My name is Lisa Danilchuk and I'm a psychotherapist specializing in trauma treatment.

我叫 Lisa Danilchuk，是一名心理治療師，專門從事創傷治療。

I created this podcast because I'm surrounded by people who have dedicated their lives to navigating healing.

我之所以創建這個播客，是因為我身邊有很多人都在為治癒疾病而奮鬥。

There is so much wisdom in each guest this season and my hope is that this show makes their important ideas and experiences available to you in a way that uplifts and inspires you.

這一季的每位嘉賓都蘊含著無窮的智慧，我希望這檔節目能以一種振奮人心、鼓舞人心的方式，讓大家瞭解他們的重要觀點和經驗。

These guests and I have committed our lives to fostering health and joy in the world even as we work through the impacts of trauma and face deep challenges.

這些客人和我都致力於在世界上營造健康和歡樂的氛圍，即使我們正努力克服創傷的影響並面臨嚴峻的挑戰。

Let's dive into season four and let's keep talking about how we can heal.

讓我們進入第四季，繼續討論如何治癒。

I want to give a big shout out and extend a huge thank you to the International Society for the Study of Trauma and Dissociation, the ISSTD, for sponsoring this episode.

在此，我要向國際創傷與解離研究學會（ISSTD）表示衷心的感謝，感謝他們贊助本期節目。

If you've been listening to this podcast for any amount of time, you've heard me talk about the ISSTD and the incredible researchers, clinicians, and advocates I've met during my time as a member and a volunteer there.

如果您一直在收聽這個播客，那麼您一定聽我說過 ISSTD，以及我作為會員和志願者期間遇到的令人難以置信的研究人員、臨床醫生和倡導者。

This group is made up of some of the kindest, most inspiring, intelligent people and I'm happy to be able to share just a few of them here on the show.

這個小組由一些最善良、最鼓舞人心、最聰明的人組成，我很高興能在節目中與大家分享其中的一些人。

This organization has been delving into the science and best practice of treating trauma and dissociation for over 40 years now and they have a rich catalog of educational offerings for both professionals and non-professionals on their website.

該組織 40 多年來一直致力於研究治療創傷和解離的科學和最佳實踐，他們的網站上為專業人士和非專業人士提供了豐富的教育課程。

That's cfas.isst-d.org.

這是 cfas.isst-d.org。

If you're a mental health professional, I highly recommend you consider becoming a member of ISSTD.

如果您是心理健康專業人士，我強烈建議您考慮成為 ISSTD 會員。

I'd love to see you during their live educational offerings and at the annual conference in

我很高興能在現場教育活動中以及在以下年度會議上見到您

Boston in March of 2025.

波士頓，2025 年 3 月。

Go to isst-d.org to learn more.

請訪問 isst-d.org 瞭解更多資訊。

Welcome back to the How We Can Heal podcast.

歡迎回到 "我們如何治癒 "播客。

Today our guest is Dr. Lauren LeBlois.

今天我們請到的嘉賓是勞倫-勒布盧斯博士。

Dr. Lauren LeBlois is a cognitive neuroscientist who is passionate about understanding how the mind, brain, and body adapt in the aftermath of trauma.

勞倫-勒布盧瓦博士是一位認知神經科學家，她熱衷於瞭解心理、大腦和身體在創傷後是如何適應的。

Her National Institute of Mental Health funded research program focuses on the neurobiology of dissociation in trauma spectrum disorders.

她受美國國家心理健康研究所資助的研究項目側重於創傷譜系障礙中解離的神經生物學。

She prioritizes translating scientific breakthroughs in accessible, compelling, and clinically relevant ways.

她優先考慮以通俗易懂、引人入勝和與臨床相關的方式轉化科學突破。

Dr. LeBlois serves as the chair of the Scientific Committee of the International Society for the Study of Trauma and Dissociation, or ISSTD.

勒布盧瓦博士是國際創傷與解離研究學會（ISSTD）科學委員會主席。

She's also the operations co-director of the Initiative for Integrated Trauma Research,

她還是 "綜合創傷研究計劃"（Initiative for Integrated Trauma Research）的營運聯合主任、

Care, and Training at McLean Hospital in Belmont, Massachusetts.

馬薩諸塞州貝爾蒙特麥克林醫院的護理和培訓中心。

Recently she was awarded the Alfred Pope Award for Young Investigators from McLean and the

最近，她獲得了麥克萊恩頒發的阿爾弗雷德-波普青年研究員獎和

Pierre Genet Writing Award and the Morton Prince Award from the ISSTD.

皮埃爾-熱內寫作獎和國際科學和技術促進發展協會莫頓-普林斯獎。

Dr. LeBlois is deeply committed to using her advances in neurobiology, behavior, and treatments to reduce stigma and improve care for individuals living with PTSD and dissociative identity disorder.

勒布盧瓦博士致力於利用她在神經生物學、行為學和治療學方面取得的進展，減少對創傷後應激障礙和分離性身份識別障礙患者的歧視，改善對他們的護理。

Lauren and I connected some years ago through the ISSTD.

幾年前，勞倫和我通過 ISSTD 建立了聯繫。

I have always appreciated her thoughtful and thorough presentations, and I'm thrilled to share her with you today.

我一直很欣賞她深思熟慮、深入淺出的演講，今天能與大家分享她的演講，我感到非常激動。

Let's welcome Lauren to the show.

讓我們歡迎勞倫來到節目現場。

Well, welcome, Lauren LeBlois.

歡迎你，勞倫-勒布盧瓦。

It's so good to have you here.

你能來真是太好了。

I've been to a bunch of your presentations and I'm always like, everyone needs to hear this.

我聽過很多你的演講，我總是想，每個人都需要聽聽這個。

Everyone needs to know this.

每個人都需要知道這一點。

So I'm excited to share a little bit of your background, your experience, and hopefully connect people to your work a little bit more.

所以我很高興能和大家分享一下你的背景和經歷，希望能讓大家更多瞭解你的作品。

Thank you.

謝謝。

That's very kind, Lisa.

你真好，麗薩。

So I have to ask first, how's everything going with the babes?

我想先問一下，孩子們都好嗎？

Because you and I had kids right around the same time, so it's kind of a miracle that we're both here.

因為你和我在同一時間有了孩子，所以我們能同時在這裡也算是個奇蹟。

It's been quite a journey.

這是一段相當漫長的旅程。

Yes.

是的。

I feel like you captured it right there.

我覺得你捕捉到了這一點。

Yeah, but things are going really well.

是的，但事情進展得很順利。

It does feel like a lot, and it's pretty intense, but it's more just like the extremes, just a moment of joy, and instantly, three seconds later, the pits of despair kick off.

感覺確實很多，也很激烈，但這更像是極端，只是一瞬間的喜悅，三秒鐘後，絕望的深淵立刻就開始了。

You had twins, too, and then you already have one?

你也生過雙胞胎，現在已經有一個了？

Do you have one before that, too?

之前也有嗎？

Yes.

是的。

Okay.

好的

I just have the one.

我只有一個。

I'm already like, oh my goodness gracious, it's a lot.

我已經在想，天哪，太多了。

This is how humanity continues.

人類就是這樣延續下去的。

Wow.

哇

Okay.

好吧

There's a lot that goes into it.

有很多事情要做。

I thought I was aware.

我以為我知道。

I'm not that aware.

我沒那麼清楚。

Now I'm learning.

現在我正在學習。

So I'm curious, just to start, I always love to just go to a little bit of your background.

所以我很好奇，首先，我總是喜歡先了解一下你的背景。

How did you come to learn about trauma and dissociation?

您是如何瞭解創傷和解離的？

How did this become such a big part of your world?

它是如何成為你世界中如此重要的一部分的？

Yeah.

是啊

I guess I feel like I've learned the most from our research participants.

我覺得我從研究參與者身上學到的東西最多。

They've been the best teachers for me.

他們是我最好的老師。

Hearing them talk about their experiences, what it's like inside their mind, has been so fascinating, and then I think at the same time, I had the great fortune of getting connected with Dr. Melissa Kaufman, who I now jointly direct the Dissociative Disorders and Trauma

聽他們講述自己的經歷，瞭解他們的內心世界，這一切都讓人著迷，與此同時，我很幸運地結識了梅麗莎-考夫曼博士。

Research Program with, but learning from her throughout my training, and she's one of those people who, well, she's an amazing psychiatrist and clinician, and she's just one of those people who asks really beautiful questions of people that they just reveal the most amazing things with the way, just her presence and how she asks questions.

她是一位了不起的精神病學家和臨床醫生，她向人們提出的問題都非常好，人們會從她的言談舉止和提問方式中發現最奇妙的東西。

And so I think both from watching her and how she asks questions and hearing how people reply about these things has been where I've learned the most.

是以，我認為從觀察她、她如何提問以及聽到人們如何回答這些問題中，我學到了最多的東西。

And I think I'm someone who's always been fascinated ever since I was little by people's stories, and that moment where you're in conversation with someone and you can see or feel that they feel seen, it's just so thrilling to me.

我想我從小就對人們的故事很著迷，當你和別人交談時，你能看到或感覺到他們被看見的那一刻，對我來說太激動人心了。

I love those little micro moments.

我喜歡這些微小的瞬間。

And so this is a place where I feel like I kind of fell into it by a chance of opportunities.

是以，在這裡，我覺得自己是在一個偶然的機會下進入這個行業的。

It was like, oh, this is home.

就好像，哦，這就是家。

This is where I can hear the most amazing stories and help in some way by kind of putting a quantitative data point to it.

在這裡，我可以聽到最令人驚歎的故事，並通過某種量化數據點來提供幫助。

And I think your work does that.

我認為你的作品做到了這一點。

It helps people feel seen because it describes something that can be difficult to encapsulate or to validate.

它讓人們感覺自己被看見了，因為它描述了一些難以概括或驗證的東西。

Right.

對

And when you come at it from that quantitative or very tangible standpoint, it's like, ah, okay.

當你從量化或非常具體的角度來看待這個問題時，就會覺得，啊，好吧。

Yeah, that's me.

對，就是我。

Or, oh, that's how that works.

或者，哦，原來如此。

And naming it and just letting that land instead of being up in the land of what's happening here.

併為其命名，讓其落地，而不是在這裡發生的事情上糾纏不休。

Yeah, exactly.

是啊，沒錯。

That's the hope.

這就是希望。

That's what I'm hoping.

這正是我所希望的。

So what is your day to day work look like?

您的日常工作是怎樣的？

Are you just like, I just imagine you around fMRI machines all the time.

我只是想象你經常和核磁共振成像儀打交道。

Is that what it's like?

是這樣嗎？

Yeah, I feel like at this point, my position is much more administrative.

是的，我覺得在這一點上，我的立場更偏向於行政管理。

So it's a lot of writing, analyzing data, writing grants, writing papers, managing the lab, mentoring trainees.

是以，要寫很多東西、分析數據、撰寫基金、撰寫論文、管理實驗室、指導受訓者。

I get less face-to-face time with research participants and like sitting at the imaging center.

我與研究參與者面對面的時間較少，我喜歡坐在成像中心。

But I get over there once in a while.

但我偶爾也會過去看看。

I don't know if I told you this, but I actually, when I first got to Harvard, I volunteered for a study at McLean.

我不知道是否跟你說過，其實我剛到哈佛時，就自願參加了麥克林大學的一項研究。

It was about yoga and GABA levels.

是關於瑜伽和 GABA 水準的。

So I think maybe that's why I just really put you like right in those.

所以我想，也許這就是為什麼我只是真的把你喜歡的權利在這些。

I was in an fMRI machine.

我當時在一臺核磁共振成像儀裡。

I went in before.

我之前進去過。

I did an hour of yoga while they watched me and then I went back in after and I just really put you in right there.

他們看著我的時候，我做了一個小時的瑜伽，做完後我又回去了，我真的把你放在了那裡。

And maybe that's near where you've worked and maybe it's not, but yeah.

也許這就在你工作過的地方附近，也許不是，但沒錯。

Well, there's one imaging center, so it's, yeah, it's right there.

有一個成像中心，就在那裡。

That's probably, probably where you and Melissa hang out quite a bit, even though you're doing a lot of other stuff now too.

這可能是你和梅麗莎經常在一起的地方，儘管你們現在也在做很多其他的事情。

So I want to try to translate, and I know we're not going to like go through a PowerPoint here, but I, you know, I've seen you present also, I think it was the grand rounds at Harvard.

所以我想嘗試翻譯一下，我知道我們不會在這裡做PPT，但我，你知道，我也看過你的演講，我想是在哈佛大學的大講堂上。

You had a presentation at some point that you sort of opened up access to.

你曾在某個時候做了一次演講，算是開放了訪問權限。

I want to like help people listen in on that.

我想幫大家聽聽。

So rather than going into like explaining all of like what trauma is and what dissociation is, we've talked a lot about that in other podcasts.

所以，與其去解釋什麼是創傷，什麼是解離，我們在其他播客中已經講過很多了。

So I'm just wondering if you can start to speak to some of the things you've seen as you've taken in this fMRI data, as you've worked with people around like changes in the brain with post-traumatic stress, with PTSD, and I think we can kind of tease that out.

所以我想知道，你是否可以開始談談你所看到的一些事情，因為你已經採取了在這個fMRI數據，因為你已經與周圍的人喜歡的變化，在大腦與創傷後應激，創傷後應激障礙，我認為我們可以種挑逗出來。

So is there anywhere you'd want to start in like the overview of what you've learned about post-traumatic stress from looking more closely at the brain?

那麼，你想從哪裡開始概述你通過更深入地研究大腦而瞭解到的創傷後應激反應呢？

That's a great question.

這個問題問得好。

I think it does, the context of it depends so much or matters so much rather.

我認為確實如此，它的背景非常重要，或者說非常重要。

So what we ask someone to do in the scanner will really dictate what looks different in their brain if they have PTSD versus not, or have a more complex post-traumatic adaptation like DID.

是以，如果一個人患有創傷後應激障礙，或者患有更復雜的創傷後適應症（如 DID），我們要求他在掃描儀中做的事情將真正決定他大腦中的不同表現。

So I think a good place to start would be what it looks like, what's different when someone is feeling really activated and symptomatic or triggered.

是以，我認為一個好的開始是，當一個人感覺真的被激活、出現症狀或被觸發時，它看起來像什麼，有什麼不同。

And maybe just briefly, we could touch on different types of post-traumatic adaptations.

也許我們可以簡單談談不同類型的創傷後適應。

So we've got PTSD, subsystem subtype of PTSD, and dissociative identity disorder.

所以我們有創傷後應激障礙、創傷後應激障礙的子系統亞型和分離性身份識別障礙。

And I'm just going to repeat those, PTSD, post-traumatic stress disorder, dissociative subtype of PTSD, and DID or dissociative identity disorder.

我再重複一遍：創傷後應激障礙、創傷後應激障礙的分離亞型、DID 或分離性身份識別障礙。

Yeah.

是啊

And I, there's a woman, Sachi Nakajima, who has this, I love her metaphor of a rollercoaster for how to describe the differences between those three different conditions.

我喜歡她用 "雲霄飛車 "來形容這三種不同情況之間的差異。

Talks about like, imagine you're on a rollercoaster.

想象你在坐雲霄飛車。

So I guess first I should say Sachi is a nonprofit founder and she's a lecturer and an author, and she's also open about being a survivor of domestic violence herself, but she talks about for PTSD, imagine you're on a rollercoaster and you're feeling that really intense adrenaline rush, and it's a frightening experience for you to be on this rollercoaster versus the dissociative subtype of PTSD, where imagine if somehow in your mind, you can make it feel like you were standing on the ground, watching yourself be on the rollercoaster provides that level of detachment.

所以我想首先我應該說 Sachi 是一個非營利組織的創始人，她是一名講師和作家，她也公開自己是一名家庭暴力的倖存者，但她談到創傷後應激障礙，想象一下你在雲霄飛車上，你感覺腎上腺素激增、與創傷後應激障礙的分離性亞型相比，在創傷後應激障礙的分離性亞型中，想象一下，如果在你的腦海中，你能讓自己感覺就像站在地面上，看著自己在雲霄飛車上，就能提供這種程度的超脫感。

So these are folks who report feelings of depersonalization and derealization where they feel a sense of detachment from their body or their sense of self or their surroundings, where it feels like they're watching themselves from above or they're in a movie or in a dream, something like that.

是以，這些人報告說，他們有人格解體和去理想化的感覺，他們感到自己的身體、自我意識或周圍環境與自己分離，感覺就像他們在上面看著自己，或者他們在電影中或在夢中，諸如此類。

Yeah.

是啊

And then add another layer on with conditions like DID, where not only can you make it feel like you're standing on the ground, watching yourself on the rollercoaster, but it feels like someone else is on the rollercoaster and you're watching from afar.

然後再加上一層條件，比如 DID，你不僅可以讓人感覺自己站在地面上，看著自己在雲霄飛車上，還可以讓人感覺別人在雲霄飛車上，而你在遠處看著。

So that's where you get this added layer of dissociation where people lose a sense of agency and ownership over some feelings or memories or actions or the sense of their body to the point where sometimes it can feel like it's someone else living in their mind.

這就是解離的另一層含義，人們會失去對某些感覺、記憶、行為或身體感覺的代理權和所有權，以至於有時會感覺是別人活在自己的腦海中。

I thought you were going to go to like passed out on the rollercoaster, right?

我還以為你會在雲霄飛車上暈過去呢，對吧？

Like that's like a meme, probably somewhere you can get someone who just got so afraid on the rollercoaster that they just passed out.

這就像一個備忘錄，你可能會在某個地方找到一個在雲霄飛車上害怕得暈過去的人。

And then they come to the end.

然後他們走到了盡頭。

They're like, are we starting yet?

他們會問，我們開始了嗎？

And you're like, oh, it already happened.

你會想，哦，已經發生了。

Yeah.

是啊

Yeah.

是啊

I like that, Lisa.

我喜歡，麗莎。

I think maybe that that could be like certain experiences in DID where it feels like you weren't there for, um, or you're like have that, that full amnesia of a fully dissociated experience.

我想，也許這就像 DID 中的某些經歷，讓人感覺你不在那裡，或者你就像有那種，那種完全失憶的完全分離的經歷。

I guess.

我猜也是。

It happens.

它發生了。

Maybe someone else is there and has a full narrative of it, but you're just like, what, where was I?

也許別人也在那裡，並有完整的敘述，但你只是想，什麼，我在哪裡？

Yeah.

是啊

Yeah.

是啊

But I think as you know, the more common experiences that you have some, like you're kind of an observer while someone else takes the wheel and drives on.

但我認為，正如你所知道的，你有一些更常見的經歷，就像你是一個旁觀者，而其他人則握著方向盤繼續駕駛。

Yeah.

是啊

So I think setting the stage with those different types of post-traumatic adaptation, and then as far as what's going on in the brain, when someone's feeling symptomatic, um, the way researchers typically study this, they're called symptom provocation paradigms.

是以，我認為，在設定了這些不同類型的創傷後適應階段後，至於大腦中發生了什麼，當一個人感覺有症狀時，嗯，研究人員通常會對此進行研究，這就是所謂的症狀激發範式。

Yeah.

是啊

They, um, have folks come in and narrate a traumatic experience they've had.

他們，嗯，讓人們來講述他們的創傷經歷。

They play this recording back to them while they're in a scanner.

他們在掃描儀中播放這段錄音。

Um, the idea being that while someone's feeling triggered or symptomatic, then they can capture what's happening in the brain at those moments while they're getting immersed in this traumatic experience that they had in the past.

嗯，我們的想法是，當一個人感覺被觸發或出現症狀時，他們就能捕捉到當時大腦中發生了什麼，而他們正沉浸在過去的創傷經歷中。

So this is the functional changes, like as it's happening, this is the different activity in the moment.

這就是功能變化，就像正在發生的變化一樣，這就是當下不同的活動。

Exactly.

沒錯。

Yes.

是的。

Okay.

好的

Great.

好極了

And so typically what happens in this paradigm for someone without PTSD, uh, is that, well, actually I should first talk about two key brain regions that often come up in this paradigm and have been studied a lot in the trauma literature, the prefrontal cortex and the amygdala.

是以，對於沒有創傷後應激障礙的人來說，在這種模式下通常會發生什麼，嗯，實際上，我應該首先談談在這種模式下經常出現的兩個關鍵腦區，它們在創傷文獻中被大量研究，即前額葉皮層和杏仁核。

And there's a particular region of the prefrontal cortex, right in the middle, in the front called the ventromedial prefrontal cortex.

在前額葉皮層的正中間，有一個特殊的區域，叫做腹內側前額葉皮層。

It's involved in lots of different functions, but kind of as a shorthand, we can think of it as an executive controller helping to regulate our emotional and physical reactions to things.

它參與許多不同的功能，但作為一種速記，我們可以把它看作是一個執行控制器，幫助調節我們對事物的情緒和身體反應。

So that's a key region.

是以，這是一個關鍵地區。

And then also the amygdala, which again, involved in lots of different things.

還有杏仁核，它同樣參與了許多不同的事情。

As a shorthand, we kind of think of it as a salience detector helping to alert us really quickly to things that would be important to pay attention to for our survival.

簡而言之，我們可以把它想象成一個突出性探測器，幫助我們迅速注意到對我們的生存至關重要的事物。

And one example of something that's important to pay attention to are potential threats.

其中一個需要注意的例子就是潛在威脅。

And so for someone in this symptom provocation paradigm who doesn't have PTSD, typically what you'd see is a rapid activation of amygdala to help mount a full body stress response to deal with this threatening information.

是以，對於沒有創傷後應激障礙的人來說，在這種症狀激發範例中，你通常會看到杏仁核快速激活，以幫助啟動全身應激反應來應對這種威脅性資訊。

And then once that threat has passed, you see activation of ventromedial prefrontal cortex kind of helping to dam things down, regulate things, because that threat isn't actually there.

一旦威脅過去，你就會看到腹側前額葉皮層被激活，從而幫助抑制和調節情緒，因為威脅實際上並不存在。

You're just listening to a narrative about what's happened to you.

你只是在聽別人講述發生在你身上的事情。

So that's how it typically works in PTSD and classic PTSD.

這就是創傷後應激障礙和典型創傷後應激障礙的典型症狀。

So that where you're on the roller coaster, you're feeling that big hyper arousal response.

這樣，當你坐上雲霄飛車時，你就會感受到強烈的亢奮反應。

We see activation in the amygdala, but less activation in the ventromedial prefrontal cortex.

我們看到杏仁核被激活，但腹側前額葉皮層的激活程度較低。

So it's as if the brakes are off in a way, and your body's kind of constantly mounting the stress response to deal with threats, even when they're not there anymore.

是以，這就好像在某種程度上剎車失靈了，你的身體會不斷啟動應激反應來應對威脅，即使威脅已經不存在了。

So that's classic PTSD.

這就是典型的創傷後應激障礙。

The dissociative subtype where you've got that more detachment from the experience with the use of dissociation, we see the opposite pattern.

在解離亞型中，通過使用解離法，你可以從體驗中獲得更多的疏離感，我們看到的是相反的模式。

So more activity in the ventromedial prefrontal cortex, less activity in regions like the amygdala.

是以，腹內側前額葉皮層的活動較多，而杏仁核等區域的活動較少。

So it's kind of like the brakes are on too tightly.

這就有點像剎車踩得太緊了。