This video is all about dissociation, dissociation in CPTSD, dissociation and shame, and how all of those connect to the journal series I've been working on, on chronic complex trauma and shame.

這段視頻主要講述瞭解離、CPTSD 中的解離、解離與羞恥，以及所有這些如何與我一直在撰寫的關於慢性複雜創傷和羞恥的系列期刊聯繫在一起。

As I've said in many videos, I really do believe that the I am unworthy, I am unlovable, I am bad belief system is often the core of what happens to us when we are raised by certain caregivers who struggle.

正如我在許多視頻中所說的，我真的相信，當我們被某些掙扎著的照顧者撫養長大時，"我不值得"、"我不可愛"、"我不好 "的信念系統往往是我們遭遇的核心原因。

And so that chronic interpersonal nature of trauma that we are experiencing at the hands of caregivers really sets us up to decide that if I really acknowledge as a child that my caregiver is not safe, what does that say about me?

是以，我們在照顧者手中經歷的這種長期人際創傷，確實讓我們決定，如果我作為一個孩子真的承認我的照顧者不安全，這說明了什麼？

That means I won't be safe, I won't survive.

這意味著我將不安全，我將無法生存。

So therefore it must be something wrong with me.

所以，一定是我出了什麼問題。

And we drag this whole belief system of not being good enough and it shows up in every relationship with everyone, including ourselves.

我們拖著這整個不夠好的信念系統，在與每個人的關係中都表現出來，包括我們自己。

So let's talk today really quickly about what dissociation looks like in the classic sense, then I'm going to go into a more complicated version of explaining dissociation and the dissociation role in CPTSD that is more complex.

是以，讓我們今天來快速談談經典意義上的解離是什麼樣的，然後我將以更復雜的方式來解釋解離以及解離在 CPTSD 中的作用。

In fact, I shot this video yesterday, but it was so wordy and so complicated, I decided to redo it.

事實上，我昨天就拍攝了這段視頻，但它太囉嗦、太複雜，我決定重拍。

And now I'm in a rush to make coconut cupcakes.

現在我急著做椰子蛋糕。

So I'm trying to get through this video, but I also want to make sure I don't talk so much and the concepts don't get so, you know, therapized that you lose the part that I think is most helpful.

所以，我想把這段視頻看完，但我也想確保我不會說得太多，概念也不會被治療得太厲害，以至於你失去了我認為最有幫助的部分。

So please feel free if you want to post more questions, I will probably make another more extensive video, especially about the part that's related to the dissociation that we see in CPTSD.

是以，如果您想提出更多問題，請隨時聯繫我，我可能會再製作一個內容更豐富的視頻，尤其是關於我們在 CPTSD 中看到的解離現象的部分。

And so we'll come back to that.

所以，我們會再來討論這個問題。

All right.

好吧

Before I do though, please don't forget to subscribe and click the bell.

不過在此之前，請不要忘記訂閱並點擊鈴聲。

And that way you'll get notified when I post new videos.

這樣，當我發佈新視頻時，你就會收到通知。

I'm going to try to slow down.

我要試著放慢腳步。

You guys know I probably talk too fast, so much.

你們知道我可能說得太快了，說得太多了。

Okay.

好的

So dissociation really is a response to an overwhelming emotion.

是以，解離確實是對壓抑情緒的一種反應。

Basically our brains and bodies are saying, this is too much for me.

基本上，我們的大腦和身體都在說，這對我來說太過分了。

I need to go somewhere else.

我需要去別的地方。

Now the classic dissociation we often think about can really be everything from what they call often highway hypnosis, where you, you know, leave somewhere and you drive home and you know, you're there, but you have no memory of the drive home to spacing out to daydreaming.

我們常說的典型解離現象，其實可以是高速公路上的催眠，也就是你離開某個地方，然後開車回家，你知道，你就在那裡，但你對開車回家的過程沒有任何記憶。

Even a daydreaming that can get a little unhealthy at times where you're sort of like, you know, planning out and playing out a story or dream in your life to a way that really removes you from the present all the way into full on dissociation and dissociative disorders, which I'm not going to go into in terms of the disorders today, I'm going to use the word dissociation in a kind of classic sense, but also not so classic as I talk to you more about this idea of the role it plays in CPTSD.

即使是做白日夢，有時也會變得有點不健康，你會覺得，你知道的，在你的生活中計劃和演繹一個故事或夢想，以一種真正讓你遠離當下的方式，一直到完全的解離和解離性障礙，我今天不會去討論這些障礙，我會在一種經典的意義上使用解離這個詞，但也不是那麼經典，因為我更多地是在和你談論這個想法，它在 CPTSD 中扮演的角色。

Now I like to think of it as this oftentimes, if you've ever had a really horrible thing happen to you, you know, something that you got shocking news about, or you maybe gave a speech in public, but something that is not your norm, you might look back on that event and say to yourself, yeah, I was there, but I wasn't there.

現在，我喜歡把它想象成這樣：很多時候，如果你遇到了非常可怕的事情，你知道，你得到了一些令人震驚的消息，或者你可能在公眾場合發表了演講，但有些事情並不是你的常態，你可能會回顧那件事，然後對自己說，是的，我在那裡，但我不在那裡。

I was sort of hovering over my body or in the room, but it wasn't really me.

我的身體或在房間裡徘徊，但那並不是真正的我。

And I can say that I've had a few times in life where I've received tragic news and I felt like, or I've actually been in the middle of an emergency where I was doing everything right in the moment, but I felt like I was like hovering above my body, right?

我可以說，在我的生活中，有幾次我收到了不幸的消息，我覺得，或者我實際上已經在緊急情況下，我在做的一切權利的時刻，但我覺得我喜歡盤旋在我的身體，對不對？

So there's some classic components we call depersonalization, which is being disconnected or detached from your person, from yourself, and derealization, which is really being detached or feeling separated from the environment.

是以，有一些我們稱之為人格解體（depersonalization）和去人格化（derealization）的典型成分，人格解體是指與個人、與自己脫節或分離，而去人格化則是指真正與環境分離或感覺與環境分離。

Like it's a dream, it's not real.

就像一場夢，不真實。

And so those can be components of dissociation.

是以，這些都可能是解離的組成部分。

Now other ways we can know we're in dissociation, like I said, or feeling like we're out of our body, feeling a sense of actually disconnection from feeling our bodies themselves, so being more numb.

現在，我們可以通過其他方式知道自己處於解離狀態，就像我說的，或者感覺自己離開了自己的身體，感覺與身體本身的感覺脫節，是以更加麻木。

We can also see some self-harm occur in those states because we are detached from ourselves and sometimes the self-harming behaviors will reconnect us to ourselves.

我們也可以看到在這些狀態下會出現一些自殘行為，因為我們脫離了自己，有時自殘行為會讓我們重新與自己聯繫起來。

We can feel that we are floating above ourselves.

我們可以感覺到，我們正漂浮在自己之上。

We can lose sense of time and space.

我們會失去時間和空間感。

We can have tunnel vision.

我們可能會有隧道視野。

We can get lost in another fantasy world like movies or books.

我們可以迷失在另一個幻想世界，比如電影或書籍。

We can really just feel like we are a completely different person sometimes, right?

有時候，我們真的會覺得自己完全變了一個人，對嗎？

So I'll list a few more of those.

所以，我再列舉幾個。

But that's sort of the classic way we think of dissociation.

但這就是我們認為解離的經典方式。

Basically I'm going along in life and something happens and it is too much for me to psychologically bear.

基本上，我在生活中一帆風順，卻發生了一些事情，讓我心理上無法承受。

And so I go somewhere else.

於是我就去了別的地方。

Now if you're having highway hypnosis, it doesn't mean necessarily you've had major trauma, although we do know that trauma is very much connected to dissociation.

現在，如果你正在進行高速公路催眠，這並不意味著你一定經歷過重大創傷，儘管我們確實知道創傷與解離有很大關係。

So some form of mild dissociation is very, very, very common.

是以，某種形式的輕度分離是非常、非常、非常常見的。

And it's something that we just do as humans.

這是我們人類的天性。

I think that all of us who live a decently long life, it's going to happen to you, right?

我認為，我們所有活得像樣的人，都會遇到這種情況，對嗎？

And so you're going to maybe sometimes have trauma and go places.

是以，你有時可能會受到創傷，去一些地方。

But when we talk about chronic complex interpersonal trauma, like we find in complex PTSD, what we're talking about here is that we are often faced with situations where we are struggling to survive.

但是，當我們談論長期複雜的人際創傷時，就像我們在複雜創傷後應激障礙中發現的那樣，我們在這裡談論的是，我們經常面臨著為生存而掙扎的情況。

And in these traumas, they're often little repeated traumas, they can be massive traumas, and they can really go to the heart of what it means to try to be safe and try to survive.

在這些創傷中，它們往往是重複出現的小創傷，也可能是巨大的創傷，它們會真正觸及試圖安全和試圖生存的核心。

And that's what I'm going to talk about next, which is the structural dissociation model.

這就是我接下來要講的結構解離模型。

And that really is this idea that we have dissociation, like I said, as a response to a difficult situation that we can't bear.

就像我說的，這就是我們解離的原因，作為對我們無法忍受的困境的一種反應。

And so oftentimes, it can be so, so difficult to even integrate and accept that the trauma lives outside of us in a separate part, right?

是以，很多時候，我們甚至很難融入和接受創傷在我們之外的獨立部分，對嗎？

So what I'm saying is I have my main part of myself, my main part of myself is Kim, the psychologist, it's Kim, the mom, it's Kim, the, you know, the, I don't know, the group member, whatever it is.

所以我的意思是，我有我自己的主要部分，我自己的主要部分是金，心理學家，是金，媽媽，是金，你知道，我不知道，小組成員，不管是什麼。

And then let's say I have a trauma, let's say it's a pretty big trauma, I don't, I can't live in that.

然後，假設我有一個創傷，假設那是一個相當大的創傷，我不會，我不能活在那個創傷裡。

It's an unprocessed trauma.

這是一種未經處理的創傷。

And it was, let's say I was, I don't know, let's say I was robbed at gunpoint, okay?

比方說，我被人用槍指著搶劫了，好嗎？

And I, and I almost died.

我，我差點就死了。

And I cannot let myself be in that every day, because I wouldn't be able to function.

我不能讓自己每天都處於這種狀態，因為那樣我會無法正常工作。

So I fragment that off, I put that somewhere else.

所以，我把它分割開來，放在其他地方。

And I put on, we basically call our normal, everyday selves, that's sort of my left brain classic idea of left brain structure.

我穿上了，我們基本上稱之為正常的、日常的自我，這是我對左腦結構的經典想法。

I'm doing things, I'm being a mom, I'm engaging with my patients, I may have a relationship that I show up in a certain way, and I can sort of integrate all of those a bit.

我在做事，我在做母親，我在與病人接觸，我可能有一種關係，我以某種方式出現，我可以把所有這些都整合一下。

But those are not compatible with this very emotional right brain experience of the robbery, let's say.

比方說，這些都與右腦對搶劫的感性體驗格格不入。

Or let's also say of repeated trauma in childhood by an unstable caregiver.

或者也可以說是童年時受到不穩定的照顧者的反覆創傷。

So what do I mean by that?

我這麼說是什麼意思？

What I'm saying is that this is the core of this model of structural dissociation.

我想說的是，這就是結構性解離模型的核心。

What I think is so fascinating is that when we are children, let's say with a borderline or narcissistic parent, but let's stick to borderline, let's say an untreated borderline or classic disorganized attachment experience of a parent, right?

我認為最吸引人的是，當我們還是孩子的時候，比方說，我們的父母是邊緣人或自戀者，但我們還是說邊緣人，比方說，我們的父母是未經治療的邊緣人或典型的無組織依戀者，對嗎？

So we often do see a relationship between BPD and disorganized attachment in children.

是以，我們經常可以看到 BPD 與兒童無序依戀之間的關係。

So let's say you have a parent, even without the label of anything, that is just, you know, really runs the gamut of being, you know, frightening and frightened and unstable and a little bit safe, you know, unpredictable, all the way up to not safe at all.

比方說，你有一位父母，即使沒有任何標籤，也會讓人感到恐懼、害怕、不穩定、有點不安全，你知道，難以預測，甚至完全不安全。

As children, as we've talked about attachment theory, we have to attach to survive, right?

作為孩子，正如我們談到的依戀理論，我們必須依戀才能生存，對嗎？

Even if you think of breastfeeding in its original form, we need other people to survive.

即使你認為母乳餵養是最原始的形式，我們也需要其他人來生存。

So kids who have a caregiver like this, let's call it a primary caregiver, they are faced with an impossible tug of war and dilemma.

是以，有這樣一個照顧者（我們姑且稱之為主要照顧者）的孩子們，他們面臨著一場不可能完成的拉鋸戰和兩難選擇。

On the one hand, they need to attach to survive.

一方面，它們需要依附才能生存。

They need something and someone to be there for them to somewhat protect them and keep them safe.

他們需要一些東西和一些人來保護他們，保證他們的安全。

But what if, as in disorganized attachment, that person is also the source of fear and danger?

但如果在無組織依戀中，這個人也是恐懼和危險的來源呢？

So there's this dilemma, right?

所以就出現了這種兩難的局面，對嗎？

There's this, I need the person for my safety and security, but I'm also terribly afraid of them and I need to be because they're scary and dangerous and risky.

我需要這個人給我帶來安全感，但我也非常害怕他們，因為他們很可怕、很危險、很冒險。

And so what happens in the dissociation of this issue is that when we're having ways we could integrate it, like I was talking about before, like I have the Kim the this and Kim the that, that's one thing.

是以，在這個問題的解離過程中，當我們有辦法整合它時，就像我之前說的，比如我有 "金這個 "和 "金那個"，那是一回事。

But when I keep having repeat traumas, the fragments become different pieces all over the place.

但當我不斷重複創傷時，碎片就會變成不同的片段，到處都是。

And I can't cope with all of that because I can't really integrate the fact that what's supposed to be safe is not safe.

我無法應對這一切，因為我無法真正融入這樣一個事實：本應安全的東西並不安全。

And I have to also protect myself and access these other parts of myself to survive.

為了生存，我還必須保護自己，接觸自己的其他部分。

Now the parts are often described as the classic trauma types.

現在，這些部分通常被描述為典型的創傷類型。

Okay, so when we talk about how we respond to trauma in a classic CPTSD dynamic with dissociation, as I mentioned in this structural dissociation model, we're really looking at how we're showing up.

好了，當我們談論如何在典型的 CPTSD 動態解離中對創傷做出反應時，正如我在這個結構性解離模型中提到的，我們實際上是在看我們是如何表現出來的。

So we're either showing up as our normal, everyday selves, right, the different roles we have, even though those can also be split apart and have sort of separate ways of functioning.

所以，我們要麼以正常的、日常的自我示人，對吧，以我們所扮演的不同角色示人，儘管這些角色也可以被拆分開來，並以不同的方式發揮作用。

Or we are operating in our traumatized child self part.

或者，我們是在受創兒童的自我部分運作。

And this will be the part you're going to use for the journal prompts if you're sticking around and doing this, okay?

如果你想繼續寫日記，這部分內容就是你寫日記時要用到的，好嗎？

But as you think about, even if you're not going to do the journal, what would be those parts that my child self used to deal with the opposite of the attachment problem I had, the defending myself, the survival part that I had to sort of, the part I had to do and be to make all of it keep me alive and keep me somewhat safe, even if the word, you know, safe is highly debatable, right?

但是，當你思考時，即使你不打算寫日記，我的孩子用來處理與我的依戀問題相反的問題的部分會是什麼呢？我不得不做的自我保護、生存的部分，我不得不做的部分，是為了讓這一切讓我活著，讓我保持一定的安全，即使安全這個詞是非常值得商榷的，對嗎？

So we have the normal part of life self, and we have the traumatized self.

是以，我們有生活中正常的自我，也有受過創傷的自我。

Now the traumatized child self, that's the part we can split into, the part we can dissociate into when we're triggered.

現在，受到創傷的兒童自我，是我們可以分裂的部分，是我們在受到觸發時可以分離的部分。

And so these are the parts I want you to think about and explore, and as I said, I'll post them down below.

是以，我希望你們思考和探索這些部分，正如我所說的，我會把它們貼在下面。

We have fight, flight, freeze, submit, collapse, attach, cry out for help, and appease and please.

我們有戰鬥、逃跑、凍結、屈服、崩潰、依附、呼救以及安撫和取悅。

And so really quickly, when you're in the fight response, you are in your vigilant response.

所以很快，當你處於戰鬥反應時，你就處於警惕反應中。

You are angry, judgmental, mistrustful, controlling, destructive.

你憤怒、批判、不信任、控制、具有破壞性。

It's that very much, you know, I need to push back to survive.

你知道，我需要反擊才能生存下去。

When you're in your flight self, you are in that more escaping.

當你處於飛行狀態時，你更多的是在逃避。

You are taking off.

你要起飛了

Like in a battle, like I mentioned, you might be out of there, right?

比如在戰鬥中，就像我提到的，你可能會離開那裡，對嗎？

But this is where you distance yourself.

但這正是你與自己保持距離的地方。

You're ambivalent.

你很矛盾。

You run away.

你逃走了

You can't commit.

你不能承諾。

Or you are addictive or eating disorders, what they talk about.

或者你是上癮或飲食失調，他們談論什麼。

Now with the freeze response, this is a result of fear.

現在的凍結反應就是恐懼的結果。

This is like that thing where animals play dead to survive, right?

這就像動物為了生存而裝死，對嗎？

So it's, or humans do actually too in violent situations.

所以，或者說人類在暴力環境中確實也是如此。

We're frozen, we're terrified, we're wary, we're phobic of being seen, and often you can see panic attacks that go with that.

我們僵住了，我們害怕了，我們警惕了，我們害怕被人看到，你經常可以看到隨之而來的恐慌發作。

When we talk about submit or collapse, this is oftentimes where we see depression, shame, filled with self-hatred, passiveness, being the good girl or caretaker, and self-sacrificing.

當我們談到屈服或崩潰時，往往會看到抑鬱、羞愧、充滿自責、被動、做乖乖女或照顧者、自我犧牲。

And those are really about just sort of completely, you know, just letting yourself fall down in terms of not really bringing your full self in in order to survive.

而這些其實都是為了生存，你知道的，只是讓自己完全墮落下去，沒有真正把自己完整地展現出來。

And we often think of dissociation as an attempt to disappear, to be invisible.

我們通常認為，解離是一種試圖消失、隱形的行為。

And that's what we're doing when we're going into all of these coping types, right?

當我們進入這些應對類型時，我們正在做的就是這個，對嗎？

We are somehow going somewhere else to deal with whatever's happening, and it may not necessarily have been the ideal response, but the self-compassion here is that it was what you had to do to survive, and that's really important.

無論發生了什麼，我們都會以某種方式去別的地方處理，這不一定是理想的反應，但這裡的自我同情是，這是你為了生存而必須做的，這真的很重要。

And then we have attach, cry out for help.

然後，我們有了附件，大聲呼救。

And that's where we're looking for connection, but it's a desperate look for connection.

這就是我們尋找聯繫的地方，但這是一種絕望的聯繫。

We're fearful of being abandoned and rejected, and we can be wanting someone to lean on.

我們害怕被拋棄、被拒絕，我們可能希望有人可以依靠。

And this particular part of a trauma type can look like borderline, which is a whole different video.

創傷類型的這一特殊部分可能看起來像邊緣型，這是完全不同的視頻。

And therapists can misinterpret a client's needs for this attach, cry out for help as being very borderline-y.

而治療師可能會誤解客戶的這種需求，認為客戶的求助呼聲非常邊緣化。

And so it's important to understand that once you pick a label, you start following the label down the road, you look for more evidence, you're probably going to get there.

是以，重要的是要明白，一旦你選擇了一個標籤，你就開始沿著這個標籤走下去，尋找更多的證據，你很可能就會走到那一步。

So we want to make sure we're separating when we're in that state where we all desperately need to be attached and be safe versus a full-on disorder, which, like I said, is another video

是以，我們要確保在我們處於這種狀態時，將我們急需依附和安全的狀態與全面失調的狀態區分開來，就像我說的，這是另一個視頻

I'll come back to.

我會回來的。

And we have appease and please.

我們還有安撫和討好。

And this is really that people-pleasing and disregarding ourselves, that fawn response to get our needs met.

這其實就是那種取悅於人、無視自我的行為，是為了滿足我們的需求而做出的獻媚反應。

So I want you to think about, as you go into the journal prompts, which of these you tend to use in terms of your own defensive styles.

是以，我希望你們在閱讀日記提示時，思考一下，就自己的防禦方式而言，你傾向於使用其中的哪一種。

What did you have to do, and how does that show up today?

你必須做什麼，今天又是如何體現的？

And I'll discuss that more in the next few seconds in the journal prompts.

接下來的幾秒鐘，我將在日記提示中詳細討論這個問題。

So, the root of dissociation is that regardless of whether we are talking about the sort of classic, I need to go somewhere else in the moment, or spacing out or being triggered, to falling back into my sort of dissociated responses of trauma, all of those remove me from real connection, from real empathy often, from real self-compassion.

所以，解離的根源在於，無論我們談論的是那種典型的 "我需要在當下去別的地方"，還是 "間隔開來 "或 "被觸發"，抑或是 "重新陷入創傷的解離反應"，所有這些都會讓我遠離真正的聯繫，遠離真正的共鳴，遠離真正的自我同情。

And dissociation, along with shame, which is, remember, that sort of internalized self-blame unfairly placed on ourselves, often the root of I am bad from caregivers who were unstable or wounding and things like that, is that our shame and our dissociation both remove us from connection to ourselves and others.

解離和羞恥感是一種內化的自我責備，不公平地加諸於我們自身，通常是 "我是個壞蛋 "的根源，來自於那些不穩定或受傷的照顧者，我們的羞恥感和解離感都讓我們無法與自己和他人建立聯繫。

And they act as like personal boundaries and barriers against the things that will actually help us.

它們就像個人的界限和障礙，阻礙著那些能真正幫助我們的東西。

Because what helps us is truly being self-compassionate, knowing how to get our bodies safe, which is why I discussed those in the first couple of videos in the journal, safe place, self-compassion.

因為幫助我們的是真正的自我同情，知道如何讓我們的身體安全，這就是為什麼我在日記的前幾個視頻中討論了這些，安全的地方，自我同情。

And being able to integrate the parts of ourselves that are wounded and that we've used to cope is part of what the therapy looks like when you talk about how to heal CPTSD, how to start to learn to calm our bodies, do some breathing, respond, let's say, in that conflict with a partner from a place of awareness, from a place of connection and calm.

當你談到如何治癒 CPTSD，如何開始學會平靜我們的身體，做一些呼吸，比方說，在與伴侶發生衝突時，從意識的角度，從連接和平靜的角度做出反應。

And so that's hard to do if we've sort of gone into that dissociated part of ourselves that is defending and protecting and surviving.

是以，如果我們已經進入了自我分裂的狀態，即防禦、保護和生存，那就很難做到這一點。

So as I said, I'll make another video on this whole concept because I think it's so fascinating.

是以，正如我所說的，我會再製作一個關於這個概念的視頻，因為我覺得它太吸引人了。

But I want you to know that when we're talking about healing shame, we're talking about how to get in connection, how to have healing and self-compassion, and how to stay present-minded.

但我想讓你知道，當我們談論治癒羞恥時，我們談論的是如何建立聯繫，如何擁有治癒和自我同情，以及如何保持當下的心態。

And that's why dissociation is such a huge part of this journal part, is understanding where do you go?

這就是為什麼解離是這本日記的一個重要部分，它讓人明白你該何去何從？

What are those dissociated parts of yourself?

你與自己分離的部分是什麼？

Where do you actually go when you are going somewhere else?

當你要去其他地方時，你究竟會去哪裡？

And so how can you learn to get yourself more grounded and back in the present?

那麼，如何才能學會讓自己更加腳踏實地，回到當下呢？

Because all of those strategies prevent us from being seen and known, and from knowing and seeing and feeling and hearing other people, in addition to ourselves, okay?