Art can heal PTSD's invisible wounds | Melissa Walker

譯者: David Hsu 審譯者: Conway Ye

You are a high-ranking military service member

假想你是高層軍官

deployed to Afghanistan.

被派駐阿富汗。

You are responsible for the lives

你要為上百個男兵女兵

of hundreds of men and women,

的生命負責。

and your base is under attack.

你基地受到侵襲，

Incoming mortar rounds are exploding all around you.

迫擊砲彈在你四周爆炸，

在塵埃和煙霧中，掙扎著想要看清，

Struggling to see through the dust and the smoke,

you do your best to assist the wounded

奮身救助傷者

再爬到附近的掩體。

and then crawl to a nearby bunker.

Conscious but dazed by the blasts,

雖有知覺，但砲浪使你發呆，

你躺在一邊試著思考剛才的經歷，

you lay on your side and attempt to process what has just happened.

As you regain your vision,

當你視覺恢復時，

you see a bloody face

一個血腥面孔就在眼前，

staring back at you.

瞠視著你。

The image is terrifying,

這一幕令人極恐懼，

but you quickly come to understand

但你很快就察覺到，

it's not real.

它不是真的。

This vision continues to visit you multiple times a day and in your sleep.

但它每天數次浮現在腦海，也在夢中。

You choose not to tell anyone for fear of losing your job

你決定不說，怕失掉工作

or being seen as weak.

或被視為懦弱。

這畫面你稱為

You give the vision a name,

「掩體的血臉」

Bloody Face in Bunker,

或縮寫為BFIB。

and call it BFIB for short.

You keep BFIB locked away in your mind,

你把BFIB鎖在心靈深處，

不為人知地侵擾著你，

secretly haunting you,

for the next seven years.

七年不停。

Now close your eyes.

現在閉上眼睛，

你能看到BFIB嗎？

Can you see BFIB?

If you can, you're beginning to see the face

如果你能看到，你就能夠開始感覺

of the invisible wounds of war,

戰爭無形的傷口，

commonly known as post-traumatic stress disorder

通稱為「創傷後應激障礙」

and traumatic brain injury.

或「創傷性腦損傷」。

While I can't say I have post-traumatic stress disorder,

我雖沒親歷過創傷後應激障礙，

但我也對它不陌生。

I've never been a stranger to it.

When I was a little girl, I would visit my grandparents every summer.

我小時候每個夏天都會探訪祖父母，

是我的祖父

It was my grandfather

讓我領會到戰爭帶來的心靈影響。

who introduced me to the effects of combat on the psyche.

While my grandfather was serving as a Marine in the Korean War,

當祖父在韓戰服役海軍時，

a bullet pierced his neck and rendered him unable to cry out.

一顆子彈穿入脖子令他不能發聲，

He watched as a corpsman passed him over,

他眼睜睜盯著走過的醫護兵

declaring him a goner,

以為他無藥可治，

and then leaving him to die.

把他留下等待死亡。

Years later, after his physical wounds had healed

多年後，他身上的傷都痊癒了，

and he'd returned home,

回到了家，

he rarely spoke of his experiences in waking life.

在他清醒的幾乎從不談那經歷。

But at night I would hear him shouting obscenities

但在深夜裡，我可聽到他的怒嚎謾罵，

from his room down the hall.

從他臥室沿著走廊滲出，

白天我會提醒他，然後進入房間，

And during the day I would announce myself as I entered the room,

careful not to startle or agitate him.

怕驚嚇或激怒他。

He lived out the remainder of his days

祖父就這樣渡過他餘生，

isolated and tight-lipped,

孤立，緊張，

never finding a way to express himself,

找不到任何表達自己的方式。

and I didn't yet have the tools to guide him.

當時我也不懂如何引導他，

I wouldn't have a name for my grandfather's condition

我也不知道他的疾病的名字，

直到我二十多歲時。

until I was in my 20s.

Seeking a graduate degree in art therapy,

攻讀藝術治療的學位，

I naturally gravitated towards the study of trauma.

我自然傾向創傷方面之研究。

And while sitting in class learning about post-traumatic stress disorder,

當我在教室裡學習創傷後應激障礙時，

or PTSD for short,

或縮寫為PTSD，

my mission to help service members who suffered like my grandfather

想幫助像祖父般受害軍人

的目標就開始立定了。

began to take form.

人類把創傷後應激障礙立了不少名稱，

We've had various names for post-traumatic stress

throughout the history of war:

自有戰爭記錄後：

homesickness,

思鄉症、

soldier's heart,

神經性循環休克、

shell shock,

砲彈休克症、

thousand-yard stare, for instance.

一千碼的呆視等等。

And while I was pursuing my degree, a new war was raging,

在我修讀學位時，一場新戰爭剛爆發。

and thanks to modern body armor and military vehicles,

因為有了先進防彈衣和軍用車輛，

service members were surviving blast injuries they wouldn't have before.

軍人爆炸受傷的存活率達到歷史新高。

But the invisible wounds were reaching new levels,

但無形的創傷卻躍上了新高，

and this pushed military doctors and researchers

這驅使軍醫和學者

to try and truly understand the effects that traumatic brain injury, or TBI,

更急需全面了解創傷性腦損傷， 也就是TBI，

and PTSD have on the brain.

和創傷後應激障礙對腦之影響。

Due to advances in technology and neuroimaging,

因科技和神經影像學之進步，

我們現在能確知【布羅卡區】會關閉

we now know there's an actual shutdown in the Broca's,

or the speech-language area of the brain, after an individual experiences trauma.

就是大腦的語言系統區， 在個人經歷創傷後。

This physiological change,

這個生理變化

or speechless terror as it's often called,

也常被稱為「無言之恐懼」，

coupled with mental health stigma,

伴隨心理創傷，

the fear of being judged

還有個人被批評

or misunderstood,

和誤會的憂慮，

possibly even removed from their current duties,

甚至調離現有職責，

has led to the invisible struggles of our servicemen and women.

都有可能導致軍人飽受內心煎熬。

Generation after generation of veterans

一代一代的退伍軍人

have chosen not to talk about their experiences,

都對他們的經歷守口如瓶，

and suffer in solitude.

孤獨的忍受折磨。

I had my work cut out for me when I got my first job

我第一份工作好像為我量身訂做的，

as an art therapist at the nation's largest military medical center,

是一位藝術治療師， 在全美最大的軍人醫院

Walter Reed.

沃爾特列得國家軍人醫療中心。

After working for a few years on a locked-in patient psychiatric unit,

在精神科單位工作數年後，

I eventually transferred to the National Intrepid Center of Excellence, NICoE,

我最後調職到國家勇士優越中心，NICoE

which leads TBI care for active duty service members.

治療在職軍人之創傷性腦損傷。

Now, I believed in art therapy,

我深信藝術治療法，

but I was going to have to convince service members,

但我需要說服那些軍人：

高大，粗獷，滿身肌肉的猛男軍兵，

big, tough, strong, manly military men,

and some women too,

偶爾還有女性，

to give art-making as a psychotherapeutic intervention a try.

來嘗試藝術創作做為心理治療方法。

The results have been nothing short of spectacular.

結果功效非常可觀。

真切，象徵性的藝術

Vivid, symbolic artwork

is being created by our servicemen and women,

從我們的軍人親手創做出來，

and every work of art tells a story.

每件創作都在訴說一個故事。

We've observed that the process of art therapy bypasses

我們觀察到在藝療過程中，

它能繞過大腦的語言區的障礙。

the speech-language issue with the brain.

藝療能接駁大腦存儲創傷經歷 的同一個腦區，

Art-making accesses the same sensory areas of the brain that encode trauma.

Service members can use the art-making to work through their experiences

使治療者借創作來重審情緒經歷，

in a nonthreatening way.

在一種無批判之氛圍中。

They can then apply words to their physical creations,

他們能夠再用文字來描述自己的創作，

將左腦和右腦重新結合。

reintegrating the left and the right hemispheres of the brain.

Now, we've seen this can work with all forms of art --

我們觀察到各類藝術媒介都有療效：

素描，油畫，拼圖

drawing, painting, collage --

but what seems to have the most impact

但最大療效

is mask-making.

是做面具。

因為無形的創傷從此不只有名稱，

Finally, these invisible wounds don't just have a name,

they have a face.

它更有個實質面孔了。

And when service members create these masks,

當這些軍人做這些面具時，

it allows them to come to grips, literally, with their trauma.

他們能用雙手雕塑心靈創傷，

And it's amazing how often that enables them

驚訝地，做面具讓他們

突破心靈的創傷，開始痊癒。

to break through the trauma and start to heal.

Remember BFIB?

大家還記得BFIB？

That was a real experience for one of my patients,

那是我的一個病人的真實經歷，

and when he created his mask,

當他做了面具之後，

he was able to let go of that haunting image.

他就能釋放心中的幽影。

Initially, it was a daunting process for the service member,

過程剛開始時，是極恐懼的，

but eventually he began to think of BFIB as the mask,

但最終軍人會視BFIB為面具，

not his internal wound,

不再是內在的傷口了。

and he would go to leave each session,

他每次療程完畢時，

he would hand me the mask, and say, "Melissa, take care of him."

他會遞那面具給我說， “梅麗莎，照顧好他。”

Eventually, we placed BFIB in a box to further contain him,

最後我們把BFIB放盒裡。

and when the service member went to leave the NICoE,

當這名軍兵離開NICoE 時，

he chose to leave BFIB behind.

他選擇把BFIB留下。

A year later, he had only seen BFIB twice,

一年後，他只有見過BFIB兩次，

and both times BFIB was smiling

兩次BFIB都是笑著的，

and the service member didn't feel anxious.

而這軍人毫無焦慮。

如今這軍人感到創傷帶來不安時，

Now, whenever that service member is haunted by some traumatic memory,

he continues to paint.

他就畫畫。

而每次他畫這些擾人的形像後，

Every time he paints these disturbing images,

he sees them less or not at all.

這些形像就減少或停止出現了。

幾千年來哲學家已在說：

Philosophers have told us for thousands of years

that the power to create

創造能力

與破壞能力是緊連的。

is very closely linked to the power to destroy.

Now science is showing us that the part of the brain

今天科學證明在大腦區

記憶創傷經歷的，

that registers a traumatic wound

can be the part of the brain where healing happens too.

也同時能引動自癒能力，

And art therapy is showing us how to make that connection.

而藝療展現出如何啟發這互動。

We asked one of our service members

我們請一位受治療人

to describe how mask-making impacted his treatment,

說出他做面具的親身治療感受。

and this is what he had to say.

他說了以下的話

(Video) Service Member: You sort of just zone out into the mask.

（錄音）軍人：你把自己投射在面具上

You zone out into the drawing,

投射在圖畫上，

and for me, it just released the block,

對我，這就能釋放壓抑的情緒

so I was able to do it.

所以我就敢於創作。

And then when I looked at it after two days, I was like,

兩天後當我再看時，我感應到

"Holy crap, here's the picture, here's the key, here's the puzzle,"

“咳！就是這圖畫，就是這鑰匙， 就是這答案。”

and then from there it just soared.

從這往後，一切就通了

I mean, from there my treatment just when out of sight,

我意思是我的治療就成功了。

作品就像是說：庫爾特解釋這個， 解釋這個…

because they were like, Kurt, explain this, explain this.

And for the first time in 23 years,

二十三年來首次

I could actually talk about stuff openly to, like, anybody.

我可以無忌諱的和任何人談論。

I could talk to you about it right now if I wanted to,

我現在也能和你談論

because it unlocked it.

因為整件事已被解開了。

It's just amazing.

真不可思議

And it allowed me to put 23 years of PTSD

它能使我能把二十三年的PTSD

and TBI stuff together in one place

和TBI拼在一塊，

that has never happened before.

這從沒發生過。

不好意思。

Sorry.

Melissa Walker: Over the past five years,

梅麗莎沃克：過去五年

we've had over 1,000 masks made.

我們做過一千多個面具。

It's pretty amazing, isn't it?

超乎想象！是不是？

Thank you.

謝謝

(Applause)

（掌聲）

I wish I could have shared this process with my grandfather,

我希望我能和祖父分享這療程，

but I know that he would be thrilled

但我肯定他會驚喜

我們已能找到方法

that we are finding ways

to help today's and tomorrow's service members heal,

幫助今時和未來的軍兵痊癒，

and finding the resources within them

啟發他們本身之自癒潛能，

that they can call upon

隨著他們的需要

to heal themselves.

來治療自己。

Thank you.

謝謝

(Applause)

（掌聲）