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  • For most of the history of humanity, there was nothing at all one could swallow when

    在人類歷史上的大部分時間裡,人們根本就沒有什麼可以吞下的東西,當

  • 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。

For most of the history of humanity, there was nothing at all one could swallow when

在人類歷史上的大部分時間裡,人們根本就沒有什麼可以吞下的東西,當

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B1 中級 中文 藥物 精神 藥丸 控制 精神病 悲傷

吃藥還是治療? 什麼對你來說是最好的? (Pills or Therapy? What is best for you?)

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    Summer 發佈於 2021 年 07 月 28 日
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