Dr. Victor Carrión: How to Heal From Post-Traumatic Stress Disorder (PTSD)
Andrew Huberman:
安德鲁·休伯曼：
Welcome to the Huberman Lab podcast, where we discuss science and science-based tools for everyday life.
欢迎来到休伯曼实验室播客，我们在这里讨论科学和基于科学的日常生活工具。
I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.
我是安德鲁·胡伯曼，斯坦福大学医学院神经生物学和眼科教授。
My guest today is Dr. Victor Carrion.
今天我的客人是维克多·卡里恩博士。
Dr. Victor Carrion is a professor and the vice chair of psychiatry and behavioral sciences at Stanford University School of Medicine.
维克多·卡里恩博士是斯坦福大学医学院精神病学和行为科学教授兼副主席。
He is one of the world's foremost experts on post-traumatic stress disorder, in particular, the treatment of post-traumatic stress disorder in children and adolescents, although his knowledge and today's discussion certainly extends to adult PTSD as well.
他是世界上创伤后应激障碍（尤其是儿童和青少年创伤后应激障碍治疗）领域最重要的专家之一，尽管他的知识和今天的讨论当然也适用于成人创伤后应激障碍（PTSD）。
Dr. Carrion is also the director of the Stanford Early Life Stress and Resilience Program, and today's discussion focuses on the psychological and the neurobiological underpinnings of PTSD, and which treatments are most effective for PTSD.
Carrion 博士还是斯坦福大学早期生活压力和复原力项目的主任，今天的讨论重点是 PTSD 的心理和神经生物学基础，以及哪些治疗方法对 PTSD 最有效。
We focus heavily on a particular therapy called cue center therapy that was developed by Dr. Carrion and colleagues that has been shown to offset the triggering by words or events or memories that often are the precursors to PTSD episodes, and this has been shown to be effective in both children and adults.
我们重点关注一种名为提示中心疗法的特殊疗法，该疗法由 Carrion 博士及其同事开发，已被证明可以抵消通常是 PTSD 发作前兆的言语、事件或记忆的触发，并且已被证明对儿童和成人都有效。
Today's discussion explores the difference between anxiety, stress, and trauma.
今天的讨论探讨了焦虑、压力和创伤之间的区别。
We talk about how those things, of course, are related, but how they can be separated out to better understand if indeed somebody has trauma and how to best approach the treatment of that trauma.
当然，我们讨论这些事情是如何相关的，但如何将它们分开，以便更好地了解某人是否确实患有创伤，以及如何最好地治疗该创伤。
As you'll soon see, what makes Dr. Carrion's work so unique is that it combines the psychological, the neurobiological, but also practical tools such as mindfulness.
您很快就会看到，卡里恩博士的工作之所以如此独特，是因为它结合了心理学、神经生物学以及正念等实用工具。
It relates mindfulness and cognitive behavioral therapy to the underlying biology and what's known about the psychiatry and psychology of PTSD at its different stages, depending on the trauma, the age of the person, et cetera.
它将正念和认知行为疗法与潜在的生物学以及对创伤后应激障碍不同阶段的精神病学和心理学的了解联系起来，这取决于创伤、人的年龄等。
Today, Dr. Carrion clearly explains all of that, so that by the end of today's conversation, you'll really understand what PTSD is and is not, and of course, the best ways to treat it.
今天，Carrion 博士清楚地解释了所有这些，以便在今天的对话结束时，您将真正了解 PTSD 是什么、不是什么，当然还有治疗它的最佳方法。
Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford.
在开始之前，我想强调一下，这个播客与我在斯坦福大学的教学和研究角色是分开的。
It is, however, part of my desire and effort to bring zero cost to consumer information about science and science-related tools to the general public.
然而，我的愿望和努力的一部分是向公众提供有关科学和科学相关工具的零成本消费者信息。
In keeping with that theme, I'd like to thank the sponsors of today's podcast.
为了与这个主题保持一致，我要感谢今天播客的赞助商。
Our first sponsor is Eight Sleep.
我们的第一个赞助商是八睡。
Eight Sleep makes smart mattress covers with cooling, heating, and sleep tracking capacity.
August Sleep 生产具有冷却、加热和睡眠跟踪功能的智能床垫套。
Now, I've spoken many times before on this podcast about the critical need for us to get adequate amounts of quality sleep each night.
现在，我之前已经在这个播客中多次谈到我们每晚获得充足的优质睡眠的迫切需要。
That's truly the foundation of all mental health, physical health, and performance.
这确实是所有心理健康、身体健康和表现的基础。
And one of the best ways to ensure that you get a great night's sleep is to control the temperature of your sleeping environment.
确保您睡个好觉的最佳方法之一就是控制睡眠环境的温度。
And that's because in order to fall and stay deeply asleep, your body temperature actually has to drop by about one to three degrees.
这是因为为了入睡并保持深度睡眠，您的体温实际上必须下降约一到三度。
And in order to wake up feeling refreshed and energized, your body temperature actually has to increase about one to three degrees.
为了醒来时感到神清气爽、精力充沛，您的体温实际上必须升高约一到三度。
Eight Sleep makes it incredibly easy to control the temperature of your sleeping environment by allowing you to control the temperature of your mattress cover at the beginning, middle, and end of the night.
八睡眠让您可以非常轻松地控制睡眠环境的温度，让您可以在晚上的开始、中间和结束时控制床垫套的温度。
And it turns out the ability to do so allows you to get the maximum amount of deep sleep, slow-wave sleep, and rapid eye movement sleep at the different stages of the night.
事实证明，这样做的能力可以让你在夜间的不同阶段获得最大限度的深度睡眠、慢波睡眠和快速动眼睡眠。
I've been sleeping on an Eight Sleep mattress cover for nearly four years now, and it has completely transformed and improved the quality of my sleep.
我已经睡在八睡眠床垫罩上近四年了，它彻底改变并改善了我的睡眠质量。
Eight Sleep has now launched their newest generation of the pod cover, the Pod 4 Ultra.
八睡眠现在推出了他们最新一代的 Pod 4 Ultra。
The Pod 4 Ultra has improved cooling and heating capacity, higher fidelity sleep tracking technology, and even has snoring detection that will automatically lift your head a few degrees to improve your airflow and stop your snoring.
Pod 4 Ultra 具有改进的冷却和加热能力、更高保真度的睡眠跟踪技术，甚至还具有打鼾检测功能，可以自动将您的头抬起几度，以改善气流并停止打鼾。
If you'd like to try an Eight Sleep mattress cover, go to eightsleep.com/huberman to save up to $350 off their Pod 4 Ultra.
如果您想尝试 8 Sleep 床垫套，请访问 foursleep.com/huberman，Pod 4 Ultra 最多可节省 350 美元。
Eight Sleep currently ships in the USA, Canada, UK, select countries in the EU, and Australia.
八睡眠目前在美国、加拿大、英国、欧盟部分国家和澳大利亚发货。
Again, that's eightsleep.com/huberman.
再说一遍，这是八睡眠.com/huberman。
Today's episode is also brought to us by BetterHelp.
今天的节目也是由 BetterHelp 为我们带来的。
BetterHelp offers professional therapy with a licensed therapist carried out entirely online.
BetterHelp 提供由持证治疗师完全在线进行的专业治疗。
I've been doing weekly therapy for well over 30 years.
三十多年来我每周进行一次治疗。
Initially, I didn't have a choice.
最初，我别无选择。
It was the condition of being allowed to stay in school.
这是允许留在学校的条件。
But pretty soon I realized that doing regular quality therapy is an extremely important component to overall health.
但很快我就意识到定期进行优质治疗对于整体健康来说是极其重要的组成部分。
In fact, I consider doing regular therapy just as important as getting regular physical exercise, including cardiovascular exercise and resistance training, which of course I also do every single week.
事实上，我认为定期治疗与定期进行体育锻炼一样重要，包括心血管锻炼和阻力训练，当然我每周都会进行这些锻炼。
There are essentially three components to excellent therapy.
优秀的治疗基本上由三个组成部分组成。
First of all, excellent therapy should provide good rapport with somebody that you can trust and talk to about all issues in your life.
首先，优秀的治疗应该与您可以信任的人建立良好的融洽关系，并可以与您谈论生活中的所有问题。
Second of all, it should provide support in the form of emotional support or directed guidance or both.
其次，它应该以情感支持或定向指导或两者兼而有之的形式提供支持。
And thirdly, expert therapy should provide useful insights, insights that can allow you to do better not just in your emotional life and relationship life, but of course also your relationship to yourself, your professional life, and all of your career and life goals.
第三，专家治疗应该提供有用的见解，这些见解不仅可以让你在情感生活和人际关系生活方面做得更好，当然也可以让你在与自己的关系、你的职业生活以及你所有的职业和人生目标方面做得更好。
With BetterHelp, they make it very easy to find an expert therapist with whom you can build all three of these effective components of therapy.
通过 BetterHelp，您可以轻松找到专家治疗师，与他一起构建所有这三个有效的治疗组成部分。
If you'd like to try BetterHelp, you can go to betterhelp.com/huberman to get 10% off your first month.
如果您想尝试 BetterHelp，可以访问 betterhelp.com/huberman，第一个月可享受 10% 的折扣。
Again, that's betterhelp.com/huberman.
再说一次，这是 betterhelp.com/huberman。
Today's episode is also brought to us by Waking Up.
今天的节目也是由Wakeing Up为我们带来的。
Waking Up is a meditation app that offers hundreds of guided meditation programs, mindfulness trainings, yoga nidra sessions, and more.
Waking Up 是一款冥想应用程序，提供数百个引导冥想计划、正念训练、瑜伽休息课程等。
I started practicing meditation when I was about 15 years old, and it made a profound impact on my life.
我大约15岁的时候开始练习冥想，它对我的生活产生了深远的影响。
And by now, there are thousands of quality peer-reviewed studies that emphasize how useful mindfulness meditation can be for improving our focus, managing stress and anxiety, improving our mood, and much more.
到目前为止，已有数以千计的高质量同行评审研究强调正念冥想对于提高我们的注意力、管理压力和焦虑、改善我们的情绪等等有多么有用。
In recent years, I started using the Waking Up app for my meditations because I find it to be a terrific resource for allowing me to really be consistent with my meditation practice.
近年来，我开始使用“Waking Up”应用程序进行冥想，因为我发现它是一个很棒的资源，可以让我真正坚持我的冥想练习。
Many people start a meditation practice and experience some benefits, but many people also have challenges keeping up with that practice.
许多人开始冥想练习并体验到一些好处，但许多人也面临着跟上练习的挑战。
What I and so many other people love about the Waking Up app is that it has a lot of different meditations to choose from, and those meditations are of different durations.
我和许多其他人喜欢“醒来”应用程序的原因是它有很多不同的冥想可供选择，而且这些冥想的持续时间也不同。
So it makes it very easy to keep up with your meditation practice, both from the perspective of novelty, you never get tired of those meditations.
所以它让你很容易跟上你的冥想练习，无论是从新奇的角度来看，你永远不会厌倦这些冥想。
There's always something new to explore and to learn about yourself and about the effectiveness of meditation.
总有一些新的东西值得探索和了解你自己以及冥想的有效性。
And you can always fit meditation into your schedule, even if you only have two or three minutes per day in which to meditate.
即使您每天只有两到三分钟的时间进行冥想，您也可以随时将冥想纳入您的日程安排中。
If you'd like to try the Waking Up app, please go to wakingup.com/huberman, where you can access a free 30-day trial.
如果您想尝试 Waking Up 应用程序，请访问 wakingup.com/huberman，在这里您可以免费试用 30 天。
Again, that's wakingup.com/huberman to access a free 30-day trial.
同样，访问 wakingup.com/huberman 即可获得 30 天免费试用。
And now for my discussion with Dr. Victor Carrion.
现在我与维克多·卡里恩博士进行讨论。
Dr. Victor Carrion, welcome.
维克多·卡里恩博士，欢迎光临。
Dr. Victor Carrión:
维克多·卡里翁博士：
Thank you.
谢谢你。
Thank you so much for having me.
非常感谢你邀请我。
Andrew Huberman:
安德鲁·休伯曼：
I'd like to talk today about PTSD, post-traumatic stress disorder, in particular in young people, but also in adults.
今天我想谈谈创伤后应激障碍（PTSD），即创伤后应激障碍，特别是在年轻人中，但在成年人中也是如此。
But before we do that, can you educate us on the definition of stress and maybe distinguish between short-term stress and long-term stress?
但在此之前，您能否告诉我们压力的定义，以及区分短期压力和长期压力？
And then perhaps we can segue into PTSD.
然后也许我们可以继续讨论创伤后应激障碍（PTSD）。
Dr. Victor Carrión:
维克多·卡里翁博士：
That's a very good way of starting because, in reality, my main interest was the role of stress and the role of stressors, and how stressors really would activate the gene makeup and make us vulnerable to things that we might be vulnerable.
这是一个非常好的开始方式，因为实际上，我的主要兴趣是压力的作用和压力源的作用，以及压力源如何真正激活基因构成并使我们容易受到我们可能脆弱的事物的影响。
But at the time when I was training, psychiatry as a field was very diagnosis-based.
但在我接受培训时，精神病学作为一个领域非常以诊断为基础。
So you needed an anchor, and hence I used PTSD to communicate what I was really referring to.
所以你需要一个锚点，因此我使用创伤后应激障碍来传达我真正指的是什么。
But the reality is that the experience of stress, as we now know, is a spectrum from beneficial to not beneficial to traumatic.
但现实是，正如我们现在所知，压力的体验是从有益到无益到造成创伤的一系列范围。
So really, stress operates in our lives as an inverted U-shaped curve.
事实上，压力在我们的生活中以倒U形曲线的形式运作。
The more stress we have, the better we perform, the better we do.
我们承受的压力越大，我们的表现就越好，我们的表现就越好。
If we don't care about that exam that we're going to have tomorrow, we'll probably fail.
如果我们不关心明天的考试，我们可能会失败。
So it's good to be somewhat stressed, right?
所以有点压力是件好事，对吧？
Vaccines are a stress in the system.
疫苗是系统中的一个压力。
So, we'll talk about this, I hope, but I'm very concerned also about the overprotection of kids to protect them from any type of stress.
所以，我希望我们会讨论这个问题，但我也非常担心对孩子的过度保护，以保护他们免受任何类型的压力。
Because it is through this experience of early stress that of us develop our problem-solving abilities, and we become aware of our coping mechanisms, we become aware of our support system.
因为正是通过这种早期压力的经历，我们发展了解决问题的能力，并且我们意识到了我们的应对机制，我们意识到了我们的支持系统。
How can I manage that stress?
我该如何应对这种压力？
And we can manage stress because in the same way that through the process of homeostasis, we have a range of temperatures, right, in which we can live.
我们可以管理压力，因为就像在体内平衡过程中一样，我们有一个可以生活的温度范围。
The same thing with stress.
压力也是如此。
We can actually cope up to a certain point.
我们实际上可以应付到一定程度。
After a certain point, it's not homeostasis anymore, and it turns into what we call allostasis, when it really starts having a physiological cost to the body.
在某一点之后，当它真正开始对身体产生生理成本时，它就不再是体内平衡，而是变成我们所说的失衡。
So in that inverted U-shaped curve, there's that optimal point where your health, your happiness, your performance, everything is better because of the stress you've been having.
因此，在倒 U 形曲线中，有一个最佳点，在该点上，您的健康、幸福、表现等一切都会因为您所承受的压力而变得更好。
But after that optimal point, all of those outcomes, health, performance, start to decline.
但在这个最佳点之后，所有这些结果，健康状况，表现，都开始下降。
Happiness starts to decline.
幸福感开始下降。
And it is in that second part of the curve where we find traumatic stress.
正是在曲线的第二部分，我们发现了创伤性压力。
Traumatic stress being a type of stress that is not only something you have to cope with, but it actually puts your physical integrity in jeopardy.
创伤性压力是一种压力，它不仅是您必须应对的压力，而且实际上使您的身体完整性处于危险之中。
It's a threat.
这是一个威胁。
And you have to manage that.
你必须处理好这一点。
And when you experience traumatic stress, many outcomes are possible.
当您经历创伤性压力时，可能会出现多种结果。
One is that you're resilient, and we'll talk a little bit about that as well, I hope.
一是你的适应能力很强，我希望我们也能讨论一下这一点。
But another one is that you may develop symptoms of post-traumatic stress disorder.
但另一个问题是，您可能会出现创伤后应激障碍的症状。
And the reason that I didn't anchor on the diagnosis right away from the outset, and I was interested in studying stressors, is because we were seeing many kids that had symptoms of PTSD without having the diagnosis that were demonstrating functional impairment.
我之所以没有从一开始就锁定诊断，并且对研究压力源感兴趣，是因为我们看到许多有 PTSD 症状的孩子，但没有诊断出功能障碍。
So they were not doing well in school, they were not doing well with their relationships.
所以他们在学校表现不佳，在人际关系上也表现不佳。
They were experiencing distress, right?
他们正在经历痛苦，对吗？
So their function was affected, yet they didn't have the diagnosis.
所以他们的功能受到影响，但他们没有得到诊断。
So the diagnosis is good in that it's there and it is a behavioral definition that we can anchor in, but there's more nuance to that.
因此，诊断是好的，因为它是存在的，并且它是我们可以锚定的行为定义，但其中还有更多细微差别。
So then that shows the whole spectrum.
那么这就显示了整个范围。
And of course, we can come out of PTSD, and we can go back to that optimal point.
当然，我们可以走出创伤后应激障碍，我们可以回到那个最佳点。
So we don't want to get rid of stress, but we just want to return to that optimal point.
所以我们并不是想摆脱压力，而是想回到那个最佳点。
And treatment is available and people can recover from PTSD, and especially kids can recover from PTSD.
治疗是可行的，人们可以从 PTSD 中康复，尤其是孩子可以从 PTSD 中康复。
But there's one thing that really gets in the way, and that's something that in my team we have a phrase that we say, "PTSD feeds on avoidance." If we pretend that something didn't happen, if we pretend that it will go away, if we pretend that treatment is not necessary, then that's when it gets complicated.
但有一件事确实很碍事，那就是在我的团队中，我们有一句话，“创伤后应激障碍以回避为食”。如果我们假装某件事没有发生，如果我们假装它会消失，如果我们假装不需要治疗，那么事情就会变得复杂。
And it gets complicated with substance abuse, it gets complicated with self-injurious behaviors, and then at that point, it becomes harder to treat.
药物滥用会让情况变得复杂，自残行为会让情况变得复杂，到那时，治疗就会变得更加困难。
Andrew Huberman:
安德鲁·休伯曼：
Is it also possible that PTSD gets worse if we tend to look at it over and over again, ruminate on it, in the absence of any structured clinical support?
如果我们在没有任何结构化临床支持的情况下一遍又一遍地审视、思考它，创伤后应激障碍是否也有可能变得更糟？
Meaning, if people perseverate on their traumas, can the negative impact of those traumas actually root deeper into us?
这意味着，如果人们坚持自己的创伤，这些创伤的负面影响实际上会在我们身上扎根更深吗？
Dr. Victor Carrión:
维克多·卡里翁博士：
It's interesting that you use the word perseverate because one of the characteristics of trauma when it affects children is that it robs them from play.
有趣的是，你使用“坚持”这个词，因为当创伤影响到儿童时，其特征之一就是它剥夺了他们的玩耍能力。
Play is something that's essential in development.
玩耍是发展中必不可少的事情。
It's how we grow socially, emotionally, physically.
这就是我们在社交、情感和身体上成长的方式。
But when play becomes traumatic play, it becomes non-joyful, but it becomes perseverant and repetitive.
但当游戏变成创伤性游戏时，它就变得不快乐，而是变得持久和重复。
This is the attempt of the individual to try to make sense of what happened.
这是个人试图理解所发生的事情的尝试。
And the reason why it's not good to be alone with it and kind of perseverate on it by oneself is that we're probably not looking at the right insult.
独自面对它并坚持下去是不好的原因是我们可能没有看到正确的侮辱。
So, in our experience, usually PTSD doesn't result from that one traumatic event.
因此，根据我们的经验，创伤后应激障碍通常不是由这一创伤事件引起的。
We all carry a backpack, and we can all carry all the stressors that have come our way, like we were saying before.
我们都背着一个背包，我们都可以承受所有的压力，就像我们之前说的那样。
But if you're five, six, seven years old, and that backpack gets really heavy, you can fall backwards.
但如果你五岁、六岁、七岁，背包变得很重，你可能会向后摔倒。
And when you fall backwards, that's because you don't have the tools really to carry that.
当你向后跌倒时，那是因为你没有真正支撑它的工具。
But what I'm saying is that it is the accumulation of stressors, some of which may be traumatic, that cause the symptoms of PTSD.
但我想说的是，压力源的积累（其中一些可能是创伤性的）导致了创伤后应激障碍（PTSD）的症状。
So, for example, some of us went to Haiti after an earthquake.
举例来说，我们中的一些人在地震后去了海地。
And I was starting my program at that time.
那时我正在开始我的计划。
I was very young.
我当时很年轻。
All ready to talk about earthquakes and know everything about earthquakes.
准备好谈论地震并了解有关地震的一切。
It was the last thing they wanted to talk about.
这是他们最不想谈论的事情。
They saw the earthquake as an opportunity to talk about the violence they had been experiencing, the poverty, the lack of education.
他们认为地震是一个谈论他们所经历的暴力、贫困和缺乏教育的机会。
So, they were talking to me about everything they were carrying that led some of them to develop symptoms of PTSD.
所以，他们和我谈论了他们所携带的一切导致他们中的一些人出现创伤后应激障碍症状的事情。
Andrew Huberman:
安德鲁·休伯曼：
I see.
我明白了。
As you describe these other aspects of one's life that can have negative impact, poverty, violence, et cetera, I get the impression that PTSD can be caused by a single event or trauma, but that there's a cumulative aspect to it.
当你描述一个人生活中可能产生负面影响的其他方面，如贫困、暴力等时，我的印象是创伤后应激障碍可能是由单一事件或创伤引起的，但它有一个累积的方面。
So is it the case that in children, because their brain is far more plastic, we know this, brain circuits are modified even by passive experience in childhood, whereas in adulthood, it requires focused attention in order to learn, unless it's a negative event, for better or worse.
儿童的情况也是如此，因为他们的大脑更具可塑性，我们知道，即使是童年时期的被动经历，大脑回路也会被改变，而在成年期，则需要集中注意力才能学习，除非这是一个负面事件，无论好坏。
That in kids, it takes far fewer or less intense negative experiences in order to create PTSD because the brain is so plastic, or is there a similarity between youth and adult PTSD?
对于孩子来说，产生创伤后应激障碍所需的负面经历要少得多或不那么强烈，因为大脑的可塑性很强，或者青少年和成人创伤后应激障碍之间是否存在相似之处？
Dr. Victor Carrión:
维克多·卡里翁博士：
Epidemiological studies confirm your assertion.
流行病学研究证实了你的说法。
One line that I really don't like is children are resilient because children are really not.
我真的不喜欢这样一句话：孩子们很有弹性，因为孩子们确实没有。
They're more vulnerable.
他们更脆弱。
They have the opportunity to become resilient if we help them and we tell them what tools to use and how to develop and all of that, but they are more vulnerable to PTSD, and part of it might be that neuroplasticity.
如果我们帮助他们，告诉他们使用什么工具以及如何发展等等，他们就有机会变得有弹性，但他们更容易受到创伤后应激障碍（PTSD）的影响，部分原因可能是神经可塑性。
And this is why we care for them.
这就是我们关心他们的原因。
This is why we protect them and give them safety because they are vulnerable.
这就是为什么我们保护他们并为他们提供安全，因为他们很脆弱。
By the same token, that neuroplasticity can work both ways because if PTSD is teaching us that the environment can have an impact on biology, that's the only lesson.
出于同样的原因，神经可塑性可以双向发挥作用，因为如果创伤后应激障碍教会我们环境可以对生物学产生影响，那就是唯一的教训。
Environment can have an impact on biology.
环境会对生物学产生影响。
In PTSD, it's a negative impact because of a negative stressor or accumulation of stressors.
在创伤后应激障碍中，这是由于负面压力源或压力源累积而产生的负面影响。
But that also means that if the impact is positive, as in a good supportive system or as in psychotherapy, that recovery can actually happen in an easier way.
但这也意味着，如果影响是积极的，例如在良好的支持系统或心理治疗中，那么康复实际上可以以更容易的方式发生。
Andrew Huberman:
安德鲁·休伯曼：
Before we talk about therapeutic interventions, I'm curious about genetic predisposition, and a topic that comes up a lot anytime the letters PTSD are stated in that order is transgenerational trauma.
在我们谈论治疗干预之前，我对遗传倾向感到好奇，每当按顺序表述 PTSD 字母时经常出现的一个话题是跨代创伤。
I can imagine at least two forms of transgenerational trauma.
我可以想象至少两种形式的跨代创伤。
One is a generation of what are now grandparents or great-grandparents or parents are impacted by some trauma, either in the family or maybe in culture or even broader scale.
一代人现在是祖父母或曾祖父母或父母，他们受到一些创伤的影响，无论是在家庭中，还是在文化中，甚至更广泛的范围内。
And then discussions about that passed through generations impact children and therefore their adult life.
然后，关于代代相传的讨论会影响儿童，从而影响他们的成年生活。
I could also imagine, and I think this is normally what people are referring to when they talk about transgenerational trauma, this idea that somehow the genome is modified by the trauma, such that even if kids are raised by parents that adopted them or they have no contact with the grandparents or great-grandparents that experienced the trauma, that somehow they are more vulnerable to, or in some cases, the idea has been put forward, carry that trauma, put it in air quotes, such that their life is more difficult even though they never had a direct experience of that trauma.
我也可以想象，我认为这通常是人们在谈论跨代创伤时所指的，这种想法认为基因组在某种程度上被创伤所改变，这样即使孩子是由收养他们的父母抚养长大的，或者他们与经历过创伤的祖父母或曾祖父母没有接触，不知何故他们更容易受到伤害，或者在某些情况下，这个想法已经被提出，携带这种创伤，把它放在空气引号中，这样他们的生活就会更加困难，即使他们从未直接经历过创伤那个创伤。
What are your thoughts about transgenerational passage of trauma, both forms, both the narrative passage as well as the potential for epigenomic or genomic passage of transgenerational trauma?
您对创伤的跨代传递（两种形式、叙事传递以及跨代创伤的表观基因组或基因组传递的潜力）有何看法？
Dr. Victor Carrión:
维克多·卡里翁博士：
No, this is a very interesting subject.
不，这是一个非常有趣的话题。
The jury is still out if genomic changes that result as a consequence of stress can be passed from one generation to the other.
压力导致的基因组变化是否可以从一代传到另一代，目前还没有定论。
But certainly, the genes that made one generation vulnerable are being passed to the next generation as well.
但可以肯定的是，使一代人变得脆弱的基因也正在传递给下一代。
That we know.
我们知道。
So it can be passed that way.
所以可以这样通过。
But what happens is that there's also this impact of learning, and I have treated kids that come to me with all of the symptoms of PTSD, and there's no trauma.
但实际情况是，学习也有这种影响，我治疗过那些患有创伤后应激障碍 (PTSD) 症状的孩子，没有受到任何创伤。
I cannot find the trauma, and the parent cannot find the trauma, and the kid doesn't report a trauma.
我找不到创伤，家长也找不到创伤，孩子也没有报告创伤。
But when I'm talking with the parent, the trauma becomes evident in the history of the parent.
但当我与父母交谈时，父母的历史中的创伤变得显而易见。
So the parent has developed PTSD and behaves in a way that has been learned by the new generation.
因此，父母已经患上创伤后应激障碍（PTSD），并且其行为方式已为新一代所习得。
Ways like avoidance or re-experience or hypervigilance or lack of trust, things like that.
诸如回避或重新体验或过度警惕或缺乏信任之类的方式。
So certainly, there are pathways in which it can go from one generation to the other.
因此，当然，它可以通过某些途径从一代人传到另一代人。
And we know that the battle between nature and nurture is pretty much over, right?
我们知道先天与后天之间的斗争已经基本结束，对吧？
We know that they both influence vulnerability and that they both interact.
我们知道它们都会影响脆弱性并且相互作用。
And I imagine that's what's happening in some of these situations.
我想这就是某些情况下所发生的情况。
Andrew Huberman:
安德鲁·休伯曼：
In terms of stress, I always think of stress as both a response within the brain and a response within the body, and I'm not alone in that belief, I think.
就压力而言，我始终认为压力既是大脑内部的反应，也是身体内部的反应，而且我认为，我并不是唯一一个有这种信念的人。
We know that adrenaline, epinephrine, is released from the adrenals, but also from areas of the brain like locus coeruleus, so that there's this parallel effect of elevated states of mind, more alert, more focused on narrow locations in space and time, and the body is also prepared for action.
我们知道，肾上腺素会从肾上腺释放，但也会从大脑的蓝斑等区域释放，因此会产生这种平行的效果：精神状态提高，更加警觉，更加专注于空间和时间的狭窄位置，身体也为行动做好了准备。
I think this is what underlies the increased heart rate, the shaking in some cases, sweating.
我认为这就是心率加快、某些情况下颤抖、出汗的原因。
It's essentially a preparation for action.
这本质上是行动的准备。
With PTSD, I often hear that some of the symptoms are more of the opposite end of the spectrum in terms of autonomic arousal.
对于创伤后应激障碍（PTSD），我经常听说一些症状在自主神经唤醒方面更像是相反的一端。
Things like dissociation, fatigue, kind of checking out, which I realize is dissociation, but things that are more akin to kind of parasympathetic.
像解离、疲劳、某种检查之类的东西，我意识到这是解离，但更类似于副交感神经的东西。
Right?
正确的？
For those that don't know, the sympathetic, parasympathetic represents the continuum of autonomic interaction.
对于那些不知道的人来说，交感神经、副交感神经代表自主神经相互作用的连续体。
Sympathetic having nothing to do with emotional sympathy.
同情与情感同情无关。
It's all about fight or flight type responses, although at lower levels, it's what's responsible for us being alert here, but not in fight or flight.
这都是关于战斗或逃跑类型的反应，尽管在较低水平上，它是我们在这里保持警惕的原因，但不是在战斗或逃跑中。
And parasympathetic being more of the rest and digest, even leading into sleep type responses.
副交感神经更多地休息和消化，甚至导致睡眠类型的反应。
So, if somebody experiences a big stressor, a trauma, or chronic stress to the point where it becomes PTSD, is there a tendency for them to be more hypervigilant and have a startle response, to have their head on a swivel all the time looking for danger, or to be more dissociative, or can both sets of phenotypes exist in the same person?
那么，如果一个人经历了巨大的压力源、创伤或慢性压力，达到了创伤后应激障碍的程度，他们是否会变得更加高度警惕并做出惊吓反应，总是转头寻找危险，或者变得更加分离，或者这两种表型可以同时存在于同一个人身上吗？
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah.
是的。
No, this is very interesting.
不，这很有趣。
While we're talking about the latter, let me say that a lot of people call post-traumatic stress disorder post-traumatic stress injury, not considering it a disorder, but considering it something that where our fight or flight mechanism, the autonomic nervous system, has been desensitized, and we need to regulate it again.
当我们谈论后者时，我要说的是，很多人将创伤后应激障碍称为创伤后应激损伤，并不认为它是一种疾病，而是认为它是我们的战斗或逃跑机制，即自主神经系统已经脱敏，我们需要再次调节它。
And it's going to hurt.
而且会很痛。
It's going to be painful.
这会很痛苦。
It's just like when you break your arm and go to the emergency room, and it hurts to be placed back in place, but it's the cure.
这就像当你摔断手臂去急诊室时，放回原处会很痛，但这是治疗方法。
It's what cures it.
这就是治愈它的方法。
So a lot of people visualize it, and sometimes I do, as an injury rather than a disorder.
所以很多人（有时我也这么认为）将其视为一种伤害而不是一种疾病。
Andrew Huberman:
安德鲁·休伯曼：
Post-traumatic stress injury.
创伤后应激损伤。
Dr. Victor Carrión:
维克多·卡里翁博士：
Injury.
受伤。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
Dr. Victor Carrión:
维克多·卡里翁博士：
And so what happens?
那么会发生什么呢？
So this autonomic system gets activated.
所以这个自主系统被激活。
We have our fight or flight reaction, but what happens to a young kid?
我们有战斗或逃跑的反应，但对于一个小孩子来说会发生什么呢？
Because they're very little, and they cannot fight.
因为它们太小了，无法战斗。
They're also very dependent, and they cannot flight.
他们也非常依赖，并且无法逃跑。
So they're stuck.
所以他们被困住了。
They're stuck there.
他们被困在那里。
So they freeze.
所以他们冻结了。
They freeze, and that's dissociation.
他们冻结了，那就是解离。
It's actually, during development, a healthy defense mechanism.
实际上，在发育过程中，这是一种健康的防御机制。
But very much like a white blood cell that's very helpful, if you have too much of it, you develop a leukemia.
但就像白细胞一样，它非常有帮助，如果你的白细胞过多，你就会患上白血病。
You can develop dissociative disorders if that's the only thing you have.
如果这是你唯一拥有的东西，你可能会患上解离性障碍。
But it does help children cope with some of these situations, pretending this is not real or this is not happening to me.
但它确实可以帮助孩子们应对其中一些情况，假装这不是真的，或者这没有发生在我身上。
It's the only thing they have left.
这是他们仅存的东西了。
And because this arousal system is so key in the development of these children, I thought that we should look at the hormone cortisol in the kids.
因为这种唤醒系统对于这些孩子的发育非常关键，所以我认为我们应该看看孩子们体内的皮质醇激素。
And when I started, when I was a fellow doing my child psychiatry fellowship, I was seeing all types of kids with all kinds of issues.
当我开始做儿童精神病学研究金时，我看到各种类型的孩子都有各种各样的问题。
Some had ADHD, some had OCD, some had PTSD symptoms.
有些人患有注意力缺陷多动症（ADHD），有些人患有强迫症（OCD），有些人有创伤后应激障碍（PTSD）症状。
But I was getting a lot of kids with notes from school saying, "This kid has ADHD, please place on Ritalin." Right?
但我收到很多孩子的学校笔记，上面写着：“这个孩子患有多动症，请服用利他林。”正确的？
A stimulant medication.
一种兴奋剂药物。
And I'm like, "Wow, the diagnosis has been made.
我想，“哇，诊断已经做出了。
There's already a treatment plan.
治疗方案已经有了。
What am I training here for?" But in some instances, they were right.
我来这里训练是为了什么？”但在某些情况下，他们是对的。
The kids had ADHD.
孩子们患有多动症。
But in most cases, what happened is that that hypervigilance that you're talking about was being misinterpreted as hyperactivity, and the dissociation was being misinterpreted as inattentiveness.
但在大多数情况下，发生的情况是，你所说的过度警惕被误解为多动，而分离被误解为注意力不集中。
So the kids were getting a diagnosis that was not correct.
所以孩子们得到的诊断是不正确的。
Of course, there are other very complex cases where you have both ADHD and PTSD.
当然，还有其他非常复杂的情况，您同时患有 ADHD 和 PTSD。
Also, ADHD can put you at risk to develop PTSD because you're not as attentive as to what's happening in your environment.
此外，注意力缺陷多动症可能会让您面临患上创伤后应激障碍的风险，因为您对周围环境中发生的事情不太关注。
But they're definitely two different conditions.
但它们绝对是两个不同的条件。
And it was that clinical observation that made me think, well, people don't know enough about PTSD, and certainly, they don't know enough about PTSD in children.
正是这种临床观察让我想到，人们对创伤后应激障碍 (PTSD) 的了解不够，当然，他们对儿童的创伤后应激障碍 (PTSD) 的了解也不够。
And we were having some research in adult around that time in terms of cortisol levels.
当时我们正在对成人的皮质醇水平进行一些研究。
David Spiegel, who you've had here, Rachel Yehuda at the Bronx VA, looking at PTSD in adults.
大卫·斯皮格尔（David Spiegel），你们在弗吉尼亚州布朗克斯区的雷切尔·耶胡达（Rachel Yehuda），正在研究成人的创伤后应激障碍（PTSD）。
But I said, "But how does PTSD look early on?
但我说：“但是创伤后应激障碍（PTSD）早期看起来怎么样？
What's happening in the hypothalamic pituitary adrenal axis that is responsible for secreting cortisol and regulate cortisol when these children are young?
当这些孩子还小的时候，负责分泌皮质醇和调节皮质醇的下丘脑垂体肾上腺轴发生了什么？
Because this is a new axis.
因为这是一个新的轴。
Is it already not working, or is it working right?" And so we did a number of studies that demonstrated that the normal circadian rhythmicity of cortisol was there.
是已经不起作用了，还是还正常？”因此，我们做了许多研究，证明皮质醇存在正常的昼夜节律。
It was higher early in the morning, we need to jump out of bed, and as the day progresses, it decreases.
清晨温度较高，我们需要从床上跳起来，随着时间的推移，温度会降低。
Very helpful.
非常有帮助。
It goes up when we are stressed, like when we have lunch.
当我们有压力时，比如我们吃午饭时，它就会上升。
After we have lunch, cortisol goes up so that we can help manage the insult of digestion or whatever.
吃完午饭后，皮质醇会上升，这样我们就可以帮助控制消化或其他方面的问题。
In these kids, we're having those levels, but something was happening in a number of studies and we noted that the pre-bedtime level was higher.
在这些孩子中，我们也有这些水平，但许多研究中发生了一些事情，我们注意到睡前水平更高。
We were measuring it at different times.
我们在不同时间测量它。
In the morning, pre-breakfast, pre-lunch, pre-dinner, pre-bedtime.
早上，早餐前，午餐前，晚餐前，睡前。
But it was the pre-bedtime level that wouldn't come as low as the healthy controls.
但睡前水平不会低于健康对照组。
It would remain high.
它将保持在高位。
And this was also important clinically because many of the symptoms these kids were having were happening at night.
这在临床上也很重要，因为这些孩子出现的许多症状都是在晚上发生的。
Enuresis, bedwetting, nightmares, not sleeping deep enough, not sleeping long enough, fears.
遗尿、尿床、噩梦、睡得不够深、睡得不够长、恐惧。
At that point, I felt, well, we don't know anything other than the cortisol pre-bedtime is elevated.
那时，我觉得，好吧，除了睡前皮质醇升高之外，我们不知道其他任何事情。
Maybe they need it to be.
也许他们需要这样。
Who knows?
谁知道？
But I was concerned about the work by Sapolsky and Bruce McEwen, his mentor, demonstrating the neurotoxicity that glucocorticoids can have in key areas of the brain, areas in the limbic system and the cortical system, which interestingly enough have a lot of glucocorticoid receptors.
但我担心萨波尔斯基和他的导师布鲁斯·麦克尤恩的工作，证明了糖皮质激素在大脑关键区域、边缘系统区域和皮质系统中可能具有的神经毒性，有趣的是，这些区域有很多糖皮质激素受体。
So then we decided to look at brain structure and brain function in youth with PTSD symptoms and see how this cortisol would relate to that or not.
因此，我们决定研究患有创伤后应激障碍症状的年轻人的大脑结构和大脑功能，看看皮质醇与此有何关系。
And we did that through MRI, magnetic resonance imaging.
我们通过核磁共振成像（MRI）做到了这一点。
Andrew Huberman:
安德鲁·休伯曼：
Let's talk about cortisol for a moment.
让我们谈谈皮质醇。
It's a topic that has not received enough attention in previous episodes of the podcast.
这个话题在之前的播客节目中没有得到足够的关注。
I'm just going to summarize a little bit of what you said, and you'll tell me where I'm wrong.
我只是总结一下你所说的，你会告诉我哪里错了。
Cortisol starts to rise just before we wake up in the morning, assuming a good night's sleep, and peaks of maybe, I don't know, 30 to 90 minutes after waking.
假设我们晚上睡得很好，皮质醇在早上醒来之前开始上升，我不知道，可能在醒来后 30 到 90 分钟达到峰值。
For you slow risers like me , probably a little delayed.
对于像我这样起床慢的人来说，可能会有点延迟。
By the way, the height of that peak and the accelerate, I would say the steepness of the curve can be increased by viewing morning sunlight.
顺便说一句，峰值的高度和加速度，我想说，通过观察早晨的阳光可以增加曲线的陡度。
We know this.
我们知道这一点。
Bright light increases that cortisol peak.
明亮的光线会增加皮质醇的峰值。
It'll make you a better early riser.
它会让你成为一个更好的早起者。
But in any case, typically the pattern then is that it rises through mid-morning and into the early afternoon and then starts to taper off to lower levels.
但无论如何，通常的模式是，它从上午中旬一直上升到下午早些时候，然后开始逐渐降至较低水平。
And as you mentioned, we'll see bumps in cortisol post-meal.
正如你所提到的，我们会看到餐后皮质醇的升高。
If there's a stressor, we get a disturbing text, we get a bump in cortisol, but these aren't huge peaks unless it's a big stressor, correct?
如果有压力源，我们会收到令人不安的文本，皮质醇会升高，但除非是很大的压力源，否则这些都不是巨大的峰值，对吗？
And then by evening, cortisol levels in healthy individuals are typically low, and that allows for transition into sleep, among other things allow for transition into sleep.
然后到了晚上，健康个体的皮质醇水平通常很低，这使得人们可以进入睡眠，除此之外，还可以进入睡眠。
But you said in these kids with PTSD, cortisol doesn't come down to low levels as much as it does in healthy individuals in the evening and nighttime.
但你说，在这些患有创伤后应激障碍的孩子中，皮质醇在晚上和夜间的水平不像健康人那样下降得那么低。
And that, I imagine, would lead to perseverating on stressors from the day.
我想，这会导致从那天起就一直承受压力。
This kid was mean.
这孩子太卑鄙了。
I have a test tomorrow.
我明天有考试。
Maybe any stressor becomes more intense in our mind and body, as it were.
也许任何压力源都会在我们的思想和身体中变得更加强烈。
And that perhaps could lead to issues with quality or duration of sleep, which then could perpetuate this cycle.
这可能会导致睡眠质量或睡眠持续时间出现问题，从而使这种循环持续下去。
Do I have that correct?
我说的对吗？
Dr. Victor Carrión:
维克多·卡里翁博士：
Correct.
正确。
Andrew Huberman:
安德鲁·休伯曼：
Okay.
好的。
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So has the direct intervention of just trying to suppress evening cortisol ever been done?
那么，试图抑制夜间皮质醇的直接干预曾经做过吗？
Certainly there are drugs that will do this.
当然有药物可以做到这一点。
Has that approach ever been taken?
这种方法曾经被采取过吗？
Dr. Victor Carrión:
维克多·卡里翁博士：
I thought about that when I had those high levels, but I felt that we needed to understand better.
当我达到如此高的水平时，我想到了这一点，但我觉得我们需要更好地理解。
I think yes, that there were some attempts with some medications, and I don't think that led to anything in terms of helping those kids or just helping individuals in general that had high levels of cortisol because of traumatic stress.
我认为是的，有人尝试过一些药物，但我认为这不会对帮助这些孩子或只是帮助因创伤性压力而皮质醇水平较高的一般人产生任何影响。
But nighttime, you're right.
但晚上，你是对的。
It is a time when basically we fall asleep because we let it go, and these kids' hyperarousability does not allow them to let it go.
在这个时候，我们基本上是因为放手而入睡，而这些孩子的过度兴奋不允许他们放手。
So if these levels are high, as I was finding, what impact are they having in brain development?
那么，如果正如我所发现的那样，这些水平很高，那么它们对大脑发育有什么影响呢？
And usually the younger you are, the more universally distributed receptors are.
通常，您越年轻，受体分布越广泛。
So glucocorticoid receptors could be anywhere at that point, but as we age, they become more localized.
因此，此时糖皮质激素受体可能存在于任何地方，但随着年龄的增长，它们会变得更加局部化。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Victor Carrión:
维克多·卡里翁博士：
And the glucocorticoid receptors and cortisol is a type of glucocorticoid, are more common in areas like the hippocampus and the prefrontal cortex, which I also found interesting because these areas relate to the symptoms that many individuals with PTSD have.
糖皮质激素受体和皮质醇是糖皮质激素的一种，在海马体和前额皮质等区域更常见，我也发现这些区域很有趣，因为这些区域与许多 PTSD 患者的症状有关。
Andrew Huberman:
安德鲁·休伯曼：
Memory, anticipation of the future, problem-solving, context-dependent problem-solving, so on.
记忆、对未来的预期、解决问题、依赖情境的问题解决等等。
Dr. Victor Carrión:
维克多·卡里翁博士：
And even those attention issues that make them overlap with kids that have ADHD as well.
甚至那些注意力问题也使他们与患有多动症的孩子重叠。
So this frontolimbic pathway, the prefrontal cortex communicating with these emotional areas of the brain, including the amygdala, which is very close to the hippocampus, needed to be investigated In pediatric PTSD and what I sometimes call pediatric PTSS because post-traumatic stress symptoms.
因此，需要在儿科 PTSD 和我有时称为儿科 PTSS（因为创伤后应激症状）中研究这种额边缘通路，即与大脑这些情感区域（包括非常接近海马体的杏仁核）进行交流的前额皮质。
Because as I mentioned, there's a group of kids that have post-traumatic symptoms, do not fulfill criteria for DSM-5 PTSD, but their function continues to be impaired.
因为正如我提到的，有一群孩子有创伤后症状，不符合 DSM-5 PTSD 标准，但他们的功能仍然受到损害。
Sometimes that's because of comorbidity.
有时这是因为合并症。
There's a high incidence of comorbidity with anxiety and depression.
焦虑和抑郁的合并症发生率很高。
So most of our studies that have looked at PTSD symptoms also look at the impact of the interventions that we're doing in anxiety and depression as well.
因此，我们大多数关注创伤后应激障碍（PTSD）症状的研究也关注我们正在采取的干预措施对焦虑和抑郁的影响。
Andrew Huberman:
安德鲁·休伯曼：
I'd like to take a quick break and acknowledge our sponsor, AG1.
我想稍微休息一下并感谢我们的赞助商 AG1。
AG1 is a vitamin mineral probiotic drink that also includes prebiotics and adaptogens.
AG1 是一种维生素矿物质益生菌饮料，还包含益生元和适应原。
AG1 is designed to cover all of your foundational nutritional needs, and it tastes great.
AG1 旨在满足您所有的基本营养需求，而且味道极佳。
Now, I've been drinking AG1 since 2012, and I started doing that at a time when my budget for supplements was really limited.
现在，我从 2012 年开始饮用 AG1，当时我的补充剂预算非常有限。
In fact, I only had enough money back then to purchase one supplement, and I'm so glad that I made that supplement AG1.
事实上，当时我的钱只够购买一种补充剂，我很高兴我制作了这款补充剂 AG1。
The reason for that is even though I strive to eat most of my foods from whole foods and minimally processed foods, it's very difficult for me to get enough fruits, vegetables, vitamins and minerals, micronutrients, and adaptogens from food alone.
原因是，尽管我努力吃天然食品和最低限度加工食品中的大部分食物，但我很难仅从食物中获取足够的水果、蔬菜、维生素和矿物质、微量营养素和适应原。
And I need to do that in order to ensure that I have enough energy throughout the day, I sleep well at night, and keep my immune system strong.
我需要这样做，以确保我全天有足够的能量，晚上睡得好，并保持我的免疫系统强大。
But when I take AG1 daily, I find that all aspects of my health, my physical health, my mental health, and my performance, both cognitive and physical, are better.
但是当我每天服用 AG1 时，我发现我的健康各方面，我的身体健康，我的心理健康，以及我的认知和身体表现都更好了。
I know that because I've had lapses when I didn't take AG1, and I certainly felt the difference.
我知道这一点，因为我在不参加 AG1 的时候也曾犯过错误，而且我确实感受到了其中的不同。
I also notice, and this makes perfect sense given the relationship between the gut microbiome and the brain, that when I regularly take AG1, which for me means a serving in the morning or mid-morning and again later in the afternoon or evening, that I have more mental clarity and more mental energy.
我还注意到，考虑到肠道微生物组和大脑之间的关系，这是完全合理的，当我定期服用 AG1（对我来说意味着早上或上午服用一次，下午或晚上再次服用）时，我的思维更加清晰，精力更加充沛。
If you'd like to try AG1, you can go to drinkag1.com/huberman to claim a special offer.
如果您想尝试 AG1，可以访问 Drinkag1.com/huberman 申请特别优惠。
Right now, they're giving away five free travel packs and a year's supply of vitamin D3 K2.
目前，他们正在赠送五个免费旅行包和一年的维生素 D3 K2。
Again, that's drinkag1.com/huberman to claim that special offer.
再次强调，您可以通过 Drinkag1.com/huberman 领取特别优惠。
I definitely want to get into some of those interventions, including some of the ones that you've developed that are very novel and are being used to great success.
我绝对想谈谈其中的一些干预措施，包括您开发的一些非常新颖且正在取得巨大成功的干预措施。
I want to just circle back for a moment on this relationship between PTSD and, in some cases, inappropriate diagnosis of ADHD.
我想回顾一下创伤后应激障碍（PTSD）与某些情况下的多动症（ADHD）的不恰当诊断之间的关系。
As you mentioned, these two things can coexist in the same person.
正如你提到的，这两件事可以在同一个人身上共存。
So we don't want anyone who has been told that they have ADHD and PTSD, or even just ADHD, to immediately assume that that diagnosis is wrong based on what we're going to talk about.
因此，我们不希望任何被告知患有 ADHD 和 PTSD，甚至只是 ADHD 的人，根据我们将要讨论的内容立即认为该诊断是错误的。
But it is possible that the ADHD that a child is told they have is reflective of PTSD.
但孩子被告知患有注意力缺陷多动症（ADHD）可能反映了创伤后应激障碍（PTSD）。
And I imagine that if that PTSD arises through something in the family structure or dynamic, it would be even harder to unmask because the parent perhaps would be less motivated to try and understand that if they played some sort of role in it.
我想，如果创伤后应激障碍是通过家庭结构或动态中的某些东西产生的，那么揭露起来就更难了，因为如果父母在其中扮演了某种角色，他们可能就没有动力去尝试和理解这一点。
So I realize this is a complex problem with a lot of layers.
所以我意识到这是一个涉及很多层面的复杂问题。
But if you were to just throw out a number based on your experience, what percentage of pure ADHD diagnosis would you like to see explored for the possibility of a PTSD influence?
但是，如果您根据自己的经验给出一个数字，那么您希望在纯 ADHD 诊断中探索 PTSD 影响的可能性是多少？
Let's just keep it kind of diplomatic that way, as opposed to saying what percentage of ADHD do you think is actually PTSD?
让我们以这种方式保持外交性，而不是说你认为多动症中实际上有多少比例是创伤后应激障碍？
Dr. Victor Carrión:
维克多·卡里翁博士：
I firmly believe that ADHD does exist.
我坚信多动症确实存在。
I'm going to say two facts that we know in the field.
我要说两个我们在该领域知道的事实。
One, are kids getting over-medicated?
第一，孩子们是否服用过量药物？
The answer is a clear yes.
答案是肯定的。
They are getting more medications that they need.
他们正在获得更多所需的药物。
Andrew Huberman:
安德鲁·休伯曼：
For ADHD?
对于多动症？
Dr. Victor Carrión:
维克多·卡里翁博士：
For anything in general, kids.
对于一般的事情，孩子们。
Now, in ADHD, they're getting under-medicated.
现在，对于多动症，他们的药物治疗不足。
So that's the second fact.
这是第二个事实。
So the first one is that if we look at kids overall in the field of mental health, those that manage to receive treatment, which access is something else we should talk about because 50% of them do not get access to mental health services.
因此，第一个是，如果我们从心理健康领域整体来看孩子，那些设法接受治疗的孩子，我们应该谈论哪些机会，因为他们中的 50% 无法获得心理健康服务。
Those that manage to get it may end up with the appropriate treatment, a medication or a psychotherapy.
那些设法得到它的人最终可能会得到适当的治疗、药物或心理治疗。
But there's another subset of them that will be medicated no matter what they present with because they need to be seen fast or it's a fast solution.
但还有另一类患者，无论他们出现什么情况，都需要接受药物治疗，因为他们需要快速就诊，或者这是一个快速的解决方案。
So there's many reasons for that.
原因有很多。
But are kids getting over-medicated?
但孩子们是否过度用药？
Yes.
是的。
But within those kids, those that truly have attention-deficit hyperactivity disorder are getting under-medicated, and that's because of that access issue because most of them we're not identifying.
但在这些孩子中，那些真正患有注意力缺陷多动障碍的孩子却得不到足够的药物治疗，这是因为访问问题，因为我们无法识别其中大多数人。
And that's a pity because the first line of intervention for ADHD is stimulant treatment.
这很遗憾，因为多动症的第一线干预措施是兴奋剂治疗。
It does work, and it works very well for children that have the correct diagnosis.
它确实有效，而且对于诊断正确的儿童来说效果非常好。
But the first line of intervention for children that have a history of PTSD, be it acute or chronic, is psychosocial.
但对于有创伤后应激障碍病史的儿童，无论是急性还是慢性，首要干预措施是心理社会干预。
It's a psychosocial intervention.
这是一种社会心理干预。
So if you give a kid that has PTSD and no ADHD a stimulant medication, not only it's not taking care of ADHD because they don't have it, but it adds to that hyperarousability that is manifested there from before.
因此，如果你给患有创伤后应激障碍（PTSD）但没有注意力缺陷多动症（ADHD）的孩子服用兴奋剂药物，不仅不能治疗注意力缺陷多动症（因为他们没有这种药物），而且还会加剧以前表现出来的过度兴奋。
By the way, there are clinical ways of separating hyperactivity from this hyperarousability and hypervigilance.
顺便说一句，临床上有一些方法可以将多动症与过度警觉性和过度警觉性区分开来。
Hyperactivity, if you see a kid that is not medicated and has ADHD, and they have the hyperactive symptoms and the hyperactive type, they're going to be hyperactive for most of the time that you're with them.
多动症，如果你看到一个没有接受药物治疗且患有多动症的孩子，并且他们有多动症症状和多动症类型，那么在你和他们在一起的大部分时间里，他们都会变得多动症。
The kid that has hyperarousability, it will be more of an on and off phenomenon.
过度兴奋的孩子，会出现断断续续的现象。
Hypervigilance and hyperarousability comes more when they're presented with a cue that consciously or unconsciously reminds their body of the traumatic event or the traumatic experiences.
当他们收到有意识或无意识地提醒他们的身体创伤事件或创伤经历的暗示时，他们会更加警惕和过度兴奋。
What happens, though, is that usually we don't know what those cues are.
然而，我们通常不知道这些线索是什么。
Right?
正确的？
So we just see a kid that sporadically becomes hypervigilant or hyperaroused.
所以我们只是看到一个孩子偶尔变得高度警惕或过度兴奋。
And then the other thing is, is hypervigilance something that needs to be treated?
另一件事是，过度警惕是否需要治疗？
I learned this from a mother early in my career.
这是我在职业生涯早期从一位母亲那里学到的。
I was giving some talk in the community, and she came to me afterwards and she said, "Listen, we live in a street that's very dark and is very dangerous, and my kid has to pass through that every day.
我当时在社区做一些演讲，后来她来找我，她说：“听着，我们住在一条非常黑暗、非常危险的街道上，我的孩子每天都必须经过那条街道。
I want him to be hypervigilant, and if he has developed this trait of hypervigilance, this is something that could be helpful to him." And I said, "You're right." I said, "You're right.
我希望他保持高度警惕，如果他已经养成了这种高度警惕的特征，这对他可能会有帮助。”我说：“你是对的。”我说：“你说得对。
It's not only to him, to a lot of people, it could become very helpful to be hypervigilant to assess the environment in which they are in." So the problem is not the hypervigilance.
不仅对他来说，对很多人来说，保持高度警惕来评估他们所处的环境可能会非常有帮助。”所以问题不在于过度警惕。
The problem is knowing when to turn it on and when to turn it off.
问题是知道何时打开它以及何时关闭它。
Having the cognitive flexibility to be able to say, "Yes, this is a dangerous situation, and I better respond this way." If I can give you an example of a kid.
拥有认知灵活性，能够说：“是的，这是一个危险的情况，我最好这样回应。”如果我可以给你举一个孩子的例子。
A kid that experiences domestic violence and has associated that with noise in the house learns that running and getting into the room is a safe thing for them because they are out of the picture, and they protect themselves in the room.
一个经历过家庭暴力并将其与房子里的噪音联系在一起的孩子知道，跑步和进入房间对他们来说是一件安全的事情，因为他们不在画面之外，他们在房间里保护自己。
But a year later, they're in the classroom, and for some reason, the classroom gets this level of noise.
但一年后，他们来到了教室，由于某种原因，教室里出现了这种程度的噪音。
The body, without him knowing, the body reacts by the response that was helpful.
身体，在他不知情的情况下，身体做出了有帮助的反应。
This is classical conditioning, right?
这是经典条件反射，对吗？
So he runs out of the classroom, but he's missing the context.
于是他跑出了教室，但他忘记了上下文。
The teacher is missing the context.
老师没有理解上下文。
When the teacher sends him to the principal's office, the principal doesn't have the context that this response was actually adaptive at one point and helpful at one point, and the body has had a hard time letting it go.
当老师把他送到校长办公室时，校长并没有意识到这种反应实际上在某一时刻是适应性的并且在某一时刻是有帮助的，并且身体很难放手。
To ask that kid to give us the only response that he has is not the way to help him.
让那个孩子给我们他唯一的回应并不是帮助他的方法。
We need to help him develop new competitive responses so that the experience of the other responses then extinguishes that response that was adaptive at one point, but now is maladaptive.
我们需要帮助他发展新的竞争性反应，以便其他反应的经验能够消除在某一时刻是适应性的、但现在是适应不良的反应。
By the way, if they are in a traumatic situation again, we still want them to use it.
顺便说一句，如果他们再次处于创伤状态，我们仍然希望他们使用它。
We still want them to run and get out of there.
我们仍然希望他们逃跑并离开那里。
It's part of that hypervigilance that's protecting them in a way.
这是过度警惕的一部分，在某种程度上保护了他们。
Andrew Huberman:
安德鲁·休伯曼：
It's so interesting.
太有趣了。
You said, if I understood correctly, that in kids with genuine ADHD, the hyperactivity is fairly persistent across environments and with different people, et cetera.
你说，如果我理解正确的话，在患有真正的多动症的孩子中，多动症在不同的环境和不同的人等中相当持久。
Dr. Victor Carrión:
维克多·卡里翁博士：
I'm sorry to interrupt, but if I could add, the inattention comes and goes.
很抱歉打扰，但如果我可以补充一点的话，注意力不集中的情况时有时无。
Because we all know kids that have ADHD, that if you give them the right video game, all of a sudden they become attentive, right?
因为我们都知道患有多动症的孩子，如果你给他们合适的视频游戏，他们会突然变得专心，对吗？
Andrew Huberman:
安德鲁·休伯曼：
Right.
对。
This is a very important point.
这是非常重要的一点。
When I did the solo episode on ADHD, I was frankly shocked to learn, but it was validated by the literature and certainly by the responses from the audience that kids with ADHD, and adults with ADHD for that matter, absolutely have the ability to sharply attend to something if it's something that's very engaging to them, really exciting, something that they typically enjoy.
当我制作关于多动症的独奏节目时，坦率地说，我很震惊，但这一点得到了文献的证实，当然也得到了观众的反应的证实，即患有多动症的孩子和患有多动症的成年人绝对有能力敏锐地关注某件事，如果某件事对他们来说非常有吸引力，非常令人兴奋，他们通常喜欢的事情。
But their ability to direct and maintain attention in other environments that are required for normal life progression, school, work, relationships, et cetera, is very diminished compared to those without ADHD.
但与没有多动症的人相比，他们在正常生活发展、学校、工作、人际关系等所需的其他环境中引导和保持注意力的能力大大减弱。
So what I have in my mind is a step function, meaning an increase and a steady state of hyperactivity in a kid with ADHD, but then a jagged line beneath that of attention.
所以我脑子里想到的是一个阶跃函数，这意味着患有多动症的孩子的多动症会增加并保持稳定状态，但在注意力下方会出现一条锯齿状的线。
This is, I believe, the picture we're painting here.
我相信，这就是我们在这里描绘的图画。
But that in PTSD, the hyperactivity is a jagged line.
但在创伤后应激障碍中，多动症是一条锯齿线。
It really needs a cue, as you said.
正如你所说，它确实需要一个提示。
A loud noise or maybe it's the presence of a particular voice.
巨大的噪音或者可能是某个特定声音的存在。
I once attended a trauma, it wasn't trauma release as much as it was genuine trauma treatment center out in Florida.
我曾经参加过创伤治疗中心，那不是创伤释放中心，而是佛罗里达州真正的创伤治疗中心。
A friend of mine runs the center, and I was out there learning about the practices they use in order to inform potential experiments for intervention in my lab back at Stanford.
我的一位朋友负责管理该中心，我在那里学习了他们使用的实践，以便为我在斯坦福大学实验室进行干预的潜在实验提供信息。
And he said something really interesting.
他说了一些非常有趣的话。
He said, "When you bring people into this sort of environment and they've all had trauma, you see a pretty rich array of responses to even just the same conversation." And then at one point, perhaps because he said that, I noted that a woman raised her hand and she said that particular timbres of voices in the room were really activating her.
他说：“当你把人们带入这种环境时，他们都曾遭受过创伤，即使是同一个对话，你也会看到相当丰富的反应。”然后有一次，也许是因为他这么说，我注意到一位女士举起了手，她说房间里特定的声音音色确实激活了她。
This was important.
这很重要。
It wasn't just what was being said.
这不仅仅是所说的。
It wasn't that people were yelling at each other or even the volume of the voices, but that even just the frequency, the lowness or the highness of the voice as it were, was triggering something in her brain that was giving her these bodily sensations.
这并不是因为人们互相大喊大叫，甚至不是声音的音量，而是即使只是声音的频率、低音或高音，都会触发她大脑中的某些东西，从而给她带来这些身体感觉。
And it was a very important insight for her to be able to then start to direct interventions.
对于她来说，能够开始直接干预是一个非常重要的洞察力。
So I guess we all hear the kind of now stereotypical example of the veteran who experiences combat, comes back, and hears a car backfire, and then they hide.
所以我想我们都听到过现在典型的例子，即退伍军人经历过战斗，回来后听到汽车回火的声音，然后他们躲了起来。
We read about this and hear about this.
我们读过并听说过这一点。
But it seems like it's much more subtle than that, that sometimes the cues for this hyperactivity, this hypervigilance is very much linked to something that sometimes even the person with PTSD doesn't recognize until they start to be put into that environment again and again, and then they can pinpoint it.
但似乎比这更微妙的是，有时这种过度活跃、这种过度警惕的线索与某些东西密切相关，有时甚至连患有创伤后应激障碍的人也无法意识到，直到他们开始一次又一次地进入那种环境，然后他们才能查明它。
My question now is, if they can pinpoint what the cue is, do they stand a better chance of recovery?
我现在的问题是，如果他们能够查明线索是什么，他们康复的机会是否更大？
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
As opposed to somebody that just feels like, "I'm hyperactive, then I'm exhausted.
相反，有些人只是觉得，“我太活跃了，然后我就筋疲力尽了。
I'm wired and tired." And now I also imagine that in kids, they don't have necessarily the verbal proficiency to be able to express what's going on for them.
我很紧张，也很累。”现在我还想象，对于孩子来说，他们不一定具备语言能力来表达他们正在发生的事情。
Dr. Victor Carrión:
维克多·卡里翁博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
And in fact, many adults don't really know, because we don't have a great language for expressing this body-mind thing.
事实上，许多成年人并不真正知道，因为我们没有一种很好的语言来表达这种身心的东西。
Dr. Victor Carrión:
维克多·卡里翁博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
In any event, a lot of questions there, but what are your thoughts about the requirement for being able to understand what the cues, what the triggers are in order for a child and/or adult to be able to start to make inroads into their PTSD?
无论如何，这里有很多问题，但是您对理解暗示、触发因素的要求有何看法，以便儿童和/或成人能够开始进入他们的创伤后应激障碍（PTSD）？
Dr. Victor Carrión:
维克多·卡里翁博士：
First, a word on the Vietnam veteran, because there's a very important study that was published years ago that demonstrated that those veterans that had a history of child maltreatment and went to war had PTSD at higher prevalence than the ones that did not have a history of child maltreatment.
首先，关于越南退伍军人，因为几年前发表的一项非常重要的研究表明，那些有虐待儿童史并参加过战争的退伍军人比没有虐待儿童史的退伍军人患创伤后应激障碍（PTSD）的患病率更高。
So-
所以——
Andrew Huberman:
安德鲁·休伯曼：
Child maltreatment.
虐待儿童。
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I see.
我明白了。
So they were traumatized before they went to combat.
所以他们在参加战斗之前就受到了创伤。
Dr. Victor Carrión:
维克多·卡里翁博士：
And maybe they did not develop PTSD, but once again, that point of the accumulation-
也许他们并没有发展出创伤后应激障碍（PTSD），但再一次，积累的那个点——
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm
嗯嗯
Dr. Victor Carrión:
维克多·卡里翁博士：
...
...
of the stressors at different times.
不同时间的压力源。
And I'm just mentioning that because you may have a veteran, and you're waiting to look at the classical cues, where in fact, it might be more like a voice, like the example that you were giving, that triggers them.
我只是提到这一点，因为你可能有一位退伍军人，你正在等待查看经典线索，事实上，它可能更像是一个声音，就像你给出的例子一样，触发了它们。
What triggers an individual is very personal.
触发一个人的因素是非常个人化的。
So cues are usually neutral, and they're usually related to our senses.
因此，线索通常是中性的，并且通常与我们的感官有关。
And I know you like senses a lot.
我知道你非常喜欢感官。
So what we see, what we hear, all of these things.
所以我们看到的，我们听到的，所有这些事情。
The senses are really the window to the central nervous system.
感官实际上是中枢神经系统的窗口。
This is how we get information the first time.
这就是我们第一次获取信息的方式。
So in this state of hyperarousability, when something traumatizing is happening, our senses are really acutely aware of what's going on.
因此，在这种过度兴奋的状态下，当发生创伤性的事情时，我们的感官会非常敏锐地意识到正在发生的事情。
And they are making sense of the insult, but they also are registering everything that's related to that.
他们正在理解这种侮辱的意义，但他们也正在记录与此相关的所有事情。
So these cues usually are neutral.
所以这些线索通常是中性的。
So they're not like a gun, for example, because a gun is not a cue, it's a threat.
例如，它们不像枪，因为枪不是暗示，而是威胁。
But it's usually a color.
但它通常是一种颜色。
So there was a red car parked near where they were, so the color red may be a cue, may be a trigger.
所以有一辆红色汽车停在他们所在的地方附近，所以红色可能是一个提示，可能是一个触发器。
It was raining the day that that happened, so rain may be a cue, may be a trigger.
事情发生的那天正在下雨，所以下雨可能是一个暗示，也可能是一个触发因素。
And to answer your question, identifying those cues are important because they let you know when your symptoms are coming.
为了回答你的问题，识别这些线索很重要，因为它们会让你知道症状何时出现。
They let you know that they're not coming out of nowhere.
他们让你知道他们不是凭空冒出来的。
They let you know that you're not a problem, or that you're crazy, or that you are bad, which is sometimes the messages that kids get when they go to that principal's office.
他们让你知道你不是问题，或者你疯了，或者你很坏，这有时是孩子们去校长办公室时得到的信息。
Okay?
好的？
But they let you know that they learn themselves this is a normal response.
但他们让你知道他们自己知道这是正常反应。
I've learned through my psychosocial intervention, I've learned that this is a cue that triggers a response from me, triggers a response that was helpful at one time.
我通过心理社会干预了解到，这是一种触发我反应的提示，触发一次有用的反应。
And through classical conditioning, and we do teach classical conditioning to the kids, those responses then become present, become conditioned when the cue is there, when the trigger's there.
通过经典条件反射，我们确实向孩子们教授经典条件反射，这些反应就会出现，当提示存在、触发因素存在时，这些反应就会成为条件反射。
So yes, to answer your question, it is important to know the cues.
所以是的，要回答你的问题，了解线索很重要。
Now, what happens?
现在，会发生什么？
Are we going to know all the cues to everything, to all of our behaviors, and these shifts in mood that sometimes we have during the day and we don't know why, right?
我们是否会知道所有事情、所有行为的所有线索，以及白天有时会出现的情绪变化，但我们不知道为什么，对吗？
No. The answer is no. We're not going to know all the cues.
不，答案是否定的。我们不会知道所有的线索。
But the beauty of this is that if we can just learn about one or two or three cues, what our response is, there's more of a forgiveness to ourselves in that when we're responding appropriately, we can think, "Well, maybe I was exposed to a cue.
但这样做的美妙之处在于，如果我们能够了解一两个或三个暗示，我们的反应是什么，当我们做出适当的反应时，我们就会更多地宽恕自己，我们可以想，“好吧，也许我接触到了一个暗示。
Because I've learned all of this about cues and classical conditioning.
因为我已经了解了所有关于线索和经典条件反射的知识。
Maybe that's what's happening here."
也许这就是这里正在发生的事情。”
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
I'm thinking again about post-traumatic stress injury.
我再次思考创伤后应激损伤。
The reason I like that term, even though I realize I'm using it non-clinically, is that if we understand that the autonomic nervous system, this see-sawing back and forth, or this push-pull between the sympathetic fight or flight and parasympathetic rest and digest, loosely speaking, systems are always at play in us.
我喜欢这个术语的原因是，尽管我意识到我在非临床上使用它，但如果我们理解自主神经系统，这种来回拉锯，或者交感神经战斗或逃跑与副交感神经休息和消化之间的推拉，松散地说，系统总是在我们体内发挥作用。
When we sleep, more parasympathetic.
当我们睡觉时，副交感神经更加活跃。
When we're alert and calm, more sympathetic.
当我们警觉、冷静时，就会更有同情心。
And when we're stressed or having a panic attack, extremely sympathetic.
当我们感到压力或惊恐发作时，我们会非常富有同情心。
If we understand that as a biological system, which it is, that deploys hormones and shapes our patterns of thinking and what's available to us in our memory, et cetera, then PTSI, post-traumatic stress injury, I feel like it liberates us a bit to understand that, yeah, this autonomic system has been disrupted in a way.
如果我们理解，作为一个生物系统，它会部署激素，塑造我们的思维模式，以及我们记忆中的可用内容等等，那么PTSI，创伤后应激损伤，我觉得它让我们有点解放，让我们明白，是的，这个自主系统在某种程度上已经被破坏了。
And if I think about the autonomic system as a seesaw, which I often do, and I think about the seesaw having a pivot point with a hinge, it's almost like the post-traumatic stress injury is to create the tendency for that hinge to be too tight, and sometimes that makes it more dissociative, and we're exhausted and kind of checked out.
如果我把自主系统想象成一个跷跷板，我经常这样做，并且我认为跷跷板有一个带有铰链的枢轴点，那么几乎就像创伤后应激损伤会导致铰链太紧，有时这会使其更加分离，我们精疲力尽，有点被检查了。
And maybe it creates the hinge to be too tight such that we're more on the sympathetic, excuse me, sympathetic the way I-- For those listening, I'm using my hands, but you don't have to see it to understand.
也许它会造成铰链太紧，这样我们就会更加同情，对不起，像我一样同情——对于那些倾听的人，我正在用手，但你不必看到它才能理解。
That the alertness system is locked in place.
警觉系统已锁定到位。
It's hard to get out of that.
很难摆脱这种情况。
And I almost feel like the injury that is post-traumatic stress injury is a tightening down of the hinge with the seesaw tilted too much to one or the other side.
我几乎感觉创伤后应激损伤是铰链收紧，跷跷板向一侧或另一侧倾斜太多。
And I, as a biologist, I just wish-
而我，作为一名生物学家，我只是希望——
Dr. Victor Carrión:
维克多·卡里翁博士：
I like that
我喜欢那样
Andrew Huberman:
安德鲁·休伯曼：
...
...
that we understood what that dysregulation was or is.
我们了解这种失调是什么。
Chances are it's not one location in the brain or body.
它很可能不是大脑或身体中的一个位置。
It's going to be a network phenomenon.
这将成为一种网络现象。
But I feel like the word disorder, the D in PTSD, is so critical because it highlights the importance and the pervasiveness of this thing.
但我觉得“障碍”这个词，即 PTSD 中的 D，非常重要，因为它强调了这件事的重要性和普遍性。
But that the I in post-traumatic stress injury hopefully will give people, it certainly is giving me some sense of relief or liberty in understanding that these are nervous system injuries that need treatment, and that there isn't something wrong or crazy with us because of the fact that we suddenly feel like we're having a panic attack.
但创伤后应激损伤中的“我”希望能给人们带来一些解脱或自由的感觉，让我明白这些都是需要治疗的神经系统损伤，而且我们并没有因为我们突然感觉自己惊恐发作而有什么问题或疯狂。
I've had people I know close to me in my life say, "I'm having a panic attack." I'm like, "What do you mean?
我一生中认识的亲近的人都对我说：“我惊恐发作了。”我说：“你什么意思？
What happened?" They're like, "Nothing happened.
发生什么事了？”他们就像是，“什么也没发生。
That's the point." "Well, how'd you sleep?" "Well, it's okay." And you start doing the curbside diagnosis that neither of us is qualified to do, right?
这就是重点。” “嗯，睡得怎么样？” “嗯，没关系。”然后你开始做我们都没有资格做的路边诊断，对吗？
But this is what we do as caretakers for each other in our lives.
但这就是我们在生活中作为彼此照顾者所做的事情。
And it very well could be that their autonomic system just got that hinge is just locked in place for whatever reason.
很可能他们的自主系统只是因为某种原因将铰链锁定到位。
Maybe it's one sip too much of coffee.
也许是喝太多咖啡了。
Maybe it's one sip too little.
也许是喝得太少了。
It's probably something or a bunch of things.
这可能是某件事或一堆事情。
I realize I'm getting outside my expertise here because I'm not a clinician, but I feel like this PTSI thing is sticky and important for people to hear about.
我意识到我在这里超出了我的专业知识，因为我不是临床医生，但我觉得 PTSI 的事情对于人们来说是粘性的和重要的。
It's certainly changing the way that I think about PTSD.
这确实改变了我对创伤后应激障碍（PTSD）的看法。
Dr. Victor Carrión:
维克多·卡里翁博士：
Mm-hmm.
嗯嗯。
Yes.
是的。
No, and I like the visualization of your seesaw and the example of the hinge because it reminds me of that cognitive flexibility, right?
不，我喜欢你的跷跷板的可视化和铰链的例子，因为它让我想起了认知灵活性，对吧？
It's not there.
它不在那里。
It's kind of stuck.
有点卡住了。
It's kind of tight, too tight.
有点紧，太紧了。
And in some individuals, they just experience the dissociation.
对于某些人来说，他们只是经历了分离。
They're stuck on the bottom, right?
他们被困在底部了，对吗？
Sitting on the bottom on the seesaw.
坐在跷跷板的底部。
Whereas for the other individuals, they're hyperaroused all the time, and then you have everything in between.
而对于其他人来说，他们总是处于亢奋状态，然后你就会遇到介于两者之间的一切。
But no, that's a very good representation of it.
但不，这是一个很好的体现。
Andrew Huberman:
安德鲁·休伯曼：
And I feel like a good night's sleep allows some recalibration of the tightness of that hinge.
我觉得睡个好觉可以重新调整铰链的松紧度。
Put differently, anytime we don't sleep well or long enough, we're not good psychologically.
换句话说，只要我们睡眠质量不好或睡眠时间不够长，我们的心理状态就会不好。
Dr. Victor Carrión:
维克多·卡里翁博士：
A good night's sleep is good for everything.
睡个好觉对一切都有好处。
Andrew Huberman:
安德鲁·休伯曼：
We're finally at the point in history where everyone seems to accept that.
我们终于到了似乎每个人都接受这一点的历史时刻。
I really have to tip my hat to Dr. Matthew Walker from UC Berkeley for writing the book "Why We Sleep."
我真的要向加州大学伯克利分校的马修·沃克博士致敬，感谢他写了《我们为什么睡觉》一书。
Dr. Victor Carrión:
维克多·卡里翁博士：
Yes.
是的。
Andrew Huberman:
安德鲁·休伯曼：
It was only a few years ago that book came out.
那本书才出版几年。
Dr. Victor Carrión:
维克多·卡里翁博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
And he deserves such a token of praise for that because prior to that, there was this, "Oh, I'll sleep when I'm dead mentality." I think people knew sleep was important, but they didn't really understand.
他值得这样的赞扬，因为在那之前，有这样的想法，“哦，当我死了的时候我会睡觉。”我认为人们知道睡眠很重要，但他们并没有真正理解。
And he had to come out as kind of the downer message.
他必须以某种令人沮丧的方式出来。
Like, "Listen, this is serious stuff."
就像，“听着，这是严肃的事情。”
Dr. Victor Carrión:
维克多·卡里翁博士：
You better sleep.
你最好睡觉。
Andrew Huberman:
安德鲁·休伯曼：
You better sleep.
你最好睡觉。
But I think we're there now.
但我想我们现在就到了。
I think in 2024, we're there.
我认为到 2024 年，我们就会实现这一目标。
I think people understand.
我认为人们理解。
Dr. Victor Carrión:
维克多·卡里翁博士：
And I think people have their own experiences with sleep, right?
我认为人们对睡眠有自己的经历，对吧？
We've all felt that cold that's coming, and if we really sleep those eight hours, we may be able to fight it-
我们都感觉到寒冷即将来临，如果我们真的睡了这八个小时，我们也许能够对抗它——
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm
嗯嗯
Dr. Victor Carrión:
维克多·卡里翁博士：
...
...
because we've strengthened our immune system.
因为我们增强了我们的免疫系统。
If we don't, we will get sick.
如果我们不这样做，我们就会生病。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, absolutely.
是的，绝对是。
Well, let's talk about some of the treatments that you use and have developed for PTSD in young people.
好吧，让我们谈谈您使用和开发的一些针对年轻人创伤后应激障碍的治疗方法。
And maybe we should define young people.
也许我们应该定义年轻人。
Are we talking about the 18 and under, just because that's typically what we think about?
我们谈论 18 岁及以下的人是否只是因为这就是我们通常的想法？
Dr. Victor Carrión:
维克多·卡里翁博士：
So in pediatric psychiatry, we have three different populations.
因此，在儿科精神病学中，我们有三个不同的人群。
We have the preschoolers, we have the school age, and we have the teenagers.
我们有学龄前儿童，有学龄儿童，还有青少年。
And they're all very different.
而且它们都非常不同。
They all have responses and defenses that are very different.
他们的反应和防御都非常不同。
The projects that I'm describing happen mostly with the school-age children.
我所描述的项目主要发生在学龄儿童身上。
Andrew Huberman:
安德鲁·休伯曼：
So preschoolers are going to be, essentially, I think of kindergarten starting at five.
所以学龄前儿童基本上是从五岁开始上幼儿园的。
So you're talking about zero to more or less five or six years old as the preschoolers, kindergartners, and then transition point.
所以你说的是零到五六岁左右的学龄前儿童、幼儿园儿童，然后是过渡点。
Dr. Victor Carrión:
维克多·卡里翁博士：
Correct.
正确。
Andrew Huberman:
安德鲁·休伯曼：
And then for the kids we're about to talk about, we're really talking about, what, six years old until about end of adolescence?
然后对于我们要谈论的孩子，我们真正谈论的是，什么，六岁直到青春期结束？
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah, 15, and then the teenagers later on.
是的，15岁，然后是青少年。
Andrew Huberman:
安德鲁·休伯曼：
Okay.
好的。
Great.
伟大的。
Dr. Victor Carrión:
维克多·卡里翁博士：
So I work mostly with the school-age kids, and like I said, when we started doing magnetic resonance imaging to look at the impact of cortisol, we have a number of studies really demonstrating that those kids with higher levels of cortisol had less volume of the hippocampus.
所以我主要与学龄儿童一起工作，就像我说的，当我们开始进行磁共振成像来观察皮质醇的影响时，我们有大量研究确实证明那些皮质醇水平较高的孩子的海马体体积较小。
The first study that we did in that was cross-sectional, and there was no difference.
我们所做的第一项研究是横断面的，没有差异。
And it gave me a lot of hope that there would be a window of opportunity there where we could intervene.
这给了我很大的希望，认为那里会有我们可以干预的机会之窗。
Because what we were seeing in chronic PTSD in adults was that there was smaller volumes of the hippocampus, which help us process memories and have strong connections with the emotional center of the brain, the amygdala, and also with the prefrontal cortex.
因为我们在成人慢性创伤后应激障碍中发现，海马体的体积较小，海马体帮助我们处理记忆，并与大脑的情感中心、杏仁核以及前额叶皮层有很强的联系。
And what we found was that cross-sectionally, there was not this difference, but we also follow a small sample longitudinally, and there we saw a correlation between that higher pre-bedtime cortisol and the smaller hippocampal volume.
我们发现，从横截面来看，不存在这种差异，但我们也纵向跟踪了一个小样本，我们发现睡前较高的皮质醇与较小的海马体积之间存在相关性。
More impactful was a functional imaging study.
更有影响力的是功能成像研究。
As many of your audience members know, with magnetic resonance imaging, we not only can look at the structure, but we can also give tasks of memory, for example, or of executive function, and different tasks that tap at the areas that we're interested in looking at.
正如许多观众所知，通过磁共振成像，我们不仅可以查看结构，还可以给出记忆任务，例如执行功能任务，以及针对我们感兴趣的区域的不同任务。
So when we give a memory task, and we looked at how children with post-traumatic stress symptoms were behaving compared to kids that do not have symptoms or other psychiatry diagnosis, we were seeing that the healthy kids were activating a lot more voxels, or units of the imaging of the hippocampus.
因此，当我们进行记忆任务时，我们观察了患有创伤后应激症状的儿童与没有症状或其他精神病学诊断的儿童相比的行为方式，我们发现健康的孩子激活了更多的体素或海马体成像单位。
So there was concern here that, yes, that plasticity that you talked at the beginning was really affecting the development of the brain of the kids.
所以这里有人担心，是的，你一开始谈到的可塑性确实影响了孩子们大脑的发育。
And then with the prefrontal cortex, we saw something similar in the ventral medial area of the prefrontal cortex.
然后在前额叶皮层中，我们在前额叶皮层的腹侧内侧区域看到了类似的东西。
But with other tasks, right?
但还有其他任务，对吧？
With tasks of executive function or tasks of emotion.
具有执行功能的任务或情感的任务。
Looking at faces, for example, emotional faces.
观察面孔，例如情绪面孔。
All of this to say that they probably have a malfunctioning frontostriatal pathway and frontolimbic.
所有这些都说明他们的额纹状体通路和额边缘可能存在功能障碍。
So, frontolimbic, I'm sorry.
所以，额叶，我很抱歉。
So, if we think of the amygdala, for example, in close proximity to the hippocampus being involved in this hypervigilance, and we have some data to show that the amygdala becomes active very quickly when you present emotional faces to young kids.
因此，如果我们想到杏仁核，例如，靠近海马体参与这种过度警惕，并且我们有一些数据表明，当你向年幼的孩子展示情绪化的面孔时，杏仁核会很快变得活跃。
And that hyperactive amygdala needs a break of some sort.
过度活跃的杏仁核需要某种休息。
That break comes from the prefrontal cortex.
这种断裂来自前额叶皮层。
But if you have a prefrontal cortex that's not working that well either, then your break is not working.
但如果你的前额皮质也不能很好地工作，那么你的休息就不起作用。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Victor Carrión:
维克多·卡里翁博士：
Right?
对吗？
So, then the issue came here, well, this is important information to know what we need to target with treatment, and can we target this with psychosocial interventions and the way that we provide treatment.
那么，问题就来了，这是重要的信息，可以帮助我们了解我们需要治疗的目标是什么，以及我们是否可以通过心理社会干预和提供治疗的方式来瞄准这一目标。
And we decided to begin with what we discussed earlier, with the cues, right?
我们决定从之前讨论的内容开始，从线索开始，对吧？
And teaching and having kids understand what cues are, what classical conditioning is, talking to them about the impact of trauma, talking to them about the impact of treatment and how recovery is possible, right?
教导并让孩子们了解什么是线索，什么是经典条件反射，与他们谈论创伤的影响，与他们谈论治疗的影响以及如何恢复，对吗？
So an educational piece.
所以这是一部有教育意义的作品。
And something that I never thought I would end up doing was developing a treatment, right?
我从未想过我最终会做的事情是开发一种治疗方法，对吗？
I felt I'm here to investigate and use the treatments that we have, but it became very clear to me that there were a population of kids that still needed a form of treatment that was not out there.
我觉得我来这里是为了研究和使用我们现有的治疗方法，但我很清楚，有一群孩子仍然需要一种尚不存在的治疗形式。
So most treatments out there for trauma were targeting one traumatic event and not targeting that backpack, that allostatic load.
因此，大多数针对创伤的治疗都是针对一种创伤事件，而不是针对那个背包，即非稳态负荷。
Also, and rightfully so, most treatments were requiring that the parents were involved in treatment as well.
此外，大多数治疗都要求父母也参与治疗，这是理所当然的。
Andrew Huberman:
安德鲁·休伯曼：
I could see where that might be problematic when the parents perhaps were the source of the trauma.
当父母可能是创伤的根源时，我可以看到哪里可能有问题。
Dr. Victor Carrión:
维克多·卡里翁博士：
And also when there's avoidance, right?
还有回避的时候，对吗？
And also when there's practicalities that if they lose one day from work, they're going to get fired.
而且现实情况是，如果他们有一天误工，他们就会被解雇。
So sometimes the parents are just not available, and the kids are totally ready to begin and do the work.
所以有时父母没空，而孩子们已经完全准备好开始做工作了。
So I wanted them to be able to do so.
所以我希望他们能够这样做。
So how can we devise a treatment that is hybrid, and by that, I mean multimodal, that is not only cognitive behavioral therapy, but that it brings other elements that are important, like self-efficacy, empowerment, insight-oriented work, and give it a structure that can be tested.
那么，我们如何才能设计出一种混合疗法，我的意思是多模式疗法，这不仅是认知行为疗法，而且还带来了其他重要的元素，例如自我效能、赋权、以洞察力为导向的工作，并赋予它一个可以测试的结构。
And that's how we created CueCenter, cue being C-U-E, CueCenter Therapy for kids that have PTSD.
这就是我们创建 CueCenter 的方式，cue 是 C-U-E，为患有 PTSD 的孩子提供 CueCenter 治疗。
And we've had a number of trials with them, and it helps decrease symptoms of anxiety, symptoms of depression, and symptoms of PTSD.
我们对它们进行了多次试验，它有助于减轻焦虑症状、抑郁症状和创伤后应激障碍症状。
And not only as scored by the student, but also scored by observers, by the parents.
不仅由学生评分，还由观察者和家长评分。
And in one of the trials where we measure actually how the parents were doing, parents that were not participating in treatment, their own anxiety was decreasing as well.
在一项试验中，我们实际上测量了父母的表现，没有参与治疗的父母，他们自己的焦虑也在减少。
And that's easy to understand, right?
这很容易理解，对吧？
If your kid is doing better, you're going to do better as well.
如果你的孩子做得更好，你也会做得更好。
So that was very good to see.
所以很高兴看到这一点。
But then we wanted to see that plasticity, too.
但我们也想看到这种可塑性。
Is this doing something to the activation of the brain?
这对大脑的激活有影响吗？
And that's when we brought functional near-infrared spectroscopy into the picture because it's cheaper than MRI, and it's more portable, and it's easier to do.
就在那时，我们将功能性近红外光谱技术引入其中，因为它比 MRI 更便宜，而且更便携，而且更容易实现。
It only gives you cortical information.
它只为您提供皮质信息。
It doesn't get into those interesting limbic structures.
它没有进入那些有趣的边缘结构。
Andrew Huberman:
安德鲁·休伯曼：
So just to highlight for a second that fMRI, functional magnetic resonance imaging, is wonderful because it allows a lot of imaging, both on the superficial outer parts of the brain, but also deep into the brain.
因此，我想强调一下，fMRI（功能性磁共振成像）非常出色，因为它可以进行大量成像，既可以在大脑的表面外部进行成像，也可以在大脑深处进行成像。
My understanding is that, and perhaps this has changed in recent years, that the spatial resolution can be very good.
我的理解是，也许近年来这种情况已经发生了变化，空间分辨率可以非常好。
You can pinpoint very small areas if you have a powerful enough machine magnet The temporal resolution, the ability to see changes in the neural circuit activation and deactivation over time, at one point was somewhat limited, but now some of those limitations have been overcome.
如果你有足够强大的机器磁铁，你可以精确定位非常小的区域。时间分辨率，即看到神经回路激活和失活随时间变化的能力，在某一点上是有限的，但现在其中一些限制已经被克服。
But then what you're talking about, near-infrared spectroscopy, is excellent because it can be taken to a school.
但你所说的近红外光谱学非常好，因为它可以带到学校。
You couldn't bring an fMRI machine to a school, unless it's a medical school where there's the machine.
你不能把功能磁共振成像机器带到学校，除非是有机器的医学院。
It's much less expensive.
它便宜得多。
The downside is-- oh, excuse me, and my understanding is that the spatial resolution isn't quite as high as MRI.
缺点是——哦，对不起，我的理解是空间分辨率没有 MRI 那么高。
Dr. Victor Carrión:
维克多·卡里翁博士：
But the temporal resolution-
但时间分辨率-
Andrew Huberman:
安德鲁·休伯曼：
But the temporal resolution is very high, which is a huge advantage.
但时间分辨率非常高，这是一个巨大的优势。
And then there's this one disadvantage that you can only really image the outer portions of the brain.
还有一个缺点，就是你只能真实地想象大脑的外部部分。
But nonetheless, there's a lot of information there.
但尽管如此，那里还是有很多信息。
So a little technical lesson for people.
所以给人们上一点技术课。
Dr. Victor Carrión:
维克多·卡里翁博士：
And these outside areas of the brain, the cortical area and the prefrontal area, were helping predict which kids would do better, only for those kids that were having cue center therapy, and another gold standard treatment called trauma-focused cognitive behavioral therapy, when they were both compared to treatment as usual.
大脑的这些外部区域，皮质区和前额叶区，可以帮助预测哪些孩子会做得更好，只有那些接受线索中心治疗和另一种黄金标准治疗（称为创伤聚焦认知行为治疗）的孩子，当他们与平常的治疗进行比较时。
Andrew Huberman:
安德鲁·休伯曼：
I'd like to take a quick break and thank one of our sponsors, Function.
我想稍微休息一下，并感谢我们的赞助商之一 Function。
I recently became a Function member after searching for the most comprehensive approach to lab testing.
在寻找最全面的实验室测试方法后，我最近成为了 Function 成员。
While I've long been a fan of blood testing, I really wanted to find a more in-depth program for analyzing blood, urine, and saliva to get a full picture of my heart health, my hormone status, my immune system regulation, my metabolic function, my vitamin and mineral status, and other critical areas of my overall health and vitality.
虽然我长期以来一直热衷于血液检测，但我真的很想找到一个更深入的程序来分析血液、尿液和唾液，以全面了解我的心脏健康状况、我的激素状态、我的免疫系统调节、我的代谢功能、我的维生素和矿物质状态以及我整体健康和活力的其他关键领域。
Function not only provides testing of over 100 biomarkers key to physical and mental health, but it also analyzes these results and provides insights from top doctors on your results.
Function 不仅提供对身心健康至关重要的 100 多种生物标志物的测试，还分析这些结果并提供顶级医生对结果的见解。
For example, in one of my first tests with Function, I learned that I had two high levels of mercury in my blood.
例如，在我第一次使用 Function 进行测试时，我发现我的血液中汞含量很高。
This was totally surprising to me.
这让我完全惊讶。
I had no idea prior to taking the test.
参加考试之前我不知道。
Function not only helped me detect this, but offered medical doctor-informed insights on how to best reduce those mercury levels, which included limiting my tuna consumption, because I had been eating a lot of tuna, while also making an effort to eat more leafy greens and supplementing with NAC, N-acetylcysteine, both of which can support glutathione production and detoxification, and worked to reduce my mercury levels.
功能不仅帮助我发现了这一点，而且还为我提供了关于如何最好地降低汞含量的医生知情见解，其中包括限制我的金枪鱼消费，因为我一直在吃大量金枪鱼，同时还努力吃更多的绿叶蔬菜并补充 NAC、N-乙酰半胱氨酸，这两者都可以支持谷胱甘肽的产生和解毒，并努力降低我的汞含量。
Comprehensive lab testing like this is so important for health, and while I've been doing it for years, I've always found it to be overly complicated and expensive.
像这样的综合实验室测试对健康非常重要，虽然我已经这样做了很多年，但我总是发现它过于复杂和昂贵。
I've been so impressed by Function, both at the level of ease of use, that is, getting the tests done, as well as how comprehensive and how actionable the tests are, that I recently joined their advisory board, and I'm thrilled that they're sponsoring the podcast.
Function 给我留下了深刻的印象，无论是在易用性方面，即完成测试，还是在测试的全面性和可操作性方面，我最近加入了他们的顾问委员会，我很高兴他们赞助了这个播客。
If you'd like to try Function, go to functionhealth.com/huberman.
如果您想尝试 Function，请访问 functionhealth.com/huberman。
Function currently has a wait list of over 250,000 people, but they're offering early access to Huberman Lab listeners.
Function 目前有超过 250,000 人的等待名单，但他们正在为 Huberman Lab 听众提供早期访问机会。
Again, that's functionhealth.com/huberman to get early access to Function.
同样，可以通过 functionhealth.com/huberman 提前访问 Function。
I want to get into the cue center therapy versus cognitive behavioral, versus the no therapy conditions you just described.
我想谈谈提示中心疗法与认知行为疗法以及您刚才描述的无治疗条件。
But before we do that, I just want to have a brief discussion about some of the neuroscience you mentioned, because I think people will find this very interesting and certainly not just a listing off of names of structures.
但在此之前，我只想简单讨论一下你提到的一些神经科学，因为我认为人们会发现这非常有趣，当然不仅仅是列出结构名称。
You said that the frontolimbic pathway is important here, the limbic pathway including the amygdala, but other structures as well.
你说额边缘通路在这里很重要，边缘通路包括杏仁核，但也包括其他结构。
And my understanding, and I think the generally accepted understanding about these limbic pathways, is that they create a response state, a state of alertness, a state of relaxation, that they translate certain information that impinges on them into a level of reactivity, either low, medium, or very high.
我的理解，以及我认为对这些边缘通路的普遍接受的理解是，它们创造了一种反应状态，一种警觉状态，一种放松状态，它们将影响它们的某些信息转化为一定的反应水平，无论是低、中还是非常高。
When I say reactivity, a tendency to move toward or away from something or stay still, put in broadly speaking.
当我说反应性时，广义上讲，反应性是指靠近或远离某物或保持静止的倾向。
Now, the fronto piece, the feeding in of information from the frontal cortex, where context-dependent decision-making and, as you said, executive function takes place, is so critical for all of us as we mature.
现在，前面的部分，即从额叶皮层输入信息，依赖于上下文的决策以及执行功能，正如你所说，随着我们的成熟，对我们所有人来说都至关重要。
I always say, if you look at a puppy, everything's a stimulus, and then over time, they're not going to pick up everything in the room.
我总是说，如果你看一只小狗，一切都是刺激，然后随着时间的推移，它们就不会拿起房间里的所有东西。
That's, without question, largely due to the development of these frontolimbic pathways.
毫无疑问，这很大程度上是由于这些额边缘通路的发展。
And in children and in humans, that is, it's the same.
对于儿童和人类来说，这是一样的。
I can imagine that the signals coming from the frontal pathway to the limbic system are going to be somewhat cryptic to people that aren't familiar with psychiatry and neuroscience.
我可以想象，对于不熟悉精神病学和神经科学的人来说，从额叶通路到边缘系统的信号会有些神秘。
So maybe we could just throw a few of those out there.
所以也许我们可以把其中一些扔出去。
Here's an example.
这是一个例子。
Tell me if I'm wrong.
告诉我我是否错了。
But the way I think about this is, okay, a kid is in a room and they're hyperactive, or maybe something set them off and they're particularly vigilant and stressed.
但我的想法是，好吧，一个孩子在一个房间里，他们非常活跃，或者可能有什么东西让他们兴奋，他们特别警惕和压力。
They're in the stress response.
他们正处于压力反应中。
The frontal cortex is the pathway by which an internal dialogue could be delivered to quiet that limbic pathway.
额叶皮层是传递内部对话以使边缘通路安静的途径。
The message that would perhaps trigger that would be the kid recognizing, because they learned, "This is okay.
孩子们可能会意识到这一点，因为他们了解到，“这没关系。
I've had this happen before.
我以前也遇到过这种情况。
It passes," or, "I'm supported.
它过去了，”或者，“我得到了支持。
There's Dr. Carrion, there's my mom, there's my dad, there's my teacher, there's my friend.
这是卡里恩博士，这是我的妈妈，这是我的爸爸，这是我的老师，这是我的朋友。
I'm supported," because we know social support is important, or, "It's normal to feel stress every once in a while." So these kinds of thoughts or these internal dialogues that we're told that we should do for ourselves when we're stressed, I think we can be pretty certain that that's the kind of information that would trigger this frontodolimbic suppression.
我得到了支持，”因为我们知道社会支持很重要，或者，“偶尔感到压力是正常的。”因此，当我们受到压力时，我们被告知应该为自己做的这些想法或内部对话，我认为我们可以非常肯定，这就是会触发这种额叶边缘抑制的信息。
Dr. Victor Carrión:
维克多·卡里翁博士：
And can I comment on that dialogue, because all of those are examples of positive thoughts, right?
我可以评论一下这段对话吗，因为所有这些都是积极想法的例子，对吧？
Positive thoughts that are good, but they are not automatic thoughts.
积极的想法是好的，但它们不是自动的想法。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Victor Carrión:
维克多·卡里翁博士：
They are thoughts that need to be practiced, right?
它们是需要练习的想法，对吧？
Negative thoughts, unfortunately, that reside in our reptile brain, are automatic.
不幸的是，存在于我们爬行动物大脑中的消极想法是自动的。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Victor Carrión:
维克多·卡里翁博士：
hyper response, I'm in danger type of situation, when we evolved, is responsible for our survival.
超反应，我处于危险类型的情况，当我们进化时，对我们的生存负责。
So we learn the negative thoughts very well.
所以我们很好地了解了消极的想法。
I'm in danger.
我有危险了。
I have to run.
我必须跑。
I have to get on top of this tree.
我必须爬上这棵树。
The lion might come, whatever.
无论如何，狮子可能会来。
So only 50 million years ago, we developed the frontal cortex more, positive thoughts came into the picture, and they're very helpful for all the reasons you're mentioning, but they're not automatic like the negative ones are.
因此，仅在 5000 万年前，我们的额叶皮层更加发达，积极的想法开始出现，它们对于你提到的所有原因都非常有帮助，但它们并不像消极的想法那样自动产生。
Hopefully, they will become.
希望他们会成为。
So what I tell the kids is if they don't play guitar, "If I give you a guitar right now, would you be able to play me a song?"
所以我告诉孩子们，如果他们不弹吉他，“如果我现在给你一把吉他，你能给我弹一首歌吗？”
Andrew Huberman:
安德鲁·休伯曼：
Absolutely not.
绝对不是。
I have absolutely zero minus one musical ability, but I love music.
我的音乐能力绝对为零负一，但我热爱音乐。
Dr. Victor Carrión:
维克多·卡里翁博士：
But if I gave you a guitar with guitar lessons and you practice, you probably will be able to play a song a year from now.
但如果我在吉他课上给你一把吉他，然后你练习，一年后你可能就能弹奏一首歌。
Andrew Huberman:
安德鲁·休伯曼：
Well, me with some degree of proficiency, but not much.
嗯，我有一定程度的熟练程度，但不多。
Dr. Victor Carrión:
维克多·卡里翁博士：
With a lot of help.
在很多帮助下。
Andrew Huberman:
安德鲁·休伯曼：
But everybody else, yes.
但其他人，是的。
Dr. Victor Carrión:
维克多·卡里翁博士：
A support system.
一个支持系统。
Andrew Huberman:
安德鲁·休伯曼：
A support system, that's right.
一个支持系统，没错。
And with enough practice hours and enough focus and determination, I'm convinced I could become at least proficient, even at 49 years of age.
只要有足够的练习时间、足够的专注和决心，我相信即使在 49 岁的时候，我至少也能变得熟练。
Dr. Victor Carrión:
维克多·卡里翁博士：
So we have a slogan in my team, which is "Practice positive thoughts." All the thoughts you were mentioning are good ones, and we have to practice them.
所以我们团队有一个口号，那就是“练习积极的想法”。你讲的这些想法都是好的，我们必须去实践。
Right?
对吗？
This is what I'm learning.
这就是我正在学习的。
No, I'm not bad.
不，我并不坏。
This is happening because of the cue.
这是由于提示而发生的。
Andrew Huberman:
安德鲁·休伯曼：
Even when the limbic system is not active, do you encourage your patients to practice positive thinking-
即使边缘系统不活跃，您是否鼓励患者练习积极思考-
Dr. Victor Carrión:
维克多·卡里翁博士：
All the time
一直以来
Andrew Huberman:
安德鲁·休伯曼：
...
...
even when they're not in the stress response?
即使他们没有处于压力反应中？
Dr. Victor Carrión:
维克多·卡里翁博士：
All the time.
一直以来。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
Dr. Victor Carrión:
维克多·卡里翁博士：
It's learning a tool.
这是学习的一个工具。
So in this CueCenter therapy, one of the lessons is that they have an empty toolbox, and this toolbox gets filled with tools that they learn, and practicing positive thoughts, deep breathing, mindfulness, all of this, muscle relaxations, are tools that we teach them.
所以在这个 CueCenter 疗法中，教训之一是他们有一个空的工具箱，这个工具箱里装满了他们学到的工具，练习积极的想法、深呼吸、正念，所有这些，肌肉放松，都是我们教给他们的工具。
But they decide, and here's where the empowerment comes in, they decide what the cues are.
但他们决定，这就是授权的用武之地，他们决定线索是什么。
They decide what tools they're going to put into their toolbox or they're not going to put in the toolbox.
他们决定将哪些工具放入工具箱或不放入工具箱。
And by far, whatever tools they develop that have not been taught by me or anybody else, work better when they develop it themselves.
到目前为止，无论他们开发什么工具，如果我或其他人没有教过，当他们自己开发时，效果会更好。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
Dr. Victor Carrión:
维克多·卡里翁博士：
And I had this case once, and it got illustrated really well.
我曾经遇到过这个案例，它的插图非常好。
In one of the sessions, you teach them breathing exercises, muscle relaxation, things that we know help, and I'll talk a little bit more about how we know that they help.
在其中一个课程中，你教他们呼吸练习、肌肉放松以及我们知道有帮助的事情，我将更多地谈谈我们如何知道它们有帮助。
And then they have a week to practice, and then they come the next week, and we see where they are and what's in the toolbox and things like that.
然后他们有一周的时间进行练习，然后他们下周就会来，我们会看到他们在哪里以及工具箱中有什么等等。
And the next week, when she came, she was much, much better.
下周，当她来的时候，她好多了。
And I was very proud.
我非常自豪。
I'm like, "Oh, you've been practicing the tools that we discussed last week." And she's like, "No, I actually don't remember anything you said last time.
我说，“哦，你一直在练习我们上周讨论过的工具。”她说：“不，我实际上不记得你上次说过的话。
But I came up with this thing that when I feel bad, I'm drinking a glass of orange juice every time." And at that moment, I knew I could go both ways, and I could go, "No, you must practice my tools."
但我想出了这个办法，当我感觉不好的时候，我每次都会喝一杯橙汁。”在那一刻，我知道我可以双向选择，我可以说，“不，你必须练习我的工具。”
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Victor Carrión:
维克多·卡里翁博士：
Or I could say, "How wonderful.
或者我可以说：“太棒了。
You've identified a tool that helps you, to drink a glass of orange juice," which obviously is what I did.
你已经找到了一个可以帮助你的工具，那就是喝一杯橙汁，”这显然就是我所做的。
And then she was able to have that in her toolbox.
然后她就可以将其放入她的工具箱中。
And we have multiple examples like this where-
我们有很多这样的例子——
Andrew Huberman:
安德鲁·休伯曼：
So she would drink a glass of orange juice in order to quell her anxiety?
所以她会喝一杯橙汁来平息焦虑吗？
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And this was-
这是——
Dr. Victor Carrión:
维克多·卡里翁博士：
If she felt bad.
如果她感觉不好的话。
Andrew Huberman:
安德鲁·休伯曼：
And is this something that she would do even when she wasn't feeling stressed?
这是她在没有压力的情况下也会做的事情吗？
It's kind of interesting.
这有点有趣。
It suggests, and it completely squares with everything I understand about prefrontal cortical limbic pathways, which is that they're highly subject to contextual learning.
它表明，它与我对前额皮质边缘通路的理解完全一致，即它们高度受情境学习的影响。
Right?
对吗？
If anything, the frontal cortex is this incredible feat of evolution that allows us to link essentially any stimulus with any non-learned response in the body.
如果说有什么不同的话，额叶皮层就是这一令人难以置信的进化壮举，它使我们能够将任何刺激与身体中任何非习得的反应联系起来。
Dr. Victor Carrión:
维克多·卡里翁博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
Right?
对吗？
This is what allows soldiers to learn to overcome their fear of bomb blasts and run toward them if necessary.
这使得士兵能够学会克服对炸弹爆炸的恐惧，并在必要时跑向炸弹。
It can cut both ways.
它可以双向切割。
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Of course.
当然。
Dr. Victor Carrión:
维克多·卡里翁博士：
But for me, and this still needs to be tested, it's not necessarily about the glass or even the orange or the vitamin C or anything like that.
但对我来说，这仍然需要测试，这不一定与玻璃杯、甚至橙子、维生素 C 或类似的东西有关。
It's about the fact that she has this message.
这是因为她有这个消息。
She has sent a message to herself, "I can take care of myself."
她给自己发了一条信息：“我能照顾好自己。”
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Victor Carrión:
维克多·卡里翁博士：
"Because the best tool that I have is me, is my own body." Wherever these kids go in the future, there's something that's always going to be there with them, which is themselves.
“因为我拥有的最好的工具就是我自己，就是我自己的身体。”无论这些孩子未来走到哪里，总有一个东西会陪伴他们，那就是他们自己。
So they, as themselves, is the best tool they can have, their body, the way they think, all of these things.
所以他们，作为他们自己，是他们可以拥有的最好的工具，他们的身体，他们的思维方式，所有这些东西。
Andrew Huberman:
安德鲁·休伯曼：
Do you think this is why we hear the kind of classic anecdote about the patient who has anxiety attacks, whose psychiatrist gives them a couple of pills of medication that can help reduce anxiety, and they decide to keep those pills in their pocket should they have an anxiety attack, and knowing they have those pills in their pocket allows them to control their anxiety?
你认为这就是为什么我们会听到关于患有焦虑症的患者的经典轶事，他的精神科医生给了他们几片可以帮助减轻焦虑的药物，他们决定在焦虑症发作时将这些药片放在口袋里，并且知道口袋里有这些药片可以让他们控制焦虑？
Dr. Victor Carrión:
维克多·卡里翁博士：
Yes, because it gives them a sense of control, right?
是的，因为这给了他们一种控制感，对吗？
And they have control over this.
他们对此有控制权。
And some people may choose to leave them in the fridge, and some people may choose to put them elsewhere.
有些人可能会选择把它们放在冰箱里，有些人可能会选择把它们放在其他地方。
But it's what they decide.
但这是他们决定的。
It's that decision they're making that gives them a sense of control.
正是他们所做的决定给了他们一种掌控感。
That's important.
这很重要。
Andrew Huberman:
安德鲁·休伯曼：
It's so interesting, the sense of agency and control over the non-negotiable stress response.
非常有趣的是，对不可协商的压力反应的代理感和控制力。
I sometimes, unfortunately, get, in my opinion, incorrectly attached to Ice baths.
不幸的是，在我看来，我有时错误地喜欢冰浴。
We've talked about cold water exposure on this podcast.
我们在这个播客中讨论过冷水暴露。
Our colleague Craig Heller at Stanford Department of Biology, phenomenal scientist, was on this podcast.
我们斯坦福大学生物系的同事克雷格·海勒（Craig Heller）是一位杰出的科学家，他参加了这个播客。
We talked about some of the beneficial uses of deliberate cold exposure.
我们讨论了故意冷暴露的一些有益用途。
There are a lot of arguments.
有很多争论。
Does it increase metabolism?
它会增加新陈代谢吗？
Doesn't seem like it does very much.
看起来作用不是很大。
Is it useful for inflammation?
对炎症有用吗？
Perhaps.
也许吧。
But the one thing that everyone agrees is that being in uncomfortably cold water makes you breathe faster and stress a bit.
但每个人都同意的一件事是，在令人不舒服的冷水中会让你呼吸加快并感到压力。
In other words, it kind of sucks.
换句话说，这有点糟糕。
It's uncomfortable.
很不舒服。
And I think one non-negotiable fact about deliberate cold exposure is that it gives people an opportunity to explore their own stress response if they're going to do it safely, right?
我认为关于故意暴露在寒冷中的一个不容忽视的事实是，如果人们要安全地这样做的话，它会给人们一个探索自己压力反应的机会，对吗？
You take a cold shower, you have some control.
你洗个冷水澡，你有一些控制权。
You can get out immediately.
你可以立刻出去。
Obviously, you don't want it so cold that you give yourself cardiac arrest.
显然，您不希望天气太冷而导致心脏骤停。
You have to be careful with deliberate cold exposure, but the adrenaline response to uncomfortable cold is non-negotiable.
你必须小心故意暴露在寒冷中，但肾上腺素对不舒服的寒冷的反应是不容忽视的。
And I believe that whether or not somebody decides to recite the alphabet or think about how cold it is or whatever it is, what they're doing is they are practicing this frontal control over the limbic pathways.
我相信，无论有人决定背诵字母表还是考虑天气有多冷或其他什么，他们所做的就是练习这种对边缘通路的额叶控制。
It's just sort of a general exercise for controlling the limbic system through thought.
这只是通过思想控制边缘系统的一般练习。
But as our colleague David Spiegel has said to me many times, he says, "It's not just the state that you're in," here we're talking about stress as the state, "it's how you got there.
但正如我们的同事大卫·斯皮格尔多次对我说过的那样，“这不仅仅是你所处的状态，”在这里我们谈论的是压力作为一种状态，“这就是你如何到达那里的。
And in particular, did you have any control over how you got there and whether or not you can get out?" And I think that the kind of stress that you're talking about in post-traumatic stress disorder or in post-traumatic stress injury is typically of the sort that people didn't have a choice.
特别是，你是否能够控制自己如何到达那里以及是否可以离开？”我认为你所谈论的创伤后应激障碍或创伤后应激损伤中的压力通常是人们别无选择的那种压力。
Certainly, these kids didn't have a choice about the initial exposure to the trauma or stressors, but that also the stress is showing up when they would least want it to appear, or when it's very inconvenient to appear.
当然，这些孩子对于最初接触创伤或压力源没有选择权，但压力也会在他们最不希望出现或非常不方便出现的时候出现。
Dr. Victor Carrión:
维克多·卡里翁博士：
So this narrative is an important part of recovery.
所以这个叙述是康复的重要组成部分。
But we feel that it needs to come after the education piece and after learning a toolbox, having defenses, because sometimes it can get very charged when you go through the narrative, and you want to assess many things during the narrative.
但我们觉得它需要在教育部分和学习工具箱之后进行，有防御，因为有时当你经历叙述时它会变得非常激烈，并且你想在叙述过程中评估很多事情。
You want to assess gaps of memory.
您想要评估记忆差距。
You want to assess potential cues.
您想要评估潜在的线索。
You want to assess the emotions that are present.
您想要评估当前的情绪。
So and the narrative should be one that covers not only negative events, but also neutral ones and also positive events.
因此，叙事不仅应该涵盖负面事件，还应该涵盖中性事件和积极事件。
And it sounds like a lot, right?
听起来很多，对吧？
But when you're talking about kids that have 10, 11, 12 years, it is doable.
但当你谈论 10、11、12 岁的孩子时，这是可行的。
You can really manage it.
你真的可以管理它。
By the way, with the cold showers, I think you're getting to the hinge of that seesaw.
顺便说一句，洗了冷水澡，我想你已经到了跷跷板的铰链了。
I think the cold shower probably does-- Not the cold shower.
我想冷水淋浴可能会——不是冷水淋浴。
What do you call it?
你怎么称呼它？
Andrew Huberman:
安德鲁·休伯曼：
Deliberate cold.
故意冷。
It could be from a cold shower.
可能是洗了冷水澡。
I always say that because oftentimes people think, oh, they're just trying to sell cold plunges.
我总是这么说，因为人们常常想，哦，他们只是想抛售冷跌。
And the truth is, you don't need that.
事实是，你不需要那个。
I mean, the fact of the matter is, it's independent of income.
我的意思是，事实是，它与收入无关。
Actually, a cold shower will save you money on your heating bill.
事实上，洗个冷水澡可以节省你的取暖费。
I'm not saying everyone should take a cold shower.
我并不是说每个人都应该洗冷水澡。
I love a nice warm or hot shower.
我喜欢洗个热水澡或热水澡。
I sometimes use the cold shower as a stimulus, and I hate it every time.
我有时会用冷水淋浴作为刺激，但每次我都讨厌它。
But I always learn something each time.
但我每次总能学到一些东西。
By the way, it feels great when you get out, so that's nice.
顺便说一句，当你出去的时候感觉很棒，所以这很好。
And it does for many hours, especially if you end it with some warm water.
它会持续几个小时，特别是如果你用温水结束它。
But the learning, I believe, is in recognizing just how destabilized our patterns of thinking get when we have adrenaline in our body, which is what uncomfortable cold does, and it deploys that adrenaline in the brain and body.
但我相信，学习的意义在于认识到当我们体内有肾上腺素时，我们的思维模式会变得多么不稳定，这就是令人不舒服的寒冷造成的，它会在大脑和身体中部署肾上腺素。
And it also is a great learning in seeing the return to a baseline, just seeing how that affects our psychology.
看到回归基线，看看这如何影响我们的心理，这也是一个很好的学习。
And to my mind, I can think of no other zero-cost or even negative-cost, meaning saves money, approach that works the first time and every time, that is safe enough, right?
在我看来，我想不出其他零成本甚至负成本，意味着省钱，第一次和每次都有效的方法，这足够安全，对吧？
I mean, I'm not interested in anything that has to do with snakes, for instance.
我的意思是，我对任何与蛇有关的事情都不感兴趣。
I don't mind spiders.
我不介意蜘蛛。
I'll pick them up with my hands as long as it's not a black widow or a particularly large spider, and I'll put it outside, but I don't like snakes.
只要不是黑寡妇或者特别大的蜘蛛我都会用手捡起来，放在外面，不过我不喜欢蛇。
I don't like thinking about them.
我不喜欢思考他们。
I don't like being near them.
我不喜欢靠近他们。
So, there are other stressors that one could use, but it's so individual, whereas cold water seems to be pretty uncomfortable for everybody.
因此，人们还可以使用其他压力源，但它是如此个体化，而冷水似乎对每个人来说都非常不舒服。
Dr. Victor Carrión:
维克多·卡里翁博士：
I think you need some exposure of snakes in your cold.
我认为你需要在寒冷中接触一些蛇。
Andrew Huberman:
安德鲁·休伯曼：
No interest.
没有兴趣。
It's so interesting these things get so firmly rooted.
有趣的是，这些事情如此根深蒂固。
But I'd love to talk about this toolbox.
但我很想谈谈这个工具箱。
Because first of all, according to your work, and this has been done repeatedly, it's very effective, and I love the idea that it can be customized.
因为首先，根据你的工作，而且这已经被重复做了，它非常有效，而且我喜欢它可以定制的想法。
So the words that come to mind is a customized toolbox for combating stress and PTSD.
因此，我想到的是一个用于对抗压力和创伤后应激障碍的定制工具箱。
And the fact that it can be customized and maybe even covert, like we can have these tools inside us.
事实上，它可以定制，甚至可能是隐蔽的，就像我们可以在我们体内拥有这些工具一样。
We don't need to share them with anybody if we don't want to, but that they are very effective.
如果我们不愿意的话，我们不需要与任何人分享它们，但它们非常有效。
I think that those are very compelling reasons for exploring the toolbox approach a bit more here.
我认为这些是在这里更多地探索工具箱方法的非常令人信服的理由。
So you mentioned one way to go about this is to think about or to have in mind some negative, some neutral, and some positive experiences, and then to think about the different tools that one would deploy under those different conditions?
所以你提到解决这个问题的一种方法是考虑或牢记一些消极的、一些中性的和一些积极的经历，然后考虑在这些不同的条件下可以部署的不同工具？
Dr. Victor Carrión:
维克多·卡里翁博士：
Correct.
正确。
So the exercise of the events is a lifeline that we do separate from the toolbox.
因此，事件的练习是我们与工具箱分开的生命线。
We actually work on the toolbox first to identify coping mechanisms and coping tools that help.
实际上，我们首先研究工具箱，以确定有帮助的应对机制和应对工具。
Andrew Huberman:
安德鲁·休伯曼：
So what would that look like?
那会是什么样子呢？
Let's say I'm a nine-year-old.
假设我是一个九岁的孩子。
I come into your clinic, and I meet the criteria for PTSI or PTSD.
我来到您的诊所，并且符合 PTSI 或 PTSD 的标准。
Dr. Victor Carrión:
维克多·卡里翁博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
What sorts of questions would you ask?
你会问什么类型的问题？
Dr. Victor Carrión:
维克多·卡里翁博士：
Yes.
是的。
So the first thing I would say, when you're feeling A certain way, whatever way we're talking about, right?
所以我要说的第一件事是，当你有某种感觉时，无论我们谈论的是哪种方式，对吗？
Andrew Huberman:
安德鲁·休伯曼：
Anxious.
着急。
Dr. Victor Carrión:
维克多·卡里翁博士：
Agitated-
激动-
Andrew Huberman:
安德鲁·休伯曼：
Yeah
是啊
Dr. Victor Carrión:
维克多·卡里翁博士：
...
...
anxious.
焦虑。
Andrew Huberman:
安德鲁·休伯曼：
Nervous.
紧张。
Dr. Victor Carrión:
维克多·卡里翁博士：
Is there anything that makes you feel better?
有什么事情能让你感觉好一点吗？
Because the experience of having something and they bringing something is important, too.
因为拥有某些东西以及他们带来某些东西的体验也很重要。
And sometimes they do.
有时他们会这样做。
They say, "I listen to music," or, "I play the guitar," or, "I go to play," or-
他们说，“我听音乐”，或者“我弹吉他”，或者“我去演奏”，或者——
Andrew Huberman:
安德鲁·休伯曼：
My friends
我的朋友们
Dr. Victor Carrión:
维克多·卡里翁博士：
...
...
or, "My friends," or, "My teammates," mostly, actually.
实际上，主要是“我的朋友”或“我的队友”。
Andrew Huberman:
安德鲁·休伯曼：
They say teammates?
他们说队友？
Dr. Victor Carrión:
维克多·卡里翁博士：
Teammates is pretty popular.
队友很受欢迎。
Andrew Huberman:
安德鲁·休伯曼：
I love that.
我喜欢那个。
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah.
是的。
There's something about sports, and sports is something that comes up a lot when we do the toolbox.
运动是有一些东西的，当我们制作工具箱时，运动是经常出现的东西。
People put in there sports they're doing, or talking to their coach, or talking to their teammates, or learning a new sport.
人们将他们正在做的运动投入其中，或者与他们的教练交谈，或者与他们的队友交谈，或者学习一项新运动。
Sports are big, so that's an example that they give.
体育运动很重要，所以这就是他们举的例子。
Talking to friends, planning a sleepover, listening to music, different things like this.
和朋友聊天，计划过夜，听音乐，诸如此类的不同事情。
Andrew Huberman:
安德鲁·休伯曼：
Are there any particular tools for when kids are stuck in a stress response?
当孩子陷入压力反应时，有什么特殊的工具可以帮助他们吗？
Dr. Victor Carrión:
维克多·卡里翁博士：
Yes.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Because I myself am familiar with the toolkit that I use.
因为我自己很熟悉我使用的工具包。
Certainly, teammates is one of them, and I have others, including long exhale breathing, physiological sighs.
当然，队友是其中之一，我还有其他的，包括长长的呼气、生理性的叹息。
These things will be familiar to some of the listeners.
这些事情对于一些听众来说会很熟悉。
But certainly, there are times when we're stressed about something, and we don't want to be, and we have a hard time pulling our thoughts and our emotions and the stress response out.
但当然，有时我们会因为某些事情而感到压力，但我们并不想这样，而且我们很难摆脱我们的想法、情绪和压力反应。
Dr. Victor Carrión:
维克多·卡里翁博士：
So the ones I just mentioned are some ideas that the kids bring with them.
所以我刚才提到的这些都是孩子们带来的一些想法。
What we always try to do is we teach them exercises of relaxation.
我们一直尝试做的就是教他们放松练习。
We have to be very careful with this because like you say, it's good to be personalized.
我们必须对此非常小心，因为就像你说的，个性化是件好事。
It's good that it's adapted to the kid.
能适应孩子就好了。
And that's why we don't tell them, "Put this in your toolbox." We tell them, "Learn it, and if it helps you, you decide if you put it in the toolbox or not." So when I talk about the treatment being not so much about the what, because there's many components here like education, narrative, that are common.
这就是为什么我们不告诉他们，“把这个放进你的工具箱里。”我们告诉他们，“学习它，如果它对你有帮助，你就决定是否将它放入工具箱。”因此，当我谈论治疗时，与其说是关于什么，不如说是因为这里有很多常见的组成部分，例如教育、叙述。
Exposure, we can talk about.
曝光，我们可以谈谈。
It's not so much about the what, but it's about the how.
重要的不是“什么”，而是“如何”。
It's about empowering kids to identify those cues, to say if a tool works or it doesn't work, to develop their own tools.
这是为了让孩子们能够识别这些线索，判断一个工具是否有效，并开发自己的工具。
But sometimes they are very stuck, and they need a little bit of help.
但有时他们会陷入困境，需要一点帮助。
So we teach them breathing exercises, and we have a script for that.
所以我们教他们呼吸练习，并且我们有一个脚本。
We teach them muscle relaxation, and we have something for that.
我们教他们肌肉放松，我们有这方面的东西。
We teach them the positive thinking, for example, so that's a cognitive type of tool.
例如，我们教他们积极思考，所以这是一种认知类型的工具。
And we teach them mindfulness because of our other work in prevention that we can talk about later, in which mindfulness has been helpful.
我们教他们正念是因为我们在预防方面的其他工作，我们稍后会讨论，其中正念很有帮助。
And also yoga, very simple yoga exercises.
还有瑜伽，非常简单的瑜伽练习。
So nothing too complicated.
所以没什么太复杂的。
Things like the mountain pose, for example, can be quite helpful for some kids.
例如，像山式这样的动作对一些孩子来说非常有帮助。
If anything, it helps them reassess the moment and stop, and if we are going to think about it in cognitive behavioral terms, kind of break that chain of negative thoughts that happen one after the other, which can lead to a panic attack.
如果有的话，它可以帮助他们重新评估当下并停下来，如果我们要从认知行为的角度来思考它，那就打破相继发生的消极想法链，这可能会导致恐慌发作。
That's many times how a panic attack can start.
很多时候恐慌症就是这样开始的。
Andrew Huberman:
安德鲁·休伯曼：
Well, what's so interesting to me about the stress response is that while it's quick to start, it's slow to shut off.
嗯，对我来说，压力反应最有趣的是，虽然它启动得很快，但关闭起来却很慢。
For logical reasons related to our evolutionary trajectory.
出于与我们进化轨迹相关的逻辑原因。
Wouldn't it be wonderful if you could stress when needed and then it would turn off when needed?
如果您可以在需要时施加压力，然后在需要时关闭它，这不是很棒吗？
But what we're really talking about here is intervening in the stress response either before or as it's happening, but then also making sure that the tail of that stress response isn't too long.
但我们在这里真正讨论的是在压力反应发生之前或发生时对其进行干预，但同时也要确保压力反应的尾部不会太长。
Dr. Victor Carrión:
维克多·卡里翁博士：
We're also talking about eradicating stress that causes discomfort, and causes distress.
我们还谈论消除引起不适和痛苦的压力。
Not necessarily to live a life without stress or to get rid completely of stress because that would be impossible.
不一定要过没有压力的生活或完全摆脱压力，因为那是不可能的。
Andrew Huberman:
安德鲁·休伯曼：
In certain cultures, there are accepted practices that adults use to deal with stress, things like worry beads.
在某些文化中，成年人有一些公认的应对压力的做法，比如忧心珠。
And a few years back, there were those, what were the little spinner things that kids had?
几年前，孩子们拥有的旋转小玩意是什么？
Dr. Victor Carrión:
维克多·卡里翁博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
When those were popular, maybe they're still popular, did you observe any reductions in stress?
当这些很受欢迎时，也许它们仍然很受欢迎，你是否观察到压力有所减轻？
Kids have a lot of energy.
孩子们有很多精力。
Sometimes I think we confuse energy and stress.
有时我认为我们混淆了能量和压力。
Wouldn't we all love to have the kind of energy that we had in childhood?
难道我们不都希望拥有童年时拥有的那种能量吗？
I was observing this the other day.
前几天我正在观察这一点。
You'll see a kid sitting cross-legged, listening in class, and then all of a sudden, it's time to move across the room, and they'll just pop up and move across the room.
你会看到一个孩子盘腿坐着，在课堂上听讲，然后突然间，到了穿过房间的时间，他们就会突然出现并穿过房间。
When was the last time any of us popped up out of our chairs unless we were particularly excited or scared as adults?
除非我们作为成年人感到特别兴奋或害怕，否则我们最后一次从椅子上站起来是什么时候？
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Just that immediacy to action implies that there's a lot of energy in the system.
立即采取行动就意味着系统中有大量的能量。
So I could imagine that having some ways to siphon off some of that energy through, as far as I can tell, things like worry beads or-
所以我可以想象，据我所知，有一些方法可以通过诸如担忧珠之类的东西吸走一些能量，或者——
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
fidgets or whatever those are called.
坐立不安或任何所谓的东西。
They might irritate some adults around, but really, they're pretty innocuous when you think about it.
它们可能会激怒周围的一些成年人，但实际上，仔细想想，它们是无害的。
Dr. Victor Carrión:
维克多·卡里翁博士：
I like that you're not calling it nervous energy because it is just what you said, it's just energy.
我喜欢你没有称其为神经能量，因为这就是你所说的，它只是能量。
It's extra energy that needs to be placed somewhere, and they're trying to find out where to place it.
这是额外的能量需要放置在某个地方，他们正在努力找出放置它的地方。
Andrew Huberman:
安德鲁·休伯曼：
We have colleagues that, not all of them, this is not a requirement for being a professor at Stanford, but I've got colleagues that work 80 hours a week.
我们的一些同事，并不是所有人，这都不是成为斯坦福大学教授的要求，但我有一些同事每周工作 80 小时。
You could argue that's healthy or unhealthy depending on the context and their agreements with others.
您可以认为这是健康还是不健康，具体取决于上下文以及他们与他人的协议。
Dr. Victor Carrión:
维克多·卡里翁博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
But that requires a lot of energy, and I know they are not particularly happy working less.
但这需要大量的精力，而且我知道他们并不是特别乐意减少工作量。
So I think sometimes we are dismissive or kind of pejorative about Physical energy and shaking and moving.
所以我认为有时我们对身体能量、震动和移动不屑一顾或有点贬义。
But I know someone in my life who bounces her knee while she works, and it kind of makes me a little bit nervous, but boy, does she have a lot of focus and energy.
但我认识我生活中的一个人，她在工作时会弹起膝盖，这让我有点紧张，但是天哪，她有很多注意力和精力吗？
So, I think it's wonderful, in other words.
所以，换句话说，我认为这很棒。
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Dr. Victor Carrión:
维克多·卡里翁博士：
And some of us choose to have meetings while walking rather than being in an office.
我们中的一些人选择边走边开会，而不是在办公室里。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
That's certainly my preference.
这当然是我的偏好。
Dr. Victor Carrión:
维克多·卡里翁博士：
I go for a walk sometimes when I have a meeting.
有时开会时我会去散步。
So yes, there is increased energy, but there's increased energy of I feel like I need to do something, and there's increased energy that causes a lot of discomfort.
所以，是的，能量增加了，但我觉得我需要做某事，能量增加了，但能量增加却导致了很多不适。
So for kids that experience discomfort, then they can look at their toolbox and say which one I'm going to use.
因此，对于感到不适的孩子，他们可以查看他们的工具箱并说出我要使用哪一个。
And that gives them also a choice, which goes back to that sense of control again.
这也给了他们一个选择，这又回到了控制感。
Andrew Huberman:
安德鲁·休伯曼：
Earlier, meaning off microphone, we were talking about the fact that some people, indeed some kids, have a different tendency to anchor towards thinking or feeling or action when under stress.
早些时候，我们谈论的是这样一个事实：有些人，实际上是一些孩子，在压力下有不同的倾向来锚定思考、感觉或行动。
And you were describing the four-quadrant system.
你正在描述四象限系统。
Could you share with us this four-quadrant system?
您能和我们分享一下这个四象限系统吗？
Because I think it's both extremely valuable to children and to adults.
因为我认为这对儿童和成人都非常有价值。
It's certainly something that I plan to incorporate into my life.
这当然是我计划融入我生活的事情。
Dr. Victor Carrión:
维克多·卡里翁博士：
Yes.
是的。
So we have to be careful with structured interventions because sometimes structured interventions can break a little bit the fluidity of the relationship that a therapist and a child may have, or a therapist and a patient.
因此，我们必须谨慎对待结构化干预，因为有时结构化干预可能会稍微破坏治疗师和孩子、或者治疗师和患者之间的关系的流动性。
So it's better to be semi-structured and to really be attentive to the temperament that the kid brings into that relationship or into that session.
因此，最好是半结构化的，真正关注孩子带入这段关系或那次会议的气质。
And certainly with the toolbox, as you mentioned, we see an example of that.
当然，正如您提到的，通过工具箱，我们看到了一个例子。
We also add that in Q center therapy by dissecting and examining a response.
我们还通过剖析和检查反应来在 Q 中心治疗中添加这一点。
So for example, a child that breaks windows or a child that screams or a child that leaves the classroom running, we try to understand what's happening at that moment.
例如，一个孩子打破了窗户，或者一个孩子尖叫，或者一个孩子跑出教室，我们试图了解当时发生了什么。
And the way that we do that is by looking at a square.
我们这样做的方法是观察一个正方形。
And a square is composed of four corners, and the four corners are what you're thinking, so it's a cognitive side to it, what you're feeling emotionally, what you're feeling physically, and what you're actually doing, what the action is.
一个正方形是由四个角组成的，这四个角就是你在想什么，所以它是它的认知方面，你在情感上的感受是什么，你在身体上的感受是什么，以及你实际上在做什么，行动是什么。
And this is your classical triangle of cognitive behavioral therapy in terms of what you're thinking, what you're doing, and how you're feeling, but we felt it was important to add that somatic physiological component because for many children, they don't have the vocabulary to talk about all of this.
这是认知行为疗法的经典三角，即你在想什么、你在做什么、你的感受如何，但我们认为添加躯体生理成分很重要，因为对于许多孩子来说，他们没有词汇来谈论所有这些。
They just tell you, "I have a headache," or, "I have a stomach ache," and there's no other medical reason that explains it, right?
他们只是告诉你，“我头痛”，或者“我胃痛”，没有其他医学原因可以解释，对吗？
So depending on the kid that comes, you're going to start examining their response through one of those corners.
因此，根据来的孩子，你将开始通过这些角落之一检查他们的反应。
So if the kid is really brainy and likes to think about the things they think or don't think, you start in the cognitive corner.
因此，如果孩子真的很聪明并且喜欢思考他们想到或没有想到的事情，那么你就从认知角落开始。
Other kids are very attentive to their body and they say, "I feel my heart racing when I engage in this behavior or in this response." And you start with that corner.
其他孩子非常关注自己的身体，他们说：“当我做出这种行为或做出这种反应时，我感到心跳加速。”然后你从那个角落开始。
The beauty of this is that most of the time you don't have to work in all of the corners.
这样做的好处是，大多数时候您不必在所有角落工作。
By just working in one corner, all the other corners change and a new response develops.
只要在一个角落工作，所有其他角落就会发生变化，并产生新的反应。
Okay, so if I'm thinking that I'm not in danger, maybe I don't need to leave running.
好吧，如果我认为自己没有危险，也许我不需要继续跑步。
Maybe I can just tell the teacher I'm distressed by the amount of noise.
也许我可以告诉老师我对噪音的大小感到苦恼。
All of a sudden, the kid has created a new square.
突然，孩子创造了一个新的正方形。
That's another square.
那是另一个广场。
So hopefully we take that one response as a square and build a cube of many potential responses so that when the cue happens, now there's an armamentarium of responses.
因此，希望我们将一个响应视为一个正方形，并构建一个由许多潜在响应组成的立方体，以便当提示发生时，现在就有了一个响应武器库。
And if I'm too distressed to think what response to do, I can bring myself there by using my toolbox.
如果我太苦恼而无法思考该采取什么应对措施，我可以使用我的工具箱将自己带到那里。
So it all kinds of starts tying together.
所以各种事情开始联系在一起。
And then as I have more responses, as I understand cues, I can begin talking about this narrative that I have where I will fix some cognitive distortions, hopefully, like, "It was my fault.
然后，当我有更多的回应，当我理解线索时，我可以开始谈论我的叙述，我将在其中修复一些认知扭曲，希望，比如，“这是我的错。
I made it happen," to things like, "No, it wasn't my fault.
我让它发生了，”诸如此类的事情，“不，这不是我的错。
Somebody else was responsible and I'm just a survivor." Right?
其他人对此负有责任，而我只是一个幸存者。”正确的？
I'm not a victim, I'm a survivor.
我不是受害者，我是幸存者。
That's another cognitive distortion that can be fixed.
这是另一种可以修复的认知扭曲。
So all of that, we've included all of this in a manual for therapists, right?
所以，我们已经将所有这些内容都包含在治疗师手册中，对吧？
So we have a manual for therapists that is called "Q Center Therapy for Youth with Posttraumatic Symptoms," published by Oxford.
因此，我们为治疗师准备了一本手册，名为“Q Center Therapy for Youth with Posttraumatic Symptoms”，由牛津大学出版。
But I believe that adults that want to reexamine their childhood or their history or want to think about their kids or are interested in trauma can get a lot from actually examining this manual and studying this manual.
但我相信，想要重新审视自己的童年或历史，或者想要思考自己的孩子，或者对创伤感兴趣的成年人，可以从实际检查本手册和学习本手册中获益匪浅。
And in fact, I believe so strongly that we are beginning the first steps of adapting it not only for youth but also for adults.
事实上，我坚信我们正在开始迈出第一步，使其不仅适用于青少年，也适用于成年人。
Andrew Huberman:
安德鲁·休伯曼：
In this four-corner system, and forgive me because I called it a four-quadrant system, but in this four corners of the square system, you said there's thinking, which is cognitive.
在这个四角系统中，请原谅我，因为我称它为四象限系统，但是在这个方形系统的四个角中，你说有思维，这是认知。
There are emotions Then there's feelings which are somatic, physical, and then actions.
有情绪，然后是躯体、身体的感觉，然后是行动。
So actions are straightforward.
所以行动很简单。
Thinking would be, for instance, if I understand correctly, "I'm in danger." Emotions would be, "I'm scared." So it's a verbal label.
例如，如果我理解正确的话，思考会是“我处于危险之中”。情绪会是“我很害怕”。所以这是一个文字标签。
"I'm depressed, I'm scared, I'm sad, I'm..."
“我很沮丧，我很害怕，我很伤心，我……”
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah.
是的。
In a way it's cognitive too, right?
在某种程度上它也是认知的，对吗？
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Dr. Victor Carrión:
维克多·卡里翁博士：
But it carries an emotion with it.
但它带有一种情感。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Okay.
好的。
And then in terms of the physical feeling, it's of the body, but it could include of the head, too, like, "I have a headache," or, "My heart is racing." Or something of that sort.
然后就身体感觉而言，是身体的感觉，但也可能包括头部的感觉，例如“我头痛”或“我的心跳加速”。或者类似的东西。
And then actions, of course, is the action that they would take.
然后行动，当然是他们会采取的行动。
Dr. Victor Carrión:
维克多·卡里翁博士：
And action is a really fun one because you can imagine there are some kids that are not psychologically-minded at all, and they don't even want to engage in this with me, and they are like, "Okay, what is it that I'm doing?
行动是一件非常有趣的事情，因为你可以想象有些孩子根本没有心理头脑，他们甚至不想和我一起参与其中，他们会说，“好吧，我在做什么？
I'll do something different." So they'll immediately develop the next square.
我会做一些不同的事情。”所以他们会立即开发下一个广场。
So they cannot talk too much about their emotions or how they're feeling physically, or look at the negative thought, but they say, "Oh, is the problem that I'm running out of the classroom?
所以他们不能过多谈论自己的情绪或身体感受，也不能关注消极的想法，但他们会说，“哦，问题是我跑出了教室吗？
Well, what if I don't?" And they give you another action.
好吧，如果我不这样做怎么办？”他们会给你另一个动作。
And so some kids start with that corner.
所以有些孩子从那个角落开始。
So you can really start with any of the corners.
所以你真的可以从任何角落开始。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
I love that earlier you were talking about practicing positive thinking, even when, perhaps especially when, one is not in the stress response or trauma response, but also, of course, when one is in the trauma response.
我喜欢你早些时候谈论的练习积极思考，即使是当一个人没有处于压力反应或创伤反应中时，也许尤其是当一个人没有处于压力反应或创伤反应中时，当然也包括当一个人处于创伤反应中时。
I think that's just so vitally important for people to hear, certainly for me to hear.
我认为这对人们来说非常重要，当然对我来说也是如此。
I'm not claiming to have PTSD, but as a novel concept that I've not heard raised before around these topics.
我并不是声称患有创伤后应激障碍，而是作为一个我以前从未听说过围绕这些主题提出的新颖概念。
The other is this four-corner system, which immediately occurs to me as so powerful because it breaks down the reflex arc of the stress response into its component parts, right?
另一个是这个四角系统，我立即想到它如此强大，因为它将压力反应的反射弧分解为其组成部分，对吗？
Of what's of the body, what's of the thinking, what's of the thinking that's emotional, and then what's the action.
什么是身体的，什么是思想的，什么是情感的思想，然后是行动。
And you said as soon as one identifies one of these corners and starts to look at it differently and consider some of the optionality that exists, an alternative, that all these other options cascade from that.
你说，一旦人们识别出这些角落之一并开始以不同的方式看待它并考虑存在的一些可选性，一种替代方案，所有其他选项都会从中级联。
And I believe that in doing that, you've described what, for thousands of years really, but recently we've heard a lot about in the mindfulness arena as creating space.
我相信，在这样做的过程中，您实际上已经描述了数千年的内容，但最近我们在正念领域听到了很多关于创造空间的内容。
Right, like this notion of creating space, not outer space, but creating space within us to choose better options, is something that I think until right now, as you've described this, has remained unfortunately very mysterious.
是的，就像这种创造空间的概念，不是外层空间，而是在我们内部创造空间来选择更好的选择，我认为直到现在，正如你所描述的，不幸的是仍然非常神秘。
People talk about, okay, you want to be responsive, not reactive.
人们会说，好吧，你想要做出反应，而不是被动反应。
Responsive implies some optionality to your responses.
响应式意味着您的响应具有一定的选择性。
Reactive implies kind of a reflex arc of just whatever the default was.
反应性意味着某种类型的反射弧，无论默认是什么。
But this notion of space is too squishy for me as a biologist to really be able to latch onto.
但作为一名生物学家，这种空间概念对于我来说太模糊了，无法真正理解。
And I would argue, given the prevalence of PTSD and stress, it's probably too squishy for most people.
我认为，考虑到创伤后应激障碍和压力的普遍存在，这对大多数人来说可能太脆弱了。
It hasn't really led anywhere specific.
它并没有真正导致任何具体的结果。
But I think what you're describing is the ability to become responsive as opposed to reactive, assuming that the word responsive includes some options within it.
但我认为你所描述的是响应性而不是反应性的能力，假设响应性这个词包含一些选项。
And so this four-corner system, to me, is genius because it gives us an anchor point to start from.
因此，对我来说，这个四角系统是天才，因为它为我们提供了一个起点。
So could you say that if a child or adult is uncomfortably stressed, maybe about a trauma, but just is caught in the stress response, that actually pulling out a pen or pencil or crayon, as it were, and write and drawing a square and just really think, what am I thinking?
那么你能说，如果一个孩子或成人感到不舒服的压力，也许是因为创伤，但只是陷入压力反应中，实际上会拿出钢笔、铅笔或蜡笔，写写画画一个正方形，然后认真思考，我在想什么？
Maybe it's just, "This is terrible.
也许只是，“这太可怕了。
I don't like it."
我不喜欢它。”
Dr. Victor Carrión:
维克多·卡里翁博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
Writing down, "I'm embarrassed." Like, "I'm not with my friends.
写下“我很尴尬”。就像，“我没有和我的朋友在一起。
My cheeks are flushing," whatever.
我的脸颊通红，”无论如何。
"I'm feeling just weighed down," or something.
“我感觉压力很大”之类的。
And then thinking, "Well, what are the actions?
然后思考：“那么，有什么行动呢？
I want to remove myself from the situation." At that point, is the suggestion that one find what is the point of entry that feels most accessible, and to start there?
我想摆脱这种情况。”在这一点上，是否建议人们找到感觉最容易进入的切入点，并从那里开始？
Dr. Victor Carrión:
维克多·卡里翁博士：
Yes, with one caveat.
是的，有一点需要注意。
We usually use Wagner's emotional thermometer-
我们通常使用瓦格纳的情绪温度计——
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm
嗯嗯
Dr. Victor Carrión:
维克多·卡里翁博士：
...
...
to measure where the kid is at, and it goes from zero to 10 or one to 10, with different levels of stress.
衡量孩子所处的位置，压力等级从 0 到 10 或从 1 到 10。
And it's good to use something concrete because sometimes we think they're a 10 and they're a five, or vice versa.
使用具体的东西是很好的，因为有时我们认为它们是 10，而它们是 5，反之亦然。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
We're very poor at assessing others' internal states.
我们非常不善于评估他人的内心状态。
Dr. Victor Carrión:
维克多·卡里翁博士：
We are.
我们是。
Andrew Huberman:
安德鲁·休伯曼：
As our colleague Carl Diener, who's also been a guest on this podcast, I heard him once say this in a very large lecture.
我们的同事卡尔·迪纳（Carl Diener）也是这个播客的嘉宾，我曾在一次大型演讲中听到他说过这样的话。
He said, "We're terrible, absolutely dreadful at assessing other people's emotions.
他说：“我们很糟糕，非常不擅长评估别人的情绪。
In fact, most of the time, we don't even know how we feel."
事实上，大多数时候，我们甚至不知道自己的感受如何。”
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah.
是的。
He always says that, and it's true.
他总是这么说，而且确实如此。
Andrew Huberman:
安德鲁·休伯曼：
It's so true.
这是真的。
Dr. Victor Carrión:
维克多·卡里翁博士：
And it's true.
这是真的。
But I would say if the kid is at 10 at that moment, the best thing is to use a tool from the toolbox and not to engage on the square at that moment until they come down a little bit, and they can pay attention, and they can listen to you.
但我想说，如果孩子当时才10岁，最好的办法就是使用工具箱中的工具，而不是在那一刻参与广场，直到他们稍微下来，他们可以集中注意力，他们可以听你的。
Because then they will be letting the information come in.
因为那样他们就会让信息进来。
They are so emotionally charged right at the moment that that may not be the right time.
他们此刻情绪激动，可能不是合适的时间。
Which also, by the way, is the same thing as when you need to talk to kids about traumas that are happening in our society, right?
顺便说一句，这也和你需要与孩子谈论我们社会中发生的创伤是一样的，对吗？
Sometimes you just want to let them know that the door is open for communication.
有时你只是想让他们知道沟通的大门是敞开的。
You may want to talk about it at the moment, but the kid may not be ready.
你现在可能想谈论这件事，但孩子可能还没有准备好。
But you can let them know, "Well, when you're ready, we can talk about it." Here, the same.
但你可以让他们知道，“好吧，当你准备好时，我们可以谈谈。”这里，也一样。
"When you're ready, let's go over the square exercise," or the example if the kid is already familiar with it.
“当你准备好后，让我们回顾一下平方练习”，或者如果孩子已经熟悉了这个例子的话。
Or, "I have something to show you," right?
或者，“我有东西要给你看”，对吗？
And pique his curiosity that way.
并以这种方式激起他的好奇心。
But I would say use the thermometer to see if that's a good time.
但我想说用温度计看看现在是否合适。
If it's 10, nine, eight, probably not.
如果是 10、9、8，则可能不会。
Wait till it's five, four, three, and then engage in that.
等到五点、四点、三点，然后再进行。
Andrew Huberman:
安德鲁·休伯曼：
So the toolbox should be used essentially under any conditions, and the kid should generate their own tools to add to the toolbox, customize the tools, and then the square can be used when they are at a slightly lower level of stress because it requires a certain level of cognitive intervention.
所以工具箱基本上应该在任何情况下使用，孩子应该生成自己的工具添加到工具箱中，自定义工具，然后当他们压力稍低时可以使用方块，因为它需要一定程度的认知干预。
They need to be able to think about and express their own state.
他们需要能够思考并表达自己的状态。
Dr. Victor Carrión:
维克多·卡里翁博士：
Correct.
正确。
Andrew Huberman:
安德鲁·休伯曼：
Okay.
好的。
And is this something that you suggest kids only do with their therapist, or is this something that they can do on their own as well, assuming that they're old enough to write and to think about it?
您是否建议孩子们只与他们的治疗师一起做这件事，或者他们也可以自己做这件事，假设他们已经足够大了，可以写作和思考？
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah.
是的。
Well, our hope is that after a kid goes through Q Center therapy, that they can internalize a lot of these activities and exercises, and like I said, become their own tool.
嗯，我们的希望是，在孩子接受 Q Center 治疗后，他们可以内化很多这些活动和练习，就像我说的，成为他们自己的工具。
Take those for life and continue to use them.
终生接受并继续使用它们。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, I'm certain that many, many adults, not just children, can benefit from these tools.
是的，我确信很多很多成年人，而不仅仅是孩子，都可以从这些工具中受益。
I would argue that most of the bad things that happen in the world are the consequence of dysregulated autonomic function.
我认为世界上发生的大多数坏事都是自主神经功能失调的结果。
Dr. Victor Carrión:
维克多·卡里翁博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
Put kind of bluntly.
说得直白一点。
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah.
是的。
Bidirectional, right?
双向的，对吗？
Kind of making things worse.
有点让事情变得更糟。
Once they happen, they impact the system even further.
一旦发生，就会进一步影响系统。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, I think most homicides are homicides of jealous rage, from what I have read.
是的，根据我所读到的内容，我认为大多数凶杀案都是出于嫉妒而愤怒的凶杀案。
I don't know if that's still true, but-- And of course then that is probably also true for all of the things that are not as severe as homicide, but still dreadfully bad, like assault and things like that.
我不知道这是否仍然正确，但是——当然，对于所有不像杀人那么严重但仍然非常糟糕的事情，比如袭击之类的事情，这可能也是正确的。
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah.
是的。
And it's interesting that you bring that up because I often think about, we've been talking about how we experience trauma as individuals, right?
有趣的是，你提出这个问题，因为我经常想，我们一直在谈论我们作为个人如何经历创伤，对吗？
But we experience trauma in our civilization.
但我们在我们的文明中经历了创伤。
We experience trauma in our history.
我们在历史上经历过创伤。
We experience trauma in our nation.
我们的国家经历过创伤。
And how does a nation heal?
一个国家如何治愈？
How does a system heal?
系统如何治愈？
Well, the steps are not that different.
嗯，步骤并没有那么不同。
Andrew Huberman:
安德鲁·休伯曼：
Perhaps this is the appropriate time to give you the opportunity to editorialize a little bit about social media and online behavior.
也许现在是让您有机会发表一些有关社交媒体和在线行为的社论的适当时机。
Setting aside really aggressive online behavior, bullying and things like that, which of course exists and is really serious, do you see the behavior of kids and adults online, maybe even the addiction to online commenting and reading of comments and the kind of battling of issues back and forth, that clearly isn't going anywhere.
抛开真正的攻击性在线行为、欺凌行为以及类似的事情，这些行为当然存在，而且非常严重，你是否看到了儿童和成人的在线行为，甚至可能沉迷于在线评论和阅读评论，以及那种来回争论的问题，这显然不会消失。
Some of it goes someplace functional, but most of it, I would argue, especially among the adults, is going nowhere.
其中一些在某个地方发挥了作用，但我认为，大多数，尤其是在成年人中，什么也没有。
It's just very circular.
它只是非常圆形。
It's my side versus your side, my side versus your side.
这是我这边对你那边，我这边对你那边。
Dr. Victor Carrión:
维克多·卡里翁博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
And emotions get really stirred on there.
那里的情绪真的很激动。
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Do you think that is reflective of a lack of tools for self-regulation?
您认为这是否反映出缺乏自我监管工具？
Do you think what we're seeing is the manifestation of just a lot of challenges in the world, and/or an outlet for people to just vent without the need to address their own internal state and what's underlying the venting?
您认为我们所看到的只是世界上许多挑战的表现，和/或人们可以发泄的出口，而无需解决自己的内部状态以及发泄背后的原因是什么？
I know many very intelligent adults who eventually just had to quit social media in order to have any level of functionality in their life.
我认识许多非常聪明的成年人，他们最终不得不退出社交媒体才能在生活中拥有任何程度的功能。
Dr. Victor Carrión:
维克多·卡里翁博士：
It comes down to that space you were talking about and building that space and creating that mindfulness time that you need, which is also going to be personalized.
归根结底是你正在谈论的空间，以及构建那个空间并创造你需要的正念时间，这也将是个性化的。
It's going to be different for different people.
对于不同的人来说，情况会有所不同。
This spring, I was in Morocco, and I visited the Medina.
今年春天，我在摩洛哥，参观了麦地那。
I was staying at the Medina, and I was overstimulated, as you can be, and enjoying it.
我住在麦地那，就像你一样，我受到了过度的刺激，并且很享受它。
But I imagine this is the state that teenagers are in all the time when they are with social media, bringing them information and different tidbits and different things that are happening all over the place.
但我想这就是青少年使用社交媒体时一直处于的状态，社交媒体为他们带来信息、不同的花絮以及各地正在发生的不同事情。
And very much like I found it restful to go to my hotel for a couple of hours before dinner, people need to build that space.
就像我发现晚餐前去酒店几个小时很放松一样，人们需要建造这个空间。
People need to create that space.
人们需要创造这个空间。
What I tell parents is that it's important to remember that this was also a very helpful tool for us when we were in the pandemic.
我告诉家长的是，重要的是要记住，当我们处于大流行期间时，这对我们来说也是一个非常有用的工具。
The kids were interacting socially.
孩子们进行社交互动。
Academics, school was happening through technology.
学术界、学校都是通过技术发生的。
So how can something so good be at times so harmful?
那么，如此美好的事物为何有时却如此有害呢？
And I remind them about when they brought hammers to their house.
我提醒他们，当他们把锤子带到家里时。
And they had little kids.
他们还有小孩子。
They had to teach them how to use them.
他们必须教他们如何使用它们。
This is a very important tool when you need to nail something or when you need to take a nail out.
当您需要钉东西或需要取出钉子时，这是一个非常重要的工具。
This can be dangerous.
这可能很危险。
You don't run with scissors.
你不会拿着剪刀奔跑。
You have all these rules around other tools.
您对其他工具也有所有这些规则。
We have to have these rules around social media as well.
我们也必须在社交媒体方面制定这些规则。
And I think that's what the surgeon general is getting at when he talks about we need some regulations around it.
我认为这就是卫生局局长在谈到我们需要围绕它制定一些法规时所要表达的意思。
But at the family level, I think parents need to say there are certain boundaries that we are going to have.
但在家庭层面，我认为父母需要告诉我们，我们将有一定的界限。
So at dinner time, for example, in these baskets, all the phones go into the basket, and that's what we're going to do from now on.
因此，例如在晚餐时间，在这些篮子中，所有手机都会放入篮子中，这就是我们从现在开始要做的事情。
But it is very difficult because when you establish rules like that, kids watch you like a hawk.
但这非常困难，因为当你制定这样的规则时，孩子们会像鹰一样盯着你。
So you have to model the behavior you are expecting.
因此，您必须对您期望的行为进行建模。
The moment that you, as a parent, decide, "Oh, no, I need to go to the basket during dinner because I need to check this thing out," then it breaks.
当你作为父母决定，“哦，不，我需要在晚餐时去篮子里，因为我需要检查这个东西”，然后它就崩溃了。
So that's what I think.
这就是我的想法。
I think it can be quite helpful, and I think that it can be dangerous.
我认为这可能很有帮助，但也可能很危险。
We've seen examples of that, and And it is a tool like any other, like a knife, that we need to learn how to use it.
我们已经看到过这样的例子，而且它是一种像刀一样的工具，我们需要学习如何使用它。
Andrew Huberman:
安德鲁·休伯曼：
I think what you're describing, to my mind, is a situation where the tool has become the terrain.
我认为你所描述的，在我看来，是一种工具已经成为地形的情况。
It's like social media has become the landscape in which many people live, as opposed to the real world.
就像社交媒体已经成为许多人生活的风景，而不是现实世界。
My original understanding of social media is that one would experience and do things in the real world and then bring those to social media.
我对社交媒体的最初理解是，人们在现实世界中体验、做事，然后把这些带到社交媒体上。
That's certainly what I do.
这当然是我所做的。
I teach on social media, and I do the learning for that teaching, the drawing in some cases, the preparation in the "real world," and then bring it to social media.
我在社交媒体上教学，并为教学进行学习，在某些情况下进行绘画，在“现实世界”中进行准备，然后将其带到社交媒体上。
But I feel it's almost like the hammer has become the landscape.
但我觉得锤子几乎已经成为了风景。
Dr. Victor Carrión:
维克多·卡里翁博士：
The house.
房子。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, something like that.
是的，类似的事情。
The hammer has become the house.
锤子变成了房子。
Yes, that's much more eloquent and appropriate.
是的，这更加雄辩和恰当。
Yeah, I feel like with social media, the tool of social media has become the terrain in which people are living in, so that just feels like a closed loop.
是的，我觉得有了社交媒体，社交媒体的工具已经成为人们生活的领域，所以感觉就像一个闭环。
To use sort of an engineering example.
使用某种工程示例。
It's like it doesn't go anywhere.
就好像它哪儿也去不了一样。
You can never actually get the relief that you're seeking.
你永远无法真正得到你所寻求的解脱。
And I think we default to descriptions about dopamine and dopamine hits, and there's some truth to that, but the more I look at the literature on brain activation during social media use, it doesn't really speak to dopamine and reward prediction error as much as it does just sort of a mindless compulsion and kind of just passive overuse as opposed to rewards, like, "Oh, this is so cool, and that's so cool." It can be.
我认为我们默认对多巴胺和多巴胺点击的描述，这有一定道理，但我越多地研究社交媒体使用过程中大脑激活的文献，它并没有真正说明多巴胺和奖励预测错误，而只是一种无意识的强迫和被动的过度使用，而不是奖励，比如，“哦，这太酷了，那太酷了。”可以的。
I've been watching some of the track and field races at the Olympics, and I was cheering out loud for a few of them.
我一直在观看奥运会上的一些田径比赛，我为其中的一些比赛大声欢呼。
Dr. Victor Carrión:
维克多·卡里翁博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
But it's usually something quite different.
但它通常是完全不同的东西。
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah.
是的。
I think if you live in a virtual world all the time, then you're not living, right?
我想如果你一直生活在虚拟世界里，那你就不算活着，对吧？
You're not in the real world.
你不在现实世界。
So it's like, are there ways that the virtual world can help you live the current world in a better way?
所以这就像是，虚拟世界是否可以帮助你更好地生活在当前的世界？
Yes.
是的。
So that's why I think it's helpful.
这就是为什么我认为它很有帮助。
But if you replace your life with a virtual life, then that's a pity.
但如果用虚拟生活来代替自己的生活，那就太可惜了。
That's very sad.
这是非常悲伤的。
Andrew Huberman:
安德鲁·休伯曼：
I see that in a lot of adults as well as kids.
我在很多成年人和孩子身上都看到了这一点。
Let's talk about risk.
我们来谈谈风险。
Up until now, we've been envisioning a treatment situation or a study that you're running where a kid, and perhaps parents as well, are brought into the laboratory or clinic at Stanford, and you're talking to them, assessing them, they're developing a custom toolbox, and that's a wonderful opportunity for kids who sadly have PTSD or PTSI to be assessed and to develop tools that can really help them.
到目前为止，我们一直在设想一种治疗情况或一项研究，你正在运行一个孩子，也许还有父母，被带入斯坦福大学的实验室或诊所，你与他们交谈，评估他们，他们正在开发一个定制工具箱，这对于不幸患有 PTSD 或 PTSI 的孩子来说是一个绝佳的机会，可以接受评估并开发真正可以帮助他们的工具。
That's been proven by the work you and others have done.
您和其他人所做的工作已经证明了这一点。
But what about the many, many millions of kids and adults who are at risk, either because of lack of access, could be due to finances, geography, poverty, any number of different things, or they simply don't even know what PTSD and PTSI are.
但是，数以百万计处于危险之中的儿童和成人呢？他们要么是因为缺乏机会，要么是因为经济、地理、贫困或许多不同的原因，或者他们根本不知道什么是 PTSD 和 PTSI。
Their parents don't know.
他们的父母不知道。
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
What are some of the tools and interventions that you think could be implemented at the level of schools, families, or even individuals that might help them?
您认为可以在学校、家庭甚至个人层面实施哪些可能对他们有帮助的工具和干预措施？
Dr. Victor Carrión:
维克多·卡里翁博士：
So here we were in my program, we had created Q Center therapy, right?
所以我们在我的计划中创建了 Q 中心疗法，对吗？
We developed a training program for it.
我们为此制定了培训计划。
We have a Q Center therapy training program.
我们有 Q 中心治疗培训计划。
And I became increasingly concerned about my own staff and my own team, because this is a team, as you can imagine, that are seeing trauma every day, and are seeing trauma in kids.
我越来越关心我自己的员工和我自己的团队，因为正如你可以想象的那样，这是一个团队，他们每天都在经历创伤，并且在孩子们身上看到创伤。
I was worried about vicarious trauma and the impact that this would have on their health.
我担心替代性创伤以及这会对他们的健康产生影响。
So I remember that when I was doing my residency, I took a course in hypnosis, and I was really struck by how much control one has during hypnosis.
所以我记得当我做住院医师实习时，我参加了催眠课程，我对催眠期间的控制力感到震惊。
So it's nothing like anyone is doing to anybody else.
所以这与任何人对其他人所做的事情都不同。
It's really kind of having the control to relax yourself.
这确实是一种让自己放松的控制。
Andrew Huberman:
安德鲁·休伯曼：
Self-directed hypnosis.
自我引导催眠。
Dr. Victor Carrión:
维克多·卡里翁博士：
It's self-directed type of hypnosis.
这是一种自我导向的催眠。
And I said, "I would like to bring something like that." And I met a PhD, John Rettger, that was a yoga instructor and also a mindfulness instructor, and I brought him to the team.
我说：“我想带那样的东西。”我遇到了一位博士，约翰·雷特格（John Rettger），他是一名瑜伽教练，也是一名正念教练，我把他带入了团队。
And he had other things to do, but one of the main goals was to take care of the team.
他还有其他事情要做，但主要目标之一是照顾球队。
And we started regularly practicing yoga and practicing mindfulness as we were seeing all these cases and working with trauma and so forth.
当我们看到所有这些案例并处理创伤等问题时，我们开始定期练习瑜伽和正念练习。
And I was able to see firsthand how helpful it was for me personally and for my team.
我亲眼目睹了它对我个人和我的团队有多大帮助。
At the time, we were doing some work in East Palo Alto in some of the schools.
当时，我们正在东帕洛阿尔托的一些学校做一些工作。
We were doing some pro bono counseling because this is another problem.
我们正在做一些无偿咨询，因为这是另一个问题。
Many of the schools have no counselors, right?
很多学校都没有辅导员吧？
But this was a while back, this is like 10 years ago.
但这是不久前的事了，就像10年前一样。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, the East Palo Alto School District, for those that don't know, Palo Alto, I guess it could be called West Palo Alto, is a separate city and county from East Palo Alto.
是的，东帕洛阿尔托学区，对于那些不知道的人来说，帕洛阿尔托，我想它可以被称为西帕洛阿尔托，是一个独立于东帕洛阿尔托的城市和县。
Palo Alto is, not exclusively, but is known for, at least nowadays, let's just be frank, fairly tremendous affluence relative to most places in the world, put bluntly.
坦率地说，帕洛阿尔托不仅是，但至少在今天，相对于世界上大多数地方来说，都以其相当富裕而闻名。
East Palo Alto, a separate county, different school district, police system, has, for as long as I can remember, having grown up in Palo Alto, has always been stricken with far fewer resources.
东帕洛阿尔托是一个独立的县，有不同的学区和警察系统，从我记事起，我在帕洛阿尔托长大，资源一直匮乏。
And while there have been tremendous efforts to improve the situation there, it is still at a steep disadvantage financially.
尽管人们为改善那里的情况付出了巨大的努力，但它在财务上仍然处于严重劣势。
But of course, many amazing people working there and living there, and growing up, there was some exchange across that East Palo Alto, West Palo Alto border, as it were, in the school district, but They're pretty separate domains when it comes to resources.
但是，当然，许多了不起的人在那里工作和生活，并在那里长大，在东帕洛阿尔托和西帕洛阿尔托边界之间，可以说，在学区内进行了一些交流，但在资源方面，它们是相当不同的领域。
Dr. Victor Carrión:
维克多·卡里翁博士：
And it is not now, but many years ago, it was the number one murder capital in the US.
而且不是现在，而是很多年前，它是美国第一大谋杀之都。
It's also the place where Facebook is now, and Ikea.
这也是现在 Facebook 和宜家的所在地。
And there's people that bring some employment to the area, but also bring some other problems.
有些人给该地区带来了一些就业机会，但也带来了一些其他问题。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
That area where Ikea is used to be called, do you remember?
以前叫宜家的那个地方，你还记得吗？
It was called Whiskey Gulch-
它被称为威士忌峡谷-
Dr. Victor Carrión:
维克多·卡里翁博士：
Mm.
嗯。
Didn't know that
不知道
Andrew Huberman:
安德鲁·休伯曼：
...
...
for years.
多年来。
A kind of terrible name, right?
一个可怕的名字，对吧？
But it was a stark contrast right as you literally crossed the train tracks heading towards Highway 101.
但当你真正穿过铁轨朝 101 号高速公路行驶时，情况却形成了鲜明的对比。
Dr. Victor Carrión:
维克多·卡里翁博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
In that case, that portion of Palo Alto, Crescent Park, an extreme of wealth to an extreme of poverty.
在这种情况下，帕洛阿尔托的新月公园那部分，是极端的财富和极端的贫困。
Dr. Victor Carrión:
维克多·卡里翁博士：
Yes.
是的。
Andrew Huberman:
安德鲁·休伯曼：
In literally a distance of 10 meters.
从字面上看，距离有10米。
Dr. Victor Carrión:
维克多·卡里翁博士：
Yes.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Dr. Victor Carrión:
维克多·卡里翁博士：
And of course, there are wonderful families there-
当然，那里还有美好的家庭——
Andrew Huberman:
安德鲁·休伯曼：
Of course
当然
Dr. Victor Carrión:
维克多·卡里翁博士：
...
...
that support the kids.
支持孩子们。
There's Ravenswood, which is also the other name for East Palo Alto, family health center, that really provides a lot of good resources to the area.
还有 Ravenswood，它也是东帕洛阿尔托家庭健康中心的别称，确实为该地区提供了很多优质资源。
And there's a good school district, but at this time it was missing counselors, so we had some presence there.
那里有一个很好的学区，但此时缺少辅导员，所以我们在那里有一些存在。
We decided to bring some of the things that we were learning in terms of yoga and in terms of mindfulness to two of the classrooms.
我们决定将我们正在学习的一些瑜伽和正念方面的知识带到其中两间教室。
At the end of about three months, I get called to the principal's office.
大约三个月后，我被叫到校长办公室。
I have to go to the principal's office.
我得去校长办公室。
Because the principal was interested in finding out what was going on in there, because none of those kids in those classrooms had gone to her office in all that time.
因为校长有兴趣了解那里发生了什么，因为那些教室里的孩子一直没有去过她的办公室。
Andrew Huberman:
安德鲁·休伯曼：
They hadn't gotten in trouble.
他们没有遇到麻烦。
Dr. Victor Carrión:
维克多·卡里翁博士：
They had not gotten in trouble.
他们没有遇到麻烦。
So I explained what it was, and we decided to do a bigger scale study, and eventually we partner with a group called Pure Power, purepowerinc.org, developing a yoga and mindfulness curriculum for students at schools.
所以我解释了它是什么，我们决定进行更大规模的研究，最终我们与一个名为 Pure Power (purepowerinc.org) 的组织合作，为学校的学生开发瑜伽和正念课程。
At that time, we started bringing yoga instructors into the classroom, but we very quickly learn that the best approach to this would be to teach the teachers and have the teachers teach the students, because the yoga instructors had no training on how to control a classroom.
当时，我们开始将瑜伽教练带入课堂，但我们很快了解到最好的方法是教老师并让老师教学生，因为瑜伽教练没有接受过如何控制教室的培训。
And the teachers did.
老师们也做到了。
And some of these poses were so elemental that it was okay if they were not a yoga instructor.
其中一些姿势非常基本，即使他们不是瑜伽教练也没关系。
So anyway, we tested this curriculum and there was a piece about it in the News Hour, I think it might still be there.
所以无论如何，我们测试了这个课程，并且在新闻时间里有一篇关于它的文章，我认为它可能仍然存在。
And I get this wonderful phone call by this family in New York that wants to see how they can help me spread this further into not only the classrooms that I was working, but into the whole school or the school district.
我接到纽约这个家庭打来的精彩电话，他们想看看他们如何帮助我将这一点进一步传播到不仅是我工作的教室，而是整个学校或学区。
And I knew at that point that two things were important.
那时我知道有两件事很重要。
Not only that they wanted and I wanted, but that the school district should want it.
不仅是他们想要，我也想要，而且学区也应该想要。
And also, that at this time, we would need to do a very in-depth study to see what our intervention was and what the curriculum was.
而且，在这个时候，我们需要进行非常深入的研究，看看我们的干预措施是什么以及课程是什么。
Because mindfulness can be the name that you give to many different things.
因为正念可以是你给许多不同事物起的名字。
So we wanted to make sure that our intervention of yoga and mindfulness exercises that now Pure Power carries, is really what we are being tested.
因此，我们想确保现在纯粹力量所进行的瑜伽和正念练习的干预确实是我们正在接受的测试。
So they were very, very helpful in helping sponsor, not only the dissemination of this curriculum through the school district, but a randomized control trial where we actually had a whole other district that would also be trained, but only after the study was over.
因此，他们在帮助赞助方面非常非常有帮助，不仅是在学区传播该课程，而且是一项随机对照试验，我们实际上还有整个其他学区也将接受培训，但只有在研究结束后才能进行。
It was a demographically comparison school in the city of San Jose.
这是圣何塞市的一所人口比较学校。
Near enough for us to conduct the study, but far enough there wouldn't be too much dissemination from one district to the other.
距离足以让我们进行研究，但也足够远，不会有太多的信息从一个地区传播到另一个地区。
And it was good that we did a district-wide control, because if we would have done it by classroom or by school, it wouldn't have worked.
我们进行了全区范围的控制，这很好，因为如果我们通过课堂或学校进行控制，那就行不通了。
Because there was so much diffusion of what the kids were learning into their friends and their family, and the other classes, and the other people in the community.
因为孩子们所学到的东西会大量传播给他们的朋友、家人、其他班级以及社区中的其他人。
That was beautiful to see, but it would have ruined a control study.
这看起来很美好，但它会毁掉对照研究。
Andrew Huberman:
安德鲁·休伯曼：
So you needed literally physical and demographic separation.
所以你需要真正的物理和人口分离。
So you went with what used to be called the Peninsula, the South Bay, East Palo Alto, and then San Jose, far enough apart that the kids weren't talking enough to blur the treatment groups.
所以你去了以前被称为半岛、南湾、东帕洛阿尔托，然后是圣何塞的地方，这些地方相距足够远，孩子们的说话不足以模糊治疗组。
Dr. Victor Carrión:
维克多·卡里翁博士：
Exactly.
正是如此。
So we demonstrated feasibility.
所以我们论证了可行性。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Yep.
是的。
Dr. Victor Carrión:
维克多·卡里翁博士：
We were able to do it.
我们能够做到。
We demonstrated acceptability.
我们表现出了可接受性。
The kids liked it.
孩子们喜欢它。
The kids would do it.
孩子们会这么做的。
Some schools actually had a room specifically for them to go and do it, even if the teachers were not doing it in the classroom.
有些学校实际上有一个房间专门供他们去做，即使老师不在教室里做。
And it range.
而且范围很广。
It was twice to three times a week for 15 or 50 minutes of this curriculum in the classrooms.
该课程每周在教室进行两到三次，每次 15 或 50 分钟。
Andrew Huberman:
安德鲁·休伯曼：
Sorry to interrupt, but could I ask you a little bit more about the curriculum?
抱歉打扰，我可以再问你一些关于课程的问题吗？
You said 15 to 50, 5-0 minutes, two to three times per week.
你说每周 15 到 50、5-0 分钟、2 到 3 次。
Dr. Victor Carrión:
维克多·卡里翁博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
And did the kids have to change over to their yoga clothes?
孩子们需要换上瑜伽服吗？
The reason I ask is that I could think of a number of real-world barriers to getting something like this implemented.
我问这个问题的原因是，我可以想到实现此类功能的许多现实障碍。
Dr. Victor Carrión:
维克多·卡里翁博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I feel like going jogging, usually you get a little sweaty.
我想慢跑，通常会有点出汗。
You need running shoes.
你需要跑鞋。
There are other forms of exercise that require that less, but these days there As far as I know, not every school requires physical education.
还有其他形式的锻炼要求较少，但据我所知，目前并不是每所学校都要求体育课。
When I was growing up and through high school, you had to literally suit up.
当我长大并读完高中时，你必须真正穿上西装。
You had to go in the locker room, put on your PE clothes as it were, and then you'd run or play volleyball.
你必须走进更衣室，穿上体育服，然后跑步或打排球。
Whatever the PE teacher told you to do, you had to do, if you wanted to get a decent grade.
如果你想取得好成绩，体育老师告诉你做什么，你就必须做什么。
Is the yoga being done-- You said it could be in the classroom or at a separate location, but are the kids basically getting up out of their chairs and just right in their school clothes, doing this for 15 to 50 minutes?
瑜伽正在进行中吗？您说可以在教室或单独的地点进行，但孩子们基本上是从椅子上站起来，穿着校服，做 15 到 50 分钟吗？
Dr. Victor Carrión:
维克多·卡里翁博士：
So they stay with the same clothes, but we had mats.
所以他们穿着同样的衣服，但我们有垫子。
They had mats.
他们有垫子。
Every student had a mat.
每个学生都有一个垫子。
And it's interesting that you mentioned PE because the first suggestion was, let's do it during PE class.
有趣的是，你提到了体育，因为第一个建议是，让我们在体育课上做吧。
And I'm like, "No, that's rowing from Paul to Peter." Until I learned that PE, like you said, was not happening.
我想，“不，那是从保罗划船到彼得。”直到我了解到体育运动，就像你说的，并没有发生。
Andrew Huberman:
安德鲁·休伯曼：
So sad.
太伤心了。
Dr. Victor Carrión:
维克多·卡里翁博士：
Which I couldn't believe.
我简直不敢相信。
And if anything, I think the study has helped for them to bring PE back.
如果说有什么不同的话，我认为这项研究帮助他们恢复了体育运动。
And the classes, which are these lessons in yoga movements and mindfulness, were really taking place in the classroom that whatever teacher learned.
这些课程，即瑜伽动作和正念课程，实际上是在课堂上进行的，无论老师学过什么。
So if it was the math teacher, she was taking 10 minutes aside to do it.
所以如果是数学老师，她就会抽出 10 分钟来做这件事。
If it was the PE and PE was not happening there, they may dedicate the 50 minutes to do the yoga and the mindfulness.
如果是体育课并且体育课没有在那里进行，他们可能会花 50 分钟来做瑜伽和正念。
So we have a number of assessments that we did, and like I mentioned, yes, it was acceptable and it improved mood and all of that.
所以我们做了很多评估，就像我提到的，是的，这是可以接受的，它改善了情绪等等。
But I think the biggest finding that we published from that study was that it increased 73 minutes of sleep.
但我认为我们从该研究中发表的最大发现是它增加了 73 分钟的睡眠时间。
Andrew Huberman:
安德鲁·休伯曼：
73?
73？
Dr. Victor Carrión:
维克多·卡里翁博士：
73 minutes of sleep.
睡眠 73 分钟。
Andrew Huberman:
安德鲁·休伯曼：
That's extraordinarily high.
这是非常高的。
Dr. Victor Carrión:
维克多·卡里翁博士：
On average for the students.
对于学生来说平均而言。
And it increased the depth of sleep.
它增加了睡眠深度。
So something that we did in this study was that we also did portable polysomnography, and it was not in a sleep center.
因此，我们在这项研究中所做的事情是，我们还进行了便携式多导睡眠图检查，而且不是在睡眠中心进行的。
It was in their own house.
那是在他们自己的房子里。
So collaborating with Ruth O'Hara from the department, we were able to assess their sleep, and deep sleep is very important.
因此，与该部门的 Ruth O'Hara 合作，我们能够评估他们的睡眠，深度睡眠非常重要。
That's where you process the events of the day.
这是您处理当天事件的地方。
So these kids were increasing REM, total sleep, deep sleep, doing much better.
所以这些孩子增加了快速眼动睡眠、完全睡眠、深度睡眠，表现好多了。
And then another thing, because of our previous studies that we've talked about in terms of brain function, this hasn't been published, but we have some preliminary data demonstrating that those kids that went through the intervention before and after the intervention were able to decrease the activity of their amygdala, which was very powerful and also very helpful.
还有一件事，因为我们之前讨论过大脑功能方面的研究，所以还没有发表，但我们有一些初步数据表明，那些在干预前后经历过干预的孩子能够减少杏仁核的活动，这是非常强大的，也非常有帮助。
So many of these kids adapted this into their daily practices after the study was over.
研究结束后，许多孩子将其融入到他们的日常实践中。
We went to our control group, and we taught those lessons there.
我们去了对照组，在那里教授这些课程。
And now it has served to identify even more tools that we can put in the toolbox of CCT.
现在，它已经帮助我们确定了更多可以放入 CCT 工具箱中的工具。
So we utilize some of the things there in here.
所以我们利用这里的一些东西。
So Pure Power and our program have been collaborating a lot because it covers the risk group and the treatment group.
所以 Pure Power 和我们的项目一直在合作，因为它涵盖了风险组和治疗组。
So sometimes when we go to schools and we do trainings, we partner with them so that we have the yoga and the mindfulness and the Q center therapy.
因此，有时当我们去学校进行培训时，我们会与他们合作，以便我们进行瑜伽、正念和 Q 中心疗法。
And I, by no means, mean these are the two things that everybody should be using.
我绝不是说这是每个人都应该使用的两件事。
I'm saying these are two more tools.
我是说这是另外两个工具。
In fact, I think we need more development, more development of interventions, both for treatment and for intervention.
事实上，我认为我们需要更多的发展，更多的干预措施的发展，无论是治疗还是干预。
And how do we identify who needs what and how is where we're moving next.
我们如何确定谁需要什么以及我们下一步要做什么。
Andrew Huberman:
安德鲁·休伯曼：
Wow, what spectacular results.
哇，多么惊人的结果啊。
I mean, 73 minutes more of sleep is like-- Talk about effective medicine.
我的意思是，多睡 73 分钟就像——谈论有效的药物。
We agreed at the outset that sleep is the foundation of mental health and physical health and all forms of cognitive and physical performance.
我们从一开始就同意睡眠是心理健康和身体健康以及所有形式的认知和身体表现的基础。
I mean, we know this.
我的意思是，我们知道这一点。
The study done at Stanford, albeit a small one, of having athletes just get a bit more sleep or even just stay in bed a bit longer.
斯坦福大学进行的这项研究虽然规模很小，但目的是让运动员多睡一点，甚至在床上多呆一会儿。
And no, not on their phones, but just lying quietly with eyes closed and resting or sleeping more improved shot accuracy in basketball players.
不，不是在玩手机，而是闭上眼睛安静地躺着，休息或睡觉可以提高篮球运动员的投篮准确性。
This has been shown in so many domains of cognitive and physical, it's not even worth spooling off all the examples.
这已经在认知和身体的许多领域得到了证明，甚至不值得把所有的例子都列出来。
But that is spectacular.
但这是壮观的。
It also makes me think I should start doing some yoga, because I do get enough sleep, but that's significant.
这也让我觉得我应该开始做一些瑜伽，因为我确实有足够的睡眠，但这很重要。
What do you think are the barriers to having this sort of thing implemented at national scale?
您认为在全国范围内实施此类措施的障碍是什么？
And I always think about this.
我一直在思考这个问题。
Okay, so the results are in.
好的，结果出来了。
Maybe it's one study, maybe it's two, but you're talking about a basically harmless intervention, and actually, it's a very therapeutic intervention.
也许这是一项研究，也许是两项研究，但你谈论的是一种基本上无害的干预措施，实际上，这是一种非常有治疗作用的干预措施。
Sure, there are some people that won't be able to do all the poses, et cetera, but there's always something that somebody can do.
当然，有些人无法完成所有姿势等等，但总有人可以做一些事情。
Even people that are immobilized, there are certain forms of, believe it or not, cognitive yoga, and that friend of mine who works with people who are quadriplegic, they can do certain things to keep nervous system function online.
无论你相信与否，即使是无法动弹的人，也有某些形式的认知瑜伽，而我的那位与四肢瘫痪的人一起工作的朋友，他们可以做某些事情来保持神经系统功能在线。
But essentially, anyone can do this.
但本质上，任何人都可以做到这一点。
What are the barriers from taking it from this East Palo Alto school to a study, to another study?
从这所东帕洛阿尔托学校进行一项研究或另一项研究有哪些障碍？
Okay, San Jose school.
好的，圣何塞学校。
Now, let's say you get all of Santa Clara or neighboring counties.
现在，假设您获得了圣克拉拉或邻近县的所有县。
What does it take to get something implemented at national scale so that the work can really ripple out and benefit all these kids who are, of course, are going to become adults?
怎样才能在全国范围内实施一些措施，以便这项工作能够真正产生连锁反应并造福所有这些即将成年的孩子？
Dr. Victor Carrión:
维克多·卡里翁博士：
Well, we need to prioritize it, right?
好吧，我们需要优先考虑它，对吗？
We need to prioritize education for starters, right?
我们需要优先考虑初学者的教育，对吗？
We were talking about classes not even having physical education or arts, for example.
例如，我们谈论的课程甚至没有体育或艺术。
And we need to prioritize mental health, and it needs to start early.
我们需要优先考虑心理健康，而且需要尽早开始。
And I think when we work our national budget, there needs to be earmarks for these two areas and that should go to the Department of Education.
我认为，当我们制定国家预算时，需要为这两个领域指定专项资金，并且应该拨给教育部。
The Department of Education should make this a priority.
教育部应将此作为优先事项。
Teachers are really, really overworked.
老师们真的是太辛苦了。
They are under-resourced and, like pediatricians many times, are responsible for doing somebody else's work, right?
他们资源不足，而且很多时候就像儿科医生一样，负责做别人的工作，对吧？
Everybody tells them, "Oh, this will only take a minute," or, "This will only take two minutes," or, "If you make this assessment, you can do that." But the time is finite, right?
每个人都告诉他们，“哦，这只需要一分钟”，或者“这只需要两分钟”，或者“如果你进行这个评估，你就可以做到。”但时间是有限的，对吧？
And the space is finite.
而且空间是有限的。
So they need more space, they need more time, they need more support, teachers.
所以他们需要更多的空间，他们需要更多的时间，他们需要更多的支持，老师。
And then this needs to be a priority from districts to really implement programs like this.
然后，这需要成为各地区的优先事项，以真正实施此类计划。
Andrew Huberman:
安德鲁·休伯曼：
So parents and even non-parents talk to the teachers in the school, talk to the principals in the school.
因此，家长甚至非家长都会与学校的老师、学校的校长交谈。
And I've been learning about the power of the telephone for lobbying.
我一直在了解电话游说的力量。
This has been around some things I've been involved with the veterans community.
这与我参与退伍军人社区的一些事情有关。
The ability to look up and call your congressman or congresswoman and tell them that you are really concerned about or excited about a particular program does have impact.
查找并致电您的国会议员并告诉他们您确实对某个特定计划感到担忧或兴奋的能力确实会产生影响。
At first, I didn't think this was true, but I realized that when they start getting 50, 100, 1,000 messages about a particular topic that people are passionate about, they pay attention.
起初，我不认为这是真的，但我意识到，当他们开始收到 50、100、1,000 条关于人们热衷的特定主题的消息时，他们就会关注。
Maybe it's because they just want to get reelected.
也许是因为他们只是想连任。
Maybe it's because they are genuinely concerned about helping people.
也许是因为他们真诚地关心帮助别人。
I like to think it's the latter, but regardless of which, they run those messages up the flagpole when they bring issues.
我喜欢认为是后者，但不管怎样，当他们带来问题时，他们都会将这些消息传递到旗杆上。
Dr. Victor Carrión:
维克多·卡里翁博士：
So let me tell you what we just started doing in Puerto Rico.
让我告诉你我们刚刚开始在波多黎各做什么。
I'm from Puerto Rico, but Puerto Rico and Puerto Rican students have gone through a number of natural disasters that started with Hurricane Maria and continue with other hurricanes and also with earthquakes, and this has led to violence, and there's interpersonal violence.
我来自波多黎各，但波多黎各和波多黎各学生经历了许多自然灾害，从玛丽亚飓风开始，一直到其他飓风和地震，这导致了暴力，还有人际暴力。
So some of the kids in Puerto Rico have gone through a lot.
波多黎各的一些孩子经历了很多事情。
But also, the whole island of Puerto Rico is one of the largest school districts in the US.
而且，波多黎各全岛是美国最大的学区之一。
The whole island is one district, meaning that if you do something like a program like the one we're talking about, you can implement it island-wide.
整个岛就是一个区，这意味着如果你做类似我们正在谈论的项目之类的事情，你就可以在全岛范围内实施它。
Currently, we are launching a project in Puerto Rico where all the teachers will be trained in the yoga and mindfulness curriculum, and all of the counselors will be trained in Q center therapy.
目前，我们正在波多黎各启动一个项目，所有老师都将接受瑜伽和正念课程的培训，所有辅导员都将接受 Q 中心疗法的培训。
The kids are being assessed at baseline, then they go through their yoga and curriculum, and at time two, when they get assessed to see how they're doing after that, we also screen those that have PTSS, post-traumatic stress symptoms that cause impairment.
对孩子们进行基线评估，然后他们完成瑜伽和课程，在第二个时间，当他们接受评估以了解他们之后的表现时，我们还会筛查那些患有 PTSS（导致损伤的创伤后应激症状）的人。
And then those go through the trained counselors, and then they get assessed again in the latter part.
然后这些人会经过训练有素的辅导员，然后在后半部分再次接受评估。
So the goal is for us to, although we've talked about the two treatments, we've never really had both of them happen simultaneously, and we want to do it in a large scale like this because if this works, if it's sustainable, if it's feasible, we can actually then bring it to other large school districts like New York, like LA, for example, and start disseminating this.
因此，我们的目标是，尽管我们已经讨论过这两种治疗方法，但我们从未真正同时发生过这两种治疗方法，我们希望像这样大规模地进行，因为如果这有效，如果它是可持续的，如果它可行，我们实际上可以将其带到纽约等其他大型学区，例如洛杉矶，并开始传播它。
Andrew Huberman:
安德鲁·休伯曼：
I'd love your thoughts on something.
我很想知道你对某件事的想法。
I'm so impressed that you were able to bring this from a study or set of studies to a much larger scale in Puerto Rico.
令我印象深刻的是，你们能够将这项研究从一项或一组研究中推广到波多黎各的更大规模。
I could be wrong here, but I feel like in the United States, we have such a culture of fame and popularity and reward around people who are extreme performers.
我在这里可能是错的，但我觉得在美国，我们有一种追求名誉、受欢迎和奖励的文化，围绕着那些表现出色的人。
We hear about these NBA stars, and right now we're seeing a lot about these incredible track stars, or we have these tech innovators that found huge companies.
我们听说过这些 NBA 球星，现在我们看到了很多关于这些令人难以置信的田径明星的信息，或者我们看到了这些创建了大公司的技术创新者。
They used to be called unicorn companies, but all these incredible successes.
他们曾经被称为独角兽公司，但取得了令人难以置信的成功。
And I wonder sometimes if the hyper-emphasis on these extreme performers has led to the conclusion in young people that unless you're going to be Michael Jordan or LeBron James or Mark Zuckerberg or Elon Musk or win an Olympic gold medal, that the practices that feed up to becoming those sorts of people, like mindfulness meditation or becoming a yogi for that matter, I feel like there's been a push towards hyper-specialization and performance to the point where people are writing off the incredible utility of physical activity, mindfulness, learning math, science, literature, and the arts.
有时我想知道，对这些极限表演者的过分强调是否会导致年轻人得出这样的结论：除非你想成为迈克尔·乔丹、勒布朗·詹姆斯、马克·扎克伯格或埃隆·马斯克，或者赢得奥运会金牌，否则那些有助于成为这类人的练习，比如正念冥想或成为瑜伽士，我觉得人们对超专业化和表现的推动力已经达到了人们忽视体育活动、正念、学习数学、科学、文学和艺术。
You talk about the arts.
你谈论艺术。
Dr. Victor Carrión:
维克多·卡里翁博士：
Humanities studies.
人文学科研究。
Andrew Huberman:
安德鲁·休伯曼：
You have music, right?
你有音乐，对吧？
Even for people like me.
即使对于像我这样的人也是如此。
Sure, they always gave me the triangle because I could manage that one, and I don't want to insult the triangle players.
当然，他们总是给我三角进攻，因为我可以做到这一点，而且我不想侮辱三角进攻球员。
I'm sure it's much more complicated than I'm giving the impression it is.
我确信它比我给人的印象要复杂得多。
But the point is that I feel like there's been a not so gradual disintegration of the idea that there is utility, indeed, there is great benefit to doing things, not with the intention of becoming a high performer, but just doing them for sake of how it enriches us in a number of different ways, including our mental health.
但重点是，我觉得这种想法并没有那么逐渐瓦解，即实用性确实是有很大好处的，不是为了成为一名高绩效者，而是为了如何以多种不同的方式丰富我们的生活，包括我们的心理健康。
And I wonder whether or not the lack of PE is sort of a, well, if you're not going to run track and try and medal or something, or go to championship meets, then what's the point?
我想知道缺乏体育是否是一种，好吧，如果你不打算参加田径比赛并尝试获得奖牌或其他什么，或者参加锦标赛，那么还有什么意义呢？
But I certainly don't subscribe to that.
但我当然不同意这一点。
I'm curious what your thoughts are.
我很好奇你的想法是什么。
Dr. Victor Carrión:
维克多·卡里翁博士：
Well, I think we need to redefine success and what it means to be successful.
嗯，我认为我们需要重新定义成功以及成功的含义。
I think that we're currently describing it with the examples that you just gave, which probably was not the way that we were describing it in the '60s or the '70s.
我认为我们目前正在用您刚才给出的例子来描述它，这可能不是我们在 60 年代或 70 年代描述它的方式。
But it is harming individuals, which is most of us that cannot attain that level of proficiency in an area.
但它正在伤害个人，而我们大多数人都无法在某个领域达到那种熟练程度。
And in fact, the individuals that are choosing to have a broader belonging, in a way, are more protected.
事实上，在某种程度上，选择拥有更广泛归属感的个人会受到更多保护。
I worry about those other individuals too that have that very personalized, not personalized, but very individualized, unique component in their life where they dedicate everything to that one thing.
我也担心那些在生活中具有非常个性化的人，不是个性化的，而是非常个性化的，独特的组成部分，他们将一切奉献给一件事。
Andrew Huberman:
安德鲁·休伯曼：
Trust me, they often suffer in one or more of their other domains of life.
相信我，他们经常在生活的一个或多个其他领域遭受痛苦。
Some don't, but I would argue most do.
有些人不这样做，但我认为大多数人都这样做。
Dr. Victor Carrión:
维克多·卡里翁博士：
But the idea of belonging is that you belong to many different facets of life.
但归属感的含义是你属于生活的许多不同方面。
You are a sports person, you're a community person, you're a student, you're a father, you're an aunt, you're different things.
你是一个运动员，你是一个社区人，你是一个学生，你是一个父亲，你是一个阿姨，你是不同的人。
When you're only one thing and that fails, your whole identity is gone.
当你只是一件事而失败时，你的整个身份就消失了。
It doesn't even have to fail.
它甚至不必失败。
You have to perceive that it has failed, and that's enough to throw you off course.
你必须意识到它已经失败了，这足以让你偏离轨道。
And so with the current definition of success, we're not doing a service for those that attain that definition and those that do not attain that definition.
因此，按照当前成功的定义，我们不会为那些达到该定义和未达到该定义的人提供服务。
I think it needs to be broader.
我认为它需要更广泛。
I think belonging needs to be included.
我认为归属感需要包括在内。
I think the way that we care not only for ourselves but for the rest of our citizens needs to be included.
我认为我们不仅需要关心自己，而且还需要关心其他公民。
Citizenship is important.
公民身份很重要。
So it is dynamic.
所以它是动态的。
So far it has been dynamic how we define success, and hopefully it will change again.
到目前为止，我们对成功的定义一直是动态的，希望它会再次改变。
Andrew Huberman:
安德鲁·休伯曼：
All right.
好吧。
I agree wholeheartedly.
我完全同意。
Let's talk about resilience.
我们来谈谈韧性。
Earlier you said kids are not resilient, but you also implied, maybe you even stated it outright, that they can become resilient.
早些时候你说孩子们没有复原力，但你也暗示，也许你甚至直言不讳地说，他们可以变得有复原力。
What is resilience, and what are some of the paths to resilience?
什么是复原力？实现复原力的途径有哪些？
Dr. Victor Carrión:
维克多·卡里翁博士：
Resilience is a physical term, right?
弹性是一个物理术语，对吧？
It means the coil bounces back to where it was originally.
这意味着线圈弹回到原来的位置。
I like to think of the word adaptation because it means not only you bounce back, but you bounce back to a better place.
我喜欢想到适应这个词，因为它不仅意味着你反弹，而且意味着你反弹到一个更好的地方。
I like to think that we adapted during the experience of the pandemic, other than we were resilient of it.
我喜欢认为我们在经历大流行期间适应了，除了我们对它有弹性之外。
Yes, we were resilient because we survived it.
是的，我们之所以有韧性，是因为我们熬过来了。
Some of us did, not all, right?
我们中的一些人这样做了，不是全部，对吗？
Some of us have to deal with the grief of what happened during that time.
我们中的一些人必须应对那段时间发生的事情的悲伤。
But adaptation means that not only we go back to where we were before the pandemic, but that now we've learned from that experience to be in a better place.
但适应不仅意味着我们回到大流行之前的状态，而且现在我们已经从这次经历中学到了如何处于一个更好的状态。
Now, we know very little about resilience, and we definitely know very little biology about resilience.
现在，我们对复原力知之甚少，而且我们对复原力的生物学也肯定知之甚少。
We know that having a sense of humor is good.
我们知道有幽默感是件好事。
We know that perseverance is good.
我们知道，坚持是好的。
We know that the presence of an adult in a child's life that was there to give them opportunity or to talk to them about things they were going through, that's probably the best-known resilient factor.
我们知道，成人在孩子的生活中的存在，给他们机会或与他们谈论他们正在经历的事情，这可能是最著名的弹性因素。
But what if it's not the presence of that adult, but there's something in that child that makes them seek and maintain that type of relationship?
但是，如果不是那个成年人的存在，而是那个孩子身上有某种东西让他们寻求并维持这种关系呢？
Right?
正确的？
So I feel that we need to start looking at the biology of resilience.
所以我觉得我们需要开始研究复原力的生物学原理。
And one way that we've done that in my program is through a collaboration with Alex Irvin from our department and from genetics, and Carolyn Perman, who's in his lab and one of his postdocs.
我们在我的项目中实现这一目标的一种方法是与我们部门和遗传学部门的亚历克斯·欧文（Alex Irvin）以及他的实验室的博士后之一卡罗琳·珀曼（Carolyn Perman）合作。
They work with organoids, and I don't know if you've mentioned organoids before to your audience.
他们使用类器官，我不知道你之前是否向观众提到过类器官。
Andrew Huberman:
安德鲁·休伯曼：
I have not, but one of my good friends and colleagues at Stanford, Sergio Pasca, is one of the world leaders in organoids, and we hope to host him on this podcast soon.
我还没有，但我在斯坦福大学的一位好朋友和同事塞尔吉奥·帕斯卡 (Sergio Pasca) 是类器官领域的世界领导者之一，我们希望很快能在这个播客中接待他。
But please educate us on organoids.
但请告诉我们有关类器官的知识。
They are oh so cool and oh so science fictiony, but they are oh so real-
它们太酷了，太科幻了，但它们却太真实了——
Dr. Victor Carrión:
维克多·卡里翁博士：
Yes
是的
Andrew Huberman:
安德鲁·休伯曼：
...
...
as well.
以及。
Dr. Victor Carrión:
维克多·卡里翁博士：
So we have stem cells that can be converted to any type of cell under the appropriate nutrients and environments that we want to examine.
因此，我们的干细胞可以在我们想要检查的适当营养和环境下转化为任何类型的细胞。
So for a psychiatrist, of course, the interest is to turn them into neurons.
因此，对于精神科医生来说，当然，兴趣是将它们变成神经元。
And not only they can grow in a Petri dish, but they grow suspended.
它们不仅可以在培养皿中生长，而且可以悬浮生长。
So it's almost like a 3D, and Sergio uses the term "assembloid" for when he actually assembles them further to build more organ-specific-
所以它几乎就像 3D，Sergio 使用术语“组装体”来表示当他实际进一步组装它们以构建更多器官特异性时 -
Andrew Huberman:
安德鲁·休伯曼：
Mini brains
迷你大脑
Dr. Victor Carrión:
维克多·卡里翁博士：
...
...
mini brains is the term that I like.
迷你大脑是我喜欢的词。
Yes.
是的。
So these mini brains are these neurons that are growing in a circle like the brain, and they communicate with each other, and they are active with each other, and we can study.
所以这些迷你大脑就是像大脑一样生长成圆圈的神经元，它们互相交流，互相活跃，我们可以研究。
So in conversations with Alex, and now that you all know my previous work with cortisol and all that, I was telling him and Carolyn, "Well, what would happen if we expose some of these organoids to cortisol?" And of course, we needed to come up with, oh, what would be the right amount that would mimic trauma?
因此，在与亚历克斯的谈话中，现在你们都知道我之前关于皮质醇的工作以及所有这些，我告诉他和卡罗琳，“好吧，如果我们将其中一些类器官暴露于皮质醇中会发生什么？”当然，我们需要想出，哦，模拟创伤的正确数量是多少？
So we also involved Robert Sapolsky to help us come up with a concentration that would be trauma mimetic.
因此，我们还邀请了罗伯特·萨波尔斯基（Robert Sapolsky）来帮助我们想出一种模拟创伤的浓度。
And so we exposed a number of organoids to different levels of cortisol.
因此，我们将许多类器官暴露于不同水平的皮质醇中。
For some of them, it was a trauma.
对于他们中的一些人来说，这是一种创伤。
For others, they were not exposed.
对于其他人来说，他们没有暴露。
Then half of that amount or much less of that amount was a trigger, the cue.
然后这个量的一半或更少的量就是一个触发器，一个提示。
So some had the trauma and the cue, some had no exposure, some only had the cue, and then we compare what was associated with really...
所以有些人有创伤和暗示，有些没有暴露，有些只有暗示，然后我们比较与真正相关的内容......
Well, the first thing that they needed to do was identify that these neurons actually had these glucocorticoid receptors and that they were active.
好吧，他们需要做的第一件事是确定这些神经元实际上具有这些糖皮质激素受体并且它们是活跃的。
And they did have them, and they were active.
他们确实有这些，而且很活跃。
So we looked through epigenetic analysis.
所以我们进行了表观遗传学分析。
We as the royal we, right?
我们作为皇室成员，对吧？
It's more Alex and Carolyn.
更多的是亚历克斯和卡罗琳。
They look at the genes that were changed, that their activity changed because of this cortisol exposure, through epigenetic analysis, which is the space between DNA and RNA, and there's methylation patterns and all that.
他们通过表观遗传分析（即 DNA 和 RNA 之间的空间）以及甲基化模式等来观察因皮质醇暴露而发生变化的基因，以及它们的活性发生变化的情况。
And some genes' activity changes.
一些基因的活性发生了变化。
Some turn on, some turn off.
有的打开，有的关闭。
So interestingly, the majority of the genes that we found there were genes that have been addressed in the literature as potentially being related to post-traumatic stress disorder, things like the glucocorticoid receptor genes and things that you would think of.
有趣的是，我们发现的大多数基因在文献中都被认为可能与创伤后应激障碍有关，比如糖皮质激素受体基因和你会想到的东西。
But there was another subset of genes that we identified that were novel, and I was very interested in those because of my interest in accelerated aging because of stress.
但我们发现了另一个新的基因子集，我对这些基因非常感兴趣，因为我对压力导致的加速衰老感兴趣。
And those were genes that are related to collagen formation.
这些是与胶原蛋白形成相关的基因。
And we know that atherosclerosis has been related to stress, for example.
例如，我们知道动脉粥样硬化与压力有关。
And we know that accelerated aging, not only in PTSD, but in mental health conditions overall, individuals that suffer from severe mental illness chronically in their life end up dying 25 years younger than the rest of the population.
我们知道，加速衰老不仅在 PTSD 方面，而且在整体心理健康状况方面，长期患有严重精神疾病的人最终比其他人要年轻 25 岁。
That's very significant.
这是非常有意义的。
And so stress and accelerated aging, interesting.
如此压力和加速衰老，有趣。
Okay, so these are interesting findings in organoids.
好的，这些是类器官中有趣的发现。
But when you have those, what you do is you move on to a population study.
但当你有了这些之后，你要做的就是继续进行人口研究。
So these kids in Puerto Rico that are going through these interventions, besides me checking on their PTSD, their anxiety, their depression, they're giving me a buccal swab.
因此，波多黎各的这些孩子正在接受这些干预措施，除了我检查他们的创伤后应激障碍、他们的焦虑、他们的抑郁之外，他们还给我做了口腔拭子。
And in the buccal swab, those epithelial cells, we can actually take them through epigenetic analysis and see those kids at time one that even though they've gone through all this trauma, may not be faring that much worse as their counterparts and compare them.
在口腔拭子中，那些上皮细胞，我们实际上可以对它们进行表观遗传分析，并在第一时间看到那些孩子，即使他们经历了所有这些创伤，也可能不会比他们的同龄人表现得那么糟糕，并对他们进行比较。
And not only that, we can actually also look at response, treatment response for the intervention, for the yoga and mindfulness preventive intervention, and for the treatment for the cue center therapy.
不仅如此，我们实际上还可以观察干预的反应、治疗反应、瑜伽和正念预防性干预以及提示中心疗法的治疗反应。
So that's the plan.
这就是计划。
That's the plan in trying to bring more light into what is the biology of resilience, and how can we understand resilience better?
这就是试图让人们更多地了解复原力的生物学原理的计划，以及我们如何更好地理解复原力？
Andrew Huberman:
安德鲁·休伯曼：
What a spectacular study.
多么精彩的研究啊。
Goodness.
善良。
And if any of you missed some of the underlying mechanics, I'll just quickly recap.
如果你们中有人错过了一些基本机制，我将快速回顾一下。
These organoids are little brains in a dish that came to be by virtue of taking fibroblasts or other cells, so skin cells essentially, put into dishes, provided for what are called transcription factors.
这些类器官是培养皿中的小大脑，是通过吸收成纤维细胞或其他细胞而形成的，因此本质上是皮肤细胞，放入培养皿中，提供所谓的转录因子。
These are the four transcription factors that Yamanaka won the Nobel Prize for identifying, that reverts those cells into stem cells.
山中伸弥因鉴定出这四种转录因子而获得诺贝尔奖，它们可以将这些细胞恢复为干细胞。
And then a few other goodies, molecular goodies, that then allow them to become neurons, in particular.
然后还有一些其他的好处，分子的好处，特别是可以让它们变成神经元。
Then they grow into little mini brains, and then, as Dr. Carreon was explaining, are exposed to cortisol at appropriate concentrations to mimic cortisol exposure in the whole person.
然后它们长成迷你大脑，然后，正如卡伦博士所解释的那样，它们会暴露在适当浓度的皮质醇中，以模仿整个人的皮质醇暴露情况。
And then from that, the genomes of those cells and the epigenomes are analyzed to identify potential targets.
然后，分析这些细胞的基因组和表观基因组，以确定潜在的靶标。
The results are brought back to these kids in Puerto Rico, such that the genomes of all these kids experiencing different levels of stress and yoga and mindfulness interventions or not, maybe they're in the control group.
结果被带回波多黎各的这些孩子身上，这样所有这些孩子的基因组就会经历不同程度的压力、瑜伽和正念干预，无论是否经历过，也许他们都属于对照组。
The outcomes can be assessed, and then one can address, hey, what are the genes that are protective against stress?
可以评估结果，然后人们可以解决，嘿，哪些基因可以抵御压力？
AKA, what are the genes that are protective against high levels of cortisol?
也就是说，哪些基因可以防止高水平的皮质醇？
And a bunch of other surely to be very transformative and important facts about how stress impacts the young brain to either give rise to PTSD or not.
还有其他一些肯定是非常具有变革性和重要的事实，关于压力如何影响年轻的大脑，从而导致或不引起创伤后应激障碍。
I must say, as you described that study, I had three thoughts.
我必须说，正如您描述的那样，我有三个想法。
One, wow, how awesome is this, that you can bridge across so many different levels of analysis.
第一，哇，这真是太棒了，你可以跨越如此多不同层次的分析。
Because you're talking about molecular genetics all the way up to yoga in school children in Puerto Rico, and PTSD, which is a complex disorder.
因为你谈论的是分子遗传学，一直到波多黎各学童的瑜伽，以及创伤后应激障碍（PTSD），这是一种复杂的疾病。
I was also thinking to myself, wow, what an incredible place Stanford is that such a collaboration is possible.
我也在想，哇，斯坦福是多么令人难以置信的地方，这样的合作是可能的。
Makes me delight in the fact that colleagues like you exist and Sergio and forgive me the names of the other colleagues I'm not familiar with.
让我很高兴的是，像你这样的同事存在，塞尔吉奥，请原谅我其他我不熟悉的同事的名字。
Dr. Victor Carrión:
维克多·卡里翁博士：
Alex Urban and Carolyn Perman.
亚历克斯·厄本和卡罗琳·珀曼。
Andrew Huberman:
安德鲁·休伯曼：
Thank you.
谢谢你。
And the third thing is how important it is to bridge across these different levels of analysis.
第三件事是跨越这些不同层次的分析是多么重要。
I think this is the first time on this podcast Where somebody has discussed an experiment that bridges across so many levels of analysis, literally from fibroblast skin cells in a dish, all the way to a complex psychiatric condition, and in an attempt, excuse me, to create novel therapeutics.
我认为这是这个播客中第一次有人讨论了一个跨越如此多层次分析的实验，从字面上讲，从培养皿中的成纤维细胞皮肤细胞，一直到复杂的精神疾病，并试图创造新颖的疗法。
So it's just truly spectacular.
所以这真是太壮观了。
So if people are sensing a even further surge in my energy, this is the kind of thing that gets me so excited because in the landscape of science, we often see a study, or we hear about organoids, or we hear about a yoga intervention, and these things tend to exist in silos, in isolation, but the ability to bridge across these levels of analysis, I believe, is critical.
因此，如果人们感觉到我的能量进一步激增，这会让我感到非常兴奋，因为在科学领域，我们经常看到一项研究，或者我们听到有关类器官的信息，或者我们听到有关瑜伽干预的信息，而这些东西往往孤立地存在于孤岛中，但我认为，跨越这些分析层面的能力至关重要。
And so, yeah, kudos to you for being a part of this incredible collaboration.
所以，是的，感谢您参与这一令人难以置信的合作。
Dr. Victor Carrión:
维克多·卡里翁博士：
And collaborations are key, right?
合作是关键，对吗？
Because the world is so complex now that there's no way that a single lab could have all this expertise.
因为现在的世界是如此复杂，单个实验室不可能拥有所有这些专业知识。
So you're right, a place like Stanford allows for these communications to happen, for these collaborations to happen.
所以你是对的，像斯坦福这样的地方允许这些交流发生，这些合作发生。
In 28 years that I've been there, I have never heard, "No, I'm not interested in that."
我在那里工作了 28 年，我从未听到过“不，我对此不感兴趣”。
Andrew Huberman:
安德鲁·休伯曼：
I always say, at Stanford especially, if two scientists meet for more than 30 minutes, what comes out of that is a collaboration.
我总是说，尤其是在斯坦福大学，如果两位科学家见面超过 30 分钟，就会产生合作。
As a final question, I'm going to ask you to limit it to one answer, but I'm sure that there are many.
作为最后一个问题，我要求您将其限制为一个答案，但我确信有很多答案。
The question is, if you had a magic wand and you could get any message out to the whole world about PTSD and PTSI, in particular in kids and young people, but also in adults, what is that message?
问题是，如果你有一根魔杖，你可以向全世界传达有关 PTSD 和 PTSI 的任何信息，特别是针对儿童和年轻人，也包括成年人，那么该信息是什么？
What do you want people to know about post-traumatic stress disorder, stress, and post-traumatic stress injury?
您希望人们了解关于创伤后应激障碍、压力和创伤后应激损伤的哪些信息？
Dr. Victor Carrión:
维克多·卡里翁博士：
The first thing that comes to mind is the importance of listening and listening to what kids and adults have to say about their experiencing, and really creating a space for them where they or us don't feel isolated.
我首先想到的是倾听孩子和成人对他们的经历的看法的重要性，并真正为他们创造一个让他们或我们不会感到孤立的空间。
That they feel supported and that they feel that they can identify their own strengths and their own capabilities of making themselves better.
他们感到受到支持，并且觉得自己可以识别自己的优势和使自己变得更好的能力。
Everyone knows or has heard about psychiatrists and everybody thinks, "Oh, what would your psychiatrist say?" And psychiatrists have these smart things to say to people that help them with their life.
每个人都知道或听说过精神科医生，每个人都会想：“哦，你的精神科医生会说什么？”精神科医生可以对那些帮助他们生活的人说这些聪明的话。
But the best psychiatrists that I know actually say very little.
但我认识的最好的精神科医生实际上说得很少。
They listen.
他们听。
So I would say that listening to the experience that people have is key.
所以我想说，倾听人们的经验是关键。
Andrew Huberman:
安德鲁·休伯曼：
Well, thank you so much for that, and Dr. Carreon, Victor, thank you so, so much for the work you do.
嗯，非常感谢你们，卡伦博士、维克多，非常非常感谢你们所做的工作。
Dr. Victor Carrión:
维克多·卡里翁博士：
Thank you for having me here.
谢谢你让我来这里。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
It's spectacular work at so many levels.
从很多层面来说，这都是一项令人惊叹的工作。
It's also very bold and brave work to tackle such a big problem with such focus and to really give people agency.
以如此专注的方式解决如此大的问题并真正赋予人们代理权也是非常大胆和勇敢的工作。
This notion of a custom toolbox, I think, is profound.
我认为，定制工具箱的概念意义深远。
To give kids and adults, as it were, agency over their own interventions in an effort to really help themselves.
可以说，让孩子和成人能够自主干预，努力真正帮助自己。
I appreciate you coming here today more than I can express.
我对你今天来到这里的感激之情难以言表。
I know the listeners and viewers of this podcast appreciate it as well.
我知道这个播客的听众和观众也很欣赏它。
You are involved with Stanford clinically.
您参与斯坦福大学的临床工作。
You're involved running studies, clinical studies that have great importance, so for you to take time to educate us with these tools is absolutely spectacular and is really appreciated.
您参与了非常重要的研究和临床研究，因此您花时间用这些工具来教育我们绝对是令人惊叹的，我们非常感激。
Please keep us updated on your progress, and please come back and tell us more about that progress when the time is right.
请随时向我们通报您的进展情况，并在适当的时候回来告诉我们更多有关进展的信息。
Dr. Victor Carrión:
维克多·卡里翁博士：
Thank you so much.
非常感谢。
Andrew Huberman:
安德鲁·休伯曼：
Thank you for joining me for today's discussion about post-traumatic stress disorder and its treatments with Dr. Victor Carreon.
感谢您今天与 Victor Carreon 博士一起讨论创伤后应激障碍及其治疗方法。
To learn more about Dr. Carreon's work, please see the links in the show note captions.
要了解有关 Carreon 博士工作的更多信息，请参阅节目注释标题中的链接。
If you're learning from and/or enjoying this podcast, please subscribe to our YouTube channel.
如果您正在学习和/或喜欢此播客，请订阅我们的 YouTube 频道。
That's a terrific zero-cost way to support us.
这是支持我们的绝佳零成本方式。
In addition, please subscribe to the podcast on both Spotify and Apple, and on both Spotify and Apple, you can leave us up to a five-star review.
另外，请在 Spotify 和 Apple 上订阅该播客，在 Spotify 和 Apple 上，您都可以给我们留下五星级的评论。
Please check out the sponsors mentioned at the beginning and throughout today's episode.
请查看今天节目开头和整个节目中提到的赞助商。
That's the best way to support this podcast.
这是支持这个播客的最佳方式。
If you have questions for me or comments about the podcast or guests or topics that you'd like me to consider for the Huberman Lab Podcast, please put those in the comments section on YouTube.
如果您对我有疑问，或者对播客、嘉宾或您希望我考虑在 Huberman 实验室播客中讨论的主题有意见，请将这些意见放入 YouTube 的评论部分。
I do read all the comments.
我确实阅读了所有评论。
For those of you that haven't heard, I have a new book coming out.
对于那些还没有听说过的人，我即将出版一本新书。
It's my very first book.
这是我的第一本书。
It's entitled "Protocols: An Operating Manual for the Human Body." This is a book that I've been working on for more than 5 years, and that's based on more than 30 years of research and experience.
它的标题是“协议：人体操作手册”。这是我花了 5 年多时间编写的一本书，它基于 30 多年的研究和经验。
And it covers protocols for everything from sleep to exercise to stress control, protocols related to focus and motivation, and of course, I provide the scientific substantiation for the protocols that are included.
它涵盖了从睡眠到运动再到压力控制的所有协议，以及与注意力和动机相关的协议，当然，我为所包含的协议提供了科学依据。
The book is now available by presale at protocolsbook.com.
该书现已在protocolbook.com 上预售。
There you can find links to various vendors.
在那里您可以找到各个供应商的链接。
You can pick the one that you like best.
您可以选择您最喜欢的一个。
Again, the book is called "Protocols: An Operating Manual for the Human Body." If you're not already following me on social media, I am Huberman Lab on all social media platforms.
同样，这本书的名字是“协议：人体操作手册”。如果您还没有在社交媒体上关注我，我是所有社交媒体平台上的 Huberman Lab。
So that's Instagram, X, formerly known as Twitter, Threads, Facebook, and LinkedIn.
这就是 Instagram、X，以前称为 Twitter、Threads、Facebook 和 LinkedIn。
And on all those platforms, I discuss science and science-related tools, some of which overlaps with the content of the Huberman Lab Podcast, but much of which is distinct from the content on the Huberman Lab Podcast.
在所有这些平台上，我讨论科学和与科学相关的工具，其中一些与胡伯曼实验室播客的内容重叠，但其中大部分与胡伯曼实验室播客的内容不同。
Again, that's Huberman Lab on all social media channels.
同样，这是所有社交媒体渠道上的 Huberman Lab。
If you haven't already subscribed to our Neural Network Newsletter, our Neural Network Newsletter is a zero-cost monthly newsletter that includes podcast summaries as well as protocols in the form of brief one- to three-page PDFs.
如果您还没有订阅我们的神经网络新闻通讯，我们的神经网络新闻通讯是一份零成本的每月新闻通讯，其中包括播客摘要以及简短的一到三页 PDF 形式的协议。
Those protocol PDFs are on things like neuroplasticity and learning, optimizing dopamine, improving your sleep, deliberate cold exposure, deliberate heat exposure.
这些 PDF 协议涉及神经可塑性和学习、优化多巴胺、改善睡眠、刻意冷暴露、刻意热暴露等内容。
We have a foundational fitness protocol that describes a template routine that includes cardiovascular training and resistance training with sets and reps all backed by science, and all of which, again, is completely zero cost.
我们有一个基本的健身协议，描述了一个模板程序，其中包括心血管训练和阻力训练，其组数和次数均得到科学支持，而且所有这些都是完全零成本的。
To subscribe, simply go to hubermanlab.com, go to the menu tab up in the upper right corner, scroll down to newsletter, and provide your email, and I should emphasize that we do not share your email with anybody.
要订阅，只需访问 hubermanlab.com，转到右上角的菜单选项卡，向下滚动到时事通讯，然后提供您的电子邮件，我要强调的是，我们不会与任何人分享您的电子邮件。
Thank you once again for joining me for today's discussion with Dr. Victor Carreon.
再次感谢您参加今天与 Victor Carreon 博士的讨论。
And last but certainly not least, thank you for your interest in science.
最后但并非最不重要的一点是，感谢您对科学的兴趣。