one was mentally ill. The full force of one's sickness had to run unchecked.

一個人有精神疾病。一個人的疾病的全部力量必須不受控制地運行。

Then, in 1950, Paul Charpentier, a French chemist working at Laboratoires Rhône-Poulenc,

然後，在1950年，在羅納-普朗克實驗室工作的法國化學家保羅-沙彭蒂埃。

succeeded in synthesising a drug called 4560RP, later renamed chlorpromazine. When rats were

成功地合成了一種名為4560RP的藥物，後來改名為氯丙嗪。當大鼠被

injected with it, placed in a crowded cage and convulsed with electric shocks, they showed

注射了它，放在一個擁擠的籠子裡，用電擊來抽搐，他們顯示了

none of the expected alarm and frenzy, settling instead into a serene and indifferent mood.

沒有預期的驚慌和狂熱，而是進入一種寧靜和冷漠的情緒。

When given to humans, the drug had a similar calming effect: American soldiers in the Korean

當給人類使用時，這種藥物也有類似的鎮靜效果。在北韓戰場上的美國士兵

war were able to walk into the battlefield with total fearlessness. In hospitals, psychotic

戰爭能夠完全無畏地走入戰場。在醫院裡，精神病患者

patients who were placed on the drug became sociable, unaggressive and ready to rejoin

使用該藥物的病人變得善於交際，沒有攻擊性，並準備重新加入。

ordinary life. The world's first antipsychotic drug was born. It would over the coming decades

普通的生活。世界上第一種抗精神病藥物誕生了。在未來的幾十年裡，它將

be followed by dozens more seemingly miraculous medicines, all of them playing - in ways that

隨後，又有幾十種看似神奇的藥物出現，它們都在發揮著作用--以這種方式

their creators did not and still do not entirely understand - with the brain's receptors

他們的創造者沒有也仍然沒有完全理解--與大腦的受體

for dopamine, the hormone held to be responsible for excessive excitement and fear. Alongside

為多巴胺，這種荷爾蒙被認為是負責過度興奮和恐懼的。伴隨著

these antipsychotics, there emerged a family of antidepressants, in particular those known

在這些抗精神病藥物的基礎上，出現了一系列的抗抑鬱藥物，特別是那些被稱為

as SSRIs, that could increase the brain's levels of serotonin, the neurotransmitter

作為SSRIs，它可以增加大腦中的血清素水準，而血清素是一種神經遞質。

and hormone associated with uplift, motivation and positive moods. The drugs were baptised

和與振奮、激勵和積極情緒有關的荷爾蒙。這些藥物被洗禮為

with names that put language to ever more daunting uses: fluoxetine, citalopram, paroxetine,

其名稱將語言用於更令人生畏的用途：氟西汀、西酞普蘭、帕羅西汀。

escitalopram, risperidone, quetiapine, aripiprazole. Whatever the particularities of each example,

艾司西酞普蘭、利培酮、喹硫平、阿立哌唑。不管每個例子的特殊性如何。

modern psychiatry ended up operating with two essential instruments: pills that could

現代精神病學最終以兩種基本的工具來運作：可用於治療的藥片。

calm us down (reducing terror, paranoia, mania, disinhibition, insomnia and aggression) and

讓我們平靜下來（減少恐怖、偏執、狂躁、抑制、失眠和攻擊性）和

pills that could lift us up (alleviating despair, moroseness and loss of meaning).

可以讓我們振作起來的藥丸（緩解絕望、低沉和失去意義）。

Thanks to these medicines, occupancy rates of psychiatric hospitals plummeted, decreasing

由於這些藥物的存在，精神病院的入住率急劇下降，降低了

by some 80% in developed countries between 1955 and 1990. Illnesses that had been a near-death

在1955年至1990年期間，發達國家的發病率下降了約80%。曾經是瀕臨死亡的疾病

sentence a generation before could now be managed by swallowing one or two pills a day.

前一代人的句子，現在可以通過每天吞下一兩顆藥丸來控制。

It looked as if our unruly minds had finally been tamed.

看起來好像我們不羈的思想終於被馴服了。

But the answer was not complete. All these medicines turned out to have serious physical

但答案並不完整。所有這些藥物都被證明具有嚴重的物理

side effects (being intermittently responsible for dramatic weight gain, diabetes, kidney

副作用（間歇性地造成體重急劇增加、糖尿病、腎臟病變等）。

malfunction and blood clots). Yet the charge against them at a psychological level was

故障和血凝塊）。)然而，在心理層面上對他們的指控是

more fundamental: that they did not and could never - on the basis of their approach - get

更為根本的是：他們沒有也不可能--根據他們的方法--得到

to grips with the true causes of mental illness. At best, they could control appalling symptoms

掌握了精神疾病的真正原因。充其量，他們可以控制駭人聽聞的症狀

while being unable to grapple with what, in the individual past, had led to them in the

而無法解決在個人的過去中，是什麼導致了他們在

first place.

第一名。

To be fair to psychiatry, even if this were true, it is no mean feat to be able to offer

對精神病學來說，即使這是真的，能夠提供的服務也不是簡單的。

a person a measure of control over their mental symptoms, given the horrors that these can

鑑於這些症狀可能帶來的恐怖，一個人在一定程度上可以控制自己的精神症狀。

entail. Those of us who have known mental illness from close up would - at the height

帶來的影響。我們這些近距離了解精神疾病的人，在高峰期會

of our suffering - generally choose to be physically tortured rather than endure yet

我們的苦難--一般選擇身體上的折磨，而不是忍耐然而

more of the abominations our minds can inflict. There are varieties of mental unwellness in

更多關於我們的思想所能造成的惡果。精神上的不健康有很多種，包括

which we are taken over by anxiety and foreboding - and paralysed by a sense that every minute

我們被焦慮和預感所佔據，並被一種每分鐘都會發生的感覺所麻痺。

is carrying us closer to an immense and unnameable catastrophe. We can no longer eat or speak,

正在把我們帶向一場巨大的、不可名狀的災難。我們再也不能吃東西，也不能說話。

we may just have to lie in a ball crying, scratching ourselves and waiting for the axe

我們可能只能躺在球裡哭泣，抓撓自己，等待斧頭的到來。

to fall. There are states in which we wake up every morning with a conviction that we

跌倒。在有些狀態下，我們每天早上醒來時都會確信我們

need to take an overdose in order to put to an end to the turmoil in our minds. There

需要服用過量的藥物，以結束我們心中的動盪。在那裡

can be voices inside us that do not for one moment cease telling us that we are guilty,

我們內心的聲音沒有一刻停止過告訴我們，我們是有罪的。

shameful and abhorrent beings. We may live in terror that we are about to lose control

可恥和可惡的人。我們可能生活在恐懼之中，擔心自己即將失去控制

or might already have done so. Our imaginations can be haunted by images of stabbing a child

或可能已經這樣做了。我們的想象力可能會被刺傷兒童的畫面所縈繞

or tearing off our own fingernails. It can feel as if there is a monster inside us urging

或撕掉我們自己的指甲。我們會感覺到似乎有一個怪物在我們體內催促我們

us to do appalling deeds and filling our consciousness with lacerating persecutory thoughts. We may

我們要做駭人聽聞的事，並在我們的意識中充滿了迫害性的思想。我們可能

feel our inner coherence dissolving and giving way to a maelstrom of aggression and paranoia.

感覺到我們內在的一致性在消解，並讓位於侵略和偏執的漩渦。

We may be so mysteriously sad that no pleasantry or act of kindness can distract us and all

我們可能是如此神祕地悲傷，以至於任何討好或善意的行為都不能分散我們的注意力，所有的

we wish to do is stare mutely out of the window and hope to be gone soon.

我們希望做的是靜靜地盯著窗外，希望能儘快離開。

With the right pills to hand however, some of these nightmares can end. We may know our

然而，只要有正確的藥丸在手，其中一些惡夢就可以結束。我們可能知道我們的

anxiety is still there but we are granted some distance from it, we are able to stare

焦慮仍然存在，但我們獲得了與它的一些距離，我們能夠盯著

at it as if it were an enraged tiger in a zoo on the other side of a thick pane of glass.

它就像動物園裡的一隻被激怒的老虎，在厚厚的玻璃窗的另一邊。

We may not lose sight of our despair and self-loathing but we can acquire an attitude of detachment

我們可能不會忽視我們的絕望和自我厭惡，但我們可以獲得一種超然的態度

in relation to it; it doesn't matter quite so much that we are entirely awful and should

與之相關的是，我們完全是可怕的，而且應該

be put down. We can park the idea for a morning in order to do some work or clean the house.

被放下。我們可以把這個想法停在一個上午，以便做一些工作或打掃房子。

We can put off thoughts of suicide until tomorrow. We don't need to have a complete reckoning

我們可以把自殺的想法延後到明天。我們不需要進行徹底的清算

with our sadistic ideas at every moment. The crushing sadness can partially lift and we

與我們每時每刻的虐待狂想法。壓抑的悲傷可以部分解除，我們

might have the energy for a conversation with a friend or a walk in the park. Only someone

可能有精力與朋友交談或在公園散步。只有某人

who hadn't endured vicious mental suffering would dare to casually dismiss such psychiatric

沒有經歷過惡性精神痛苦的人，敢於隨便否定這種精神疾病。

interventions as a plaster over a wound.

干預，就像在傷口上貼膏藥一樣。

Nevertheless, most mental illness has a psychological history - and its hold on us will for the

然而，大多數精神疾病都有一個心理歷史--它對我們的控制將為

most part only properly weaken the more episodes of this painful history we can start to feel

大多數情況下，只有適當地削弱這種痛苦歷史的更多情節，我們才能開始感到

and make sense of. Pills may be able to change the background atmosphere of our minds, but

並使之有意義。藥片也許能夠改變我們頭腦中的背景氣氛，但

our thoughts about ourselves need to be challenged and adjusted with conscious instruments if

我們對自己的想法需要用有意識的工具進行挑戰和調整，如果

we are to be able to grow truly well. The genuine resolution of mental disturbance lies

我們要能夠真正地健康成長。精神障礙的真正解決之道在於

in our ability to think - especially of our early childhoods and the key figures and events

在我們的思維能力中--特別是在我們的早期童年以及關鍵人物和事件中。

within it.

在它裡面。

The unfortunate paradox is that illnesses of the mind generally effect precisely the

不幸的悖論是，心理疾病通常恰恰會影響到那些人。

instrument that we require in order to interpret our lives. It is our conscious reason that

我們為了解釋我們的生活而需要的工具。它是我們有意識的理性，是

is both sick and desperately needed in order to do battle with despair and fear; it is

為了與絕望和恐懼作鬥爭，它既是病態的，也是迫切需要的；它是

the reason that we need in order to locate persuasive grounds to keep living. This is

我們需要找到有說服力的理由來繼續生活。這就是

where pills may usefully join up with psychotherapy to deliver a coherent solution. We might say

在這裡，藥片可以有效地與心理治療結合起來，提供一個連貫的解決方案。我們可以說

that the supreme role of pills is to hold back panic and sadness just long enough that

藥片的最高作用是抑制恐慌和悲傷，只要足夠長的時間就可以了。

we can start to identify why we might want to continue living; they aren't in themselves

我們可以開始確定為什麼我們可能想要繼續生活；它們本身並不是

the cure, but they are at points the essential tools that can make therapy, and through it

療，但它們在某些方面是可以使治療的基本工具，並通過它

authentic healing, possible. They promise our minds the rest and safety they require

真正的癒合，是可能的。他們承諾我們的頭腦將得到所需的休息和安全。

to harness their own strengths.

以利用他們自己的力量。