3 Steps of Anxiety Overload — and How You Can Take Back Control | Lisa Damour | TED

翻译人员: Aileen Lim 校对人员: Yanyan Hong

So the most important thing to know about anxiety straight out of the gate,

所以关于焦虑，最重要的是要知道，

is that it has gotten an unnecessarily bad rap,

是它已经得到了一个不必要的坏名声，

as has happened for a lot of negative emotions.

就像很多负面情绪一样。

But you should know that psychologists have long understood

但你要知道心理学家早就明白,

that anxiety has both healthy forms and unhealthy forms.

焦虑既有健康的形式， 也有不健康的形式。

And a lot of the anxiety we experience in the day-to-day is healthy.

而我们在日常生活中 经历的很多焦虑都是健康的。

OK, so what makes anxiety healthy?

好吧，那么是什么使焦虑成为健康的呢？

Anxiety is healthy when it is serving as an alarm system

当焦虑作为一个警报系统时 它就是健康的，

that lets us know that something's not right,

这让我们知道有些事情不对劲，

that it gets our attention and helps us to keep ourselves safe.

它引起了我们的注意 并帮助我们保护自己的安全。

So if you're driving and somebody swerves and cuts you off

所以如果你在开车， 有人突然转向并把你截住了

and you have a surge of anxiety, that's a good thing.

而你有一股焦虑的情绪， 这是件好事。

It will focus your attention,

它将集中你的注意力，

it will help you be safe around that driver,

它将帮助你在那个司机身边保持安全，

maybe take evasive maneuvers.

也许会采取回避措施。

But it's good for you to respond.

但你能做出回应是件好事。

If you're entirely indifferent or relaxed in that setting,

如果你在那种环境中 完全无动于衷或放轻松，

it's not as safe.

那就不安全了。

So we look for anxiety to be of help to us, to guide us

所以我们寻找焦虑 来帮助我们，引导我们

and to let us know what we're supposed to be doing and not doing.

并让我们知道我们应该做什么， 不应该做什么。

I care for a lot of teenagers clinically, and, you know, I will say to them,

我在临床上照顾过很多青少年， 而且，你知道吗，我会对他们说，

if you walk into a party that you thought was going to be a little get-together,

如果你走进一个你认为 会是小聚会的派对，

and it turns out it's kind of, you know, wild and you feel anxious,

结果发现有点，你知道的， 有点狂野，然后你感到焦虑，

pay attention to that reaction.

注意这种反应。

Like, that's telling you something,

就好像那是在告诉你一些事情，

that's indicating that you may not be as safe

这表明你可能不像你想象的那样安全，

as you thought you were going to be.

So that's healthy anxiety.

所以这是健康的焦虑。

The only time we consider anxiety to cross the line

我们唯一时间认为焦虑跨越了 从健康到不健康的界限

from healthy to unhealthy

is under two conditions, actually.

实际上是在两种情况下。

One is when we have anxiety, but there’s no threat,

一种是当我们有焦虑，但没有威胁，

that there's nothing wrong.

没有什么问题的时候。

So if it's, you know, a lovely Sunday morning and you're taking a drive

所以，如果是一个美好的星期天早晨， 你正在开车，

and there's no traffic nearby,

而附近没有交通，

you shouldn't be having an anxiety response in that moment.

那一刻你不应该有焦虑反应。

And if you do, we would consider that grounds for concern.

如果你焦虑了，我们会认为 这是令人担忧的理由。

The other time we pay attention to anxiety

我们注意到了焦虑 并认为它是不健康的另一种情况，

and consider it to be unhealthy

is if the anxiety response is way too big for what's happened,

就是如果焦虑反应对于 所发生的事情来说太大了，

out of proportion to events.

与事件不成比例的时候。

So if somebody swerves and cut you off

所以如果有人转向并截住你，

and you have a panic attack in that moment,

而在那一刻你有恐慌的发作，

that is not healthy anxiety, it is not helping you.

那不是健康的焦虑，它对你没有帮助。

And we would address that clinically.

我们会在临床上解决这个问题。

Other than that, we really see anxiety as largely normal, protective,

除此之外， 我们真的认为焦虑在很大程度上

是正常的、保护性的、

healthy and useful in our lives.

健康的和对我们生活有用的。

OK, all the same, it feels terrible, right?

好吧，不管怎样， 感觉很糟糕，对吧？

I mean, I think one of the things that's so true about anxiety

我的意思是，我认为关于焦虑的 一个很真实的情况

is it doesn't feel good

是它并不感觉良好，

even if it's actually serving a useful purpose.

即使它实际上是为了一个有用的目的。

And so whether the anxiety is healthy or unhealthy,

所以无论焦虑是健康的还是不健康的，

it's really great to know how to get it in check if you want to.

如果你愿意，知道如何 把它控制住，那真是太好了，

And that's what I'm going to teach you now.

这就是我现在要教你的。

And you may be surprised to hear me say,

你可能会觉得惊讶对于听到我说：

"Oh, let me just teach you how to do this,"

“哦，让我教你怎么做吧。”

because our experience of anxiety is that it's kind of out of control,

因为我们对焦虑的体验是它有点失控，

that it sort of takes over.

它有点接管了一切。

But despite that,

但尽管如此，

the reality is that anxiety is probably the most systematic human emotion.

现实是，焦虑可能是人类最系统的情绪。

It unfolds in a very stepwise fashion,

它以一种非常循序渐进的方式展开，

it's actually a one-two-three process when it really goes off the rails.

当它真的失去控制时， 它实际上是就是一个“一二三”的过程。

And so I'm going to walk you through the one-two-three

所以我将带你们了解焦虑是如何通过这个 “一二三”步骤在我们所有人身上展开。

of how anxiety unfolds for all of us.

And then we're going to come back

然后我们会回来，

and I'm going to show you how at every step of the way

我将向你展示如何在每一步

there are things you can do to bring that anxiety back under control.

都可以做些什么来让焦虑重新得到控制。

OK, so the first thing that happens when we have an anxiety response

好的，所以当我们有焦虑反应时 发生的第一件事

is our bodies react.

是我们的身体做出反应。

There's actually just a physical reaction that we have,

实际上只是我们的一种生理反应，

and it's pretty universal and it's very familiar to all of us.

它是非常普遍的， 而且对我们所有人来说都非常熟悉。

Your heart rate accelerates,

你的心率会加快，

your breathing gets really quick and shallow.

你的呼吸变得非常快速和浅薄。

It feels uncomfortable,

这感觉很不舒服，

there's other stuff happening in our bodies, too, at the same time.

同时，我们的身体里也有其他的事情发生。

But that activated heart,

但那颗活跃的心，

that kind of hyperventilating sense of breathing,

那种呼吸急促的感觉，

everybody knows that feeling.

大家都知道这种感觉。

OK, what's happening here?

好吧，这是发生了什么？

The sympathetic nervous system,

交感神经系统，

which is the part of our nervous system

这是我们神经系统中的一部分， 它关注环境，

that is paying attention to the environment,

is sympathetic to what's around us,

它感知我们周围的事物，

is kicking off some degree of the fight or flight response, right?

它启动了某种程度的 战斗或逃跑反应，对吗？

That ancient response that we all know about.

我们都知道的那个古老的反应。

And in the fight or flight response,

在战斗或逃跑反应中，

what we want to do is get ready to run or attack.

我们要做的是准备好奔跑或进攻。

And so our sympathetic nervous system is taking measures

因此，我们的交感神经系统正在采取措施

to send a whole lot of heavily oxygenated blood

将大量的高氧血送到 我们的大肌肉群，以达到这个目的。

out to our large muscle groups for that purpose.

That's why the heart accelerates, that's why breathing changes.

这就是为什么心脏会加速， 这就是为什么呼吸会变化的原因。

And I, you know, especially in caring for people

而我，你知道的，尤其是在照顾那些 以前从未听过这些的人时，

who have not ever heard any of this before,

it can be really helpful to understand that as strange as this reaction is,

理解这种反应虽然很奇怪， 但确实很有帮助，

it has a sort of ancient logic to it, may not fit the moment,

它有一种古老的逻辑， 可能不适合当下，

but it definitely makes sense.

但这绝对有道理。

And it's not something going, you know,

而且这不算什么事情，你知道的，

kind of, out of whack when our heart and our lungs accelerate.

当我们的心脏和肺部加速时， 就会出现失调。

So that's the first thing that happens.

所以这就是发生的第一件事。

The second thing that happens is we notice that change in our body

第二件发生的事是 我们会注意到我们身体的变化，

and we come to the conclusion that we're going to call it anxiety.

然后我们得出的结论是 我们将称之为焦虑。

We decide to use that label.

我们决定了使用该标签，

This is often an arbitrary decision.

这通常是一个武断的决定。

We can call it something else,

我们可以叫它别的东西，

but we can sometimes default, unhelpfully, to calling it anxiety.

但我们有时会默认， 无益地称它为焦虑。

And then the third thing that happens,

然后是发生的第三件事，

and this is where things really do go off the rails,

而这正是事情真正失去控制的地方，

is we engage in catastrophic thinking.

是我们进行灾难性的思考。

And the definition of catastrophic thinking is actually very straightforward.

而灾难性思考的定义其实是非常直接的。

It's when we overestimate the risks

就是当我们高估了风险，

and we underestimate our ability to manage the risks.

却低估了自己管理风险的能力。

That's it.

就是这样。

So if your body reacts, you're like, "I must be anxious,

所以，如果你的身体有反应， 你就会说：“我一定是焦虑了，

oh, my gosh, this situation is completely out of control

哦，我的天啊， 这种情况完全失去了控制，

and there's nothing I can do to stop it."

而我却无能为力阻止它。”

That's when anxiety really becomes miserable.

那正是焦虑真正变得痛苦的时候。

And that's the one-two-three.

这就是所谓的“一二三”。

Alright, so knowing that,

好吧，那么知道了这些，

let's go back and hit every one of these in terms of how we can work against them.

让我们回过头来讨论 我们将如何对付它们。

So the first one, the body reacting.

所以，第一个，身体的反应。

OK, so one of the most powerful ways to get the body to calm down,

好的，所以让身体平静下来的 最有力的方法之一，

is through controlled breathing.

就是通过控制呼吸。

And I will tell you,

我会告诉你，

if you're having like, this, "Uh, really, breathing?

如果你反应像这样， “呃，真的吗，呼吸吗？

Like, you're going to go to breathing?"

你是在说呼吸吗？”

I totally get it.

我完全理解。

For years, I was like, "Oh, that's so woo woo.

多年来，我一直认为， “哦，那是什么空穴来风的想法。

That's not that technical. It's not that scientific."

它不是技术性的，它不是那么科学。”

Ok, I was wrong.

好吧，我错了。

I learned I was wrong.

我知道自己错了。

And in fact, breathing is this really biological intervention.

事实上，呼吸是真正的生物干预。

And what it does is it kickstarts

它的作用是启动我们神经系统的 副交感神经部分。

the parasympathetic part of our nervous system.

And the parasympathetic nervous system,

而副交感神经系统，

its job is to reset the body to its resting state.

它的工作是将身体重置为静止状态。

OK, here's how this works, it's kind of amazing.

好的，这就是它的工作原理， 这有点不可思议。

So just as the brain can signal to the heart and lungs

所以就像大脑可以向 心脏和肺部发出信号一样，

like, "go into overdrive,"

比如，“进入超速状态”，

you know, "we might have to do something here,"

你知道的，“我们可能要在 这里做一些事情。”

we're also of a mind that the lungs can communicate back to the brain.

我们还认为肺部可以与大脑进行交流。

So when we’re anxious, we’re breathing quickly and ... shallowly.

因此，当我们焦虑时， 我们的呼吸很快并且……很浅。

And if we override that,

而如果我们推翻了这一点，

if we deliberately deepen and slow our breathing,

如果我们刻意加深和放慢呼吸，

what we think we're doing,

我们认为我们正在做的事情，

this is sort of the understood science,

这是一种被理解的科学，

is that we are hacking into a set of nerves

是我们侵入了肺表面的一组神经，

on the surface of our lungs

that are stretch receptors.

这些神经是牵张感受器。

And all day, every day,

而一整天，每一天，

those nerves are paying attention to our breathing

这些神经都在关注我们的呼吸，

to keep us safe.

以确保我们的安全。

And they notice that we have slowed our breathing

他们注意到我们已经放慢了呼吸，

and things have gotten calmer

事情变得平静了，

and they read that as evidence of safety

他们将此视为安全的证据，

because we only breathe deeply and slowly when we're safe.

因为我们只有在安全时 才会深呼吸和缓慢呼吸。

And they send that message up to the brain saying,

然后他们把这个信息发送到大脑，说：

"you're kind of having a reaction that doesn't make sense

“你的反应有点不合理，

because the nerves on the lungs are telling us that we must be safe."

因为肺部的神经告诉我们， 我们一定是安全的。”

And that's how anxiety comes under control.

这就是焦虑得到控制的方式。

That's step one.

那就是第一步。

Step two, if we want to, need to,

第二步，如果我们想要，需要的话，

is to consider whether anxiety is the right name for what's happening.

就是考虑正在发生的事情 是否真的是焦虑。

That we have a kind of activated response all the time.

就像我们一直都有一种激活的反应。

So it might be like, I was excited for this presentation.

所以它可能是这样的： 我对这次演讲感到很兴奋。

And before this presentation, I kind of felt a little bit of a rev.

在这次演讲之前，我感觉有点激动。

I could have said, "I must be anxious."

我本来可以说：“我一定很焦虑。”

But instead I said, "No, I think I'm really excited."

但相反，我说： “不，我觉得我真的很兴奋。”

And that shift in thinking actually makes a huge difference

这种思维上的转变实际上使我们

对所参与的事情的感受 产生了巨大的影响。

in terms of how we feel about what we're engaging.

The third thing we want to watch out for

我们要注意的第三件事

is anxiety going off the rails with catastrophic thinking.

是焦虑会失去控制带着灾难性的思考。

And again, that's overestimating risk,

再一次，这是高估了风险，

underestimating our ability to handle it.

低估了我们应对风险的能力。

So if something is feeling really, really scary to you,

所以如果某件事让你感觉 真的、真的很可怕，

really, really anxiety-provoking,

真的，真的很让人焦虑，

key questions to ask yourself are,

需要问自己的关键问题是：

"Am I imagining this to be worse than it might really be?"

“我是不是把这一切想象得 比实际情况更糟糕了？”

So you're going to try to bring that estimation of risk down.

所以你要尝试把这个风险估计降低。

And also, "Do I have more say in how this is going to go

还有就是，“我对这件事的发展

是否比我给自己的评价更有发言权？”

than I'm giving myself credit for?"

"Are there things I can do to actually increase my sense of control,

“我是否可以做一些事情 来实际增强我的控制感，

not feel as helpless as I do right now?"

而不是像现在这样感到无助？”

So you're not trying to get rid of the anxiety entirely,

所以你并不是要完全摆脱焦虑，

but you're trying to sort of get it in the narrower band

而是要让它处于更窄的范围内，

of not overestimating risk

即不要高估风险，

and not underestimating your own powers.

也不要低估自己的能力。

So I'm going to start to wrap up, but here is the bottom line.

所以我要开始总结了， 但这里是关键之处。

Most of the time,

大多数时候，

we don't need to feel anxious about feeling anxious.

我们不需要为感到焦虑而焦虑，

It really is there to help us out.

它真的是为了帮助我们。

And whether we want it there or not, or whether it's helping us or not,

不管我们是否想要它， 或者它是否对我们有帮助，

if we want to get it under control,

如果我们想控制住它，

knowing the basics of how it unfolds

了解它是如何展开的基本知识

really does put you in the driver's seat

会在你感到焦虑时让你掌握 如何让自己平静下来的主动权。

of knowing how to calm yourself when you feel anxious.

And so you don't have to feel

所以你不必觉得这是一件 你任人摆布的事情。

like it's something that you are at the mercy of.

David Biello: You spoke about breathing

大卫·比罗（David Biello）： 你谈到了呼吸

and how you were skeptical in the early days.

以及你在早期是如何持怀疑态度的。

Do you have the particular breathing practice you like?

你是否有自己喜欢的特定呼吸练习？

Lisa Damour: I do.

丽莎‧达摩儿（Lisa Damour）：我有。

Once I got over my snobbery about breathing,

一旦我克服了对呼吸的势利心态，

I use something called square breathing or box breathing.

我使用一种叫做方形呼吸 或箱式呼吸的方法。

And, you know, people have often heard of this.

而且，你知道吗， 人们经常听说过这个。

And it's really simple.

这真的很简单。

It’s where you breathe in on a count of three,

就是你在数到三的时候吸气，

so one, two, three, in --

所以一、二、三，吸气——

and I'm actually going to walk us through it as a group.

然后实际上我将引导我们 作为一个小组完成它。

Then you hold it for a count of three: one, two, three.

然后你保持吸气数三下： 一、二、三。

Then you exhale slowly on a count of three: one, two, three.

然后你慢慢地呼气，数三下： 一、二、三。

And then you wait, one, two, three.

然后你就等着，一、二、三。

So, one, two, three, in.

所以，一、二、三，吸气。

One, two, three, hold.

一、二、三，保持。

One, two, three, exhale.

一、二、三，呼气。

One, two, three, wait.

一、二、三，等等。

OK, so let's all do it together.

好的，那么让我们一起做吧。

But here is my instruction to you.

但是，我在这里要给你指示。

If you really want this to work,

如果你真的想让它发挥作用，

picture the nerves on the surface of your lungs getting the message.

想象一下，你的肺部 表面的神经收到了信息。

You're not just breathing to breathe, right?

你不仅仅是为了呼吸而呼吸，对吗？

You're breathing because you are hacking into this system

你在呼吸是因为你正在侵入这个系统，

and using those nerves to communicate to your brain that everything's OK, right?

并利用这些神经向你的大脑 传达一切正常，对吧？

So everybody, like, (Exhales) blow out breath a little bit, ready?

所以每个人，像这样，（呼气） 稍微呼一口气，准备好了吗？

Breathe in slowly.

慢慢吸气。

One, two, three.

一、二、三。

Hold it.

保持住。

One, two, three.

一、二、三。

Exhale slowly, one, two, three.

慢慢地呼气，一、二、三。

Now, pause.

现在，暂停一下。

One, two, three.

一、二、三。

That’s it. (Laughs)

就是这样。（笑）

And you can do it a few times.

你可以多做几次。

If you get really anxious a lot,

如果你真的经常感到焦虑，

you should be practicing this when you're not anxious

你应该在不焦虑的时候练习这个，

so that you can slip right into that groove.

这样你就可以直接进入那个状态。

But it is powerful.

但它是强大的。

It is really powerful.

它真的很强大。

And I am a little embarrassed

我对自己花了这么长时间才开始 进行呼吸训练感到有些尴尬。

about how long it took me to get on the breathing train.

DB: I mean, it's actually incredible because just doing that with you,

DB：我的意思是，这真的很不可思议， 因为只是和你一起做了一下，

you know, the little ball of whatever, excitement in my stomach

你知道吗，那个小球什么的， 我胃里的兴奋感就这样消散了。

just sort of dissipates.

So breathing, people, it's real.

所以，呼吸吧，大家，这是真实的。

It's important.

这很重要。

So we already have some questions flooding in.

所以我们已经有一些问题涌入了，

And I want to make this useful for the members.

我想让这对会员们来说很有用。

Let's get right to them.

让我们开始吧。

First up, Gordon wants to know about helping other people.

首先，戈登想了解如何帮助他人。

How can we help if we notice

我们该如何提供帮助如果我们发现

that a friend or a family member is experiencing excessive anxiety?

一个朋友或家庭成员 正在经历过度的焦虑？

LD: OK, I love this question.

LD：好的，我喜欢这个问题。

So the first thing I would say just by being generally useful,

所以我想说的第一件事就是普遍有效的，

is, we'll get to the excessive piece,

是，我们会进入过度的阶段，

but just, people need validation that anxiety makes sense

但只是说，人们需要确认 焦虑在大多数时候是有意义的。

most of the time.

And one of the real hazards

焦虑的真正危害之一是， 它被谈论得好像它无处不在，

of anxiety being talked about as though it's everywhere

and always pathological

而且总是病态的，

is that people experience normal anxiety

那就是人们会经历正常的焦虑，

and then they think, "Oh, I'm having anxiety.

然后他们会想，“哦，我在焦虑。 哦，不，真的有什么不对劲。”

Oh, no, there's something really wrong."

And so one quick thing you can do to say [to] somebody who’s anxious

因此，你可以快速的 [对] 焦虑的人说，

if they’re like, “Oh my gosh, I have a big talk tomorrow and I’m anxious,”

如果他们说，“哦，我的天哪， 我明天有一个重要的演讲，我很焦虑。”

you can say, “You’re having the right reaction ...

你可以说，“你的反应是对的……

That's going to give you energy and juice.

这会给你能量和能力。

There's nothing wrong with being anxious about a talk"

对演讲感到焦虑并没有什么错”，

or "there's nothing wrong with having to go tell your boss

或者 “不得不去告诉你的老板 一些他们不想听的事情”，这没有什么不对。

something they don't want to hear.

And that making you anxious,

而这让你感到焦虑，

that's evidence that you work perfectly."

这证明你工作得很棒。

So that alone reassures people a lot.

因此，光是这一点就能让人们放心很多。

And then I think the next step you can do is to say,

然后我认为下一步你可以说，

"If it gets uneasy,

“如果它变得不安，

if it gets to be too much more anxiety than is helpful to you, right?” --

如果它变得过于焦虑 而对你没有帮助，对吗？” ——

Even framing it is like, “This should help you out until it doesn’t.” --

甚至把它框起来就像，“这应该能帮助你， 直到它无法为止。” ——

“You can actually dial it back.”

“你实际上可以把它调回来。”

So walk them through why breathing works.

因此，要让他们了解 为什么呼吸会起作用。

Everybody knows they're supposed to breathe.

每个人都知道他们应该呼吸。

Very few people know why.

很少有人知道为什么，

And so that's why people won't do it.

这就是为什么人们不会这样做的原因。

And so when I'm caring for people, I will say,

所以当我关心别人时，我会说，

think about your anxiety being on a dial, right?

想想你的焦虑是在一个表盘上，对吧？

And if it's a zero to 10 dial,

如果它是一个零到十的表盘，

two to three, you actually tend to do a better job

二到三，无论你需要做什么， 你实际上往往会做得更好,

with whatever you're needing to do

if you have a little energy, a little rev.

如果你有一点能量，一点点转速。

Once it gets into four, five, six, seven, you start to be in trouble.

一旦进入四、五、六、七， 你开始有麻烦了。

And so I teach people to use the breathing to actually turn down the dial.

因此，我教人们用呼吸来实际调低表盘。

But that idea of like, you're not at the mercy of this.

但这种想法就像， 你不是在任由它摆布。

You can be in the driver's seat on this

你可以在这个问题上占据主导地位，

and you can use breathing or reframing

你可以使用呼吸或重构，

or questioning your own thinking,

或质疑你自己的想法，

is really helpful because there is a general sense of like,

这真的很有帮助， 因为有一种普遍的感觉是，

we're helpless in the face of anxiety, and we're really not.

我们在焦虑面前很无助， 而我们其实没有。

DB: So Catarina describes an anxiety that leads them to avoid things.

DB：所以卡塔琳娜描述了一种 导致他们逃避事物的焦虑。

So meeting new people because it’s scary.

所以结识新朋友因为这很可怕。

Do you --

你是否——

What do you recommend for that kind of avoidance tactic around anxiety?

对于这种围绕焦虑的回避机制， 你有什么建议？

LD: Oh, Catarina, I'm so glad you brought up avoidance.

LD：哦，卡塔琳娜， 我很高兴你提到了逃避问题。

This is actually the most important thing we need to say

这实际上是我们在谈论焦虑时， 需要说的最重要的事情。

when it gets to talking about anxiety.

So, when we're frightened of something,

所以，当我们对某些东西感到恐惧时，

our instincts are like,

我们的本能是这样的，

"Get away."

“走开“。

And if that is a tiger or a bad driver,

而如果那是一只老虎或一个差劲的司机，

those are really good instincts.

这些都是非常好的本能。

And so when we remain frightened of something that's in our everyday lives,

因此，当我们对日常生活中的 一些东西保持恐惧时，

we can actually feel very compelled to avoid it.

我们实际上会感到非常被迫地去避免它。

Here is, if you remember anything from what we talk about today,

在这里，如果你还记得 我们今天谈论的内容，

these are the three words I want you to remember most.

这是我最希望你记住的三个词。

Avoidance feeds anxiety.

逃避会助长焦虑。

So here's the process.

所以过程是这样的。

It's actually a wonderfully -- I think it's fascinating science on this.

这实际上是一个奇妙的—— 我认为这是有趣的科学。

So say, Catarina, you're thinking about going to a party.

所以比如说，卡塔琳娜， 你正在考虑去参加一个派对。

You've been invited to a party and you're like, OK,

你被邀请参加一个派对， 你就想说，好吧，

"I'm going to try to go to this party."

“我会试着去参加这个派对。”

And then it's time to go to the party

然后到了去参加派对的时候，

and you feel your anxiety starting to bubble up

你觉得焦虑的感觉开始冒出来了，

and you're like, "Forget it. I'm going to cancel."

你就想说，“算了吧。 我还是不去了。”

OK, here's what's going to happen.

好的，下面是将要发生的事情。

You'll go from feeling very, very anxious

你会从感到非常、非常的焦虑

to suddenly feeling much, much better.

到突然感觉好多了、好太多了。

So this is the first helping of how avoidance feeds anxiety,

因此，这是逃避所带来的 如何助长焦虑的第一个帮助，

which is that it feels good.

那就是，感觉很好。

That, we call it a reinforcing experience.

这一点，我们称之为强化的经验。

You felt bad, you avoided, you feel better.

你感觉不好，你避开了， 你感觉好多了。

So you're like, avoidance is kind of fun.

所以你就会觉得逃避蛮有趣的。

Or not fun, but it solves the problem.

或者并不有趣，但它能解决问题。

Here comes the second helping.

但第二种情况是，

Because you haven't gone to the party,

因为你没有去参加派对，

nothing challenges your beliefs about how frightening that party is.

所以没有什么可以挑战 你对于派对有多可怕的假想。

The party remains whatever you have pictured in your mind --

派对仍然是你脑海中所想象的那样——

people not talking to you, you know, people, you know, whatever.

人们不跟你说话，你知道的， 人们嘛，你懂的，随便怎样。

Like whatever you have imagined about what makes that party scary

就像你想象的那样，关于那个派对的 可怕之处，这假想没有受到挑战。

goes unchallenged.

If you actually go to the party,

如果你真的去参加派对，

you often find it's a little bit, if not a lot, better than you expected.

你往往会发现它比你预期的 要好一点，甚至很多。

But if you don't go, it remains very frightening.

但是如果你不去， 它仍然是非常可怕的。

So that is how avoidance actually entrenches anxiety over time.

因此，这就是逃避实际上是如何 随着时间的推移巩固焦虑的。

It feels good to do it and it actually doesn't give us any competing data.

这样做的感觉很好，而且实际上并没有 给我们提供任何有说服性的数据。

So when you go see a clinician for treatment of anxiety,

所以当你去看临床医生治疗焦虑时，

often we will start by asking about what are you avoiding

通常我们会先问一下， 你因为焦虑而逃避了什么？

as a result of your anxiety?

And we will work with you

我们将会帮助你—— 我们称之为渐进式暴露，

on -- we call it graduated exposure, which is like basically baby steps --

这基本上就像婴儿学步一样——

getting you in there, right?

让你进入状况，对吧？

So we'll say, OK,

所以我们会说，好的，

could you go to a small thing with a couple people?

你能和几个人一起去做一件小事吗？

Could you use your breathing to make that bearable?

你能用你的呼吸来使 这一切变得可以忍受吗？

And it would just sort of work you into it very, very slowly,

然后它会非常、非常缓慢地 让你融入其中，

because the solution to anxiety is often what we call exposure,

因为解决焦虑的方法 往往就是我们所说的暴露，

making yourself do it.

让自己去做。

But you are not alone in this sense of like, you know,

但在以下这种意义上 你并不是一个人，就像是，你知道的，

why not just not go?

可以不去做吗？

It feels better to not go.

不去做的感觉更好。

And that's something that we, as clinicians, work really hard on.

而这是我们作为临床医生 非常努力的事情。

And I will tell you, you know, the pandemic and kids and school,

我会告诉你，你知道的， 流行病、孩子和学校，

you know that, and, you know,

你知道的，而且，你懂的，

we've always known if this child is frightened of school,

我们一直都知道如果这个孩子害怕上学，

the solution is get them to school.

解决办法就是让他们上学。

Even if they sit in the teacher’s ... back office for the day.

即使他们当天就坐在老师的…… 后面的办公室里。

Physically being at school is better than being home

如果他们在学校是安全的， 那么实际的待在学校比在家好。

if it's otherwise safe for them to be there.

DB: So another ...

DB：所以另一个…… 聊天框中出现的焦虑领域

Area of anxiety that's popping up in the chat

is dealing with it in our sort of, children.

是处理这种像是我们孩子们的焦虑。

Robert wants to know what,

罗伯特想知道，

or are there any differences between words like

焦虑和担心或恐惧这样的词之间 是什么样的区别，或者说有什么区别？

anxiety and worry or fear

as it might pertain to how a teenager is describing

因为它可能涉及到一个青少年如何描述，

or trying to put a name to what they're feeling?

或试图给他们的感受命名？

LD: I think it means for the kid whatever it means.

LD：我认为这对孩子来说 意味着什么都可以。

But I will say teenagers use the term anxiety a lot,

但我要说的是，青少年经常 使用焦虑这个词，

and they use it very broadly.

并且他们使用的范围非常广。

And I've been practicing for a very long time.

而我已经练习了很长时间。

And then in the last I'd say 10 years, I started to notice,

然后在过去的 10 年里，我开始注意到，

like, kids use this term a lot

就好像孩子们经常使用这个词，

and I wasn't quite sure what to make of it.

但我不太确定该如何理解它。

And then I was actually rereading "Jane Eyre" --

然后我实际上是在重读《简·爱》——

no, it was "Pride and Prejudice."

不，是《傲慢与偏见》。

And Mrs. Bennet, I don't know if you remember her,

还有班纳特夫人， 我不知道你是否记得她，

she's like, the kind of piece of work mom in that book.

她就像那本书里的那种在职妈妈。

There is a line in the book that was,

书中有一句话是这样的，

"Whenever Mrs. Bennet was discontented, she fancied herself to be nervous."

“每当班纳特夫人不满的时候， 她就主张说自己是紧张。”

And I thought, Oh, I think that's often what I'm seeing with teenagers,

我就想到说，哦，我想这往往就是 我在青少年身上看到的情况，

is they'll say, "I feel anxious" when they usually mean not calm.

他们会说，“我感到焦虑” 而他们通常是指不平静。

"I don't feel calm."

“我感到不平静。”

And so the first thing I would do if a teenager says

因此，如果青少年说：“我感到焦虑”，

"I feel anxious" is to say, "Tell me what's going on."

我会做的第一件事就是说： “告诉我发生了什么事。”

And they might say, you know, “I’ve got a big try out tomorrow”

他们可能会说，你知道的， “我明天有一个重要的试演”，

or, you know, “This concert is happening

或者，“这场音乐会正在举行， 我要和我的朋友们一起去。”

that I’m going to with my friends.”

And listen for the possibility that it’s something besides anxiety.

并倾听它是否有可能是焦虑之外的东西。

It could be they're excited, they're amped, they're apprehensive.

有可能是他们很兴奋， 他们很激动，他们很忐忑。

So try to make more granular

因此，要尽量使他们的描述更加细化，

their description of what is causing the stirred-up feeling.

也就是他们对造成这种 激动的感觉的描述，

And sometimes they are anxious.

有时他们也会感到焦虑。

And that's when there's a threat, right?

而那是在有威胁的时候，对吗？

Like, "I'm feeling anxious because I have my driver's test tomorrow

比如说，“我感到焦虑， 因为我明天要参加

驾驶考试，但我还没准备好。”

and I am not ready."

That is anxiety.

那就是焦虑。

There is a threat, they could fail that driver's test, right?

有一种威胁是他们可能无法通过 那个驾驶考试，对吗？

So listen for a threat and then ...

所以要倾听威胁，然后呢……

if they’re anxious about something, be like, “Yeah, of course you’re anxious.

如果他们对某些事情感到焦虑， 就说：“是的，你当然会焦虑。

That's kind of scary.

这有点可怕。

Let's see what we can do to reduce your sense of risk,

让我们看看我们能 做些什么来减少你的风险感，

increase your sense of control."

增加你的控制感。”

But often it's very important that we help them

但往往非常重要的是，我们帮助他们

bring more nuance to the language they use

把更多的细微差别 带到他们所使用的语言中，

around a sort of sense of being stirred up.

围绕着一种被激起的感觉。

And what's so nice is that act of a teenager saying or a kid saying,

而非常好的现象是 当一个青少年或孩子说：

“明天要上学我真的很焦虑。”——

“I feel really anxious about school tomorrow.” --

“What’s making you anxious?” --

“是什么让你感到焦虑？”——

"New classroom, new kids, don't know where things are going to be."

“新的教室，新的同学们， 不知道事情会发展成怎样。”

You say, "Yeah, you should feel apprehensive,

你就说，“是的，你应该感到忐忑不安，

there's a lot there,

那里有很多东西，

and also maybe a little excited."

也许还有一点兴奋。”

If you can get in there with words that are more accurate

如果你能用比泛泛的焦虑 更准确的词语融入其中，

than the big generic of anxiety,

that act is in and of itself therapeutic.

那么这种行为本身就是治疗性的。

Kids are like, "Yes, I am apprehensive and also excited."

孩子们会说： “是的，我很忐忑，也很兴奋。”

That they feel heard, they feel better,

他们感觉有被倾听，他们感觉更好，

and they have a better language.

并且他们有更好的语言。

So what I watch for especially,

所以我特别关注的是，

is kids saying, "I have anxiety."

孩子们说：“我有焦虑症。”

I like to say, “You’re feeling anxious.”

我喜欢说，“你是感到焦虑。”

Because I think, there is this sense of, “I have anxiety,”

因为我认为存在着一种 “我有焦虑”的氛围，

I think there's very much among adolescents a sense of like,

我认为青少年中有很多像这样的氛围，

"I have anxiety,"

就是“我有焦虑。”

but I try not to say, well, everybody has anxiety at some level

但我尽量不说，好吧， 每个人在某种程度上都有焦虑，

because I don't want to be dismissive,

因为我不想轻视他们，

but to really help them make that distinction

而是要真正帮助他们 区分“来来去去”的感觉，

between a feeling that comes and goes,

and a diagnosis they would need to be concerned about.

以及他们需要关注的诊断。

DB: Several folks want to know how can they tell when to seek help,

DB：有几位朋友想知道， 他们如何判断何时寻求帮助，

when anxiety has become too crippling?

当焦虑已经变得非常严重时？

LD: This is a great place to wrap up. This is a perfect place to wrap up.

LD：这是一个很棒的总结点， 这是一个完美的总结点。

So mostly this has been an ad for anxiety.

所以这主要是一个焦虑的广告。

Like, don't be frightened of it.

就是说，不要害怕它，

Be curious about it.

要对它感到好奇。

Trust that it’s trying to tell you something.

相信它试图告诉你一些事情。

If it feels too uncomfortable,

如果感觉太不舒服，

try these strategies to get it under control.

请尝试这些策略来控制它。

But two conditions.

但有两个条件。

Let's go back to them.

让我们回到它们身上。

If you feel like your anxiety is showing up

如果你觉得你的焦虑出现了，

and there's no reason, like, there's no threat,

而且没有任何理由， 比如说，没有威胁，

there's nothing to be worried about,

没有什么可担心的，

that would be a great time to seek out support.

那将是一个寻求帮助的好时机。

The other is if your anxiety like, well, there's a threat,

另一个是如果你的焦虑是比如说， 好吧，有威胁的，

but like my anxiety is off the charts and making me miserable

但就像我的焦虑超出了图表， 让我很痛苦

or getting in the way of my life,

或妨碍了我的生活，

that's a good time to seek support.

那将是寻求帮助的好时机。

So, you know,

所以，你知道的，

pretty straightforward in terms of how we define

关于我们如何定义我们考虑的问题 而言，是非常直接的。

what we consider concerning.

But I really want you to know,

但我真的想让你知道，

most anxiety does not need to make you feel anxious about its own presence.

大多数的焦虑并不是需要让你 对它本身的存在感到焦虑的。

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