The surprising connection between brain injuries and crime | Kim Gorgens

翻译人员: Lipeng Chen 校对人员:

A traumatic brain injury, or TBI,

创伤性脑损伤，又称TBI，

is a disruption in brain function caused by an external blow to the head.

是由于头部受到外部重击 而导致的大脑功能紊乱。

And when you hear that definition,

当你们听到这个概念时，

you might think about sports and professional athletes,

你们可能会想到职业运动员，

since it's the kind of injury we're used to seeing on the playing field.

因为这是我们在球场上 经常看到的损伤。

And this imagery has really come to define TBI in the public consciousness.

这的确是公众意识中 脑损伤的形象。

I myself do research on TBI in retired and college athletes.

我自己也在研究退役和 大学运动员的创伤性脑损伤。

I stood on a TED stage in 2010,

2010年我站在TED舞台上，

talking about concussions in kids' sports.

谈论儿童运动中的脑震荡。

So I have to say, as someone who researches and treats these injuries,

所以我不得不说， 作为研究和治疗这些损伤的人，

that I've been really gratified to see the growing awareness of TBI

我为人们对创伤性脑损伤 意识的增强感到高兴。

and specifically, the short- and long-term risks to athletes.

尤其是有关运动员的 短期和长期风险。

Today, though, I want to introduce you to a larger but no less controversial

不过，今天我想介绍一个 涵盖面更广但富有争议的，

group of people impacted by traumatic brain injury,

受到创伤性脑损伤影响的人群，

who don't often show up in the headlines.

他们不经常出现在头条上。

I've come to recognize these inmates and probationers

我逐渐认识到囚犯和缓刑犯

as surprisingly among the most vulnerable members of society.

出乎意料地， 是社会上最脆弱的群体之一。

For the last six years, my colleagues and I have been doing research

在过去的六年里， 我和我的同事一直在做研究，

这完全改变了我们 对刑事司法系统

that has completely changed the way we think about the criminal justice system

and the people in it.

以及相关人员的看法。

And it may change the way you think about those things, too.

我们的研究也可能改变你们 对这些事情的看法。

So I'll start with a shocking statistic:

所以我先从一个令人震惊的 统计数据开始：

50 to 80 percent of people in criminal justice

50%到80%的深陷刑事案件的人员

have a traumatic brain injury.

曾经受到过脑损伤。

Up to 80 percent.

高达80%。

In the general public, in this room, for example,

然而，在普通民众中，

that number is less than five percent.

这个数字不到百分之五。

And I'm not just talking about getting your bell rung.

我说的不仅仅是头部受到了撞击。

These are the kinds of injuries that require hospitalization.

我说的这些损伤需要住院治疗。

Most of them are the product of a physical assault,

大部分是由于身体受到攻击引起的，

and some of them are actually sustained in jail.

他们中的一些人实际上 已经被关进了监狱。

All of these numbers are even higher among the women in criminal justice.

所有这些数字对于 触犯刑事法律的女性而言更高。

Almost every single woman in the criminal justice system

刑事案件中几乎每一个女性，

has been exposed to interpersonal violence and abuse.

都曾遭受过暴力和虐待。

More than half of these women have been exposed to repeated brain injuries.

这些女性中有一半以上 脑部反复遭受重击。

In this way, these women's brains look like the brains of retired NFL players,

这些女性的大脑看起来就像是 退役的美国橄榄球联盟球员的大脑，

and they'll likely face the same risks for dementing diseases as they age.

而且随着年龄的增长， 她们可能面临着同样的痴呆症风险。

The same risks.

同样的风险。

TBI, together with mental illness and substance abuse and trauma,

脑损伤，与精神疾病、 药物滥用和创伤交织作用，

makes it hard for people to think.

使得人们难以思考。

They have cognitive impairments like poor judgment and poor impulse control,

他们有认知障碍，比如较差的判断力 和较差的冲动控制能力，

problems that make criminal justice a revolving door.

这使得刑事司法成为一道旋转门 （意味着一再进出法院和监狱）。

People get arrested and booked into jail.

人们被逮捕并被关进监狱。

They oftentimes get into trouble while they're in there.

他们经常在那里遇到麻烦。

They get into fights. They fall out of their bunk.

他们打架。 他们从床铺上掉下来。

And then they get released and do stupid things,

然后他们被释放， 做一些愚蠢的事情，

like forgetting mandatory check-ins, and they get rearrested.

就像忘记强制登记一样， 他们会重新被捕。

Statistically speaking,

从统计学上讲，

they're actually more likely to be rearrested than not.

他们更有可能重新被捕。

A colleague calls this "serving a life sentence 30 days at a time."

一位同事称之为 “每次服30天的无期徒刑”。

And oftentimes, these folks don't know why this is so hard for them.

通常，这些人不知道 为什么这对他们来说如此困难。

They feel out of control and frustrated.

他们感到失控和沮丧。

So knowing that TBI is at the root of so many of these challenges,

在得知创伤性脑损伤 是这些挑战的根源之后，

the mission for a group of us in Colorado has been to disrupt that cycle,

我们科罗拉多州的一个小组的 任务就是打破这个循环，

to jam the revolving the door.

堵住这扇旋转的门。

So working together with my state and local partners,

因此，通过和我所在的州和地方 的合作伙伴合作，

we crafted a plan to meet everyone's needs:

我们制定了一个 满足每个参与者需求的计划：

司法系统，囚犯，缓刑犯

the system, the inmates and probationers,

my graduate students.

和我的研究生。

In this program, we assess how each person's brain works

在这个项目中，我们评估 每个人的大脑是如何工作的

so that we can recommend basic modifications

以便我们建议做出基本的修改，

to make this system more effective

使得这个系统更有效

and safer.

并且更安全。

And here when I say "safer," I mean safer not only for the inmates,

在这里，当我说“更安全”时， 我的意思是不仅对囚犯更安全，

but safer also for correctional staff.

对于惩教人员也更安全。

In some ways, this is such a simple approach.

在某些方面， 这是一种非常简单的方法。

We're not treating the brain injury,

我们不是在治疗脑损伤，

we're treating the underlying problem that gets people into all of this trouble

我们把处理 让人们陷入困境的根本问题

in the first place.

放在第一位。

We do quick neuropsychological screening tests

我们做快速的神经心理检查，

to identify strengths and weaknesses in the way an inmate thinks.

以囚犯的思维方式 找出优点和缺点。

Using that information, we write two reports.

利用这些信息， 我们写了两份报告。

One, a report for the system

一，给司法系统的报告，

with specific recommendations on how to manage that inmate.

关于如何管理那个囚犯的具体建议。

The other is a letter to the inmate

另一封是给犯人的信，

with specific suggestions for how to manage themselves.

关于如何管理自己的具体建议。

For example, if our test result suggests that a probationer has a hard time

例如，如果我们的测试结果 表明一个缓刑犯很难

remembering the things they hear,

记住他们听到的东西，

that would be an auditory memory deficit.

那可能是听觉记忆缺陷。

In that case, our letter to the court might suggest

在这种情况下， 我们给法院的信可能会建议

that that probationer get handouts of important information.

给那个缓刑犯有关重要信息的手册。

And our letter to that probationer would say, among other things,

我们给那个缓刑犯的信中会说，

that they should carry a notebook to record that information for themselves.

他们应该随身携带 一本笔记本来记录这些信息。

Now, most importantly,

现在，最重要的是，

is that I pause here to be really clear about one point.

我在这里停下来想澄清一点。

This program does not minimize responsibility

这个计划并没有逃避责任，

or make excuses for anyone's behavior.

或者为任何人的行为找借口。

This is about changing longstanding negative perceptions

这主要是改变长期以来的负面看法

and building self-advocacy.

并倡导自我重建。

It's actually about taking responsibility.

实际上是要承担责任。

The inmates move from,

囚犯们从

"I'm a total screwup, I'm a loser,"

“我彻底搞砸了，我是个失败者。”

to, "Here's what I don't do well,

转变为“我做得不好，

and here's what I have to do about it."

但这就是我要改进的。”

(Applause)

（掌声）

And the system comes to see an inmate's problematic behavior

司法系统逐渐认识到 囚犯的问题行为

as the things they can't do

是因为他们做不到，

versus the things they won't do.

而不是因为他们不想做。

And that change --

这一变化——

seeing behavior as a deficit rather than outright defiance --

把行为看成是一种缺陷 而不是彻底的蔑视——

is everything in these settings.

就是这一系列设计想达成的目的。

We hear from inmates around the country,

我们收到了来自全国囚犯的来信，

and they write, and more than anything, they want to know how to help themselves.

他们写信，更重要的是， 他们想知道如何帮助自己。

This is an excerpt from a letter from Troy in Virginia,

这是一封来自弗吉尼亚州 一位名叫特洛伊的囚犯的信件摘录，

从长达50页的信中摘录的。

an excerpt from a 50-page letter.

And he writes,

他写道，

"Can you tell me what you think of all the head traumas I've dealt with?

“你能告诉我你对我经历过的 所有头部创伤有什么看法吗？

What can I do? Can you help me?"

我能做什么？你能帮我吗？”

Closer to home, we have thousands of stories like this,

言归正传， 我们有上千个这样的故事，

and smart stories, stories that have a great outcome.

精彩的故事，有很好结果的故事。

Here's Vinny.

这是维尼。

Vinny was hit by a car when he was 15,

维尼15岁时被车撞了，

and from that moment forward, spent more time in jail than in school.

从那时起，他在监狱里呆的时间 比在学校里多。

With some basic skill-building,

通过一些基本技能的培训，

after our assessment revealed

那是在我们的评估显示

that he had some pretty significant memory impairments,

他有相当严重的记忆障碍之后，

Vinny learned to use the alarm and reminder function on his iPhone

维尼在他的iPhone上学会了 使用闹钟和提醒功能。

to track important appointments,

跟踪记录重要的约定，

and he keeps a checklist to break larger tasks

他还做了一份清单， 以把更大的任务

into smaller, manageable ones.

变成更小的，可管理的任务。

And with basic tools like that under his belt,

多亏了这样的基本工具，

Vinny's been out of jail for two years,

维尼已经出狱两年了，

clean for nine months,

九个月内没有犯罪记录，

and recently back to work.

最近又开始工作了。

(Applause)

（掌声）

What's so striking for Vinny

对于维尼来说，最让人惊叹的是

is that this is his first time off of court supervision

这是自他15年前受伤以来

since his injury more than 15 years ago.

首次在脱离庭外监管。

He made it out of the revolving door.

他从司法旋转门中脱身了。

(Applause)

（掌声）

He says now, "I can do anything.

他现在说，“我能做任何事。

I just have to work a lot harder at it." (Laughs)

我只需要更努力的工作就行了。” （笑）

And here's Thomas.

这是托马斯。

Thomas has some pretty significant attention and behavior problems

托马斯自受伤、昏迷了一个多月后，

after an injury landed him in a coma for more than a month.

开始产生一些相当严重的 注意力和行为问题。

After relearning how to walk,

在重新学会走路之后，

his first stop?

他的第一站？

Court.

法庭。

He couldn't imagine a future where he wasn't in trouble.

他无法想象没有麻烦的未来。

He now carries a calendar to avoid being held in contempt

他现在带着日历

以避免因为缺席庭审 而被判蔑视法庭，

for missed court dates,

and he schedules a break into his day every day

他每天都安排时间休息，

to recharge before he gets agitated.

使他在焦躁不安前平静下来。

And nobody knows the revolving door

没有人更了解旋转门

better than the person sitting at the front of the courtroom.

比坐在法庭最前排的人。

This is my good friend and colleague Judge Brian Bowen.

这是我的好朋友和同事， 布莱恩·伯恩法官。

Now, Judge Bowen was already on a mission to make the system work for everyone,

现在，伯恩法官已经承担起 让司法系统为每个人工作的使命，

and when he heard about this program, he saw the perfect fit.

当他听说这个项目时， 他觉得非常合适。

He actually sits down with all of his prosecutors

他和所有的检察官坐在一起，

to help them see that there's basically two categories of defendants

帮助他们发现 基本上有两类被告人

in the courtroom:

在法庭上：

the ones we're afraid of -- oftentimes, rightfully so --

我们害怕的那些—— 通常，是这样的——

and the ones we're mad at.

还有那些让我们很抓狂的人。

These are the ones who miss all of their scheduled appointments

他们错过了所有预定的出庭日，

and they blow through the best-laid probation plans.

因而搞砸了缓刑计划。

And Judge Bowen believes that, with a little more support,

鲍恩法官认为， 如果能得到更多的支持，

we could move people in this latter category,

我们可以调动后一类人，

the maddening category,

令人发狂的那类人，

through and ultimately out of the system.

通过，并最终退出司法系统。

He proved that with Navy veteran Mike.

他与海军老兵迈克证明了这一点。

Judge Bowen saw the correlation between Mike's history of a massive 70-foot fall

鲍恩法官看出了以下两者的相关性： 一是迈克曾从70英尺高摔下，

and his long-standing pattern of difficulty showing up on the right day

二是他长期以来无法按时

for court appointments

出现在庭审上。

and complying with mandatory therapy requirements, for example.

还有，例如无法遵守 强制性治疗的相关性。

And instead of sentencing him to more and more jail time,

伯恩法官不是判处他 越来越多的监禁，

Judge Bowen sent him home with maps and checklists and handouts

而是让他回家， 给予地图、清单和手册，

and recommended instead vocational rehabilitation

并建议改为职业康复

and flexible scheduling for those therapies.

以及灵活的治疗计划。

And this with those supports, Mike's back to work

有了这些支持， 迈克又开始工作了，

这是他在服役期间 受伤之后的第一次。

for the first time since his injury while he was in the service.

He's repairing relationships with his family,

他在修复与家人的关系，

and just last month,

就在上个月，

he graduated from Judge Bowen's veteran's court.

他从伯恩法官的老兵法庭“毕业”了。

(Applause)

（掌声）

This program shows us the overwhelming prevalence

这个项目向我们展现了

of traumatic brain injuries and cognitive deficits

创伤性脑损伤和认知缺陷无处不在，

以及刑事司法系统中的种种不足。

and the accumulation of brokenness in the criminal justice system.

And it highlights the extraordinary power of resilience and responsibility.

它强调了非凡的韧性和责任感。

In Mike and Thomas and Vinny,

在迈克、托马斯、维尼，

even Judge Bowen's story,

甚至是鲍恩法官的故事中，

you saw the transformation made possible by a change in perception

你们看到了认知改变以及 一些简单的调整

所带来的转变。

and some simple accommodations.

All told, in this program,

总之，在这个项目中，

these inmates and probationers come to see themselves differently.

这些囚犯和缓刑犯 对自己的看法改变了。

The system sees them differently,

司法系统对他们的看法改变了，

and when you meet them in the community, I hope you see them differently, too.

当你们在社区里遇到他们时，

我希望你们也能以 不同的方式看待他们。

Thanks, guys.

谢谢你们。

(Applause)

（掌声）