 |
| 229 | in his field when he came to see me. | 当他来看我的时候 |
| 230 | And he was laughing because he said | 他笑是因为他说 |
| 231 | no one would ever imagine me going to therapy. | 没有人会想象我要去治疗。 |
| 232 | He'd grown up in a family where they didn't discuss feelings, | 他成长在一个家庭 他们没有讨论感情, |
| 233 | especially painful ones. | 特别痛苦的 |
| 234 | But his father had died suddenly. | 但他父亲突然去世了 |
| 235 | And Michael had never told his dad that he loved him | 迈克尔从未告诉他爸爸 他爱他 |
| 236 | despite the tumultuous relationship they'd had. | 尽管他们的关系很混乱 |
| 237 | And Michael couldn't forgive himself for that. | 迈克尔无法原谅自己 |
| 238 | As we talked about his childhood | 当我们谈论他的童年 |
| 239 | and current decisions he was trying to make, | 以及他试图做出的当前决定, |
| 240 | he began to see patterns. | 他开始看到规律。 |
| 241 | He could see how he'd covered up his horrific abuse | 他可以看到他是如何掩盖 他可怕的虐待 |
| 242 | as a child and tried to cover it up | 小时候还试图掩盖 |
| 243 | with greater and greater achievement | 取得更大成就 |
| 244 | to reach some sort of destination | 到达某个目的地 |
| 245 | that would blot out or blur the painful secrets | 那会抹去或模糊痛苦的秘密 |
| 246 | he kept hidden inside. | 他一直躲在里面 躲起来 |
| 247 | But it didn't work. | 但没成功 |
| 248 | He told me one day very painfully | 他告诉我有一天,很痛苦 |
| 249 | that he also had feelings of the intent to die. | 他也有死欲的感觉 |
| 250 | I told him those feelings were normal | 我告诉他这些感觉是正常的 |
| 251 | given the extent of his pain and how long he had felt it. | 鉴于他的痛苦程度 以及他感受了多久 |
| 252 | In our continuing work, | 在我们的继续工作, |
| 253 | he found that he could have compassion for himself | 他发现他可以同情自己 |
| 254 | without carrying the shame that was not his to carry. | 而不带着不是他的耻辱 |
| 255 | He could grieve without pummeling himself | 他可以悲伤而不自责 |
| 256 | with self-loathing and he could decide to live. | 与自我厌恶 他可以决定活下去。 |
| 257 | I truly will never forget the day | 我真的永远不会忘记那一天 |
| 258 | that Michael strolled into my office, | 迈克尔走进我的办公室, |
| 259 | laughing, big smile on his face and said, | 笑,大笑在他的脸上说, |
| 260 | hey doc, I gotta tell you something. | 嘿,医生,我得告诉你一件事。 |
| 261 | I was on this crowded airplane, | 我在飞机上, |
| 262 | journaling instead of working, | 日记而不是工作, |
| 263 | writing about my childhood and my father in public. | 在公众场合写我的童年和我父亲 |
| 264 | And when I felt a tear roll down my cheek, | 当我感觉到我的脸颊被撕裂时 |
| 265 | I didn't care. | 我不关心。 |
| 266 | We all have secrets. | 我们都有秘密 |
| 267 | But the cost that can accompany the feelings | 但与感情相关的费用 |
| 268 | of those secrets has never been more evident. | 这些秘密从未如此明显 |
| 269 | But you and I can realize we could have an impact | 但你和我可以意识到 我们可以有一个影响 |
| 270 | right now on our culture | 现在,我们的文化 |
| 271 | so that transparency is seen as strength. | 因此,透明度被视为力量。 |
| 272 | Baby, baby, baby, baby... | 宝贝,宝贝,宝贝,宝贝... |
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