多巴胺专家：短视频正在摧毁大脑！人们尚未意识到这是场多巴胺灾难！

顺便说一下，最快回到平衡状态的方法当然是使用更多的药物。

And by the way, this is, of course, the fastest way to to to get back to the level position is to use more of your drug.

对吧？

Right?

因为那样你就能立刻回到原位。

Because that then you're right there.

你又回来了。

You're back again.

这种方法的问题在于，大脑会通过更多的神经适应来做出反应。

The the problem with this method is that the the brain will respond by more neuroadaptation.

所以我们现在往天平上加了更多的石头，而你现在就是在这么做。

So now we're putting more rocks in on the in the pains, and now you're now you're now you're doing this.

对吧？

Right?

现在我需要更多才能

Now I need even more to

现在你需要更多了。

Now you need even more.

对吧？

Right?

所以随着时间的推移，你知道，你一直在这么做。

So and eventually, over time, you know, you're you're footing you're doing this.

这仅仅是成瘾大脑的一种隐喻性表示。

And this is simply a metaphorical representation of the addicted brain.

对吧？

Right?

现在，我们的大脑已经降低了奖励通路中的多巴胺传递，进入了一种慢性多巴胺缺乏状态。

Now now our brain has downregulated dopamine transmission in the reward pathway to a kind of chronic dopamine deficit state.

所以当我严重滥用我钟爱的药物时，为了再次感到愉悦，我可能必须频繁地使用大量药物。

So to feel good when I've really abused my drugs of choice, I'm gonna have to do so much, probably so frequently, to feel good again.

完全正确。

That's exactly right.

你需要更多剂量的药物，而且是更高效的形式，更频繁地使用，不是为了感到兴奋或快乐，而只是为了平衡状态，感觉正常。

You're gonna need more of your drug in more potent forms more often, not even to feel, like, high and go to the pleasure side, but just to level the balance and feel normal.

所以在不良习惯的背景下，如果我每天吃一块饼干，我吃的饼干越多，明天我就越想吃、越需要吃更多饼干，才能再次感觉良好。

So in the context of people with bad habits, if I I'm having a cookie every day, the more and more cookies that I eat, the more and more cookies I'm gonna want tomorrow and need tomorrow just to feel good again.

基本上，没错。

Essentially, yes.

同样的道理也适用于色情内容，还有可能像与AI互动、社交媒体、威士忌和酒精这样的东西。

And the same applies for things like pornography and maybe, you know, interacting with an an AI and social media and whiskey and alcohol.

所以我消费得越多，这就是为什么我认为每个听众都可能在人生中经历过这样的时刻：感觉自己正在失去对某种习惯的控制，每天都重复做这件事。

So the more of it I consume this is why, you know, I think everybody listening can probably relate to having moments in their life where they feel like they're they're kind of losing control of a particular habit and they're doing it every day.

他们知道其实并不真的想做，但还是在做。

They know they don't really want to, but they're doing it.

他们对做这件事产生了渴望。

They're they're getting cravings to do it.

我反思自己的生活，发现每年都会有一段时间，我会称之为‘从马上摔下来’，就是怎么也控制不住自己，第二天又忍不住去吃那些不健康的东西。

I I reflect to my own life and I go, there there will be periods every year where I just, like, I call it, like, falling off the horse and I just can't seem to get control of, like, not eating that bad thing again the next day.

然后发生了一些事情，也许我生活中有一周压力变小了

And then something happens, maybe there's less stress in my life for a week

嗯。

Mhmm.

也许生活更有规律了，我回到了洛杉矶或英国，不再四处旅行，然后突然间我又能够重新掌控了。

And I'm and maybe there's more routine, and I'm back home in Los Angeles or The UK, and I'm not traveling around, and then suddenly I can get back on the horse.

嗯。

Mhmm.

那背后发生了什么？

What's going on there?

是的。

Yeah.

很好的问题。

Great question.

首先，我要说的是，许多人也报告说，在压力大的时期，他们更容易重新陷入失控状态，或再次出现与强迫性过度消费或成瘾相关的问题，但相反的情况也同样成立。

So, first of all, let me just say that many people also report that in periods of high stress, they are more vulnerable to going back to falling off the wagon or going back to some problem with related to compulsive overconsumption or addiction, but the opposite is also true.

有些人表示，当生活中有压力时，他们反而表现得更好，而一旦压力消失，他们就觉得可以放松自己的界限或防护措施。

So some people say that they actually do better when there's stress in their lives, and it's when that stress is removed, and they feel like, oh, I can relax my boundaries or my guardrails.

这些人在生活顺遂时更容易陷入强迫性过度消费。

And those individuals are more more vulnerable to compulsive overconsumption in times when things are going well.

因此，情况糟糕时可能成为诱因，情况好转时也可能成为诱因，这取决于你独特的生活经历和生理特质。

So so things going badly can be a trigger, and things going well can be a trigger depending upon your unique, like, life history and unique wiring.

有一个很棒的动物实验：如果把一只老鼠放进笼子里，笼子里有一个可以按压获取可卡因的杠杆，这只老鼠会一直按压杠杆，直到筋疲力尽或死亡，这本质上是成瘾的动物模型。

There's a wonderful animal experiment where if you put a rat in a cage with a lever to press for cocaine, that rat will press that lever till exhaustion or death, which is essentially the animal model of addiction.

但如果在老鼠上瘾之前，将可卡因移除，使得按压杠杆不再获得奖励，这只老鼠最终会停止按压杠杆的行为。

But if before the rat becomes addicted, if the cocaine is then removed such that pressing that lever no longer yields the reward, that rat will eventually extinguish that lever pressing behavior.

所以它们会停止按压杠杆。

So they'll they'll stop pressing the lever.

对吧？

Right?

它们会停止做这种行为。

They'll stop doing the work.

这可能需要一段时间，但最终，它们不会再按杠杆了。

It can take a while, but eventually, they won't press the lever anymore.

现在，如果同一只大鼠在经历一段时间后，再次受到剧烈的足部电击，它对这种痛苦的第一反应就是跑过去重新开始按杠杆。

Now if that same rat, after a period of time, is then exposed to a very painful foot shock, the first thing the rat will do in response to that painful foot shock is run over and start pressing that lever again.

对我来说，这完美地模拟了人类的情况：当个体承受极大压力时，他们通常更容易复发，因为他们的大脑已经将使用这些高多巴胺奖励作为应对任何痛苦的方式编码了。

And to me, that's just a wonderful model of what we see in humans that when individuals are under extreme stress, they are typically more vulnerable to relapse because their brain has already encoded using these high dopamine rewards in response to any kind of pain as a way to get out of that state.

所以我们在这里谈到了快感与痛苦的平衡。

So we talked about the pleasure pain balance here.

所以，如果在我的生活中经历了某种形式的痛苦，我可能会去寻求快乐，而压力理论上可以被视为一种痛苦。

So but if in my life I experience some form of pain, I'm likely to go and seek out pleasure, and stress could theoretically be considered a form of pain.

是的。

Yeah.

这就是为什么童年遭受严重创伤的人更容易成瘾。

Which is why people with severe childhood trauma are at higher risk for addiction.

他们的大脑中可能发生了表观遗传层面的DNA表达变化，使他们更容易成瘾。

There are probably epigenetic changes that are happening at the level of DNA expression in their brains, making them more vulnerable to addiction.

我们知道，生活在贫困中的人更容易上瘾。

We know that people who are living in poverty are more vulnerable to addiction.

那些经历代际创伤、失业、重大社会和地理迁移的人。

People who are struggling with multigenerational trauma, unemployment, major social and geographic dislocation.

这些个体更容易上瘾。

Those individuals are more vulnerable to addiction.

因此，环境压力确实起到了作用。

So environmental stresses definitely play a role.

我们还知道，共存的精神疾病会使人们更容易上瘾。

We also know that co occurring psychiatric disorders make people more vulnerable to addiction.

这可能意味着，患有双相情感障碍、抑郁、焦虑、精神分裂症的人更容易成瘾，而且很可能是因为他们在自我治疗。

Probably, that means that people who struggle with bipolar disorder, depression, anxiety, schizophrenia are at higher risk of becoming addicted, and probably it's because they're trying to self medicate.

那注意力缺陷多动障碍（ADHD）呢？

What about ADHD?

患有多动症的孩子比没有多动症的孩子在成年后更容易发展出成瘾问题。

So kids with ADHD are at higher risk to develop an addiction in adulthood than kids without ADHD.

这种机制尚不明确，但有一些非常有趣的理论。

And the mechanism of action for that is not well understood, but there are some really interesting theories.

其中一个理论是，患有多动症的孩子在基线状态下存在奖励缺陷。

One of the theories is that kids with ADHD have reward deficit at baseline.

实验表明，当向多动症患者展示奖励性刺激时，他们的奖励通路激活程度不如健康对照组。

And that has been shown in experiments that people with ADHD, when you show them rewarding stimuli, their reward pathway isn't as activated as healthy control subjects.

当你说到奖励性刺激时，这指的是什么？

When you say rewarding stimuli, what's what does that mean?

比如蛋糕、酒精，或任何他们认为令人愉悦的东西。

Images of cupcakes or alcohol or anything that they will endorse is something that that's pleasurable for them.

所以当他们看到有奖励的东西时，大脑释放的多巴胺较少。

So their brain doesn't release as much dopamine when they when they see something rewarding.

没错。

That's right.

脑成像研究显示，多动症患者不仅对奖励的多巴胺释放较少，而且在基线状态下多巴胺受体数量也更少。

So brain imaging studies showing that not only do people with ADHD not release as much dopamine in response to rewards, but also have at baseline fewer dopamine receptors.

请记住，我们之前谈到过，多巴胺受体减少是人们成瘾后发生的情况。

And remember, we talked about the decrease in dopamine receptors being what happens as people become addicted.

因此，在某种程度上，你可以把注意力缺陷多动障碍患者理解为在接触导致D2受体下调的成瘾物质之前，就已经在基线水平上存在渴望。

So in some ways, people with ADHD, you could conceptualize them as already having craving at baseline, even before they've been exposed to the kinds of intoxicants that lead to downregulation of those d two receptors.

我曾多次邀请加博尔·马特做客我的播客，他跟我谈到，注意力缺陷多动障碍可以被看作是儿童时期学会通过分心来逃避生活中的压力。

I had him Gabel Mate on the podcast a few times, and Gabel talks to me about how ADHD could be perceived as learning at a young age to kind of distract yourself from the stress in your life.

他大量讲述了自己在纳粹德国时期的成长经历，他的母亲因为担心他面临纳粹的威胁，而把他托付给他人，他因此学会了屏蔽周围的环境。

So he was talking a lot about his own experience growing up in Nazi Germany times and his mother giving him to someone else because he was at risk of the Nazis and the stress of that moment and how he'd kind of learned to tune out of the environment because of that.

我一直对此感到好奇，也曾从理论上思考过这一点。

And I've always wondered I thought about that theoretically.

比如，如果你在充满尖叫和暴力的家庭中长大，你就会学会屏蔽外界的刺激。

It's like, you know, if you grew up in a household where there's loads and loads of screaming and loads of violence, for example, you kind of learn to to tune out.

但你同时也会发展出过度警觉的倾向。

But you you can also develop a hypervigilance.

嗯。

Mhmm.

所以，如果这个理论成立，那么这些人的痛苦基线本来就比较高，这对我来说是说得通的。

And so it kinda does make sense to me that so many of those people, if this theoretically holds, would start with a bit of a pain baseline.

我们确实知道，在具有复杂依恋关系的创伤环境中长大的孩子，更容易发展出成瘾行为。

We we definitely know that kids who are raised in traumatic environments where there is complex attachment with caregivers, those kids are at higher risk for developing addiction.

这种对创伤的解离反应——无论是通过心理上的解离或分心来逃避现实，还是通过寻找能带来安慰的行为——都已被广泛观察和充分记录。

And this kind of dissociative response to trauma, just trying to escape the situation, either in your own mind, with your own mental, you know, dissociation or distractions, or actually finding a behavior that gives you comfort is well, you know, well observed and well well documented.

回到我们之前关于数字媒体及其潜在危害的讨论，最近有一项皮尤调查报告发布，询问父母如何应对让孩子接触智能手机的问题。

Just getting back to our early conversation about digital media and the dangers they're in, So a Pew survey report just came out asking parents how they navigate exposing their kids to smartphones.

在那些表示允许五岁以下孩子玩智能手机的父母中，当被问及这样做的原因或情境时，其中一个主要原因是：当孩子不开心或感到痛苦时，用手机来安抚他们。

And in the cohort of parents who said that, yes, they do let their children under the age of five play with a smartphone, when they were asked why did they do that or in what circumstances, one of the top reasons was to soothe their child when their child was unhappy or distressed in some way.

我觉得这非常令人担忧，因为这实际上是在让孩子形成一种感知-行为循环：将内在的痛苦作为接触智能手机的触发信号，而这种方式确实有效。

Now I found that very concerning because that is basically setting up the child for the perception action loop of using internal distress as a cue, for reaching for a smartphone, which is works.

它在短期内确实有效。

It definitely works in the short term.

但问题在于，通过这种神经适应的迭代过程，最终智能手机将不再足够。

But the problem, again, is that through this iterative process of neuroadaptation, ultimately, that smartphone will not be sufficient.

现在孩子会需要一部智能手机，还有我不知道的、能随时满足他们一切需求的AI定制宠物。

And now the kid will need a smartphone and, I don't know, you know, an AI tailored pet who will do whatever they want whenever they they want it.

等孩子八岁的时候，这就不够了，他们可能会需要老虎机，或者别的什么东西。

And then by the time the kid is eight, you know, that won't be sufficient, and the kid will need, I don't know, a slot machine, or or whatever it is.

你知道，这是一种不断升级的现象。

You know, it's this escalating phenomenon.

目前有一些初创公司，主要是AI公司，正在把AI技术放进毛绒玩具里。

There's a couple of startups at the moment, AI startups, who are putting AI in cuddly toys.

哦，是的。

Oh, yes.

对。

Right.

把AI放进毛绒玩具里。

AI in cuddly toys.

嗯。

Mhmm.

所以你可以像用设备和ChatGPT对话一样，回到家后拿起你的毛绒玩具，它会跟你说话，问你今天过得怎么样，还能教你东西。

And so you can just like you can speak to ChatGPT using your devices, you can come home, can you pick up your cuddly toy, your cuddly toy will talk to you, it'll ask you how your day's been, it will it can teach you things.

从神经科学、多巴胺或情感联结的角度来看，你怎么看这种现象？

What do you think of of that from a neuroscience or, you know, a dopamine or connection perspective?

我认为这非常非常危险，因为我们本质上是在把育儿和建立亲子关系的工作外包出去。

I think that this is very, very dangerous because we're essentially offloading the work of parenting and creating those relationships.

我不是说要指责父母，因为育儿真的很艰难，我在育儿过程中也犯过很多错误。

You know, not again, I I hate judging parents because parenting is hard, and I've made many mistakes in my parenting.

你知道的？

You know?

但我想这些父母的初衷肯定是好的。

But what's and I'm sure these the parents have the best of intentions.

但与其去努力与孩子沟通，想办法了解孩子生活中的状况——这确实很难，因为即使是小孩子也不一定愿意坦露心声——

But instead of, you know, navigating, finding a way to communicate with their child to figure out how to know what's going on in that child's life, which can be hard to do because, you know, even young children aren't necessarily willing to disclose.

但一旦孩子到了青春期，那就更别想了。

But once they get to be teenagers, forget it.

那你就得等他们愿意告诉你，而这种情况几乎总是在晚上10点，你一天工作完后精疲力尽的时候。

Then you gotta, like, wait until they're ready to tell you, which is almost always, like, at 10PM at night when you're exhausted after working all day.

对吧？

Right?

所以，这确实是其中一部分。

So so so there's that piece of it.

对吧？

Right?

他们并没有付出努力，花时间陪伴孩子，寻找共同的语言。

They're they're not putting in the work, spending the time with the child, finding a common language.

但另一方面，你现在有了一个孩子，他本质上是在用机器自我安慰。

But you also then then the second piece of it is now you've got this child who is essentially self soothing with a machine.

对吧？

Right?

而且这些机器的设计初衷就是奉承、肯定和安慰。

And again, this the the the machines are designed to flatter, to validate, to comfort.

那里没有任何摩擦。

There's no friction there.

对吧？

Right?

这是一种极其强大的社会认可和自我安慰方式。

This is incredibly potent social validation and soothing, self soothing.

这本质上就像一台自慰机器。

It's essentially a masturbation machine.

然后你还会遇到一个非常奇怪的额外循环：父母们通过阅读和观察孩子与人工智能的互动来了解孩子的日常生活。

And then you've got this really weird additional loop where now the parents are finding about out about their child's life through reading and observing her interactions with the AI.

这就像是玩传话游戏。

So it's like a game of telephone.

现在他们通过这种过滤后的信息，以为自己了解孩子生活中的情况，但当然，他们并不真正了解。

Now they've, like, filtered this thing where they they think they know what's going on in their child's life, but, of course, they don't.

而这一切都没有用于促进父母与孩子之间的关系。

And none of that has gone toward fostering a relationship between those parents, you know, and their child.

而这只是，你知道的，真的非常可怕，因为它会导致家庭和社会纽带的巨大分裂。

And this is just, you know, really, really scary because it's gonna lead to this incredible fragmentation of families, of social bonds.

我的意思是，这真的、真的，我们不能朝这个方向走。

I mean, it's it's it's I just we cannot go in that direction.

我们真的必须与此抗争。

We really have to fight against that.

话虽如此，考虑到这些算法会变得更具成瘾性，因为人工智能会越来越了解我，实际上，任何这些大型科技公司背后的商业模型都是为了让我更长时间地关注他们的产品，以便投放更多广告或收取更高的订阅费。

So with all this said, and with the knowledge that these algorithms are gonna get more addictive because AI is gonna know me more and more and more, and actually, the commercial model behind any of these big technology companies is to keep my attention on their product more so they can deliver more ads or they can charge me a higher subscription fee.

你是否感到一丝希望？

Are you at all hopeful?

因为从这些公司背后的商业模型来看，我不明白为什么事情不会继续恶化，反而倒退回去。

Because I can't see from an incentive perspective when we're talking about, you know, the commercial models behind these companies why things aren't are gonna stop and go back.

我的意思是，我同意你的看法。

I mean, I agree with you.

潘多拉的盒子已经打开了。

The genie is out of the bottle.

我们不会倒退，但我依然抱有希望，因为我只是一个现实的乐观主义者。

We're we're not going to go back, but I am hopeful because I think I'm just a realistic optimist.

我相信人类有能力适应并解决问题。

I I do believe in the human capacity to adapt and solve problems.

而我们现在正在讨论这些问题，这在十年前、十五年前是根本不存在的，我认为这是件好事。

And the simple fact that we're talking about these problems now, which we weren't doing, you know, ten, fifteen years ago, I think is a good thing.

公众对数字媒体潜在危险的意识已经大大提高。

There's much more awareness in the population about the potential dangers of digital media.

在发出警报的最前沿，是家长们，因为他们正在实时目睹核心家庭的瓦解，而他们并不喜欢这样。

And and at the forefront of raising the alarm, has been parents, because parents are seeing the sort of disintegration of the nuclear family in real time, and and they don't like it.

所以我充满希望，因为我相信我们会团结起来，尝试不同的解决方案。

So I am hopeful because I just I just think that we're gonna come together, and we're gonna try different solutions.

其中一些解决方案会涉及技术，比如设计护栏或开发更好的技术。

And some of those solutions will involve technology, you know, and and, like, trying to come up with guardrails or or better technology.

我认为我们现在走的这条路，比如使用情色聊天机器人，显然不是正确的方向。

I think the way that we're going now, you know, with, like, the erotic chatbot is is not the right direction.

但话说回来，我们生活在一个自由的民主社会中，成年人在知情同意的情况下可以做他们想做的事，直到我们作为社会决定这些危害超过了潜在的好处。

But then again, we live in a, you know, free democracy, and consenting adults, you know, can do what they're gonna do until we decide as a society that the harms outweigh the potential benefits.

但我真的认为，短期内我们需要关注孩子，因为孩子是脆弱的。

But I I really think in the short term, we need to focus on kids because kids are vulnerable.

他们在许多方面都很脆弱。

They're vulnerable on so many levels.

从神经生物学层面来看，他们很脆弱，因为他们的大脑仍在迅速发展，具有极强的神经可塑性。

On a neurobiological level, they're vulnerable because their brains are still rapidly evolving, incredibly neuroplastic.

他们会削减那些不使用的神经元。

They're cutting back on the neurons they're not using.

他们会为最常使用的神经元进行髓鞘化，使其更加高效。

They're myelinating and making more efficient the neurons they use most often.

整个过程大约在25岁时结束。

That whole process ends at about age 25.

此外，还有大量激素涌入青少年体内，而青少年天生就是风险承担者，根据他们的进化阶段，他们本应在那时外出结识他人、充满好奇并建立联系。

Plus, you've got the buckets of hormones that are going into kids, the the fact that teenagers are natural risk taker risk takers, that they they should, based on their evolutionary milestone, be going out and meeting people and be curious and making connections at that time.

然而，越来越多的青少年待在家里，通过数字方式满足自己的需求。

And yet more and more teenagers are staying at home and getting their needs met, you know, digitally.

所以我们必须关注孩子。

So we've got we've gotta look at kids.

这必须是首要任务。

That's gotta be, like, the first priority.

我们必须帮助父母，因为我们不能把责任全留给父母。

And we've gotta help parents because we can't leave it up to to parents alone.

因此，我对我们将能找到解决方案持乐观态度，我认为我们只需要尝试各种不同的方法，看看哪些有效。

So I I'm optimistic that we are going to, you know, come up with solutions, and I think we just have to try a lot of different things and see what works.

但这不能仅仅是个体的解决方案。

But it's can't just be an individual, you know, solution.

我们不能只把责任留给个人、父母或家庭。

We can't just leave it to individuals or parents or families alone.

学校、政府、立法者，以及制造并从数字媒体中获利的公司，都必须参与进来。

The schools have to join the solution, governments, legislators, and also the companies that make and profit from digital media.

他们确实有责任制造不会伤害孩子的商品。

They they really are responsible for making a product that doesn't harm kids.

而目前，你知道，我们有一个伤害孩子的商品。

And right now, you know, we have a product that harms harms kids.

你最近在某些法庭审判中担任过专家证人。

You've recently been an expert witness in certain trials in court.

对吗？

Right?

是的。

Yes.

在正在进行的诉讼中。

In ongoing litigation.

是的。

Yes.

你能告诉我关于这件事，以及涉及的各方，还有你为什么被召为专家证人吗？

What can you tell me about about that and and about the parties in play and why you're being called to be an expert witness?

我实际上不能告诉你太多。

I can't actually tell you too much.

我不能谈论这件事。

I can't talk about it.

但我可以告诉你，基本前提是儿童属于弱势群体，社交媒体对儿童并不安全，它在多个层面上造成伤害，主要通过其本身具有成瘾性，影响儿童大脑，并利用设计特征激发他们的动机和奖励系统，让他们不断点击和滑动。

But I can tell you that the the basic premise is that kids are a vulnerable group, that social media is not safe for kids, that it causes harm at many different levels, but primarily through the medium itself being addictive and engaging their brains and exploiting their motivational reward system with design features that keep them clicking and swiping.

在这种情况下，有人正在起诉社交媒体公司。

And in that case, someone's suing the social media companies.

没错。

That's right.

所以你现在有学区、县、州、联邦政府，以及代表联邦政府的实体正在起诉社交媒体公司。

So you've got school districts, counties, states, the federal government, entities representing the federal government suing social media companies.

是的。

Yeah.

他们希望达成什么结果？

What outcome are they looking for?

他们希望为孩子提供更安全的产品。

They're looking for a safer product for kids.

他们希望帮助父母、孩子和学校保护孩子免受社交媒体的危害，而这些危害不仅仅是成瘾问题。

They're looking to help parents and kids and schools protect kids from the harms of social media, which, again, are are not just the harms of addiction.

你知道，这实际上是参与行为走向病态的过程，然后由于花费的时间过多，各种危害也随之加剧。

You know, that's sort of the the process by which the engagement becomes pathological, and then the harms multiply because of the sheer amount of time spent.

但这些危害还包括网络欺凌、性剥削、性虐待内容，以及抑郁、焦虑、饮食失调、身体畸形障碍和睡眠紊乱等后果。

But the harms include things like cyberbullying, sexploitation, sexual abuse material, the outcomes of depression, anxiety, eating disorders, body dysmorphia, sleep disruption.

当今的商业世界与十五年前截然不同。

The world of business looks entirely different today than it did fifteen years ago.

那时，打造一个品牌意味着需要巨额预算、仓库、办公空间以及大量员工。

Back then, building a brand meant having huge budgets, warehouses, office space, and lots and lots of staff.

但现在，你只需要一台笔记本电脑、一个想法和合适的工具就能创业，而我比任何人都更有发言权，因为这正是我当初所做的。

But now you can start a business with your laptop, an idea, and the right tools, and I would know more so than anybody else because that's exactly what I did.

Shopify 是我们节目长期的赞助商之一，当我推荐人们创业时，我经常提到它，因为它本身就是一个包含众多工具的平台。

Shopify is one of our long standing sponsors on this show, and they're a brand I often refer people to when they're starting their businesses because it's a tool that contains many more tools within itself.

当你刚开始时，一切都会分散各处。

And when you're starting out, everything is everywhere.

事情杂乱无章，令人困惑，因此把所有东西集中在一起非常有用。

It's messy and it's confusing, so having everything in the same place is incredibly useful.

Shopify 将店铺设计、支付、库存、物流，甚至人工智能工具都整合在一个平台上，你可以直接通过自己的网站或社交媒体销售，也就是在客户活跃的任何地方进行销售。

Shopify puts store design, payments, inventory, shipping, and even AI tools all in one place, and you can sell directly from your website or on social media, essentially wherever your customers spend their time.

这确实是一个出色的商业工具。

It's truly a brilliant business tool.

所以如果你想试试，前往 shopify.com/bartlett，注册每月 1 美元的试用期。

So if you wanna give it a go, head to shopify.com/bartlett and sign up for your $1 per month trial period.

那就是 shopify.com/bartlett。

That's shopify.com/bartlett.

所以如果我刚从十二月出来

So if I'm coming out of December

对。

Right.

十二月我吃得有点多，可能还抽了点烟，不管我有什么坏习惯，比如喝太多酒，因为那是新年，新年派对之类的，我的大脑目前在多巴胺平衡上会有点失调。

And I've been eating a little bit too much in December, maybe I've been smoking a bit, whatever bad habit I might have been doing, drinking too much because it was New Year's new you know, New Year's parties, etcetera, my brain is currently gonna be slightly out of balance in terms of its dopamine balance.

是的。

Yes.

所以假设你的大脑会处于多巴胺匮乏状态。

So hypothetically, your brain will be in a dopamine deficit state.

你需要做的是，足够长时间地戒掉你依赖的物质，以重新调整奖励通路。

What you'll want to do is you'll want to abstain from your drug of choice long enough in order to reset reward pathways.

好的。

Okay.

如果我有糖瘾，

So if I've got a sugar problem

嗯。

Mhmm.

那我是不是得暂时戒掉糖？

Then I need to just lay off the sugar for a little while?

你需要戒糖至少四周。

You need to lay off the sugar for at least four weeks.

四周？

Four weeks?

对。

Yeah.

为什么是四周？

And why four weeks?

因为平均而言，四周是人们摆脱急性戒断状态、开始能够从其他更普通的奖励中获得快乐、不再处于持续渴望状态所需的时间。

Because on average, four weeks is about the amount of time it takes for people to get out of the state of acute withdrawal and begin to be able to take joy in other more modest rewards and not be in a constant state of craving.

好的。

Okay.

最糟糕的是前十到十四天。

The worst part is those first ten to fourteen days.

那是我们处于急性戒断的时候。

That's when we're in acute withdrawal.

原因在于，当我们最初把奖励从愉悦的一端移除时，就像我现在要做的那样。

And the reason for that is when we first take our reward off the pleasure side of the balance, right, which I'm gonna do now.

所以当我们刚开始戒掉糖、人工智能或香烟时。

So when we first stop the sugar or the AI or the cigarettes.

没错。

That's right.

首先发生的是，由于神经适应的过程，我们的愉悦-痛苦平衡会急剧向痛苦一侧倾斜。

The first thing that happens is our pleasure pain balance crashes down to the side of pain because of this process of neuroadaptation.

对吧？

Right?

现在我们进入了急性戒断的状态。

Now we're in the state of acute withdrawal.

而且我有渴望。

And I want I've got cravings.

渴望。

Cravings.

那么，戒断的特征有哪些呢？

And, yeah, what are the characteristics of withdrawal?

焦虑、易怒、失眠、情绪低落或抑郁，以及渴求。

Anxiety, irritability, insomnia, dysphoria or depressed mood, and cravings.

这太疯狂了，因为当我处于那种状态，比如一两天没碰我最爱的东西时，我对那种东西的看法就变了。

And it's crazy because when I'm in that state, when I've not had my drug of choice for, say, a day or two, I look at the drug differently.

它看起来完全不一样了。

Like, my it just looks different to me.

真的太不可思议了。

It's so crazy.

比如，我会走过我特别喜欢的东西，像是胡萝卜蛋糕。

I'll I'll walk past, let's say, something I really like, maybe carrot cake.

如果我——你知道的——最近吃了好多糖，虽然这对我来说很少见，但只是为了举例。

If I've, you know, if I've been having a lot of sugar, which is quite rare for me, but just so I have.

当我吃了一块胡萝卜蛋糕的第二天再看它时，它看起来超级棒，特别美味。

When I look at the carrot cake the day after I had carrot cake, it looks amazing and it looks so delicious.

但当我处于生酮状态，连续四到八周没有摄入碳水化合物时，我看到胡萝卜蛋糕却没有任何情感联系。

But when I'm in the ketogenic state where I've not had carbohydrates for, say, four, eight weeks, I look at carrot cake, and I have no emotional connection to it.

没错。

Exactly.

这完美地总结了这一点。

So that summarizes it perfectly.

对吧？

Right?

我曾有一位患有严重食物成瘾的患者，当她走进办公室的休息室看到甜甜圈时，会冷汗直冒，甚至出现胃痛。

I had a patient with a severe food addiction who, when she walked into the break break room at work and saw the donuts, she broke out into a cold sweat and actually had stomach pains.

仅仅看到甜甜圈，就会引发一种生理上的渴求和高度兴奋状态。

It was a physiologic state of craving and hyperarousal just by looking at the doughnuts.

这本质上就是发生的情况。

And that's what happens essentially.

对吧？

Right?

因为我们一直处于持续的渴望状态。

Because we're we're in this state of constant craving.

我们的大脑过度高估了这种奖励。

Our brain has overvalued this reward.

我们对最初使用药物时的愉悦回忆依然强烈，记得它当时有多美味。

We have euphoric recall of our earlier use of the drug when we first tasted it, how delicious it was.

即使现在，当我们吃它时，由于耐受性，它已经没有以前那么好了，但我们的大脑仍然记得过去的体验，因此我们仍然过度高估了‘它会有多美味’的预期。

And even now if we even now when we eat it, because of tolerance, it's not as good as earlier use, Our brain still remembers earlier use, and and we have this overweighted value of, oh, how delicious it's going to be.

这一点非常重要，因为当我们处于急性渴望状态时，感觉这种渴望永远不会结束。

And so this is really important to remember because when we're in that acute state of craving, it feels like it will never end.

确实如此。

It really does.

在我的临床工作中，我仍然对早期戒断期的人们常说‘渴望太可怕了’感到惊讶。

And I'm I'm I'm still amazed in in my clinical work how in early withdrawal, people just say, the craving is is horrible.

就像，我真的无法这样活下去。

Like, I I just I can't live like this.

我认为这一点非常重要：许多人试图戒掉他们钟爱的药物，但他们没有坚持足够长的时间，无法摆脱那场渴望的漩涡，到达彼岸。

And I think that's really important to point out that many people try to stop using their drug of choice, but they don't try they don't stop for long enough to be able to get out of that vortex of craving to get come get to the other side.

这种渴望感觉永远不会结束。

And it feels like the craving will never end.

所以我总是要安慰他们，只要他们能足够耐心地不使用药物，最终会达到不再处于持续渴望状态的境地。

So I I always have to reassure them that if they can just wait long enough without using, they will eventually get to that place where they're not in that constant state of craving.

当然，这假设他们拥有足够的神经可塑性来实现这一点，但并非所有人都具备。

Now that's assuming they have enough neuroplasticity to do that, and not not everybody does.

那么，戒断的意义究竟何在？

And so what what what what is the purpose then of abstinence?

再次说明，当我们的大脑不再获得这种外源性的刺激或多巴胺时，最终大脑会明白：哦，好吧。

It's, again, when our brain is no longer getting this exogenous source of stimulation or dopamine, eventually, the brain gets the message, oh, okay.

我需要开始自行调节我的多巴胺传递。

I need to start up regulating my own dopamine transmission.

对吧？

Right?

我需要重新调动或重新部署我的突触后多巴胺受体。

I I need to reemploy or re I need to redeploy my postsynaptic dopamine receptors.

对吧？

Right?

我需要从自己的大脑内部获取它。

I need to get it from inside of my brain.

所以最终，我会把天平疼痛一侧的石头拿掉。

And so eventually I'm just gonna take the rocks now off the pain side of the balance.

你知道的？

You know?

本可以更容易的。

Could have made this easier.

来，让我来处理。

Here, let me do this.

好了。

There we go.

最终，如果我们戒断足够长的时间，这种神经适应过程就会自我逆转。

Eventually, if we abstain for long enough, those that process of neuroadaptation reverses itself.

当你说到神经适应时，你指的是大脑发生变化吗？

When you say neuroadaptation, you mean the brain changing?

对。

Right.

大脑会发生变化。

The brain changes.

因此，我们所看到的成瘾相关的神经可塑性，在大多数情况下是可以逆转的。

So the the kind of neuroplasticity that we see with addiction can be reversed in most cases.

神经可塑性就是大脑再次发生变化。

Neuroplasticity is just the brain, again, changing.

对。

Right.

发生变化。

Changing.

对吧？

Right?

或者回到过去。

Or or or going back.

有趣的是，爱德·沙利文等人对戒断过程中大脑变化的研究表明，这些成瘾相关的神经回路可能永远不会消失，但就像火堆中熄灭的余烬，它们会逐渐平静下来。

Now, interestingly, you know, the work of Ed Sullivan and others looking at what happens in the brain during recovery suggests that those addiction neural circuits probably never go away, but but like the dying embers of a fire, they quiet down.

而康复的特点是发展出新的神经网络，绕过这些受损区域。

And then recovery is characterized by the development of new neural networks that route around those injured areas.

但关键是，由于神经可塑性，我们最终可以恢复到正常的愉悦和痛苦水平。

But the bottom line is that because of neuroplasticity, we can eventually return to kind of baseline levels of pleasure and pain.

我们可以恢复我们的享乐或快乐设定点。

We can restore our hedonic or joy set point.

当我们做到这一点时，我们就处于一个更健康的状态。

And when we do that, we're in a much healthier place.

因为现在，我们可以从药物以外的其他奖励中获得快乐。

Because now, we can take pleasure in other rewards that are not our drug.

对吧？

Right?

比如看日落、和朋友聊天、散步，这些我们因为被药物劫持了奖励通路而失去享受能力的事情。

Like watching a sunset, talking to a friend, going for a walk, things that we lost the capacity to enjoy because our reward pathway was hijacked by our drug of choice.

我觉得你说‘药物选择’这一点非常重要，因为从我们上次的对话中我了解到，我和你都容易对不同的药物选择产生或多或少的成瘾。

I think this is a really important point as well when you say drug of choice because one thing I learned from our conversation last time is that me and you will both be susceptible to becoming more or less addicted to different drugs of choice.

对我来说，可能是威士忌。

So for me, it might be whiskey.

对你来说，我想你之前说过，情色小说是你其中之一的偏好。

For you, it might I think you said it was like erotic novels were one of your things.

我喝威士忌并不是因为别的，但也许吧，我不知道。

I don't drink whiskey just for the But it might be I don't know.

可能是阿片类药物，或者是人工智能。

It might be opioids or AI.

我可能更容易上瘾。

I might be more susceptible.

所以，如果我和你花一小时刷抖音，由于我的大脑构造、我人生中的经历等原因，我可能会对抖音上瘾，而你却不会感到上瘾。

So if me and you spend one hour on TikTok, the way my brain is wired, the things I've been through in my life, whatever, might mean that I get really addicted to TikTok, whereas you don't feel that.

没错。

Exactly.

而区分成瘾性药物或致幻物质与其他物质的关键在于，它们会一次性在奖赏通路中释放大量多巴胺。

And what distinguishes, you know, addictive drugs or intoxicants from other substances is that they do release a lot of dopamine all at once in the reward pathway.

因此，许多人——如果不是大多数人——会发现这些致幻物质具有强化作用，但这并非普遍适用。

So many, if not most people, will find intoxicants reinforcing, but that's not universally true.

比如，有些人服用阿片类药物后反而感到非常不适，并不会产生欣快感。

Like, there are some people who take opioids and find them that they feel very uncomfortable, and it's not doesn't make them feel euphoric.

对吧？

Right?

还有些人喝咖啡因却感受不到刺激效果，有些人喝酒后反而头痛，得不到任何放松。

And other people will drink caffeine and not feel the stimulating effects, and other people will have alcohol and, you know, get a headache and not not feel relief.

因此，我们大脑中的这些差异是一个非常重要的概念。

So and and so these differences in our brains is a really important concept.

那关于所谓‘成瘾型人格’这个说法呢？

What about this idea of having an addictive personality?

这真的存在吗？

Is that a real thing?

这确实是一个真实存在的现象。

It is a real thing.

不过我们现在不再使用这个术语了。

We don't use that terminology anymore.

我们现在谈论的是成瘾的遗传或基因风险。

We talk about the inherited or genetic risk of addiction.

我们确实知道，如果你的生物学父母或祖父母有成瘾障碍，即使你是在一个不接触这些物质的家庭中长大的，你患上成瘾的风险也会比普通人群更高。

We do know that if you have a biological parent or grandparent, with an addictive disorder, you are at increased risk of developing addiction compared to the general population even if you're raised outside of that substance using home.

我是不是理解对了，你不用这个术语是因为它暗示人无法改变、注定被困住，还是有其他原因？

Am I right in thinking you don't use that term because it suggests one can't change and that they're stuck, or is there another reason?

这是个好问题，为什么这个术语不再受欢迎了。

You know, it's a good question why that term has gone out of favor.

我认为，一般来说，当我们谈论‘是的’时。

I think in general, when we talk about yeah.

当我们谈论性格时，它似乎是一种人性格中固定不变的特征，所以我们可能正试图避免使用这个说法。

When we talk about personality, it does seem like a kind of a fixed feature of somebody's character, and so we're probably trying to avoid that.

你刚才说的这一点真的很令人释然，也许我们不需要制定新年决心。

One of the really liberating things about what you've just said is maybe we don't need to make New Year's resolutions.

也许我们只需要制定一个一月决心，因为那只有四周长。

Maybe we need to make just a January resolution because that's four weeks long.

如果我能坚持到四周结束，那么渴求感很可能就消失了。

And if I can get to the end of the four weeks, then the cravings are likely to have gone.

当你想到新年决心时，一周后你就会想：天啊。

And, you know, when you think about a New Year's resolution, then you get, a week in and you're like, god.

我能坚持整整365天吗？

Am I gonna be able to do this for the whole three sixty five days?

嗯。

Mhmm.

或者你刚才实际上已经指出，也许你只需要给自己设定一个四周的决议。

Or you've just said actually eliminates the fact that maybe you should just set yourself a four week resolution.

没错。

Exactly.

这正是我们在临床护理中经常做的事情。

And that's what we often do in clinical care.

如果我们要求人们终身戒断，这似乎是不可能的。

If we were to ask people to abstain for their whole lives, it seems impossible.

但如果我们要求他们戒断三十天，这个时间长度就更容易让人理解和接受。

But if we ask them to abstain for thirty days, it's kind of an amount of time that they can wrap their heads around.

而且，对于大多数愿意并能够做到的人来说，这也很重要——当然，前提是这样做对他们来说是安全的，因为这并不适合所有人。

And also, not in all, but in most folks who are willing and able to do it, and also importantly for whom it's safe to do because it's not safe for everybody.

对吧？

Right?

我们不会建议那些有酒精或苯二氮䓬类药物戒断时危及生命风险的人这样做。

We wouldn't recommend that for someone who is at risk for life threatening withdrawal from alcohol or benzodiazepines or something like that.

但对于那些愿意并能够做到的人，他们在三十天结束时通常会感觉更好，然后可以决定是继续戒断还是重新开始使用。

But for people who are willing and able to do it, they usually feel better at the end of the those those thirty days, and then they can make a decision about whether they want to continue to abstain or or they want to go back to using.

如果他们决定重新开始使用，通常他们的药物耐受性已经降低，这意味着当他们再次使用时，又能重新获得愉悦感——而由于神经适应，长期大量使用会让我们失去这种能力。

And if they do decide to go back to using, they've typically, you know, have lowered their tolerance for their drug of choice, which means that when they do use again, they can get reward from it again, which, again, because of neuroadaptation, we lose the ability to do that with chronic heavy use.

因此，这种适度使用的想法，过去在成瘾领域根本没人讨论，因为当时认为只有完全戒断才是唯一途径。

So so that, you know, that that there is this whole concept of moderating our use, which didn't used to be something that we even talked about in the field of addiction when it was thought that abstinence was the only way.

但越来越多地，我们在思考在一段戒断期后如何以健康的方式进行适度使用。

But more and more, you know, we are thinking about healthy ways to moderate after a period of abstinence.

我们推荐一段戒断期的原因，即使长期目标是适度使用，是因为我们发现，人们如果先戒断一段时间，之后进行适度控制会更成功。

And the reason we recommend a period of abstinence, even if the long term goal is moderation, is because we find that people are more successful moderating if they first, abstain for a period of time.

那如果我想培养一个新习惯呢？

What about if I'm trying to pick up a new habit?

嗯。

Mhmm.

关于这个苦乐权衡，我需要怎么思考呢？

What what how do I need to be thinking about this pain pleasure scale?

那么，考虑到这一点，有什么好的策略吗？

And what are what's a good strategy with this in mind?

我想开始，比如说，我想开始去健身房。

So I wanna start let's say, I wanna start going to the gym.

对。

Right.

所以你选择了一个难以坚持且需要付出努力的习惯——去健身房。

So you've chosen a habit going to the gym that is hard to do and involves effort.

这意味着，这个习惯不会像那些与奖励通路中多巴胺突然释放相关的习惯那样轻易养成。

So that means that habit won't happen easily the way that habits that are related to the sudden release of dopamine in the reward pathway.

因为那些习惯是毫无阻力的。

Because those are habits that are frictionless.

我们会立刻养成它们。

We we pick them up instantaneously.

但对于需要付出努力且奖励不即时的习惯，你可以再次思考这种愉悦与痛苦的平衡。

But a habit that involves effort and for which the rewards are not immediate, you can you can again think about this pleasure pain balance.

现在，我们不是在愉悦的一侧施压，而是有意识地在痛苦的一侧施压，强迫自己早上起床，去健身房，进行费力的锻炼。

And now instead of pressing on the pleasure side, we're intentionally pressing on the pain side by making ourselves get out of bed in the morning, go to the gym, engage in effortful exercise.

有趣的是，当我们这样做时，我之前提到的神经适应‘小妖精’——也就是我们今天所用的这些石头——实际上会移到我们天平的另一侧。

And what's interesting is that when we do that, the neural adaptation gremlins that I talk about are these rocks that we've used here today will actually go on the other side of our balance.

于是，在愉悦的一侧，我们会通过提前付出代价来间接获得多巴胺。

So on the pleasure side, and we will get our dopamine indirectly by paying for it upfront.

这可能发生的机制是：我们的身体在感知到损伤后，会上调一些让人感觉良好的激素和神经递质，比如多巴胺，以及内源性阿片肽和内源性大麻素。

And the way that that's probably happening is that our body in sensing injury is up regulating feel good hormones and neurotransmitters like dopamine, but also endogenous opioids, endogenous cannabinoids.

从进化角度来看，这正是我们愉悦与痛苦平衡系统演化的真正方式。

And from an evolutionary perspective, that's really how our pleasure pain balance evolved.

所以为了让我更好地理解，简化一下，是这样吗？

So just to simplify this for me Yeah.

我去健身房。

I go to the gym.

我起床。

I get up.

我去健身房。

I travel to the gym.

我举起那些哑铃。

I lift up those weights.

我跑步。

I do my run.

我会感觉很好，但那是延迟的。

I'm gonna feel good, but it's gonna be delayed.

对。

Right.

重要的是，你刚开始锻炼时不会感到舒服。

And importantly, you're not gonna feel good when you first start exercising.

嗯。

Mhmm.

对吧？

Right?

至少大多数人不会。

At least most people don't.

不会。

No.

这很痛苦。

It's it's painful.

你在想，我已经练了多久了？

And you're thinking, how how many minutes am I?

你知道，我还剩多少分钟？

You know, how many minutes do I have left?

事实上，我们知道运动对细胞来说是即时有毒的，这真的很奇怪，因为我们知道运动对我们有益。

And we do know, in fact, that exercise is immediately toxic to cells, which is really kinda strange because we know exercise is good for us.

但同样，可能在分子层面上发生的是，身体感知到细胞损伤，并因此上调了所有那些让人感觉良好的激素和神经递质，但这需要时间。

But, again, what's probably happening at a molecular level is that the body is sensing cellular injury and in response, upregulating all those feel good hormones and neurotransmitters, but it takes time.

这需要时间，因此我们会有一个延迟的奖励感。

It takes time, and so we're gonna have a delayed sense of reward.

这就是跑者的愉悦感，对吧？那种运动结束后才出现的感觉。

And that's the runner's high, right, that kind of comes after, the exercise is over.

或者对某些人来说，这种感觉会出现在运动过程中，当你已经进行了一段时间或走到一半时。

Or maybe for some people, it comes in the middle of exercise when you're a little bit into it or halfway through.

但到了某个时刻，你会分泌内啡肽，那种感觉很棒。

But at some point, you know, you get the endorphins and that feels good.

那我该如何设计一种机制，让自己更有可能去运动呢？

How would one go about gaming this so that I'm more likely to do it?

因为你知道，奖励是事后才来的，这并不太有用。

Because, you know, the reward comes after, which is not incredibly useful.

你几乎得对运动有一种宗教般的信念，因为你心里想：我根本不想做这件事。

You almost have to have a religious belief in exercise because you go, no, I'm not going to want to do this.

但我事后一定会感谢自己做了它。

But I'm going to be glad I did afterwards.

所以，我还能做些什么呢？

So is there anything I can do?

比如，我去健身房的时候会不会有个打卡机制之类的？

Like, do I have a mask bar when I get to the gym or something?

我不知道。

I don't know.

你知道的，人们有太多方法和技巧来培养新的健康习惯。

You know, there are so many ways and so many tricks that people use to kind of create new healthy habits.

我们能做到的一点是，在面对困难任务之前就提前做好准备。

One of the ways that we can do it is to prepare in advance for that moment when we want to do something that's hard.

因为如果我们等到那一刻才决定是否要做一件困难的事，我们几乎总是会选择不做。

Because if we wait till that moment to decide whether or not to do something that's hard, we almost always choose not to do it.

但如果我们提前规划好，比如前一天就决定：明天我会在这个时间起床，收拾好东西，然后去健身房，我们就更有可能去执行这个活动。

But if we make a plan in advance, let's say the day before, that tomorrow, I'm gonna get up at this time, I'm gonna, you know, get my stuff together, and I'm gonna go to the gym, we're much more likely to engage in that activity.

这也可以包括提前准备好的与这项活动相关的仪式。

And that can also include then rituals around that activity that we prepare in advance.

比如，打包好我们的包。

So for example, packing our bag.

对吧？

Right?

日程本身，安排时间，也许计划和朋友见面。

The schedule itself, setting up a time, maybe planning to meet a friend.

对吧？

Right?

所以我们把友谊或社交与那些难做的事联系起来。

So we connect friendship or socialization with the thing that's hard to do.

和别人一起做这些困难的事，比独自完成要容易得多。

It's much easier to do these difficult things with other people than than to have to do it alone.

这和平衡中的痛苦方面有什么关联吗？或者根本无关？

How does that link to the the pain side of the balance, or does it at all link to the pain side of the balance?

这个想法是，如果我前一天晚上把衣服准备好，安排好时间，认真规划，是不是在减少痛苦，从而提高行为发生的可能性？

This idea that if I put my clothes out the night before, and I I schedule it, and I really plan for it, is it it's reducing the pain involved, and that's gonna increase the probability of the behavior occurring?

你是在说这个吗？

Is that what you're saying?

还是有其他原因？

Or is there something else?

还是说这并不像我

Or is it not like I

我不这么认为。

I don't think so.

我认为，前额叶皮层是位于我们前额后方的一大片灰质区域，对未来的规划和延迟满足至关重要，同时也与自传式叙事有关。

I think instead, you know, the prefrontal cortex is the large gray matter area right behind our foreheads that's so important for future planning and delayed gratification, also for auto autobiographical narrative.

我认为，通过把这些因素安排好，就能让我们的前额叶皮层为那些我们知道并不想做、但又希望去做的事情做好规划。

And I think by putting these, you know, pieces in place that allows our prefrontal cortex to plan for this future event that we know we're not gonna wanna do, but that we want to do.

是的。

Yeah.

它让我们能够抑制短期欲望，将自己投射到未来，以实现长期目标。

It allows us to kind of put the brakes on our short term desires and project ourselves into the future to achieve our long term desires.

因此，神经科学家萨姆·麦克卢尔发现，当面对即时奖励时，情绪脑会被激活。

So Sam McClure, a neuroscientist, has shown that in response to immediate rewards, the emotion brain gets activated.

嗯。

Mhmm.

对于长期奖励，前额叶皮层会被激活。

In response to long term rewards, the prefrontal cortex gets activated.

因此，通过提前规划这些小步骤——有时被称为习惯叠加——我们实际上是在激活前额叶皮层，将自己投射到未来，预期长期奖励，从而让我们能够坚持做困难的事，抑制短期欲望，为未来的自己服务。

So by planning in advance all of these little pieces, sometimes called habit stacking, we're essentially activating our prefrontal cortex, projecting ourselves into the future, and anticipating a long term reward, which then allows us to do hard things and avoid short term rewards in the service of our future selves.

很多人可能会有这样的经历：他们戒掉某个习惯一段时间后又复吸了。

So many people might have an experience where they kick the habit for a little while and then they relapse.

嗯。

Mhmm.

可能是一个月，可能是两个月，也可能是三个月。

You know, it might take it might be a month, might be two months, might be three months.

有没有什么方法可以避免复吸呢？

Is there is there any art to avoiding the relapse?

尤其是在我们今天所处的世界里，人们不断被诱惑去消费各种刺激物——比如喝酒、吸烟或沉迷各种娱乐形式，这些诱惑真的会紧追不舍，因此复吸是非常常见的。

So it's very common to relapse, especially living in the world that we do today where we're constantly being invited to consume really, these stimuli, you know, getting us to to drink or to smoke or to do various forms of entertainment, really chase us down.

我们无法避免它们，或者很难避免。

We we can't avoid them, or it's very difficult to.

所以我经常和我的病人谈论自我约束策略。

So I talk a lot about self binding strategies with my patients.

自我约束策略是一种在我们自己和我们的成瘾物之间设置实际和元认知障碍的方法。

And self binding strategies are a way of putting both a literal and a metacognitive barrier between ourselves and our drug of choice.

什么是元认知障碍？

What's a metacognitive barrier?

它就像一种想法，对吧，或者一种叙述。

So it's like a it's a thought, right, or a a narrative.

比如，物理屏障就是把智能手机拿出卧室，或者删除一个应用，或者把酒精从家里清除，等等，这些都是在自己和成瘾物之间建立物理屏障。

So instead of it being a physical barrier like, a physical barrier would be, for example, getting the smartphone out of the bedroom or deleting an app, right, or getting alcohol out of the house or whatever it is, creating both a physical barrier between myself and my drug of choice.

而元认知障碍则更像是一种思维过程。

A metacognitive barrier is something like more like a thought process.

比如，我们之前谈到过思考长期目标，或者你的价值观是什么？

For example, we were talking about thinking about long term goals or, you know, what are my what are my values?

对吧？

Right?

我的价值观如何战胜我的即时欲望？

And how do my values trump my immediate desires?

或者，我如何与他人进行共同调节？

Or how can I, co regulate with other people?

这些都是我们可以使用的自我约束策略，让我们不完全依赖意志力。

These are all self binding strategies that we can use so that we're not relying on willpower alone.

因为如果我们等到仅靠意志力时才行动，我们注定会失败，尤其是在这个诱惑无处不在的世界里。

Because if we wait to rely on our willpower alone, we will not make it, especially in this world of overwhelming overabundance.

诱惑实在太多了。

There are just too many temptations.

意志力是一种有限的资源，意味着它不会永远持续。

Willpower is an exhaustible resource, meaning that it doesn't last forever.

它最终会耗尽。

It eventually runs out.

所以我们必须在自己和自己的成瘾物之间设置障碍，这样我们就能多一点时间，而这多出来的一点时间，放慢节奏，有时就足以让我们驾驭住渴望，熬过去而不真正使用。

So we've gotta actually create barriers between ourselves and our drug of choice so that we can have a little bit more time, and that little bit more time, that slowing things down is sometimes just enough to allow ourselves to surf the cravings and get through them without actually using.

对好事也可能上瘾吗？

Is it possible to become addicted to good things too?

当我使用‘成瘾’这个词时，我实际上指的是一个疾病过程，一种精神疾病。

So when I use the term addiction, I'm really talking about a disease process, a form of mental illness.

这是一个在日常生活中广泛使用的术语，但人们并不总是用这个含义来使用它。

It's a very common term that's used in everyday life, and people don't always use it in that way.

但当我使用它时，我指的确实是尽管对自身或他人造成伤害，仍持续强迫性过度消费的问题。

But when I'm using it, I I'm really talking about the problem of compulsive overconsumption despite harm to self and or others.

区分成瘾和习惯很重要，我不认为习惯——哪怕是坏习惯——属于成瘾。

And it's important to distinguish addiction from something like a habit, which I don't consider to be, you know, an addiction or even a bad habit.

对吧？

Right?

还不足以达到成瘾的标准。

Doesn't meet threshold criteria for addiction.

此外，重要的是要将这一切与热情区分开来，热情是我们真正投入并热爱的事情，它对我们自己或他人有益，而不会持续造成伤害。

And also, it's important just to distinguish all of that from a passion, something that we really invest in and that we love to do, but that's helpful for ourselves and or other people is not consistently causing harm.

有没有一些日常习惯，比如晨间仪式，你建议那些想要戒除习惯或成瘾的人去尝试？

Are there any daily practices, like a morning ritual, that you would advise someone to consider if they were trying to set themselves up to kick a habit or to kick an addiction?

所以我建议先做困难的事情。

So I recommend doing the hard things first.

这样说的一个简短方式就是：用痛苦开启你的一天。

A shorthand way of saying that is to start your day with pain.

意思是，比如，一醒来就做那些困难的事，作为你晨间例行的一部分，比如锻炼。

Meaning, for example, do the hard things when you first get up as part of your morning routine, like Exercise.

比如锻炼、整理床铺、吃早餐、刷牙、规划你的一天——如果你还没做的话，就先规划好你要做什么，然后在喝早上的第一杯咖啡之前，或者在接触任何屏幕或数字设备之前，把这些事情全部做完。

Like exercise, make your bed, eat breakfast, brush your teeth, plan your day, plan what you're gonna do if you haven't done it already, and do all of those things before, for example, you have your morning cup of joe or before you touch a single screen or digital device.

为什么？

Why?

因为这些强化物太强大了，我们所有人都容易被它们劫持自己的目标和愿望。

Because those are reinforcers that are so powerful that we're all vulnerable to having our goals and desires be hijacked by them.

因此，早上花时间建立一个良好的晨间习惯至关重要，在此之前不要让你的大脑接触这些极具强化作用的物质。

So really important to take the time in the morning to set up a good morning routine before you expose your brain to these incredibly reinforcing substances

我不太明白为什么。

I wasn't clear on why.

我不清楚为什么我要早去健身房，或者为什么要在刷TikTok或社交媒体之前先做困难的事情？

Wasn't clear on the why I would do why I'd go to the gym early or why I do hard things first before I get into TikTok or social media?

如果你先接触成瘾物质，也就是说，早上一醒来就让大脑接触那些极其愉悦的东西，那你之后就无路可走了。

If you do intoxicants first, right, if you expose your brain first thing in the morning to things that are incredibly pleasurable, you have nowhere to go from there.

事实上，你接下来只会从那种状态中回落。

And in fact, if any if anywhere, you're going to have a comedown from that.

然后你就从一种妥协的状态开始，这样一来，做困难的事情就变得更加艰难了。

And then you're gonna be starting from a place of compromise, where then doing the hard things is is even harder.

但如果你先做困难的事情，你可能会因为完成这些困难任务而获得回报。

Whereas if you start with the hard things, you will potentially get rewards from having done those hard things.

对吧？

Right?

而且还会产生一种胜任感。

And also feel a sense of competence.

对吧？

Right?

以及一种成就感，这能让你的一天过得更好，而不是一开始就做那些极其愉悦的事情。

And and accomplishment that then allows for you to move through your day in a way that's better if you just start with something that's incredibly pleasurable.

如果我打算戒掉一个大习惯——一个长期存在的大习惯，我应该在准备进行多巴胺禁断或戒除这个习惯之前做些什么吗？

If I am getting ready to kick a habit, a big one, a big, you know, one that's really hung around for a long time, Is there something I should do in preparation to plan for my dopamine fast or for kicking that habit?

因为我知道你说过，从第一天开始，大约需要四周时间才能开始感受到渴望减弱。

Because I know you said, you know, from day one, it will take about four weeks to start to to feel the cravings diminish.

但在开始这四周之前，我应该做些什么呢？

But is there something I should be doing before I even start those four weeks?

是的。

Yeah.

所以我强烈建议提前为多巴胺禁断做好准备。

So I strongly recommend preparing for the dopamine fast in advance.

首先要做的第一件事是弄清楚你的成瘾物是什么。

And the things to do are first, figure out what is your drug of choice.

也就是说，你过度且频繁消费的是什么，以至于事后会感到后悔。

That is to say, what is the thing that you're consuming too much and too often such that you regret it later Mhmm.

或者导致明显负面后果的东西，或者那些伴随机会成本的东西。

Or the thing that's leading to obvious negative consequences, or the thing that just has opportunity costs associated with it.

也就是说，你花了太多时间消费这种成瘾物，以至于没有时间去做其他事情、其他爱好，或者投资对你有意义的其他方面，比如你的重要人际关系。

That is to say, you're spending so much time consuming this drug that you're not doing other things, other hobbies, investing in other things that are meaningful to you, like your primary relationships.

所以，首先弄清楚这一点非常重要。

So that's very important to just figure that out first.

我通常建议使用一种叫做‘时间线回顾法’的方法。

I usually recommend something called the timeline follow back method.

就是从今天开始，倒推回这一周的每一天。

That's where you start today, and you count backwards for every day of the week.

你每天消费了多少你的成瘾物？

What did you consume in terms of your drug of choice?

多少，以及多频繁？

How much, and how often?

因此，真正关注数量和频率，然后将这七天的量加总起来。

So really looking at quantity and frequency and then adding that up over those seven days.

这一点很重要，因为当我们追求多巴胺时，很容易忽视自己消费这种成瘾物的方式。

And the reason that's important is because we can really lose track of how we're consuming our drug of choice when we're chasing dopamine.

我们作为自我观察者非常不准确。

We're very bad self observers.

举个个人例子，我养成了下班后看YouTube视频来放松的习惯，嗯。

So just to give a personal example, I had gotten into this habit of watching YouTube after work as a way to relax Mhmm.

尤其是在我长时间出诊、特别疲惫的时候。

Especially on my long clinic days when I was more tired.

我以为自己只是偶尔看半小时，或者每周看几次。

And I thought it was just that I was watching for maybe half an hour or a couple times a week.

然后我的女儿，一个青少年，走过来对我说：妈妈，你现在总是看YouTube。

And then my daughter, a teenager, came up to me and she said, mom, you're always watching YouTube now.

我说：没有。

And I said, no.

我没有。

I'm not.

我其实挺受伤的，因为在我心里，这根本不算多。

And I was really kind of insulted because in my mind, it was not very much.

我想：天哪。

I thought, jeez.

我偶尔放松一下，看看YouTube不行吗？

Can I relax every once in a while and watch some YouTube?

但女儿走后，我对自己说：好吧。

But then after she left me, I thought to myself, well, okay.

我现在到底看了多久？

How much have I been watching right now?

结果发现，哦，我已经看了一个半小时。

And it turned out, oh, I've been watching for an hour and a half.

然后我想了想前一天，哦，大概看了两个小时。

And then I thought about the day before that, oh, it was probably two hours.

再前一天，也差不多是这个时间。

And the day before that, it was probably about the same.

整个一周算下来，大概看了十四个小时的YouTube，相当于一整天。

And over the course of a whole week, it was probably about fourteen hours of YouTube, which is a whole day.

一整天。

A whole day.

对吧？

Right?

那你都看了些什么？

And so What were you watching?

天哪。

Gosh.

真丢人。

So embarrassing.

我陷入了看《痘痘医生》的狂热中，我知道这真的很奇怪。

For I I I got into this jag of watching doctor pimple popper, which I know is really weird.

你甚至都不知道那是什么。

You don't even know what that is.

对吧？

Right?

嗯。

Yeah.

就是给人挤痘痘。

So it's people popping other people's pimples.

天啊。

Oh my god.

太糟糕了。

So bad.

太糟糕了。

So bad.

这不是我预期你会说的。

Not what I expected you to say.

是的。

Yeah.

对吧？

Right?

我以为会是人工智能，或者一些心理学内容，

I thought it was gonna be AI, some psychology things,

一些科学。

some science.

不。

No.

不。

No.

人们挤别人的痘痘。

People popping other people's pimples.

嗯。

Yeah.

嗯。

Yeah.

嗯。

Yeah.

你不会花一整天看这个吧。

You don't spent a whole day watching that.

嗯。

Yeah.

当我把一周的时长加起来时，我花了整整一天看医生米普尔挤痘。

When I added it up over a week, it was a whole day of watching doctor Mipple Popper.

我不知道有任何创始人是因为喜欢做行政工作才创业的。

I don't know any founder who started their business because they like doing admin.

但不管你喜不喜欢，这都是成功经营企业的重要组成部分。

But whether you like it or not, it's a huge part of running a business successfully.