Name: 創傷、療癒與大腦：社區學習會，由 Gabor Maté 醫師主講！ (Trauma, Healing and The Brain: Community Learning Event, Dr. Gabor Mate)
Uploaded: 2026-02-08T10:07:22.000Z
Duration: 18 min 39 s

So I'm a retired doctor and I don't work as a doctor anymore.

所以我是一位退休醫生，現在已經不做醫生了。

I did work for 20 years in family practice.

情態副詞

Seven years I was coordinator of the palliative care unit looking after terminally ill people in Vancouver hospital.

在溫哥華醫院，我擔任安寧療護單位的協調員七年，照顧末期病人。

And for 12 years I worked in Vancouver's downtown Eastside looking after people with severe addictions to cocaine, to crystal meth, to opiates like heroin, to alcohol, of course, people dying of hiv, of hepatitis C, and

在溫哥華市中心東區，我工作了12年，照顧有嚴重成癮症的病人，像是古柯鹼、安非他命、鴉片類藥物如海洛因，還有酒精，當然還有愛滋病、丙型肝炎的病人，以及

every other disease caused by addictions.

任何其他由成癮症引起的疾病。

And in my practice, I looked after young families, I looked after people of all ages.

在我的執業期間，我看診過年輕家庭，也看診過各個年齡層的病人。

The one thing I've learned, I've learned many things, but

我學到了一件事，其實我學到很多，但是

the one thing that I can reduce it to or simplify it to is that virtually everything I ever saw, whether it was cancer, whether it was multiple sclerosis, whether it was depression, whether it was addiction, whether it was adhd, whether it was colitis, rheumatoid arthritis, you know what it came down to?

我可以把它簡化成，幾乎我所見過的一切，不管是癌症、多發性硬化症、憂鬱症、成癮症、注意力不足過動症、結腸炎、類風濕性關節炎，你們知道這都歸結於什麼嗎？

It came down to what happens in people's childhoods.

這都歸結於人們童年時期發生了什麼。

In other words, the major contributor, I don't say the only, but

換句話說，主要的貢獻者，我不是說唯一的，但

the major contributing factor to the onset of illness, whether it's mental illness, physical illness, whether it's addiction, whether it's behavior problems, what happens to people in the first few years of life.

是疾病發生，不管是精神疾病、身體疾病，不管是成癮症、行為問題，人們生命最初幾年發生的事，主要的促成因素。

And that may seem like an astonishing statement.

And how is this guy going to prove it in the 16 minutes that he's got left?

而這位先生要在剩下的 16 分鐘內證明這一點，要怎麼證明呢？

In the downtown Eastside, which is Vancouver's drug area.

在溫哥華的毒品區，市中心東區。

And not only is it Vancouver's drug area, it's also known as North America's most concentrated area of drug use.

而且它不只是溫哥華的毒品區，它也被稱為北美最集中的毒品使用區域。

We have more people there using injecting substances than any other place in North America in a few square block radius.

在幾平方街區的範圍內，我們有比北美其他任何地方都多的人在使用注射藥物。

I can tell you that over a 12 year period, I didn't meet a single female patient who had not been sexually abused as a child.

我可以告訴你，在 12 年的時間裡，我沒有遇到過一位沒有在童年時期遭受過性虐待的女性病人。

Not a single male patient who had not been either physically abused or sexually abused or neglected or abandoned in significant ways.

沒有一位男性病人沒有遭受過身體虐待、性虐待、疏忽或被嚴重遺棄。

And in North America, we like to think of addiction as either a choice that people make, and

而且在北美，我們傾向於認為成癮是一種人們的選擇，

if they make that choice, then we punish them for it.

如果他們做了這個選擇，我們就會懲罰他們。

So we build jails where we keep people use drugs, or we see it as a brain disease that's genetically inherited.

所以我們蓋監獄來關那些用藥的人，或者我們把它看成是一種基因遺傳的腦部疾病。

So if we look at the sad fact that in Canada, 30% of the people in our jails are first nations origin, where they only make up 4 to 5% of the population, we explain that by saying that these poor People genetically are susceptible to addiction.

所以如果我們看看加拿大的這個令人難過的事實，監獄裡 30% 的人是原住民，但他們只佔人口的 4-5%，我們就解釋說，這些可憐的原住民基因上就容易成癮。

So it's either we make it into a disease or we make it into a choice.

所以要嘛我們把它當成疾病，要嘛我們把它當成選擇。

Nobody ever chooses to be an addict, nor is it something that's inherited.

沒有人會選擇成為一個癮君子，它也不是遺傳來的。

We know, for example, that even people that do inherit some genes that are predisposed to addictions, if they're brought up in proper environments, they have no more risk of addiction than anybody else.

我們知道，舉例來說，即使是那些繼承了某些易感基因的人，如果在適當的環境中長大，他們罹患成癮症的風險不會比其他人高。

So it's not ever the genes that cause the addictions, and nobody ever chooses the addiction.

所以，造成成癮症的從來都不是基因，也沒有人會選擇成癮。

What actually happens is when people are traumatized, that increases their risk of addiction.

其實，當人們遭受創傷時，會增加他們罹患成癮症的風險。

And if you want to know why the first nations population in this country, it's because they're the most traumatized segment of the Canadian population historically.

如果你想知道為什麼原住民人口在這個國家是這樣，那是因為他們在歷史上是加拿大人口中最常遭受創傷的群體。

I don't suppose I have to tell you about that, but

the fact that in the Prairie Provinces, I'm not sure what the percentage are in Alberta, but

但就草原省份來說，我不確定亞伯達省的比例是多少，

I know in Saskatchewan and Manitoba, I know the percentage is high.

我知道在沙士卡 चूक萬省和曼尼托巴省，我知道比例很高。

I don't know how high it is in Alberta, but

most of the kids in CAIR are First nations origin.

This is in a population that knew how to look after their kids beautifully, that if you look at the parenting practices of first nations people across the world, they're actually superior to those of industrial societies, according to all the research, unless they're traumatized, in which case the trauma is passed on from one generation to the next.

這是在一個原本懂得如何好好照顧孩子的族群裡，如果你看看世界各地原住民的育兒方式，根據所有研究，它們實際上優於工業社會，除非他們遭受創傷，在這種情況下，創傷會從一代傳給下一代。

So when it comes to addiction, then what we're looking at is the impact of childhood trauma.

所以，談到成癮症，我們看到的是童年創傷的影響。

我們就來定義一下什麼是成癮症。

An addiction is any behavior, substance related or not, that an individual pursues because they find pleasure, relief, or they crave it temporarily, so they pursue it for the pleasure and the relief despite negative consequences.

成癮症是任何一種行為，不論是否與物質有關，個人會去追求，因為他們覺得快樂、舒緩，或是暫時渴望，所以他們為了快樂和舒緩而追求，即使會產生負面後果。

And they don't give it up in the face of negative consequences.

而且即使面對負面後果，他們也不會放棄。

So that could be sex, gambling, eating, shopping, work, relationships or substances.

所以可能是性、賭博、飲食、購物、工作、人際關係或物質。

And if you ask yourself, by that definition, have you ever had an addictive pattern in your life?

如果你問自己，根據這個定義，你人生中有沒有過成癮模式？

If you're like most of the people I speak with, if I asked that question, many of you would put your hand up by that definition, if you ever had an addictive behavior.

如果你跟我認識的大多數人一樣，我問這個問題時，很多人都會舉手，根據這個定義，如果你曾經有過成癮行為。

And then if you ask yourself, but what did that behavior give me?

然後你再問自己，但那個行為給了我什麼？

Well, you'll tell yourself it relieves stress.

嗯，你會告訴自己，這樣可以減輕壓力。

So when I am very stressed, I go home and I eat a lot, or I turn on the TV and I veg out, or I do drugs, or I go shopping and I spend a lot of money.

所以當我壓力很大的時候，我就會回家大吃大喝，或者開電視放空，或者吸毒，或者去購物花很多錢。

So in other words, the addiction serves a purpose.

所以換句話說，成癮是有目的的。

It temporary relieves stress, or it distracts you from emotional pain that you're experiencing, or it gives you pleasure that otherwise is not available to you.

它暫時緩解壓力，或者讓你暫時忘記正在經歷的情緒痛苦，或者給你帶來原本得不到的快樂。

What I'm saying to you is that the addiction is never the primary problem.

我想告訴你的是，成癮從來都不是主要問題。

The addiction is always an attempt on the individual's part to solve a problem.

成癮總是個人試圖解決問題的一種方式。

The problem is, why am I having so much emotional pain?

問題是，我為什麼會有這麼多情緒上的痛苦？

And how come I don't know how to deal with emotional pain?

為什麼我不知道該如何處理情緒上的痛苦？

為什麼我的生活中有這麼多壓力？

And how is it that I can't regulate my stresses without an addictive expression?

而且為什麼我無法在沒有成癮表現的情況下調節壓力？

If you're feeling shy and isolated and it takes a few drinks to loosen your tongue, what happened to you that you feel so scared of people?

如果你感到害羞、孤僻，需要幾杯酒才能讓你放鬆，是什麼讓你這麼害怕人群？

In other words, the addiction is not the problem.

換句話說，成癮本身不是問題。

The addiction is actually an attempt at a solution.

成癮其實是一種解決問題的嘗試。

The problem arose because early in childhood you were somehow hurt.

問題的根源在於，在童年早期，你曾經受過傷害。

Because when people are traumatized, number of things happen.

因為當人們受到創傷時，會發生很多事情。

One is they begin to feel themselves as deficient.

其中一件就是他們開始覺得自己有缺陷。

And I don't mean that in the sense of any pejorative implication.

我這麼說並不是帶有任何貶低的意味。

What I mean by that is they think it's all about them.

我的意思是，他們會覺得一切都跟自己有關。

They think everything is about themselves.

他們覺得所有事情都圍繞著自己。

So when good things happen to a child, the child will assume, hey, I must be great because I got all these great things that are happening.

所以當好事發生在孩子身上時，孩子會想，嘿，我一定很棒，因為我得到了所有這些美好的事物。

But if bad things happen to a child, if the child is yelled at or beaten or sexually abused or told to go to their room when their parents don't like their behavior, or the parents are just depressed or unhappy or stressed, traumatized in their own life, the child thinks these bad things are happening because I'm a bad person.

但如果壞事發生在孩子身上，如果孩子被吼罵、被毆打、被性侵，或者在父母不喜歡他們的行為時被叫回房間，又或者父母只是憂鬱、不開心、壓力大，他們自己的人生也充滿創傷，孩子就會覺得這些壞事發生是因為我很糟糕。

The second thing that happens is that what we now know, and

第二件發生的事是，我們現在知道，

this is a conference on the brain, what we now know is that the circuits of the brain are actually shaped by early experiences.

這是一場關於大腦的研討會，我們現在知道，大腦的神經迴路其實是由早期經驗塑造的。

So that the brain isn't just genetically determined.

That already in the uterus, what's happening to the mother is already affecting the brain circuitry of the child.

甚至在子宮裡，母親的遭遇就已經影響到胎兒的大腦迴路了。

So when the mother is stressed, that's affecting the baby's brain.

所以當媽媽有壓力時，這也會影響到寶寶的大腦。

And these people that are traumatized in childhood, they don't have the conditions for healthy brain development.

而這些童年時期遭受創傷的人，他們的大腦就沒有健康的發展條件。

And then they're going to have mental health problems.

接著他們就會有精神疾病的問題。

And they're going to have ways of compensating for those mental health problems through addictive behaviors.

然後他們會透過成癮症的行為來補償這些精神疾病。

So whether we're looking at the low Self esteem, whether we're looking at the brain physiology, whether we're looking at the spiritual isolation of how alone the addict feels, that it all goes back to what happened early in childhood.

所以，無論我們看的是低自尊、大腦生理學，或是成癮者感受到的那種孤獨的靈魂上的隔絕，這一切都回溯到童年早期所發生的事。

It began with suffering of the young child.

Now, as I said, everything I've seen, whether it was cancer, multiple sclerosis, or mental illness or addiction, begins with childhood issues.

我說過，我所見的一切，無論是癌症、多發性硬化症，還是精神疾病或成癮症，都始於童年時期。

Well, how can cancer begin with childhood issues, you ask yourself?

你可能會問，癌症怎麼會始於童年時期呢？

A Canadian study showed that when children are abused, when they grow up to be adults, the risk of cancer goes up nearly 50%.

一項加拿大的研究顯示，當兒童遭受虐待，長大成人後，罹患癌症的風險會增加近 50%。

Because the abuse or the trauma creates coping mechanisms.

因為虐待或創傷會產生應對機制。

Now, one of the ways that we cope when children are traumatized, one of the ways they cope with it is to soothe themselves.

當兒童受到創傷時，他們會用來應對的方式之一，就是安撫自己。

And then that's where addictions come in.

But another way to cope would be, is if you get the message that you're not good enough, that you are not worthy enough to.

但另一種應對方式是，如果你接收到你「不夠好」、「不夠有價值」的訊息。

Then you might spend the rest of your life trying to prove that you are.

那麼你可能會花餘生來證明自己是夠好的。

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創傷、療癒與大腦：社區學習會，由 Gabor Maté 醫師主講！ (Trauma, Healing and The Brain: Community Learning Event, Dr. Gabor Mate)

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mental

depression