最多回放片段：现代育儿方式是否导致多动症？你的决定塑造孩子心智！

多动症。

ADHD.

是的，好吧。

Yeah, Okay.

我觉得我甚至都不用在这里提问，但为了铺垫一下，我之所以对这个如此关注，原因就在于此：我必须说，过去十年诊断和处方数量的惊人增长。

I don't feel like I don't even have to ask a question here, but just to set the stage, reason why I'm so compelled by this is just this, I have to say it, the shocking rise in diagnosis and prescriptions over the last ten years.

在2038年，英国的多动症诊断数量增长了约20倍。

Between 2038, ADHD diagnosis in The UK rose approximately 20 fold.

是的。

Yes.

在10至16岁的男孩中，诊断率从大约1%上升到2018年的3.5%。

Among boys aged 10 to 16 diagnosis increased from one percent roughly to about three point five percent in 2018.

而在18至29岁的男性中，同一时期多动症的处方数量增加了近50倍。

And in men aged 18 to 29, there was a nearly 50 fold increase in ADHD prescriptions during the same period.

美国的情况也是如此，据估计，美国有约1550万成年人被诊断出患有多动症。

And the same applies to The United States, where an estimated fifteen point five million adults in The US have been diagnosed with ADHD.

大约每九名美国儿童中就有一人曾在某个时候被诊断出患有多动症，其中10.5%目前仍处于确诊状态。

Approximately one in nine US children have been diagnosed with ADHD at some point, with ten point five percent having a current diagnosis.

我不知道多动症以前在哪里，但关于它的讨论、药物处方和诊断似乎在文化中急剧升温，规模非常大。

I don't know where ADHD was, but the conversation around it, the prescriptions, the diagnosis seemed to have really surged into culture in a really, really big way.

到底发生了什么？

What's going on?

多动症是我投身于此的原因之一，因为我看到儿童被诊断出多动症并过早接受药物治疗的现象急剧增加。

So ADHD was one of the factors that drove me to being there Because I was seeing this huge uptick in ADHD diagnosis and children being medicated so, so early.

你知道战斗或逃跑反应是什么吗？

Do you know what the fight or flight reaction is?

当交感神经系统开始启动时，

That's when the sympathetic nervous system starts to kick into action and

是的。

Yes.

这基本上是我们对捕食者威胁的进化反应。

So, well, it's basically our evolutionary response to predatorial threat.

所以，如果一只剑齿虎在追你，你要么站住战斗，要么拼命逃跑。

So, if a sable tooth tiger was chasing you, you either stood and fought, fight, or you ran for your life, flight.

当我们的孩子处于压力之下时，他们会进入战斗或逃跑状态。

So, when our children are under stress, they go into fight or flight.

因此，孩子无法应对压力的第一个表现之一，就是在学校变得具有攻击性。

So, one of the first signs that a child is under stress that they cannot manage is when they become aggressive in school.

他们会打人、咬人、扔椅子。

They hit, they bite, they throw chairs.

他们在托儿所、幼儿园甚至学校里都会出现社交困难。

They have trouble, you know, socially in daycare or preschool or even in school.

或者他们变得注意力不集中，这就是战斗或逃跑反应中的‘逃跑’部分。

Or they become distracted, which is the flight part of fight or flight.

所以，正在发生的是，他们的神经系统——大脑中负责调节压力的部分——被激活了。

So what's happening is their nervous systems, the stress regulating part of their brain is getting turned on.

我们说，大脑中负责调节压力的部分与一个叫杏仁核的、形状像杏仁的小结构有关。

So, we say that the stress regulating part of their brain has to do with a little almond shaped part of the brain called the amygdala.

这是大脑中非常原始、非常古老的部分。

It's a very primitive part of the brain, very old part of the brain.

它贯穿我们的一生来调节压力。

And it regulates stress throughout our lives.

它帮助我们应对压力。

It helps us to manage it.

我们知道，大脑的这一部分本应在出生后第一到三年内保持休眠状态，这就是为什么母亲会把婴儿背在身上。

What we know is that part of the brain is supposed to remain offline for the first year to three years, which is why mothers wear babies on their bodies.

这就是为什么婴儿在前三岁会紧紧依偎母亲的原因。

It's why babies stay close to their mothers in the first three years.

为了保持杏仁核的平静，逐步、逐步地让孩子接触他们能够应对的压力和挫折。

To keep the amygdala quiet and only incrementally, incrementally expose children to stress and frustration that they can manage.

所以，想象一下，一点点地吃，这样你才能消化，对吧？

So, imagine taking small bites of it so you can digest it, right?

而你的母亲就在身边，帮助你消化压力。

And your mother's there to help you digest the stress.

我们现在通过让母亲和婴儿分离，把婴儿送到陌生人的日托中心，进行睡眠训练，这些做法都是在激活杏仁核。

What we're doing now by separating mothers and babies, by putting babies into daycare with strangers, by sleep training babies.

我们正在过早地让杏仁核变得活跃。

All these weird things that we're doing to babies is we're turning the amygdala on.

我们过早地让它变得活跃了。

We're making it active precociously too early.

当杏仁核过早被激活时，它会迅速变得非常活跃且体积增大。

What happens when the amygdala is activated too early is it becomes very active and very large very quickly.

问题是，它随后会萎缩并耗尽，因为它无法在这么小的年龄应对如此大的压力。

The problem is then it shrivels up and burns out also because it cannot manage that kind of stress so early.

一旦它失去功能，这种功能丧失将伴随终身。

When it ceases to be functional, it ceases to be functional for a lifetime.

因此，保护……你知道那句俗语是什么吗？

And so, it's very important to protect, you know, what's the expression?

家族的珍宝。

The family jewels.

这些是婴儿大脑中的家庭珍宝。

These are the family jewels in the brain of a baby.

这就是珍宝——杏仁核。

This is the jewel, the amygdala.

在第一年里，你需要将压力降到绝对最低，这就是为什么睡眠训练很危险。

You want to keep the stress to an absolute minimum in the first year, which is why sleep training is dangerous.

这就是为什么让婴儿哭闹不管。

It's why letting babies cry it out.

这就是为什么把婴儿送去日托。

It's why putting babies into daycare.

这就是为什么在婴儿如此脆弱的时候，让他们独自一人数小时，对他们的大脑伤害如此之大，因为这会促使皮质醇（压力激素）分泌，使大脑的这一部分过度活跃。

It's why leaving babies for hours on end when they're so, so very fragile is so bad for their brains because it gets the cortisol flowing, which is the stress hormone, but it makes this part of the brain very active.

于是它不断生长、生长、再生长，随后在未来失去功能，就像创伤后应激反应一样。

So, it grows, grows, grows, and then and ceases to be functional in the future, like a PTSD response.

因此，我们知道这些孩子处于高度警觉的压力状态中。

So, what we know is that these children are in hypervigilant states of stress.

多动症儿童。

ADHD children.

高度警觉的压力状态。

Hypervigilant states of stress.

如果你长期处于高度警觉的压力状态，就会进入低度警觉的压力状态，进而导致抑郁。

If you stay in a hypervigilant state of stress long enough, you go into a hypo vigilant state of stress, which then causes depression.

所以我们现在面对的并不是疾病。

So, what we have now are not disorders.

因此，曾有一股运动试图将ADHD中的‘D’去掉，因为这根本不是一种疾病。

So, there was a whole movement to take the D off of ADHD, because it's not a disorder.

这仅仅是一种压力反应。

It is a stress response.

而我们没有提出正确的问题，比如：是什么导致了压力？

And instead of asking the right questions, which are, okay, what's causing the stress?

我们该如何确保孩子不会暴露在这种压力之下，以免他们陷入战斗或逃跑状态？

How do we make sure that our children are not exposed to this kind of stress because they're going into fight or flight?

所以，神经系统，正如你所说，大脑有开启和关闭的开关。

So, the nervous system, as you said, the brain has an on switch and an off switch.

压力的开启开关是杏仁核。

The on switch to stress is the amygdala.

海马体是关闭开关。

The hippocampus is the off switch.

你会说压力反应是一个负反馈回路。

And you'd say the stress response is in a negative feedback loop.

这其实很重要。

It's actually important.

换句话说，如果一只剑齿虎在追你，能够激活反应是非常重要的，对吧？

Like in other words, if a sable tooth tiger is chasing you, very important that you can activate, right?

逃跑或战斗。

Run or fight.

所以，压力反应本应是短期的。

So, the stress response is supposed to be short term.

它应该是急性的，而不是慢性的。

It's supposed to be acute rather than chronic.

因此，我们可以某种程度上表现出它。

So, we can kind of manifest it.

我们可以激活它。

We can activate it.

但随后它应该被关闭开关——海马体——关闭。

But then it's supposed to be turned off by the turn off switch, the hippocampus.

我们在儿童大脑中看到的是，杏仁核过早地变得非常大，而作为关闭开关的海马体却非常小。

What we're seeing in children's brains is that the amygdala is growing very precociously large and the hippocampus, which is the off switch, is very small.

因此，我们面临这个问题。

So, we have this problem.

正如我们所说，休斯顿，我们遇到问题了。

As we say, Houston, we have a problem.

我们有一个全速运转、油门踩到底、却没有刹车的开启开关，也没有关闭开关。

We have an on switch going full speed, gas, no brakes, and no off switch.

这导致了儿童在学校中注意力缺陷多动障碍（ADHD）和行为问题急剧上升，出现大量攻击性和暴力行为。

And that's causing ADHD, behavioral problems that are hugely rising in children in school, a lot of aggression and violence.

因此，这就是正在发生的情况。

And so, that's what's happening.

这是一种应激反应。

This is a stress response.

然而，我们没有提出正确的问题，比如：这些问题从何而来？

And again, instead of asking the right questions, like, Where is this coming from?

是什么导致了这种压力？

What's causing the stress?

相反，我们压制了孩子们的痛苦。

Instead, we silence the children's pain.

我们告诉家长：我们用药物治疗，只是缓解症状而已。

We tell parents, We'll medicate it and we'll just relieve the symptoms.

对我来说，这就是医疗失当。

For me, that's malpractice.

我们治疗ADHD的方式是一种医疗过失。

The way we treat ADHD is malpractice.

当孩子处于压力下时，他们会进入战斗或逃跑状态。

A child develops, goes into fight or flight when they are under stress.

这可能是家庭中的心理社会压力。

It could be psychosocial stressors at home, in the family.

也可能是学校里的压力。

It could be at school.

也可能是朋友之间的压力。

It could be with their friends.

也可能是学习障碍。

It could be a learning disability.

导致孩子压力的事情太多了。

There's so many things that can cause kids stress.

所以，与其给他们用药，为什么不深入探究到底是什么原因让这个孩子进入战斗或逃跑状态呢？

So instead of medicating them, why don't we figure out what's happening to that child deeply that's causing them to go into fight or flight?

对于这个观点，我有两个问题。

Isn't that point of view I've got two questions here.

第一个问题是，你怎么知道这是压力造成的？

The first is, how do you know that it's stress?

第二个问题是，如果确实是压力，那么问题所在，或者说由此带来的不便真相就是：父母负有责任。

And the second is, if it is stress, then that the problem, or at least the inconvenient truth that that then creates is that the parent is responsible.

是的。

Yes.

是的。

Yes.

对于他们的孩子，是的。

For their child's Yes.

这就是不便的真相。

That's the inconvenient truth.

事情没那么简单。

It's not so simple.

有时是家庭原因。

Sometimes it's the family.

通常是家庭原因，尤其是对于年幼的孩子。

Usually it's the family, particularly with small children.

但当孩子上学后，可能是社交因素造成的。

But when children get to school, it could be social.

正如我所说，你无法控制孩子是否接触到社交问题或欺凌，有很多事情都可能给孩子带来压力。

As I said, you know, you can't control whether your children are exposed to social issues or bullying, or there's many things that can cause stress in children.

但当他们还很小的时候，你就是他们的环境。

But when they're very little, you are their environment.

所以，令人不安的真相是，当你的孩子被诊断出患有多动症时，你首先应该做的是去找一位治疗师，接受父母指导。

So, the inconvenient truth is that when your child gets an ADHD diagnosis, the first thing you should do is go to a therapist who will do parent guidance with you.

不要急于带孩子去看精神科医生并给他们用药。

Don't rush that child to a psychiatrist to medicate them.

你和伴侣一起去找一位父母指导专家，探讨是什么导致了孩子感受到如此大的压力。

You go with your partner or spouse and talk to a parent guidance expert about what could be causing this child to feel such stress.

看看心理社会压力源。

And look at the psychosocial stressors.

看看这个孩子生活中可能导致他们陷入这种压力状态的影响和动态。

Look at the influences and the dynamics in this child's life that would be causing them to go into a state of stress like this.

你能举一些例子吗？我们如今让儿童承受的日常压力有哪些，这些压力在你看来会导致多动症？

Give me some examples of the type of stresses, the everyday stresses that we're now exposing children to that are leading to ADHD in your opinion?

好吧，我们还是从家庭开始。

Well, again, let's start at home.

在家中，压力可能源于他们过早被送到托儿所，这过早地激活了他们的杏仁核反应，也过早地激活了大脑中调节压力的区域。

At home, the stresses might be that they were handed over to a daycare center at an early age, which turned that amygdala response on, which turned the stress regulating part of their brain on too early.

现在你有了这种过度警觉的反应，而他们却无法关闭它，对吧？

Now you have that hypervigilant reaction, and they can't turn it off, right?

也可能是离婚的情况。

It could be a divorce situation.

百分之五十的夫妻会离婚，这意味着离婚是一种逆境。

Fifty percent of couples divorce, which means that divorce is an adversity.

你知道吗，我有一本书将在一年后出版，内容是如何离婚并减轻离婚对孩子的影响。

You know, I have a book coming out in a year about how to divorce and mitigate the impact of the divorce on the child.

但无论如何，离婚对孩子来说都是一种逆境和压力。

But no matter what, a divorce is an adversity on a child and a stress.

当父母在家里激烈争吵，或者家中存在严重的兄弟姐妹竞争，又或者迎来了另一个孩子，这些都会带来压力，对吧？

When parents fight dramatically in the home, if there's tremendous sibling rivalry issues in the home, if there's the birth of another child, it's stressful, right?

如果你有一个兄弟姐妹，信不信由你，这本身就是一件非常有压力的事情。

If you have a sibling, believe it or not, that's a very stressful thing.

如果父母对此敏感，这种压力是可以缓解的。

If parents are sensitive about that, then it can be mitigated.

但如果父母对第二个孩子的出生以及第一个孩子可能产生的感受漠不关心，就可能引发压力。

But if parents are insensitive about the birth of a second child and the feelings that your first child may have, that can cause stress.

搬家也会带来压力。

Moving can cause stress.

父母患病或患有精神疾病也会造成压力。

Illness or mental illness in a parent can cause stress.

酗酒或任何类型的成瘾都会造成压力。

Alcoholism, any kind of addiction can cause stress.

祖父母、叔叔、阿姨，甚至父母生病或去世，都会带来压力，我的意思是，能造成压力的事情太多了。

A grandparent or uncle or aunt or even a parent getting sick and dying can cause I mean, there are so many things that can cause stress.

但关键是，压力是可以调节的，但只有当父母具有内省能力、自我觉察，并愿意审视自己在其中的角色时，才能实现调节。

But the point is that stress can be regulated, but it can only be regulated if parents are introspective and self aware and willing to look at their part in it.

如果父母把孩子丢给精神科医生，说‘治好我的孩子’，精神科医生当然会配合你，压抑孩子的痛苦。

If parents hand the child over to a psychiatrist and say, Fix my child, of course, psychiatrists will cooperate with you and silence your child's pain.

但这真的是你想要做的吗？

But is that really what you want to be doing?

因为最终，你只是用手指堵住了堤坝。

Because in the end, you're just putting your finger in a dike.

你只是用手指堵住了水坝。

You're putting your finger in a dam.

而最终，这座水坝一定会溃决。

And eventually, that dam is going to burst.

你对那些关于 ADHD 存在遗传成分的证据怎么说？

What'd you say to some of the evidence around there being a link to a hereditary component?

在双胞胎研究中，他们发现 ADHD 的遗传率约为百分之七十四到八十，使其成为遗传影响最显著的精神疾病之一。

In twin studies, they found that ADHD is about seventy four percent to eighty percent heritable, making it one of the most genetically influenced psychiatric conditions.

让我告诉你另一个研究，它能帮助你理解刚才那个研究：我们知道，精神疾病没有遗传前因。

Let me tell you a different study that will help you to understand that study, which is that we know that there is no genetic precursor to mental illness.

ADHD 没有遗传前因。

There is no genetic precursor to ADHD.

抑郁症和焦虑症也没有遗传前因。

There is no genetic precursor to depression and no genetic precursor to anxiety.

你所说的‘前因’是什么意思？

What do you mean by precursor?

意思是说，不存在遗传关联。

Meaning there's no genetic connection.

你不是从基因里遗传到它的。

You don't get it in your genes.

如果你的父亲或母亲患有抑郁症，你会通过一种叫做‘获得性状遗传’的方式遗传它。

If your father or your mother were depressed, you get it by something called the inheritance of acquired characteristics.

如果你在患有抑郁症的父母身边长大，你更有可能患上抑郁症。

If you're raised by a depressed parent, you're more likely to become depressed.

这是先天与后天的争论。

It's the nature nurture argument.

好吧，但他们现在发现，精神分裂症与遗传有关。

Okay, but what they did find now, schizophrenia has a genetic connection.

双相情感障碍也是如此，它们有遗传因素，但其他疾病没有。

Bipolar disorder, those have genetic, but the rest do not.

焦虑、抑郁、多动症，都没有遗传因素。

Anxiety, depression, ADHD, no genetics.

他们发现了一种与所谓‘敏感基因’相关的遗传联系。

What they did find is a genetic tie to something called the sensitivity gene.

这是血清素受体上的一个短等位基因。

It's a short allele on the serotonin receptor.

我们知道，血清素用于调节快乐的情绪，调节情绪，对吧？

And serotonin, as we know, is used to regulate happy emotions, to regulate emotions, right?

所以，当你拥有短等位基因时，意味着你更难吸收血清素。

So, when you have a short allele, it means that you have a harder time picking up the serotonin.

但这也意味着你对压力更敏感。

But it also means that you are more sensitive to stress.

那些出生时携带这种基因——血清素受体基因上的短等位基因——的儿童，由于对压力更敏感，日后更容易患上精神疾病。

Now, those children who are born with this gene, this short allele on the serotonin receptor gene, they are more prone to mental illness later on because of that sensitivity to stress.

研究显示，如果出生时携带这种敏感基因的儿童在第一年获得了情感上和身体上都持续存在的依恋安全感，这种基因的表达就会被中和。

What the study shows is if those children who are born with that gene for sensitivity are provided with emotionally and physically present attachment security in the first year, it neutralizes the expression of that gene.

因此，表观遗传学意味着我们生来就带有某些基因，比如你可能有类风湿性关节炎的基因，或者有癌症的基因，但这些基因并不会表达出来。

So, epigenetics means that we're born with genes like you might have a gene for rheumatoid arthritis, or you might have a gene for cancer, but it never gets expressed.

其实，我们每个人都有某种基因。

Well, we all have genes for something.

但它们并不一定会表达出来。

But they don't necessarily get expressed.

这就是表观遗传学。

That's what epigenetics is.

这意味着环境必须激活基因，让它发挥作用，对吧？

Means the environment has to turn on the gene to make it let's rock and roll, right?

什么？

What

这项研究显示，那些天生具有这种遗传倾向（对压力敏感）的儿童，如果在第一年拥有敏感、富有同理心、充满关爱且陪伴在身边的父母，这种基因的表达就会被中和，使这些孩子能够像那些没有这种基因的孩子一样健康。

it showed in this study is that the children who were born with this genetic precursor, this sensitivity to stress, if they had sensitive, empathic, nurturing, and present parents in the first year, it neutralized the expression of that gene so those children could be as healthy as children born without that gene.

然而，如果天生具有这种敏感基因的儿童被忽视、遗弃，未能获得敏感、富有同理心、陪伴和关爱的照顾，这种基因的表达就会被加剧。

If, however, children born with that sensitivity gene were neglected, abandoned, not provided with sensitive empathic present nurturing, it exacerbated that gene.

因此，我们知道，这种敏感基因与日后的精神疾病密切相关，除非有敏感、富有同理心和充满关爱的环境来缓解这种基因的影响。

So, we know that that sensitivity gene is tied and correlated to mental illness later on, unless the sensitive empathic nurturing mitigates that gene.

那你怎么回应那些提到核磁共振扫描的人呢？

And what do you say to people that point to MRI scans?

功能性核磁共振成像。

FMRIs.

而且，现在有很多种神经学检测方法，我们可以看到大脑的活动状态。

And yeah, there's all kinds of neurological tests now where we can see the brain in action.

所以，这并不是一成不变的。

So it's not a static thing.

我们实际上可以看到大脑的血流情况。

We can actually see the blood flow to the brain.

我们可以看到大脑中的电活动。

We can see the electrical activity in the brain.

真的很惊人。

Amazing, actually.

有些人说，这证明了这是你的大脑运作方式。

Some people say that this proves that it's the way your brain is.

我很多患有注意力缺陷多动障碍的朋友，在谈论他们的ADHD或他们的性格时，会说：我的大脑就是这样运作的。

And lots of my friends that have ADHD, when they talk about their ADHD or the way that they are, they say, My brain works like this.

不，这种说法是不正确的。

No, it's not correct.

他们的大脑对压力更敏感。

Their brain is sensitive to stress.

患有多动症的人对压力更敏感。

Someone with ADHD is more sensitive to stress.

所以，你可以问他们这样的问题。

So, you could ask them questions like this.

你可以说：你小时候是不是更容易敏感？

You could say, Were you more Are you a more sensitive person?

你小时候对噪音、气味、触觉是不是更敏感？

Are you more sensitive to noise, to smells, to touch when you were a child?

你不喜欢痒痒的东西吗？

Did you not like itchy things?

你是不是更容易哭？

Did you cry more?

当你的父母晚上外出时，你是不是更容易感到敏感？

Were you more sensitive when your parents would go out for the night?

你妈妈去上班的时候，你是不是更敏感？

Were you more sensitive when your mom would go to work?

或者你被送到幼儿园的时候，是不是更敏感？

Or were you more sensitive when you were left at nursery school?

他们很可能都会回答是的。

And they're probably gonna say yes.

但如果他们回答不是，而他们仍然被诊断为ADHD呢？

But if they say no and they still have an ADHD diagnosis?

我敢保证，几乎可以肯定他们不会回答不是。

I would guarantee, almost guarantee, they wouldn't say no.

因为患ADHD的人就是敏感的人。

Because people with ADHD are people who are sensitive.

如果敏感得到理解，它就是一种了不起的优势。

Sensitivity is an amazing strength if it's met with sensitivity.

如果你有一个敏感的孩子，那么一个敏感的孩子是什么样子的？

If you have a sensitive child So, what does a sensitive child look like?

如果你有多个孩子，那你就会明白，因为每次我做公开演讲时，第一件事就是问：‘在座的各位，谁有敏感的孩子？’

If you have multiple children, then you know Because the first thing I'll do when I give a public talk is I'll say, Okay, everybody here, who has a sensitive child?

我会描述一下，敏感的孩子通常更容易哭闹、更难安抚、更粘人，不喜欢你离开他们，难以分离，入睡困难，也不愿独自睡觉，对噪音、气味和触觉等刺激特别敏感。

And I describe, Okay, a sensitive child is a child who cries more, is harder to soothe, is more clingy, doesn't like you leaving them, has a harder time separating, has a harder time going to sleep and being left to sleep on their own, is sensitive to things like noise and smells and touch.

如果你在充满压力的环境中长大，而我们已经知道，压力可以以多种形式存在。

If you grew up in an environment that was stressful and again, we've identified that stress can come in many forms.

它可能是父母之间的争吵。

It could be arguing parents.

可能是邻居或其他环境因素导致了这种压力。

It could be a neighbor or whatever, some environmental factor that caused that stress.

你天生敏感，因此发展出了注意力缺陷多动障碍，成年后在30岁时被诊断出患有ADHD。

You were sensitive, you developed ADHD, you become an adult, you get diagnosed at 30 years old as having ADHD.

是的。

Yeah.

你被建议服药，服药后你在工作、人际关系和生活中都变得更有功能了。

You're offered medication, you take the medication, the medication makes you much more functional in your career, in your relationships, in your life.

这是一种兴奋剂。

It's a stimulant.

兴奋剂的作用是可能引发严重的焦虑。

And so what stimulants do is they can cause great anxiety.

它们可能引发恐慌发作。

They can cause panic attacks.

在青少年中，它们可能导致生长问题。

In adolescents, they can cause growth issues.

所以我有一些患者，年轻男性，因为他们小时候被服用兴奋剂而没有正常生长。

So I have patients who come to me, young men, who didn't grow because they were put on stimulants when they were young.

因此，关于使用兴奋剂的后果，尚无定论，但我们知道它们会导致生长问题、恐慌发作、焦虑障碍和抑郁。

So, in terms of the consequences of using stimulants, the jury is still out, but we know that they cause growth issues, they cause panic attacks, they cause anxiety disorders, they cause depression.

它们能救命。

They're quite lifesaving.

对某些人来说，它们确实能救命

They're quite lifesaving for some people in terms

他们可能会有。

of They having a can be.

他们可能会。

They can be.

所以，我想说的是，如果你已经尝试了所有方法来找出导致你如此反应的压力源，但仍然感到如此，那么有时药物可以成为救命稻草。

So, what I would say is if you have tried everything to uncover what the stress is that's causing you to react this way, and you still are feeling that way, then sometimes medication can be a lifesaver.

问题是，我们在青少年、儿童和年轻人中过度依赖药物。

The problem is that we turn to medication in adolescents and children and young adults.

我们把药物当作提升表现的工具，因为现代生活压力太大，人们在事业、学业上必须表现出色、取得好成绩，孩子们承受着巨大的压力。

We turn to it as a performance drug because there's so much stress in modern life and there's such a need for people to perform and be successful in their careers and in school and get good grades, there's so much pressure on kids.

我今年60岁了，我们小时候并没有这种压力。

So, you know, I'm 60 and we didn't have this kind of pressure growing up.

因此，后几代人承受着巨大的压力。

And so, the generations that follow have so much pressure.

这种压力让孩子们真的陷入失控。

That pressure makes children literally go off the rails.

我们可以谈谈学业压力、竞争性和完美主义。

We could talk about the academic pressure, the competitiveness, the perfectionism.

所以，ADHD是一个笼统的类别。

So, ADHD is a bucket.

它是一个容器，把那些从未得到治疗的焦虑症患者都扔进去。

It's a bucket which you throw people in who have anxiety that has never been treated.

而且，对于治疗也有不同的看法。

And and there's different ways of thinking about treatment, too.

我们是一个喜欢表面化速效解决方案的社会。

So, we are a society that likes superficial quick fixes.

我们喜欢药物。

We like drugs.

我们喜欢认知行为疗法。

We like CBT therapy.

事实是，这并不是一个速效解决方案。

The truth is that this is not a quick fix.

弄清楚你在童年时经历了什么关系上的变化、动态的事件，你的失去是什么，你的创伤是什么，是什么让你感到如此焦虑，是什么让你陷入战斗或逃跑状态，这是一项艰难的工作。

Figuring out relationally, dynamically what happened to you as a child, what your losses were, what your traumas were, what caused you to feel so anxious, what's caused you to go into fight or flight, is hard work.

这需要忍受挫折。

It requires frustration.

这需要承诺。

It requires commitment.

这需要去找一个能与你深入思考的人。

It requires going to someone who can think very deeply with you.

我想定义一下什么是焦虑，因为我觉得这非常重要。

You know, I wanna define what anxiety is because I think it's really important.

因为我们很少定义抑郁和焦虑。

Cause we rarely define depression and anxiety.

抑郁是对过去失去的过度关注。

Depression is preoccupation with past losses.

焦虑是对可能永远不会发生的未来失去的过度关注。

Anxiety is preoccupation with future losses that may never occur.

他们有什么共同点？

What do they

都与失去有关。

have in common?

一切都关乎失去。

It's all about losses.

关乎失去。

All about loss.

可以说，现在的世代非常关注失去。

And you could say the generations now are very preoccupied with loss.

地位和成就的丧失，但因为我们同样非常关注获得。

Loss of status, achievement, but because we're also very preoccupied with gain.

嗯，我们关注的是，我不想评判，但我想说，生活中的那些不重要的事情。

Well, we're preoccupied with, what I say, I don't want to judge, but I want to say the unimportant things in life.

生活中什么是重要的事情？

What are the important things in life?

关系、爱、连接、健康，对吧？

Relationships, love, connection, health, right?

你会说，客观地讲，是家庭。

You would say, objectively, family.

这些才是生活中重要的事情。

These are the important things in life.

但我们却过分关注物质成功、金钱、职业成就和名声。

But we've become very preoccupied with material success, money, career achievements, fame.

我想有一项研究采访过青少年。

I think there was a study that interviewed teenagers.

结果非常令人沮丧，因为孩子们说，他们生活中最渴望的就是成名。

And it was really discouraging because they said that the thing they wanted more in life than anything was to be famous.

所以我们把注意力放在了错误的事情上。

And so we're preoccupied with the wrong things.

关于压力与注意力缺陷多动障碍（ADHD）之间的联系，根据injury.com研究教育组的一些研究，数据显示，ACE评分（即创伤评分，我认为包含约10个不同问题）达到4分或以上的儿童，相比没有任何ACE创伤经历的儿童，被父母报告患有ADHD的可能性高出近四倍，即百分之四百。

On this point of stress and the link with ADHD, looking at some research from the injury.com research education group, it says that children with an ACE score, which is the trauma score, where I think it goes up to 10 different sort of questions, with an ACE score of four or more, so four experiences of trauma or more, have nearly four times, which is four hundred percent more chance of having parent reported ADHD compared to children with no ACEs.

是的。

Yep.

还有一些影响很大的因素：社会经济困难会使患ADHD的概率增加百分之四十，父母离婚增加百分之三十五，父母患有精神疾病会使概率上升至近百分之六十，我认为是百分之五十五。

And some of the factors that have big impact is socioeconomic hardship increases your probability of having ADHD by forty percent, parental divorce by thirty five percent, familial mental illness parent having a mental illness increases up to almost sixty percent, fifty five percent, I believe.

邻里暴力，几乎增加百分之五十。

And neighborhood violence, almost fifty percent.

家庭成员入狱。

Familial incarceration.

如果父母入狱，那么孩子患ADHD的概率也会增加约百分之四十。

So if a parent goes to prison, then that increases your probability of ADHD by about forty percent as well.

这是由我认为是《新英格兰》期刊发表的。

And that's published by the, I think it's the New England.

对。

Yeah.

或者说是美国国家医学图书馆、国家生物信息中心。

Or the National Library of Medicine, National Centre of Biological Information.

是的。

Yeah.

所以，请记住我之前说的，你无法控制孩子身上发生的一切。

So remember what I said that you can't control everything that happens to your child.

离婚确实会发生，孩子也会遭遇逆境。

Divorces do happen and adversities happen to children.

孩子也会遇到健康问题。

Health issues happen to children.

你能控制的是前三年，尽可能多地陪伴在孩子身边。

What you can control is you can control the first three years and be as present as possible for your child.

所以，当我的孩子在超市里大喊大叫时，一种普遍的建议是，直接走开，或者作为父母也大喊大叫来示威。

So, my kid starts screaming in a supermarket, one of the prevailing pieces of advice says, just walk off or start screaming yourself as the parent to show them.

我难道应该在孩子尖叫发脾气时置之不理吗？

Do am I supposed to just ignore my child when it's screaming and throwing a tantrum?

我难道应该放下手头的一切，去迎合他们吗？

Am I meant to drop what I'm doing and go and cater to them?

在这种情况下，我该怎么做？

What am I meant to do in these situations?

把我的号码设为快捷拨号吧，史蒂文。

Have me on speed dial, Steven.

你可得小心点。

You be careful.

因为如果你许下这样的承诺

Because if you make a promise like that

我保证。

I promise.

我保证。

I promise.

我会设为快捷拨号的。

I'll be on speed dial.

你想放弃事业，专心抚养我的孩子吗？

Wanna drop your career and focus on raising my children.

不，但你可以给我打电话。

No, but you can call me.

你，我已经把这事录下来了。

You I've got this have on video.

我，这具有法律效力。

Me That's legally binding.

不，你可以把我设为快捷拨号。

No, you can have me on speed dial.

多少钱？

How much?

是的，你想打多少次都行。

Yeah, you can as much as you want.

所以协议是，你不能对你的孩子大喊大叫。

So the deal is you don't yell at your children.

情绪稳定的父母，健康的父母，才能培养出健康的孩子。

An emotionally regulated parent, a healthy parent produces a healthy child.

那么，什么是健康的父母？

So what is a healthy parent?

健康的父母是那些对自己感觉良好的人，他们拥有真正健康的自尊，不是自大，而是真心觉得自己不错，了解自己的优势和局限，作为一个完整的人，整体上对自己感到满意。

A healthy parent is a parent who feels good about themselves, who has authentically good self esteem, not grandiosity, but really feels good about themselves, knows their strengths and limitations, and overall, as a whole person, feels good about themselves.

他们有能力调节自己的情绪，不让情绪过度高涨或低落。

They have the capacity to regulate their emotions, to keep their emotions from going too high and too low.

记住，就像在加勒比海航行一样，意味着他们能在风暴中保持冷静。

Remember, sailing in The Caribbean, meaning they can stay calm in a storm.

作为养育者，他们敏感且富有同理心。

Is sensitive and empathic as a nurturer.

这些是父母健康的表现。

These are signs of health in a parent.

所以，如果我的孩子说：‘我想吃那包糖果’，而我回答：‘你不能吃那包糖果。’

So if my kid says, I want that pack of sweets, and I go, You can't have that pack of sweets.

首先，你在管教之前，总要先表达共情。

Well, first you have to So, before you discipline, you always wanna be empathic first.

所以，我总是说，如果你要管教孩子，首先得理解他们的感受。

So, I always say that if you are gonna discipline a child, first you have to recognise how they feel.

我的意思是，无论何时，理解孩子的感受都很重要。

I mean, recognizing how children feel is important anyway.

也就是说，当你意识到孩子的感受时，如果他们难过，你就回应他们的悲伤。

Meaning, when you recognize a child's feelings, if they're sad, you mirror their sadness.

如果他们生气，你就说：我能看出你很生气。

If they're angry, you say, I can see you're angry.

如果他们开心，你就和他们一起表现出开心。

If they're happy, you look happy with them.

这种回应方式让孩子知道，你认可他们，把他们当作一个独立的人看待。

That kind of reflection is the way that your child knows that you acknowledge them, that they're a person to you, that they're a separate person to you.

这是他们感到自己有价值的方式。

It's how they feel valuable.

所以，当你认可他们的感受时，这就是最基础、最关键的育儿第一步。

So, when you acknowledge their feelings, that's the first critical, you'd say, parenting 101.

承认孩子的感受。

Acknowledge your child's feelings.

所以，我会对我的孩子说：你想要糖果吗？

So, I would turn to my child and say, You want sweets?

你饿了吗？

Are you hungry?

是的，你可以说：我看得出来你真的很想要那包糖果。

Yeah, you can say, I can see that you really want that packet of sweets.

我明白这对你来说很难，因为你真的很想要，但你知道晚饭前不能吃。

I can see how hard it is because you really want it, but you know you can't have it before dinner.

你知道这是规矩。

You know that's the rule.

然后他们就开始尖叫。

And then they start screaming

然后你也开始尖叫，你说：你又在重复老一套了，这是一种沟通方式，你会说：我知道这对你来说真的很难，但你还是不能吃糖果。

And and then you start screaming and you say, you've broken record is a communication style where you say, Oh, I can see it's really hard for you, but you still can't have the sweets.

你陪着他们，持续表达共情，然后设定界限，共情、界限、共情、界限。

And you stay with them and you keep empathizing and then setting structure, empathizing structure, empathizing structure.

父母常犯的错误是直接说‘不行’。

The mistake that parents make is that they go right into the no word.

他们没有使用共情。

They don't use empathy.

他们没有融入共情。

They don't bring empathy in.

事实上，即使作为成年人，如果有人在不先认可你的感受的情况下直接说‘不行’，你也会感到非常不满，对吧？

And the truth is that even as an adult, if somebody just says no without first recognizing how you feel, you feel very unsatisfied, right?

对孩子来说，这至关重要。

For a child, it's critical.

即使你必须说‘不’，尤其是当你必须说‘不’的时候，先认可他们的感受至关重要。

It's critical that even when you have to say no, and particularly if you have to say no, that you first recognize how they feel.

我的意思是，这个节目里的所有关系专家都告诉我这一点。

I mean, that's what all the relationship experts on this show tell me.

他们说，如果你想在恋爱关系中取得成功，首先必须让你的伴侣感到被倾听和理解。

They say, if you wanna be successful in a romantic relationship, then you first must make your partner feel heard and understood.

没错。

That's right.

即使你在争论中不同意对方的观点。

Even if you disagree in an argument.

没错。

That's

对。

right.

先承认他们说了什么，也许复述一遍给他们听，这样他们就会感到被倾听和理解，从而打破这种反复循环。

First acknowledge what they said, maybe repeat it back to them, and then they'll feel heard and understood, and it kinda stops the broken record.

你刚才听到的是上一期节目中被重复播放最多的片段。

What you just listened to was a most replayed moment from a previous episode.

如果你想收听完整的那一期节目，我已在下方提供了链接。

If you want to listen to that full episode, I've linked it down below.

查看描述。

Check the description.

谢谢。

Thank you.