study the poignant phenomenon that psychologists call dermatillomania - more commonly known

研究心理學家稱之為皮膚病的淒涼現象--更常見的是

as skin picking.

作為扒皮。

Those who suffer from it will, by definition, be at the anxious end of the spectrum. Few

患此病的人，按理說會處於焦慮的一端。很少有

days will be free of great worry, sometimes a specific concern with a threat that feels

日子會沒有很大的擔憂，有時會有一種具體的擔憂與威脅的感覺。

like it will be the end of us, or else a general eeriness and nameless dread.

就像這將是我們的末日，否則就是一種普遍的陰森和無名的恐懼。

In response, as we've probably done for years, we will start to pick. Perhaps we reach

對此，我們可能已經做了很多年，我們會開始挑選。也許我們會達到

for one of our hands and a very special zone we've almost certainly not told anyone about;

對於我們的一隻手和一個非常特殊的區域，我們幾乎肯定沒有告訴任何人。

a zone of hardened skin made up of extra layers that we begin to press or squeeze at, file

堅硬的皮膚區，由額外的層組成，我們開始按壓或擠壓，銼刀。

down or unsheathe. Or we go to an area of our face and start worry away, pinching, squeezing,

下或解脫。或者我們到臉上的某個部位，開始煩惱去了，捏、擠。

lifting, skewering. It might equally - or also - be a part of our lips we go to or a

提升、串聯。它可能同樣--也可能--是我們嘴脣的一部分，我們去或者是一個。

bit of our ankle. In all cases, the skin buckles, damages, goes sore and on occasion, when we

我們的腳踝的位。在所有的情況下，皮膚彎曲，損壞，疼痛，並在偶爾，當我們

go too far, starts to bleed, perhaps profusely. If someone were to come into the room, they

走得太遠，開始流血，也許是大出血。如果有人走進房間，他們就...

might gasp - though we generally do a good job of covering up the blood once we're

可能會喘氣--雖然我們一般會很好地掩蓋血跡，一旦我們

done.

完成。

We know - of course - we shouldn't be doing any of this. But it feels, at the time, so

我們知道--當然--我們不應該做這些事。但當時感覺

nice, or more accurately, irresistible, like the only thing that is going to work, like

好的，或者更準確的說，是不可抗拒的，就像唯一能用的東西，就像。

exactly the action that will be able to deliver relief. What can it matter, in the context,

正是能夠提供救濟的行動。能有什麼關係，在這種情況下。

that we'll be left with a pitted face or a bleeding foot or a purple raw thumb? It's

我們會留下一張坑坑窪窪的臉 或一隻流血的腳或一個紫色的拇指？是的

what we had to do - and have been doing, probably, for many years. We know we do it, but it escapes

我們必須做的事情--而且可能已經做了很多年。我們知道我們在做，但它逃脫了。

and resists direct thought. This might be the first time we've heard anyone else talking

並拒絕直接思考。這可能是我們第一次聽到有人在談論

about it.

關於它。

Dermatillomania, the psychologists tell us, has to do with anxiety; that much is evident.

心理學家告訴我們，皮膚病與焦慮有關，這一點很明顯。

What is distinctive is how the anxiety is being handled. Some will act out their pain

有特色的是如何處理焦慮情緒。有些人會把自己的痛苦表現出來

in dramatic and noisy ways; screaming, insulting, cursing... Skin picking is a quieter, more

以戲劇性的方式和嘈雜的方式；尖叫、侮辱、咒罵......。扒皮是一種更安靜，更多的

solitary way of trying to come to terms with alarm and self-loathing. It is an introvert's

試圖用孤獨的方式來面對驚恐和自我厭惡。這是一個內向者的

disease.

病。

The skin picker might well like to scream, panic loudly, tell someone to go away or collapse

扒皮者很可能喜歡尖叫，大聲驚慌，叫人走開或倒下

in another's welcoming arms - but their characters have been shaped through aeons

在另一個人的懷抱中--但他們的性格已經在時代中被塑造出來了。

of solitude. They have no faith in any possibility of turning towards someone else for help.

的孤獨。他們對向別人求助的任何可能性都沒有信心。

They are fundamentally alone. They only have experience of directing anger and sorrow in

他們從根本上來說是孤獨的。他們只有將憤怒和悲傷導向的經驗。

on themselves. They are taking their pain out on the only character they can reach.

在自己身上。他們把自己的痛苦發洩在唯一能接觸到的人物身上。

Knowing all this helps us to imagine what a cure might look like. For a start, it will

瞭解這一切有助於我們想象治療方法是什麼樣子的。首先，它將

involve recognising the degree of solitude that has inspired the masochism. No one ends

包括認識到激發受虐狂的孤獨程度。沒有人結束

up picking their skin raw who had an early consistent experience of tenderness and attuned

有著早期一致的溫柔和適應性經驗的人，可以生摘他們的皮膚。

care. One does this kind of thing because absolutely no one was around or those that

關心。一個人做這種事情，是因為絕對沒有人在身邊，或者說那些。

were did a lot of humiliating. It may help to recognise that one is still now terrified

被做了很多羞辱。它可能有助於認識到，一個人現在仍然是可怕的

pretty much all the time. The targets may shift - losing one's job, being made fun

幾乎所有的時間。目標可能會轉移--丟掉工作，被人取笑。

of, being sexually rejected, ridicule - but the essential drift is that one is a terror-struck

的、被性拒絕的、被嘲笑的--但本質上的漂移是，一個人是一個恐怖的、被驚嚇的

person; we tend only to be in a position to acknowledge our distress when someone is on

人；我們往往只有當有人在時，才會有資格承認自己的苦惱。

hand who could understand.

手誰能理解。

When we can compassionately realise that the picking is about fear and self-disgust (the

當我們能慈悲地意識到，挑剔是為了恐懼和自我厭惡（the

legacy of neglect or cruelty), we are in a position to start to 'see' rather than

忽視或殘忍的遺留問題），我們就可以開始 "看"，而不是。

merely be compelled by our pain. We need to find a better way of being worried. We are

僅僅是被我們的痛苦所蠱惑。我們需要找到一種更好的方式來擔憂。我們是

trying to gain control over a cruel-seeming and cold world, but turning our index finger

想控制這個看似殘酷冰冷的世界，卻把我們的食指... ...

raw or taking a penknife to our heel isn't where the issue lies. We need to know that

生的或拿著小刀砍我們的腳後跟並不是問題所在。我們要知道

this isn't some un-analysable quirk. It's a known and very moving problem, one of the

這不是什麼不可分析的怪癖。這是一個眾所周知的，非常動人的問題，其中的一個。

many things a sensitive mind will do in response to a lack of love and to a basic fear that's

一個敏感的心靈會做很多事情來回應愛的缺失和基本的恐懼，這是

had to be borne alone. We need to start to pick at the real source of the agony and learn to leave our innocent bleeding body in peace.

不得不獨自承受。我們需要開始挑起痛苦的真正根源，學會讓自己無辜流血的身體安詳地離開。