Essentials: Understanding & Healing the Mind | Dr. Karl Deisseroth

And so psychiatry is much more mysterious, and the only tools we have are words.

因此，精神病学更加神秘，我们唯一拥有的工具就是语言。

Neurologists are fantastic physicians.

神经科医生是出色的医生。

They see the stroke on brain scans.

他们通过脑部扫描看到中风。

They see the seizure, and the pre-seizure activity with an EEG, and they can measure and treat based on those measurables.

他们通过脑电图观察癫痫发作和癫痫发作前的活动，并且可以根据这些可测量值进行测量和治疗。

In psychiatry, we have a harder job.

在精神病学领域，我们的工作更加艰巨。

We use words.

我们使用文字。

We have rating scales for symptoms.

我们有症状评定量表。

We can measure depression and autism with rating scales.

我们可以用评级量表来衡量抑郁症和自闭症。

But those are words, still.

但这些仍然是文字。

And ultimately, that's what psychiatry is built around.

最终，这就是精神病学的基础。

It's an odd situation because we've got the most complex, beautiful, mysterious, incredibly engineered object in the universe.

这是一个奇怪的情况，因为我们拥有宇宙中最复杂、最美丽、最神秘、最令人难以置信的工程物体。

And yet, all we have are words to find our way in.

然而，我们所拥有的只是话语。

But ultimately, you do need something.

但最终，你确实需要一些东西。

You need some words to help guide you.

你需要一些话语来帮助指导你。

And that in fact, there's challenges that I can tell you about where patients with depression who are so depressed they can't speak.

事实上，我可以告诉你一些挑战，抑郁症患者抑郁得无法说话。

That makes it a bit of a challenge to distinguish depression from some of the other reasons they might not be speaking.

这使得将抑郁症与他们可能不说话的其他一些原因区分开来有点困难。

And this is the art and the science of psychiatry.

这就是精神病学的艺术和科学。

And it's due to the circuits and the connections and the projections and the brain that are not working as they would in a typical situation.

这是由于电路、连接、投射和大脑没有像典型情况下那样工作。

And I do think we'll have those measurables at some point.

我确实认为我们会在某个时候拥有这些可衡量的指标。

Could it be abused or misused, certainly but that's, I think, true for all of medicine.

它肯定会被滥用或误用，但我认为这对于所有医学都是如此。

It can lead to worsening symptoms.

它可能导致症状恶化。

We know, for example, patients who have untreated anxiety issues, if you go for a year or more with a serious, untreated anxiety issue, that can convert to depression.

例如，我们知道，患有未经治疗的焦虑问题的患者，如果您患有严重的、未经治疗的焦虑问题一年或更长时间，可能会转化为抑郁症。

You can add another problem on top of the anxiety.

除了焦虑之外，你还可以添加另一个问题。

And so it would be-- why do people not come for treatment?

那么，为什么人们不来接受治疗呢？

They feel like this is something they should be able to master on their own, which can be true, but usually, some help is a good thing.

他们觉得这是他们应该能够自己掌握的东西，这可能是真的，但通常来说，一些帮助是一件好事。

I mean, there are so many words.

我的意思是，有这么多字。

I don't know how many but I'm guessing there are more than a dozen words to describe the state that I call sadness.

我不知道有多少个，但我猜有十多个词来形容我称之为悲伤的状态。

But as far as I understand, we don't have any way of comparing that in a real objective sense.

但据我了解，我们没有任何方法可以真正客观地进行比较。

So how, as a psychiatrist, when your job is to use words to diagnose words of the patient, to diagnose, do you maneuver around that?

那么，作为一名精神科医生，当你的工作是用语言来诊断患者的语言时，你会如何应对呢？

And what is this landscape that we call feelings or emotions?

我们称之为感受或情感的景观是什么？

So part of psychiatry is to get beyond that word and to get into how they're actually feeling, get rid of the jargon and get to real-world examples of how they're feeling.

因此，精神病学的一部分就是超越这个词，了解他们的实际感受，摆脱行话，找到他们感受的真实例子。

So how much do you look forward into the future?

那么您对未来有多少期待？

How much hope do you have?

你还有多少希望？

How much planning are you doing for the future?

你对未来做了多少规划？

So these here now you're getting into actual things you can talk about that are unambiguous.

因此，现在您正在讨论可以明确谈论的实际事情。

If someone says, yeah, I can't even I can't even think about tomorrow, I don't see how I'm going to get to tomorrow.

如果有人说，是的，我什至无法想象明天，我不知道我将如何走向明天。

That's a nice, precise thing that it's sad.

这是一件美好而精确的事情，但令人悲伤。

It's tragic.

真是悲剧。

But it's also that means something, and we know what that means.

但这也意味着一些东西，我们知道那意味着什么。

That's the hopelessness symptom of depression.

这就是抑郁症的绝望症状。

And that is what I try to do when I do a psychiatric interview.

这就是我在进行精神病学访谈时尝试做的事情。

I try to get past the jargon and get to what's actually happening in the patient's life and in their mind.

我试图摆脱行话，了解患者生活中和他们的想法中实际发生的事情。

But as you say, ultimately, this shows up across-- I address this issue every day in my life, whether it's in the lab where we're looking at animals, whether fish or mice or rats, and studying their behavior, or when I'm in a conversation with just a friend or a colleague, or when I'm talking to a patient, I never really know what's going on inside the mind of the other person.

但正如你所说，最终，这会出现在我的生活中每天都会遇到这个问题，无论是在实验室里观察动物，无论是鱼还是老鼠，并研究它们的行为，或者当我与朋友或同事交谈时，或者当我与病人交谈时，我永远不知道对方的内心在想什么。

I get some feedback, and I get words.

我得到一些反馈，我得到话语。

I get behaviors.

我得到了行为。

I get actions.

我得到行动。

But I never really know.

但我从来不知道。

Cognitive behavioral therapy, just working with words, helping people identify the early signs of when they're starting to move toward a panic attack, what are the cognitions that are happening.

认知行为疗法，仅用言语来帮助人们识别何时开始恐慌发作的早期迹象，以及正在发生的认知。

You can train people to derail that, and you can very potently treat panic disorder that way.

你可以训练人们摆脱这种情况，这样你就可以非常有效地治疗恐慌症。

There are many psychiatric medications that are very effective for the conditions that they're treating anti-psychotic medications, they have side effects, but boy, do they work.

有许多精神科药物对于治疗抗精神病药物的病症非常有效，它们有副作用，但是天哪，它们有效吗？

They really can clear up auditory hallucinations, the paranoia.

它们确实可以消除幻听、偏执。

And then, this is a frustrating and yet heartening aspect of psychiatry.

然后，这是精神病学令人沮丧但又令人振奋的方面。

There are treatments like electroconvulsive therapy, which is where it's extremely effective for depression.

有一些治疗方法，例如电休克疗法，对抑郁症非常有效。

We have patients who nothing else works for them, or they can't tolerate medications.

我们有些患者对其他药物均无效，或者无法耐受药物治疗。

And you can administer under a very safe, controlled condition where the patient's body is not moving.

您可以在非常安全、受控的条件下进行治疗，患者的身体不会移动。

They're put into a very safe situation where the body doesn't move or sees.

他们被置于一个非常安全的环境中，身体无法移动或看到。

It's just an internal process that's triggered in the brain.

这只是大脑触发的内部过程。

This is an extraordinarily effective treatment for treatment resistant depression.

这是治疗难治性抑郁症的一种非常有效的治疗方法。

At the same time, I find it as heartening as it is to see patients respond to this with who have severe depression.

与此同时，我发现看到患有严重抑郁症的患者对此做出反应同样令人振奋。

I'm also frustrated by it.

我也为此感到沮丧。

Why can't we do something more precise than this for these very severe cases.

对于这些非常严重的情况，我们为什么不能做一些比这更精确的事情呢？

In all of these cases, though, in psychiatry, the frustrating thing is that we don't have the level of understanding that a cardiologist has in thinking about the heart.

然而，在所有这些情况下，在精神病学中，令人沮丧的是我们没有心脏病专家对心脏的理解水平。

The heart is-- we now know it's a pump, it's pumping blood.

心脏是——我们现在知道它是一个泵，它泵送血液。

And so you can look at everything about how it's working or not working in terms of that frame.

因此，您可以根据该框架查看有关它如何工作或不工作的所有内容。

It's clearly a pump.

很明显这是一个泵。

We don't really have that level of what is the circuit really there for in psychiatry.

我们还没有真正了解精神病学中电路的真正用途。

And so then, that turns our attention as neuroscientists we think, OK, let's think about the parts of the brain that are involved in dealing with merging complex data streams that are very high in bit rate, that need to be fused together into a unitary concept.

那么，这将我们的注意力转向神经科学家，我们认为，好吧，让我们考虑一下大脑中参与处理合并复杂数据流的部分，这些数据流的比特率非常高，需要融合在一起形成一个统一的概念。

And that starts to guide us and maybe we can-- and we know other animals are social in their own way, and we can study those animals.

这开始指导我们，也许我们可以——而且我们知道其他动物以自己的方式进行社交，我们可以研究这些动物。

And so that's how I think about it.

这就是我的想法。

There's hope for the future, thinking about the symptoms as an engineer might and trying to identify the circuits that are likely working to make this typical behavior happen.

未来充满希望，像工程师一样思考症状，并尝试识别可能导致这种典型行为发生的电路。

And that will help us understand how it becomes atypical.

这将帮助我们理解它是如何变得非典型的。

That work can be done alongside work where various elements within those circuits are tweaked just right, like the tuning of a piano in the subtle way or maybe even the replacement of a whole set of keys if the piano is lacking keys, so to speak.

这项工作可以与对这些电路中的各种元素进行恰到好处的调整的工作一起完成，例如以微妙的方式调整钢琴，或者甚至可以说，如果钢琴缺少琴键，则可以更换整套琴键。

In 2015, there was this what I thought was a very nice article published in The New Yorker describing your work and the current state of your work in the laboratory and the clinic and an interaction with a patient, so as I recall, a woman who was severely depressed, and you reported in that article some of the discussion with this patient and then, in real time, increase the activation of the so-called vagus nerve, this 10th cranial nerve that extends out of the skull and innervates many of the viscera and body.

2015 年，《纽约客》上发表了一篇我认为非常好的文章，描述了您的工作以及您在实验室和诊所的工作现状以及与患者的互动，我记得，一位患有严重抑郁症的女性，您在那篇文章中报道了与该患者的一些讨论，然后实时增加了所谓的迷走神经的激活，这是第 10 脑神经，从头骨延伸出来，支配大脑的许多神经。内脏和身体。

What is the potential for channelrhodopsins or related types of algae engineering to be used to manipulate the vagus?

视紫红质通道蛋白或相关类型的藻类工程用于操纵迷走神经的潜力有多大？

Because I believe, in that instance, it wasn't channel opsin stimulation.

因为我相信，在这种情况下，这不是通道视蛋白刺激。

It was electrical stimulation or to manipulate, for instance, a very small localized region of the brain.

例如，它是电刺激或操纵大脑的一个非常小的局部区域。

Let me reframe it a little bit differently in light of what we were talking about a couple of minutes ago, my understanding is that if somebody has severe depression and they take any number of the available pharmaceutical agents that are out there, SSRIs, serotoninergic agents increased, dopamine increased, whatever that sometimes they experience relief, but they're often serious side effects.

让我根据几分钟前讨论的内容稍微改变一下，我的理解是，如果有人患有严重抑郁症，他们服用任何数量的可用药物，SSRIs、血清素能药物增加、多巴胺增加，无论什么有时他们会感到缓解，但它们通常是严重的副作用。

Sometimes they don't experience relief.

有时他们并没有感受到解脱。

But as I understand it, channel opsins and their related technologies, in principle, would allow you to turn on or off the specific regions of the brain that lead to depressive symptoms, or maybe you turn up a happiness circuit or a positive anticipation circuit.

但据我了解，通道视蛋白及其相关技术原则上可以让你打开或关闭导致抑郁症状的大脑特定区域，或者你可以打开幸福回路或积极预期回路。

Where are we at now in terms of bringing this technology to the nervous system?

在将这项技术引入神经系统方面，我们现在处于什么阶段？

And let's start with the body and then move into the skull.

让我们从身体开始，然后进入头骨。

And by innervate, I means it sends little connections down to help guide what happens in these organs in the abdomen and chest.

我所说的神经支配是指它向下发送很少的连接，以帮助指导腹部和胸部这些器官发生的情况。

It also collects information back, and there's information coming back from all those organs that go also go through this vagus nerve, the 10th cranial nerve, back to the brain.

它还会收集返回的信息，所有这些器官都会返回信息，这些器官也会通过迷走神经（第十脑神经）返回大脑。

And so this is somewhat of a superhighway to the brain.

所以这在某种程度上是通往大脑的高速公路。

Then, it was the idea.

然后，这就是这个想法。

And maybe the idea is maybe we could put a little cuff, a little electrical device around the vagus nerve itself, so a way of getting into the brain without putting something physical into the brain.

也许我们的想法是，我们可以在迷走神经周围放置一个小袖带、一个小电子装置，这样就可以在不向大脑中放入任何物理物质的情况下进入大脑。

And when you turn on the vagus nerve stimulator, the voice patient's voice becomes strangulated and hoarse.

而当你打开迷走神经刺激器时，声音患者的声音就会变得压抑、沙哑。

They can have trouble swallowing.

他们可能有吞咽困难。

They can have trouble speaking, for sure, even some trouble breathing because everything in the neck, every electrically responsive cell and projection in the neck is being affected by this electrode.

当然，他们可能会出现说话困难，甚至呼吸困难，因为脖子上的所有东西、每个电敏感细胞和脖子上的突起都受到这个电极的影响。

And so you can go up just so far with the intensity, and then you have to stop.

所以你的强度可以上升到一定程度，然后你就必须停下来。

So to your initial question, could a more precise stimulation method like optogenetics help in this setting?

那么，对于你最初的问题，像光遗传学这样更精确的刺激方法可以在这种情况下有所帮助吗？

In principle, it could, because that if you would target the light sensitivity to just the right kind of cell, let's say cell x that goes from point A to point B that you know causes symptom relief of a particular kind, then you're in business.

原则上是可以的，因为如果你将光敏感性瞄准正确类型的细胞，比如说从 A 点到 B 点的细胞 x，你知道它会导致某种特定类型的症状缓解，那么你就成功了。

You can have that be the only cell that's light sensitive.

你可以让它成为唯一对光敏感的细胞。

You're not going to affect any of the other cells, the larynx and the pharynx and the projections passing through.

你不会影响任何其他细胞、喉部和咽部以及穿过的突出物。

So that's the hope.

这就是希望。

That's the opportunity.

这就是机会。

The problem, is that we don't yet have that level of specific knowledge.

问题是我们还没有达到那种程度的具体知识。

We don't know, OK, it's the cell starting in point A going to point B that relieves this particular cell.

我们不知道，好吧，是从 A 点开始到 B 点的细胞减轻了这个特定细胞的负担。

And this is pretty powerful.

这非常强大。

It's important this will let us understand what's going on in the brain in psychiatric disease and neurological disease and will give us ideas for treatment.

重要的是，这将使我们了解精神疾病和神经系统疾病的大脑发生了什么，并为我们提供治疗思路。

I see that as something that will be part of psychiatry in the long run.

我认为从长远来看这将成为精神病学的一部分。

Already, with deep brain stimulation approaches, we can help people with psychiatric disorders, and that's putting just a single electrode, not even a complex closed-loop system where you're both playing in and getting information back.

通过深度脑刺激方法，我们已经可以帮助患有精神疾病的人，而这只需放置一个电极，甚至不需要一个复杂的闭环系统，您可以在其中玩耍并获取信息。

Even just a single stimulation electrode in the brain can help people with OCD, for example, quite powerfully.

例如，即使大脑中只有一个刺激电极也可以非常有效地帮助患有强迫症的人。

And then, you can help patients.

然后，你就可以帮助病人。

It's interesting that ADHD is one of those disorders where people are trying to work on quantitative EEG-based diagnoses, and so there's some progress toward making a diagnosis with looking at particular externally detectable brainwave rhythm.

有趣的是，多动症是人们试图进行基于脑电图的定量诊断的疾病之一，因此通过观察特定的外部可检测脑电波节律进行诊断已经取得了一些进展。

Meaning, if I look at people's phone use, including my own, and I don't think of it like addiction, it looks to me and feels to me more like OCD.

意思是，如果我观察人们（包括我自己）的手机使用情况，并且我不认为它是成瘾，那么在我看来，它更像是强迫症。

And I'll come clean here by saying, when I was younger, when I was a kid, I had a grunting tick.

我要坦白说，当我年轻的时候，当我还是个孩子的时候，我有一只咕噜咕噜的蜱虫。

I used to hide it.

我曾经把它隐藏起来。

I actually used to hide in the closet because my dad would make me stop, and I used to-- I couldn't feel any relief of my mind until I would do this.

事实上，我过去常常躲在壁橱里，因为我爸爸会让我停下来，而我曾经——直到我这样做之前，我的心情无法得到任何缓解。

And actually, now, if I get very tired, if I've been pushing long hours, it'll come back.

事实上，现在，如果我很累，如果我长时间工作，它就会回来。

Maybe that would have avoided more impact, but things like skateboarding, boxing, they bring relief.

也许这样可以避免更多的影响，但像滑板、拳击这样的运动可以带来缓解。

I feel clarity after I had hit, which I avoid.

击球后我感觉很清晰，我避免了击球。

But I used to say that's the only time I feel truly clear for a long.

但我曾经说过，这是我很长一段时间以来唯一一次感到真正清醒的时候。

And then eventually it dissipated.

然后最终它消散了。

By about age 16 or 17, it just disappeared.

到了大约 16 或 17 岁的时候，它就消失了。

So I have great empathy for those that feel like there's something contained in them that won't allow them to focus on what they want to focus on.

因此，我对那些感觉自己身上有某种东西不允许他们专注于自己想要专注的事情的人深表同情。

And these days, with the phone and all these email, et cetera, I wonder and I empathize a bit when I hear people saying like, I think I might have ADHD or ADD.

这些天，有了电话和所有这些电子邮件等等，当我听到人们说“我想我可能患有注意力缺陷多动症”或注意力缺失症时，我感到有点同情。

Do you think it's possible that our behaviors and our interaction with the sensory world, which is really what phones and email really are, could induce ADD or reactivate it?

你认为我们的行为以及我们与感官世界的互动（实际上就是电话和电子邮件）可能会诱发或重新激活ADD吗？

And people do, I think these days do have this.

人们确实这样做了，我想现在确实有这样的情况。

If they haven't checked their phone in a while, they do have a buildup and build up and build up until they can check it and relieve it.

如果他们有一段时间没有检查手机，他们确实会积聚、积聚、积聚，直到他们可以检查并缓解它。

And there's some similarities.

并且有一些相似之处。

There is a little reward that comes with the checking.

检查后会有一点奖励。

But the key question in all of psychiatry what we do is we don't diagnose something unless it's disrupting what we call social or occupational functioning.

但在我们所做的所有精神病学中，关键问题是我们不会诊断某些东西，除非它扰乱了我们所谓的社会或职业功能。

Like, you could have any number of symptoms, but literally every psychiatric diagnosis requires that it has to be disrupting someone's social or occupational functioning.

就像，你可能有任意数量的症状，但实际上每一个精神病学诊断都要求它必须扰乱某人的社交或职业功能。

And these days, checking your phone is pretty adaptive.

如今，检查手机已成为一种非常适应性的行为。

That pretty much helps your social and occupational functioning.

这对你的社交和职业功能很有帮助。

And so we can't make we can't make it a psychiatric diagnosis.

所以我们不能将其作为精神病学诊断。

And I realize it's a huge category of compounds, but LSD and psilocybin, as I understand, trigger activation of particular serotonin receptor mechanisms may or may not lead to more widespread activation of the brain, more that one wouldn't see otherwise.

我意识到这是一大类化合物，但据我所知，LSD 和裸盖菇素会触发特定血清素受体机制的激活，可能会也可能不会导致大脑更广泛的激活，更多的是人们在其他情况下不会看到的。

But when you look at the clinical and experimental literature, what is your top contour sense of how effective these tools are going to be for treating depression?

但是，当您查看临床和实验文献时，您对这些工具治疗抑郁症的效果的总体感觉是什么？

They do have problems.

他们确实有问题。

They can be addictive.

它们可能会让人上瘾。

They can cause lasting change that is not desirable.

它们可能会导致不可取的持久变化。

Now, that said, even as these medications exist now, as you know, there's an impulse to use them in very small doses and to use them as adjunctive treatments for therapy of various kinds, and I'm also supportive of that, if done carefully and rigorously.

话虽如此，正如你所知，即使这些药物现在已经存在，人们仍然有一种冲动以非常小的剂量使用它们，并将它们用作各种治疗的辅助治疗，如果仔细而严格地进行，我也支持这一点。

Of course, there's risk, but there's risk with many other kinds of treatment, and I'm not sure that the risks for these medications vastly outweigh the risks that we normally tolerate in other branches of medicine.

当然，存在风险，但是许多其他类型的治疗也存在风险，而且我不确定这些药物的风险是否远远超过我们通常在其他医学分支中容忍的风险。

And there is this element of synesthesia, of blending of the senses, feeling colors and hearing light and things of that sort.

还有联觉的元素，感官的混合，感觉颜色和听到光以及诸如此类的东西。

You hear these reports anyway.

无论如何，你都会听到这些报道。

Why would having that dream-like experience somehow relieve depression long term.

为什么拥有这种梦幻般的经历会以某种方式长期缓解抑郁症呢？

Do we have any idea why that might be?

我们知道为什么会这样吗？

The brain and in particular, our cortex, I think, is a hypothesis generation and testing machine.

我认为，大脑，特别是我们的皮层，是一个假设生成和测试机器。

It's coming up with models about everything.

它正在提出关于一切的模型。

It's got a lot of bits of data coming in, and it's making models and updating the models and changing them, theories, hypotheses for what's going on.

它收到了大量的数据，它正在制作模型、更新模型并改变它们、关于正在发生的事情的理论和假设。

And some of those never reach our conscious mind, and this is something I talk about in projections in the book quite a bit, is many of these are filtered out before they get to our conscious mind, and that's good, we think how distracted we'd be if we were constantly having to evaluate all these hypotheses about what kinds of shapes or objects or processes were out there.

其中一些永远不会到达我们的意识头脑，这是我在书中的预测中经常谈到的，其中许多在到达我们的意识头脑之前就被过滤掉了，这很好，我们认为如果我们不断地不得不评估所有这些关于那里有什么样的形状、物体或过程的假设，我们会多么分心。

And so a lot of this is handled before it gets to consciousness, what the psychedelics seem to do is they change the threshold for us to become aware of these incomplete hypotheses or wrong hypotheses or concepts that might be noise but are just wrong.

因此，很多事情在进入意识之前就得到了处理，致幻剂似乎所做的是，它们改变了我们意识到这些不完整的假设或错误的假设或概念的阈值，这些假设或概念可能是噪音，但实际上是错误的。

And so are never allowed to get into our conscious mind.

因此永远不会被允许进入我们的意识。

Now, that that's pretty interesting, and it goes wrong in psychiatric disorders.

现在，这非常有趣，但在精神疾病中却出了问题。

I think in schizophrenia, some of the times, the paranoid delusions that people have are examples of these poor models that escape into the conscious mind and become accepted as reality, and they never should have gotten out there.

我认为在精神分裂症中，有时，人们的偏执妄想就是这些可怜的模型的例子，这些模型逃进了意识思维并被接受为现实，而他们根本不应该走出去。

Now, how could something like this in the right way help with something like depression?

那么，这样的事情如何以正确的方式帮助治疗抑郁症呢？

Patients with depression often are stuck.

抑郁症患者常常陷入困境。

They can't look into the future world of possibilities as effectively.

他们无法有效地审视未来世界的可能性。

Everything seems hopeless, and what does that really mean?

一切看起来都毫无希望，这到底意味着什么？

They discount the value of their own action.

他们低估了自己行动的价值。

They discount the value of the world at giving rise to a future that matters.

他们低估了世界在创造重要未来方面的价值。

Everything seems to run out like a river, just running out into the desert and drying up.

一切似乎都像一条河流一样，流进沙漠，然后干涸。

And what these agents may do that increase the flow through circuitry, if you will, the percolation of activity through circuitry may end up doing for depression is increasing the escape of some tendrils of process of forward progression through the world.

这些药物可能会增加通过回路的流动，如果你愿意的话，通过回路的活动渗透最终可能会导致抑郁症，那就是增加了世界前进过程中一些卷须的逃逸。

That's a concept.

这是一个概念。

It's how I think about it.

我就是这么想的。

There are ways we can make that rigorous.

我们可以通过多种方法使其变得严格。

We can indeed identify in the brain by recording.

我们确实可以通过记录在大脑中进行识别。

We can see cells that represent steps along a path and look into the future, and we can rigorously define these cells, and we can see if these are altered on psychedelics.

我们可以看到代表道路上的步骤并展望未来的细胞，我们可以严格定义这些细胞，我们可以看看这些细胞是否会因迷幻药而改变。

And so that's one of the reasons that we're working with these agents in the laboratory, to say, is this really the case, or are these opening up new paths or representations of paths into the future?

这就是我们在实验室与这些代理合作的原因之一，也就是说，情况真的如此吗？或者这些代理是否开辟了通向未来的新路径或代表路径？

However, it is a unique compound, and it's different than the serotonergic compounds like LSD and psilocybin.

然而，它是一种独特的化合物，与LSD和裸盖菇素等血清素能化合物不同。

And there are now data still emerging that it might be and in some cases can be useful for the treatment of trauma, PTSD, and similar things.

现在仍有数据表明，它可能并且在某些情况下可能对治疗创伤、创伤后应激障碍和类似疾病有用。

Why would that work?

为什么那会起作用？

And do You-- And a larger question, perhaps the more important question is psychedelics, MDMA, LSD, all those compounds there, in my mind there are two components.

你呢——还有一个更大的问题，也许更重要的问题是致幻剂、MDMA、LSD，所有这些化合物，在我看来有两个组成部分。

There's the experience you have while you're on them, and then there's the effect they have after people are generating variations of these compounds that are non-hallucinatory variations.

这是你在使用它们时所获得的体验，然后是当人们产生这些化合物的非幻觉变异后它们所产生的效果。

But how crucial do you think it is to have-- let's stay with MDMA-- the experience of huge levels of dopamine, huge levels of serotonin, atypical levels of dopamine serotonin released, having this highly abnormal experience in order to be normal again.

但你认为拥有大量的多巴胺、大量的血清素、释放的非典型水平的多巴胺、血清素的体验有多重要——让我们继续使用摇头丸——为了再次恢复正常，拥有这种高度异常的体验。

And then, the drug wears off.

然后，药效就消失了。

The brain learned from that experience.

大脑从那次经历中吸取了教训。

And so what people will report is, yeah, I'm not in that state.

所以人们会报告说，是的，我不处于那种状态。

But I saw what was possible.

但我看到了一切的可能性。

I saw, yeah, you can-- it doesn't need to be barriers or at least not as many barriers as I thought.

我看到，是的，你可以——它不需要成为障碍，或者至少不需要像我想象的那么多障碍。

I can connect with more people in a way that is helpful.

我可以以一种有帮助的方式与更多的人联系。

And so I think it's the learning that happens in that state that actually matters.

所以我认为真正重要的是在这种状态下发生的学习。

When I was speaking about science, when I was speaking about the neurobiology of the brain or psychiatry, I wanted to not have any of my scientific colleagues think, oh, he's going too far.

当我谈论科学时，当我谈论大脑的神经生物学或精神病学时，我不想让我的任何科学同事认为，哦，他走得太远了。

He's saying too much.

他说得太多了。

And so I had these two goals, which I kept in my mind the entire time, and a lot of this trying to find exactly the right word we talked about was on this path of staying excruciatingly, rigorous in the science, and yet letting people see the hope that where things have everybody see that we've come a long way; we have a long way to go.

所以我有这两个目标，我一直牢记在心，很多努力都在试图找到我们所讨论的正确的词，在科学上保持极其严格的态度，同时让人们看到希望，在事情让每个人都看到的地方，我们已经取得了长足的进步；我们还有很长的路要走。

But the trajectory and the path is beautiful.

但轨迹和路径是美丽的。

And so that was the goal.

这就是我们的目标。

I think, of course, that sounds almost impossible to jointly satisfy those two goals.

当然，我认为这听起来几乎不可能共同实现这两个目标。

But I kept that in my mind the whole way through.

但我自始至终都将这一点牢记在心。

And yes, I am optimistic, and I hope that came through in the book.

是的，我很乐观，我希望这在书中得到体现。

There are other people in our community that, of course, are going to be reaching out on your behalf, but it's incredible that you juggle this enormous number of things, perhaps even more important.

当然，我们社区中还有其他人会代表您伸出援手，但令人难以置信的是，您同时处理了如此多的事情，甚至可能更重要。

However, is that it's all in service to this larger thing of relieving suffering.

然而，这一切都是为了减轻痛苦这个更大的事情。

So thank you so much for your time today for the book and the work that went into the book.

非常感谢您今天抽出时间来阅读这本书以及为本书所做的工作。

I can't even imagine for the laboratory work and the development channel ops and clarity and all the related technologies and for the clinical work you're doing and for sharing with us.

我什至无法想象实验室工作、开发渠道操作和清晰度以及所有相关技术以及您正在做的临床工作以及与我们分享的情况。