Erasing Fears & Traumas Based on the Modern Neuroscience of Fear
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。
Andrew Huberman:
安德鲁·休伯曼：
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。
Today we're going to talk about the neuroscience of fear.
今天我们要讨论恐惧的神经科学。
We are also going to talk about trauma and post-traumatic stress disorders.
我们还将讨论创伤和创伤后应激障碍。
The neuroscience of fear has a long history in biology and in the field of psychology.
恐惧的神经科学在生物学和心理学领域有着悠久的历史。
However, I think it's fair to say that in the last 10 years, the field of neuroscience has shed light on not just the neural circuits, meaning the areas of the brain that control the fear response and the ways that it does it, but some important ways to extinguish fears using behavioral therapies, drug therapies, and what we call brain-machine interfaces.
然而，我认为可以公平地说，在过去的十年中，神经科学领域不仅揭示了神经回路，即控制恐惧反应的大脑区域及其实现方式，而且还揭示了使用行为疗法、药物疗法和我们所说的脑机接口来消除恐惧的一些重要方法。
Today we are going to talk about all of those.
今天我们将讨论所有这些。
And you are going to come away with both an understanding of the biology of fear and trauma as well as many practical tools to confront fear and trauma.
你将会了解到恐惧和创伤的生物学原理，以及许多应对恐惧和创伤的实用工具。
Andrew Huberman:
安德鲁·休伯曼：
In fact, we are going to discuss one very recently published study in which five minutes a day of deliberate exposure to stress was shown to alleviate longstanding depressive and fear-related symptoms.
事实上，我们将讨论最近发表的一项研究，该研究表明每天有意识地承受压力五分钟可以缓解长期的抑郁和恐惧相关症状。
We will get into the details of that study and the protocol that emerges from that study a little later in the podcast, but it stands as a really important, somewhat counterintuitive example of how stress itself can be used to combat fear.
我们将在稍后的播客中详细介绍这项研究以及该研究得出的方案，但它是一个非常重要的、有点违反直觉的例子，说明了如何利用压力本身来对抗恐惧。
Andrew Huberman:
安德鲁·休伯曼：
To give you a sense of where we are going, I'll just lay out the framework for today's podcast.
为了让您了解我们的发展方向，我将列出今天播客的框架。
First, I'm going to teach you about the biology of fear and trauma, literally the cells and circuits and connections in the body and chemicals in the body that give rise to the so-called fear response, and why sometimes, but not always, fear can turn into trauma.
首先，我将教您有关恐惧和创伤的生物学知识，实际上是体内的细胞、电路和连接以及体内引起所谓恐惧反应的化学物质，以及为什么有时（但并非总是）恐惧会变成创伤。
I will also describe the biology of how fear is unlearned, or what we call extinguished.
我还将描述如何消除恐惧或我们所说的消除恐惧的生物学原理。
And there too, you're going to get some serious surprises.
在那里，您也会得到一些严重的惊喜。
You're going to learn, for instance, that we can't just eliminate fears; we actually have to replace fears with a new positive event.
例如，你将了解到我们不能仅仅消除恐惧；我们还可以消除恐惧。我们实际上必须用新的积极事件取代恐惧。
And again, there are tools with which to do that, and I will teach you those tools today.
再说一次，有一些工具可以用来做到这一点，今天我将教你这些工具。
Andrew Huberman:
安德鲁·休伯曼：
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将有关科学和科学相关工具的零成本消费者信息带给公众。
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。
Andrew Huberman:
安德鲁·休伯曼：
So what is fear?
那么什么是恐惧呢？
Well, fear falls into a category of nervous system phenomenon that we can reliably call an emotion, and it is hotly debated nowadays, and it's been hotly debated, really, for centuries, what an emotion is and what an emotion isn't.
好吧，恐惧属于神经系统现象的范畴，我们可以可靠地将其称为情绪，现在人们对它进行了激烈的争论，而且几个世纪以来，人们一直在激烈争论什么是情绪，什么不是情绪。
Now, that's not a debate that I want to get into today.
现在，这不是我今天想要讨论的辩论。
I think it's fair to say that emotions include responses within our body, quickening of heart rate, changes in blood flow, things that we experience as a warming or a cooling of our skin, but that there's also a cognitive component.
我认为可以公平地说，情绪包括我们体内的反应、心率加快、血流变化、皮肤变暖或变冷的感觉，但也有认知成分。
There are thoughts, there are memories.
有思念，有回忆。
There's all sorts of stuff that goes on in our mind and in our body that together we call an emotion.
我们的思想和身体里发生着各种各样的事情，我们统称为情绪。
Andrew Huberman:
安德鲁·休伯曼：
And there's a vast amount of interest in literature devoted to trying to understand how many different emotions there are, how different people experience emotions, and that's certainly a topic that we will embrace in a future podcast episode.
人们对文学有很大的兴趣，致力于了解有多少种不同的情感，不同的人如何体验情感，这肯定是我们将在未来的播客节目中讨论的主题。
But today I just want to talk about fear as a response because when we talk about fear as a physiological response and as a cognitive response, then we can get down to some very concrete mechanisms and some very concrete and practical tools that can be used to deal with fear when fear is not wanted.
但今天我只想谈论恐惧作为一种反应，因为当我们将恐惧视为一种生理反应和认知反应时，我们可以深入探讨一些非常具体的机制和一些非常具体和实用的工具，可以在不需要恐惧时用来处理恐惧。
Andrew Huberman:
安德鲁·休伯曼：
So let's talk first about what fear isn't.
所以我们先来谈谈恐惧不是什么。
Most people are familiar with stress, both as a concept and as an experience.
大多数人都熟悉压力，无论是作为一个概念还是作为一种体验。
Stress is a physiological response.
压力是一种生理反应。
It involves quickening of the heart rate, typically quickening of breathing, blood flow getting shuttled to certain areas of the brain and body and not to others.
它涉及心率加快，通常是呼吸加快，血液流向大脑和身体的某些区域，而不是其他区域。
It can create a hypervigilance or an awareness.
它可以产生高度警惕或意识。
Typically, that awareness is narrower, literally narrower in space, like a soda-straw view of the world, than when we are relaxed.
通常情况下，这种意识比我们放松时更窄，实际上在空间上更窄，就像苏打吸管的世界观一样。
And it is fair to say that we cannot have fear without having several, if not all of the elements of the stress response.
可以公平地说，如果没有压力反应的几个（如果不是全部）要素，我们就不可能产生恐惧。
However, we can have stress without having fear.
然而，我们可以有压力而不用害怕。
Likewise, people are familiar with the phrase, or the word rather, anxiety.
同样，人们也熟悉这个词，或者更确切地说，焦虑这个词。
Anxiety tends to be stress about some future event, although it can mean other things as well.
焦虑往往是对未来某些事件的压力，尽管它也可能意味着其他事情。
We can't really have fear without seeing or observing or experiencing some of the elements of anxiety, but we can have anxiety without having fear.
如果没有看到、观察或经历一些焦虑的因素，我们就不可能真正感到恐惧，但我们可以在没有恐惧的情况下感到焦虑。
Andrew Huberman:
安德鲁·休伯曼：
So what you're starting to realize is that fear is built up from certain basic elements that include stress and anxiety.
因此，您开始意识到，恐惧是由某些基本元素（包括压力和焦虑）构成的。
And then there is trauma.
然后就是创伤。
And trauma also requires a specific, what we will call operational, definition.
创伤也需要一个具体的、我们称之为操作性的定义。
Operational definition is just a definition that allows us to have a conversation because we both agree on or mostly agree on what the meaning of a given word is.
操作定义只是一个允许我们进行对话的定义，因为我们都同意或基本同意给定单词的含义。
It makes conversations much easier.
它使对话变得更加容易。
In fact, I would argue if we all had operational definitions for more things in the world that there would be fewer misunderstandings and arguments, and we'd all move a lot further as a species.
事实上，我认为，如果我们对世界上更多的事物都有可操作的定义，那么误解和争论就会减少，而且作为一个物种，我们都会走得更远。
But that's another topic entirely.
但这完全是另一个话题了。
Andrew Huberman:
安德鲁·休伯曼：
The operational definition of trauma is that some fear took place, which of course includes stress and anxiety, and that fear somehow gets embedded or activated in our nervous system such that it shows up at times when it's maladaptive, meaning that fear doesn't serve us well, and it gets reactivated at various times.
创伤的操作定义是发生了一些恐惧，其中当然包括压力和焦虑，并且恐惧以某种方式嵌入或激活在我们的神经系统中，这样它有时会在适应不良时出现，这意味着恐惧不能很好地为我们服务，并且它会在不同的时间重新激活。
Like when you first wake up in the morning, if you're not in the presence of something that scared you, but you suddenly have what feels like a panic attack and you're in deep fear, well, that's post-traumatic stress.
就像当你早上第一次醒来时，如果你没有看到让你害怕的东西，但你突然感到惊恐发作，并且处于深深的恐惧之中，那么，这就是创伤后应激障碍。
That's post-traumatic fear.
这就是创伤后恐惧。
So I don't want to get bogged down too much in the nomenclature, but what I'm doing here is building up a sort of a series of layers where stress and anxiety form the foundation of what we're calling fear and trauma.
所以我不想过多地陷入术语中，但我在这里所做的是建立一系列层次，其中压力和焦虑构成了我们所说的恐惧和创伤的基础。
Andrew Huberman:
安德鲁·休伯曼：
And then there are other phrases out there that we would be remiss if we didn't mention, things like phobias and panic attacks.
还有其他一些短语，如果我们不提及，那就是失职，比如恐惧症和惊恐发作。
Panic attacks are the experience of extreme fear, but without any fear-inducing stimulus, so it's kind of like trauma, and a phobia tends to be extreme fear of something specific, fear of spiders, fear of heights, fear of flying, fear of dying, these kinds of things, okay?
惊恐发作是一种极度恐惧的体验，但没有任何引起恐惧的刺激，所以它有点像创伤，而恐惧症往往是对特定事物的极度恐惧，对蜘蛛的恐惧，对高度的恐惧，对飞行的恐惧，对死亡的恐惧，这些事情，好吗？
Andrew Huberman:
安德鲁·休伯曼：
The reason for laying all that out there is not to create a word soup to confuse us.
之所以把所有这些都列出来，并不是为了创造一个词汤来迷惑我们。
Rather, it is to simplify the issue because now that we acknowledge that there are many different phrases to describe this thing that we call fear, and in related phenomenon, we can start to just focus on two of these issues, fear and trauma, as it relates to specific biological processes, specific cognitive processes, and we can start to dissect how fears are formed, how fears are unformed, and how new memories can come to replace previously fearful experiences.
相反，它是为了简化问题，因为现在我们承认有很多不同的短语来描述我们称之为恐惧的东西，在相关现象中，我们可以开始只关注其中两个问题，恐惧和创伤，因为它与特定的生物过程、特定的认知过程有关，我们可以开始剖析恐惧是如何形成的，恐惧是如何消失的，以及新的记忆如何取代以前的恐惧经历。
Andrew Huberman:
安德鲁·休伯曼：
So in this effort to establish a common language around fear and trauma, I want to point out autonomic arousal.
因此，在围绕恐惧和创伤建立共同语言的努力中，我想指出自主唤醒。
Autonomic arousal relates to this aspect of our nervous system that we call the autonomic nervous system.
自主神经唤醒与我们神经系统的这个方面有关，我们称之为自主神经系统。
Autonomic means automatic.
Autonomic 的意思是自动的。
That's somewhat of a misnomer because there are aspects of your autonomic nervous system that you can control, but your autonomic nervous system controls things like digestion, urination, sexual behavior, stress, when you want to be awake, when you want to be asleep.
这有点用词不当，因为你的自主神经系统的某些方面是你可以控制的，但你的自主神经系统控制着消化、排尿、性行为、压力、当你想清醒时、当你想睡觉时等。
It basically has two branches to it, two branches meaning two different systems.
它基本上有两个分支，两个分支意味着两个不同的系统。
One is the so-called sympathetic autonomic nervous system.
一是所谓的交感自主神经系统。
It has nothing to do with sympathy, it has everything to do with increasing alertness.
这与同情心无关，而与提高警觉性有关。
Think of the sympathetic nervous system as the alertness nervous system.
将交感神经系统视为警觉神经系统。
It's what ramps up your levels of alertness, ramps up your levels of vigilance.
它可以提高你的警觉性，提高你的警惕性。
Think about it as the accelerator on your alertness and attention.
将其视为提高警觉性和注意力的加速器。
Andrew Huberman:
安德鲁·休伯曼：
The other branch of the autonomic nervous system is the so-called parasympathetic branch of the autonomic nervous system.
自主神经系统的另一个分支是所谓的自主神经系统的副交感神经分支。
I know that's a mouthful.
我知道那是拗口的。
The parasympathetic branch of the autonomic nervous system are the cells and neurons and chemicals and other aspects of your brain and body that are involved in the calming nervous system.
自主神经系统的副交感分支是大脑和身体中参与镇定神经系统的细胞、神经元、化学物质以及其他方面。
So sympathetic is alerting, parasympathetic is calming, and it acts as sort of a seesaw to adjust your overall level of alertness.
因此，交感神经使人警觉，副交感神经使人平静，它就像跷跷板一样调节你的整体警觉水平。
So for instance, right now I'm alert, but I feel pretty calm.
举例来说，现在我很警觉，但我感觉很平静。
I'm not ready to go to sleep or anything like that.
我还没有准备好去睡觉或者类似的事情。
I don't feel like I need a nap.
我不觉得我需要小睡。
I'm alert, but I'm calm.
我很警惕，但我很冷静。
I'm not in a state of stress or panic.
我没有处于压力或恐慌的状态。
So that seesaw we could imagine is more or less level.
所以我们可以想象的跷跷板或多或少都是水平的。
Maybe it's tilted up a little bit to the side of increased sympathetic or alertness rather than parasympathetic because I feel wide awake.
也许它稍微偏向交感神经或警觉性增强的一侧，而不是副交感神经，因为我感觉很清醒。
If I were sleepy, the opposite would be true.
如果我困了，情况就会相反。
The parasympathetic side would be increased relative to the sympathetic side.
副交感神经侧相对于交感神经侧会增加。
Andrew Huberman:
安德鲁·休伯曼：
There are many different aspects to the autonomic nervous system, but one of the main aspects is an aspect that's going to come up again and again and again today.
自主神经系统有许多不同的方面，但其中一个主要方面是今天会一再出现的方面。
It's very important that you understand what it is.
了解它是什么非常重要。
It's called the HPA axis.
它被称为 HPA 轴。
The HPA axis stands for hypothalamic-pituitary-adrenal axis.
HPA 轴代表下丘脑-垂体-肾上腺轴。
The hypothalamus is a collection of neurons.
下丘脑是神经元的集合。
It's an area of your brain, real estate that's deep in the brain, at the base of the brain that contains many, many different areas that control things like temperature and desire to have sex, desire to eat, thirst.
它是你大脑的一个区域，是大脑深处的一个区域，位于大脑的底部，包含许多不同的区域，控制着温度、性欲、进食欲、口渴等事物。
It also controls the desire to not mate, have sex, not eat, not drink more water or any other type of fluid.
它还控制着不交配、不做爱、不吃东西、不喝更多水或任何其他类型液体的欲望。
So it has accelerators and brakes in there as well.
所以它也有加速器和制动器。
Andrew Huberman:
安德鲁·休伯曼：
The hypothalamus connects to the so-called pituitary.
下丘脑与所谓的垂体相连。
The pituitary lives close to the roof of your mouth.
垂体位于上颚附近。
It releases hormones into your bloodstream.
它将激素释放到您的血液中。
And so the hypothalamus has this ability to trigger the release, or prevent the release, of particular hormones like cortisol or the hormones that go stimulate ovaries to produce estrogen or testes to produce testosterone or adrenals to produce adrenaline.
因此，下丘脑有能力触发或阻止特定激素的释放，例如皮质醇或刺激卵巢产生雌激素或刺激睾丸产生睾酮或刺激肾上腺产生肾上腺素的激素。
And speaking of the adrenals, that A in the HPA are the adrenals.
说到肾上腺，HPA 中的 A 就是肾上腺。
You have two glands that sit above your kidneys in your lower back.
您的下背部有两个位于肾脏上方的腺体。
They receive signals by way of nerve cells, neurons, and by way of hormones and other things released from the brain and elsewhere in the body, and they release different hormones and other types of chemicals into the body.
它们通过神经细胞、神经元以及从大脑和身体其他部位释放的激素和其他物质接收信号，并向体内释放不同的激素和其他类型的化学物质。
The two main ones that you need to know about today are adrenaline, also called epinephrine, and cortisol.
今天您需要了解的两种主要物质是肾上腺素（也称为肾上腺素）和皮质醇。
Both of those are so-called stress hormones, but they're not always involved in stress.
这两种激素都是所谓的压力荷尔蒙，但它们并不总是与压力有关。
They're also involved in waking up in the morning when you rise from sleep.
当你早上从睡梦中醒来时，它们也参与其中。
Andrew Huberman:
安德鲁·休伯曼：
And so this HPA axis should be thought of in the following way.
所以这个 HPA 轴应该按以下方式思考。
The HPA axis includes a piece of the brain, the hypothalamus; the pituitary; and the adrenal.
HPA 轴包括大脑的一部分，即下丘脑；垂体；和肾上腺。
So it's a beautiful three-part system that can use your brain to alert or wake up your body and prepare it for action.
因此，这是一个由三部分组成的美丽系统，可以使用您的大脑来提醒或唤醒您的身体，并为其采取行动做好准备。
And it can do that in the short term by triggering the release of hormones and chemicals that make you alert and ready to go right away, and by triggering the release of neurotransmitters and hormones and other chemicals that give that alertness a very long tail, a very long latency before it shuts off.
它可以在短期内做到这一点，通过触发激素和化学物质的释放，让你警觉并准备好立即出发，并通过触发神经递质、激素和其他化学物质的释放，使警觉性有一个很长的尾巴，在它关闭之前有很长的潜伏期。
Andrew Huberman:
安德鲁·休伯曼：
That's important because one of the hallmarks of fear and one of the hallmarks of trauma is that they involve fear responses that are long-lasting.
这很重要，因为恐惧的标志之一和创伤的标志之一是它们涉及持久的恐惧反应。
Even if those fearful events, the events in the world that trigger the HPA axis, can be very brief, like a car that almost hits you as you step off the curb or something, a gunshot that goes off suddenly, and it's just a very quick, like 500-millisecond or one-second event.
即使那些可怕的事件，世界上触发 HPA 轴的事件，可能非常短暂，比如当你走下路边时一辆汽车几乎撞到你或其他什么，突然一声枪响，而且它只是一个非常快的事件，比如 500 毫秒或一秒的事件。
The fear response can reverberate through your system because the chemicals that are involved in this HPA axis have a fast component and a longer-lasting component.
恐惧反应会在您的系统中产生反响，因为该 HPA 轴中涉及的化学物质具有快速成分和持久成分。
The longer-lasting component can actually change not just the connections of different areas of the brain and the way that our organs work, like our heart and the way that we breathe, it actually can feed back to the brain and literally control gene expression, which can take many days and build out new circuits and new chemicals that can embed fear in our brain and body.
这种更持久的成分实际上不仅可以改变大脑不同区域的连接和我们器官的工作方式，比如我们的心脏和我们的呼吸方式，它实际上可以反馈到大脑并真正控制基因表达，这可能需要很多天的时间，并建立新的电路和新的化学物质，将恐惧嵌入我们的大脑和身体。
Andrew Huberman:
安德鲁·休伯曼：
And that might sound very depressing, but there's a reason, and there's an adaptive reason why there's this slow and fast phase of the HPA axis and the fear response.
这听起来可能非常令人沮丧，但是 HPA 轴和恐惧反应出现这种缓慢和快速的阶段是有原因的，而且有一个适应性的原因。
And fortunately, that gene expression and the long arc of the fear response, the way it kind of lives in our system, kind of like a phantom in some ways, can also be leveraged to undo the fear response, to extinguish the fear response and replace it with nonfearful associations.
幸运的是，基因表达和恐惧反应的长弧，它在我们系统中的生存方式，在某些方面有点像幻影，也可以用来消除恐惧反应，消除恐惧反应并用非恐惧的联想取而代之。
Andrew Huberman:
安德鲁·休伯曼：
So let's dig a little deeper into the neural circuits and biology of fear because in doing that, we can start to reveal the logic of how to attack fear if that's the goal.
因此，让我们更深入地研究恐惧的神经回路和生物学，因为通过这样做，我们可以开始揭示如何攻击恐惧的逻辑（如果这是目标的话）。
We can't really have a discussion about fear without discussing the famous amygdala, famous because I think most people by now have heard of the amygdala.
如果不讨论著名的杏仁核，我们就不能真正讨论恐惧，之所以著名是因为我认为现在大多数人都听说过杏仁核。
Amygdala means almond.
Amygdala 的意思是杏仁。
It's an almond-shaped structure on both sides of the brain.
它是大脑两侧的杏仁状结构。
So you have one on the right side of your brain and one on the left side of your brain.
所以你的右脑有一个，左脑有一个。
Andrew Huberman:
安德鲁·休伯曼：
The amygdala is part of what we can call the threat reflex, and this is very important to conceptualize fear as including a reflex.
杏仁核是我们所说的威胁反射的一部分，这对于将恐惧概念化为包括反射非常重要。
So, much as you have reflexes that cause you to lift your foot up if you are to step on something sharp — you literally have a reflex within your spinal cord that causes you to lift up one foot and extend the other one toward the ground.
因此，就像如果您要踩到尖锐的东西时，您会产生抬起脚的反射一样，实际上，您的脊髓内也有一种反射，会导致您抬起一只脚并将另一只脚伸向地面。
Believe it or not, you always think you step on something sharp, you pull your foot up, but you actually step on something sharp, you pull your foot up, and in pulling it up, there's another reflex that's activated as you extend your other leg so that you don't fall over.
不管你信不信，你总是认为你踩到了尖锐的东西，你把脚向上拉，但实际上你踩到了尖锐的东西，你把脚向上拉，在向上拉的过程中，当你伸展另一条腿时，会激活另一种反射，这样你就不会摔倒。
Andrew Huberman:
安德鲁·休伯曼：
Similarly, in the process of experiencing fear, you have a reflex for particular events in your brain and body.
同样，在经历恐惧的过程中，你的大脑和身体会对特定事件产生反射。
And that reflex involves things like quickening of your heart rate, hypervigilance, your attentional systems pop on, increased ability to access energy stores for movement and thought, and so forth.
这种反射涉及心率加快、高度警惕、注意力系统启动、运动和思考能量储存能力增强等。
But just like that step-on-the-tack reflex example, all of the neural circuits that are associated with being calm, with being able to go to sleep, with being able to visualize the full picture of your environment, literally to see your entire environment or to hear other things around you, all of those get shut down when the so-called threat reflex gets activated.
但就像那个直接反应的例子一样，所有与保持冷静、能够入睡、能够形象化周围环境的全貌、真正看到整个环境或听到周围其他事物相关的神经回路，当所谓的威胁反射被激活时，所有这些都会被关闭。
The amygdala is part of the threat reflex, so much so that we can really say that it's the final common pathway through which the threat reflex flows.
杏仁核是威胁反射的一部分，以至于我们可以说它是威胁反射流动的最终共同路径。
In other words, the amygdala is essential for the threat response.
换句话说，杏仁核对于威胁反应至关重要。
Andrew Huberman:
安德鲁·休伯曼：
But the threat reflex and the threat response is kind of a dumb response.
但威胁反射和威胁反应是一种愚蠢的反应。
It's not a sophisticated thing, it's very generic.
这不是一个复杂的事情，而是非常通用的。
And this is also a very important point.
这也是非常重要的一点。
One of the beauties of the fear system is that it's very generalizable.
恐惧系统的优点之一是它非常通用。
It's not designed for you to be afraid of any one thing.
它并不是为了让你害怕任何一件事而设计的。
Sure, there are some debates and probably some good data out there that support the fact that human babies are innately, meaning requires no learning, innately afraid of certain things like heights or snakes or spiders.
当然，有一些争论，可能还有一些好的数据支持这样一个事实：人类婴儿天生就害怕某些东西，比如高度、蛇或蜘蛛，这意味着不需要学习。
There's debate about this that depends on the quality of the experiment, et cetera, but the real capacity of the fear system is that we can become afraid of anything provided that this threat system is activated in conjunction with some external experience.
关于这一点存在争议，这取决于实验的质量等，但恐惧系统的真正能力是，只要该威胁系统与某些外部经验结合激活，我们就可以变得害怕任何事物。
Andrew Huberman:
安德鲁·休伯曼：
So the way I'd like you to think about the amygdala is not as a fear center, but that it's a critical component of the threat reflex.
因此，我希望您不要将杏仁核视为恐惧中心，而是威胁反射的重要组成部分。
I'd like you to also internalize the idea that the threat reflex involves this activation of certain systems and suppression of all the systems for calming, the parasympathetic system.
我希望你也能内化这样的想法：威胁反射涉及某些系统的激活和所有镇静系统（副交感系统）的抑制。
And now I'm going to describe the way that information flows into and through this threat reflex.
现在我将描述信息流入并通过这种威胁反射的方式。
And in doing that, it will reveal how specific things like a spider, like a snake, like a physical trauma, like a car accident, like a fear of public speaking, whatever happens to scare you or scare somebody, how that gets attached to this reflex, because this reflex is very generic.
在这样做的过程中，它将揭示具体的事物如何像蜘蛛，像蛇，像身体创伤，像车祸，像对公开演讲的恐惧，无论发生什么吓到你或吓到别人，这些是如何与这种反射联系在一起的，因为这种反射是非常普遍的。
It doesn't really know what to be afraid of.
它真的不知道该害怕什么。
It only knows how to create this sensation, this internal landscape that we think of as fear.
它只知道如何创造这种感觉，这种我们认为是恐惧的内部景观。
Andrew Huberman:
安德鲁·休伯曼：
So while the amygdala might look like an almond, it's actually part of a much bigger complex or collection of neurons called the amygdaloid complex.
因此，虽然杏仁核可能看起来像杏仁，但它实际上是一个更大的复合体或称为杏仁体复合体的神经元集合的一部分。
That complex has anywhere from 12 to 14 areas, depending on which neuroanatomist is naming things and carving it up.
该复合体有 12 到 14 个区域，具体取决于哪个神经解剖学家对事物进行命名和划分。
In neuroscience and in much biology, we like to joke that there are lumpers and there are splitters.
在神经科学和许多生物学领域，我们喜欢开玩笑说，有混杂者，也有分裂者。
So some people like to draw boundaries between every little distinct difference and say, "Oh, that's a separate area," and other people are lumpers and they say, "Well, listen, why complicate things?
因此，有些人喜欢在每一个微小的明显差异之间划定界限，并说，“哦，这是一个单独的领域，”而另一些人则是笨蛋，他们说，“好吧，听着，为什么要把事情复杂化呢？
Let's lump those together." I'm neither a lumper nor a splitter.
让我们把它们放在一起。”我既不是一个统一者，也不是一个分裂者。
I'm somewhere in between.
我介于两者之间。
I think the number 12 is a good number in terms of the number of different areas of the amygdala.
我认为就杏仁核不同区域的数量而言，12 是一个很好的数字。
Why is that important to us?
为什么这对我们很重要？
Well, it turns out that the amygdala is not just an area for threat, it's an area for generating threat reflexes that integrates lots of different types of information.
好吧，事实证明，杏仁核不仅仅是一个威胁的区域，它还是一个产生威胁反射的区域，整合了许多不同类型的信息。
Andrew Huberman:
安德鲁·休伯曼：
So for those of you that want to know, I'm going to give you some names, some nomenclature.
对于那些想知道的人，我将为你们提供一些名称和术语。
For those of you that don't, you can tune out for this.
对于那些不这样做的人，您可以忽略这一点。
But basically, information from our memory systems, like the hippocampus, and from our sensory systems, our eyes, our ears, our nose, our mouth, et cetera — so taste information, vision, auditory information, touch, et cetera — flow into the so-called lateral portion of the amygdala, or the amygdaloid complex.
但基本上，来自我们的记忆系统（如海马体）和来自我们的感觉系统（眼睛、耳朵、鼻子、嘴巴等）的信息——味觉信息、视觉、听觉信息、触觉等——流入所谓的杏仁核外侧部分，或杏仁核复合体。
It flows into the lateral portion.
它流入侧面部分。
Andrew Huberman:
安德鲁·休伯曼：
And then there are multiple outputs from the amygdala.
然后杏仁核有多个输出。
And this is where things get particularly interesting because the outputs of the amygdala have a lot of different areas, but there are two main pathways.
这就是事情变得特别有趣的地方，因为杏仁核的输出有很多不同的区域，但有两条主要路径。
One involves the hypothalamus, which you heard about before, this collection of neurons that control a lot of our primitive drives for sex, for food, for thirst, and for warmth, et cetera.
其中之一涉及下丘脑，你以前听说过，它是一组神经元，控制着我们对性、食物、口渴和温暖等的许多原始驱动力。
And it also feeds out to our adrenals, those glands that you learned about a few minutes ago, to create a sense of alertness and action.
它还向我们的肾上腺（您几分钟前了解到的那些腺体）提供信息，以产生警觉和行动感。
It also feeds out; what I mean by feeds out, by the way, is there are neurons that send wires, we call those wires axons, connections where they can release chemicals and trigger the activation of different brain areas.
它也能进食；顺便说一句，我所说的“输出”是指神经元发送电线，我们将这些电线称为轴突，它们可以释放化学物质并触发不同大脑区域的激活的连接。
Andrew Huberman:
安德鲁·休伯曼：
So it feeds out to other brain areas, such as the PAG.
因此它会向其他大脑区域（例如 PAG）提供信息。
PAG is very interesting for our discussion today.
PAG 对我们今天的讨论非常有趣。
It's the periaqueductal gray.
这是导水管周围灰质。
The periaqueductal gray contains neurons that can trigger freezing.
导水管周围灰质含有可以引发冻结的神经元。
Some people talk about the fawning response, which is kind of an appeasing response to traumatic events.
有些人谈论阿谀奉承反应，这是对创伤事件的一种安抚反应。
But some people outright freeze in response to fear, right?
但有些人因为恐惧而彻底僵住了，对吗？
We've heard of fight or flight.
我们听说过“战斗或逃跑”。
And indeed the pathway that I'm describing can create a sense of fight and cause people to want to lean-in in an aggressive way to combat things that they're afraid of, or flight, to run away, essentially to avoid by mobilizing the thing that they feel they're threatened by.
事实上，我所描述的途径可以创造一种战斗感，让人们想要以一种积极的方式前倾，以对抗他们害怕的事物，或者逃跑、逃跑，本质上是通过动员他们认为受到威胁的事物来避免。
Andrew Huberman:
安德鲁·休伯曼：
Now, even in the absence of some threat, somebody that has, say, fear of public speaking might hesitate or move away from a podium or hesitate or move away from raising their hand if raising their hand meant that they might be called on and would be public speaking.
现在，即使没有某种威胁，害怕公开演讲的人也可能会犹豫或离开讲台，或者犹豫或放弃举手，如果举手意味着他们可能会被点名并进行公开演讲。
So there's fight and flight, but there's also the freeze response.
所以有战斗和逃跑，但也有冻结反应。
The freeze response is controlled by a number of brain centers, but the periaqueductal gray, the PAG, is central for the freeze response.
冻结反应由许多大脑中心控制，但导水管周围灰质（PAG）是冻结反应的中心。
Neurons there also create what are called endogenous opioids.
那里的神经元还会产生所谓的内源性阿片类药物。
Many of you have heard of the opioid crisis, which is a crisis of prescription medication given out too broadly for people that don't need it who become addicted to opioids.
你们中的许多人都听说过阿片类药物危机，这是一场处方药向阿片类药物成瘾的人提供过于广泛的危机。
Those are exogenous opioids.
这些是外源性阿片类药物。
Andrew Huberman:
安德鲁·休伯曼：
But endogenous opioids are chemicals released from neurons in the PAG and from elsewhere in the body that give us a sense of numbing.
但内源性阿片类药物是 PAG 神经元和身体其他部位释放的化学物质，会给我们带来麻木感。
They actually numb us against pain.
它们实际上使我们麻木以对抗疼痛。
And you can imagine why biology would be organized this way.
你可以想象为什么生物学会这样组织。
A threat occurs or something that we perceive as a threat, we're afraid of it, and a natural analgesic is released into our body because there's likely to be an interaction that's very uncomfortable, that's physically uncomfortable.
当威胁发生或我们认为是威胁的事情发生时，我们会害怕它，并且天然的镇痛剂会释放到我们的体内，因为可能会发生一种非常不舒服的相互作用，身体上会感到不舒服。
So it's like we have our own endogenous release of these opioids, and that's occurring in the PAG.
因此，就像我们自己内源性释放这些阿片类药物一样，这发生在 PAG 中。
Andrew Huberman:
安德鲁·休伯曼：
The other area, and again, sorry to litter the conversation with these names of structures, but some people seem to enjoy knowing these structures.
另一个领域，再次抱歉，在对话中乱扔这些结构的名称，但有些人似乎喜欢了解这些结构。
You're fine if you just understand what the structures do.
如果您只了解这些结构的作用，那就没问题了。
If you want to know the names, that's fine.
如果你想知道名字，那很好。
But the other structure is the locus coeruleus.
但另一个结构是蓝斑。
The locus coeruleus creates a sense of arousal by releasing adrenaline, epinephrine, and norepinephrine, a related chemical, into the brain.
蓝斑通过向大脑释放肾上腺素、肾上腺素和去甲肾上腺素（一种相关化学物质）来产生兴奋感。
Andrew Huberman:
安德鲁·休伯曼：
So basically, the activation of the amygdaloid complex could be from any number of different things, a memory of something fearful, an actual sensory experience of something that's fearful.
所以基本上，杏仁核复合体的激活可能来自许多不同的事物，比如对可怕事物的记忆，对可怕事物的实际感官体验。
But then the fear response itself is taking part because of the threat reflex gets activated.
但由于威胁反射被激活，恐惧反应本身也参与其中。
And that threat reflex then sends a whole set of other functions into action: freezing, activation of the adrenals, activation of locus coeruleus for arousal and alertness, activation of this endogenous pain system, or antipain system, in the PAG.
然后，威胁反射会发出一整套其他功能：冻结、激活肾上腺、激活蓝斑以实现唤醒和警觉、激活 PAG 中的内源性疼痛系统或抗痛系统。
That's one pathway out of the amygdala.
这是离开杏仁核的一条途径。
Andrew Huberman:
安德鲁·休伯曼：
The other pathway out of the amygdala is to a very interesting area that typically is associated with reward and even addiction.
离开杏仁核的另一条途径是一个非常有趣的区域，通常与奖励甚至成瘾有关。
So this might come as a surprise to many of you.
所以这可能会让你们很多人感到惊讶。
In fact, it came as a surprise to me.
事实上，这让我感到惊讶。
I remember when these data were published, but the amygdaloid complex actually projects to areas of the dopamine system, the so-called nucleus accumbens, the mesolimbic reward pathway.
我记得这些数据发表时，但杏仁核复合体实际上投射到多巴胺系统的区域，即所谓的伏隔核，即中脑边缘奖励通路。
For those of you that want to look that up or remember from the dopamine episodes, we have pathways in our brain that are associated with pursuit, motivation, and reward, and the neuromodulator dopamine is largely responsible for that feeling of craving, pursuit and reward.
对于那些想要查找或记住多巴胺事件的人来说，我们的大脑中有与追求、动机和奖励相关的通路，而神经调节剂多巴胺在很大程度上负责这种渴望、追求和奖励的感觉。
This threat center is actually able to communicate with and activate the dopamine system.
这个威胁中心实际上能够与多巴胺系统进行通信并激活它。
Later you will realize why that is very important and why you can leverage the dopamine system in order to wire in new memories to replace fearful ones.
后来你会意识到为什么这非常重要，以及为什么你可以利用多巴胺系统来连接新的记忆来取代恐惧的记忆。
Andrew Huberman:
安德鲁·休伯曼：
So I've been hitting you with a lot of names of things, but for the moment, even if you're interested in all the neuroscience names and structures, and so forth, I'd like you to just conceptualize that you have a circuit in your brain, meaning a set of cells and connections that are arranged in the following way.
所以我一直在用很多东西的名称来打击你，但目前，即使你对所有神经科学名称和结构等感兴趣，我也希望你能概念化你的大脑中有一个电路，意味着一组按以下方式排列的细胞和连接。
You have a threat reflex that can be activated at any time very easily.
你有一种威胁反射，可以随时很容易地激活。
But what activates that threat reflex can depend on two things.
但激活威胁反射的因素取决于两件事。
One, our prior memories, coming from brain areas that are involved in storage of memories.
一是我们之前的记忆，来自参与记忆存储的大脑区域。
Or it can be immediate experiences, things are happening in the now.
或者它可以是直接的经历，事情正在发生。
Okay?
好的？
So were something fearful to happen right now, your threat reflex could be activated.
因此，如果现在发生了可怕的事情，你的威胁反射就会被激活。
Were you to remember something very scary that happened to you in the past, your threat reflex could be activated.
如果你记得过去发生在你身上的一些非常可怕的事情，你的威胁反射就会被激活。
Andrew Huberman:
安德鲁·休伯曼：
That threat reflex circuit has two major outputs.
该威胁反射电路有两个主要输出。
One of the major outputs is to areas that are involved in the threat response, freezing, pain management, and alertness.
主要产出之一是涉及威胁响应、冷冻、疼痛管理和警觉的领域。
And the other major output is to areas involved in reward, motivation, and reinforcement, okay?
另一个主要输出是涉及奖励、激励和强化的领域，好吗？
There's a fourth component, and I promise this is the last component that we need to put into this picture of the neural circuits for fear.
还有第四个组件，我保证这是我们出于恐惧而需要放入神经回路图片中的最后一个组件。
This is a circuit that involves an area of the brain called the prefrontal cortex, and some of its subdivision.
这是一个涉及大脑中称为前额皮质的区域及其一些细分区域的回路。
So literally in the front.
所以字面上的意思是在前面。
It's involved in what we call top-down processing.
它涉及我们所说的自上而下的处理。
Andrew Huberman:
安德鲁·休伯曼：
Top-down processing is the way that your prefrontal cortex and other areas of the brain can control or suppress a reflex, okay?
自上而下的处理是你的前额皮质和大脑其他区域控制或抑制反射的方式，好吗？
A good example of this would be the step-on-the-tack example that I gave before.
一个很好的例子就是我之前给出的一步到位的例子。
So when you step on a tack, you immediately pull up your foot and you extend the other leg.
因此，当您踩到大头钉时，您会立即抬起脚并伸出另一条腿。
That's the reflex that prevents you from injuring yourself and from falling over.
这就是防止你受伤和摔倒的本能反应。
However, if you wanted, not that you would want to, but if you wanted, you could, for instance, place your foot onto a tack and decide not to pull your foot away; it would be difficult.
然而，如果你愿意，不是你愿意，而是如果你愿意，你可以，例如，把你的脚放在大头钉上，然后决定不把脚拉开;这会很困难。
And again, I don't recommend that you do that, but you could override that reflex, okay?
再说一遍，我不建议你这样做，但你可以忽略这种反射，好吗？
Andrew Huberman:
安德鲁·休伯曼：
There are other examples of reflexes like, for instance, getting into cold water.
还有其他反射的例子，例如进入冷水中。
Most people will start to huddle their body.
大多数人会开始蜷缩身体。
Most people won't want to get into the cold water.
大多数人都不想进入冷水中。
Many people will jump out.
很多人都会跳出来。
But all of that is reflexive.
但所有这些都是反射性的。
And should you want to, you could override that reflex through top-down processing.
如果您愿意，您可以通过自上而下的处理来覆盖该反射。
You could tell yourself, "Oh, I heard on a previous Huberman Lab podcast or on an Instagram post that cold water exposure can be beneficial for metabolism and resilience, et cetera." And indeed it can.
你可以告诉自己，“哦，我在之前的 Huberman Lab 播客或 Instagram 帖子中听说，接触冷水有益于新陈代谢和恢复力等等。”确实可以。
And you can decide to get into the water and to stretch out your body, not to huddle, and you can fight those reflexes, okay?
你可以决定进入水中并伸展你的身体，而不是蜷缩在一起，你可以对抗这些反应，好吗？
Andrew Huberman:
安德鲁·休伯曼：
The fighting of reflex is carried out through top-down processing, largely through the prefrontal cortex.
反射的对抗是通过自上而下的处理进行的，主要是通过前额叶皮层。
You provide a narrative.
你提供一个叙述。
You tell yourself, "I want to do this," or "I should do this," or "Even though I don't want to, I'm going to do it anyway." So top-down processing is not just for getting into cold water, and it certainly isn't for overriding reflexes that can damage us, like stepping on the tack example.
你告诉自己，“我想做这个”，或者“我应该做这个”，或者“即使我不想做，我还是会做”。因此，自上而下的处理不仅仅是为了进入冷水，它当然也不是为了压倒性的可能伤害我们的反射，比如踩到大头钉的例子。
It is the way in which we can override any number of internal reflexes, including the threat reflex.
通过这种方式，我们可以超越任何数量的内部反射，包括威胁反射。
Andrew Huberman:
安德鲁·休伯曼：
The way that we do that is by giving a new story or a new narrative to this experience that we call threat.
我们这样做的方式是为这种我们称之为威胁的体验提供一个新的故事或新的叙述。
And you know the threat response.
而且你知道威胁的反应。
The threat response is quickening of the heart rate, quickening of the breathing.
威胁反应是心率加快、呼吸加快。
We don't generally like the feeling of adrenaline in our system.
我们通常不喜欢我们的系统中肾上腺素的感觉。
Some people are so-called adrenaline junkies, and they get a mixture of dopamine and adrenaline from certain high-intensity events.
有些人是所谓的肾上腺素瘾君子，他们从某些高强度活动中获得多巴胺和肾上腺素的混合物。
I confess, in previous aspects of my life, I've tended to like adrenaline.
我承认，在我以前的生活中，我倾向于喜欢肾上腺素。
I don't think I was at the extreme of thrill seeking, but I'm somebody that, for instance, I tend to like roller coasters.
我不认为我是一个追求刺激的极端人，但我是一个喜欢过山车的人。
I've done various things where I'm familiar with and I enjoy the sensation of adrenaline in my body.
我做过各种我熟悉的事情，我喜欢体内肾上腺素分泌的感觉。
But I enjoy it because of the alertness that it brings and the hyperacuity that it brings.
但我喜欢它，因为它带来的警觉性和超敏锐度。
Many people don't feel that way.
很多人不这么认为。
Andrew Huberman:
安德鲁·休伯曼：
In fact, most people don't like the sensation of a lot of adrenaline in their system.
事实上，大多数人不喜欢体内大量肾上腺素的感觉。
It makes them feel very uncomfortable and out of control.
这让他们感到非常不舒服和失控。
We will do an entire episode about adrenaline and adrenaline junkies and adrenaline aversives in the future.
未来我们将制作一整集关于肾上腺素、肾上腺素成瘾者和肾上腺素厌恶者的节目。
But the threat reflex inevitably involves the release of adrenaline into the system, and then it becomes a question of whether or not you remain still, move forward or retreat from that adrenaline experience.
但威胁反射不可避免地涉及到肾上腺素释放到系统中，然后就变成了你是否保持静止、前进或从肾上腺素体验中撤退的问题。
And when I say the adrenaline experience, I mean the threat reflex.
当我说肾上腺素体验时，我指的是威胁反射。
Andrew Huberman:
安德鲁·休伯曼：
So this fourth component of fear is really our ability to attach narrative, to attach meaning and to attach purpose to what is, by all accounts and purposes, a generic response.
因此，恐惧的第四个组成部分实际上是我们将叙述、意义和目的附加到从所有方面和目的来看都是通用反应的能力。
There's no negotiating what fear feels like.
恐惧的感觉是无法协商的。
There's only negotiating what it means.
只是谈判这意味着什么。
There's only negotiating whether or not you persist, whether or not you pause, or whether or not you retreat.
只是商量要不要坚持，要不要停下来，要不要退缩。
Andrew Huberman:
安德鲁·休伯曼：
So this is usually the point in the podcast where I think people start asking, "Okay, well, there's the biology, there's the mechanism, there's the logic.
因此，我认为这通常是播客中人们开始问的一点：“好吧，有生物学，有机制，有逻辑。
How do I eliminate fear?" Well, it's not quite that simple.
如何消除恐惧？”嗯，事情没那么简单。
Although by understanding the logic and the mechanisms by which these circuits are built, we can eventually get to that place.
尽管通过理解构建这些电路的逻辑和机制，我们最终可以到达那个地方。
I do want to plant a flag around a particular type of tool, or a logical framework around a particular set of tools, rather, that we are going to build out through this episode.
我确实想围绕特定类型的工具树立一个标志，或者围绕一组特定工具建立一个逻辑框架，而是我们将通过这一集构建出来。
And based on what you now know that the threat reflex gets input, and it has outputs, and it's subject to these top-down processing events, these narratives, you should be asking yourself, "What sort of narrative should I apply to eliminate fear?"
根据你现在所知道的，威胁反射得到输入，它有输出，并且它受到这些自上而下的处理事件、这些叙述的影响，你应该问自己，“我应该采用什么样的叙述来消除恐惧？”
Andrew Huberman:
安德鲁·休伯曼：
Well, first, let's take a step back, and just acknowledged the reality, which is that fear is in some cases an adaptive response.
好吧，首先，让我们退一步，承认现实，即恐惧在某些情况下是一种适应性反应。
We don't want people eliminating fears that can get them injured or killed, right?
我们不希望人们消除可能导致他们受伤或死亡的恐惧，对吧？
The reason that the fear-threat response and reflex exists at all is to help us from dying, to help us from making really bad decisions.
恐惧威胁反应和反射存在的原因就是为了帮助我们免于死亡，帮助我们避免做出非常糟糕的决定。
It just so happens that a number of things happen to us that are not lethal, that don't harm us, but that harm us from the inside.
碰巧发生在我们身上的许多事情并不致命，不会伤害我们，但会从内部伤害我们。
And here I'm borrowing language from an excellent researcher who's done important work in this area at Harvard.
在这里，我借用了一位在哈佛大学该领域做过重要工作的优秀研究人员的语言。
His name is Dr. Kerry Ressler.
他的名字是克里雷斯勒博士。
He's both a medical doctor and a PhD, so an MD, PhD.
他既是医生又是博士，所以是医学博士、博士。
He's the Chief Scientific Officer at McLean Hospital.
他是麦克莱恩医院的首席科学官。
He's a professor of psychiatry at Harvard Medical School.
他是哈佛医学院精神病学教授。
He's done extensive and important work on fear.
他在恐惧方面做了广泛而重要的工作。
I'm going to refer back to Dr. Ressler's work several times during this podcast, including important and super interesting work on transgenerational passage of trauma.
我将在这个播客中多次回顾雷斯勒博士的工作，包括关于创伤跨代传递的重要且超级有趣的工作。
He's an absolutely world-class biologist, absolutely world-class clinician.
他绝对是世界一流的生物学家，绝对是世界一流的临床医生。
Andrew Huberman:
安德鲁·休伯曼：
Dr. Ressler has described fear before as containing a historical component.
雷斯勒博士之前曾将恐惧描述为包含历史成分。
So it's not just about a readiness for things that might injure us or kill us in the immediate circumstance, but also protecting us for the future because of our important need and ability to anticipate.
因此，这不仅仅是为在当前情况下可能伤害我们或杀死我们的事情做好准备，而且还因为我们的重要需求和预测能力而为未来提供保护。
And what he describes are memories as protective or memories as dangerous.
他所描述的是具有保护性的记忆或具有危险性的记忆。
Some memories, even if they evoke a sense of fear in us, are protective.
有些记忆即使引起我们的恐惧感，也具有保护作用。
They protect us from making bad mistakes that could get us injured or killed or put us into really horrible circumstances.
它们保护我们免于犯下可能导致我们受伤或死亡或使我们陷入非常可怕的境地的严重错误。
Other memories are dangerous because they create a sense in us of discomfort, and they tend to limit our behavior in ways that are maladaptive, that prevent us from having healthy relationships to others, healthy job relationships, healthy relationship to ourselves, frankly.
其他记忆是危险的，因为它们会给我们带来一种不适感，并且往往会以不适应的方式限制我们的行为，坦率地说，这会阻止我们与他人建立健康的关系、健康的工作关系、与自己的健康关系。
Andrew Huberman:
安德鲁·休伯曼：
So this language of memories as protective or memories as dangerous, in the context of fear, is not something that I said.
因此，在恐惧的背景下，这种将记忆视为保护性或将记忆视为危险的语言，并不是我所说的。
It's really something that I lifted from Dr. Ressler in one of his many impressive lectures.
这确实是我从雷斯勒博士众多令人印象深刻的讲座之一中学到的东西。
It's an important aspect of fear because much of the fear system is a memory system.
这是恐惧的一个重要方面，因为恐惧系统的大部分是记忆系统。
It's designed to embed a memory of certain previous experiences in us such that the threat reflex is activated in the anticipation of what might happen, okay?
它的目的是在我们体内嵌入对某些先前经历的记忆，以便在预测可能发生的事情时激活威胁反射，好吗？
Andrew Huberman:
安德鲁·休伯曼：
So let's talk for a second about how certain memories get attached to this fear system.
那么，让我们谈谈某些记忆是如何与这个恐惧系统联系在一起的。
And this brings us to a beautiful and, indeed, Nobel Prize-winning aspect of biology and physiology, which is Pavlovian conditioning.
这给我们带来了生物学和生理学中一个美丽且确实获得诺贝尔奖的方面，这就是巴甫洛夫条件作用。
Many of you are probably familiar with Pavlov's dogs and the famous Pavlovian conditioning experiments.
你们中的许多人可能熟悉巴甫洛夫的狗和著名的巴甫洛夫条件反射实验。
They go something like this.
他们是这样的。
Pavlov did these experiments.
巴甫洛夫做了这些实验。
Ring a bell, a dog doesn't do much in response to a bell.
按响铃，狗对铃没有太多反应。
It might attend to it, but it doesn't salivate, typically, in response to the bell.
它可能会注意到它，但通常不会因铃声而流口水。
However, if you pair the ringing of a bell with a presentation of food enough times, the dog will salivate in response to the food.
然而，如果你将铃声与食物的呈现结合足够多次，狗就会对食物产生唾液反应。
Eventually, you take away the food; you just ring the bell and the dog will salivate in response to the bell, okay?
最终，你拿走了食物；你只要按响铃，狗就会流口水，好吗？
Andrew Huberman:
安德鲁·休伯曼：
So in the context of so-called Pavlovian conditioning, these things have names like conditioned stimulus, and unconditioned stimulus and responses.
因此，在所谓的巴甫洛夫条件作用的背景下，这些东西有条件刺激、无条件刺激和反应等名称。
People often get these mixed up, and it can be a little confusing, but I'm just going to make it really simple for you.
人们经常把这些混为一谈，这可能有点令人困惑，但我只是想让你变得简单一些。
The unconditioned stimulus is the thing that evokes a response unconditionally.
无条件刺激是无条件引起反应的事物。
So food is the unconditioned stimulus in the example I just gave.
所以在我刚才举的例子中，食物是无条件刺激。
A foot shock or a loud bang would be the unconditioned stimulus in, for instance, an experiment geared toward exploring fear.
例如，在旨在探索恐惧的实验中，脚部震动或巨响将是无条件刺激。
That unconditioned stimulus is unconditional.
这种无条件的刺激是无条件的。
It unconditionally evokes a startle.
它无条件地引起震惊。
Or in the case of food, salivating.
或者就食物而言，流口水。
The bell in the previous example is what we call the conditioned stimulus or the conditioning stimulus-
前面例子中的铃声就是我们所说的条件刺激或者条件刺激——
Andrew Huberman:
安德鲁·休伯曼：
We call the conditioned stimulus or the conditioning stimulus.
我们称之为条件刺激或条件刺激。
Sometimes people mix these up.
有时人们会把这些混为一谈。
The conditioned stimulus is paired with the thing that naturally creates a response, and then eventually the conditioned stimulus creates the response itself.
条件刺激与自然产生反应的事物配对，然后最终条件刺激本身创造反应。
You might think, "Well, that just seems endlessly boring and simple." But this is actually the way that our fear systems work.
你可能会想，“嗯，这看起来非常无聊和简单。”但这实际上就是我们的恐惧系统的运作方式。
Except unlike Pavlov's dogs, you don't need many, many pairings of a bell with some unconditioned stimulus in order to get a response.
与巴甫洛夫的狗不同的是，你不需要很多很多的铃铛与一些无条件刺激的配对来获得反应。
Andrew Huberman:
安德鲁·休伯曼：
You can get what's called one-trial learning.
您可以获得所谓的“一次尝试学习”。
And in this circuit that involves the amygdala, the threat reflex, and all this other stuff that I was talking about earlier, the system is set up for learning.
在这个涉及杏仁核、威胁反射以及我之前谈到的所有其他东西的回路中，系统是为学习而设置的。
It's set up to create memories and to anticipate problems.
它的目的是创造记忆并预测问题。
It's a very good system because it was designed to keep us safe.
这是一个非常好的系统，因为它旨在保证我们的安全。
So the way to think about this is that for many people, one intense experience, one burn, one bad breakup, one bad experience public speaking, one bad experience with somebody's pet snake, or whatever it happens to be, can cause intense fear in the moment, a long reverberatory experience of fear, like trouble sleeping that night and the following night, memories of the experience that are troubling, physiological responses that are troubling.
因此，思考这个问题的方法是，对很多人来说，一次强烈的经历、一次烧伤、一次糟糕的分手、一次糟糕的公开演讲经历、一次与某人的宠物蛇相处的糟糕经历，或者任何发生的事情，都会在当下引起强烈的恐惧，一种长期的恐惧回响体验，比如当晚和第二天晚上睡眠困难、令人不安的经历记忆、令人不安的生理反应。
Essentially, it gets wired in as a fear with one trial, which is quite different than the other forms of neuroplasticity.
从本质上讲，它是通过一次试验而产生的恐惧，这与其他形式的神经可塑性截然不同。
Neuroplasticity, of course, just being the nervous system's ability to change in response to experience.
当然，神经可塑性只是神经系统根据经验而改变的能力。
Other forms of neuroplasticity like learning a language, learning music, learning math, those take a while.
其他形式的神经可塑性，比如学习语言、学习音乐、学习数学，这些都需要一段时间。
We don't generally get one-trial learning to positive or neutral experiences.
我们通常不会通过一次尝试就获得积极或中性的体验。
We get one-trial learning to negative experiences.
我们通过一次尝试学习负面经历。
So there's this asymmetry in how we're wired.
所以我们的连接方式存在这种不对称性。
Andrew Huberman:
安德鲁·休伯曼：
So now you should understand how classical conditioning, as it's called, occurs.
所以现在你应该了解所谓的经典条件反射是如何发生的。
You go to give a piano recital as a kid, you sit down and you freeze up, and it's horribly embarrassing.
当你还是个孩子的时候，你去参加一场钢琴演奏会，你坐下来，然后你就僵住了，这是非常尴尬的。
Even if you just freeze up for a few seconds, the heart rate increase and the perspiring, the sweating and the shame that you feel, leads you to want to avoid playing instruments or public displays of performances for a long period of time unless you do something to overcome it.
即使你只是僵住了几秒钟，心率加快、出汗、出汗和你感到的羞耻感都会导致你想要长时间避免演奏乐器或公开表演，除非你采取一些措施来克服它。
That's one-trial learning.
这就是一次尝试学习。
Andrew Huberman:
安德鲁·休伯曼：
Some people, it tends to be an accumulation of experiences.
有些人，往往是经验的积累。
They have a bad relationship that lasts an entire summer, an entire year, or God forbid a decade, and then they have what they feel is kind of a general sense of fear about closeness to others and attachment.
他们的糟糕关系持续了整个夏天、一整年，或者上帝禁止十年，然后他们对与他人的亲密和依恋产生了一种普遍的恐惧感。
These are common fears that people experience.
这些是人们经历的常见恐惧。
Fears can be in the short term, fears can be in the long term, they can be in the medium term.
恐惧可以是短期的，恐惧可以是长期的，也可以是中期的。
Again, the fear system is very generic.
再次强调，恐惧系统非常通用。
It's wired to include memories that are very acute that happen within a moment, or that include many, many events in long periods of time that kind of funnel into a general sense of, you know, relationships are bad, or this particular city or location is bad.
它包含了瞬间发生的非常敏锐的记忆，或者包括很长一段时间内发生的许多、许多事件，这些记忆会融入一种普遍的感觉，你知道，关系不好，或者这个特定的城市或地点不好。
Andrew Huberman:
安德鲁·休伯曼：
So there's a key, what we call temporal, component.
所以有一个关键，我们称之为时间成分。
There's a component of the fear system being able to batch many events in time and create one specific fear, or take one very specific isolated incident that happened very briefly and create one very large general sense of fears.
恐惧系统的一个组成部分能够及时批处理许多事件并产生一种特定的恐惧，或者采取一个非常具体的、发生非常短暂的孤立事件并产生一种非常大的普遍恐惧感。
I'll give an example of the latter just to kind of flesh this out a little bit.
我将给出后者的一个例子，只是为了稍微充实一下这一点。
I had a friend come visit me in San Francisco some years ago, and their car got broken into, unfortunately, a frequent occurrence in San Francisco even in the middle of the day.
几年前，我有一个朋友来旧金山看望我，不幸的是，他们的车被闯入，这在旧金山经常发生，即使是在中午。
Never leave anything in your car in San Francisco.
在旧金山，切勿将任何物品留在车内。
They'll break in in the middle of the day, doesn't matter.
他们会在中午闯入，没关系。
Andrew Huberman:
安德鲁·休伯曼：
Police can be having coffee right there in front of them, they'll still do it.
警察可以在他们面前喝咖啡，他们仍然会这样做。
For reasons we could discuss, this is a problem.
出于我们可以讨论的原因，这是一个问题。
They got their belongings taken, and they decided they were never coming back to San Francisco.
他们的物品被拿走了，他们决定永远不再回到旧金山。
This was an isolated incident that forever colored their view of the city, which frankly, understanding the fear system, I can understand.
这是一个孤立的事件，永远影响了他们对这座城市的看法，坦率地说，了解恐惧系统，我可以理解。
We can have isolated incidents that wick out to broad decisions about entire places, or we can have many experiences that funnel into very specific isolated fears about particular circumstances, places and things.
我们可能会经历一些孤立的事件，这些事件会影响整个地方的广泛决策，或者我们可能会有许多经历，这些经历会引发对特定情况、地点和事物的非常具体的孤立的恐惧。
Andrew Huberman:
安德鲁·休伯曼：
So I like to think that by now you have a pretty good understanding of the circuits that underlie the threat reflex, the fear response, and how we have top-down control, meaning we can attach a narrative to the fear response, and that the fear response can be learned in association with particular events, okay?
所以我想，现在你已经很好地理解了威胁反射、恐惧反应背后的回路，以及我们如何进行自上而下的控制，这意味着我们可以将叙述附加到恐惧反应上，并且恐惧反应可以与特定事件相关联来学习，好吗？
I haven't really talked about how the learning occurs, and so I just want to take a moment and describe that because it leads right into our discussion about how to eliminate fears and indeed how to replace fears with more positive experiences.
我还没有真正谈论学习是如何发生的，所以我只想花点时间描述一下，因为它直接引导我们讨论如何消除恐惧，以及如何用更积极的经历取代恐惧。
Andrew Huberman:
安德鲁·休伯曼：
There's a process in our nervous system that we call neuroplasticity.
我们的神经系统中有一个过程，我们称之为神经可塑性。
Neuroplasticity, broadly defined, is the nervous system's ability to change in response to experience.
广义上的神经可塑性是指神经系统根据经验而改变的能力。
But at a cellular level, that occurs through a couple of different mechanisms.
但在细胞水平上，这是通过几种不同的机制发生的。
One of the main mechanisms is something called long-term potentiation.
主要机制之一是所谓的长时程增强。
Long-term potentiation involves the strengthening of particular connections between neurons, the connection sites between neurons we call synapses.
长时程增强涉及加强神经元之间的特定连接，即神经元之间的连接位点，我们称之为突触。
Actually technically, synapses are the gaps between those connections.
实际上从技术上讲，突触是这些连接之间的间隙。
But nonetheless, synapses are the point of communication between neurons, and those can be strengthened so that certain neurons can talk to other neurons more robustly than they happen to before.
但尽管如此，突触是神经元之间的交流点，这些神经元可以得到加强，以便某些神经元可以比以前更强有力地与其他神经元进行交流。
Andrew Huberman:
安德鲁·休伯曼：
Anytime we talk about a particular event, the car, the snake, the public speaking, the trauma, the horrible experience wiring into the fear system, what we're talking about is a change in synaptic strengths.
每当我们谈论某个特定事件时，汽车、蛇、公开演讲、创伤、恐惧系统中的可怕经历，我们谈论的是突触强度的变化。
We're talking about neurons that previously did not communicate well communicating very well.
我们谈论的是以前不能很好地沟通的神经元。
It's like going from an old-school dial-up connection or even an old-school telephone connection or Morse code connection of communication to high-speed Ethernet, to a 5G connection.
这就像从老式的拨号连接，甚至老式的电话连接或莫尔斯电码通信连接到高速以太网，再到 5G 连接。
It gets faster, it gets more robust, and it's very, very clear.
它变得更快，更强大，而且非常非常清晰。
Andrew Huberman:
安德鲁·休伯曼：
That's what happens when you get long-term potentiation.
这就是当你获得长期增强时会发生的情况。
Long-term potentiation involves a couple of cellular mechanisms that are going to be relevant to our discussion about treatments to undo fear.
长时程增强涉及到一些细胞机制，这些机制将与我们关于消除恐惧的治疗方法的讨论相关。
I'll just throw out a couple of the names of some of those cellular elements right now.
我现在就列出其中一些细胞元素的几个名称。
The main one is the so-called NMDA receptor, N-methyl-D-aspartate receptor.
主要的一种是所谓的NMDA受体，N-甲基-D-天冬氨酸受体。
What this is is this is a little docking site, like a little parking slot on a neuron, and when a neuron gets activated very strongly, like from an intense event, in the example of my friend, the intense event almost certainly activated NMDA receptors related to their concept of protecting their property in their cars.
这是一个小对接点，就像神经元上的一个小停车位，当神经元被非常强烈地激活时，比如来自激烈的事件，在我朋友的例子中，激烈的事件几乎肯定会激活 NMDA 受体，这与他们保护汽车财产的概念有关。
Andrew Huberman:
安德鲁·休伯曼：
The break in to their car caused the NMDA receptor to be activated.
闯入他们的汽车导致 NMDA 受体被激活。
Normally, that NMDA receptor is not easily activated.
通常情况下，NMDA 受体不容易被激活。
When it is activated, it sets off a cascade, a series of signals within those neurons that change those neurons.
当它被激活时，它会引发级联，即这些神经元内的一系列信号，这些信号会改变这些神经元。
It changes the genes they express.
它改变了它们表达的基因。
It shuttles more parking spots to the surface of those cells so that the communication to those cells becomes easier.
它将更多的停车位运送到这些细胞的表面，以便与这些细胞的通信变得更加容易。
It becomes faster.
它变得更快。
So the way to think about the NMDA receptor is it's used sometimes for normal things that we do every day, making cups of coffee and things like that, but it's often used for learning.
因此，思考 NMDA 受体的方式是，它有时用于我们每天做的正常事情，泡咖啡之类的事情，但它经常用于学习。
It's used for creating new associations in our nervous system.
它用于在我们的神经系统中创建新的关联。
Andrew Huberman:
安德鲁·休伯曼：
So the activation of the NMDA receptor and LTP, and it involves some other things that you may have heard of, like brain-derived neurotrophic factors and calcium entry, things that we can leave for a discussion for a future time.
所以NMDA受体和LTP的激活，它还涉及到一些你可能听说过的其他东西，比如脑源性神经营养因子和钙进入，这些我们可以留到以后讨论。
But basically, a whole cascade of events happen within cells that then make just even the mere thought of something or somebody or some event that happened able to activate that threat reflex, okay?
但基本上，一连串的事件发生在细胞内，然后仅仅想到发生的某事、某人或某件事就能够激活威胁反射，好吗？
So long-term potentiation is one of the main mechanisms by which we take formally innocuous or irrelevant events and we make them scary.
因此，长期增强是我们将形式上无害或无关的事件视为令人恐惧的主要机制之一。
We make them traumatic.
我们让他们受到创伤。
Our neurons have mechanisms to do this.
我们的神经元有做到这一点的机制。
Andrew Huberman:
安德鲁·休伯曼：
Now, fortunately, the NMDA receptor and long-term potentiation can also run the whole system in reverse.
现在，幸运的是，NMDA 受体和长时程增强也可以反向运行整个系统。
You can get what's called long-term depression, and that doesn't have anything to do with the depression associated with low mood.
你可能会患上所谓的长期抑郁症，但这与情绪低落引起的抑郁症没有任何关系。
What we're talking about is a weakening of connections.
我们正在谈论的是联系的削弱。
You can go from having a very high-speed Ethernet connection between neurons, so to speak, to a connection that's more like Morse code or is like a poor dial-up connection or really weak signal.
可以说，你可以从神经元之间拥有非常高速的以太网连接，转变为更像摩尔斯电码的连接，或者像糟糕的拨号连接或非常弱的信号。
That's what's happening when you extinguish a fear, when you unlearn a fear.
这就是当你消除恐惧、忘却恐惧时所发生的事情。
Andrew Huberman:
安德鲁·休伯曼：
So now I'd like to talk about therapies that are carried out in humans that allow fears to be undone, that allow traumas to be reversed, such that people no longer feel bad about a particular person, place or thing — either real interactions with that person, place or thing or imagined interactions with that person, place or thing.
所以现在我想谈谈在人类身上进行的疗法，这些疗法可以消除恐惧，扭转创伤，使人们不再对某个特定的人、地方或事物感觉不好——无论是与那个人、地方或事物的真实互动，还是与那个人、地方或事物的想象互动。
That process, as I just mentioned, also involves things like the NMDA receptor, but rather than strengthening the connections, the first thing that has to happen is there needs to be a weakening of connections that associate the person, place or thing with that threat reflex.
正如我刚才提到的，这个过程还涉及 NMDA 受体之类的东西，但首先要做的不是加强联系，而是需要削弱将人、地点或事物与威胁反射联系起来的联系。
Andrew Huberman:
安德鲁·休伯曼：
Subsequent to that, we will see, there needs to be a strengthening of some new experience that's positive, okay?
接下来，我们会看到，需要加强一些积极的新体验，好吗？
This is a key element of where we are headed.
这是我们前进方向的一个关键要素。
Contrary to popular belief, it is not going to work to simply extinguish a fear.
与普遍看法相反，仅仅消除恐惧是行不通的。
One needs to extinguish a fear and or trauma and replace that fearful or traumatic memory or idea or response with a positive response.
人们需要消除恐惧和/或创伤，并用积极的反应取代恐惧或创伤性的记忆、想法或反应。
This is something that's rarely discussed both in the scientific literature, but certainly in the general discussion around fear and trauma.
这是科学文献中很少讨论的问题，但在有关恐惧和创伤的一般讨论中肯定是这样。
Andrew Huberman:
安德鲁·休伯曼：
There's this idea that we can extinguish fears, we can rewire ourselves, we can eliminate our traumas, and indeed we can.
有这样一种想法，我们可以消除恐惧，我们可以重新调整自己，我们可以消除我们的创伤，我们确实可以。
But that process has to involve not just becoming comfortable with a particular fearful event or trauma but also attaching a new positive experience to that previously fearful or traumatic event.
但这个过程不仅需要适应特定的恐惧事件或创伤，还要为之前的恐惧或创伤事件带来新的积极体验。
There are a lot of different approaches out there that are in clinical use to try and alleviate fear and trauma, and indeed, PTSD, post-traumatic stress disorder.
临床上有很多不同的方法可以尝试减轻恐惧和创伤，甚至减轻 PTSD（创伤后应激障碍）。
Andrew Huberman:
安德鲁·休伯曼：
It might be surprising to learn that many of those treatments, such as SSRIs, the selective serotonin reuptake inhibitors; things like Prozac and Zoloft and similar and other antidepressants; or things like benzodiazepines, which are essentially like painkillers.
令人惊讶的是，其中许多治疗方法，例如 SSRIs（选择性血清素再摄取抑制剂）；诸如百忧解（Prozac）和左洛复（Zoloft）以及类似药物和其他抗抑郁药；或苯二氮卓类药物，本质上就像止痛药。
They create elevation in certain transmitters in the brain like GABA, among others.
它们会导致大脑中某些递质（如 GABA 等）升高。
They can have a pain-relieving effect.
它们可以起到缓解疼痛的作用。
They are generally, however, considered anxiolytics, they reduce anxiety, and even antipsychotic drugs or beta blockers, sometimes called adrenergic blockers, drugs that are designed to prevent the heart from beating too fast or to reduce blood pressure, to reduce some elements of that hypothalamic-pituitary axis response that we talked about earlier.
然而，它们通常被认为是抗焦虑药，可以减轻焦虑，甚至是抗精神病药或β受体阻滞剂，有时称为肾上腺素能阻滞剂，这些药物旨在防止心脏跳动过快或降低血压，以减少我们之前讨论过的下丘脑-垂体轴反应的某些要素。
Andrew Huberman:
安德鲁·休伯曼：
Many people experience some degree of relief from the symptoms of anxiety and fear and PTSD in taking these various compounds.
许多人在服用这些不同的化合物后，焦虑、恐惧和创伤后应激障碍的症状得到了一定程度的缓解。
Indeed, that's why they're prescribed so broadly.
事实上，这就是为什么它们的规定如此广泛。
But you may find it interesting to note that none of those current treatments are based on the neurobiology of fear, at least not directly, right?
但您可能会发现有趣的是，目前的治疗方法都不是基于恐惧的神经生物学，至少不是直接的，对吗？
People that take SSRIs oftentimes will experience a reduction in anxiety.
经常服用 SSRI 的人的焦虑感会减轻。
It depends on the dosage and the individual, of course, all right?
当然，这取决于剂量和个人，好吗？
You have to work with a doctor, a psychiatrist, to determine whether or not they're right for you, and the correct dosage if they are right for you.
您必须与医生、精神科医生合作，以确定它们是否适合您，以及是否适合您的正确剂量。
Andrew Huberman:
安德鲁·休伯曼：
But that modulation of anxiety can indirectly reduce the likelihood that one will have a panic attack or experience a fear or an intense experience of fear or reliving of a trauma.
但这种焦虑的调节可以间接降低一个人惊恐发作或经历恐惧或强烈的恐惧经历或重温创伤的可能性。
But the SSRIs themselves are not plugging into some specific mechanism related to how fear comes about in the system.
但 SSRI 本身并没有插入与系统中如何产生恐惧相关的某些特定机制。
It's an indirect support.
这是一种间接的支持。
That's important because if the goal of modern psychiatry and the goal of modern biology is to provide mechanistic understanding that leads to treatments, we need to think about what are the sorts of treatments that tap into the very fear circuits that we described before.
这很重要，因为如果现代精神病学和现代生物学的目标是提供导致治疗的机制理解，那么我们需要考虑什么样的治疗方法可以利用我们之前描述的恐惧回路。
Andrew Huberman:
安德鲁·休伯曼：
The fact that there are memories attached to a generic threat reflex and response, and the threat reflex response can be linked up with the dopamine system and can be linked up with other systems that are involved in pain relief and anxiety, and so forth.
事实上，存在与一般威胁反射和反应相关的记忆，并且威胁反射反应可以与多巴胺系统连接，并且可以与涉及疼痛缓解和焦虑等的其他系统连接。
So that brings us to which treatments are directly related to the fear circuitry and the circuitry related to trauma.
因此，这给我们带来了哪些治疗与恐惧回路和与创伤相关的回路直接相关。
The primary one to begin with is the so-called behavioral therapies.
第一个开始是所谓的行为疗法。
Andrew Huberman:
安德鲁·休伯曼：
Now, oftentimes we all wish, I think, from time to time, that there's some specific pill that we can take, or there's some machine or device that we can plug our finger into, or that we can put on a headset, and all of a sudden we just rewire our nervous system.
现在，我想，我们时不时地都希望有一些特定的药片可以服用，或者有一些机器或设备可以让我们的手指插入，或者我们可以戴上耳机，突然间我们就重新连接了我们的神经系统。
Fear is gone, trauma's gone, but it doesn't work that way.
恐惧消失了，创伤消失了，但事情并非如此。
When we think of language and narrative as a tool to rewire our nervous system, in comparison to those kinds of ideas about pills and machines and potions, it starts to seem a little bit weak, right?
当我们将语言和叙事视为重新连接我们神经系统的工具时，与那些关于药丸、机器和魔药的想法相比，它开始显得有点弱，对吧？
If we just think, "Oh, well, how could talking actually change the way that we respond to something?"
如果我们只是想，“哦，好吧，说话怎么能真正改变我们对某事的反应方式呢？”
Andrew Huberman:
安德鲁·休伯曼：
But actually, there are three forms of therapy that purely through the use of language have been shown to have very strong positive impact, meaning reduced fears and traumas.
但实际上，三种纯粹通过使用语言的治疗形式已被证明具有非常强烈的积极影响，意味着减少恐惧和创伤。
Those three are prolonged exposure therapy, cognitive processing, or CPT, and cognitive behavioral therapy.
这三种疗法是长期暴露疗法、认知处理疗法（CPT）和认知行为疗法。
I'm not going to go into the entire literature around prolonged exposure, cognitive processing and cognitive behavioral therapy, but I will just illustrate the central theme that allows them to work.
我不会深入探讨有关长期接触、认知处理和认知行为疗法的全部文献，但我只会说明使它们发挥作用的中心主题。
Now, remember that the circuit for fear, the circuit for trauma, involves this generic reflex, and then there are those top-down elements coming from the forebrain.
现在，请记住，恐惧回路、创伤回路涉及这种通用反射，然后还有来自前脑的自上而下的元素。
Andrew Huberman:
安德鲁·休伯曼：
It's very clear, because it's been measured, that if you look at the amount of anxiety, the pure physiological anxiety response of quickening of heart rate, flushing of the skin, sometimes quaking of the hands, that the experience of fear over time when people recount or retell their trauma, that the first time they do that, especially when it's recounted in a lot of detail, there's a tremendous anxiety response, sometimes even as great or greater than the actual exposure to the fearful event or trauma.
很明显，因为已经测量过，如果你观察焦虑的程度，心率加快、皮肤潮红、有时双手颤抖等纯粹的生理性焦虑反应，当人们讲述或重述他们的创伤时，随着时间的推移，他们会经历恐惧，当他们第一次这样做时，尤其是在详细叙述时，会出现巨大的焦虑反应，有时甚至与实际暴露于可怕事件或创伤时一样强烈或更大。
Obviously, this is something that is done with a clinician present because it is very traumatic to the person.
显然，这是在临床医生在场的情况下完成的，因为这会给人带来很大的创伤。
They're literally reliving the trauma in full rich detail, and they are encouraged to provide full rich detail.
他们实际上是在以完整丰富的细节重温创伤，并且鼓励他们提供完整丰富的细节。
Andrew Huberman:
安德鲁·休伯曼：
They're often encouraged to speak in complete sentences, to flesh out details about how they felt inside, to flesh out details about their memories going into this traumatic or fearful event, going through it, and after really digging into all the nuance and contours of these horrible experiences.
他们经常被鼓励用完整的句子说话，充实他们内心感受的细节，充实他们对这一创伤或可怕事件的记忆的细节，经历它，并在真正深入挖掘这些可怕经历的所有细微差别和轮廓之后。
But what's remarkable is that in the second and the third and the fourth retelling of these traumatic or fearful events, that anxiety response and the amount of the physiological response, I should say the amplitude of the physiological response, becomes progressively diminished with each retelling.
但值得注意的是，在第二次、第三次和第四次重述这些创伤性或恐惧事件时，焦虑反应和生理反应的量，我应该说生理反应的幅度，随着每次重述而逐渐减弱。
Andrew Huberman:
安德鲁·休伯曼：
Now, some of you might be saying, "Well, duh.
现在，你们中的一些人可能会说：“嗯，呃。
Tell a story enough times, that eventually it wears off." Just like if you watch a movie enough times, and you hear the same joke enough times, eventually it doesn't have the same impact.
把一个故事讲得足够多，最终它就会消失。”就像如果你看一部电影足够多的次数，并且你听到同一个笑话足够多的次数，最终它不会产生同样的影响。
But that may be the case, right?
但情况可能就是这样，对吧？
You could imagine that this high-amplitude anxiety response, this high-amplitude activation of the sympathetic nervous system in retelling would actually create an even deeper-routed fear response and trauma.
你可以想象，这种高强度的焦虑反应，这种复述中交感神经系统的高强度激活实际上会产生更深层次的恐惧反应和创伤。
But that's not what happens.
但事实并非如此。
Andrew Huberman:
安德鲁·休伯曼：
Every clinician I spoke to in anticipation of this episode, which include clinical psychologists, psychiatrists, and people who actually work on the fear system at a biological level, said the exact same thing, which is that a detailed recounting of the traumatic and fearful events is absolutely essential in order to get the positive effects of prolonged exposure, cognitive processing and cognitive behavioral therapy.
我在预期这一事件时采访过的每一位临床医生，包括临床心理学家、精神病学家和在生物学层面上实际研究恐惧系统的人，都说了完全相同的事情，那就是，为了获得长期暴露、认知处理和认知行为治疗的积极效果，详细叙述创伤和恐惧事件是绝对必要的。
Again, this has to be done with the appropriate support.
同样，这必须在适当的支持下完成。
This isn't something that should be taken lightly because as we've mentioned before, the fear response can have a very long-lasting contour to it.
这不应该掉以轻心，因为正如我们之前提到的，恐惧反应可以有一个非常持久的轮廓。
Andrew Huberman:
安德鲁·休伯曼：
People can sometimes have trouble sleeping for days and days, and afterwards we'll talk about sleeping a little bit.
人们有时会连续几天都难以入睡，之后我们会谈谈睡眠。
But the point is that the retelling is important.
但重点是，复述很重要。
The idea here is to take what was a terrible and extremely troubling, meaning physiologically troubling, psychologically troubling story, and turn it into what is essentially a boring bad story, okay?
这里的想法是把一个可怕的、极其令人不安的故事，即生理上令人不安、心理上令人不安的故事，变成本质上无聊的坏故事，好吗？
It never really becomes a good story at this point in the treatment process that we're describing.
在我们所描述的治疗过程的这一点上，它永远不会真正成为一个好故事。
Andrew Huberman:
安德鲁·休伯曼：
So, a terrible event is a terrible event, period.
所以，可怕的事件就是可怕的事件。
But there's a way in which the retelling of that event starts to uncouple the threat reflex from the narrative.
但通过某种方式，重述该事件开始将威胁反射与叙述脱钩。
With each successive retelling in detail of these traumatic events, of these fearful events, the threat reflex is activated at a progressively lower and lower amplitude, such that eventually it just becomes a really bad, really boring story.
随着每一次连续详细地重述这些创伤性事件、这些可怕的事件，威胁反射的激活幅度逐渐降低，最终变成一个非常糟糕、非常无聊的故事。
Now, that's one part of the process of getting over a fear.
现在，这是克服恐惧过程的一部分。
It's what we call fear extinction.
这就是我们所说的恐惧灭绝。
Andrew Huberman:
安德鲁·休伯曼：
We can bring ourselves back to our earlier example of Pavlovian conditioning because many studies have been done, both in animals and in humans, showing that, for instance, if you pair a tone, a bell or a buzzer, with a foot shock, that an animal or a person will brace themselves for the foot shock.
我们可以回到前面的巴甫洛夫条件反射的例子，因为已经在动物和人类身上进行了许多研究，表明，例如，如果你将声音、铃声或蜂鸣器与脚部震动配对，动物或人就会为脚部震动做好准备。
Eventually you can just give the bell or tone, and the person will experience that same freezing up or that same fight or flight or freeze response.
最终，你只需发出铃声或音调，人们就会经历同样的冻结或同样的战斗、逃跑或冻结反应。
So they condition that.
所以他们提出了这样的条件。
But if you give the tone or the bell over and over and there's no foot shock, there's no pain, and in humans this is sometimes done with foot shock, sometimes, believe it or not, with mild burn, there are even some studies, there's older studies, you couldn't do those now, nor would you want to.
但如果你一遍又一遍地发出声音或铃声，没有脚部震动，就没有疼痛，而在人类中，这有时是通过脚部震动来完成的，有时，信不信由你，轻微烧伤，甚至有一些研究，有较早的研究，你现在不能做这些，你也不想这样做。
Andrew Huberman:
安德鲁·休伯曼：
But eventually what happens is the tone, the bell no longer evokes that response, okay?
但最终发生的是音调，铃声不再引起那种反应，好吗？
So you see this as a reversal of the classical conditioning, and we call that reversal "extinction." So the retelling of this traumatic or fearful narrative is essentially an extinction process.
所以你认为这是经典条件反射的逆转，我们称这种逆转为“灭绝”。因此，这种创伤性或恐惧性叙事的重述本质上是一个灭绝的过程。
Now, how is this done?
现在，这是如何完成的？
One can do this in a therapist's office face-to-face.
人们可以在治疗师的办公室面对面地这样做。
That's sometimes done.
有时就是这么做的。
It's sometimes done in group-type settings where people actually stand up or sit in front of a group, small or large, and recount in detail their traumatic experience.
有时，它是在团体类型的环境中进行的，人们实际上站起来或坐在一群人（无论大小）面前，详细叙述他们的创伤经历。
Andrew Huberman:
安德鲁·休伯曼：
It's sometimes done by people writing out the experience in detail, and which one of these is most effective isn't really clear.
有时，人们会详细地写出经验来完成这一工作，但其中哪一项最有效还不清楚。
The literature points to the fact that a feeling of trust, obviously, between the patient and the clinician or the person and the group is essential, some people don't access to because of finances or other limitations to therapy of that sort.
文献指出这样一个事实，显然，患者与临床医生或个人与团体之间的信任感至关重要，有些人由于财务或此类治疗的其他限制而无法获得信任感。
In that case, journaling in detail has been shown to be effective, although again, I want to caution people about reactivating traumas without consideration for the kinds of social support they might need around that reactivation.
在这种情况下，详细记录日记已被证明是有效的，尽管我想再次提醒人们不要重新激活创伤，而不考虑他们在重新激活时可能需要的社会支持类型。
We will talk a little bit later about some of the chemicals involved in social support, and why those help extinguish fears.
稍后我们将讨论一些与社会支持有关的化学物质，以及为什么它们有助于消除恐惧。
Andrew Huberman:
安德鲁·休伯曼：
So the thing to embed in your mind is that recognition of the early traumatic or fearful event in detail over and over is key to forming a new nontraumatic association with that event or person.
因此，要牢记在心的是，一遍又一遍地详细认识早期的创伤性或可怕事件，是与该事件或人形成新的非创伤性关联的关键。
So that's part one.
这是第一部分。
You need to diminish the old experience.
你需要减少旧的经历。
When I say diminish, I mean reduce the amplitude of the physiological response.
当我说减少时，我的意思是减少生理反应的幅度。
Now, this is just but one approach.
现在，这只是一种方法。
I'm going to talk about other approaches to eliminating fear and trauma as we go forward, but I want to emphasize that diminishing the amplitude of the physiological response is the first step.
在我们前进的过程中，我将讨论消除恐惧和创伤的其他方法，但我想强调的是，第一步是减少生理反应的幅度。
Andrew Huberman:
安德鲁·休伯曼：
So it's like a clearing away of the association between the person, place or thing and that threat reflex.
因此，这就像清除人、地点或事物与威胁反射之间的关联。
But even after that's occurred, there's an essential need to relearn a new narrative.
但即使在这种情况发生之后，仍然有必要重新学习新的叙述方式。
Why is there essential need to relearn a new narrative or create a new association?
为什么有必要重新学习新的叙述或创建新的关联？
Well, that has to do with that fear reflex circuitry.
嗯，这与恐惧反射电路有关。
As you recall, there are outputs to areas of the brain that are associated with dopamine release and reinforcement, and that we now know offers the capacity for these fear circuits and these circuits that underlie trauma to be mapped onto new experiences that are of positive association.
你还记得吗，大脑中与多巴胺释放和强化相关的区域有输出，我们现在知道这些输出可以将这些恐惧回路和这些构成创伤的回路映射到具有积极关联的新体验上。
Andrew Huberman:
安德鲁·休伯曼：
So I'm going to give a kind of basic example.
所以我将举一个基本的例子。
It's a kind of silly example, but I'm giving it as a template for what could be any number of other different examples.
这是一个愚蠢的示例，但我将其作为可能有许多其他不同示例的模板。
Example I'll give is let's say a kid is biking to play soccer, soccer practice, and they get into a bad car accident, okay?
我举的例子是，假设一个孩子骑自行车去踢足球，练习足球，然后他们遭遇了一场严重的车祸，好吗？
Terrible thing to happen, but they survive, they recover.
可怕的事情发生了，但他们活了下来，他们康复了。
We really don't know why certain fear memories get wired in more broadly or more narrowly; somehow this kid just doesn't even want bicycle anymore, and they actually don't even want to play sports, and they actually just don't want to go anywhere.
我们真的不知道为什么某些恐惧记忆会变得更广泛或更狭窄；不知何故，这个孩子甚至不再想要自行车了，他们实际上甚至不想参加运动，他们实际上只是不想去任何地方。
Andrew Huberman:
安德鲁·休伯曼：
They're kind of isolating and not interacting with friends very much at all.
他们有点孤立，根本不与朋友互动。
It's a pretty broad response.
这是一个相当广泛的回应。
It didn't have to be that way.
事情本来不必如此。
Some kids would just decide they don't want to cycle anymore down that particular street.
有些孩子会决定不再沿着那条特定的街道骑自行车。
Well, the process of retelling the narrative to a clinician would allow an extinction of the fear response, right?
好吧，向临床医生复述故事的过程可以消除恐惧反应，对吗？
So a reduction in the heart rate, a reduction in the narrowing of focus, a reduction in all the things that we consider fear.
因此，心率降低，焦点范围缩小，所有我们认为恐惧的事情都减少。
But a really good cognitive behavioral therapist or somebody that understands the neuroscience of fear and trauma would understand that that's not sufficient.
但真正优秀的认知行为治疗师或了解恐惧和创伤神经科学的人会明白这还不够。
Andrew Huberman:
安德鲁·休伯曼：
That what's really important is that this child, this hypothetical child, relearn a new narrative, that they don't just manage to bike to soccer practice or manage to spend time with friends, but that they actually start wiring in new positive associations with biking to practice, with playing soccer, with social events, and this is the somewhat surprising feature of this, and that they link that back to that early traumatic experience, that it's not just that they're replacing a bad experience and memory with a good experience and memory, but they're actually holding in mind in these top-down narrative circuits, if you will.
真正重要的是，这个孩子，这个假设的孩子，重新学习一种新的叙述，他们不只是设法骑自行车去足球训练或设法与朋友共度时光，而是他们实际上开始与骑自行车练习、踢足球、社交活动建立新的积极联系，这是其中有点令人惊讶的特征，他们将其与早期的创伤经历联系起来，这不仅仅是他们用良好的经历和记忆取代了糟糕的经历和记忆，而且如果你愿意的话，他们实际上是在这些自上而下的叙事循环中记住的。
Andrew Huberman:
安德鲁·休伯曼：
They're holding in mind, "Ah, I'm not just biking to soccer practice.
他们牢记：“啊，我不仅仅是骑自行车去参加足球训练。
I'm actually biking to soccer practice, and I'm enjoying it despite the fact that I was in a bad car accident, despite the fact that two months ago or two years ago, or maybe even 10 years ago, I couldn't even leave my room, or I didn't want to associate with anybody." So the building up of the positive associations are key, and the linking of those positive associations with the earlier traumatic event is key for the following reason:
我实际上正在骑自行车去参加足球训练，我很享受它，尽管我遭遇了一场严重的车祸，尽管事实上两个月前或两年前，甚至十年前，我什至不能离开我的房间，或者我不想与任何人交往。”因此，建立积极的关联是关键，而将这些积极的关联与早期创伤事件联系起来也是关键，原因如下：
Andrew Huberman:
安德鲁·休伯曼：
The top-down circuitry from the prefrontal cortex to this threat reflex circuit is not like the other connections in that circuit.
从前额叶皮层到威胁反射电路的自上而下的电路与该电路中的其他连接不同。
The other connections in that circuit are what we call "glutamatergic" and "excitatory." They are all about activating other neurons, like a chain reaction, one neuron activates the next, activates the next like dominoes falling.
该回路中的其他连接就是我们所说的“谷氨酸能”和“兴奋性”。它们都是为了激活其他神经元，就像连锁反应一样，一个神经元激活下一个神经元，再激活下一个神经元，就像多米诺骨牌倒下一样。
These top-down circuits that feed into the threat reflex and all its parts is what we call inhibitory.
这些进入威胁反射及其所有部分的自上而下的电路就是我们所说的抑制性电路。
It tends to prevent activation of those given circuitries.
它往往会阻止那些给定电路的激活。
It tends to prevent activation of the threat reflex.
它往往会阻止威胁反射的激活。
So it's acting as a brake.
所以它起到了刹车的作用。
Andrew Huberman:
安德鲁·休伯曼：
So when we think of positive experiences being associated with what was previously a negative experience, we're not talking about forgetting that the car accident was horrible or forgetting that the assault was absolutely dreadful.
因此，当我们将积极的经历与之前的消极经历联系起来时，我们并不是在谈论忘记车祸是可怕的，或者忘记袭击是绝对可怕的。
We're talking about attaching a new positive memory to the circuitry, so that the previous fear response is far less likely to occur and that it remains extinguished.
我们谈论的是在电路上附加一个新的积极记忆，这样以前的恐惧反应就不太可能发生，并且它仍然会消失。
So just to make sure this is absolutely clear, there's a first step, which involves retelling and reliving in order to extinguish the fear and the trauma, to reduce the amplitude of the response.
因此，为了确保这一点绝对清楚，第一步是重述和重温，以消除恐惧和创伤，减少反应的幅度。
Andrew Huberman:
安德鲁·休伯曼：
Then there's a need to replace or attach positive experiences to the earlier, what would be, traumatic response.
然后需要将积极的经历替换或附加到早期的创伤性反应上。
The extinction has to go first.
灭绝必须先行。
This is key.
这是关键。
You can't simply say, "Oh, the car accident was actually a good thing because I stayed home a lot that year and I got to study." You can tell yourself that, and that could also be true, but that won't necessarily and probably won't eliminate the fear or the traumatic association of the car accident.
你不能简单地说，“哦，车祸其实是一件好事，因为那一年我呆在家里，我可以学习。”你可以告诉自己，这也可能是真的，但这不一定也可能不会消除车祸带来的恐惧或创伤。
Again, I'm using car accident as a general example, or generic example, here.
再次，我在这里使用车祸作为一般示例或一般示例。
Andrew Huberman:
安德鲁·休伯曼：
Okay, so there's the three-part process.
好的，这就是三部分的过程。
One, diminish the old experience through repetitive narrative, and almost inevitably, the initial repetition of that is going to be very high amplitude and quite troubling.
第一，通过重复的叙述来减少旧的经验，几乎不可避免地，最初的重复将是非常高的幅度并且相当令人不安。
But over time, it will reduce, right?
但随着时间的推移，它会减少，对吗？
You're turning the terrible, really upsetting story into a terrible boring story.
你正在把一个可怕的、令人心烦意乱的故事变成一个可怕无聊的故事。
That's the extinction process.
这就是灭绝的过程。
Then there's a relearning of a new narrative that includes some sort of sense of reward, and that sense of reward has to be tacked back onto the traumatic event or what was previously a traumatic event.
然后，需要重新学习一种新的叙述，其中包括某种奖励感，而这种奖励感必须重新回到创伤性事件或以前的创伤性事件中。
Andrew Huberman:
安德鲁·休伯曼：
That is all through narrative.
这都是通过叙述来实现的。
It's all through cognition.
这都是通过认知来实现的。
I think this is a very important point.
我认为这是非常重要的一点。
Oftentimes, I think we tend to undervalue the importance of rationalization and of story and of narrative, but the prefrontal cortex is this amazing capacity of our brain real estate to create meaning, to attach meaning and purpose to things that otherwise are just reflexive.
很多时候，我认为我们倾向于低估合理化、故事和叙事的重要性，但前额叶皮层是我们大脑中创造意义的惊人能力，可以将意义和目的赋予那些本能的事物。
In the example of an ice bath, it might be a little trivial.
在冰浴的例子中，这可能有点微不足道。
In the example of the kid with a car accident, it becomes a little more relevant.
在发生车祸的孩子的例子中，它变得更加相关。
Andrew Huberman:
安德鲁·休伯曼：
And in the example of things like people surviving genocide or attaching stories of great victory to what were previously thought of as stories of great loss — of time, of people, of any number of things — that process of narrative is one of the major ways that the human brain rewires itself.
在诸如种族灭绝中幸存的人们或将伟大胜利的故事附加到以前被认为是时间、人员或任何数量的巨大损失的故事中的例子中，叙事过程是人类大脑重新连接自身的主要方式之一。
Narrative should not be undervalued as a tool for relieving fear and trauma.
叙事作为缓解恐惧和创伤的工具，不应被低估。
In fact, narrative is one of the best and most potent ways that we can rewire our fear circuitry, and that indeed we can form completely new relationships to things over time.
事实上，叙事是我们重新连接恐惧回路的最好、最有效的方式之一，而且随着时间的推移，我们确实可以与事物形成全新的关系。
Andrew Huberman:
安德鲁·休伯曼：
So basically, narratives should not be undervalued as a tool to rewire our nervous system, but it has to be engaged in the correct sequence.
因此，基本上，叙事作为重新连接我们神经系统的工具不应被低估，但它必须以正确的顺序进行。
That correct sequence is first, extinction, then relearning a new narrative with positive associations and attaching those positive associations to the formerly traumatic or fearful event.
正确的顺序是首先是灭绝，然后重新学习具有积极联想的新叙述，并将这些积极联想与以前的创伤或恐惧事件联系起来。
Now, I mentioned prolonged exposure therapy, cognitive processing and cognitive behavioral therapy.
现在，我提到了延长暴露疗法、认知处理和认知行为疗法。
For those of you that are seeking relief from fear and traumatic events, you can look up licensed clinicians that can carry out one or several of those types of therapies.
对于那些寻求摆脱恐惧和创伤事件的人来说，您可以查找有执照的临床医生，他们可以进行其中一种或几种类型的治疗。
Andrew Huberman:
安德鲁·休伯曼：
I get a lot of questions about other forms of therapy.
我收到很多关于其他形式的治疗的问题。
One of the ones that comes up a lot is so-called EMDR, eye movement desensitization reprocessing, developed by Francine Shapiro in the '80s.
其中经常出现的方法之一是所谓的 EMDR，即眼动脱敏再处理，由 Francine Shapiro 在 80 年代开发。
Eye movement desensitization reprocessing involves moving the eyes side to side while recounting a traumatic or fearful narrative, typically with a clinician present.
眼动脱敏再处理涉及在讲述创伤或恐惧的叙述时左右移动眼睛，通常有临床医生在场。
Why would that work?
为什么那会起作用？
Well, basically, when I first heard about EMDR, from my stance as a vision scientist, I thought the whole thing was kind of crazy and half-baked, frankly.
好吧，基本上，当我第一次听说 EMDR 时，从我作为视觉科学家的立场来看，坦率地说，我认为整个事情有点疯狂和不成熟。
Andrew Huberman:
安德鲁·休伯曼：
I heard these theories that, "Oh, it recreates the eye movements in rapid eye movement sleep, or REM sleep." That's completely false.
我听到这些理论，“哦，它重现了快速眼动睡眠或快速眼动睡眠中的眼球运动。”那是完全错误的。
It does not.
事实并非如此。
I heard the argument, EMDR activates both sides of the brain, which I guess hypothetically was thought to be important somehow.
我听到了这样的论点，EMDR 激活了大脑的两侧，我想这在某种程度上被认为是重要的。
Frankly, there's no evidence whatsoever that EMDR activates both sides of the brain in a way that's beneficial.
坦率地说，没有任何证据表明 EMDR 能够以有益的方式激活大脑两侧。
I mean, by looking from side to side, just because of the way that binocular visual circuits are organized, it will do that.
我的意思是，通过从一侧看向另一侧，仅仅因为双眼视觉回路的组织方式，它就能做到这一点。
Andrew Huberman:
安德鲁·休伯曼：
But it never made any sense to me why EMDR would work until several years ago when I saw, because I reviewed no fewer than five papers, some in animal models, others in humans, looking at lateral eye movements, meaning eye movements from side to side with eyes open, not eyes up or down.
但直到几年前我看到时，我才明白为什么 EMDR 会起作用，因为我审阅了不少于五篇论文，其中一些是动物模型，另一些是人类，研究横向眼球运动，即睁眼时从一侧到另一侧的眼球运动，而不是向上或向下的眼睛运动。
What was observed in these experiments, in all of them, actually, all five of those papers, was a dramatic reduction in the activation, and actually an inhibition, a suppression of the fear or threat reflex circuitry, which was a jaw dropper for me.
在这些实验中，实际上，在所有五篇论文中，观察到的是激活的急剧减少，实际上是抑制，对恐惧或威胁反射电路的抑制，这对我来说是一个令人惊叹的结果。
Andrew Huberman:
安德鲁·休伯曼：
I thought, "Wow, that actually was a jaw dropper." Eye widener for me.
我想，“哇，这真是令人惊叹不已。”让我睁大眼睛。
I thought, "Oh my goodness, maybe this EMDR stuff works according to some mechanism, and maybe this is the mechanism." Indeed, many laboratories, not mine, but many laboratories are now pursuing that idea, and it's looking very likely.
我想，“天哪，也许 EMDR 的东西是根据某种机制起作用的，也许这就是机制。”事实上，很多实验室，不是我的，但现在很多实验室都在追求这个想法，而且看起来很有可能。
Why would that happen?
为什么会发生这种情况？
Well, just very briefly, lateralized eye movements of the sort that I'm describing, and I'm moving my hand like this, but I'll just do it with my eyes even though it's a little embarrassing to do that because I know it looks strange.
嗯，只是非常简单地，我所描述的那种侧向眼球运动，我像这样移动我的手，但我只会用我的眼睛来做，尽管这样做有点尴尬，因为我知道它看起来很奇怪。
I don't mind because I'm doing EMDR.
我不介意，因为我正在做 EMDR。
Andrew Huberman:
安德鲁·休伯曼：
EMDR reduces activation of the amygdala and related circuitries, which reduces anxiety and reduces the amplitude of the threat reflex, reduces sympathetic autonomic arousal.
EMDR 减少杏仁核和相关回路的激活，从而减少焦虑并降低威胁反射的幅度，减少交感神经自主兴奋。
In other words, we feel calmer, or we feel less alert, less stressed when moving our eyes from side to side.
换句话说，当我们的眼睛从一侧移动到另一侧时，我们会感到更平静，或者感觉不那么警觉，压力更小。
Just a story about this is that these are the sorts of eye movements that we do when we are ambulating, moving through space through some sort of self-generated motion.
关于这个的一个故事是，这些是我们在行走时所做的眼球运动，通过某种自生运动在空间中移动。
One can make up a pretty reasonable story in the evolutionary context or ethological context, that forward movement and fear are generally incompatible with one another, that generally a fear response involves a freezing or a retreating.
人们可以在进化背景或行为学背景下编造一个相当合理的故事，前进的运动和恐惧通常是彼此不相容的，通常恐惧反应涉及冻结或后退。
Andrew Huberman:
安德鲁·休伯曼：
Some people will advance, but that's usually a trained advance in response to fear, so first responders, and so forth.
有些人会前进，但这通常是为了应对恐惧而训练有素的前进，所以急救人员等等。
Most people freeze or retreat when they're afraid.
大多数人在害怕时都会僵住或退缩。
Forward movement generates these eye movements.
向前运动会产生这些眼球运动。
It does seem to suppress activation of this threat reflex and the amygdala, in particular.
它似乎确实抑制了这种威胁反射和杏仁核的激活，尤其是。
So for the many EMDR practitioners out there, these papers I think are a great celebration.
因此，对于许多 EMDR 从业者来说，我认为这些论文是一次伟大的庆祝。
I think there is now increasing excitement about EMDR in the psychiatric and psychological community for its utility for treating fear, trauma and PTSD.
我认为现在精神病学和心理学界对 EMDR 越来越感兴趣，因为它在治疗恐惧、创伤和创伤后应激障碍 (PTSD) 方面具有实用性。
Andrew Huberman:
安德鲁·休伯曼：
However, I should point out that in discussing EMDR with various colleagues of mine at Stanford and elsewhere, I was told that EMDR has been shown to be beneficial in particular for single-event-type traumas or fearful experiences, not so much for relieving the trauma or feelings of fear associated, for instance, with an entire bad marriage or an entire childhood, but more for single, more acute events that can be described within a very, kind of, brief narrative, brief not necessarily in time, but the car accident ...
然而，我应该指出的是，在与斯坦福大学和其他地方的同事讨论 EMDR 时，我被告知 EMDR 已被证明对缓解单一事件类型的创伤或恐惧经历特别有益，而不是缓解与整个糟糕的婚姻或整个童年相关的创伤或恐惧感，而是更适合单个、更尖锐的事件，这些事件可以用非常简短的叙述来描述，简短的不一定是及时的，但车祸......
PART 1 OF 3 ENDS Andrew Huberman:
第 1 部分（共 3 部分）结束 Andrew Huberman：
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...
Brief, not necessarily in time, but the car accident, the bad interaction with another individual, the assault, God forbid, these sorts of things.
简短，不一定是及时的，但是车祸，与另一个人的不良互动，攻击，上帝禁止，诸如此类的事情。
And I realize we're down in the weeds of topics that are unpleasant, so I have great sensitivity to that, but I think it's also important that we be realistic about the kinds of things that traumatize people.
我意识到我们陷入了令人不快的话题之中，所以我对此非常敏感，但我认为我们对那些给人们带来创伤的事情保持现实也很重要。
So is EMDR useful?
那么EMDR有用吗？
Well, it seems like it works for these single event or kind of constrained-event-type traumas, that people can describe while moving their eyes from side to side, generally in the presence of a clinician.
嗯，它似乎适用于这些单一事件或某种受限事件类型的创伤，人们可以在将眼睛从一侧移动到另一侧时进行描述，通常是在临床医生在场的情况下。
Andrew Huberman:
安德鲁·休伯曼：
However, if we think back to the model of how you extinguish and then replace a trauma or fear, remember you have to diminish the old experience, the amplitude of that.
然而，如果我们回想一下如何消除并取代创伤或恐惧的模型，请记住，您必须减少旧的经历及其幅度。
That's the extinguish portion.
这就是熄灭的部分。
Then you need to relearn a new narrative and attach reward to the old traumatic event.
然后你需要重新学习新的叙述，并对旧的创伤事件给予奖励。
EMDR only really taps into the extinction of the physiological response to the old experience.
EMDR 只是真正利用了对旧经历的生理反应的消失。
I'm sure that there are EMDR practitioners out there that are thinking about the attaching of the new narrative and reward, but there I've heard less and I've seen fewer peer-reviewed papers on that.
我确信有 EMDR 从业者正在考虑附加新的叙述和奖励，但我听到的更少，看到的同行评审论文也更少。
Andrew Huberman:
安德鲁·休伯曼：
So let's think about this logically.
那么让我们从逻辑上思考一下这个问题。
Let's say, and indeed it's the case, that sitting down in a chair, moving eyes side to side deliberately for some period of time, reduces activation of the threat reflex.
假设，事实确实如此，坐在椅子上，刻意地左右移动眼睛一段时间，会减少威胁反射的激活。
I, or the patient in this case, recites or repeats over and over the traumatic event or the fearful event.
我，或者这种情况下的病人，一遍又一遍地背诵或重复创伤事件或可怕的事件。
I'm doing that in the presence of a lower-amplitude response.
我是在存在较低幅度响应的情况下这样做的。
Remember back to where we talked about how the retelling works best if the first time it's done there's a huge amplitude response, and then with each successive repeat, that response, the threat response, gets lower and lower.
还记得我们讨论过如果第一次重述时有一个巨大的振幅响应，那么重述效果如何最好，然后随着每次连续的重复，该响应，威胁响应，变得越来越低。
Andrew Huberman:
安德鲁·休伯曼：
With EMDR, you're sort of short-circuiting, you're kind of sneaking around the corner of that high-amplitude response.
对于 EMDR，您有点短路，有点偷偷绕过高振幅响应的拐角处。
It's taking a somewhat different approach of trying to extinguish the bad feelings in body and mind associated with an experience, by reducing the physiological response, so it's somewhat different.
它采取了一种稍微不同的方法，试图通过减少生理反应来消除与体验相关的身体和心灵中的不良感觉，所以它有些不同。
And at least to my knowledge, and EMDR practitioners, please correct me, but at least to my knowledge, there isn't an active component to EMDR of relearning a new narrative and attaching reward.
至少据我所知，EMDR 实践者请纠正我，但至少据我所知，EMDR 没有重新学习新叙述和附加奖励的积极组成部分。
Andrew Huberman:
安德鲁·休伯曼：
Now, reward and attaching reward requires a somewhat high-amplitude, sympathetic arousal.
现在，奖励和附加奖励需要一定程度的高强度的同情心唤醒。
It requires a feeling of a victory, which is arousal.
它需要一种胜利的感觉，这就是唤醒。
Okay?
好的？
It's positive arousal, not negative arousal, but it is arousal.
这是积极的唤醒，不是消极的唤醒，但它是唤醒。
So I'm not focusing on this to try and diminish the potential impact of EMDR.
因此，我关注这一点并不是为了试图减少 EMDR 的潜在影响。
I know many people have achieved great relief from EMDR, but it doesn't tap into all the aspects of the extinction and relearning that we talked about previously.
我知道很多人已经从 EMDR 中获得了很大的缓解，但它并没有充分利用我们之前讨论过的灭绝和重新学习的所有方面。
And therefore, I think, on its own, at least in many cases, is unlikely to be a complete therapy for fear and trauma.
因此，我认为，至少在许多情况下，它本身不太可能成为恐惧和创伤的完整疗法。
Andrew Huberman:
安德鲁·休伯曼：
If there are people out there who've had terrific results with the EMDR, please let us know — in the comments section on YouTube would be the ideal place.
如果有人使用 EMDR 取得了出色的效果，请告诉我们 - YouTube 上的评论部分将是理想的地方。
If you've had bad experiences with an EMDR, or it didn't work for you, also let us know.
如果您在 EMDR 方面有过不好的经历，或者它对您不起作用，也请告诉我们。
I think that EMDR practitioners, like most practitioners in the psychiatric and psychological space, are eager to expand their practices in order to make them more effective, rather than clinging ardently to something that perhaps is incomplete or that doesn't work for certain individuals.
我认为 EMDR 从业者，就像精神病学和心理学领域的大多数从业者一样，渴望扩大他们的实践，以使它们更有效，而不是热衷于某些可能不完整或对某些个人不起作用的东西。
So I think they would appreciate that feedback, as would I.
所以我认为他们会像我一样感谢这种反馈。
Andrew Huberman:
安德鲁·休伯曼：
So as I mentioned before, most of these therapies are done in conjunction with a skilled, often, one would hope, a credentialed clinician.
正如我之前提到的，大多数治疗都是与一位熟练的、通常是人们希望的有资格的临床医生一起完成的。
There are many people, however, that don't have access to that, or who are working through stuff.
然而，有很多人无法获得这些，或者正在处理一些事情。
They have things in their past that are very uncomfortable to them.
他们过去有一些让他们感到非常不舒服的事情。
And I'm aware that many people are working through those things through journaling, through talking to a friend, through any number of different sort of nontraditional approaches.
我知道很多人正在通过写日记、与朋友交谈以及各种不同的非传统方法来解决这些问题。
One thing that really pertains to everybody who's working through fear and trauma of any kind is the importance of social connection as it relates to the chemical systems and the neural circuits associated with fear and trauma.
对于每个正在经历任何形式的恐惧和创伤的人来说，真正重要的一件事是社会联系的重要性，因为它与与恐惧和创伤相关的化学系统和神经回路有关。
Andrew Huberman:
安德鲁·休伯曼：
And this is an emerging literature in neuroscience that is really a beautiful one, because it's a very conserved biology.
这是神经科学领域的新兴文献，确实是一篇非常精彩的文献，因为它是一种非常保守的生物学。
We see it, believe it or not, in flies, in fruit flies, a commonly used model system, in mice and indeed in humans as well.
不管你信不信，我们在苍蝇、果蝇（一种常用的模型系统）、小鼠甚至人类身上都看到了这一点。
And this is the work of David Anderson's group at Caltech, again, of Dr. Ressler's group at Harvard Medical, and elsewhere of course.
这是加州理工学院大卫·安德森团队的工作，也是哈佛医学院雷斯勒博士团队的工作，当然还有其他地方的工作。
And this is the work as it relates to tachykinin.
这就是与速激肽相关的工作。
Andrew Huberman:
安德鲁·休伯曼：
Tachykinin is a very interesting molecule in our brain.
速激肽是我们大脑中一种非常有趣的分子。
And it turns out that tachykinin is activated in neurons of what's called the central amygdala and some nearby structures, so really smack dab within the middle of this threat reflex, very soon after some traumatic or fear-inducing event occurs.
事实证明，速激肽在中央杏仁核和一些附近结构的神经元中被激活，因此在某些创伤或引起恐惧的事件发生后不久，速激肽就真正出现在这种威胁反射的中间。
And it actually sets in motion a number of other things, including changes in gene expression and potentiation, meaning long-term potentiation, activation of NMDA receptors, and so on, in the circuits that reinforce that fearful or traumatic experience.
它实际上启动了许多其他事情，包括基因表达和增强的变化，即长期增强，NMDA 受体的激活，等等，在强化恐惧或创伤经历的回路中。
Now, what's interesting about tachykinin is also that it's been shown to lead to low to moderate levels of anxiety and even aggression, irritability.
现在，速激肽的有趣之处还在于，它已被证明会导致低至中度的焦虑，甚至攻击性、易怒。
Tachykinin levels are further increased by social isolation.
社会隔离会进一步提高速激肽水平。
And that social isolation is oftentimes what can exacerbate preexisting traumas or fearful events.
这种社会孤立往往会加剧已有的创伤或可怕事件。
Andrew Huberman:
安德鲁·休伯曼：
And in a kind of beautiful symmetry to that kind of dark and depressing story, social connection with people that we trust, and it doesn't have to be direct physical contact, but just social connection.
与那种黑暗和压抑的故事形成一种美丽的对称，与我们信任的人建立社会联系，它不一定是直接的身体接触，而只是社会联系。
Conversing with, sharing a meal with, it could be physical touch if that's appropriate.
与人交谈，一起吃饭，如果合适的话，可以是身体接触。
Those sorts of connections actually serve to reduce the effectiveness or even the levels of tachykinin.
这些类型的连接实际上会降低速激肽的有效性甚至水平。
So the important point here is that trauma is traumatic in and of itself.
所以这里重要的一点是创伤本身就是创伤。
Fearful events are hard in and of themselves.
可怕的事件本身就很困难。
And if people are working through them, either through clinical work or through individual work, it is important.
如果人们通过临床工作或个人工作来解决这些问题，那么这一点很重要。
And ideally, one would still be trying to access social connection outside of that specific work related to the trauma.
理想情况下，人们仍然会尝试在与创伤相关的特定工作之外建立社会联系。
Andrew Huberman:
安德鲁·休伯曼：
Now, it doesn't necessarily have to be outside of that.
现在，它不一定必须在此之外。
For instance, if you have a good relationship with a clinician or therapist, to the point where there's real trust and you feel a social connection with them, wonderful.
例如，如果您与临床医生或治疗师关系良好，达到真正信任的程度，并且您感到与他们有社交联系，那就太好了。
But for many people, they have a more transactional relationship to their EMDR practitioner, or to their therapist, or they're working through things on their own.
但对于许多人来说，他们与 EMDR 执业者或治疗师有更多的交易关系，或者他们正在自己解决问题。
And it's really important to understand that regular social connection, trusting social connection of any kind, is going to be very beneficial for that process.
重要的是要明白，定期的社交联系、任何形式的信任社交联系将对这一过程非常有益。
And so, this is not kind of just hand-wavy, new-agey stuff like, "Oh.
所以，这不仅仅是挥手的、新时代的东西，比如“哦。
You know, you need social connection." There's an actual neurochemical basis for social isolation that has an amplifying effect on fear and trauma.
你知道，你需要社交联系。”社会孤立有一个实际的神经化学基础，它对恐惧和创伤有放大作用。
And there is a neurochemical basis for the relief from fear and trauma and isolation.
缓解恐惧、创伤和孤立是有神经化学基础的。
And in the ideal circumstance, one is working through these traumas and fears very intensely, in a very dedicated way, but then is also engaging in the sorts of social interactions that are going to diminish the amount of tachykinin and going to suppress those very circuits that would otherwise be amplified.
在理想的情况下，一个人正在以一种非常专注的方式非常强烈地克服这些创伤和恐惧，但随后也会参与各种社交互动，这将减少速激肽的数量并抑制那些原本会被放大的回路。
Andrew Huberman:
安德鲁·休伯曼：
So next, I'd like to talk about some really interesting and almost kind of eerie scientific findings.
接下来，我想谈谈一些非常有趣且几乎令人毛骨悚然的科学发现。
And that's the transgenerational passage of trauma, or predisposition to fear and trauma.
这就是创伤的跨代传承，或者说是恐惧和创伤的倾向。
This is a scientific literature that's been debated many times over the last, really, 50-plus years, but in more recent studies have really proven that we as humans have the capacity to inherit a predisposition to trauma or fear.
这是一篇科学文献，在过去 50 多年里，已经被争论了很多次，但最近的研究确实证明，我们人类有能力继承对创伤或恐惧的倾向。
Now, that doesn't necessarily mean that we will become traumatized or experience extreme fear just because our parents or grandparents experienced that; it's a predisposition, it's a bias.
现在，这并不一定意味着我们会因为我们的父母或祖父母经历过这些而受到创伤或经历极度恐惧；这是一种倾向，这是一种偏见。
Andrew Huberman:
安德鲁·休伯曼：
Let me explain the papers that focus on this for a little bit, and then we'll talk about what this means for each of us.
让我稍微解释一下关注这一点的论文，然后我们将讨论这对我们每个人意味着什么。
One of the most important papers in this area comes to us from someone I mentioned earlier, Dr. Kerry Ressler at Harvard.
该领域最重要的论文之一来自我之前提到的哈佛大学的克里·雷斯勒 (Kerry Ressler) 博士。
And the title of the paper is "Association of FKB5 polymorphisms and childhood abuse with risk of posttraumatic stress disorder symptoms in adults." And there are other papers as well.
论文的标题是“FKB5 多态性和儿童虐待与成人创伤后应激障碍症状风险的关联”。还有其他论文。
Another one from the Ressler Lab, first author Brian Dias, D-I-A-S: "Parental olfactory experience influences behavior and neural structure in subsequent generations." I'm going to summarize these papers and their general contour and papers related to them, although feel free to look up the papers I just described.
雷斯勒实验室的另一篇文章，第一作者 Brian Dias，D-I-A-S：“父母的嗅觉体验影响后代的行为和神经结构。”我将总结这些论文及其总体轮廓以及与它们相关的论文，尽管您可以随意查找我刚才描述的论文。
We will provide a link to them in the caption if you'd like to go further.
如果您想进一步了解，我们将在标题中提供它们的链接。
Andrew Huberman:
安德鲁·休伯曼：
But basically, these explorations involve looking at the histories of human individuals who had trauma or abuse of some kind in their childhood and then looking at the likelihood of fear and PTSD-type symptomology in their offspring.
但基本上，这些探索涉及研究童年时期遭受过某种创伤或虐待的人类个体的历史，然后研究他们的后代出现恐惧和创伤后应激障碍 (PTSD) 型症状的可能性。
And essentially what they identified is that, indeed, if you had a parent, and there does seem to be a kind of bias toward an effect where if the father had abuse, and it's severe abuse or moderate abuse, that abuse causes a change in his genetics, in his sperm, that can be passed on to offspring, such that the offspring have a lower threshold to develop trauma or extreme fear to certain types of events.
从本质上讲，他们发现，如果你有父母，并且似乎确实存在一种偏见，即如果父亲遭受虐待，无论是严重虐待还是中度虐待，这种虐待都会导致他的基因和精子发生变化，这种变化可以遗传给后代，从而使后代对某些类型的事件产生创伤或极度恐惧的阈值较低。
Andrew Huberman:
安德鲁·休伯曼：
Now, what's important to point out is that predisposition or bias is not necessarily to the same sorts of events.
现在，重要的是要指出的是，倾向或偏见不一定是针对同一类型的事件。
It's not that the abuse itself gets passed from one generation to the next.
这并不是说虐待本身会代代相传。
It's a predisposition.
这是一种倾向。
And the title of that paper mentioned FKB5, excuse me, FKBP5 polymorphisms.
那篇论文的标题提到了FKB5，请问，FKBP5 多态性。
And the FKBP5 polymorphism maps to a location in the genome that's associated with the so-called glucocorticoid system, with cortisol release.
FKBP5 多态性映射到基因组中与所谓的糖皮质激素系统相关的位置，可释放皮质醇。
So the predisposition that one might inherit from having a parent — father or mother, but stronger tendency to inherit it from the father — who experienced abuse is one in which the glucocorticoid system, the cortisol system, and that HPA axis that we talked about before, the hypothalamic pituitary adrenal axis, is sensitized or reactive in a way that sets a lower threshold to become traumatized or very afraid of certain types of events, but it's not unique to the specific type of abuse that the parent experienced.
因此，一个人可能会遗传自父母（父亲或母亲）的倾向，但更倾向于从经历过虐待的父亲那里继承，这种倾向是指糖皮质激素系统、皮质醇系统以及我们之前讨论过的 HPA 轴（下丘脑垂体肾上腺轴）以某种方式变得敏感或反应，从而设定了较低的阈值，使其受到创伤或非常害怕某些类型的事件，但这并不是特定类型的虐待所独有的。家长有经验。
Andrew Huberman:
安德鲁·休伯曼：
Now this is really, really important because a lot of times out there, I will hear that there's passage, or transgenerational passage, of actual trauma, the specific trauma.
现在这真的非常非常重要，因为很多时候，我会听到有实际创伤、特定创伤的传递或跨代传递。
Now, that could be through narrative telling.
现在，这可以通过叙事来实现。
If somebody is exposed to a lot of narrative about their parent's trauma in one form or another, it may be that they start to internalize some of that trauma.
如果某人以某种形式接触到大量有关父母创伤的叙述，他们可能会开始内化其中的一些创伤。
And there could be, because we obviously can't rule it out ...
可能有，因为我们显然不能排除这种可能性......
There could be some other signatures of prior specific traumas that get passed on to offspring.
先前特定创伤的一些其他特征可能会遗传给后代。
But more likely, and certainly what these data about these polymorphisms point to, is that what gets passed on is a propensity for the threat reflex to get activated and attached to a wider variety, or to less intense types of inputs and experiences.
但更有可能的是，这些关于这些多态性的数据所表明的，是威胁反射被激活并附着在更广泛的种类或不太强烈的输入和体验类型上的倾向。
Andrew Huberman:
安德鲁·休伯曼：
And the important point to take away from this is that it's not some magical, mysterious and mystical thing that's being transplanted from parent to child.
重要的是，从父母那里移植到孩子身上并不是什么神奇、神秘和神秘的东西。
It's a gene, or it's a modification in a set of genes, that gives a heightened level of responsivity to fearful-type events, or even a heightened level of responsivity such that things that wouldn't be fear-inducing or trauma-inducing to certain individuals can trigger fear and trauma in these children that inherit this particular gene.
它是一个基因，或者是一组基因的修改，它可以提高对恐惧型事件的反应水平，甚至提高反应水平，使得那些不会引起某些个体恐惧或创伤的事情可以引发这些遗传了这种特定基因的孩子的恐惧和创伤。
Now, that doesn't necessarily mean that they are fated to forever be traumatized or live in fear, simply not the case.
现在，这并不一定意味着他们注定要永远受到创伤或生活在恐惧中，事实并非如此。
It's just a genetic predisposition.
这只是一种遗传倾向。
Regardless of whether or not you had a parent or parents that were traumatized or not, there's no evidence, at least as far as I'm aware, that the treatments for trauma should be any different.
不管你的父母是否受过创伤，至少据我所知，没有证据表明创伤的治疗应该有所不同。
As far as I know, there aren't gene therapies currently aimed at these particular variants like FKBP5, and so forth, that could reverse those particular genetic underpinnings of the trauma predisposition.
据我所知，目前还没有针对 FKBP5 等特定变异的基因疗法可以逆转创伤易感性的特定遗传基础。
Andrew Huberman:
安德鲁·休伯曼：
So this transgenerational passage of trauma, I think is extremely interesting, in large part because it brings us back to this idea that the threat reflex is part of a larger sensory system.
因此，我认为这种创伤的跨代传承非常有趣，很大程度上是因为它让我们回到了这样的想法：威胁反射是更大的感觉系统的一部分。
Normally, we think of seeing as a sensory system, or hearing as a sensory system, but the threat-detection and threat-learning system, the fear-learning system, is in many ways a sensory system.
通常，我们认为视觉是一个感觉系统，或者听觉是一个感觉系统，但威胁检测和威胁学习系统，恐惧学习系统，在很多方面都是一个感觉系统。
It's just a sensory system that is very generic in its response.
它只是一个反应非常通用的感觉系统。
That generic response, again, is good because it allows for flexibility, but it's bad because it reduces specificity, right?
同样，通用响应是好的，因为它允许灵活性，但它是坏的，因为它降低了特异性，对吗？
We can essentially become fearful or traumatized by anything if the circuit gets activated.
如果该回路被激活，我们本质上可能会因任何事情而感到恐惧或受到创伤。
And these particular children inherit a predisposition for more things and less intense things to traumatize them.
这些特殊的孩子继承了一种倾向，喜欢更多的事情和不太强烈的事情来给他们带来创伤。
Andrew Huberman:
安德鲁·休伯曼：
In a few minutes, we are going to discuss some of the behavioral treatments, including some really new exciting protocols for dealing with fear and trauma.
几分钟后，我们将讨论一些行为治疗，包括一些真正令人兴奋的新方案来应对恐惧和创伤。
But for a few minutes, I'd like to discuss some of the drug treatments that are starting to emerge as potential therapeutics, in particular for PTSD.
但我想用几分钟的时间讨论一些正在成为潜在疗法的药物治疗，特别是针对创伤后应激障碍（PTSD）。
Andrew Huberman:
安德鲁·休伯曼：
The two drug treatments I'd like to focus on are ketamine-assisted psychotherapy and MDMA-assisted psychotherapy.
我想重点关注的两种药物治疗是氯胺酮辅助心理治疗和摇头丸辅助心理治疗。
Currently, ketamine-assisted psychotherapy is legal.
目前，氯胺酮辅助心理治疗是合法的。
It is approved, provided it is prescribed by a board-certified physician in the United States.
只要是由美国委员会认证的医生开出的处方，它就会获得批准。
I'm not certain about other areas of the world.
我不确定世界其他地区的情况。
MDMA — also sometimes called ecstasy — therapy is in clinical trials in the U.S. It is still an illegal drug to possess or to sell, so I want to be very clear about that.
MDMA（有时也称为摇头丸）疗法正在美国进行临床试验。拥有或销售它仍然是一种非法药物，所以我想非常清楚地说明这一点。
However, MDMA is being explored as a potential therapeutic for PTSD and other forms of trauma.
然而，MDMA 正在被探索作为治疗创伤后应激障碍和其他形式创伤的潜在疗法。
And of course, ketamine and MDMA are also both being explored for chronic depression, eating disorders, and a number of other psychiatric disorders.
当然，氯胺酮和摇头丸也正在被探索用于治疗慢性抑郁症、饮食失调和许多其他精神疾病。
But for the moment, I would just like to touch on ketamine and MDMA as they relate to the fear circuitry and trauma circuitry that we've described in the early part of the episode and throughout the episode, because I think that in viewing them through that lens, we can gain some additional insight into how they might be providing the sorts of relief that some of the early clinical studies are starting to point to.
但目前，我只想谈谈氯胺酮和摇头丸，因为它们与我们在这一集的早期部分和整个情节中描述的恐惧回路和创伤回路有关，因为我认为通过这个镜头观察它们，我们可以进一步了解它们如何提供一些早期临床研究开始指出的那种缓解作用。
Andrew Huberman:
安德鲁·休伯曼：
Ketamine is a dissociative anesthetic.
氯胺酮是一种解离麻醉剂。
That's right, it's a dissociative anesthetic.
没错，它是一种解离麻醉剂。
Its main function is to create a state of dissociation.
它的主要功能是创造一种解离状态。
And I've never taken ketamine personally, so I can't describe the experience of it, but a colleague of mine in psychiatry shared their experience with a patient's experience of it as making that patient feel as if quote, "They were getting out of the cockpit of a plane, but that they were observing themselves doing it." And this was, of course, during an approved therapeutic session that they were doing this, and they were in some sort of intense visualization about a traumatic experience.
我个人从未服用过氯胺酮，所以我无法描述它的经历，但我的一位精神病学同事与患者分享了他们的经历，让该患者感觉好像在引用，“他们正在离开飞机驾驶舱，但他们正在观察自己这样做。”当然，这是在一次批准的治疗过程中，他们正在这样做，并且他们对创伤经历进行了某种强烈的想象。
They were describing some of their depressive symptoms, as well as the trauma, and the narrative that they basically created or took away from this and that was relayed to me was one in which the patient felt like they were in their own body, but they were also viewing their own body from the outside.
他们正在描述他们的一些抑郁症状，以及创伤，他们基本上创造或剥夺的叙述，并转达给我的是，病人感觉他们在自己的身体里，但他们也从外面观察自己的身体。
So dissociative, in other words.
换句话说，如此分离。
Again, I've never had this experience.
再说一次，我从未有过这种经历。
Some of you may have, with ketamine or through other means.
你们中的一些人可能会使用氯胺酮或通过其他方式。
Andrew Huberman:
安德鲁·休伯曼：
But we might want to just take a moment and think about what ketamine actually does and what dissociation actually does at the level of neural circuits.
但我们可能想花点时间思考氯胺酮的实际作用以及解离在神经回路层面的实际作用。
And for that, we can look to this really beautiful paper that was published by my colleagues Karl Deisseroth in psychiatry; Robert Malenka, also in psychiatry; Liqun Luo, also at Stanford.
为此，我们可以看看我的精神病学同事 Karl Deisseroth 发表的这篇非常漂亮的论文；罗伯特·马伦卡 (Robert Malenka)，也是精神病学专家； Liqun Luo，也在斯坦福大学。
They paired up, or teamed up rather, to explore how systemic ketamine adjusts circuitries in the brain.
他们结对，或者更确切地说是合作，探索全身性氯胺酮如何调整大脑回路。
And what they discovered was that it changes the rhythm of cortical activity in certain layers of the cortex.
他们发现它改变了大脑皮层某些层的皮层活动节律。
The cortex is like a layered sandwich, the cortex of course being the outside of the brain.
皮质就像一个分层的三明治，皮质当然是大脑的外部。
And there was a particular rhythm, a 1-to-3 Hz rhythm.
并且有一种特殊的节奏，1 到 3 赫兹的节奏。
One-to-3 Hz just means a particular frequency of electrical activity.
1 到 3 Hz 仅表示电活动的特定频率。
In this case, in these layer 5 neurons of retrosplenial cortex.
在这种情况下，位于压后皮质的第 5 层神经元中。
So you don't need to know much about retrosplenial cortex or 1-to-3 Hz rhythms.
因此，您不需要了解太多关于压后皮质或 1 至 3 Hz 节律的信息。
Andrew Huberman:
安德鲁·休伯曼：
I think the important thing to just take away from this is that there is now starting to be an understanding of how drugs like ketamine work to create this subjective experience that this patient and other patients describe as dissociation.
我认为重要的是，现在人们开始了解氯胺酮等药物如何产生这种主观体验，该患者和其他患者将其描述为分离。
Dissociation, in its essence, is really about not feeling what's happening.
从本质上讲，分离实际上是感觉不到正在发生的事情。
It's about viewing what's happening from a different perspective than what normally one would view that experience from.
它是从与通常人们看待经历不同的角度来看待正在发生的事情。
And so if we kind of plug that general notion of dissociation, and ketamine-induced dissociation, into the circuit that we talked about before, where we have this threat reflex involving the amygdala, these outputs for freezing or for reward, and the accumbens, and we've got this prefrontal narrative coming down as top-down processing, it brings us right to that prefrontal cortical input to the threat system and that narrative.
因此，如果我们将解离的一般概念和氯胺酮引起的解离插入到我们之前讨论过的回路中，其中我们有涉及杏仁核的威胁反射，这些输出用于冻结或奖励，以及伏隔核，并且我们得到了这种前额叶叙事作为自上而下的处理，它使我们正确地了解了威胁系统和叙事的前额皮质输入。
Andrew Huberman:
安德鲁·休伯曼：
What seems to be the case, in my review of the paper I just described plus a review on how ketamine-assisted trauma relief might work, is that it somehow allows the patient, the individual, to recount their trauma while feeling either none or a very different set of emotional experiences that they experienced in the actual trauma or fearful experience.
在我对我刚刚描述的论文的评论以及对氯胺酮辅助创伤缓解如何发挥作用的评论中，情况似乎是，它以某种方式允许患者、个人讲述他们的创伤，同时感觉不到他们在实际创伤或恐惧经历中经历的情感体验或完全不同的情感体验。
So it's a remapping of new onto old — new, meaning new feelings, onto old feelings — while staying in the exact same narrative.
因此，这是新到旧的重新映射——新的，意味着新的感受，到旧的感受——同时保持完全相同的叙述。
So it's a little bit like EMDR, of suppressing the threat reflex, but it seems to bring in a replacement of previous emotional experiences and sensations in the body with new ones.
所以它有点像 EMDR，抑制威胁反射，但它似乎用新的情感体验和身体感觉取代了以前的情感体验和感觉。
Andrew Huberman:
安德鲁·休伯曼：
And so in that way, we can sort of view, or we can try and view, ketamine-assisted psychotherapy for the treatment of trauma as bringing together the three elements that we talked about before.
因此，通过这种方式，我们可以认为，或者我们可以尝试将用于治疗创伤的氯胺酮辅助心理疗法视为将我们之前讨论过的三个要素结合在一起。
You want to diminish the intensity, the potency of the old, original trauma experience or fear experience.
你想要减弱旧有的、原始的创伤经历或恐惧经历的强度和效力。
So that seems to be accomplished through this dissociation, and maybe through the kind of anesthetic component.
所以这似乎是通过这种分离来完成的，也许是通过某种麻醉成分来实现的。
So it's a reduction in pain in the body, a dissociation, a kind of observing of the self.
所以这是身体疼痛的减少，一种分离，一种对自我的观察。
That leads to the extinction of the trauma and the fear.
这会导致创伤和恐惧的消失。
But then there also seems to be an automatic, or kind of built-in relearning of a new narrative and new set of experiences, which is the next step that we described earlier.
但似乎还有一种自动的，或者说是一种内置的对新叙事和新体验的重新学习，这是我们之前描述的下一步。
Andrew Huberman:
安德鲁·休伯曼：
It's an intriguing therapy.
这是一种有趣的疗法。
It's one that's really catching on, and there are many, many clinics around the U.S. that are now doing it.
这是一种非常流行的方法，美国各地有很多很多诊所正在这样做。
Whether or not it turns out to be the ultimate treatment for trauma and for fear isn't clear.
目前还不清楚它是否是治疗创伤和恐惧的最终方法。
My colleagues in psychiatry tell me that that's unlikely.
我的精神病学同事告诉我，这不太可能。
Although it does seem to be beneficial for a number of people, especially people that are experiencing trauma, or have existing traumas and fear that are coupled with depressive symptoms, because the data on ketamine and depression seems to be quite strong.
尽管它似乎确实对许多人有益，特别是那些正在经历创伤的人，或者已经存在创伤和恐惧并伴有抑郁症状的人，因为关于氯胺酮和抑郁症的数据似乎相当有力。
Andrew Huberman:
安德鲁·休伯曼：
So now let's talk about MDMA.
现在我们来谈谈 MDMA。
MDMA, also sometimes called ecstasy or molly in its recreational form, is a powerful synthetic drug that, at least as far as we know, creates a state in the brain and body that is unlike any other chemical state in the brain and body that's normally experienced.
MDMA，有时也被称为摇头丸或莫莉，是一种强效合成药物，至少据我们所知，它会在大脑和身体中产生一种不同于大脑和身体中通常经历的任何其他化学状态的状态。
What do I mean by that?
我这么说是什么意思？
Well, we have several neuromodulator systems in our body.
嗯，我们体内有几个神经调节系统。
Neuromodulators are chemicals that change the likelihood that certain neural circuits will be active, meaning they can make it very likely that certain circuits will be active and make it very unlikely that other neural circuits will be active.
神经调节剂是一种化学物质，可以改变某些神经回路活跃的可能性，这意味着它们可以使某些神经回路很可能活跃，而其他神经回路不太可能活跃。
Andrew Huberman:
安德鲁·休伯曼：
Good examples of neuromodulators are dopamine, serotonin, acetylcholine, norepinephrine.
神经调节剂的好例子是多巴胺、血清素、乙酰胆碱、去甲肾上腺素。
These tend to work on different systems in the brain and body, but they tend to be activated more or less in parallel, right?
这些往往在大脑和身体的不同系统上起作用，但它们往往或多或少是并行激活的，对吗？
You can have dopamine released in your brain and also norepinephrine.
您的大脑中会释放多巴胺和去甲肾上腺素。
You can have serotonin released in your brain and also acetylcholine.
您的大脑可以释放血清素和乙酰胆碱。
So it's not an all-or-none kind of thing, but the degrees to which these things are activated tends to vary.
因此，这并不是一种非此即彼的事情，但这些东西被激活的程度往往会有所不同。
And there is a little bit of a seesaw-type phenomenon with dopamine and serotonin.
多巴胺和血清素之间存在一点跷跷板现象。
Dopamine most commonly associated with activating neural circuits related to motivation, craving, and reward, and serotonin more typically activated in response to situations or conditions in which we are very happy and content with what we have.
多巴胺最常与激活与动机、渴望和奖励相关的神经回路相关，而血清素更通常在我们感到非常高兴和满足于我们所拥有的情况或条件时被激活。
So dopamine is more about pursuing and seeking.
所以多巴胺更多的是追求和寻求。
Serotonin is more about, kind of, pleasure and satisfaction with resources that we have in our immediate sphere.
血清素更多的是关于我们眼前所拥有的资源的愉悦和满足。
Serotonin doesn't tend to place the brain and body into a mode of action quite as much as dopamine does, more or less.
血清素或多或少不会像多巴胺那样使大脑和身体进入某种活动模式。
Andrew Huberman:
安德鲁·休伯曼：
MDMA is a unique compound in that it leads to very large increases in the amount of both dopamine and serotonin in the brain and body simultaneously.
MDMA 是一种独特的化合物，它会同时导致大脑和身体中多巴胺和血清素的量大幅增加。
And that's a unique circumstance that is just simply not seen under normal conditions.
这是一种在正常情况下根本看不到的独特情况。
From a subjective standpoint, people under the influence of MDMA, in the therapeutic setting, tend to report immense feelings of connection or resonance with people, or even things, with music, with objects.
从主观角度来看，在治疗环境中，受 MDMA 影响的人倾向于报告与人、甚至与音乐、与物体的巨大联系或共鸣的感觉。
Certainly if it's being done in conjunction with a family member or a partner or with a therapist, they will feel extremely connected to that person.
当然，如果是与家庭成员、伴侣或治疗师一起进行，他们会感到与那个人有非常紧密的联系。
They'll feel a very close understanding and association, oftentimes, that goes beyond words.
他们常常会感受到一种非常密切的理解和联系，这是超越言语的。
There is a chemical reason for that.
这是有化学原因的。
Andrew Huberman:
安德鲁·休伯曼：
It turns out that MDMA causes massive release of oxytocin, this neuropeptide that's associated with pair-bonding and with bonding, generally.
事实证明，MDMA 会导致催产素大量释放，这种神经肽通常与配对和结合有关。
The oxytocin system and the serotonin system are closely linked to one another in the brain and body, and they tend to be coreleased often, at the same times and by the same sorts of events.
催产素系统和血清素系统在大脑和身体中彼此紧密相连，并且它们往往经常在同一时间、通过相同类型的事件共同释放。
So MDMA is one mechanism by which oxytocin is released in these massive amounts.
因此，摇头丸是催产素大量释放的一种机制。
And I should just relay some of the levels of oxytocin because they're really quite striking, gives a kind of more vivid picture of why it is that MDMA would make people feel so associated in a positive way with the various things that are happening to them while they're under the influence of the drug.
我应该转达一些催产素的水平，因为它们确实非常引人注目，更生动地说明了为什么 MDMA 会让人们感觉与他们在药物影响下发生的各种事情有着积极的联系。
Andrew Huberman:
安德鲁·休伯曼：
So the paper related to this that I'd like to highlight is in the journal Psychoneuroendocrinology.
因此，我想强调的与此相关的论文发表在《心理神经内分泌学》杂志上。
The title of the paper is "Plasma oxytocin concentrations following MDMA or intranasal oxytocin in humans." And just remarkably, MDMA increased plasma oxytocin levels to 83.7, this is an average, 83.7 picograms per milliliter about 90 to 120 minutes into the MDMA session, compared to a typical level of 18.6.
论文的标题是“人类使用 MDMA 或鼻内催产素后的血浆催产素浓度”。值得注意的是，MDMA 使血浆催产素水平增加至 83.7，这是服用 MDMA 后约 90 至 120 分钟的平均水平，每毫升 83.7 皮克，而典型水平为 18.6。
So this is a massive increase in oxytocin, and I think that massive increase in oxytocin is part of the reason why people have these feelings of close resonance and association.
所以这是催产素的大量增加，我认为催产素的大量增加是人们产生这些密切共鸣和联想的感觉的部分原因。
Andrew Huberman:
安德鲁·休伯曼：
Now, the dopamine increases are generally what lead to the feelings of euphoria inside of the MDMA session, and then the serotonin increases, it is thought, are what lead to the feelings of safety and comfort.
现在，多巴胺的增加通常会导致 MDMA 疗程中的欣快感，而血清素的增加被认为会带来安全感和舒适感。
So again, a very unusual chemical cocktail that would never be seen, at least not at this amplitude, under any normal conditions outside of an MDMA clinical psychotherapeutic session.
再说一遍，这是一种非常不寻常的化学混合物，在 MDMA 临床心理治疗之外的任何正常条件下都不会出现，至少不会出现这种幅度。
Why would this state of mind and body be potentially useful for the treatment of trauma?
为什么这种精神和身体状态可能对治疗创伤有用？
Andrew Huberman:
安德鲁·休伯曼：
Well, indeed it is revealing itself to be useful for the treatment of trauma.
嗯，确实它显示出它对于治疗创伤是有用的。
Again, these are legal clinical trials where people are doing this and discovering this.
再说一次，这些都是合法的临床试验，人们正在这样做并发现这一点。
What it seems to allow is a very fast relearning, or new associations, to be tacked onto the previously traumatic experience.
它似乎允许非常快速地重新学习或新的联想，以附加到以前的创伤经历上。
So again, it brings us back to the same model of how people extinguish fears and traumas and replace them with new experiences when there is no drug treatment involved.
因此，它再次让我们回到了同样的模式，即在不涉及药物治疗的情况下，人们如何消除恐惧和创伤，并用新的经历取而代之。
There needs to be a diminishing of the old experience, meaning an extinction, and then a relearning of a new narrative.
旧的经验需要逐渐减少，这意味着消失，然后重新学习新的叙述。
Andrew Huberman:
安德鲁·休伯曼：
What the chemical milieu of MDMA seems to be doing is creating an opportunity for all that to happen very fast, without the need for many repetitions of the original trauma and reliving of the original trauma, probably because the reliving of it inside of one of these MDMA sessions is very acute, very intense.
MDMA 的化学环境似乎正在为所有这一切创造一个快速发生的机会，而不需要多次重复最初的创伤和重温最初的创伤，可能是因为在这些 MDMA 疗程中重温它是非常尖锐、非常强烈的。
Plus it seems to be offering the opportunity to extinguish and rewrite in, or write in, a new narrative associated with that trauma very quickly, as well.
另外，它似乎也提供了一个机会，可以很快地消除和重写或写入与该创伤相关的新叙述。
So what this means, is that treatments like MDMA that are under investigation in these clinical trials are unlikely to be magic potions, if you will, that allow access to a particular process that would otherwise not be accessible.
因此，这意味着，在这些临床试验中正在研究的 MDMA 之类的治疗方法不太可能成为神奇药水（如果你愿意的话），可以进入原本无法进入的特定过程。
It's more that the typical process of trauma and fear reduction that's carried out in things like prolonged exposure, cognitive processing, cognitive behavioral therapy seems to be compacted into a much shorter session, and that session is performed at a much higher intensity.
更重要的是，通过长时间暴露、认知处理、认知行为治疗等方式进行的创伤和恐惧减少的典型过程似乎被压缩为一个更短的疗程，并且该疗程以更高的强度进行。
Higher intensity because the chemical milieu of the brain is completely different.
强度更高，因为大脑的化学环境完全不同。
Andrew Huberman:
安德鲁·休伯曼：
I mean, the experience of MDMA is one in which people have a very heightened sense of euphoria, very heightened sense of connection.
我的意思是，MDMA 的体验让人有一种非常强烈的欣快感，非常强烈的联系感。
So those positive experiences are essentially primed to be written in and over the traumatic experience.
因此，这些积极的经历本质上是准备好写在创伤经历之上的。
And because of the high levels of serotonin in the system, and probably oxytocin as well, there's a safety that's written into the situation that allows people to lean into, perhaps, narratives or components of narratives that they would otherwise be holding back from.
由于系统中的血清素水平很高，可能还有催产素，这种情况存在一种安全感，可以让人们倾向于可能会阻碍他们的叙述或叙述的组成部分。
Andrew Huberman:
安德鲁·休伯曼：
So these are powerful compounds, and I think the future of MDMA-assisted psychotherapy, for trauma in particular, is holding great promise.
因此，这些都是强大的化合物，我认为 MDMA 辅助心理治疗的未来，特别是针对创伤，前景广阔。
As of now, meaning at the time of the recording of this podcast — again, I want to reiterate that these are clinical trials that are being done legally.
截至目前，即在录制本播客时，我想再次重申，这些是合法进行的临床试验。
These drugs are still illegal to possess or sell outside of clinical trials.
在临床试验之外拥有或销售这些药物仍然是非法的。
Doing this sort of thing is punishable.
做这种事是要受到惩罚的。
But it does seem that the FDA and some of the related bodies that control these sorts of things are eyes open to this stuff.
但 FDA 和一些控制此类事情的相关机构似乎确实对这些事情睁大了眼睛。
And I think it's very likely in the next few years, things like MDMA, and certainly ketamine is already in widespread use within the psychiatric community, and I think we're going to be seeing a lot more of that.
我认为在接下来的几年里，像摇头丸这样的东西，当然还有氯胺酮，很可能已经在精神病学界广泛使用，而且我认为我们将会看到更多这样的情况。
Andrew Huberman:
安德鲁·休伯曼：
One thing we have not touched on yet is how do you know if you're traumatized?
我们还没有触及的一件事是你怎么知道你是否受到了创伤？
How do you know if you have chronic fear or a debilitating fear?
你怎么知道你是否患有慢性恐惧或使人衰弱的恐惧？
Much of the psychiatric community focuses on how many other problems people might have.
精神病学界的大部分人都关注人们可能存在多少其他问题。
Trouble sleeping, trouble eating, trouble maintaining quality work, or school work, and so forth.
睡眠困难、饮食困难、维持高质量工作或学业困难等等。
And all of those are certainly very valid criteria, necessary criteria, for determining whether or not somebody meets a clinical diagnosis or not.
所有这些当然都是非常有效的标准，必要的标准，用于确定某人是否符合临床诊断。
Andrew Huberman:
安德鲁·休伯曼：
But there's a biological component that I think we can all assess for ourselves, and that's one of interoceptive versus exteroceptive balance.
但我认为我们都可以自己评估一个生物学成分，那就是内感受与外感受平衡。
That sounds confusing, but it's actually really easy to understand.
这听起来很令人困惑，但实际上很容易理解。
We can focus our perception on the external world, events going on around us beyond the confines of our skin, or within the confines of our skin.
我们可以将感知集中在外部世界、我们周围发生的超出我们皮肤范围或在我们皮肤范围内的事件。
A focus and a perception on the external world is what's called "exteroception," and a focus on what's happening inside us is "interoception."
对外部世界的关注和感知被称为“外感受”，而对我们内部发生的事情的关注被称为“内感受”。
Andrew Huberman:
安德鲁·休伯曼：
And we have the capacity to build mental appraisal into that, right?
我们有能力对此进行心理评估，对吧？
I can, for instance, stop for a moment and assess how my stomach feels, how hungry I feel, how quick my heart is beating.
例如，我可以停下来评估一下我的胃部感觉如何，我感觉有多饿，我的心跳有多快。
Some people, by the way, are much better at sensing whether or not their heart is beating at a particular rate, and others not so much.
顺便说一句，有些人更善于感知自己的心脏是否以特定的速度跳动，而另一些人则不然。
Some people can actually count their heart beats without having to take their pulse by placing pressure on their wrist or their neck.
有些人实际上可以通过在手腕或脖子上施加压力来计算自己的心跳，而无需测量脉搏。
Some people can't.
有些人不能。
In other words, some people have very high interoceptive awareness, and other people less so.
换句话说，有些人的内感受意识非常高，而另一些人的内感受意识则较差。
This whole business of fear and trauma relates to taking external experiences and funneling those experiences into this thing that I'm calling a "threat reflex," or the "fear circuitry."
恐惧和创伤的整个过程都与获取外部经验并将这些经验汇集到我称之为“威胁反射”或“恐惧电路”的东西中有关。
Andrew Huberman:
安德鲁·休伯曼：
A recent paper published in the journal Science, so absolutely spectacular journal — Science, Nature and Cell being the apex journals of scientific publishing — gets at this issue of where in our mind and how do we assess whether or not what we are feeling internally is reasonable, given what's going on externally.
最近发表在《科学》杂志上的一篇论文，这绝对是一本引人注目的杂志——《科学》、《自然》和《细胞》是科学出版的顶尖期刊——探讨了我们的思想在哪里，以及我们如何评估我们内心的感受是否合理（考虑到外部发生的事情）的问题。
And it's a really fascinating study.
这是一项非常有趣的研究。
I'm just going to highlight a little bit of it for you, and then I'll touch on some of the relevant aspects and how that can be adopted into a practice to assess and reduce fear and anxiety.
我只想为您强调其中的一点点，然后我将讨论一些相关方面以及如何将其应用于评估和减少恐惧和焦虑的实践中。
The title of this paper, published just a few weeks ago in Science, is "Fear balance is maintained by bodily feedback to the insular cortex in mice."
几周前发表在《科学》杂志上的这篇论文的标题是“通过对小鼠岛叶皮层的身体反馈来维持恐惧平衡”。
Andrew Huberman:
安德鲁·休伯曼：
We've not talked too much about the insula, also called the insular cortex.
我们没有过多谈论岛叶，也称为岛叶皮质。
This is a brain area that my lab has worked on and other labs have worked on.
这是我的实验室和其他实验室都在研究的一个大脑区域。
It's a brain area that has within it a map of our internal interoceptive landscape.
它是一个大脑区域，里面有我们内部内感受景观的地图。
It's a map of our internal bodily sensations.
这是我们内部身体感觉的地图。
It's a really interesting structure.
这是一个非常有趣的结构。
So the way this study was carried out is that subjects were taught, or conditioned to a particular dangerous signal through repeated presentation of a sound with a foot shock.
因此，这项研究的进行方式是通过重复呈现带有足部震动的声音来教导受试者或使受试者适应特定的危险信号。
So there's a sound and there's a foot shock.
于是就有了声音，还有脚部震动。
And as you know from our earlier discussion about Pavlovian learning, conditioned stimuli and unconditioned stimuli, eventually the sound alone comes to evoke the fear response, and that's just classical conditioning.
正如您从我们之前关于巴甫洛夫学习、条件刺激和非条件刺激的讨论中知道的那样，最终仅声音就会引起恐惧反应，而这只是经典条件反射。
Andrew Huberman:
安德鲁·休伯曼：
The insula is this brain area that's associated with determining whether or not one's internal sensations, gut, heart, lungs, et cetera, are reasonable or not given the external circumstances.
岛叶是一个大脑区域，它与确定一个人的内部感觉（肠道、心脏、肺等）在外部环境下是否合理有关。
It can even measure, or is associated with, our understanding of what are called atrial baroreceptors.
它甚至可以测量或与我们对心房压力感受器的理解相关。
These are blood pressure-
这些是血压——
PART 2 OF 3 ENDS Andrew Huberman:
第 2 部分（共 3 部分）结束 Andrew Huberman：
Of what are called atrial barrel receptors.
所谓的心房桶受体。
These are blood pressure sensors.
这些是血压传感器。
So believe it or not, when your pulse rate increases or you feel like you're stressed out, your atrial baroreceptors are sending a signal to your insular cortex, and your insular cortex is saying, "Wow, I'm really stressed out.
因此，无论您相信与否，当您的脉搏频率增加或您感觉压力很大时，您的心房压力感受器会向您的岛状皮层发送信号，而您的岛状皮层会说：“哇，我真的压力很大。
My blood pressure is up." You don't actually have to measure your blood pressure with a cuff, your insula is doing it for you.
我的血压升高了。”实际上，您不必用袖带测量血压，您的岛叶会为您测量血压。
It's not getting a quantitative readout, but it's getting a qualitative readout.
它不是获得定量读数，而是获得定性读数。
Andrew Huberman:
安德鲁·休伯曼：
The main effect of inhibiting or reducing the activity of the insula was that the intensity of an outside-world experience led to a range of different internal effects.
抑制或减少岛叶活动的主要作用是外部世界体验的强度导致一系列不同的内部影响。
In other words, for most people, a mild shock would induce a mild increase in heart rate, a mild increase in blood pressure, whereas an intense shock to the skin would lead to a big increase in heart rate and a big increase in blood pressure.
换句话说，对于大多数人来说，轻微的电击会导致心率轻微加快、血压轻微升高，而对皮肤的强烈电击则会导致心率大幅加快、血压大幅升高。
Andrew Huberman:
安德鲁·休伯曼：
Turns out the insula is important for establishing that match of intensity.
事实证明，岛叶对于建立强度匹配非常重要。
And when the insula is inhibited, what ends up happening is that a mild shock can create a big increase in blood pressure, and that can be maintained such that anything that's paired with that shock, like a bell or a tone, would lead to a big increase in blood pressure.
当岛叶受到抑制时，最终发生的情况是，轻微的电击会导致血压大幅升高，并且这种情况可以持续下去，任何与电击相关的东西，比如铃声或音调，都会导致血压大幅升高。
Andrew Huberman:
安德鲁·休伯曼：
You've probably seen examples of this in the real world.
您可能在现实世界中见过这样的例子。
Maybe this is even you.
也许这就是你。
Some people are very jumpy in response to just even small changes in their environment.
有些人即使对环境的微小变化也会感到非常紧张。
So if somebody's working and you walk in and you say, "Hello," and they'll go , and they're jumpy.
因此，如果有人在工作，你走进去说“你好”，他们就会走开，而且他们会很紧张。
They have a low threshold to a big anxiety or fear response.
他们对严重焦虑或恐惧反应的阈值较低。
Other people are really calm.
其他人还真是冷静。
Andrew Huberman:
安德鲁·休伯曼：
I recall my bulldog — unfortunately, he passed away, but before he passed away, if you walked in the room and you said, "Hey, Costello," he might turn his eyes in your direction.
我记得我的斗牛犬——不幸的是，他去世了，但在他去世之前，如果你走进房间说：“嘿，科斯特洛”，他可能会把目光转向你的方向。
He had a very high threshold to respond.
他的回应门槛非常高。
He was a pretty low-anxiety animal.
他是一种焦虑程度很低的动物。
A lot of people are like that.
很多人都是这样的。
You come up behind someone, and you say, "Hello," and they just turn around real slow, or they might just turn around at normal speed and say, "Hello." Whereas other people jump out of their seat.
你走到某人后面，你说“你好”，他们就会很慢地转身，或者他们可能会以正常速度转身说“你好”。而其他人则从座位上跳起来。
Andrew Huberman:
安德鲁·休伯曼：
The insula seems to be involved in calibrating how big or how high amplitude a given physiological response is.
岛叶似乎参与校准给定生理反应的幅度有多大或多高。
So it's pairing the internal landscape with the external world.
所以它将内部景观与外部世界配对。
Andrew Huberman:
安德鲁·休伯曼：
And this might seem like just a mechanistic but nonactionable point, but what you'll see from the next study that I'm going to describe is that recalibrating the relationship between outside events and internal responses, which is the job of the insula, is actually something that's under our control.
这可能看起来只是一个机械但不可操作的观点，但你将从我将要描述的下一项研究中看到的是，重新调整外部事件和内部反应之间的关系（这是脑岛的工作）实际上是在我们控制之下的事情。
And through a very simple, very short protocol, we can actually recalibrate that system, so much so that we can potentially reduce the amount of fear and trauma that we experience in response to a memory or to a real event, and the entire process can occur very quickly.
通过一个非常简单、非常短的协议，我们实际上可以重新校准该系统，这样我们就有可能减少我们因记忆或真实事件而经历的恐惧和创伤，并且整个过程可以非常快地发生。
Andrew Huberman:
安德鲁·休伯曼：
So I'm really excited to tell you about this next study for a number of reasons.
因此，出于多种原因，我很高兴向您介绍下一项研究。
First of all, it's extremely recent.
首先，它是最近才出现的。
Second of all, it's very well-grounded in our current understanding of the mechanisms of stress, trauma and PTSD and unlearning of stress, trauma and PTSD.
其次，它以我们目前对压力、创伤和创伤后应激障碍机制的理解以及对压力、创伤和创伤后应激障碍的遗忘为基础。
And third, it points to an actionable protocol that — while certainly is not the only approach that I think people could or should take for fear, trauma and PTSD — is one that I think we are going to see implemented into the clinical setting very soon, if it's not happening already.
第三，它指出了一种可行的方案，虽然我认为人们可以或应该采取的应对恐惧、创伤和创伤后应激障碍的方法当然不是唯一的方法，但我认为我们很快就会看到它在临床环境中实施，如果它还没有发生的话。
Andrew Huberman:
安德鲁·休伯曼：
There's a fourth reason I'm very interested in it, which is that my lab works on stress, stress relief, and tools for managing sleep and improving focus, et cetera.
我对此非常感兴趣的第四个原因是，我的实验室致力于压力、缓解压力以及管理睡眠和提高注意力的工具等。
And one of the hallmarks of the studies we've been doing lately is very brief, five-minute-a-day interventions of the sort that was used in this particular study.
我们最近所做的研究的特点之一是非常简短的、每天五分钟的干预措施，就像在这项特定研究中使用的那样。
Although I should emphasize I had nothing to do with this particular study.
尽管我应该强调我与这项特定研究无关。
Andrew Huberman:
安德鲁·休伯曼：
Now, this particular study was carried out in an animal model, in mice.
现在，这项特殊的研究是在小鼠动物模型中进行的。
The work in my laboratory focuses on human subjects, but the similarities of the stress system, at least at the level that it was explored in this study, I think have great relevance, maybe even direct relevance, to humans.
我实验室的工作重点是人类受试者，但压力系统的相似性，至少在本研究中探讨的水平上，我认为与人类有很大的相关性，甚至可能是直接相关。
Andrew Huberman:
安德鲁·休伯曼：
So the title of this study is "Repeated exposure with short-term behavioral stress resolves pre-existing stress-induced depressive-like behavior in mice." Again, this study was in mice, and basically what they did is they stressed-out mice, got them depressed, and you actually can do that in a mouse using a restraint protocol, and that's a long-lasting restraint protocol of 15 minutes or more.
因此，这项研究的标题是“反复暴露于短期行为压力可以解决小鼠先前存在的压力诱发的抑郁样行为”。再说一次，这项研究是在小鼠身上进行的，基本上他们所做的就是让小鼠承受压力，让它们抑郁，实际上你可以使用约束方案在小鼠身上做到这一点，这是一个 15 分钟或更长时间的持久约束方案。
Mice don't like it.
老鼠不喜欢。
You do it often enough, they stop working so hard in their mouse life to gain food, to gain mates.
如果你经常这样做，它们就不再为了获取食物、交配而在老鼠的生活中如此努力地工作。
They show depressive symptoms at a number of levels.
他们在多个层面上表现出抑郁症状。
They show elevated glucocorticoids.
他们表现出糖皮质激素升高。
You see the same thing in humans, okay.
你在人类身上也看到同样的事情，好吧。
Chronic stress in humans lasting weeks or more does the same exact thing.
人类持续数周或更长时间的慢性压力也会产生同样的作用。
So again, a very close match here in terms of mechanism overall.
再说一次，就整体机制而言，这里的匹配非常接近。
Andrew Huberman:
安德鲁·休伯曼：
And then what they did was a very counterintuitive thing.
然后他们所做的就是一件非常违反直觉的事情。
Rather than give these animals stress relief at the level of reducing their anxiety with benzodiazepines or giving them a nice little mouse vacation or enriched environment, things that had been done in a lot of previous studies, what they did is they subjected them to five minutes a day of intense stress, but only five minutes a day.
他们并没有像以前的许多研究那样，用苯二氮卓类药物减轻它们的焦虑，或者给它们一个愉快的小老鼠假期或丰富的环境来缓解压力，而是让它们每天承受五分钟的强烈压力，但每天只有五分钟。
And what they found was miraculously, but also very convincingly, daily short bouts of intense stress actually undid, reversed, the effects of chronic stress.
他们奇迹般地发现，但也非常令人信服的是，每天短暂的强烈压力实际上消除、逆转了慢性压力的影响。
And it did this at the level of glucocorticoids, of hormones, of neurotransmitters and a number of other different mechanisms.
它在糖皮质激素、激素、神经递质和许多其他不同机制的水平上做到了这一点。
Andrew Huberman:
安德鲁·休伯曼：
Now, I find this very exciting, for a number of reasons, but in particular because my laboratory, in collaboration with David Spiegel's laboratory, our Associate Chair of Psychiatry at Stanford, been exploring how five-minute-a-day respiration protocols can alleviate stress.
现在，我发现这非常令人兴奋，原因有很多，但特别是因为我的实验室与斯坦福大学精神病学副主任 David Spiegel 的实验室合作，一直在探索每天五分钟的呼吸方案如何缓解压力。
And while those data are not yet published, they are at the stage where I'm comfortable talking about them.
虽然这些数据尚未发布，但我已经处于可以轻松谈论的阶段。
And we are seeing some very impressive and significant effects on stress reduction, not just from respiration protocols that allow people to calm themselves but also respiration protocols that bring people into a heightened state of autonomic sympathetic arousal, aka stress.
我们看到了一些对减轻压力非常令人印象深刻和显着的影响，不仅来自使人们平静自己的呼吸方案，还来自使人们进入自主交感神经兴奋（又称压力）高度状态的呼吸方案。
Andrew Huberman:
安德鲁·休伯曼：
As my colleague Dr. David Spiegel, he's an MD, psychiatrist and PhD, likes to say, when it comes to trauma, anxiety and PTSD and the treatment of trauma, anxiety and PTSD, it's not just the state that you are in or that you go into.
正如我的同事、医学博士、精神病学家和博士 David Spiegel 博士喜欢说的那样，当谈到创伤、焦虑和 PTSD 以及创伤、焦虑和 PTSD 的治疗时，这不仅仅是你所处的状态或你将要进入的状态。
It's how you got there and whether or not you had anything to do with it.
这就是你如何到达那里以及你是否与它有任何关系。
And this brings us right back to those top-down mechanisms and the narrative around what we are experiencing internally.
这让我们回到了那些自上而下的机制以及围绕我们内部经历的叙述。
So let's zoom out, and I'll explain how this works and what to do about it.
因此，让我们缩小范围，我将解释它是如何工作的以及如何处理它。
Andrew Huberman:
安德鲁·休伯曼：
We have this brain structure called the insula.
我们的大脑结构称为岛叶。
We talked about the insula a few minutes ago.
几分钟前我们讨论了脑岛。
The insula is calibrating how we feel internally versus what's going on externally.
脑岛正在校准我们的内部感受与外部发生的情况。
It's involved in setting whether or not what we are feeling is appropriate given what's happening.
它涉及确定我们的感受对于正在发生的事情是否合适。
We have a system that can generate threat responses, and in the case of trauma, PTSD and extreme stress, chronic stress, that system gets ramped up so that it takes very little, maybe even just a memory or maybe even an association that we're not even aware of.
我们有一个可以产生威胁反应的系统，在发生创伤、创伤后应激障碍和极端压力、慢性压力的情况下，该系统会增强，因此它只需要很少的时间，甚至可能只是一段记忆，甚至可能是我们甚至没有意识到的关联。
A location triggers something, we're not even aware of it, and we start experiencing that symptomology.
某个地点触发了某些事情，我们甚至没有意识到，然后我们就开始经历这种症状。
Andrew Huberman:
安德鲁·休伯曼：
How do we recalibrate the system?
我们如何重新校准系统？
Well, most of the approaches that are out there involving drug treatments, typical drug treatments, would involve suppressing the level of internal arousal, just trying to bring that down.
嗯，大多数涉及药物治疗的方法，典型的药物治疗，都会涉及抑制内部唤醒的水平，只是试图降低它。
Now, some of those drug treatments work, but oftentimes they don't.
现在，其中一些药物治疗有效，但通常不起作用。
And if you think about it, it's probably not surprising that they don't because by taking a drug that just lowers your anxiety overall, you are creating a different sort of miscalculation of the system.
如果你仔细想想，他们不这样做可能并不奇怪，因为通过服用一种只能降低你整体焦虑的药物，你正在对系统造成一种不同类型的误判。
Andrew Huberman:
安德鲁·休伯曼：
So what we've been doing in human subjects is having them do either breathing protocols that calm them, and I'll explain what that is in a moment, or doing breathing protocols that increase their level of autonomic arousal and seeing how that impacts their response to stress overall, not just during that particular breathing protocol.
因此，我们在人类受试者中所做的就是让他们要么执行让他们平静的呼吸方案，我稍后会解释这是什么，要么执行增加他们自主唤醒水平的呼吸方案，看看这如何影响他们对压力的整体反应，而不仅仅是在特定的呼吸方案期间。
So the calming protocol that we use involves physiological sighs.
因此，我们使用的镇静方案涉及生理叹息。
I've talked about these previously on the podcast and elsewhere, but if you just need a reminder, if you haven't heard about it, there's a pattern of breathing that we all do in sleep when our carbon dioxide levels in our bloodstream get too high, and we do this when we get claustrophobic, meaning we do it reflexively.
我之前在播客和其他地方谈到过这些，但如果你只是需要提醒一下，如果你还没有听说过的话，当我们血液中的二氧化碳含量过高时，我们在睡眠中都会做一种呼吸模式，当我们患有幽闭恐惧症时，我们就会这样做，这意味着我们会条件反射地这样做。
And that's a double inhale through the nose followed by a long exhale.
这是通过鼻子两次吸气，然后长呼气。
So it's ...
所以这是...
And, yes, the inhales should be through the nose and, yes, the exhales should be done through the mouth, ideally.
是的，理想情况下，吸气应该通过鼻子，呼气应该通过嘴。
Andrew Huberman:
安德鲁·休伯曼：
So it's a big filling of the lungs through two breaths back-to-back.
因此，这是通过连续两次呼吸使肺部充满的。
Inhales , even if you can only sneak in a little air on that second one — no talking if you're going to do it right — and then a long exhale, which allows you to offload a lot of carbon dioxide in the exhale.
吸气，即使你在第二次只能偷偷吸入一点空气——如果你要做对的话，就不要说话——然后长长地呼气，这可以让你在呼气中排出大量二氧化碳。
And we have people doing that in real-time anytime they experience stress.
我们让人们在遇到压力时实时这样做。
But the particular breathing protocol that we've been giving human subjects is for them to do the repeated what we call "cyclic sighing." So double inhale, exhale.
但我们给人类受试者提供的特殊呼吸方案是让他们重复我们所说的“循环叹息”。所以双吸气，呼气。
Double inhale, exhale.
双吸气，呼气。
Double inhale, exhale — repeatedly for five minutes, which is actually a pretty long time to repeat that, but you can do it pretty slowly.
双吸气，呼气——重复五分钟，实际上重复这个动作的时间相当长，但你可以慢慢地做。
And people report and the data point to the fact that it's very calming.
人们报告和数据表明，它非常平静。
People feel more relaxed afterwards, and that relaxation wicks out into other aspects of their life.
之后人们会感到更加放松，并且这种放松会渗透到他们生活的其他方面。
Andrew Huberman:
安德鲁·休伯曼：
Now, we did not look at stress and trauma in that condition.
现在，我们没有考虑那种情况下的压力和创伤。
We also have another condition where people do what's called "cyclic hyperventilation," which is very different and creates a very different internal state and is somewhat stressful.
我们还有另一种情况，人们会进行所谓的“周期性过度换气”，这是非常不同的，会产生非常不同的内部状态，并且有些压力。
It's five minutes a day of stress, much like the study that I just described.
每天有五分钟的压力，就像我刚才描述的研究一样。
And it involves basically doing this, what I'll do in a moment, for five minutes, which is hyperventilating.
它基本上涉及到这样做，我一会儿就会做，五分钟，这是换气过度。
Which is , but not continuously for the five minutes because many people would pass out or feel extremely uncomfortable.
是的，但不能连续五分钟，因为很多人会昏倒或感到极度不舒服。
Andrew Huberman:
安德鲁·休伯曼：
It involves inhale, exhale, inhale, exhale, very deep inhale through the nose, exhale through the mouth, and then every 25 or 30 breaths or so, doing a full exhale and holding one's breath, lungs empty, for about 25, maybe 30, maybe even 60 seconds, and then continuing until five minutes is up.
它包括吸气、呼气、吸气、呼气，通过鼻子深深吸气，通过嘴呼气，然后每25或30次呼吸左右，做一次完全呼气并屏住呼吸，肺部排空，大约25秒，也许30秒，甚至可能60秒，然后持续到五分钟。
Andrew Huberman:
安德鲁·休伯曼：
Subjects report and our data indicate that people feel a heightened level of autonomic arousal.
受试者报告和我们的数据表明，人们感受到自主神经兴奋水平的提高。
In fact, I can feel it right now even from that very brief cyclic hyperventilation bout I just did.
事实上，即使是从我刚刚进行的那次非常短暂的周期性过度换气中，我现在也能感觉到。
You feel a heating up, some people will perspire, some people get wide-eyed, some people feel agitated.
你感到一阵发热，有的人会出汗，有的人会睁大眼睛，有的人会感到烦躁。
That's adrenaline being released into your system.
那是肾上腺素被释放到你的系统中。
Andrew Huberman:
安德鲁·休伯曼：
Now, I'm not suggesting everyone run out and do this.
现在，我并不是建议每个人都跑出去这样做。
And if you have a predisposition to panic attack or anxiety attacks, please don't do this because it is very stimulating and can trigger those sorts of attacks.
如果您有惊恐发作或焦虑发作的倾向，请不要这样做，因为它非常刺激并且可能引发此类发作。
But this five-minute-a-day protocol of cyclic hyperventilation does lead to big increases in autonomic arousal.
但这种每天五分钟的周期性过度换气确实会导致自主神经兴奋度大幅增加。
So it's "stressful," in air quotes, but to bring us back to my colleague David Spiegel's quote, it really was him that said it, not me.
所以，用空中引语来说，这是“有压力的”，但让我们回到我的同事大卫·斯皮格尔的引言，确实是他说的，而不是我。
"It's not just about the state that you're in, it's about the state that you're in plus how you got there and whether or not you directed entry into that state."
“这不仅仅是关于你所处的状态，而是关于你所处的状态以及你如何到达那里以及你是否指示进入该状态。”
Andrew Huberman:
安德鲁·休伯曼：
And that point of one directs their own entry into a state deliberately is really key, and I think has an important implications for whether or not there's stress relief and fear relief and trauma relief from bringing oneself into a state of increased autonomic arousal.
一个人故意引导自己进入一种状态的这一点确实很关键，我认为对于使自己进入一种自主觉醒增强的状态是否能缓解压力、缓解恐惧和缓解创伤具有重要意义。
Why?
为什么？
Because of the way that that fear and trauma circuitry is organized.
因为恐惧和创伤回路的组织方式。
If you recall, it's got these components of how external events can trigger an internal stress response and fear response and trauma response.
如果你还记得的话，它包含外部事件如何触发内部压力反应、恐惧反应和创伤反应的这些组成部分。
But there's that top-down prefrontal component that can inhibit certain aspects of that fear and threat circuitry.
但自上而下的前额叶部分可以抑制恐惧和威胁回路的某些方面。
Andrew Huberman:
安德鲁·休伯曼：
Now, earlier we were talking about that prefrontal circuit being engaged through narrative, through self-directed deliberate narrative.
现在，早些时候我们讨论过前额叶回路是通过叙事、通过自我引导的刻意叙事来参与的。
It's the person deliberately retelling the story.
是这个人故意复述这个故事。
Here we're talking about a deliberate reactivation of the sensations in the body.
在这里，我们谈论的是有意重新激活体内的感觉。
So where I think this is all going, meaning where my laboratory and the Spiegel laboratory and other laboratories out there are taking this, is you can imagine a very brief five minutes a day — two weeks was the time that they did this – for five minutes a day for two weeks, intervention in which people, with the support of a clinician, we would hope, would deliberately induce a physiological state that's very stressful.
所以我认为这一切的发展方向，意味着我的实验室、明镜实验室和其他实验室正在采取这一措施，你可以想象一下，每天非常短暂的五分钟——他们这样做的时间是两周——每天五分钟，持续两周，我们希望，在临床医生的支持下，人们会故意诱发一种非常紧张的生理状态。
Not shying away from the stress response, but increasing their own stress response deliberately and maybe in conjunction with recounting the traumatic or fearful circumstance.
不回避压力反应，而是故意增加自己的压力反应，可能还结合叙述创伤或恐惧的情况。
Andrew Huberman:
安德鲁·休伯曼：
This is far and away different than the kind of state of mind and body that would come about in a ketamine-assisted trauma-induced psychotherapy session or an MDMA-assisted trauma psychotherapy session, or in a purely narrative-based psychotherapy session aimed at alleviating fear or trauma.
这与氯胺酮辅助创伤心理治疗或摇头丸辅助创伤心理治疗，或旨在减轻恐惧或创伤的纯粹基于叙述的心理治疗中所产生的精神和身体状态截然不同。
Andrew Huberman:
安德鲁·休伯曼：
The reason I like these sorts of interventions is that A, they're very low cost or even zero cost, right?
我喜欢这类干预措施的原因是，它们的成本非常低，甚至为零，对吗？
You could imagine doing this while journaling or while recounting a particular experience.
您可以想象在写日记或讲述特定经历时这样做。
Again, they're very compact.
同样，它们非常紧凑。
Five minutes a day for two weeks is what was done in this particular mouse study.
在这项特定的小鼠研究中，每天五分钟，持续两周。
We don't know if that translates directly to the human study or not.
我们不知道这是否可以直接转化为人类研究。
What was interesting is that if they used longer daily bouts of stress, like 15 minutes a day, that actually exacerbated the trauma and exacerbated the fear.
有趣的是，如果他们每天施加更长的压力，比如每天 15 分钟，实际上会加剧创伤并加剧恐惧。
So one has to be very careful.
所以一个人必须非常小心。
Stress and deliberate entry into stress and self-stressing are very potent tools.
压力、刻意进入压力和自我压力是非常有效的工具。
There are very sharp blades that it does appear, or it's likely, can help alleviate trauma and fear.
它确实出现了非常锋利的刀片，或者很可能可以帮助减轻创伤和恐惧。
But how long to do this, exactly what the protocol should be is still something that needs to be cultivated.
但要做到这一点需要多长时间，协议到底应该是什么，仍然需要培养。
Andrew Huberman:
安德鲁·休伯曼：
I know there are going to be people out there that, nonetheless, are going to want to experiment with some of this.
我知道仍然会有人想要尝试其中的一些。
I will say that I do not think it matters how one gets into that stressed state, provided it is self-directed, and that, therefore, could be cold shower, it could be ice bath, it could be anything that induces an acute, meaning a sudden onset, of adrenaline and is self-directed.
我想说的是，我认为一个人如何进入那种压力状态并不重要，只要它是自我导向的，因此，可以是冷水淋浴，可以是冰浴，可以是任何诱发肾上腺素急性发作（意思是突然发作）的东西，并且是自我导向的。
That's really the key feature here.
这确实是这里的关键特征。
Andrew Huberman:
安德鲁·休伯曼：
So I'm very excited about these data, both the five-minute intervention data from the animal study, the work that's ongoing in my laboratory and Dr. Spiegel's laboratory, and the work that's being done on the insula because I think what we're starting to see now is a picture of fear and trauma and PTSD that has this sensory component: what's happening in the world around us?
因此，我对这些数据感到非常兴奋，包括来自动物研究的五分钟干预数据、我的实验室和斯皮格尔博士实验室正在进行的工作，以及正在对脑岛进行的工作，因为我认为我们现在开始看到的是一幅恐惧、创伤和创伤后应激障碍（PTSD）的画面，其中包含这种感觉成分：我们周围的世界正在发生什么？
This internal and interceptive component, how appropriate are the signals that are occurring in my body?
这个内部和拦截组件，我体内发生的信号有多合适？
Andrew Huberman:
安德鲁·休伯曼：
I mean, let's face it, if you almost get hit by a car and your heart rate is 140 beats per second, and that lasts for a little while and you're kind of stressed out and you don't get the best night's sleep, that's pretty normal.
我的意思是，让我们面对现实吧，如果您差点被车撞到，您的心率为每秒 140 次，并且这种情况持续一段时间，您会感到压力很大，并且晚上无法获得最佳睡眠，这是很正常的。
That means you have a healthy fear system.
这意味着你有一个健康的恐惧系统。
If that persists and you're dealing with a lot of issues a week later, six weeks later, two years later, then it's moved into the realm of trauma and PTSD.
如果这种情况持续存在，并且一周后、六周后、两年后你要处理很多问题，那么它就进入了创伤和创伤后应激障碍的领域。
Andrew Huberman:
安德鲁·休伯曼：
So we need to always be taking into account the different components of the circuitry.
因此，我们需要始终考虑电路的不同组件。
I do think that deliberate self-directed entry into these short bouts of stress is a very promising approach, and it's one that if people are going to experiment — I just again want to caution people with anxiety or panic disorders, be very cautious, probably don't do it.
我确实认为，刻意地自我引导进入这些短暂的压力是一种非常有前途的方法，如果人们打算尝试这种方法，我只是想再次警告患有焦虑症或恐慌症的人，要非常谨慎，可能不要这样做。
Ideally, you would do this in conjunction with support from a clinician, but I'm also aware that there are a lot of people out there that are dealing with trauma and dealing with post-traumatic stress of various kinds and that they're desperate for various self-directed intervention approaches.
理想情况下，您应该在临床医生的支持下进行此操作，但我也知道有很多人正在处理创伤和各种创伤后压力，他们迫切需要各种自我指导的干预方法。
Andrew Huberman:
安德鲁·休伯曼：
So just very briefly, I want to touch on some of the lifestyle and supplementation factors that can impact things like fear and trauma and getting over fear and trauma.
因此，我想简单地谈谈一些生活方式和补充因素，这些因素可能会影响恐惧和创伤以及克服恐惧和创伤等事情。
To make a long story short, there are many things that we all can and should do to support our overall mental and physical health.
长话短说，我们所有人都可以而且应该做很多事情来支持我们的整体身心健康。
And these are the foundational elements of quality nutrition, what that means to you, quality sleep on a regular basis, ample sleep on a regular basis.
这些是优质营养的基本要素，这对您意味着什么，定期优质睡眠，定期充足睡眠。
Andrew Huberman:
安德鲁·休伯曼：
We have an episode on how to master sleep in bed.
我们有一集关于如何掌握床上睡眠的节目。
We have four episodes that you can go to hubermanlab.com or elsewhere and scroll down, and you can find those episodes in order to get your sleep really dialed-in, as they say.
我们有四集，您可以访问 hubermanlab.com 或其他地方并向下滚动，您可以找到这些剧集，以便真正让您的睡眠如他们所说。
If you're sleeping regularly and for sufficient duration, all of the systems of your fear circuitry are going to function better, mainly because the autonomic nervous system becomes very dysregulated when we are not getting good sleep on a regular basis.
如果你有规律地睡眠并且睡眠时间足够长，你的恐惧回路的所有系统都会更好地发挥作用，这主要是因为当我们没有定期获得良好的睡眠时，自主神经系统会变得非常失调。
Dysregulated means that out of nowhere we can have a higher propensity to have sympathetic activation, or we can feel really tired and wired.
失调意味着我们会突然变得更容易激活交感神经，或者我们会感到非常疲倦和紧张。
That seesaw that I described earlier of alertness and calmness, of sympathetic and parasympathetic — in that analogy, we can imagine that seesaw has a hinge, and that hinge can neither be too tight nor too loose.
我之前描述的警觉和冷静、交感和副交感的跷跷板——在这个类比中，我们可以想象跷跷板有一个铰链，这个铰链既不能太紧也不能太松。
If it's too tight, you can get locked into chronic activation of alertness or chronic fatigue.
如果太紧，您可能会陷入长期的警觉性激活或慢性疲劳。
Andrew Huberman:
安德鲁·休伯曼：
If it's too loose, you're bouncing all over the place, and you might be tired and wired one moment and then really hyperalert.
如果太松，你就会到处弹跳，你可能会在某一时刻感到疲倦和紧张，然后又变得高度警觉。
Sleep resets that balance and resets that hinge to the appropriate tightness, if you will, so that all these circuits, and not just the circuits related to fear but also the circuits related to cognition, clear thinking, to be able to spell out very clear, detailed narratives — to feel like you are in control.
如果你愿意的话，睡眠会重置这种平衡，并重置与适当松紧度相关的铰链，以便所有这些回路，不仅是与恐惧相关的回路，还包括与认知、清晰思维相关的回路，能够阐明非常清晰、详细的叙述——感觉自己处于掌控之中。
You are deliberately bringing yourself into these protocols, if that's what you intend to use.
如果您打算使用这些协议，那么您是在故意将自己纳入这些协议中。
All of that functions much better when you're sleeping well and eating well.
当你睡得好、吃得好时，所有这些都会发挥更好的作用。
Andrew Huberman:
安德鲁·休伯曼：
We talked about social connection.
我们谈论了社交联系。
Those are all indirect supports of trauma relief and of getting over fear, but they are essential.
这些都是缓解创伤和克服恐惧的间接支持，但它们是必不可少的。
Okay, I think of them sort of like the tide.
好吧，我认为它们有点像潮汐。
When the tide is high enough, a boat can leave harbor, and if the tide is not high enough, then that boat is going to be stranded on shore.
当潮水足够高时，船可以离开港口，如果潮水不够高，那么船就会搁浅在岸上。
And in this analogy, the boat stranded on shore is your attempt or anybody's attempt to try and work through something, very hard to do when we're sleep-deprived, very hard to do when we're not fed enough or fed the proper foods for you.
在这个类比中，搁浅在岸上的船是你或任何人尝试解决某件事的尝试，当我们睡眠不足时很难做到，当我们没有给你足够的食物或没有为你提供适当的食物时很难做到。
And that's a highly individual thing.
这是一个非常个人化的事情。
Andrew Huberman:
安德鲁·休伯曼：
And social connection, as we talked about earlier, creates a general sense of support for the ability to move through things, but also chemical support at the level of suppressing tachykinin.
正如我们之前谈到的，社会联系不仅为穿越事物的能力创造了一种普遍的支持感，而且还为抑制速激肽水平提供了化学支持。
Okay?
好的？
So those foundational elements are absolutely key, but they are indirect.
因此，这些基本要素绝对是关键，但它们是间接的。
Andrew Huberman:
安德鲁·休伯曼：
I just want to briefly mention a few of the things that some people find great benefit from in the supplementation realm as it relates to anxiety, stress, fear, and PTSD.
我只想简单提一下一些人在补充剂领域发现的巨大益处，因为它与焦虑、压力、恐惧和创伤后应激障碍有关。
But I want to point out that again, these are somewhat indirect in their support and most of them focus on reducing anxiety overall.
但我想再次指出，这些支持在某种程度上是间接的，而且大多数都侧重于总体上减少焦虑。
Andrew Huberman:
安德鲁·休伯曼：
The two that I want to focus on are two that I've never talked about on this podcast before because I've done podcasts before on stress and managing stress in the kind of shorter term.
我想重点关注的两个问题是我以前从未在这个播客上谈论过的两个问题，因为我之前做过关于压力和短期压力管理的播客。
So we've talked about ashwaghanda in a previous podcast.
我们在之前的播客中讨论过 ashwaghanda。
Check out the podcast on stress if you're interested in how that might be relevant as well as other tools.
如果您对压力以及其他工具的相关性感兴趣，请查看有关压力的播客。
But the two are interesting ones.
但这两个是很有趣的。
Andrew Huberman:
安德鲁·休伯曼：
The first one is saffron, of all things, but there are 12 studies, believe it or not, that orally ingested saffron, at 30 milligrams, seems to be a reliable dose for reducing anxiety on the standard inventories, The Hamilton Anxiety Rating Scale, for those of you that want to know.
第一个是藏红花，不管你信不信，有 12 项研究表明，对于那些想知道的人来说，根据汉密尔顿焦虑评定量表标准清单，口服 30 毫克的藏红花似乎是减少焦虑的可靠剂量。
And these are significant effects, and these were carried out in both male and female subjects.
这些都是显着的效果，而且是在男性和女性受试者中进行的。
Here I'm only referring to human studies.
这里我仅指人类研究。
Several of these were double-blind studies.
其中一些是双盲研究。
There's a meta-analysis of the positive effects, meaning anxiolytic effects, anxiety-reducing effects, that is, of things like saffron.
有一项关于积极作用的荟萃分析，即抗焦虑作用、减少焦虑作用，即藏红花之类的东西。
Definitely have to check with your doctor, make sure it's right for you.
一定要咨询你的医生，确保它适合你。
But they're fairly impressive effects when you really think about it, given that these are legal over-the-counter substances.
但当你认真思考时，考虑到这些是合法的非处方药，它们的效果相当令人印象深刻。
Again, check with a doctor.
再次，请咨询医生。
Andrew Huberman:
安德鲁·休伯曼：
The other one is inositol.
另一种是肌醇。
Inositol has been shown to create a very notable decrease in anxiety symptoms.
肌醇已被证明可以显着减少焦虑症状。
It's a fairly high dose that's used, but believe it or not, the potency of this effect is on par with many of the prescription antidepressants.
使用的剂量相当高，但不管你信不信，这种效果的效力与许多处方抗抑郁药相当。
That's pretty impressive.
这真是令人印象深刻。
These studies, again, are double-blind studies that all showed decreases in anxiety.
这些研究同样是双盲研究，均显示焦虑有所减少。
These were done in males and females.
这些实验是在男性和女性身上进行的。
The age range is very broad, which is great.
年龄范围很广，这很好。
Eighteen all the way up to 64, across the studies that I looked at.
在我研究的所有研究中，从 18 一直到 64。
One of the more important things is that the dosages are quite high.
更重要的事情之一是剂量相当高。
Eighteen grams of inositol, taken for a full month, and it does take some time for these symptoms of anxiety to be improved.
十八克肌醇，服用整整一个月，这些焦虑症状确实需要一段时间才能得到改善。
The low-dose range was about 12 grams of inositol.
低剂量范围约为12克肌醇。
So as high as 18, as low as 12 grams.
所以高至18克，低至12克。
But then again, pretty impressive results considering that these are over-the-counter supplement compounds.
但话又说回来，考虑到这些是非处方补充剂化合物，结果相当令人印象深刻。
Andrew Huberman:
安德鲁·休伯曼：
There's even some evidence — I should just mention, that the inositol is also used for things like obsessive compulsive disorder.
甚至有一些证据——我只想提一下，肌醇也可用于治疗强迫症等疾病。
We will do a full episode on OCD in the future.
我们将来会做一整集关于强迫症的节目。
You can count on that.
您可以信赖这一点。
But in the meantime, inositol does seem to have some positive effects on anxiety and therefore might provide a kind of supportive indirect effect for people that are trying to work through trauma and PTSD.
但与此同时，肌醇似乎确实对焦虑有一些积极的影响，因此可能为那些试图克服创伤和创伤后应激障碍的人提供一种支持性的间接作用。
Andrew Huberman:
安德鲁·休伯曼：
Now, the question is, when would you take it?
现在的问题是，你什么时候服用？
Well, by the logic of what we spelled out today, you probably would not want to take it during a session, or prior to a session, where you were trying to amplify the intensity of an experience and the recounting of an experience in efforts to eventually extinguish that experience, right?
好吧，按照我们今天阐述的逻辑，你可能不想在会议期间或会议之前接受它，因为你试图放大体验的强度并重新叙述体验，以最终消除该体验，对吧？
Because if you put a drug or a compound of any kind, prescription drug or supplement of any kind into your system, you are essentially short-circuiting the extinguishing effect, right?
因为如果你将药物或任何类型的化合物、处方药或任何类型的补充剂放入你的系统中，你基本上就会短路灭火效果，对吗？
So you could imagine doing this outside of that session as a way to kind of bring your system back to baseline, perhaps.
因此，您可以想象在该会话之外执行此操作，也许可以将您的系统恢复到基线。
So if you're going to use these sorts of things, you want to think about them logically.
因此，如果您要使用这些东西，您需要逻辑地考虑它们。
Andrew Huberman:
安德鲁·休伯曼：
And this also really points to the fact that many of the things that people are doing out there to self-medicate, overuse of alcohol or other substances to try and calm themselves because they have fear, anxiety, and PTSD, are actually driving that fear, anxiety, and PTSD deeper into their system, or at least is not allowing it to relieve itself through any attempts to recount or replay in using these top-down narrative circuits or other approaches.
这也确实指出了这样一个事实，即人们因为有恐惧、焦虑和创伤后应激障碍而进行自我治疗、过度使用酒精或其他物质来试图让自己平静下来，实际上正在将恐惧、焦虑和创伤后应激障碍更深地推入他们的系统，或者至少不允许它通过使用这些自上而下的叙事回路或其他方法来重述或重播来缓解自己。
Andrew Huberman:
安德鲁·休伯曼：
And the last compound I want to mention is a particularly interesting one because it's neither an anxiolytic, nor is it something that increases overall levels of stress and alertness, but it has some kind of MDMA-ish-like contour to it.
我想提到的最后一种化合物是一个特别有趣的化合物，因为它既不是抗焦虑药，也不是增加整体压力和警觉水平的东西，但它有某种类似 MDMA 的轮廓。
It does not produce, as far as we know, the same mental effects or physical effects as MDMA, by any stretch, but the substance that I'm referring to, rather, is kava.
据我们所知，无论如何，它都不会产生与 MDMA 相同的精神影响或身体影响，但我指的物质是卡瓦。
Andrew Huberman:
安德鲁·休伯曼：
Kava has been shown in eight studies to have a very potent effect on reducing anxiety.
八项研究表明卡瓦对减轻焦虑具有非常有效的作用。
But what's interesting about kava is that kava functions by increasing GABA, this inhibitory neurotransmitter in the brain.
但卡瓦的有趣之处在于，卡瓦通过增加 GABA（大脑中的一种抑制性神经递质）来发挥作用。
Remember, GABA is the inhibitory neurotransmitter that is used, that's employed by the very neurons in the prefrontal cortex that serve to inhibit the threat reflex.
请记住，GABA 是一种抑制性神经递质，前额皮质中的神经元使用它来抑制威胁反射。
So it seems to increase GABA, but it also increases dopamine.
所以它似乎增加了GABA，但它也增加了多巴胺。
And that's a somewhat unusual compound.
这是一种有点不寻常的化合物。
I'm not aware of many compounds that simultaneously increase GABA and increase dopamine.
我不知道有多少化合物可以同时增加 GABA 和多巴胺。
And as you recall, that threat reflex has outputs that tap into the dopamine system.
你还记得吗，威胁反射的输出会进入多巴胺系统。
Now, that's a big leap to go from a compound that increases GABA and dopamine and look at a circuit spelled out on paper in front of us and say, "Oh, well there's GABA and dopamine in this circuit, and therefore this is a good compound to take."
现在，从增加 GABA 和多巴胺的化合物，到我们面前纸上写出的电路并说：“哦，这个电路中有 GABA 和多巴胺，因此这是一种很好的化合物，这是一个很大的飞跃。”
Andrew Huberman:
安德鲁·休伯曼：
But the effects of kava and human studies are pretty interesting as it relates to anxiety, stress, PTSD and fear.
但卡瓦的影响和人类研究非常有趣，因为它与焦虑、压力、创伤后应激障碍和恐惧有关。
I'm not going to summarize all of these because there're eight studies that I'm aware of, but I'll just mention again, these are double-blind studies.
我不会总结所有这些，因为我知道有八项研究，但我只想再次提及，这些都是双盲研究。
So the trial design is solid.
所以试验设计是可靠的。
The age ranges are anywhere from 18 to 64, which is a nice broad age range.
年龄范围从 18 岁到 64 岁，这是一个很宽的年龄范围。
The number of subjects is quite high, both men and women.
受试者数量相当多，无论男性还是女性。
No signs of hepatotoxic signals, so meaning liver toxicity, although of course, check with your doctor.
没有肝毒性信号的迹象，因此意味着肝毒性，当然，请咨询您的医生。
Andrew Huberman:
安德鲁·休伯曼：
But what was interesting is that after a period of about three weeks of treatment with anywhere from 150 milligrams of what are called active kava lactones.
但有趣的是，经过大约三周的服用 150 毫克活性卡瓦内酯的治疗后。
Okay, so there are dosages that relate to that kava.
好的，有一些与卡瓦有关的剂量。
So a hundred milligrams of extract of kava is a kind of reasonable typical dose in these studies, but that spells out to a certain amount of kava lactone.
因此，在这些研究中，一百毫克卡瓦提取物是一种合理的典型剂量，但这表明卡瓦内酯的含量是一定的。
So you have to kind of boil down to what is the appropriate dosage, and it turns out, it's extremely broad.
所以你必须归结为适当的剂量，事实证明，它的范围非常广泛。
You'll see evidence of 50 milligrams, you'll see evidence of 300 milligrams.
你会看到 50 毫克的证据，你会看到 300 毫克的证据。
It's kind of all over the place.
到处都是这样的情况。
Andrew Huberman:
安德鲁·休伯曼：
But each of these studies, alone and together, point to the fact that kava does seem to produce a very potent anxiolytic and general kind of improvement in depressive symptoms and reduction in generalized anxiety across the board.
但这些研究，无论是单独研究还是综合研究，都表明卡瓦似乎确实能产生非常有效的抗焦虑作用，可以改善抑郁症状并全面减少广泛性焦虑。
So it's an interesting compound.
所以这是一个有趣的化合物。
Andrew Huberman:
安德鲁·休伯曼：
I've never actually tried any of the compounds I just mentioned, kava, saffron or inositol, so I can't report on them personally.
我从未真正尝试过我刚才提到的任何化合物，卡瓦、藏红花或肌醇，所以我无法亲自报告它们。
I just know that a number of listeners of this podcast are interested in supplements and legal over-the-counter approaches to their biology and psychology, and so that's why I mentioned them.
我只知道这个播客的许多听众对他们的生物学和心理学的补充剂和合法的非处方方法感兴趣，所以这就是我提到它们的原因。
Those were the three for which I found the most convincing evidence and the largest bulk of evidence.
这是我找到的最有说服力的证据和最多的证据的三个。
So if you're interested in exploring those, proceed with caution, but they do seem quite interesting.
因此，如果您有兴趣探索这些内容，请谨慎行事，但它们看起来确实很有趣。
Andrew Huberman:
安德鲁·休伯曼：
So today we've reviewed a large amount of information about the biology of pathways in the brain and body that underlie the fear response and that give rise to chronic fear and, in some cases, trauma and PTSD.
因此，今天我们回顾了大量有关大脑和身体通路生物学的信息，这些通路是恐惧反应的基础，会引起慢性恐惧，在某些情况下还会引起创伤和创伤后应激障碍。
Andrew Huberman:
安德鲁·休伯曼：
We also touched on a large variety of approaches to dealing with fear, trauma and PTSD that currently exists in the clinical landscape out there.
我们还探讨了目前临床上存在的各种应对恐惧、创伤和创伤后应激障碍的方法。
Andrew Huberman:
安德鲁·休伯曼：
I also touched on some of the emerging themes.
我还谈到了一些新兴主题。
For instance, this short, five-minute-a-day, deliberate, self-directed stress of any kind, through respiration or other approaches of increasing adrenaline, as an approach that might be viable, I should emphasize, might, be viable for enhancing the speed or the potency of treatments to reduce fear or eliminate trauma.
例如，这种每天五分钟、刻意的、自我导向的任何形式的压力，通过呼吸或其他增加肾上腺素的方法，作为一种可能可行的方法，我应该强调，可能可以提高治疗的速度或效力，以减少恐惧或消除创伤。
Andrew Huberman:
安德鲁·休伯曼：
Most important, I believe, is to understand and really think about the logical structure of the circuits that underlie fear and PTSD, because in doing that, each of us, all of us can think about what sorts of treatments and approaches make the most sense for them.
我认为，最重要的是理解并真正思考恐惧和创伤后应激障碍背后的回路的逻辑结构，因为在这样做时，我们每个人，我们所有人都可以思考什么样的治疗和方法对他们最有意义。
Andrew Huberman:
安德鲁·休伯曼：
I also hope that it will help people lean into certain practices involving re-exposure, provided that's done in a supportive environment, re-exposure to a given traumatic event in an attempt to extinguish that.
我还希望它能帮助人们采取某些涉及重新暴露的做法，前提是这是在支持性环境中进行的，重新暴露于特定的创伤事件，试图消除这种情况。
Obviously you want to do that safely, meaning psychologically safely and physically safely.
显然你想安全地做到这一点，这意味着心理上和身体上的安全。
There are great practitioners out there that can help you with that work.
有很多优秀的从业者可以帮助您完成这项工作。
There are also a number of people out there, I am certain, that are carrying certain traumas or certain fears that they would like to alleviate that are not in the extreme clinical realm, and that's the reason why I touched on a number of things, including some self-directed practices that might be useful and reasonable for them to explore.
我确信，还有很多人患有某些创伤或某些恐惧，他们希望减轻这些创伤或恐惧，但这些创伤或恐惧并不属于极端的临床领域，这就是为什么我谈到了很多事情，包括一些对他们探索可能有用且合理的自我导向实践。
Andrew Huberman:
安德鲁·休伯曼：
I realize we covered a lot of information today.
我意识到我们今天涵盖了很多信息。
If you're enjoying and or learning from this podcast and you're not traumatized by the amount of information covered, please subscribe to our YouTube channel.
如果您喜欢这个播客并从中学习，并且您没有因其中涵盖的信息量而受到伤害，请订阅我们的 YouTube 频道。
Andrew Huberman:
安德鲁·休伯曼：
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 Apple and Spotify, and on Apple, you have the opportunity to leave us up to a five-star review.
另外，请订阅Apple和Spotify上的播客，在Apple上，您有机会给我们留下五星级的评论。
Andrew Huberman:
安德鲁·休伯曼：
If you have suggestions of guests you'd like us to host on the podcast, or you have topics that you'd like us to cover, please put that in the comment section on YouTube.
如果您对我们在播客中主持的嘉宾有任何建议，或者您有希望我们讨论的主题，请在 YouTube 的评论部分中提出。
Andrew Huberman:
安德鲁·休伯曼：
Also, please check out the sponsors that we mentioned at the beginning of this episode.
另外，请查看我们在本集开头提到的赞助商。
That's a terrific way to support us.
这是支持我们的好方法。
Andrew Huberman:
安德鲁·休伯曼：
If you're not already following Huberman Lab on Twitter and Instagram, there I do short neuroscience tutorials.
如果您还没有在 Twitter 和 Instagram 上关注 Huberman Lab，我在那里提供了简短的神经科学教程。
I offer a lot of tools, oftentimes that don't overlap with the content of the podcast.
我提供了很多工具，通常与播客的内容不重叠。
Andrew Huberman:
安德鲁·休伯曼：
And last but 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。
PART 3 OF 3 ENDS
第 3 部分（共 3 部分）结束