每天这样做一次，修复多巴胺重置快乐阈值｜斯坦福神经科学专家

每天这样做一次，修复多巴胺重置快乐阈值｜斯坦福神经科学专家

发布于 2026-10-22 · 时长 2:11:21

字幕摘录

时间	英文	中文
0:00	There's a very famous experiment in which rats were engineered to have no dopamine,	有一个非常著名的实验 老鼠被设计成没有多巴胺,
0:04	and the scientists discovered that if they put food in the rat's mouth, the rat would	科学家发现,如果他们把食物放进老鼠的嘴里,老鼠就会
0:08	eat.	吃饭
0:08	But if you put the food even a body length away, the rat will starve to death, which	但如果你把食物放远一点 老鼠就会饿死
0:12	tells us that dopamine is fundamental to get the things that we need for our basic survival.	告诉我们多巴胺对于获得我们基本生存所需要的东西至关重要。
0:18	Now every time we're doing something that's pleasurable, from sugar to video games, work,	每当我们做一些令人愉快的事情 从糖到电子游戏,工作,
0:22	pornography, social media, that will affect dopamine.	色情,社交媒体, 这将影响多巴胺。
0:25	And the more dopamine that's released, the more likely that drug or behavior is to be	释放的多巴胺越多 药物或行为就越有可能
0:30	But also the genetic risk of addiction is about 50 to 60 percent.	但也有50%到60%的基因上瘾风险。
0:33	So if you have a biological parent or grandparent with addiction, you are more likely to develop	所以,如果你有亲生父母 或祖父有瘾, 你更有可能发展

展开字幕全文（2074 条）

序号	英文	中文
1	There's a very famous experiment in which rats were engineered to have no dopamine,	有一个非常著名的实验 老鼠被设计成没有多巴胺,
2	and the scientists discovered that if they put food in the rat's mouth, the rat would	科学家发现,如果他们把食物放进老鼠的嘴里,老鼠就会
3	eat.	吃饭
4	But if you put the food even a body length away, the rat will starve to death, which	但如果你把食物放远一点 老鼠就会饿死
5	tells us that dopamine is fundamental to get the things that we need for our basic survival.	告诉我们多巴胺对于获得我们基本生存所需要的东西至关重要。
6	Now every time we're doing something that's pleasurable, from sugar to video games, work,	每当我们做一些令人愉快的事情 从糖到电子游戏,工作,
7	pornography, social media, that will affect dopamine.	色情,社交媒体, 这将影响多巴胺。
8	And the more dopamine that's released, the more likely that drug or behavior is to be	释放的多巴胺越多 药物或行为就越有可能
9	But also the genetic risk of addiction is about 50 to 60 percent.	但也有50%到60%的基因上瘾风险。
10	So if you have a biological parent or grandparent with addiction, you are more likely to develop	所以,如果你有亲生父母 或祖父有瘾, 你更有可能发展
11	that addiction.	那个瘾君子
12	We have to keep it in balance in order to stay healthy.	为了保持健康,我们必须保持平衡。
13	Dr. Anna Lemke is Professor of Psychiatry at Stanford, Chief of the Stanford Addiction	Anna Lemke博士是斯坦福精神病学教授,斯坦福毒瘾主任
14	Clinic.	诊所
15	And a world-leading expert on the subject of dopamine.	也是多巴胺主题的世界领先专家.
16	She will tell you how this one powerful chemical is controlling your life and what to do about	她会告诉你 这个强大的化学物质是如何控制你的生命的 以及该做什么
17	it.	这个
18	One of the most important findings in neuroscience in the past 75 years is that the same parts	在过去75年里神经科学最重要的发现之一是 同样的部分
19	of the brain that process pleasure also process pain, and the balance wants to remain level.	在大脑中, 过程快乐 也处理疼痛, 平衡想要保持水平。
20	The problem is that we automatically seek out pleasure and avoid pain, and we're exposed	问题是,我们自动寻找快乐 避免痛苦,我们暴露了
21	to all kinds of pleasures that we have in the modern world.	给现代世界的各种快乐
22	And our brains are reeling in response to try to compensate.	我们的大脑在回旋 试图补偿。
23	Now I need more of my drug and more potent forms to get the same effect, which then leads	现在,我需要更多的药和 更强大的表格 得到同样的效果,然后导致
24	to addiction.	上瘾。
25	And that's what happened to me when I got addicted to romance novels.	当我沉迷于浪漫小说时,我就是这样
26	Take me into that phase of your life.	带我进入你生命的阶段
27	I was out of control, and I needed to restore a level balance and take advice I give my	我失控了,我需要恢复平衡 并接受我的建议
28	patients.	病人们
29	And what is that advice?	那建议是什么?
30	The diary of a CEO is independently fact-checked.	首席执行官的日记经过独立的事实检查.
31	For any studies or science mentioned in this episode, please check the show notes.	对于本集中提到的任何研究或科学,请检查节目笔记.
32	This has always blown my mind a little bit.	这总是让我心碎
33	53% of you that listen to the show regularly haven't yet subscribed to the show.	经常收听节目的53%的人还没有订阅节目.
34	So could I ask you for a favour before we start?	所以在开始之前 我能请你帮个忙吗?
35	If you like the show and you like what we do here and you want to support us, the free	如果你喜欢节目,你喜欢 我们在这里做什么,你想支持我们,免费
36	simple way that you can do just that is by hitting the subscribe button.	只需按下订阅按钮即可。
37	And my commitment to you is if you do that, then I'll do everything in my power, me	我对你的承诺是,如果你这样做, 那么我会尽我所能,我
38	to make sure that this show is better for you every single week.	确保这个节目适合你每个星期。
39	We'll listen to your feedback.	我们会听你的反馈
40	We'll find the guests that you want me to speak to and we'll continue to do what we	我们会找到客人,你要我跟他们说话 我们会继续做我们的事
41	do.	说吧
42	Thank you so much.	非常感谢
43	I've sat here for the last 20 minutes trying to figure out how to say this to you.	我在这里坐了20分钟 试着想怎么跟你说
44	So I'm just going to say how it comes out my mouth.	所以,我只想说它是如何出来的我的嘴。
45	And I apologise if this is messy.	我道歉 如果这是乱七八糟的。
46	But if there was ever an episode this year that you should listen to, it is this one.	但如果今年有你该听的插曲 就是这个
47	I've since this episode was recorded about a month ago.	我从一个月前就被录下来了
48	All I've been thinking about is how on earth I get you to watch this.	我一直想着如何让你看这个
49	And I don't say this often.	我不常这么说
50	The last time I said this was the first time Mogul came on this podcast.	上次我说这是莫古尔第一次出现在播客上
51	This is the second time I've said this in almost four years of recording this podcast	这是我在录制这个播客近四年来 第二次这么说
52	(原始内容存档于2017-09-29). On YouTube.
53	And the reason for that is so many of the things that I know you're	原因很多 我知道你是
54	struggling with in your life that stand in the way of the person you want to become,	与你生活中的挣扎 阻碍你想要成为的人,
55	that relationship you have with your phone, the procrastination, the cycles of	你和手机的关系 拖延 周期
56	behaviour that make you feel embarrassed and full of shame that you've just never	让你感到尴尬和羞愧的行为 你从来没有
57	been able to crack.	能够破解。
58	All of them, all of them.	一切众生.
59	I genuinely believe for many of you are going to be understood today.	我真心相信今天你们中许多人会理解。
60	If you listen to this episode, it has changed my life and it has changed much	如果你听这集,它改变了我的生活,也改变了很多
61	of the lives of my team.	我的团队的生命
62	If I'm wrong here, you have the right to message me and tell me that I was wrong.	如果我错了,你有权告诉我,我错了。
63	Please listen to this episode.	请听此集.
64	Really, really, I mean that from the bottom of my heart.	真的,真的,我的意思 从我的心脏底部。
65	And just to make sure you do, throughout this episode is going to be these pop ups.	为了确保你这样做, 整个剧集将会是这些弹出。
66	If you collect eight of these codes that are going to pop up on the screen and put	如果你收集到其中8个代码 将弹出在屏幕上
67	them in the document link below, you'll unlock something very special,	在下面的文档链接中,你会解锁一些非常特殊的东西,
68	some additional content.	一些额外的内容。
69	Please listen to this episode.	请听此集.
70	Dr Anna Lemke, you wrote one of the most iconic, well-known books about dopamine,	安娜·莱姆克博士 你写了一本关于多巴胺的 最具标志性的著名书
71	which propelled the subject matter of dopamine into the public consciousness.	将多巴胺主题推进公众意识
72	But I guess the most important question I should ask you is, why does dopamine	但我想我应该问你最重要的问题是 为什么多巴胺
73	matter?	物质?
74	Ah, good question.	啊,好问题。
75	Good place to start.	好地方开始。
76	I mean, dopamine matters because it's fundamental to our survival, right?	多巴胺很重要,因为它对我们的生存至关重要,对吧?
77	So it's the chemical that we make in our brain that tells us this is something we	所以我们大脑里的化学物质告诉我们
78	should approach, explore, investigate.	应接近,探索,调查。
79	So it's really almost the survival chemical.	所以它真的几乎是生存的化学物质。
80	So what is dopamine?	那多巴胺是什么来着?
81	If you had to explain it to a 10-year-old, how would you go about explaining it?	如果你不得不向一个10岁的孩子解释, 你会怎么解释呢?
82	So dopamine is a chemical that we make in our brain.	多巴胺是我们大脑中的一种化学物质。
83	It has many different functions, but one of its most important functions is that it	它有许多不同的功能,但最重要的功能之一是它
84	helps us experience pleasure, reward, and motivation.	帮助我们体验快乐、奖励和动力。
85	It may be even more important for the motivation to do things than it is for the	做事情的动机可能比
86	pleasure itself.	快乐自己。
87	So, for example, there's a very famous experiment in which rats were engineered to	所以,比如说,有一个非常著名的实验 老鼠被设计成
88	have no dopamine in the brain's reward pathway.	大脑里没有多巴胺
89	And the scientists discovered that if they put food in the rat's mouth, the rat would	科学家发现如果他们把食物放进老鼠的嘴里 老鼠就会
90	eat the food, would seem to get some pleasure from the food, if you can determine that	吃食物,似乎从食物中得到一些乐趣, 如果你可以确定
91	from watching a rat eat, which I think they felt like they could.	从看老鼠吃, 我认为他们觉得可以。
92	But if you put the food even a body length away, the rat will starve to death.	但如果你把食物放远一点 老鼠就会饿死
93	The idea being that without dopamine, we're not motivated to seek out the things that	想法是,没有多巴胺, 我们没有动机寻找的东西
94	we need for our basic survival.	我们需要我们的基本生存。
95	That's crazy.	这太疯狂了
96	So you get a rat, you put the food an inch from its mouth, and it will starve to death	所以,你得到一只老鼠,你把食物 从它的嘴一英寸, 它会饿死
97	because it doesn't have dopamine, the dopamine required to just reach out and eat.	因为它没有多巴胺, 多巴胺只是伸手吃。
98	Yeah, essentially.	是啊,本质上。
99	Maybe it's not an inch, maybe it's a little more than an inch, but the idea being that	也许这不是一英寸, 也许它有点超过一英寸, 但想法是
100	dopamine is necessary to be motivated to do the work to get the thing that we need.	多巴胺是必须的 被激励做工作 得到我们需要的东西。
101	And having an understanding of dopamine, how might that improve my life?	对多巴胺有了解 这能如何改善我的生活?
102	Having a basic understanding of how dopamine works, how we process pleasure and pain, and	基本了解多巴胺如何作用,我们如何处理快乐和痛苦,以及
103	also what happens with dopamine as we go from adaptive recreational use to maladaptive addictive	多巴胺会怎么样? 当我们从适应性娱乐用到不良适应性上瘾
104	use is something that is really useful, especially for those of us living in the modern world	使用是真正有用的, 特别是对我们生活在现代世界的人
105	where now we're exposed to so many reinforcing substances and behaviors that we've all become	在那里,我们现在接触到 如此多强化的物质和行为
106	vulnerable to the problem of addiction.	容易成瘾
107	And what are the biggest misconceptions on the subject of dopamine?	关于多巴胺这个话题最大的误解是什么?
108	Because it's kind of thrown around in society, I see it in my group chats, people saying	因为这在社会上是一种抛售, 我从我的团体聊天中看到,人们说
109	I need more dopamine or whatever, or that person just craves dopamine.	我需要更多的多巴胺什么的, 或者那个人只是渴望多巴胺。
110	What are the biggest misconceptions you've come across?	你遇到的最大误解是什么?
111	The main misconception is that somehow we can get addicted to dopamine.	主要的误解是 不知何故 我们可能会上瘾 多巴胺。
112	We're not getting addicted to dopamine itself.	我们不会染上多巴胺的
113	Dopamine is neither good nor bad.	多巴胺既不好也不坏。
114	It's a signal to tell us whether or not something that we're doing is potentially	这是一个信号告诉我们 我们做的东西是不是潜在的
115	useful for our survival.	对我们的生存有用
116	And also it's related to what we predicted about how rewarding or pleasurable something	也与我们所预测的 如何奖励或愉快的东西有关
117	would be.	这将是。
118	And so it's really, you know, I sort of sometimes I joke it's like the reward theory of relativity,	所以,真的,你知道, 我有点喜欢开玩笑 它就像奖励理论 相对论,
119	dopamine is, in the sense that pleasure and pain really are truly relative to one another.	多巴胺是,从这个意义上说, 快乐和痛苦是真正相对的。
120	And so dopamine gives us information about where we are in that relativity scale between	多巴胺让我们知道 我们所处的相对比尺度
121	pleasure and pain.	快乐与痛苦.
122	And when you say relative, you mean, I mean, it's quite fitting for anyone that can't	当你说亲戚,你是说, 我的意思是,它相当适合任何人不能
123	see, we have a set of scales on the table.	你看,我们有一套 天平在桌上。
124	And scales are relative to each other, because if you pour in one end, the other end goes	而天平是相对的, 因为如果你倒在一端,另一端去
125	up.	起来
126	And if you pour in the other end, the other end goes up and this end goes down.	如果你倒在另一端, 另一端会上升, 而这一端会下降。
127	And when you say relative, that's what you're describing, right?	当你说亲戚, 这就是你描述的,对不对?
128	Yes, that's what I'm describing.	是的,这就是我描述的。
129	Okay.	摆
130	And what activities that I do every day have an impact on my dopamine?	我每天做什么活动 都会影响我的多巴胺?
131	Well, probably almost everything, you know, in some ways, I mean, every time we are doing	嗯,也许几乎一切,你知道, 在某些方面,我的意思是,每一次我们做
132	something that's pleasurable, reinforcing, rewarding, that will affect dopamine.	令人愉快的,强化的,奖励的, 会影响多巴胺。
133	It's really the primary signal that lets us know that this thing is potentially important	这真的是一个主要信号,让我们知道 这东西可能很重要
134	for our survival, as I mentioned.	正如我所说的 为了我们的生存
135	But, you know, even aversive stimuli can trigger dopamine.	但是,你知道,即使逆刺激 可能触发多巴胺。
136	What's aversive?	什么是反向的吗?
137	Oh, something that's painful or not pleasurable.	哦,这是痛苦或不愉快的。
138	Dopamine gets involved in that equation.	多巴胺参与到这个方程式中
139	Anything that's novel or new is something that triggers our dopamine in our reward pathway.	任何新奇或新奇的东西 都会触发我们的多巴胺 在我们的奖励路径。
140	Dopamine is fundamental for movement.	多巴胺是运动的根本.
141	So not just pleasure and reward, but also movement.	所以不只是快乐和奖励,还有运动。
142	So for example, Parkinson's disease, which is a disease related to stiffness and tremor,	例如帕金森的病 与僵硬和颤抖有关
143	is caused by a depletion of dopamine in a part of the brain called the substantia nigra.	由脑部一部分的多巴胺耗竭引起,称为亚硝基甲酸.
144	And as dopamine gets depleted in that part of the brain, people lose the ability to move	随着多巴胺在大脑的这一部分耗尽 人们失去了移动的能力
145	their bodies.	他们的身体。
146	And it's probably no coincidence that the same neurotransmitter that is so important	同样的神经递质 如此重要 可能不是巧合
147	for pleasure, reward, motivation, is also really important for movement because most	快乐,奖励,激励, 也是真正重要的运动,因为大多数
148	organisms have to locomote toward the object of their desire.	生物必须朝欲望的物体飞去
149	We want that thing, we have to exert effort, right?	我们要那东西,我们必须努力,对不对?
150	We have to put in the work to go get it.	我们必须投入工作去得到它。
151	But in the world today, we really don't have to do that, right?	但是在今天的世界里,我们真的没有做到这一点,对不对?
152	We can swipe right, we can swipe left, and all of a sudden it magically appears at the	我们可以右转,我们可以左转, 突然,它神奇地出现在
153	touch of a finger.	手指的触觉。
154	And that's very confusing for our brains because that's not how we evolved.	这对我们的大脑来说非常困惑, 因为这不是我们进化的方式。
155	We really evolved for having to do quite a bit of upfront work for a tiny little bit	我们真的进化 不得不做 相当先行的工作 一点点
156	of reward.	奖励。
157	I just want to, before we move on, talk about this point you said, because I think it's	我只是想,在我们继续前, 谈谈这一点,你说, 因为我认为这是
158	quite foundational to everything we're going to talk about, about dopamine being relative	我们将要谈论的多巴胺是相对的
159	to pain.	给痛苦。
160	And I have this set of scales in front of me.	我面前还有一套天平
161	And here I have some chemicals that are likely to produce dopamine in my brain, I believe.	这里我有一些化学物质 可能会在我的大脑里产生多巴胺。
162	Right?	对吧?
163	So alcohol.	这么酒。
164	I have some rum.	我有一些朗姆酒。
165	I have some whiskey.	我有一些威士忌。
166	I have some vodka.	我有一些伏特加。
167	And can you explain to me, using this rum, whiskey, and vodka, how dopamine is relative	你能给我解释一下,用这 朗姆酒,威士忌和伏特加,多巴胺是如何相对的
168	to pain and what's going on in my brain?	痛苦和发生了什么事在我的大脑?
169	Sure.	当然
170	I'll slide this over to you.	我会告诉你的。
171	So one of the most exciting findings in neuroscience in the past 75 years is that pleasure and	在过去75年里,神经科学最令人兴奋的发现之一 就是快乐和快乐
172	pain are co-located in the brain.	疼痛在大脑里是同一地点的。
173	So the same parts of the brain that process pleasure also process pain.	所以大脑的同样部分 处理快乐 也处理疼痛。
174	And in a very simple reductionist kind of way, they work like opposite sides of a balance.	以一种非常简单的简化主义的方式, 它们的工作就像平衡的对立面。
175	So imagine that deep in your brain's reward pathway, which is another exciting discovery,	想象一下你脑中的悬赏之路, 这是另一个令人兴奋的发现,
176	right, that there's this dedicated reward pathway of the brain that consists, broadly	是的,有一条专门的奖励途径 大脑的大致构成
177	speaking, of the prefrontal cortex, which is this large gray matter area right behind	说到前额皮层 就是后面的灰色大块
178	our foreheads that's so important for future planning, for delayed gratification, for appreciating	我们的额头,对于未来的规划, 对于迟缓的满足, 对于欣赏,
179	future consequences.	未来的后果。
180	You might think of it as like the brakes on the car, if we're going to analogize to	你可以把它当成汽车上的刹车, 如果我们要模拟到
181	an engine.	一个引擎。
182	And then deep in the brain, we've got what we call the limbic areas or the emotion brain.	然后在大脑深处,我们得到了我们所谓的四肢区域或情感大脑。
183	And there you have the nucleus accumbens and the ventral tegmental area that are rich in	里面有核糖体 和胸腔构造 富含
184	dopamine-releasing neurons, right?	多巴胺释放神经元,对不对?
185	And they act like the accelerator on the car.	他们就像车上的加速器
186	So when you've got a healthy functioning brain, you've got enough accelerator but not too	所以,当你有一个健康 运行的大脑, 你有足够的加速器,但不是太
187	much, right?	很多,对不对?
188	So enough dopamine being released but not too much.	足够的多巴胺被释放,但不会太多。
189	And you've got a healthy prefrontal cortex putting the brakes on that dopamine release.	你有一个健康的前额皮质 将制动器放在多巴胺释放上。
190	When people become addicted, there's either a problem with the brakes, the prefrontal	当人们上瘾时 要么是刹车的问题 要么是前额
191	cortex, or the accelerator, the nucleus accumbens and ventral tegmental area, or both, right?	皮层,或加速器, 核蓄积物和排气区,或两者兼有,对不对?
192	What we're finding is that there's actually a disconnect.	我们发现的其实是断开的
193	So there are large neuronal circuits and pathways between those deep limbic structures and the	因此,这些深四肢结构之间有大型的神经电路和路径。
194	prefrontal cortex that literally get severed or disconnected when people become addicted.	当人们上瘾时 前额皮质被切开或断开
195	As we think about pleasure and pain being co-located in the same parts of the brain,	当我们想到快乐和痛苦 在同一部分的大脑,
196	working like opposite sides of the balance, in order to understand what happens in the	工作就像平衡的对立面, 以便了解发生了什么
197	appreciate that there are fundamental rules governing this balance.	理解有关于这种平衡的基本规则。
198	And one of the most important rules is that the balance wants to remain level.	而最重要的规则之一是平衡想要保持平稳.
199	It does not want to be tilted very long to the side of either pleasure or pain.	它不想被倾斜到快乐或痛苦的一侧。
200	And in fact, what our brain does is first tilt an equal and opposite amount to whatever	事实上,我们的大脑首先倾斜 一个相等和相反的量
201	the initial stimulus is.	最初的刺激是。
202	So I'm going to try to illustrate that here.	所以我想在这里说明这一点。
203	So let's say our initial stimulus is alcohol.	我们的最初刺激是酒精
204	Now, alcohol works through its own chemical pathway.	现在,酒精通过自己的化学途径起作用。
205	It works on our endogenous opioid system, the opioids that we make.	它对我们的内生类阿片系统, 我们制造的类阿片有作用。
206	We have receptors for opioids in our brains.	我们大脑里有类阿片的受体
207	It works on our endogenous GABA system, which is our calming neurotransmitter.	它对我们的内生GABA系统有作用, 它就是我们平静的神经递质。
208	And at the end of the day, it releases dopamine in the reward pathway.	最后,它释放多巴胺 在奖励路径。
209	So any potentially addictive substance will release dopamine in the reward pathway.	所以任何潜在的成瘾物质 都会释放多巴胺 在奖励路径。
210	The more that's released and the faster that's released in a given individual, the more likely	释放得越多 释放得越快
211	that substance is to be addictive.	物质是上瘾。
212	Now, another important concept here is what we call drug of choice, which is to say what	现在,这里另一个重要的概念是 我们所谓的药物选择,这就是说
213	releases a lot of dopamine in your brain may not release a lot of dopamine in my brain	释放很多多巴胺 在你的大脑 可能不会释放很多多巴胺在我的大脑
214	and vice versa, right?	反之,对不对?
215	Which is this idea that people have predilections to different kinds of drugs.	这就是人们对不同药物的偏好。
216	And by the way, people can get addicted to behaviors too.	顺便说一句,人们也会对行为上瘾。
217	I should emphasize that.	我应强调这一点。
218	When you say drug of choice, you mean the brain has a particular sensitivity to that	当你说选择的药物,你的意思是, 大脑有特别的灵敏度
219	drug in terms of dopamine?	多巴胺类药物?
220	Yes.	对
221	Okay.	摆
222	The more dopamine that's released, the faster that it's released, the more likely that drug	多巴胺的释放越快,释放得越快,那药就越有可能
223	is to be addictive for a given individual.	对某个人来说是上瘾的
224	So you're holding some whiskey there.	所以,你持有一些威士忌在那里。
225	I'm holding some whiskey.	我拿着威士忌
226	There could be a brain that is very sensitive to whiskey, and there could be a different	可能有一个对威士忌很敏感的大脑 也可能是不同的
227	brain that you could pour all the whiskey in you like and the dopamine response is sort	大脑,你可以倒 所有威士忌在你喜欢 和多巴胺反应是排序
228	of limited.	有限。
229	Exactly.	没错
230	Okay.	摆
231	And for many of my patients who become addicted to alcohol, they will tell you that from the	对于很多酗酒的病人来说 他们会告诉你
232	moment they had alcohol, they knew they were either in trouble or had met their best friend	他们知道自己有麻烦或遇到最好的朋友
233	or some combination.	或某种组合。
234	It was a very potent experience for them.	对他们来说这是一个非常有力的经历。
235	All right.	好吧,我们走。
236	So let's go ahead and put this on the pleasure side of the balance.	因此,让我们先把这个放在平衡的快乐方面.
237	Dopamine is being released, but no sooner has that happened than my brain will work	多巴胺被释放了, 但刚刚发生 比我的大脑工作
238	very hard to restore a level balance.	很难恢复水平平衡。
239	And by the way, a level balance is what neuroscientists call homeostasis, okay?	顺便说一下,一个水平平衡 是神经科学家所谓的 顺势疗法,好吗?
240	And one of the overarching physiologic drives for all living organisms is to return to homeostasis.	所有生物体的生理动力之一 就是回归顺位
241	Homeostasis is that parameter of what's often called affordances or states of being that	Homostasis是常被称为支付或状态的参数
242	are adaptive and healthy for the organism.	对机体具有适应性和健康性。
243	For example, like we have a certain homeostasis of body temperature, and if we go much beyond	比如说,像我们身体温度有某种顺势反应, 如果我们超越了很多
244	that, either too high or too low, we will disintegrate and die, right?	不管是太高还是太低 我们都会分崩离析而死 对吧?
245	So homeostasis is that states of being that are compatible with existence and potentially	因此,顺势态是,状态 与存在是相容的
246	advantageous too.	也有好处。
247	Sort of baseline level?	某种基线水平?
248	That's right.	没错
249	Okay, balance.	好的,平衡点
250	Yeah, baseline level.	是的,基线水平。
251	And by the way, we're always releasing dopamine at a kind of tonic baseline level in our brains.	顺便说一句,我们总是释放多巴胺 在某种兴奋剂基线水平 在我们的大脑。
252	I sometimes think of it as the heartbeat of the brain.	有时候我认为这是大脑的心跳。
253	So what's happened here for people that can't see is you've poured a little bit of whiskey	所以,这里发生的人 看不到的是你倒了一点威士忌
254	into one end of the scale, the pleasure side of the scale, and the other side of the scale	进入天平的一端,天平的快乐一端,天平的另一端
255	has risen because now there's whiskey in the pleasure side, which I guess has released	已经上升,因为现在有威士忌 在快乐的一面, 我想已经释放
256	dopamine.	多巴胺.
257	Exactly.	没错
258	So now we've released dopamine in the reward pathway.	现在我们释放了多巴胺 在奖励路径。
259	Because the pain side went up, does that mean there's now less pain in the brain?	因为疼痛的侧面上升了,这是否意味着现在大脑的疼痛减少?
260	Well, I think, you know, again, this is a metaphor, it's an oversimplification.	嗯,我想,你知道,再次, 这是一个比喻, 这是一个过度简化。
261	The idea here is just when we press on the pleasure side, we're releasing dopamine in	这里的想法只是当我们压在快乐的一面, 我们释放多巴胺英寸
262	the reward pathway and experiencing pleasure.	以报应和享受。
263	But no sooner has that happened than our brain will try to compensate or adapt to increase	但我们的大脑会努力补偿 或适应增加
264	dopamine firing by down regulating dopamine transmission, for example, by involuting postsynaptic	多巴胺通过下调调节多巴胺的传播,例如通过静脉注射
265	dopamine receptors.	多巴胺受体.
266	What does that mean?	这是什么意思?
267	Okay.	摆
268	So our brain is a bunch of wires, you know, that conduct these electrical signals.	所以,我们的大脑是一堆电线, 你知道,这些电讯。
269	And these long spindly cells are called neurons.	这些细长的旋转细胞被称为神经元.
270	And the thing about neurons is that they don't actually touch end to end.	神经元的问题在于 它们实际上不会触摸到末端
271	There's a little gap or space between them.	它们之间有一点间隙或空间.
272	And that gap is called the synapse.	这个缺口叫做突触。
273	And that gap or synapse is bridged by what we call neurotransmitters.	而那个缺口或突触被我们所谓的神经递质所弥合。
274	And dopamine is one of those neurotransmitters, okay?	多巴胺是神经递质之一 好吗?
275	And when the presynaptic neuron pulses and releases dopamine, it crosses the synapse	当突触前神经元脉冲 释放多巴胺时 它会穿过突触
276	and binds to a receptor on the postsynaptic neuron, which either continues or aborts that	并附着在后突触神经元上的受体上。
277	electrical signal.	电讯
278	Does that make sense?	这有道理吗?
279	Yes.	对
280	Okay.	摆
281	So one of the ways that our brain can decrease the effects of dopamine, decrease dopamine	所以我们的大脑可以减少多巴胺的影响 减少多巴胺的作用
282	transmission is by involuting or taking inside the neuron the postsynaptic receptor.	传播是通过神经元的内伏或内接后突触受体.
283	That way when dopamine is released, it has nowhere to bind.	这样,当多巴胺被释放时,它就无处可装了。
284	Oh, okay.	哦,还好。
285	So it's like removing the docking station.	故如去除停靠站.
286	Exactly.	没错
287	Okay.	摆
288	Very good.	很不错。
289	It's removing the docking station.	正在拆除停靠站.
290	So essentially getting back to our scale, we've ingested alcohol, we've increased dopamine	所以基本上回到我们的规模, 我们摄入了酒精, 我们增加了多巴胺
291	firing in the reward pathway.	在报酬的道路上开火。
292	But remember, our pleasure-pain balance wants to return to a level position, level with	但是记住 我们的快乐平衡 想要回到一个水平的位置
293	the ground homeostasis.	地面的顺位
294	So it's going to decrease dopamine transmission by, for example, involuting those postsynaptic	因此,它会减少多巴胺的传播, 例如,通过刺激这些后突触
295	dopamine receptors.	多巴胺受体.
296	But one thing about the brain in its process of trying to get back to homeostasis, and	但有一点关于大脑在试图回到 顺势疗法的过程中,
297	again, I like to think of this neuroadaptation process as these gremlins hopping on the pain	再说一次,我想这个神经适应过程 当这些甘姆林在痛苦中跳跃
298	side of the balance to bring it level again.	平衡的侧面使其恢复水平。
299	You don't have gremlins here.	你这里没有葛林斯
300	You have these little rocks.	你有这些小石头。
301	But let's go ahead and put a rock on the pain side of the balance.	但是,让我们先把一块石头放在平衡的痛处.
302	These rocks are friends, right?	这些石头是朋友,对吧?
303	Their job is to level the balance, because remember, we've got to go back to homeostasis.	他们的工作是平衡, 因为记住,我们得回到自给症。
304	So I'm going to put a rock on, and you're going to say, oh my gosh, it overshot, right?	所以我要把一块石头, 你会说, 哦,我的天哪,它过度拍摄,对不对?
305	Now I've got it pressed down on the pain side of the balance.	现在我把它压在平衡的痛处了
306	But that's exactly what happens in our brains.	但这正是我们大脑里发生的事情。
307	In this process of neuroadaptation, those gremlins hopping on the pain side of the balance	在这个神经适应的过程中, 这些腺素跳在平衡的疼痛一侧
308	don't get off as soon as the balance is level.	平衡后不要马上下来
309	They stay on until we're tilted an equal and opposite amount.	他们坚持到我们倾斜 相等和相反的数量。
310	So is that what a hangover is, or a come down, as they would say when people take drugs,	宿醉是怎样的,还是如人们吸毒时所说,
311	they say, I have a come down?	他们说,我有一个下来?
312	Exactly.	没错
313	That's exactly what it is.	这正是它是什么。
314	That's the hangover, the come down, the blue Monday, or on a much smaller scale, just that	这是宿醉, 下来,蓝色星期一, 或规模小得多,只是
315	moment of craving, right?	渴望的时刻,对不对?
316	That moment of wanting to have one more shot, right?	那刻想再试一次 对吧?
317	Why does it overshoot?	为什么它过度射击?
318	Why can't it just perfectly hit homeostasis?	为什么它不能完全打 优酷?
319	Such a great question.	真是个大问题
320	Because then we'd feel fine.	因为那样我们就会感觉很好
321	Yeah.	对
322	Why did Mother Nature do that to us?	大自然为什么这样对我们?
323	So cruel, right?	太残忍了,对吧?
324	Yeah.	对
325	Okay.	摆
326	I'm going to tell you an evolutionary just so story.	我要告诉你一个进化论 就是这样的故事。
327	What we mean by that is we don't really know why this mechanism exists, but from an evolutionary	我们的意思是,我们不知道为什么存在这个机制, 而是从一个进化中
328	perspective, if you're living in a world of scarcity and ever present danger, this is	如果你生活在一个 稀缺的世界 和现在的危险中
329	the perfect mechanism to make sure that we're never satisfied with what we have, that we're	完美的机制 确保 我们永远不会满足 我们拥有,我们
330	always wanting more, it's made us the ultimate seekers.	总是想要更多 它让我们成为最终的追求者
331	Okay, because immediately after getting something, I'm now feeling a lack of pleasure, and I'm	好吧,因为一旦得到一些东西, 我现在感到 缺乏乐趣,我
332	{\fn黑体\fs22\bord1\shad0\3aHBE\4aH00\fscx67\fscy66\2cHFFFFFF\3cH808080}这表示我要去寻找
333	more dopamine, and in a world where everything is quite scarce, that could mean going on	更多巴胺, 在一个世界上, 一切都相当稀少, 这意味着继续
334	another four-hour hunt the next day to go kill a gazelle or something.	第二天再打四小时的猎杀瞪羚之类的
335	Perfect.	不错
336	Okay, interesting.	好吧,有趣的是,我们是...
337	Yeah.	对
338	Okay, so that's going to motivate me because this gets so ... Jesus, people that have hangovers	好吧,那会激励我 因为这样... 老天爷,有宿醉的人
339	don't seem very motivated.	似乎没什么动机
340	Right.	对
341	So now that's it.	所以现在就是这样。
342	So why is that, right?	为什么?
343	It's because alcohol is a product of human engineering that releases so much dopamine	因为酒精是人类工程的产物 释放出这么多多巴胺
344	all at once in the reward pathway that our brains are reeling to compensate, right?	我们的大脑正在折腾 来补偿,对吧?
345	We really weren't evolved for this much pleasure with this much easy access.	我们真的没有进化的 这么多的乐趣 与这么容易进入。
346	As you said yourself, we were really evolved to have to do quite a lot of work up front	正如你本人所说,我们真的进化了,不得不在前面做很多工作。
347	and to be hungry and to be lonely and to be tired, and then get a little bit of reward	饥饿 孤独 疲倦 然后得到一点回报
348	that would then bring us back up to homeostasis.	那样我们就能重回故乡了
349	So really, we were evolved to be pressing on the pain side of the balance in our effort	所以,真的,我们进化到 压力在痛苦的一边 在我们的努力中
350	to find pleasure, and then when we find it, that little bit of food or clothing or shelter	找到乐趣,然后当我们找到它, 一点点的食物或衣服或住所
351	or a mate would bring us back to the level of position.	或者一个伙伴会让我们回到位置
352	Does that make sense?	这有道理吗?
353	Yeah.	对
354	So you're telling me essentially that we're all wired to be addicted because if this is	所以,你告诉我 基本上,我们都是 被窃听成瘾 因为如果这是
355	how our brain works, in a world, it's designed to seek out more dopamine, but the problem	我们的大脑是如何工作的,在一个世界上, 它的设计寻找更多的多巴胺, 但问题
356	we have now is we have all this synthetic dopamine effectively, like this synthetic	我们现在有这么多合成多巴胺 就像这种合成
357	chemicals and synthetic things and an internet that is wiring us to give us so much dopamine	化学和合成物 和互联网 连接我们 给我们这么多多巴胺
358	so easily.	这么容易。
359	That means that our brains are effectively mismatched to the world that we live in, and	这意味着我们的大脑实际上与我们生活的世界不匹配,
360	therefore wired to be addicted.	因而被窃听成瘾。
361	I think you actually said that.	我想你真的这么说了
362	I found a quote you said in an interview where you said, we're all wired to be addicted,	我在一次采访中发现了一句你说过的话, 你说,我们都被窃听成瘾,
363	and if you're not addicted yet, it's right around the corner.	如果你还没有上瘾,它就在拐角处。
364	Right.	对
365	Coming to a website near you.	到你附近的一个网站
366	Yes.	对
367	I guess I would qualify that a little bit by saying we're wired for survival in a world	说我们是在世界上生存的线
368	of scarcity.	缺乏资源。
369	That's not the world we live in now.	那不是我们现在生活的世界
370	We live in a world of overwhelming overabundance, and so there is a mismatch between this ancient	我们生活在一个超乎寻常的富足世界里 所以这个古老的
371	wiring that has us relentlessly pursuing pleasure in order to survive and a world that's	线条让我们不懈地追求快乐 为了生存和世界
372	so infused with pleasure and so many rewarding stimuli that now we're overwhelming our reward	充满了欢乐和很多有回报的刺激 以至于现在我们压倒了我们的回报
373	system, and our brains are reeling in response to try to compensate.	我们的大脑在回旋 试图补偿
374	So what happens to this scale then in such a world where I can get a big hit of dopamine	那么这个尺度会发生什么,然后在这样一个世界上, 我可以得到一个大打击多巴胺
375	all the time using some of these synthetic things or the internet or pornography or whatever	总是使用一些 合成的东西, 互联网或色情,什么的
376	else?	还有呢?
377	What's going on with this scale over and over again?	一遍又一遍地看这个尺度是怎么回事?
378	Okay, great.	好吧,伟大的。
379	So let me get there.	让我过去
380	Let me first say though that, remember, after we do something that's highly pleasurable,	首先让我说,尽管,记住, 在我们做了一件非常令人愉快的事之后,
381	our brain compensates with neuroadaptation, tilting an equal and opposite amount to the	我们的大脑通过神经适应来补偿, 倾斜一个相等和相反的量到
382	side of pain, and then restoring our balance back to the level position or what we call	痛苦的一面,然后恢复我们的平衡 回到水平位置或我们所谓的
383	home home
384	So this doesn't last forever.	故此不长.
385	It's to pleasure, then it's to pain, then it's back to the level position.	是以悦之,然后痛之,然后复位.
386	But if we continue to consume our drug of choice over days to weeks to months to years,	但如果我们继续消费 我们选择的药物 在几天到几周到几个月到几年,
387	and we add in a whole bunch of other drugs, and now we're consuming pornography and smoking	我们加了一大堆其他毒品, 现在我们消费色情和吸烟
388	pot and eating donuts and, you know, you name it, all at the same time, then essentially	罐头和甜甜圈,你知道, 你命名它,所有的时间,然后本质上
389	what happens is those gremlins on the pain side of the balance end up camped out there.	情况是 平衡部位疼痛部位的腺素 最后会露营在那里
390	For anyone that can't see, she put all of the rocks into the pain side to represent	对于看不见的人来说 她把所有的石头 放在痛苦的一侧来代表
391	all of the addictive behaviors that this individual has now taken on.	这个人现在所有的上瘾行为
392	Right.	对
393	And now we've entered addicted brain, by which I mean that we've changed our hedonic or	现在,我们进入了瘾君子的大脑, 我的意思是,我们已经改变了我们的狂妄或
394	joy set point to the side of pain.	欢乐设定指向痛苦的侧面.
395	Now we need more and more of our drug in more potent forms, not to get high and feel good,	现在我们需要越来越多的药物 更强大的形式, 而不是得到高和感觉好,
396	but just to level the balance and feel normal.	但为了平衡 感觉正常
397	And this is not going to be enough.	这还不够
398	To level the balance, I would have to like keep filling this much more than this container	为了平稳平衡,我更希望 继续填满这个比这个容器更多的东西
399	can hold.	可以坚持。
400	And that would be in pursuit really of just trying to level that balance so that we can	这会是真正的追求 仅仅试图实现平衡 这样我们可以
401	feel normal.	感觉正常。
402	And when we're not using, we're walking around with a balance tilted toward the side of pain,	当我们不使用, 我们走来走去,有一个平衡 倾斜到痛苦的一侧,
403	experiencing the universal symptoms of withdrawal from any addictive substance or behavior,	经历从任何致瘾物质或行为中退出的普遍症状,
404	which are anxiety, irritability, insomnia, depression, and craving.	焦虑、烦躁、失眠、抑郁和渴望
405	So if I manage to get enough vodka, whiskey, rum, and pour it into the pleasure side of	所以,如果我设法得到足够的伏特加,威士忌,朗姆酒, 并倒进快乐的一面
406	the scale, now that all the rocks are in the pain side of the scale, and I managed	现在所有的岩石都处于海平面的痛处 我设法
407	to outweigh it, what would then happen?	超过它,然后会发生什么?
408	More rocks.	更多石头。
409	More rocks would be added.	还会增加更多的岩石。
410	More rocks.	更多石头。
411	So momentarily, I would maybe be in a little bit of pleasure, but then my brain would remove	暂时地,我可能会有点高兴, 但然后我的大脑会去除
412	those docking stations again, remove more of them, and more rocks would go in and I'd	那些停靠站, 移除更多的它们, 更多的岩石会进入,我会
413	slam down on the pain side again, which means I need more alcohol to try and get up to pleasure.	重击疼痛的一面, 这意味着我需要更多的酒精 尝试起来享受。
414	Okay, so really you want to like dopamine fast, or you need to just balance this.	好吧,所以你真的想喜欢多巴胺快速, 或者你需要只是平衡这一点。
415	And this is so difficult because of the world we live in, it's almost, it's funnily enough	这太困难了,因为我们生活的世界, 它几乎,它已经很有趣了。
416	because this little scales experiment analogy here has given me a huge amount of empathy	因为这个小尺度实验类比 给了我大量的同情
417	for people that are addicts.	以成瘾者发誓,
418	Oh gosh, I'm so glad you said that, because I think that is the key to empathy for the	哦,天哪,我真高兴你这么说 因为我认为这是同情
419	disease of addiction, as well as for people with the disease having empathy for themselves,	成瘾的疾病 以及那些同情自己的人
420	is recognizing that on some level, it's out of their control, right?	承认在某种程度上 这超出了他们的控制范围 对吧?
421	Because when we are tilted to the side of pain, the overwhelming drive to restore a	因为当我们倾斜到痛苦的一面, 压倒性的驱动力 恢复一个
422	level balance or restore homeostasis as quickly as possible overwhelms any other rational	水平平衡或尽快恢复自动性 超过任何其他理性
423	thought about the consequences of my drug use, right?	想想我吸毒的后果,对吧?
424	It's just like, get back to the level position because if I do that, I'll at least feel	这就像,回到级别的位置 因为如果我这样做,我至少会感觉
425	temporarily better.	暂时更好。
426	One of the things this analogy also highlights for me is that people who are addicted aren't	这个类比也让我想到 瘾君子不是
427	trying to self-harm, and this is kind of the prevailing narrative that if you're like,	试图自我伤害, 这是一种流行的说法 如果你喜欢,
428	why would you do that to yourself?	你为什么要这样对自己?
429	Whereas when I look at this analogy, I go, actually what they're trying to do is to deal	当我看这个类比时,我走了, 其实他们想做的是处理
430	with pain, and we're all trying to find ways to deal with our pain.	和痛苦, 我们都在试图 找到方法处理我们的痛苦。
431	But in this analogy, what ultimately happens, and I guess is what's happening with addicts	但在这个类比中, 最终会发生什么, 我想是发生在瘾君子身上
432	is the way they're choosing to deal with their pain is becoming self-destructive,	他们选择处理疼痛的方式 变得自毁,
433	and that's creating more pain, and it's this vicious downward cycle.	这造成了更多的痛苦, 它的恶性循环。
434	I think that sort of reframing of what's going on there is really critical because again,	我认为那种对那里发生的事情的重新描述 是非常关键的,因为,
435	it begets more empathy.	这引起了更多的同情。
436	Absolutely, I agree with you.	当然,我同意你的看法。
437	And I think this metaphor, it makes an assumption that we all start with a pleasure-pain balance	我觉得这个比喻 假设我们都从快乐的平衡开始
438	that's level with the ground, but actually that's probably not true, right?	这和地面是相当的, 但实际上,这可能不是真的,对不对?
439	Some people at baseline may actually be more depressed or more anxious or may have had	一些处于基线的人实际上可能更沮丧,或更焦虑,或可能有过
440	life experiences that sets them up for a kind of chronic stress reaction.	生活经历 设置它们 一种慢性压力反应。
441	And we know that people with co-occurring psychiatric disorders, for example, are at	我们知道,例如,患有共同发作性精神病的人正在
442	increased risk of developing addiction probably because they're reaching for that substance	增加成瘾的风险 可能是因为他们正在接触这种物质
443	to self-medicate their psychiatric problem.	自我治疗他们的精神病。
444	The issue with that is that it's not medicinal, right?	问题在于它不是药,对吧?
445	It's not healing.	不疗.
446	Although in the short term, substances can help with those kinds of feelings of psychological	虽然短期内,物质可以帮助这些类型的心理感觉
447	and physical pain, over time, because of the way the brain adapts, as we've discussed,	和身体疼痛,随着时间的推移, 因为大脑的适应方式, 正如我们讨论过,
448	substances and other addictive behaviors just make psychiatric problems worse, right, as	药物和其他成瘾行为 只会使精神问题更糟,对吗,因为
449	we drive ourselves further into the pain side of the balance.	我们更深入到 痛苦的一方平衡。
450	So is this why trauma often leads to addictive behaviors?	这就是为什么创伤常常导致成瘾行为?
451	Because the trauma has caused a pain, a stress, and we're searching for ways to medicate	因为创伤造成了痛苦和压力 我们正在寻找治疗的方法
452	that pain or stress.	那个痛苦或压力。
453	Yeah, to numb ourselves, to not be present in our reality and have to deal with what's	是啊,为了麻木自己, 不在我们的现实中存在, 并不得不处理什么
454	going on there.	就是这样
455	What role is dopamine playing in trauma?	多巴胺在创伤中扮演什么角色?
456	It's all the same.	一切如来.
457	Dopamine originally was to help us find those things that we need to survive.	多巴胺最初是为了帮助我们找到我们需要生存的东西。
458	Food, clothing, shelter, a mate.	食物,衣服,住所,一个伴侣。
459	We call those natural rewards.	我们称之为自然的奖励。
460	But today, that same reward pathway that relies on dopamine has been hijacked by all of these	但今天 依赖多巴胺的同样的奖赏途径 被所有这些人劫持了
461	artificial rewards that our brain confuses as necessary for survival.	人为的奖励 我们的大脑混淆 生存的必要。
462	Which is why people with severe addiction will be willing to lose, you know, not consciously	这就是为什么严重上瘾的人 会愿意失去,你知道, 没有意识
463	but unconsciously, their loved ones, their homes, their jobs, everything they have in	但无意识地,他们的亲人,他们的家园,他们的工作,他们拥有的一切
464	pursuit of their drug of choice.	追求他们选择的药物。
465	It's because their brain has been hijacked and they now confuse the drug as necessary	因为他们的大脑被劫持了 现在他们迷惑了毒品
466	for survival.	为了生存
467	The other thing about drugs is that they're incredibly potent.	药物的另一件事是 它们的力量非常强大
468	They release a lot of dopamine all at once, which again is confusing for our brain.	它们立刻释放出大量的多巴胺, 这对我们的大脑来说再次令人困惑。
469	Natural rewards require upfront effort where we do a lot of work and then we get a little	自然回报需要我们做很多工作 然后再得到一点
470	bit of dopamine.	有点多巴胺。
471	And that's what our brains evolve for.	这就是我们的大脑进化的原因。
472	I mean, that makes sense in my own life.	我的意思是,这在我的生活中是有道理的。
473	When I'm most stressed or most challenged by something professionally is when I immediately	我最紧张或最受专业挑战的时候 就是马上
474	notice that my diet goes out the window, I start eating things that are bad, I actually	我开始吃坏东西,其实...
475	stop going to the gym as much.	别去健身房了
476	And it can form a bit of a downward spiral, can't it?	它可以形成一个有点下垂的螺旋,不是吗?
477	I guess as we've kind of seen from the dopamine scale.	我猜我们从多巴胺比例上看得出
478	Can I get back to your question about trauma and stress?	我可以回到你的问题 关于创伤和压力?
479	So, there's a very interesting series of experiments in rodents, mice and rats, where they, first	因此,有一系列非常有趣的实验 在啮齿动物,小鼠和大鼠,在那里,他们首先
480	of all, rodents very easily get addicted to cocaine.	啮齿类动物很容易上瘾
481	They will press a lever for cocaine until exhaustion or death.	他们会用杠杆控制可卡因 直到用尽或死亡
482	But if that cocaine is then taken away, that behavior will extinguish, which means that	但是如果可卡因被拿走, 这种行为将会消失, 这意味着
483	mice will eventually just stop pressing the lever, right, because they're not getting	老鼠终究会停止按杠杆,对吗,因为他们没有得到
484	any cocaine.	任何可卡因。 任何可卡因。
485	Totally makes sense.	说得通
486	And then they'll go off and do something else in the cage.	然后他们会在笼子里做别的事
487	But if they're then exposed to a very painful foot shock, right, so a very extreme physical	但是如果他们受到非常痛苦的脚部冲击, 那么非常极端的身体冲击,
488	pain, which you could equate to a serious life stressor, the first thing the rat will	痛苦,你可以等同于 严重的生命压力, 首先是老鼠会
489	do is run over to the lever and start pressing for cocaine, which tells us that once our	跑到杠杆开始催促可卡因 这告诉我们一旦我们
490	brain has discovered a drug that releases a lot of dopamine in our reward pathway, even	大脑发现了一种药物 释放了很多多巴胺 在我们的奖励路径,甚至
491	after we stop using that drug, if we are exposed to an extreme stressor, our brain will tell	我们停止使用毒品后, 如果我们接触到一个极端的压力, 我们的大脑会告诉
492	us immediately, go and do that thing that gives us a lot of dopamine, because you are	我们马上去做那个 给我们很多多巴胺的东西 因为你是
493	under stress and I need to be relieved of stress.	在压力下 我需要放松压力
494	Does that make sense?	这有道理吗?
495	Makes perfect sense.	说得通
496	Yeah.	对
497	So if you discover your drug of choice when you're younger, and it's food or it's pornography	所以如果你发现你选择的药物 当你年轻, 这是食物还是色情
498	or if it's, I don't know, anything that really made you feel good for a moment, a moment	或者,如果它是,我不知道, 任何真正让你感觉好 一瞬间,一瞬间
499	of pleasure, that will always become, in the case of these rodent experiments, the thing	乐于享受, 将永远成为, 在这些啮齿类实验中,
500	you run back to when life gets hard.	你跑回当生活变得艰难。
501	Right.	对
502	And we see that again and again in people in sustained recovery from addiction, that	我们一遍又一遍地看到,在人们 在持续恢复 从毒瘾,
503	when they are under stress, that is a trigger potentially for them to relapse.	当他们处于压力中时,那可能是他们复发的导火索。
504	So they have to be really thoughtful in their lives for, number one, trying to avoid stressful	因此,他们必须真正体贴 在他们的生活中,第一, 试图避免压力
505	situations.	情况
506	And by the way, stress can come in many different forms.	顺便说一句,压力可以以多种不同的形式出现.
507	There's a great acronym in Alcoholics Anonymous called HALT, Hungry, Angry, Lonely, Tired.	"酗酒无名氏"中有一个伟大的缩写,叫HALT,饥饿,愤怒,孤独,疲倦.
508	Those kinds of stressors, everyday stressors, which we all experience, hungry, angry, lonely,	这些压力,日常压力, 我们都经历,饥饿,愤怒,孤独,
509	tired, can trigger us to want to use.	累了,可以触发我们想要使用。
510	So people in recovery have to be really thoughtful about not getting too hungry, not getting	所以在康复中的人必须真正体会到 不要太饿,不要得到
511	too angry, not getting too lonely, and not getting too tired.	太生气了,别太寂寞,别太累了
512	At the end of this conversation, I want to go through all of the sort of practical solutions	在谈话结束时,我想通过各种切实可行的解决办法
513	that someone struggling with an addiction to social media, pornography, food, whatever	某人在社交媒体、色情、食物上挣扎
514	it might be, can implement to try and shift that cycle that they might be going through,	可能,可以实施 尝试改变 他们可能经历的循环,
515	especially when they're halting, hungry, angry, lonely, or tired.	特别是当他们停止,饥饿,愤怒,孤独,或者疲惫的时候.
516	How often have you worked with addicts?	你和瘾君子合作多久一次?
517	Have you spent much time working with addicts directly?	你直接和瘾君子一起工作很久了吗?
518	Oh my gosh, yeah.	哦,我的上帝,没错。
519	So that's the bulk of my career, is working with people with all different kinds of addictions.	所以这就是我职业生涯的主要部分, 和各种成瘾的人一起工作。
520	Give me an example of the most obscure.	举个最晦涩的例子
521	I had a patient who was addicted to water, I know, hard to imagine.	我有个病人沉迷于水 我知道 很难想象
522	You have to though understand her narrative.	你必须理解她的叙述。
523	So she had a very severe alcohol addiction.	她酗酒成瘾很严重
524	She got into recovery from that addiction and gave up alcohol.	她从毒瘾中恢复过来 放弃了酗酒
525	But she discovered that by drinking copious amounts of water, she could become hyponatremic,	但是她发现喝了很多水 她可能会患抑郁症
526	meaning that she could lower the sodium levels in her bloodstream, which would then lead	意思是她可以降低血流中的钠含量 这会导致
527	her to become delirious.	她变得神志不清
528	And so in her desire to just be checked out, she would do that.	所以她想被检查出来 她会这么做
529	She would drink large amounts of water.	她会喝大量的水。
530	She's doing okay?	她还好吗?
531	No, sadly, she's not.	不,很遗憾,她不是。
532	She ended up taking her own life.	她最后自杀了
533	So that was very sad.	所以,这是非常可悲的。
534	Gosh.	天呐
535	In that situation, was there a root cause of that behavior pattern further upstream?	在这种情况下,这一行为模式是否有进一步上游的根本原因?
536	Some kind of trauma or experience that had set this sort of cascading set of issues off?	某种创伤或经历 导致这种连锁问题?
537	Yeah, you know, I'm just speaking broadly.	是啊,你知道,我只是说广义。
538	For some patients with severe addiction, trauma is a huge factor, especially severe early	对于一些严重成瘾的病人来说,创伤是一个巨大的因素,尤其是早期严重的创伤。
539	childhood trauma.	童年创伤.
540	But there are also many folks we see who have kind of great parents and have had happy childhoods	但也有许多人,我们看到他们有 那种伟大的父母, 并有快乐的童年
541	and have great social networks and work that they enjoy, and yet they still become addicted.	并拥有他们所享受的伟大社交网络和工作,然而,他们仍然沉迷于其中。
542	And that's because, again, we are wired to consume as much as possible of whatever releases	这是因为,再次,我们被电线 消耗尽可能多的任何释放
543	dopamine in our brains, to have survived evolution to this date.	多巴胺在我们大脑中, 生存了进化至今。
544	And yet we're living in this world where we have access to so many drugified substances	然而我们却生活在一个 我们能够获得这么多药物的世界里
545	and behaviors that we've all become vulnerable to this problem.	以及我们都容易受到这个问题影响的行为。
546	And the reason I highlight this is because one of the things that I think has happened	我之所以强调这一点 是因为我想发生了一件事
547	in the field of addiction medicine that maybe isn't the best is that oftentimes patients	在瘾君子医学领域 也许不是最好的 是病人经常
548	as well as their providers are digging really deep to find the trauma or the reason that	以及他们的提供商正在深入挖掘 寻找创伤 或原因
549	someone has become addicted.	有人上瘾了
550	And I think that that's important to do in some cases, but in other cases, it can lead	我认为这很重要 在某些情况下,但在其他情况下,它可以导致
551	to kind of manufacturing trauma where there really isn't any.	那种制造创伤 真正不存在的地方。
552	Furthermore, I would say that when a person is in the throes of their addiction, they're	此外,我会说,当一个人 在他们的毒瘾的折磨, 他们是
553	going to be able to really do the complex emotional processing of their trauma while	将能够真正做 复杂的情感处理 他们的创伤同时
554	they're still using their drug of choice, that they really need to get out of that vortex	他们仍然使用他们选择的药物, 他们真的需要走出漩涡
555	{\fn黑体\fs20\shad2\2aH82\3aH20\4aH33\fscx95\3cH592001\be1}迷上瘾并恢复到某种程度 {\fn黑体\fs20\shad2\2aH82\3aH20\4aH33\fscx95\3cH592001\be1}你甚至想去对付一些
556	of those early traumatic experiences.	这些早期的创伤经历。
557	How many people do you think are struggling with some form of addiction?	你认为有多少人在挣扎 与某种形式的成瘾?
558	Well, if you think of addiction as a spectrum disorder, right, there's mild, moderate and	如果你认为成瘾是一种光谱障碍, 右,有温和,温和和和
559	severe.	严重。
560	And there's, I would even say, a kind of a pre-addiction state where we're all sort of	我甚至会说, 有一种预药状态, 我们都是那种
561	dabbling in compulsive overconsumption.	强迫过度消费
562	I would say the vast majority of us, like 90, probably 95 percent, have some degree	我想说,我们大多数人, 像90%,可能95%, 有某种程度
563	of compulsive overconsumption.	强迫性过度消费。
564	And if and when it tips over into what we would call addiction, there's not a brain	如果和当它倾注到 我们称之为上瘾, 没有大脑
565	scan or a blood test to assess that.	扫描或血液检测来评估
566	It's not like switching a light switch and it's like, oh yeah, now you have addiction.	这不是像切换一个灯开关 它就像,哦,是的,现在你有瘾。
567	It's not like that.	不是那样的
568	It's, you know, it's a gradual, often a gradual and insidious thing.	这是,你知道,这是一个渐进, 经常是渐进和阴险的东西。
569	And we don't in fact have a biological measurement of addiction.	事实上,我们并没有对成瘾进行生物测量。
570	We base it on what we call phenomenology, which is patterns of behavior that repeat	我们把它建立在我们所谓的"现象学"上, 那就是重复的行为模式
571	themselves across time.	穿越时间
572	And broadly speaking, the definition of addiction is the continued compulsive use of a substance	广义上说,毒瘾的定义是继续强制使用一种物质
573	or a behavior despite harm to self and or others.	或行为 尽管伤害了自己或他人。
574	And so, you know, that harm can be very subtle or not, right?	所以,你知道,伤害 可以是非常微妙或不,对不对?
575	And it can be a judgment call.	也可以是判决
576	Interesting.	有意思,这很有趣
577	Because we do throw the word addiction around a lot in society, but really the most important	因为我们在社会上常说"上瘾" 但其实是最重要的
578	part of that is to understand if it's harming yourself or someone else, the behavior pattern.	部分内容是理解它是否伤害了自己或他人,行为模式.
579	Yes, that's right.	没错
580	And to also recognize that we're not very good judges of that when we're chasing dopamine.	还承认我们在追杀多巴胺时 并不擅长判断
581	Okay.	摆
582	So we sometimes justify behaviors we have as being not harmful and it's fine and it's	所以我们有时会证明我们的行为是无害的,它很好,它很好。
583	not impacting me at all.	一点也不影响我
584	And what do you mean?	何谓.
585	Exactly.	没错
586	And we don't, we're not very good at seeing true cause and effect, honestly, when it comes	我们没有,我们不太擅长看到真正的因果, 说实话,当它出现的时候
587	to these behaviors, which is why oftentimes people won't really see the harm until they've	所以人们往往不会真正看到伤害 直到他们
588	stopped using for a period of time.	停止使用一段时间。
589	In your book, Dopamine Nation, you talk about an addiction that you had.	在你的书"多巴胺民族"中,你谈到你曾经有过的上瘾.
590	Yes.	对
591	And it was really surprising to me because I would never have thought that being obsessed	这真的让我惊讶 因为我永远不会想到
592	with erotic novels could be classified as an addiction.	与色情小说可以归类为成瘾。
593	What happened?	发生了什么事?
594	What was the behavior?	是什么行为?
595	Take me into that phase of your life.	带我进入你生命的阶段
596	So I was in my early 40s.	所以我40多岁了
597	My kids were no longer little.	我的孩子已经不小了。
598	I got a lot of my self-worth and identity from being a mom.	我从做妈妈开始就有很多自我价值和身份
599	And my kids were sort of entering adolescence.	我的孩子进入了青春期。
600	They were doing fine, but they didn't need me as much.	他们很好,但他们并不需要我
601	So I had kind of a grief reaction in response to that, was trying to figure out how to navigate	所以我有种悲伤的反应 针对这一点, 试图找出如何导航
602	this next phase of my life.	我生命的下一个阶段
603	I'd always been a reader, and in particular, a reader of novels.	我一直是一个读者,尤其是小说读者。
604	In my own way, that was how, as a child, I self-soothed, was to escape into the fantasy	以我自己的方式,这就是如何,作为一个孩子, 我自慰, 是逃入幻想
605	life of novels.	小说的生活。
606	But I never had what I would call a problem with it.	但我从来没有什么 我会称之为一个问题。
607	And then one day, I heard another mother at school said that she was reading this great	有一天,我听到另一个母亲在学校说, 她正在读这个伟大的
608	book.	书。
609	It was called Twilight.	当时名为 T.
610	It was about these vampires.	是关于这些吸血鬼的
611	She was going on and on about it.	她一直在说
612	And I read it.	我读了
613	And I can't tell you what it was, but it was just like the key in my particular lock.	我不能告诉你它是什么, 但它就像钥匙在我的特定锁。
614	It was completely transporting.	它完全运输。
615	It just released a lot of dopamine, is all I can imagine, in my brain's reward pathway.	它刚刚释放了很多多巴胺, 我只能想象,在我的大脑的奖励路径。
616	And so I read the whole series, and then I read the series again, and I read it again.	于是我读了整个系列,然后又读了系列,又读了一遍.
617	And of course, by the third or fourth time, it wasn't as, you know, reinforcing.	当然,在第三次或第四次之前, 它不像,你知道的,加强。
618	And I thought to myself, I wonder if there are any more vampire romance novels.	我想,我自己,我想知道 有没有更多的吸血鬼浪漫小说。
619	And then for me, the real tipping point was I got an e-reader.	对我来说,真正的转折点是 我有一个电子阅读器。
620	我有一个Kindle。
621	Because what happened was, even before I got the Kindle, I started reading, you know, novels	因为发生的事 甚至在我拿到金德之前 我开始读小说
622	that I would say I would be slightly embarrassed to admit that I was reading, like kind of	我会说,我会有点尴尬 承认我正在阅读, 像那种
623	Bodice开膛手小说.
624	As time went on, I needed more and more, like, graphic kinds of descriptions in order to	随着时间的流逝,我需要越来越多的, 像,图形类的描述,以便
625	find it pleasurable.	感觉很愉快
626	And by the way, that's classic for the addiction narrative, right, where you start out with	顺便说一句,这是典型的瘾君子叙事, 对,你从那里开始
627	and it goes a long way.	这会很长一段时间。
628	And then over time, you build up tolerance.	然后随着时间推移, 你建立宽容。
629	That's neuroadaptation, the gremlins pressing down on the pain side of balance.	这就是神经适应,Gremlins压在平衡的疼痛方面.
630	Now I need more of my drug and more potent forms to get the same effect.	现在,我需要更多的药和 更强大的表格来得到同样的效果。
631	Gradually over time, I started reading, you know, more and more sort of graphic, erotic,	逐渐地,我开始阅读,你知道, 越来越多的图形,色情,
632	sexualized versions of this novel.	这本小说的性化版本.
633	And I was embarrassed.	我当时很尴尬
634	So I would hide that I was reading them.	所以我会隐藏我在读
635	And that gets into the whole double life of addiction, where now we're lying about our	这进入了毒瘾的双重生活, 在那里我们现在说谎 关于我们的
636	abuse, we're using our drug over here, but pretending like we're not.	滥用,我们在这里使用我们的药物, 但假装我们不是。
637	So my kids or my husband would walk in the room and I would be, you know, hiding behind	所以我的孩子或我丈夫会走进房间 我会,你知道,躲在后面
638	another book, one book behind another book.	另一本书,另一本书后面的一本
639	So it looked like I was reading something, you know, I don't know, more sophisticated.	所以看起来我读了一些东西, 你知道,我不知道,更精密。
640	And then the tipping point for me came really when I got a Kindle or an e-reader.	然后当我得到Kindle或电子阅读器时, 对我而言的临界点真的来了。
641	And then my reading was totally anonymous.	然后,我的阅读完全匿名。
642	I could read these books anywhere, anytime.	我可以随时随地读这些书
643	No one knew what I was reading.	没人知道我在读什么
644	And as soon as I finished one, I could read another one.	我一完成一个,我就可以读另一个。
645	And I almost overnight became a chain reader, like literally.	我几乎一夜之间变成了一个连锁读者, 就像字面上一样。
646	When I wasn't doing something else that I had to do, I was reading romance novels one	讽и⊿暗и璶暗ㄆ и
647	after another after another, which meant I was, you know, less present for my kids, less	后一个又一个, 这意味着我,你知道, 少礼物给我的孩子,
648	present for my husband.	送给我丈夫的礼物
649	I would often stay up till two, three, four in the morning on a weeknight reading romance	我经常呆到凌晨2、3、4点 在一周晚上看浪漫
650	novels.	小说。
651	Have to get up two hours later, go to work exhausted, not able to be present for my patients,	两小时后必须起床 工作疲惫 无法为我的病人服务
652	not enjoying my work, gradually getting more depressed, more irritable, more anxious, more	不享受我的工作, 逐渐变得更沮丧, 更刺激, 更焦虑,
653	insomnia.	失眠症
654	We went on a family vacation with a family, friends of ours, everybody together at this	我们和家人,朋友,大家一起度假
655	beach house, all the kids playing.	沙滩屋,所有的孩子玩。
656	I was like hiding in a room reading romance novels.	我就像躲在看浪漫小说的房间里
657	So and this is exactly what happens with addiction is that our focus narrows and the things that	所以,这正是发生 与上瘾 是我们的焦点缩小 的东西
658	we used to enjoy are no longer pleasurable.	我们曾经的享受不再令人愉快。
659	Only this one thing has salience for us.	只有这一件事对我们来说很重要。
660	We plan our whole day around getting it, using it, hiding our use.	我们计划了一整天的获取, 使用它,隐藏我们的用途。
661	And that's what happened to me.	亦复如是. 师曰.
662	It's so interesting because as you were talking about that, I was thinking about all the behaviors	这太有趣了,因为当你在谈论这个, 我在想所有的行为
663	that I have that are maybe isolating me or, you know, even things like spending a lot	可能我被隔离了 甚至连花很多钱
664	the internet, just watching video after video after video on YouTube or those kinds of things	在YouTube上的视频之后看视频之类的
665	or just like spending tons of time in my WhatsApp group chat talking, like roasting my friends	或者就像花很多时间 在我的WhatsApp小组聊天, 像烤我的朋友
666	about nothing.	什么都没有。
667	Right.	对
668	How do you know if like this is it's because on one end of the spectrum, I could say, okay,	你怎么知道,如果是这样 是因为在光谱的一端,我可以说,好吧,
669	well, that's harming my relationship with people in the real world, but it's helping	那会伤害我和现实世界的人的关系 但有帮助
670	me feel good and it's, you know, maybe helping me in another department because I'm learning	我觉得很好,你知道的, 也许帮助我在另一个部门 因为我正在学习
671	more about vampires, you know, because there's there might be net harm somewhere else, but	更多关于吸血鬼,你知道, 因为那里可能有净伤害 其他地方,但
672	then an upside over here, which and then I start rationalizing this behavior, like how	然后这里的倒置, 然后我开始理顺 这种行为,比如如何
673	do you just distinguish between these behaviors and know what's bad and what's good?	你只是区分这些行为,知道什么是坏什么是好?
674	You know what?	你知道吗?
675	It's really hard.	这真的很难。
676	These digital devices are powerful tools, but also very potent drugs.	这些数字设备是强大的工具,但也是非常强大的药物。
677	There's no doubt that digital media lights up the same reward pathway as drugs and alcohol.	毫无疑问,数字媒体 照亮同样的奖励路径 与毒品和酒精。
678	These devices and platforms were designed to be addictive.	这些装置和平台的设计具有上瘾性.
679	That is to keep us scrolling and tapping long beyond what we plan for or what we want or	就是让我们在计划或计划之外 不断滚动和挖掘
680	even what's pleasurable.	甚至是令人愉快的
681	I think we can all relate to using this medium to a point where we don't even like it anymore	我想我们都可以使用这个介质 到我们甚至不喜欢它的地方
682	and yet have difficulty getting ourselves off of it.	却很难摆脱这一切
683	That really speaks to the inherently reinforcing and cognitively adherent nature of this medium.	这确实说明了这个媒介固有的强化和认知的坚持性。
684	It is a drug.	这是药物。
685	And so, you know, if and when and how we're crossing into addictive use, I think we need	所以,你知道,如果,什么时候,我们如何 进入成瘾用途,我认为我们需要
686	to be very vigilant about whether that's happened in our lives.	要非常警惕 我们的生活是否发生。
687	One of the ways to do that is actually to try cutting out that particular digital medium,	其中一个方法就是尝试切除那个特定的数字媒介,
688	that website or that behavior for a period of time long enough to experience withdrawal,	那个网站或者那个行为 足够长的时间来经历退出,
689	potentially reset reward pathways, and then reevaluate.	有可能重设奖励路径,然后重新评估。
690	Because when we're in the behavior, as you yourself noted, it's very easy to rationalize	因为当我们的行为, 正如你自己指出, 这很容易合理化
691	oh, I need to do this for work, oh, I need to do this to stay in touch with my friends,	哦,我需要这样做的工作, 哦,我需要这样做 与我的朋友保持联系,
692	oh, I'm learning so much from this, right?	哦,我学到这么多 从这一点,对不对?
693	And all of that may have been true initially, but may not be that true anymore.	而所有这一切可能 一开始是真实的, 但也许不是现在。
694	And what I often point to is the subtler signs of addiction, which are things like depression,	我经常提到的是 上瘾的微妙迹象 像是抑郁症
695	anxiety, inattention, insomnia, restlessness.	焦虑,无心,失眠,不安。
696	These can be early signals for our consumption entering into that addiction range, but us	这些可能是早期的信号 用于我们进入毒瘾范围,但我们
697	not realizing it, because again, we don't see cause and effect.	没有意识到它, 因为再次,我们没有看到因果关系。
698	Which is why doing an experiment like I did with my romance novels, you know, following	这就是为什么做一个实验 像我做 我的浪漫小说,你知道,
699	in the footsteps of my patients and taking the advice I give them, and I gave my romance	带着病人的脚步 接受我给他们的忠告
700	novels up for 30 days, right?	小说上30天,对不对?
701	Just to see like, okay, I think this is a problematic behavior, can I give it up?	只是看看,好吧,我想 这是一个问题的行为,我可以放弃吗?
702	How will I feel?	我有什么感觉?
703	And the very first day that I, the very first 24 hours that I did not read any romance novel,	而第一天,我, 头24小时 我没有读任何浪漫小说,
704	any novel at all, I was astounded at my level of anxiety, restlessness, and utter insomnia.	任何小说,我惊奇地 在我的焦虑,不安, 和完全失眠。
705	I had completely unlearned the art of putting myself to sleep without this digital narrative.	我完全没学过没有这种数字叙事 自己睡觉的技巧
706	And that lasted a good 10 to 14 days, completely mapping on with the amount of time it takes	这持续了10到14天, 完全用时间来描绘
707	typically to get out of acute withdrawal, that is to say for those neuroadaptation gremlins	也就是那些神经适应性腺素
708	to hop off the pain side of the balance and for homeostasis to begin to be restored.	跳出平衡的疼痛侧 并开始恢复顺势
709	But by the time I got to weeks three and four, I felt not just better than I had in the first	但到了3周和4周,我感觉不只比第一次好
710	two weeks, but actually better than I had felt in a really long time.	但实际上比我在很长一段时间里感觉的好
711	I enjoyed my kids more, I was more present for them, I enjoyed my husband more.	我更喜欢我的孩子 我更喜欢他们 我更喜欢我丈夫
712	My work seemed salient again.	我的工作又显得很突出
713	I had started to think, oh, maybe I should do something else, you know, maybe, maybe	我开始想,哦, 也许我应该做别的事情, 你知道,也许,也许
714	I, you know, this work, I've been doing it a long time, it's not that interesting anymore.	我,你知道,这个工作, 我做了很长时间, 它不再那么有趣了。
715	All of a sudden it was interesting again, right?	突然又有趣了 对吧?
716	So you see the relativity of that hedonic pathway and how when we're doing that behaviour	所以,你可以看到 相对论的螺旋路径 和如何 当我们这样做
717	or substance that's so reinforcing that everything else loses its salience, we can really misidentify	或物质如此强化 以致一切失去其显著性, 我们可以真正错误地识别
718	what is causing our irritability, anxiety, insomnia until we stop that substance for	是什么导致我们的烦恼,焦虑,失眠 直到我们停止这种物质
719	long enough to see its impact on our lives.	足够看它对我们生活的影响
720	How is it making you feel?	感觉怎么样?
721	Because I think a lot of people can't understand how you could get addicted to a book.	因为我觉得很多人都不明白 你怎么会对一本书上瘾
722	I'm sure some people understand that, but for me, it's not something I've ever become	我敢肯定,有些人明白, 但对我来说,这不是我曾经变成
723	addicted to.	上瘾了
724	So how did it feel?	感觉怎么样?
725	Was it like exciting?	兴奋吗?
726	Is it arousing?	刺激吗?
727	Is it somewhere in between?	在中间吗?
728	I mean, I think that romance novels are essentially socially sanctioned pornography for women.	我的意思是,我认为浪漫小说 本质上是社会认可的 女性色情。
729	And the medium is narrative.	而媒介是叙事.
730	And if you're a person for whom narrative is a powerful drug, as it is for me, a story,	如果你是一个人, 叙事是一个强大的药物, 就像对我来说,一个故事,
731	a narrative, a fiction, very potent since I was a child, then, you know, it was a natural	叙事 虚构 从我小时候起就非常强大
732	that that would be the thing that I would get addicted to.	那样我就会上瘾
733	And basically, just like we've hacked and bioengineered everything to make it more potent,	基本上,就像我们已经黑了 和生物工程 一切使它更强大,
734	I mean, there's a formula for writing romance novels.	写浪漫小说的公式
735	If you take a physical copy, if you go to a store and you pick up a romance novel and	如果你拿一份物理拷贝, 如果你去商店 拿起浪漫小说,
736	you literally physically open it to two thirds of the way through, you will get to the climactic	你从身体上打开它 到三分之二的路程 你会到达高潮
737	scene pun intended, right?	场景是故意的 对吧?
738	It's like it's engineered.	犹如工程.
739	I mean, I got to a point where I wouldn't even read it.	我的意思是,我得到了一个点 我甚至不会读它。
740	Read after.	后读.
741	I wouldn't finish the book.	我不会完成这本书。
742	I would go on to the next book.	我会继续看下一本书。
743	But just to get to the climax part and then you'd move on.	但是,只是进入高潮的部分 然后你会继续前进。
744	Yeah.	对
745	And I wouldn't even read the denouement or like what happens to the characters.	我甚至不会看 登场或喜欢 发生在角色。
746	I didn't care.	我不关心。
747	You didn't care about the future?	你不关心未来?
748	Nope.	没有
749	And also, I got to a point where I didn't care about the quality of the writing or the	而且,我得到了一个点,我不在乎 质量的写作或
750	depth of the character.	字符的深度。
751	It didn't matter.	没关系
752	It was the drug.	这是药物。
753	It was that moment I was looking for.	那是我寻找的时刻。
754	And you know, there are a lot of free books on Amazon, some of which are high quality	亚马逊有很多免费的书 有些是高质量的
755	and some of which are not.	而有些则不然。
756	But like any good drug dealer knows, free samples, that's the way you hook people.	但是,像任何好毒贩都知道,免费的样品, 这就是你勾搭人的方式。
757	I would search for these free samples and that's part of it too, like the searching	我会寻找这些免费的样本 这也是其中的一部分 就像搜索
758	for the drug.	为了药物。
759	So the working, the upfront work you do for the drug is part of the drug, right?	所以工作,前期工作 你为药物做 是药物的一部分,对不对?
760	It's all that, you know, the machinations and the hiding and this and that, that gets	这一切,你知道, 诡计和隐藏,
761	to be part of like all of the rituals surrounding it.	成为所有仪式的一部分
762	As you were talking as well, I thought about work and work addiction.	就像你刚才说的 我考虑过工作和工作上瘾
763	Yes.	对
764	Because you earlier used the term excessive consumption.	因为你之前用过过度消费这个词
765	And when I think about work, even my work, I think Jesus, I excessively consume work.	当我想到工作,甚至我的工作, 我认为耶稣,我过度消耗工作。
766	I start so many bloody businesses and invest in so many things.	我开始很多血腥的企业 并投资这么多的东西。
767	And if you look to that behavior objectively, if you're like an alien looking down at me,	如果你客观地看那个行为 如果你像外星人一样看着我
768	you'd go, this guy's got a fucking problem.	你会去,这家伙有一个他妈的问题。
769	Do you know what I mean?	你知道我的意思吗?
770	Do you think that's funny?	你觉得好笑吗?
771	No.	没有
772	I'm joking.	我开玩笑的
773	You know, I feel for you.	你知道,我觉得你。
774	Do you know, and it's funny because in society we then, those people are reinforced.	你知道吗,这很有趣,因为在社会上,我们那时,那些人得到了强化。
775	We clap.	我们鼓掌。
776	That's right.	没错
777	We clap.	我们鼓掌。
778	We go, this guy's not sleeping.	我们走了,这家伙不睡觉。
779	He's working 18 hours a day.	他每天工作18小时
780	lap,lap也.
781	Give him a trophy, an award.	给他一个奖杯,一个奖项。
782	Name a thing after him or her or, you know, and it's just really interesting that that	以他或她的名字命名,或者,你知道的, 这真的很有趣,
783	addiction of work, and you tell me if it is, it can be an addiction, certainly in the scale	工作上瘾,你告诉我,如果这是, 它可能是一种上瘾,肯定在尺度上
784	of one end being sort of consumption, excessive consumption, and the other hand being addictionist	一端是消费 过度消费 另一端是瘾君子
785	on there somewhere.	在某个地方
786	People can get addicted to work.	人们可以上瘾工作。
787	And part of the reason is that we've drugified work, right?	部分原因是我们给工作下了药 对吧?
788	And when I say drugified, what do I mean?	当我说下药了,我是什么意思?
789	We've made it more potent.	我们使它更强大。
790	And this is true for all these drugs.	这对所有这些药物都是如此。
791	We've made them more potent, more novel, more bountiful, meaning there's more of it and	我们让他们变得更强壮 更新颖 更丰盛 意味着它更多
792	more accessible.	更无障碍.
793	So if we break that down with work, how is work more potent?	所以,如果我们用工作来打破它, 工作如何更强大?
794	Well, certain types of work are more reinforcing, not all types of work.	某些类型的工作更加强化,而不是所有类型的工作.
795	So, for example, works, white collar work is often now associated with stock options	所以,比如说,工作,白领工作 现在往往与股票期权有关
796	and bonuses, right?	和奖金,对不对?
797	There's often like a social media aspect to it or maybe even a fame aspect, or as you	经常有类似社交媒体的一面 甚至是名声的一面 或者你
798	pointed out, those are our cultural heroes, right?	那些是我们的文化英雄,对吧?
799	So you get all this, you know, adulation for being a workaholic.	所以,你得到这一切,你知道, 标榜是一个工作狂。
800	And that also, because we're such social creatures, right, and human connection stimulates	而且,因为我们是这样的 社会生物,正确的, 和人类的连接刺激
801	mean that that also makes work more of a potent drug.	这意味着这也使得工作 更强的药物。
802	A personal brand, right?	个人品牌,对不对?
803	Right.	对
804	You're LinkedIn.	你是连线网
805	Oh my God, this person got a promotion.	哦,我的上帝,这个人得到了晋升。
806	We'll all clap.	我们都鼓掌。
807	We'll all drop the likes, the comments.	我们都放弃喜欢,评论。
808	You're amazing.	你真厉害
809	The adulation.	标语.
810	I just said the awards, the trophies.	我只是说奖项,奖杯。
811	And then you've got the fact of novelty.	然后你有了新奇的发现
812	So once we've exposed our brains enough times to a certain drug, as I said, we develop tolerance,	因此,一旦我们 已经暴露我们的大脑 足够的时间与某种药物, 正如我说,我们发展 容忍,
813	right?	对吧?
814	And then we need more potent forms or novel forms.	然后我们需要更强大的形式 或新的形式。
815	One of the ways we overcome tolerance is by taking our drug and then changing it slightly,	我们克服容忍的方法之一 就是吃药 然后稍微改变一下
816	like adding a little new molecule on this chemical, right?	就像在这种化学物质上添加一个新分子,对吧?
817	Or on the internet, you know, when we're searching videos, we want something similar to what	或者在互联网上,你知道, 当我们在搜索视频, 我们想要类似的东西
818	we liked before, but just a little bit different.	我们以前很喜欢 但有点不同
819	And that's what the algorithm does automatically, right?	这就是算法自动做的 对吧?
820	It offers, oh, you should check this out.	它提供,哦,你应该检查这一点。
821	Oh, how about this?	哦,这个怎么样?
822	Oh, check that out, right?	哦,看看这个,对不对?
823	And that engages our treasure-seeking function.	这涉及到我们的寻宝功能。
824	We're looking for that novel thing, but that's not too novel, right?	我们在找那个新奇的东西,但这不是太新奇,对不对?
825	It has to be in our category of things we like.	它必须是我们喜欢的东西。
826	And I think for work, we have that too.	我想为了工作,我们也有
827	Like, there are so many ways now that people can engage in their work.	喜欢,现在有这么多的方法,人们可以从事他们的工作.
828	And it's not all bad that it's novel, but, you know, certain types of work, it makes	并不是所有不好,这是新颖的, 但是,你知道,某些类型的工作, 它使
829	it very enticing.	它非常诱人。
830	Then you have quantity, right?	那么,你有数量,对不对?
831	I mean, work never ends.	我的意思是,工作永远不会结束。
832	There's like no natural stopping point for work.	工作没有自然的止点
833	You know, you do a line of cocaine, you run out of money, you run out of cocaine, you're	你知道,你做一行可卡因, 你耗尽了钱,你耗尽了可卡因,你
834	done, right?	搞定了 对吧?
835	But that's not true for work everywhere, anytime, and then that gets to accessibility.	但无论何时何地, 工作都不是这样, 然后就可以进入。
836	One of the biggest risk factors for addiction to any drug or behavior is simple access.	对任何药物或行为致瘾的最大风险因素之一是简单获得药物。
837	We know that if you grow up in a neighborhood where drugs are sold on a street corner, you're	我们知道如果你在街角卖毒品的街区里长大
838	more likely to try them, more likely to get addicted.	更可能尝试它们, 更有可能上瘾。
839	If you live in a world where you have access to work 24-7, you're more likely to expose	如果你生活在一个有24 -7工作机会的世界 你更有可能暴露
840	your brain to more work and more likely to get addicted to work.	让你的大脑多工作 更可能上瘾工作。
841	Again, especially if it's got all those other reinforcing qualities.	再说一遍,特别是如果它有其他的强化品质的话。
842	This is probably in part why people quit their jobs.	这也许是人们辞职的原因之一。
843	You mean if they just get overwhelmed or it's partially why people can never quit.	你是指如果他们只是被压抑 或者这是部分原因 人们永远不能放弃。
844	But I think it's important to make a distinction between work that's reinforcing in those ways	但我认为重要的是要区分 以这些方式加强的工作
845	and then work that's completely not reinforcing.	然后工作是完全不加强的。
846	Yeah.	对
847	Alienating, mind-numbing, work in which the actual task is separated from the meaning	异形、心智、实际任务与意义分离的工作
848	of the task.	任务。
849	I mean, they quit their jobs either in search of more dopamine.	我的意思是,他们辞掉工作 要么寻找更多的多巴胺。
850	So if I'm working in a job where, I don't know, maybe it once gave me dopamine and now	所以,如果我在一个工作 在那里,我不知道, 也许它曾经给了我多巴胺 现在
851	it's become monotonous and the same, I need to quit to go find...	它变得单调 同样的,我需要退出去寻找...
852	There's novelty for you.	有新奇之处
853	That's right.	没错
854	Yeah.	对
855	And that's true.	亦复如是.
856	Many people change jobs every two to three years.	许多人每两到三年更换一次工作。
857	I recently read that the average life of a business now is like 15 years, whereas 50	我最近读到一个企业的平均寿命是15年 而50年
858	years ago, it was 50 years.	几年前,这是50年。
859	And there's all this turnover, all this churn chasing novelty.	和所有的这些转折, 所有这个churn追逐新颖。
860	Also, I do want to emphasize that people who are in work that's not intrinsically rewarding	另外,我还想强调,那些在工作的人 本质上没有回报
861	but is the opposite, kind of soul sucking, that's also a risk factor for addiction because	但恰恰相反 吸食灵魂 这也是吸毒成瘾的风险因素
862	people just wait till the end of the day till they can go home and then use a drug to numb	人们只是等到一天结束 直到他们可以回家 然后用药物麻木
863	themselves from the stress of work.	从工作的压力。
864	So it's plausible that people who are in lower pleasure jobs are more likely to be overweight	因此,人们在 低乐趣工作 更有可能超重
865	or addicted or dependent on alcohol.	或吸毒或依赖酒精。
866	Yeah.	对
867	Or simply opt out of the workforce as many young men are doing now in the United States.	或者像美国现在许多年轻人所做的那样,干脆退出劳动力队伍。
868	And what we know from data that's been collected is many of them are playing video games, right?	我们从收集的数据中了解到, 他们中许多人在玩电子游戏,对吧?
869	They've just completely opted out of the workforce.	他们刚刚完全退出了劳动力队伍。
870	I guess this in part explains why there's a drinking culture that's associated with	我想这在一定程度上解释了为什么 酒文化与
871	people who are potentially lower class because they're doing potentially less pleasurable	那些可能低级的人 因为他们做的可能不那么令人高兴
872	work and therefore they, if we think about the scale, they would then end up in the pub	工作,所以他们,如果我们考虑这个尺度, 他们最后会在酒吧里。
873	after work.	工作结束后。
874	You know, maybe that's partially true but even people doing like doctors and lawyers,	你知道,也许这部分是真实的, 但即使人们做 像医生和律师,
875	there are equal rates of alcoholism among those groups.	这些群体的酗酒率相当。
876	I think what's happening there though is that the nature of the work is just so stressful,	我想那里发生的事情是 工作性质太紧张了
877	whether it's white collar or blue collar, that there's this kind of work hard, play	不管是白领还是蓝领 都有这种努力的工作
878	hard, right?	很难吧?
879	Where I'm going to work all day and at the end of the day I'm going to reward myself.	在那里,我整天工作,最后,我会奖励自己.
880	So now you've got a pleasure pain balance that's going pleasure pain, pleasure pain	所以,现在你有一个快乐的疼痛平衡 这将是快乐的疼痛,快乐的疼痛
881	And remember, the biological definition of stress is any deviation from neutrality so	记住 压力的生物定义是 任何偏离中立的
882	that every time our brain has to work to restore a level balance, we're actually triggering	每次我们大脑必须努力恢复水平平衡时 我们都会触发
883	our stress response, triggering our own adrenaline.	引发我们自己的肾上腺素
884	It's stressful to have to restore the balance from those extremes of pleasure and pain.	需要从这些极致的快乐和痛苦中恢复平衡是压力很大.
885	I read in your book you were talking about how different behaviors and sort of chemicals	我在你的书里读到的 你在说不同的行为和化学物质
886	and substances have different impacts.	和物质有不同的影响。
887	I was on page 50 of Dopamination.	我登上了《施政》第50页
888	In a study of mice, sex increases the release of dopamine by 100% and amphetamines, which	在一项对小鼠的研究中,性使多巴胺的释放量增加了100%,安非他明的释放量增加了100%。
889	is like drugs, right, hardcore drugs, increases it by 1000%.	就像药物,对,硬核药物, 增加1000%。
890	By this accounting, one hit of a meth pipe is equal to 10 orgasms.	根据这一说法,一击冰毒管等于10次高潮.
891	Yes.	对
892	It's interesting to think about the different behaviors we have and how they'll have a bigger	考虑一下我们的不同行为 以及它们会如何更大
893	impact on our dopamine.	对多巴胺的影响
894	Is there like any, in a typical order of things that are like extremely dopamine-inducing	是否有类似,在典型的顺序 事物,像极端多巴胺诱导
895	and things that aren't, what's at like the top and bottom of the list in your view?	和那些没有的东西, 什么是像 榜单的上下 在你的观点?
896	You know, I really think that it depends on the person and we've got to look at drug of	你知道,我真的认为 这取决于 人和我们必须看看药物
897	choice, right?	选择,对不对?
898	I mean, potent drugs like methamphetamine, like opioids, like alcohol, like nicotine,	我的意思是,像甲基苯丙胺, 像类阿片, 像酒精, 像尼古丁,
899	like cannabis are going to be very reinforcing for many people, but not for all people.	大麻对许多人来说会很有加强作用 但并不是对所有人来说
900	And most people do have their one drug that they sort of prefer above all others.	大多数人都有一个药物 他们更喜欢其他药物。
901	So although generally speaking, intoxicants release a lot of dopamine in the reward pathway,	因此,尽管一般来说,毒物释放了很多多巴胺 在奖励路径,
902	I think every person is going to be different.	我觉得每个人都会不同
903	And also we don't really have good ways of measuring absolute values of dopamine in human	而且我们没有很好的方法 测量人类多巴胺的绝对值
904	beings, right?	人,对不对?
905	We can do that in rats, but we can't really do that in humans.	我们可以在老鼠身上做到这一点, 但我们不能真正在人类身上做到这一点。
906	It's relative values.	是相对价值.
907	I've got this picture here, which shows what looks like brain scans in a normal person,	我这有张照片 显示正常人的大脑扫描
908	but then in someone who's addicted to different substances.	但是在对不同物质上瘾的人身上
909	I'll put this on the screen and I'll link it below in the description for anyone that	我会把这个放到屏幕上, 并在下面的描述中把它链接到任何人
910	needs it and wants to see it, but it effectively shows the impact that like cocaine has on	需要它,并想看到它, 但是它有效地显示 影响像可卡因
911	the brain, meth, alcohol and heroin.	大脑 冰毒 酒精和海洛因
912	What is going on here?	这是怎么回事?
913	So the red in this image represents dopamine transmission.	所以这个图像中的红色代表多巴胺的传播.
914	So how much dopamine is being released from the presynaptic neuron, crossing that synapse,	多巴胺从突触神经元释放出来 穿过突触
915	binding to receptors on the postsynaptic neuron, how much dopamine is kind of swirling around	绑定在后突触神经元上的受体上 多巴胺在周围旋转
916	in the reward pathway part of the brain.	在奖励路径 部分大脑。
917	And what this image shows is that on the left-hand side in healthy control subjects who do not	而这个图像显示的是 在左侧 健康控制对象 谁不
918	have addiction, there's plenty of red, right?	有上瘾,有很多红色,对不对?
919	So there's plenty of dopamine transmission in the reward pathway, specifically here in	因此,有很多多巴胺传播 在奖励路径, 具体在这里,
920	the nucleus accumbens.	核子杂交剂
921	But if you look at the right-hand column, you'll see that in these individuals who have	但是,如果你看右栏, 你会看到,在这些个人 谁有
922	been using cocaine, methamphetamine, alcohol and heroin in addictive ways, there's almost	可卡因、甲基安非他明、酒精和海洛因 以成瘾的方式使用,几乎
923	no red, which means there's decreased or below normal levels of dopamine transmission.	没有红色,这意味着多巴胺的传播减少或低于正常水平.
924	They are in a chronic dopamine deficit state.	他们处于慢性多巴胺缺乏状态。
925	This is evidence of the brain trying to compensate for too much dopamine being triggered by downregulating	这是大脑试图弥补 过多多巴胺通过降温引发的证据
926	its own dopamine production and transmission, not just to baseline but below baseline.	其多巴胺的生产和传播,不仅达到基线,而且低于基线。
927	And importantly, these individuals who are addicted to these substances, these brain	更重要的是,这些个人 谁上瘾 这些物质,这些大脑
928	scans were done two weeks after they stopped using.	扫描是在停止使用两周后完成的.
929	Oh, wow.	哦,哇呜。
930	Yeah.	对
931	Which tells us that this dopamine deficit state persists for some period of time.	这告诉我们,多巴胺缺乏状态持续了一段时间。
932	How long?	多长时间?
933	Well, it depends on the person, but we know at least from this experiment that the first	嗯,这取决于一个人, 但我们至少从这个实验中知道,第一个
934	two weeks are this persistent dopamine deficit state, which is consistent with acute withdrawal,	两周是这种持续的多巴胺缺乏状态, 这与急性提取一致,
935	right?	对吧?
936	People feel, when they first stop their drug of choice, they feel terrible, right?	人们觉得,当他们第一次停止 选择的药物, 他们感觉可怕,对不对?
937	They experience all of the symptoms of physical withdrawal that correspond with that particular	他们经历所有身体退缩的症状 与特殊
938	drug they were using, usually the opposite of what the drug did, plus the universal symptoms	他们使用的药物,通常与药物的用途相反,加上普遍的症状
939	of withdrawal from any addictive substance or behavior, anxiety, irritability, insomnia,	远离任何上瘾物质或行为、焦虑、刺激、失眠,
940	depression and craving.	抑郁和渴望。
941	Now, if they can get through the first 10 to 14 days, what we see clinically is those	现在,如果他们能度过头10到14天, 临床上我们看到的是那些
942	acute withdrawal symptoms slowly start to get better.	急性戒除症状慢慢开始好转.
943	And we think that that is mapping on to regenerating dopamine transmission in the reward pathway.	我们认为,这是在绘制图 在奖励路径中重新生成多巴胺传播。
944	And if they can make it to a month, that's usually the point for, on average, based on	如果他们能活到一个月 那通常就是根据
945	clinical experience, when people really can start to get out of that constant state of	当人们真正能够摆脱这种
946	craving for their drug of choice and begin to see some light at the end of the tunnel	渴望自己选择的药物,开始在隧道尽头看到一些光芒
947	for what their lives might look like if they can maintain abstinence from their drug.	如果他们能保持禁欲,他们的生活会是什么样子。
948	And we can't just inject or drink dopamine.	我们不能只是注射或喝多巴胺。
949	I mean, I guess that would be like drinking alcohol.	我的意思是,我想这将是 像喝酒。
950	We can't just artificially mess with the balances to try and restore the dopamine levels	我们不能人为地搅乱平衡 试图恢复多巴胺水平
951	in an addict, can we?	在瘾君子,可以吗?
952	We can't just add a little bit of dopamine.	我们不能只加入一点多巴胺
953	Yeah, it's a great question because we have some natural experiments that suggest what	是啊,这是一个伟大的问题,因为我们有一些自然实验 说明什么
954	might happen if we do that.	如果我们这样做,可能会发生。
955	So as I mentioned before, people with Parkinson's have depletion of dopamine in the substantial	正如我之前提到的那样 帕金森氏症患者 体内有多巴胺的消耗
956	nigra.	涅盘.
957	That's what causes that motor disease.	这就是引起运动疾病的原因。
958	The treatment for it is to give L-Dopa, which is a dopamine precursor.	治疗方法是给L-Dopa,这是一种多巴胺前体.
959	If I were to give you a spoonful of dopamine, it would do absolutely nothing because it	如果我给你一勺多巴胺, 它绝对不会做任何事情,因为它
960	doesn't cross into the brain, it doesn't cross the blood-brain barrier.	不交叉进入大脑, 它不会越过血脑屏障。
961	But I could give you L-Dopa, which is a precursor chemical that would cross your blood-brain	但我可以给你L -Dopa, 这是一个前体化学 它会跨越你的血脑
962	barrier and get turned into dopamine and then diffusely bind dopamine receptors in your	屏障,然后变成多巴胺,然后在你的体内 散装多巴胺受体
963	brain in the reward pathway but also in the movement pathways.	大脑在奖励路径 但也在移动路径。
964	When we give patients with Parkinson's, when we give patients with Parkinson's, when we give patients with Parkinson's, when we give patients with Parkinson's, when we give patients with Parkinson's, when we give patients with Parkinson's, when we give pa	当我们给帕金森氏症患者 帕金森氏症患者 帕金森氏症患者 帕金森氏症患者 帕金森氏症患者 帕金森氏症患者 帕金森氏症患者 帕金森氏症患者 帕金森氏症患者 帕金森氏症患者 帕金森氏症患者 帕金森氏症患者 帕金森氏症患者 帕金森氏症患者 帕金森氏症患者
965	dopamine in this form, that can temporarily improve their movements, but in about one	这种多巴胺可以暂时改善它们的运动,但大约一种
966	in four Parkinson's patients, they will develop a de novo addictive disorder, shopping addiction,	在帕金森的4个病人中 他们将出现新的瘾症 购物成瘾
967	sex addiction, other types of addiction, because we have the same problem.	性上瘾,其他类型的上瘾,因为我们有同样的问题。
968	We are stimulating the reward pathway with dopamine that is ingested exogenously from	我们正在刺激多巴胺的奖励途径 从外部摄取
969	the outside.	外边
970	And our brain reads that as, oh boy, got to compensate by down regulating dopamine transmission	我们的大脑读到,作为,哦,男孩, 必须通过降低调节多巴胺传播
971	to below baseline, which then puts us in that addiction vortex.	到基线以下, 然后让我们在上瘾漩涡。
972	Does that make sense?	这有道理吗?
973	It does.	没错
974	So we have to, I mean, it tells me that we have to live lives in a certain sense of,	因此,我们必须,我的意思是, 它告诉我,我们必须生活 在某种意义上,
975	we have to live our lives in a certain sort of homeostasis, and it's so easy not to in	我们不得不生活在 某种优雅的生活, 这是那么容易不进入
976	the world we live in.	我们生活的世界
977	It's like, it's like impossible to live in a perfect homeostasis balance in the world	这就像,它像不可能 生活在一个完美的顺势平衡 在世界上
978	we live in.	我们住在这里。
979	Right.	对
980	Even more than having to try to live within this sort of narrow range of homeostasis.	甚至不只是要尝试生活在这种 狭小的顺势疗法。
981	In the world we live in today, we probably have to intentionally do things that are painful,	在我们今天生活的世界里 我们可能不得不故意做一些痛苦的事
982	do things that are hard.	做一些很难的事
983	Pleasure pain balance.	快乐的疼痛平衡。
984	Like we learned that when we press on the pleasure side of the balance, like with alcohol	就像我们学会了,当我们按 快乐的一方平衡, 像酒精
985	or pornography or romance novels or cannabis or whatever it is, right, no sooner does that	或色情或浪漫小说 或大麻 或它是什么,权利, 不久
986	happen than our brain adapts by those neuroadaptation gremlins hopping on the pain side of the balance	发生于我们的大脑适应 通过那些神经适应 腺素跳跃在平衡的疼痛方面
987	{\fn黑体\fs22\bord1\shad0\3aHBE\4aH00\fscx67\fscy66\2cHFFFFFF\3cH808080}但是他们喜欢平衡点 {\fn黑体\fs22\bord1\shad0\3aHBE\4aH00\fscx67\fscy66\2cHFFFFFF\3cH808080}所以他们不会右转
988	when it's level.	当是平时.
989	They stay on until we're tilted.	他们坚持到我们倾斜。
990	An equal and opposite amount to the side of pain, that's the come down, the hangover,	和痛苦的一面是相等的,相反的, 这就是下来,宿醉,
991	et cetera.	等诸经.
992	But it turns out the opposite is also true.	但事实证明,情况正好相反。
993	If we intentionally press on the pain side of the balance, for example with exercise	如果我们故意压在平衡的疼痛方面,例如锻炼
994	or an ice cold water bath or intermittent fasting, those gremlins will hop on the pleasure	或冰冷的水浴或断断续续的禁食, 那些葛林会跳上乐趣
995	side of the balance and we will get our dopamine indirectly by paying for it upfront.	平衡的一面 我们会通过预付钱 间接获得多巴胺
996	And there are studies in humans showing that when humans expose themselves to exercise,	人类的研究表明 当人类暴露自己去锻炼时
997	for example, dopamine levels gradually rise over the latter half of the exercise.	例如,多巴胺含量在后半期逐渐上升。
998	And then when the exercise stops, dopamine levels will remain elevated for hours afterwards	然后当运动停止时 多巴胺浓度会持续升高数小时
999	before going back down to the baseline level position without ever going into that dopamine	在回到基线水平之前 永远不要进入多巴胺
1000	deficit state.	赤字状态。
1001	So it's a great way to get our dopamine indirectly because it's much less vulnerable to that	所以这是间接获得多巴胺的好方法 因为它更容易被感染
1002	compulsive craving phenomenon of overuse.	强迫性渴望过度使用的现象.
1003	So you're not going to get an exercise come down?	所以,你不会得到 锻炼下来?
1004	You can, and people can get addicted to exercise, right?	你可以,人们可以上瘾 锻炼,对不对?
1005	But typically it's very unusual because the upfront cost to do the work and endure the	但通常这很不寻常 因为做工和忍受
1006	pain of exercise in the first place mitigates our vulnerability to an exercise addiction.	锻炼的痛苦首先减轻了我们对锻炼成瘾的脆弱性。
1007	And in general...	总的来说...
1008	Ah, okay, because it's so hard to do that it's going to be hard.	啊,好吧,因为这样做太难了, 它会很难。
1009	It's not like pulling a lever on a slot machine or clicking on a porn website.	这不像在插槽机上拉杠杆或者点击色情网站.
1010	It's difficult.	难曰.
1011	Yes.	对
1012	Okay.	摆
1013	So fighting for the dopamine insulates us against the chance of an addiction, having	因此为了多巴胺而斗争 使我们免于成瘾
1014	to really fight hard for it.	真正为它而奋斗。
1015	Okay.	摆
1016	And this kind of explains, I guess, in part why I pulled out some stats ahead of our conversation	我想,这种解释 部分地,我为什么要在谈话前 拿出一些数据
1017	today that from 1996 to 2008, participation in ultramarathons has increased by 1,676%.	如今,从1996年到2008年,超马拉松的参赛人数增加了1 676%。
1018	The ice bath market is expected to rise from 350 million in 2024 to nearly half a billion	冰浴市场预计将从2024年的3.5亿增至近5亿
1019	by 2030.	在2030年之前。
1020	The number of people taking part in obstacle course races like Tough Mudder or Hyrox, etc.,	参加障碍赛诸如坚硬泥巴或海罗克斯等比赛的人数,
1021	etc., has increased by almost 7x from 2010 to 2017.	等,2010年至2017年增加了近7倍.
1022	It seems like in society there's this counter movement towards people seeking out hard dopamine,	社会上似乎有一场反运动 向人们寻找硬多巴胺
1023	chasing pain.	追寻痛苦
1024	Yeah, those are amazing.	是啊,这是惊人的。
1025	I didn't know that.	我不知道这一点。
1026	Those are amazing numbers.	这些是惊人的数字。
1027	In general, there's a part of me that wants to say, well, that's a good thing.	总而言之,我有一部分人想说,嗯,这是一件好事.
1028	But there's another part of me that's wary also because we're so good at drugifying	但是,我还有另一部分很谨慎 因为我们很擅长下药
1029	everything that we do that there's a way in which these types of behaviors can also	我们所做的一切 都有这样一种方法 这些行为也可以
1030	be drugified, right, be more potent with all of the technology, the way that we count ourselves,	被下药,正确的, 更强大 与所有的技术, 方式,我们算我们自己,
1031	the leader boards, the social comparisons.	领导委员会,社会比较。
1032	All of that takes this thing which is really in its natural state kind of impervious to	所有这一切需要这个 真正处于自然状态的东西 那种不能够
1033	addiction.	瘾
1034	Like you just typically wouldn't get addicted to these types of painful physical activities.	就像你一般不会对痛苦的身体活动上瘾
1035	You would do what you needed to do for survival.	你会为生存做你该做的
1036	But we've managed to make them addictive in all these different ways.	但是我们设法让他们在所有这些不同的方面上瘾。
1037	I still think it's a better way to get your dopamine.	我仍然认为这是更好的方法 得到你的多巴胺。
1038	Like I really encourage exercise.	我真的很鼓励锻炼
1039	We always talk about movement as medicine.	我们总是说运动是医学。
1040	And in general, our life is so convenient, so easy, so passive, so sedentary that I'm	一般来说,我们的生活是如此的方便,如此的轻松,如此被动,如此的定居,以至于我
1041	telling patients all the time, you know, get up off the couch, move your body, walk around	一直告诉病人,你知道的,起床 沙发,移动你的身体,走来走去
1042	the block.	这个街区。
1043	I think that's the bigger obstacle right now is just getting people to move.	我认为这是最大的障碍 现在只是让人们移动。
1044	But I do think we need to be wary of not going too far in the direction of like the ultra,	但我确实认为我们需要警惕 不要走得太远的方向 像超能力,
1045	ultra, ultra, whatever it is.	超,超,无论它是什么。
1046	So what is a better way to live if we're trying to optimize for happiness and to keep our	所以,如果我们试图优化 幸福和保持我们的
1047	dopamine in balance and not have the crashes, et cetera, and come downs and hangover?	多巴胺在平衡,没有 撞车,等等, 下来和宿醉?
1048	What is a optimal way to live our lives?	什么是我们生活的最佳方式?
1049	Do we have to look back at our caveman ancestors and live like them?	我们一定要回首我们的穴居人祖先,像他们一样生活吗?
1050	I think that part of the problem is that we've organized our lives now around rewards.	我认为问题的一部分 是,我们已经组织 我们的生活现在围绕着奖励。
1051	Almost everything that we do is predicated on the feel good moment we'll have at the	几乎我们所做的一切 都取决于 感觉好的时候,我们会在
1052	end of it.	结束了。
1053	And because of that, we are missing out on the process.	因此,我们忽略了这一进程。
1054	We're projecting our psyche forward into the future toward the reward and not able to really	我们把我们的心灵投射到未来 走向回报 却不能真正
1055	be here in the moment.	马上就到
1056	Okay.	摆
1057	This is going to sound weird.	这听起来很奇怪。
1058	I'm going to give you a weird example.	举个奇怪的例子
1059	So driving over here today, I found I was nervous for this interview and in a way looking	所以今天开车过来 我发现这次采访很紧张 从某种意义上看
1060	forward to it, but in a way wanting it to be over, right?	但还是希望它能结束 对吧?
1061	And in seeing that in myself, I thought, that's so sad.	我亲眼看到这一点,我想,那太可悲了。
1062	That's so sad that we live our lives that way, myself included, always this weird blend	这太悲哀了,我们的生活是这样的, 包括我自己,总是这种奇怪的混合
1063	of wanting whatever we're doing to be over so that in a way we can just go hide and do	想要我们所做的一切结束 这样我们就可以躲起来做
1064	whatever that self-stim thing is that we do where we're safe and we're like stimulating	不管那些自以为是的东西是,我们做 我们安全的地方,我们就像刺激
1065	ourselves in some way.	以某种方式,我们自己。
1066	And then I thought, well, what if I knew that I was going to die right after this?	然后我想,嗯,如果我知道 我会死在这之后?
1067	This is making me – I'm going to come off really weird now.	这让我感到非常奇怪
1068	But what if I knew that I was actually going to die right after our conversation today?	但是,如果我知道 我其实会死 在我们今天的对话之后?
1069	That totally changes my perspective, doesn't it?	这完全改变了我的观点,不是吗?
1070	Because this time you and I have – that's all I got.	因为这次你和我只有这么多
1071	It's over for me when this – so this conversation is it.	这时候我结束了 所以这次谈话就结束了
1072	I really better be right here right now and really taking joy in whatever you and I can	我最好现在就在这里 真正享受你我所能的快乐
1073	find together.	一起寻找
1074	And I think the more we can do that, the better.	我认为,我们越能做到这一点,就越好。
1075	What's happening now?	发生什么事了?
1076	You're removing the thought of the outcome, the reward, the potential failure or whatever,	你删除了对结果,奖励, 潜在失败或什么的思考,
1077	and you're focusing on just being present.	而你正专注于 只是在场。
1078	And in doing so, what is happening?	在这样做时,发生了什么?
1079	It's a great question and I've actually given this quite a lot of thought because	这是一个很好的问题,我实际上 给这个很多思考 因为
1080	I remember when I was in college and I met some like Zen people and they were like, be	我记得我大学的时候 我遇见了一些像禅宗的人 他们喜欢,是
1081	here now, be here now.	在这里,现在,在这里。
1082	And I thought, whenever I'm here now, I'm miserable.	我想,每当我现在在这里, 我痛苦。
1083	Like, I don't like me and I don't like being in the world.	喜欢,我不喜欢我 不喜欢在世界上。
1084	I don't want to be here now.	我现在不想在这里
1085	I want to be somewhere else.	我想去别的地方
1086	So I didn't really understand what they were getting at.	所以,我并不知道 他们得到了什么。
1087	It really took me, you know, till I had lived quite a lot of life and had some, you know,	这真的花了我,你知道, 直到我生活了 相当多的生活,并有一些,你知道,
1088	some significant experiences and given it some thought that I realized, oh, be here	一些重要的经验 和一些想法 我意识到,哦,在这里
1089	now means be here now and be uncomfortable and be okay with being uncomfortable and being	现在意味着现在在这里, 和不舒服, 并接受不舒服和作为
1090	okay with not being able to control my pleasure or my pain or my comfort level, but just being	无法控制我的快乐 疼痛 或舒适程度
1091	open to whatever comes.	随时随地
1092	And I think that's a really a key shift that I'm not trying to control my experience in	我觉得这真的是个关键转变 我并不想控制我的经验
1093	{\fn黑体\fs22\bord1\shad0\3aHBE\4aH00\fscx67\fscy66\2cHFFFFFF\3cH808080}这时候 {\fn黑体\fs22\bord1\shad0\3aHBE\4aH00\fscx67\fscy66\2cHFFFFFF\3cH808080}不高兴或不安 或不舒服
1094	to run away from that, but just really turn and face it and embrace the discomfort, which	逃离,但只是真正的转身 面对它,并拥抱不适,
1095	I also think is quite universal.	我也认为相当普遍。
1096	I don't think I'm alone in that.	我不认为我独自在那个。
1097	And then the key piece about not anticipating the reward helps me be in the moment, right?	然后关于不预期奖励的关键作品 帮助我在此刻,对不对?
1098	Because I'm not just waiting for the good thing to come after.	因为我不只是在等待好的事情发生
1099	I'm saying to myself, imagine there's nothing good coming after, nothing at all, right?	我对自己说,想象一下没有好结果,什么都没有,对吧?
1100	There aren't rewards.	没有奖励
1101	This is it.	就是这样
1102	And then also being able to say, and it's okay if in the moment, like, it's not great.	也可以说,如果在那一刻,它不是很好。
1103	Like, I can embrace that.	喜欢,我可以接受。
1104	You know, I can be unhappy or restless or anxious or whatever it is.	你知道,我可以不高兴 或不安 或焦虑 或它是什么。
1105	And then when I do that, you know, I feel like there's a funny, funny thing that happens	然后当我这样做,你知道, 我觉得有一个有趣的事情发生
1106	and all of a sudden I'm not as anxious, right?	突然间,我又没那么紧张,对吧?
1107	And I am present and there is some joy there.	我在场,那里有一些快乐。
1108	Interesting.	有意思,这很有趣
1109	So when you allow yourself to deal with being uncomfortable in the moment, it turns out,	所以,当你允许自己 面对不舒服的时刻, 它发现,
1110	it removes the thing that was making you uncomfortable in the moment, which is like the avoidance	它移除了让你感到不舒服的东西 在那一刻,这就像回避
1111	or the worry or overthinking or whatever else.	或担心或过度思考 或别的什么。
1112	I think we have this, and it's fed by modern culture, this kind of expectancy that really	我认为我们有这个, 它的饲料 现代文化, 这种期望,真的
1113	we should be happy all the time.	我们应该一直快乐
1114	And that if, you know, if we've arranged things appropriately for our lives and we've done	而且,如果,你知道,如果我们已经 妥善安排了我们的生活,我们已经做了
1115	our work and, you know, aimed true, then we should just be like, life is great.	我们的工作,你知道,目标真实, 那么我们应该只是喜欢, 生活是伟大的。
1116	And I don't believe that anymore.	我不再相信这一点。
1117	I think that, you know, I mean, like Buddha said, life is suffering, but I really think	我想,你知道,我的意思是, 像佛祖说, 生活是痛苦, 但我真的认为
1118	that fundamentally, like, it's uncomfortable to be alive.	根本上来说 活着很不舒服
1119	And that it's a kind of a constant state of restlessness and discomfort.	且说此是常住烦恼烦恼烦恼.
1120	If we're being really honest and tuning in, when I really let myself see that and feel	如果我们真的诚实和调整, 当我真的让自己看到,感觉
1121	that, all of a sudden, I'm freed from some of that.	突然间,我摆脱了这些
1122	What has caused your anxiety throughout your life in the moment?	是什么让你这一辈子的焦虑?
1123	You referenced earlier that some things have happened that have led you to understand this	你刚才提到一些事情 让你明白这一点
1124	better and understand yourself better.	更清楚,更了解你自己。
1125	What am I missing from this jigsaw puzzle?	这个拼图中我漏了什么?
1126	Yeah, you're good.	是啊,你还不错。
1127	You could have been a psychiatrist.	你本可以当心理医生的
1128	Oh, really?	是吗?
1129	Yeah.	对
1130	It's always time.	总是时.
1131	This doesn't work out.	这行不通。
1132	We're still time, right?	我们还是时间,对不对?
1133	It's not too late.	亦不迟.
1134	You've got a new profession.	你有一个新的职业。
1135	Yay.	赞
1136	I think, you know, for me, the big turning point was that we lost our...	我认为,对我来说,最大的转折点是 我们失去了我们的...
1137	We lost a child.	我们失去了一个孩子。
1138	And in the immediate aftermath of our child's death, I was just determined to, like, sort	在孩子死后不久,我决定... ...
1139	of undo the experience and, you know, get enough psychotherapy and enough whatever,	和,你知道, 获得足够的心理治疗 和足够的任何东西,
1140	whatever it took to sort of not feel that pain.	不管它花了多少 那种感觉的痛苦。
1141	And it wasn't until I really just said, oh, like, I'm going to feel this pain for the	直到我说, 哦,像,我会感到这种痛苦
1142	rest of my life.	一辈子
1143	It's never going away.	永不退转.
1144	But suddenly, I felt some relief from that pain.	但突然间,我感觉从这种痛苦中得到了一些解脱.
1145	And that was a real window for me.	那是我真正的窗户
1146	So interesting that it's acceptance.	有趣的是,这是接受。
1147	Yeah.	对
1148	And, you know, and I think, you know, one of the reasons I love treating patients with	而且,你知道,我想,你知道, 一个原因我喜欢治疗患者
1149	addiction is because I really relate to that hitting bottom moment.	上瘾是因为我和那个打底时刻有关
1150	You know, that moment when it's like, you just have the feeling that, like, everything	你知道,当它像, 你只是有感觉,喜欢的一切
1151	I try to do to manage this behavior or to make my life better only makes it worse.	我试图管理这个行为 或使我的生活更好 只是使它更糟。
1152	I felt like I had a very similar experience.	我觉得我也有类似经历
1153	And that it was only when I kind of realized, oh, yeah, I can't run from this.	只有当我意识到 我不能逃避这一切时
1154	I can't outrun this pain.	我逃不过这种痛苦
1155	That I began to have some, the beginnings of relief from that experience.	我开始有一些, 从那段经历的开始。
1156	I can't outrun this pain.	我逃不过这种痛苦
1157	It's all natural sort of disposition to try and outrun pain, isn't it?	尝试和克服痛苦都是自然的,不是吗?
1158	That's the irony, right?	这就是讽刺,对不对?
1159	We're really wired to outrun the pain.	我们真的有线能摆脱痛苦
1160	We are.	我们是。
1161	Like, we reflexively seek out pleasure and avoid pain.	喜欢,我们反射 寻找快乐和避免痛苦。
1162	And yet that's the very thing that doesn't get us to where we want to go.	而这正是我们无法到达我们想去的地方。
1163	But we do now live in a world where it's very easy to outrun the pain.	但我们现在确实生活在一个非常容易摆脱痛苦的世界。
1164	Yes.	对
1165	This is not a lion that's chasing me.	这不是追我的狮子。
1166	This could be a bad email.	这可能是一个坏邮件。
1167	And then I open up a tab and start doom scrolling or open up a tab and start watching video	然后我打开一个标签 开始末日滚动 或者打开一个标签 开始观看视频
1168	playing video games or pornography or whatever.	玩电子游戏或色情之类的
1169	Yeah, that's exactly right.	对,没错
1170	There are so many ways that we can now distract ourselves from, you know, our own suffering	有很多方法,我们现在可以 分散我们自己对痛苦的注意力
1171	or our own awareness.	或我们自己的意识。
1172	And where do you find yourself now with dealing with that grief and the pain as we sit here?	面对我们坐在这里的悲伤和痛苦,你现在在哪里?
1173	Yeah, I mean, I feel like in many ways it's been a real gift in my life.	是的,我的意思是,我觉得 在许多方面,它一直是 一个真正的礼物在我的生活。
1174	You know, it's really informed my life in ways that, I mean, I've learned things from	你知道,它真的为我的生活提供了信息的方式, 我的意思是,我已经学到了一些东西
1175	that experience that I think it would have been almost impossible for me to learn otherwise.	那种经历,我认为我几乎不可能 学到其他。
1176	You deal with a lot of people that are in a state of suffering.	你和很多处于困境的人打交道
1177	I imagine that's a weight, because I, even hearing the story of the lady that passed	我想那很重,因为我,甚至听到一个女人的故事
1178	away after that water addiction, it was like a weight on my shoulders just to hear it.	水瘾过后,我肩膀上就好像有重物
1179	So if your profession puts you right at the heart of this type of suffering, how do you	所以如果你的职业将你 置于这种痛苦的核心,你如何
1180	manage that, to hold that weight?	管理它, 保持重量?
1181	A couple of things.	数事.
1182	First of all, a lot of people get better.	首先,很多人会好起来.
1183	And when people with addiction get better, it's so much better that it's incredibly	当瘾君子好起来时 就会好到难以置信
1184	rewarding to see.	值得一见
1185	And they're amazing people, like the most tenacious, talented people you'll ever meet.	他们是惊人的人, 像最顽强,有才华的人 你会遇到。
1186	And when they get better, it impacts so many other people, right?	当他们好起来,它会影响 这么多其他人,对不对?
1187	Their friends, their family, the people they work with.	他们的朋友,他们的家庭, 他们工作的人。
1188	So it's very rewarding work and not at all burdensome.	因此,这是非常有报酬的工作,而不是任何负担。
1189	Of course, for patients who don't get better or patients who die, it's a terrible feeling.	当然,对于没有好转的病人或者死亡的病人来说,这是一种可怕的感觉.
1190	And there is a sense of responsibility and guilt.	有一种责任感和内疚感。
1191	Even when I feel like there was nothing that I could have done otherwise, I carry those	即使我感觉自己什么也做不了 否则,我带着那些
1192	losses with me, so it's hard.	与我损失,所以很难。
1193	Is there any particular cases that have stayed with you the most?	有没有什么特别的情况 一直留在你身边最多?
1194	I mean, every patient I've had who's died while under my care, those are incredibly	我的意思是,每一个我曾经有过的病人 谁死了 在我照顾下,那些令人难以置信
1195	painful and I will never, you know, those are sort of, those people will be with me	痛苦,我永远不会,你知道, 那些是那种,那些人会和我一起
1196	as a part of me for all of my life.	作为我一生的一部分
1197	Young and old?	年轻又老?
1198	Yeah, young and old.	是啊,年轻又老。
1199	Yeah, it's especially tragic to lose young people.	是啊,这特别悲惨 失去了年轻人。
1200	And it always feels like they're second guessing, like, oh, if only I had done that or if only	总是觉得他们只是第二个猜测, 比如,哦,如果只有我这样做,或者只有
1201	we had intervened here.	我们在这里干预。
1202	But I just think that's the nature of death.	但我认为这就是死亡的本质
1203	We can't get away from the feelings of guilt around it, no matter who we are and no matter	无论我们是谁 也无论我们是谁
1204	the circumstances.	情况
1205	How young can addiction and the consequences of addiction ruin someone's life?	成瘾和成瘾的后果如何会毁了别人的生活?
1206	Like, how young can someone be when their life is ruined from the work you've done	比如说,当生活被你的工作毁了时, 一个人能有多年轻?
1207	and the patients you've worked with?	你和病人一起工作吗?
1208	And what are those addictions typically that seem to be most susceptible to those that	那些瘾君子最容易染上
1209	are young?	年轻吗?
1210	Well, I mean, you know, some kids start with drugs and alcohol, you know, in 5, 6, 7, 8.	嗯,我的意思是,你知道,一些孩子 从毒品和酒精开始, 你知道,在5,6,7,8。
1211	Really, 5, 6, 7, 8?	真的,5,6,7,8吗?
1212	Oh, yeah.	对
1213	I mean, it's, you know, some kids use with their parents or their caregivers, they're	我的意思是,这是,你知道, 一些孩子用 他们的父母或他们的照顾者,他们是
1214	exposed very early.	曝光时间很早
1215	If we seriously conceptualize digital media as a drug, I mean, then we've got, you know,	如果我们真的把数字媒体 视为一种药物,我的意思是, 然后,你知道,
1216	even younger cohorts starting with that and we do know that kids can get addicted to digital	更年轻的群体从这个开始,我们确实知道 孩子们可以上瘾 数字
1217	media and as a result, die from that.	媒体也因此死亡。
1218	I mean, there was just this tragic case of a young man who essentially got addicted to	我的意思是,只是有一个悲惨的案件 一个年轻人基本上 上瘾
1219	a chat box.	一个聊天盒。
1220	I think he was 14, not my patient.	我觉得他14岁 不是我的病人
1221	It was written up in the New York Times, in the Wall Street Journal, and he fell in love	写在《纽约时报》和《华尔街日报》 他坠入爱河
1222	with this chat box, started to isolate, wasn't spending time with his family or friends,	用这个聊天箱,开始孤立, 不是花时间与他的家人或朋友,
1223	and then eventually took his own life purportedly so he could join this imaginary person.	最终他自杀了 声称他可以加入这个想象中的人。
1224	What's the youngest patient you've ever seen?	你见过的最年轻的病人是什么?
1225	The youngest I've seen is probably around 15, 14, 15.	我见过的最小的大概是15,14,15岁左右
1226	And they had an addiction?	他们有瘾?
1227	Yeah, usually cannabis, alcohol, nicotine.	对 通常是大麻 酒精 尼古丁
1228	Can you get addicted to cannabis?	你能吸大麻吗?
1229	Oh, yeah.	对
1230	Oh my gosh.	天呐
1231	Cannabis is very addictive.	大麻非常容易上瘾。
1232	Really?	真的吗?
1233	Oh, yeah.	对
1234	Harmful?	有害?
1235	Very harmful.	非常有害
1236	The target organ that it damages the most is the brain.	伤害最大的目标器官是大脑。
1237	It's harmful in many ways.	在许多方面都是有害的.
1238	I mean, number one, it demotivates people often.	我的意思是,第一,它常常使人们失去动力。
1239	And so they can have the feeling that they're getting stuff done or that they're creative	这样他们就能感觉到 他们正在做一些事情 或者他们具有创造力
1240	when in fact they're not doing anything.	事实上他们什么都没做
1241	Most people smoke it, and so it can be damaging to the lungs and other organs.	多数人吸烟,因此可能对肺部和其他器官造成损害.
1242	A lot of people say that, well, cannabis isn't addictive because I don't have this standard	很多人说大麻不会上瘾 因为我没有这个标准
1243	withdrawal phenomenon when I stop, like I don't have the shakes or anything like that.	当我停下来时,像没有摇晃什么的
1244	But keep in mind, the universal symptoms of addiction are psychological symptoms, anxiety,	但记住 吸毒成瘾的普遍症状是心理症状 焦虑
1245	irritability, depression, insomnia, craving.	烦躁,抑郁,失眠,渴望.
1246	And people have that in spades when they try to stop using cannabis.	当人们试图停止使用大麻时,黑桃里就有这个。
1247	Plus, we often see something called the hyperemesis syndrome.	此外,我们经常看到一种叫做超症候群的症状。
1248	So cannabis can help with nausea and vomiting.	因此大麻可以帮助恶心和呕吐.
1249	It can help decrease the feeling of wanting to vomit.	它可以帮助减少呕吐的感觉.
1250	But again, as the brain continues to be exposed to it, there's this process of neuroadaptation.	但同样,随着大脑不断暴露在它的体内,有这种神经适应的过程.
1251	It stops working, and it can even turn on them and do the opposite.	它停止工作,甚至可以打开它们,做相反的事情.
1252	So eventually people can actually have a cyclical vomiting syndrome as a result of cannabis.	因此最终人们实际上可以因大麻而出现周期性呕吐综合征.
1253	So they'll show up in the emergency room and say, I can't stop vomiting.	所以他们会出现在急诊室 说,我不能停止呕吐。
1254	And the reason is because of the cannabis that they maybe initially started to stop	原因是大麻,他们可能 开始停止
1255	feelings of nausea.	恶心的感觉。
1256	On page 40 of Dopamine Nation, you say we've lost the ability to tolerate even minor forms	在"多巴明民族"第40页上,你说我们已经丧失了 容忍哪怕是轻微形式的能力
1257	of discomfort.	令人不适。
1258	And as I was reading through this section of your book, I was thinking, it sounds like	当我读到你书的这一节时 我在想,听起来像
1259	we've gone a little bit soft in society.	我们社会上有点软
1260	We've reset our pleasure pain threshold to the side of pain that even the slightest	我们把快乐的痛度 重设到痛苦的一面
1261	thing feels like trauma to us.	对我们来说是创伤
1262	Even things that, objectively speaking, a generation or two ago would not have been	即使是客观上说 一代两代之前就不会发生的事
1263	considered traumatic are now trauma.	被认为是创伤 现在的创伤。
1264	We live in a bit of a trauma society, one that doesn't appear to be very resilient.	我们生活在一个有点创伤的社会, 一个似乎不太有弹性的社会。
1265	And the only measure of that that I have is if I think about the work that my grandfather	我唯一能衡量这一点的是 如果我想到我祖父的工作
1266	{\fn黑体\fs22\bord1\shad0\3aHBE\4aH00\fscx67\fscy66\2cHFFFFFF\3cH808080}我这代人做的工作 和抱怨
1267	seem to be objectively suffering over and stressed about, it seems like there's been	似乎在客观上受苦受难,而且压力很大,
1268	a shift in our threshold, our tolerance levels.	我们的门槛和容忍程度都发生了变化。
1269	Can this be explained through dopamine?	这能否通过多巴胺来解释?
1270	What's going on here?	这是怎么回事?
1271	And do you believe that's true?	你相信这是真的吗?
1272	Have we gone a bit soft?	我们是不是有点软?
1273	I would say succinctly, yes, I do believe we have gone a bit soft.	我要简洁地说,是的,我相信我们已经有点软弱。
1274	But I don't think it's a moral problem or a character problem.	但我不认为这是道德问题或性格问题.
1275	I actually think it's a physiological problem based on the fact that we're insulated from	事实上,我认为这是一个生理问题 基于我们被隔绝
1276	pain and we're exposed to all kinds of pleasures.	痛苦和我们接触 各种乐趣。
1277	So I really think that we have individually and collectively reset our reward pathways	所以,我真的认为,我们已经单独和集体 重设我们的奖励路径
1278	to the side of pain, meaning that the gremlins have now accumulated on the pain side.	痛苦的一面, 意思是, 腺素已经积累 在痛苦的一面。
1279	We've tipped ourselves to the side of pain.	我们告诉自己痛苦的一面。
1280	Because we've had so much pleasure.	因为我们有这么多的乐趣。
1281	Yes, thanks for having me clarify.	是的,谢谢你让我澄清。
1282	So that now we need more and more pleasure to feel any pleasure at all.	因此,我们现在需要越来越多的快乐来感受任何快乐。
1283	And the slightest little pain and we're experiencing excruciating pain.	而一点点的疼痛,我们正经历着痛苦。
1284	You add to that the fact that we have a culture that tells us we should never be in pain and	你补充了一个事实,我们有一个文化告诉我们 我们不应该痛苦和
1285	that if we are, something's wrong with our life or something's wrong with our wife or	如果我们是的话 我们的生活有问题 或者我们的妻子有问题
1286	something's wrong with our job.	我们的工作有问题
1287	And so now you've got a whole generation of folks who feels like they're experiencing	所以现在你有整整一代人 他们觉得他们正在经历
1288	more pain because they literally do not have the mental calluses to tolerate pain.	更多的痛苦,因为他们实际上没有 精神的呼噜器来容忍痛苦。
1289	And now they're being told, and if you have any pain at all, you must have something wrong	现在有人告诉他们 如果你有任何痛苦 你一定有问题
1290	with your brain.	用你的大脑。
1291	Go see a doctor.	去看医生吧
1292	Go take a pill.	去吃药吧
1293	And I think this is really, this is not a direction we want to keep going in.	我认为这是真的, 这不是我们想要继续前进的方向。
1294	We have a mental health culture where we assume most things are a mental health illness.	我们有一个精神卫生文化 我们假设大多数事情是精神疾病。
1295	In page 186 of your book, you say, I've become convinced that the way we tell our personal	在你的书第186页里,你说, 我开始相信,我们告诉自己的方式
1296	stories is a marker and predictor of mental health.	故事是精神健康的标志和预测。
1297	Now, if you live in a society where everything has a label and it's a disease or an illness	现在,如果你生活在一个有标签的社会中, 它是一个疾病或疾病
1298	or, you know, I don't feel good today, so I've got this disorder and therefore I need	或者,你知道,我今天不舒服, 所以我有这种障碍,所以我需要
1299	this medication, I guess there's two questions.	我想这药有两个问题
1300	Is my assessment of the situation correct?	我对情况的评估是否正确?
1301	And B, is this a bad place to be in a society where we think everything, every feeling we	B,这是一个不好的地方 在一个社会,我们想的一切, 我们的感受
1302	have, every, you know, we think everything that makes us different is a deficiency?	每一个,你知道, 我们认为,一切 使我们不同的是缺陷?
1303	Let me start, let me answer this by talking a little bit about the role of language and	让我开始,让我回答这个问题, 略谈一下语言的作用,
1304	narrative, because I think this is very fascinating.	叙事,因为我觉得这很有趣
1305	And you know, as a psychiatrist and a therapist, that is my bread and butter, right, is narrative,	你知道,作为一个心理医生 和一位治疗师, 这是我的面包和黄油,对,是叙事,
1306	how people tell their stories.	人们如何讲述他们的故事。
1307	By giving language to our experience, we gain awareness of our conceptual models of the	通过将语言赋予我们的经验,我们了解了我们的概念模式。
1308	world, okay?	世界,好吗?
1309	And what I have learned over time is that the way people tell their stories is a window	随着时间的推移,我学到的是 人们讲述自己故事的方式是一个窗口
1310	into their model of the world and that there are healthy narratives and not so healthy	他们的模范世界, 和有健康的叙述 而不是如此健康
1311	narratives.	叙事。
1312	And in general, in my clinical experience, when people come into the room and they tell	一般来说,在我的临床经验中, 当人们进入房间,他们告诉
1313	their life story in such a way that they're always the victim of other people and circumstance	他们的生活故事 的方式,他们总是 受害者其他人和情况
1314	in the world, those are people who are, number one, not doing well, and number two, not going	在世界上,这些人是第一, 不做好, 第二,不走
1315	to do well going forward unless they change that narrative to acknowledge what they've	除非他们改变叙述方式 承认他们所做的一切
1316	contributed to the problem.	造成这个问题。
1317	And the reason for that is because the way that we narrate our lives is not just a way	原因就在于我们讲述生活的方式 不仅仅是一种
1318	to understand our past, it actually is our roadmap for the future.	为了理解我们的过去,它实际上是我们未来的路线图。
1319	So if I see myself as a victim and that's my narrative, I will literally create victimhood	所以,如果我将自己视为受害者,这是我的叙述, 我将真正地创造受害者
1320	for myself going forward.	为了我前进
1321	I will literally change my sensed experience so that whatever happens, I'll make sure I	我会改变我的感觉 这样不管发生什么 我都会确保
1322	end up as a victim.	最终成为受害者。
1323	When people with severe addiction get into recovery, one of the most palpable changes	当有严重成瘾的人进入康复状态时 最明显的变化之一
1324	that I see is the way that they narrate their lives.	我所看到的就是他们讲述生活的方式。
1325	They go from in addiction talking about their lives as if it's always everybody else's fault	他们从瘾君子开始谈论自己的生活 好像总是别人的错一样
1326	to in recovery talking about their lives in a way that says, oh, you know what?	在康复中 谈论他们的生活的方式 说,哦,你知道吗?
1327	I could have done better here, or you know what, that's something that I keep doing that	我本可以在这里做得更好, 或者,你知道什么, 那是我一直做的
1328	really messes with my life that I want to change and I'm going to figure out how to	真正惹恼我的生活 我想改变, 我会想出如何
1329	change that.	改变这一点。
1330	Why is it so hard to take responsibility in such a way?	为什么如此难以承担责任?
1331	Great question.	问得好
1332	We just hate to do it.	我们只是讨厌这样做。
1333	Because when we do it, we feel shame, and shame is an incredibly painful emotion.	因为当我们这样做的时候,我们感到羞愧,羞愧是一种令人难以置信的痛苦的情感.
1334	It's like a gut punch of an emotion that is associated with fear of abandonment, fear	这就像一个直觉的拳头 一种情绪 与恐惧的恐惧,恐惧
1335	of being shunned by our tribe.	被我们的部落避开。
1336	We'd much rather paper that shame over with anger and resentment toward others.	我们宁愿用愤怒和对别人的怨恨来证明这种耻辱
1337	It's interesting because there'll be different groups of people listening to this now.	很有趣 因为现在会有不同的人群在听这个
1338	There'll be the high responsibility group that just love and revel in taking responsibility	将有一个高度的责任团体 爱和欢乐地承担责任
1339	because they think taking responsibility means that they are strong.	因为他们认为承担责任意味着他们很坚强。
1340	It means that I'm so strong, I can take the blame and withstand it.	谓我坚固坚固,能负罪责而忍.
1341	And it's funny because the more I've learned to take responsibility for things in certain	这很有趣,因为我学会了越多 承担某些事情的责任
1342	areas of my life, the more I've become proud of myself and the more I think I'm strong	我对自己越感到骄傲 我就越觉得自己很坚强
1343	and I'm like, oh, look at me.	我就像,哦,看着我。
1344	I can take responsibility for anything.	我可以为任何事负责
1345	And then if you go down this spectrum, you'll eventually get to the end of the spectrum	如果你走下这个光谱, 你最终会到达光谱的尽头
1346	where you've got people who, even as they heard you say that, will feel cognitive dissonant.	在那里,你有的人, 即使他们听到你这么说, 将感觉认知不协调。
1347	They'll feel a sense of like a little, it'll irritate them, it'll piss them off and they	他们会觉得有点像,会激怒他们,会激怒他们
1348	will be the what about tree gang.	将是树帮。
1349	They'll be saying, yes, but what about Dave?	他们会说,是的,但戴夫呢?
1350	He did this to me and they'll immediate reaction would be they're pissed off.	他这样对我 他们会立刻反应的 他们很生气
1351	They've probably gone now.	他们可能已经走了
1352	They've gone.	他们走了。
1353	So we're not even talking to them anymore.	所以,我们甚至不再和他们说话了。
1354	But it's fine.	但无碍.
1355	We can talk about them.	我们可以谈谈他们。
1356	They're no longer here.	他们已经不在了
1357	But that group of people, my question really is, how do you speak to that group of people	但是,那群人,我的问题其实是, 你怎么跟那群人说话?
1358	and convince them that actually taking personal responsibility is a good thing for them?	并且说服他们 真正承担个人责任 对他们是好事?
1359	And if they're focused on what their core values or their north star is in their life,	如果他们专注于 他们的核心价值 或他们的北星 在他们的生命,
1360	then personal responsibility is the path there, not blame, not victimhood.	那么个人的责任就是道路,而不是责备,而不是伤害。
1361	You know, like how do you turn those people around?	你知道,就像你如何扭转那些人?
1362	Great question.	问得好
1363	And I have to say, what I know about this, I learned from Alcoholics Anonymous and what	我不得不说,我知道的, 我从酒类匿名者那里学到了什么
1364	they do because they do something that's really incredible.	他们这样做是因为 他们做了一些非常不可思议的事。
1365	First of all, it's necessary to validate somebody's victimhood.	首先,必须验证某人的牺牲品
1366	So this is to say you have been wrong, if they really have been wronged, to validate	所以,这是说你错了, 如果他们真的被冤枉了,
1367	that or you experience this trauma or you were born into this crappy situation and you	要么你经历这种创伤 要么你生来就陷入这种糟糕的处境
1368	were just a kid and you had no choice about that and to really acknowledge that.	只是个孩子 你别无选择 不得不承认这一点
1369	But then the fourth step of the 12 Steps of Alcoholics Anonymous talks about looking at	但随后的第四步 在12步的酒类 无名氏谈论看
1370	each of those situations and after writing down like this person wronged me and exactly	写完这些事之后 都像这个人一样 伤害了我
1371	what they did, so you know, taking time to focus on the resentment, right, then only	他们做了什么,所以你知道, 花时间专注于 不满,正确的,然后只有
1372	after that to say, okay, but is there anything that I did that contributed to that problem?	之后说,好吧,但有什么 我做了什么 促成这个问题?
1373	Is there anything at all that I could have done differently?	有什么我可以改变的吗?
1374	And for a little kid, you know, born into a horrific situation, there's not much, right,	对于一个小孩,你知道, 出生在一个可怕的情况, 没有太多,对不对,
1375	that a kid could have, you know, we don't expect a child to take responsibility, but	小孩本可以的,你知道, 我们不期望一个孩子 承担责任,但
1376	the adult who was that child, who continues to perpetuate some of the harms they experienced	继续遭受某些伤害的成年人
1377	on other people, now we're talking.	其他人,现在我们正在谈论。
1378	Now you can begin to take responsibility for your actions in the world.	现在你可以开始为自己在世界中的行动负责了.
1379	So I think starting with validating, you know, the trauma or the victimhood or the way in	所以,我想从确认开始,你知道, 创伤或受害者,或道路进入
1380	which we were wronged, processing it, so giving it air time, right, but not stopping there,	我们曾受亏枉,曾受亏枉,曾受亏枉,曾受亏枉,曾受亏枉,曾受亏枉,曾受亏枉,曾受亏枉,曾受亏枉。
1381	which is by the way often, you know, in therapy, certain types of therapy, that's often where	顺便说一句,在治疗中, 某些类型的治疗, 经常是在那里
1382	we stop.	我们停下来。
1383	We don't then take it that very important next step and say, but you know, let's go	我们不采取那非常重要的下一步 说,但你知道,我们走吧
1384	and look at that again and like, is there anything at all that you're contributing	再看一遍,就像, 你的贡献是什么
1385	to this problem?	这个问题?
1386	Maybe it's just that you continue to ruminate about it, right, that like you're ruminating	也许只是你继续纠缠,对吗,你好像在纠缠
1387	on your resentments is in a way your happy place.	你的怨恨在某种程度上是你的快乐之地
1388	And maybe that's what you need to stop doing.	也许这就是你需要停止做的事情。
1389	So that form of sort of psychotherapy that stops there can help keep us sick and make	所以这种精神疗法 停止在那里 可以帮助我们生病
1390	us sick.	我们病了。
1391	It's interesting because someone that's in that therapy room, who has ruminated themselves	有趣的是,在治疗室里的人, 曾经自暴自弃
1392	all the way down to having a low self-esteem, being depressed or whatever, it appears to	一直到有 低自尊, 沮丧或什么的, 它似乎
1393	me that people who are at that sort of ground floor state find it hardest to take responsibility	那种底层的人 很难承担责任
1394	for some reason.	出于某种原因
1395	And just that's an observation in my life that the people that I have met that are the	我生命中的观察就是 我遇到的人就是
1396	worst or that struggle the most with taking responsibility are those that have a very	最坏的或最难承担责任的是那些
1397	low self-esteem.	低自负.
1398	So it's almost this double-edged like catch-22.	所以它几乎像22号渔获物一样被双刃形。
1399	And then I've also pondered whether, you know, someone that never takes responsibility is	然后我也考虑过,你知道, 一个从未承担责任的人是
1400	more likely to have bad things happen to them, make mistakes, which are then going to further	更可能发生坏事 犯错误,然后会进一步
1401	hurt their self-esteem, which are going to make it even harder to take responsibility.	伤害了他们的自尊 这会让承担责任变得更加困难
1402	So I guess the question is, is there a relationship between my current self-esteem and my ability	所以我想问题是 我目前的自尊与能力之间
1403	or inability to take responsibility for a situation?	或者无法对某一情况承担责任?
1404	Yeah, great question.	问得好
1405	It brings to mind a patient of mine who said to me that, you know, that he had very, very	这让我想起我的一个病人 他对我说,你知道,他有非常,非常
1406	low self-esteem.	低自负.
1407	And he said, essentially, Dr. Lemke, I'm the piece of crap around which the universe	他说,基本上,莱姆克博士,我是宇宙的垃圾
1408	revolves, meaning that he had his own brand of narcissism in which he wasn't the most	转动,意思是他有他自己的自恋品牌 在他不是最
1409	successful person.	成功的人。 成功的人吗?
1410	He was the most successful at being the least successful person.	他是最成功的 最不成功的一个人。
1411	And that became his identity, right?	这成了他的身份,对吧?
1412	That was sort of how he saw himself and also how he saw the world.	这是他如何看待自己 和他如何看待世界。
1413	And it became very entrenched.	它变得根深蒂固。
1414	And it was a kind of a narcissism because he created then situations in order to perpetuate	这是一种自恋 因为他创造了当时的情况 以延续
1415	like I'm the worst of the worst.	就像我是最差劲的
1416	So I think the ways in which we get these sort of entrenched ideas about ourselves and	所以,我想我们是如何 获得这种根深蒂固的想法 关于我们自己和
1417	the world can really hold us back from seeing clearly who we are, who other people are,	世界真的可以阻止我们 清楚地看到我们是谁, 其他人是谁,
1418	and what the possibilities are.	还有可能是什么
1419	Does our personal narrative need to be positive?	我们个人的叙述需要积极吗?
1420	I guess, well, what do you mean by positive?	我猜,你是什么意思 积极?
1421	Like, rah-rah, I'm great.	喜欢,啦,啦,我很好。
1422	Almost like have a positive ending because I was thinking about the personal narrative	几乎像有一个积极的结局 因为我在想 个人的叙述
1423	I've created in my life.	我一生创造.
1424	And my personal narrative is like kid born in Africa, came to the UK, little bit of	我个人的叙述就像在非洲出生的孩子,来到英国,一点点
1425	racial abuse here and there, felt different, shame, insecurity, parents weren't around,	这里和那里有种族虐待, 感觉不同,羞耻,不安全, 父母不在身边,
1426	this made me independent, shame made me motivated.	这让我独立,羞耻 让我有动力。
1427	And then I did this, this, this, and it went well.	然后,我做了这个,这个,这个,它运行得很好。
1428	That's like my personal narrative.	这就像我的个人叙述。
1429	But if my personal narrative was moved to Plymouth from Botswana in Africa, a little	但是如果我的私人叙事 被移到来自非洲博茨瓦纳的普利茅斯
1430	bit of shame, a little bit of pain, parents weren't around, my parents didn't love me,	有点羞愧,有些痛苦, 父母不在身边, 我的父母不爱我,
1431	people don't love me.	人们不爱我。
1432	Right, right.	对,对。
1433	If my personal narrative ended there, would it be detrimental to me ever becoming successful,	如果我的私人叙事到此结束 会不会对我的成功不利
1434	happy, healthy?	快乐,健康?
1435	I'm just wondering, because we all have a personal narrative, we have a story, if we're	我只是在想,因为我们都有 个人叙述,我们有一个故事,如果我们
1436	up on stage and someone passes a mic to us and says, tell us your story, we'll narrate	在舞台上 有人给我们递了个麦克风 然后说 告诉我们你的故事
1437	this version of events skewed towards victimhood, to heroism, to, you know.	这版本的事件 扭曲到受害者, 英雄主义,你知道的。
1438	Yeah, I mean, as I said before, how we narrate our lives is important, right?	是啊,我的意思是,正如我之前说过的, 我们如何描述我们的生活是重要的,对不对?
1439	It's not trivial.	这不是小事
1440	And there are healthier narratives and there are not healthy narratives.	还有更健康的叙事,没有健康的叙事.
1441	And I would argue that the victim narrative, where it perpetuates victimhood, you could	我会说,受害者的陈述, 它使受害者身份永久存在, 你可以
1442	make the same argument that the hero's journey narrative perpetuates herohood.	提出同样的论点 英雄的旅程叙述 使英雄身份永久化。
1443	Having said that, if we get too stuck in any fixed identity or any narrative, I think that	说到这个,如果我们被任何固定身份 或任何叙事都卡住了,我认为
1444	can become its own trap, right, and then we wall ourselves off, feeling like we have to	可以成为它自己的陷阱,对, 然后我们自己围起来, 感觉我们必须
1445	show up in a certain way or be a certain person.	以某种方式出现或成为某个人.
1446	And I wonder if you have that experience, like, you know, you have this hero's journey	我想知道你是否有那种经历, 比如,你知道,你有这个英雄的旅程
1447	and now you've got to be this hero, and I mean, I can imagine that that would be burdensome	现在,你必须成为这个英雄, 我的意思是,我可以想象,这将是负担
1448	at times.	有时
1449	Yeah, I think it causes a lot of like dissonance internally.	是的,我觉得这会引起很多像 内部不和。
1450	What I mean, like, so when I say dissonance, I mean discomfort internally, because people	我的意思是,喜欢,所以当我说不和, 我的意思是不适 内部,因为人们
1451	meet a version of you that doesn't reflect the version of you that you know.	满足一个不反映你认识的版本。
1452	So like the experience you have when you go, like I go to the gym or something, and I say	就像你去健身房什么的一样 我说
1453	this to my team all the time, anyone that knows me personally has heard me say this	所有认识我的人 都听到我这么说
1454	I will say the phrase, I just don't understand what these people are talking about.	我要说这句话 我只是不明白这些人在说什么
1455	Like, I just don't get it.	喜欢,我只是不明白它。
1456	And I said to my team the other day in the office, I went, it's almost like I think they're	我那天在办公室对我的团队说,我去了, 几乎就像我认为他们是
1457	lying to me.	骗我
1458	And I said I was in this meeting group.	我说我在这个会议组里
1459	When you say you don't understand, you mean when they when they praise you?	你说你不明白,你是说当他们称赞你的时候?
1460	Yeah, because it's so unbelievable what they're saying to me that it feels like you're, I've	是啊,因为这是如此不可思议 他们告诉我,它的感觉 像你是,我
1461	not even watched the Truman show, I just know what it means, but it feels like these people	连杜鲁门的节目都没看 我只知道这意味着什么 但感觉这些人
1462	are just all lying to you.	都是骗你的
1463	And I think I was talking to Jack and the team the other day about going to Thailand	我想那天我和杰克和球队谈过 去泰国的事
1464	and being so far away from home, and people coming up to you, like thousands of people	离家那么远的人 上你身边的人 就像成千上万的人
1465	{\fn黑体\fs22\bord1\shad0\3aHBE\4aH00\fscx67\fscy66\2cHFFFFFF\3cH808080}然后告诉你这些事情 {\fn黑体\fs22\bord1\shad0\3aHBE\4aH00\fscx67\fscy66\2cHFFFFFF\3cH808080}你应该知道
1466	And I said to the team, I think it's part of my brain that's like, these people are	我对球队说,我认为这是我大脑的一部分, 就像,这些人
1467	lying to me.	骗我
1468	And also, yeah, you can see how it can be a slippery slope to slide in to that narrative	还有,是的,你可以看到 滑向那段叙事的滑坡
1469	of you.	你们的
1470	And you've got to do quite a lot to just like, stay at home.	而且你必须做很多事情 喜欢,留在家里。
1471	What I mean by stay at home, I don't mean like physical location.	我的意思是呆在家里, 我不是说像物理位置。
1472	I mean, like staying grounded in like who you actually are.	我的意思是,像保持禁足 像你实际上是谁。
1473	And this goes for people that obviously, you know, have a public platform or don't.	这对于那些显然有公共平台或没有公共平台的人来说。
1474	It's very easy for one person on the internet to say something to you, and then to start	一个人在网络上对你说些话很轻松 然后开始
1475	to accept that as your narrative.	接受这作为你的叙述。
1476	It's easy for your parents to tell you that you should be a doctor, and then you go to	你父母告诉你你应该做医生 很容易,然后你去
1477	university and you study to be a doctor, and you become a doctor, and then you start thinking	大学,你学习成为一名医生, 你成为一名医生, 然后你开始思考
1478	you're a doctor, and how that can sway you away from the full array of things that make	你是一个医生, 和如何摇动你 远离所有的事情 使
1479	you who you are.	你是谁。
1480	The music, you know, whatever hobbies you had.	音乐,你知道的, 无论你的爱好。
1481	Narratives are comfortable sometimes.	叙述有时很舒适.
1482	They make us feel heard and understood.	他们让我们感觉听到和理解。
1483	They make us fit.	他们让我们适合。
1484	Yeah.	对
1485	But they also are a double-edged sword because they can take us away from like who we actually	但他们也是双刃剑 因为他们能把我们从我们身边夺走
1486	are.	对
1487	Yes.	对
1488	Yeah, so when I think about, you know, your experience of feeling like people must be	是啊,所以当我想到,你知道, 你的经验 感觉像人必须是
1489	lying to you.	骗你
1490	I mean, sometimes we call this something like the imposter syndrome, where you feel like	我的意思是,有时我们称之为 类似冒牌货综合症, 你感觉在那里
1491	that.	那个
1492	I never thought of it like that.	我从没想过会这样
1493	But that's exactly what it is.	但这正是它是什么。
1494	Yeah, a projected personal persona that is true in a way but also doesn't capture the	是啊,一个被预测的人物a 在某种程度上是真实的,但也没有抓住
1495	fullness of who you are or maybe is so extreme in terms of looking good that it's inevitable	完全的你是谁 或也许如此极端 在看起来好,这是不可避免的
1496	that you'll feel some dissonance with that kind of heroic figure.	你会觉得与那种英雄人物有些不和谐
1497	And I think the way to think about that and also, you know, not become like cynically	我认为,思考的方式 以及,你知道, 不是变得像玩世不恭
1498	suspicious of people who praise you when they meet you is just to recognize that you	怀疑别人在遇见你时会赞美你 只是为了认出你
1499	have become a kind of cipher or a vehicle for their projections.	成为他们预测的密码或载体
1500	So they've listened to you.	所以他们听了你的话
1501	They've had a very positive experience or maybe they learned something and it meant	他们有过非常积极的经验 或者他们学到了一些东西 这意味着
1502	a lot in their lives and you are the vehicle for that.	他们生活中很多事,而你就是这的载体。
1503	And so you're a symbol for them and they're projecting positive feelings onto you because	所以你是他们的象征 他们对你表示积极的感情 因为
1504	you're now integrated in their mental tapestry as kind of a totemic figure or a token, something	你现在被融入他们的心理挂毯 作为一种图腾人物或象征
1505	important and symbolic.	重要和象征性的。
1506	It's so interesting because as you were talking, I was thinking, do you know what's interesting?	这太有趣了 因为当你在说话,我在想, 你知道什么是有趣的吗?
1507	I'm not even the smart one in this.	我甚至不是这个聪明的人。
1508	I'm interviewing these smart people and the smart people are changing their lives.	我正在采访这些聪明人,聪明人正在改变他们的生活.
1509	And that's what comes up to me in Thailand and says...	那就是我在泰国时要说的...
1510	You're wrong about that.	你错了
1511	So you're obviously really smart and you also have a really high emotion quotient, right,	显然你非常聪明 而且你也有很高的情绪商数
1512	which is its own kind of underappreciated smarts where you read people really well and	这是一种它自己 低估的智能 在那里你读人 真的很好,
1513	you have intuitive reasoning.	你有直觉的推理
1514	And I mean, I don't know you, but you also seem very humble and real.	我的意思是,我不认识你, 但你看起来也非常谦卑和真实。
1515	And so all of these things that people have a craving for, you know, authenticity, someone	所以所有这些事情 人们有一个渴望, 你知道,真实的,某人
1516	they can relate to, someone familiar, I mean, keep in mind too that more and more people	他们可以联系到一个熟悉的人, 我的意思是,也记住,越来越多的人
1517	live alone and have maybe fewer close contacts.	独自生活,或更少的亲密接触。
1518	So a person like you with a regular show that they tune into regularly, you become, you're	所以像你这样的人 有正常的节目, 他们经常调和, 你变成,你是
1519	in their living room.	在他们的客厅。
1520	Yeah, you're not just some distant celebrity, like you are, your voice is there, your face	是啊,你不只是一些遥远的名人,像你一样, 你的声音在那里,你的脸
1521	is there.	在那边
1522	They feel they know you because they've seen you in all these different situations.	他们觉得他们认识你 因为他们见过你 在所有这些不同的情况。
1523	And I think that's really natural and normal and not a bad thing.	我认为这是很自然和正常的,不是坏事。
1524	So you just have to realize when you go out into the world, you know, you become a symbol	所以你必须意识到 当你走进世界, 你知道,你成为一个象征
1525	for people.	为人们。
1526	They're projecting onto you.	他们在投射你
1527	You don't have to necessarily identify with that, but it's okay to let them have their	你不必认同这一点,但让他们拥有他们的
1528	experience through you, if that makes any sense.	通过你的经验,如果这有什么意义。
1529	It makes a lot of sense.	其义甚广.
1530	Yeah, it makes a lot of sense.	是啊,这很有道理。
1531	I felt the same imposter syndrome as you said everything now.	我现在感觉和你说的一样
1532	It's like that's very kind of you to say, but it's just very, I think part of the dissonance	你这么说真好,不过我觉得有点不和
1533	comes from the fact that I sit here in a room with you and there's only the person	我坐在你的房间里 只有一个人
1534	in this whole room.	整个房间。
1535	We're in this big studio here in Los Angeles is Jack.	我们在洛杉矶的大工作室是杰克
1536	And so there's part of your brain, the like prehistoric brain that thinks the three people	所以有一部分你的大脑, 像史前的大脑,认为三个人
1537	that are aware of what happened in this room are me, you and Jack, that's it.	我,你和杰克,就是这样。
1538	And then you go to Kuwait and a kid comes up to you in the gym and goes, that conversation	然后你去科威特 一个孩子在健身房里找你 然后去,那段对话
1539	that you had about addiction.	说你有上瘾。
1540	And that's the dissonance.	且道是烦恼.
1541	Like you weren't there.	就像你不在一样
1542	But it's, I don't know, the prehistoric brain might not be able to fully comprehend the	但是,我不知道,史前大脑可能无法完全理解
1543	idea of cameras and numbers, you know, people are listening at the moment.	摄像头和数字,你知道, 人们正在听。
1544	Oh, no, they feel that they're there.	哦,不,他们觉得他们在那里。
1545	And they, and again, you know, the guests are totally secondary because they're watching	他们,而且,再次,你知道, 宾客完全二级 因为他们在看
1546	because they're identifying with you.	因为他们正在认同你
1547	And the questions that you ask, as you yourself said, are questions that you anticipate they	你问的问题,就像你自己说过的, 是你预料到的问题
1548	would want to ask.	会想问。
1549	Right?	对吧?
1550	You said that.	你说的
1551	So you are also channeling them.	这么说你也在引导他们
1552	When it comes to food, I trust my gut and I trust Zoe, a business I'm an investor in	关于食物,我信任我的直觉,我信任佐伊,我是一个投资者
1553	and today's sponsor of this podcast.	和今天赞助这个播客。
1554	All the nutritionists I've spoken to have highlighted just how misleading information	所有营养学家我都强调过 如何误导信息
1555	is out there when it comes to food.	当它涉及到食物的时候,
1556	Take healthy halos.	带上健康的光环
1557	The claims you see on packaging that say things like low sugar and nothing artificial are	在包装上你看到的 说的东西 像低糖和任何人工
1558	often a sign of foods to avoid.	经常是食物的标志
1559	Have you ever noticed a health claim on fresh fruit?	你注意到新鲜水果的健康要求吗?
1560	You probably get my point.	你也许明白我的意思了
1561	Understandably, there's loads of distrust out there.	可以理解,那里有很多不信任。
1562	Who should you turn to for accurate information?	你该找谁提供准确的信息?
1563	I use Zoe, which is backed by one of the world's largest microbiome databases and most scientifically	我使用Zoe,它由世界最大的微生物数据库之一 和最科学的
1564	advanced at-home gut health tests.	高级家庭肠道健康测试。
1565	Zoe gives you proven science whenever you need it.	佐伊随时给你科学证明
1566	As a Zoe member, you'll get an at-home test kit and personalized nutrition program to	作为Zoe的一员,你会得到一个家庭测试包和个性化营养方案
1567	help you make smarter food choices that support your gut.	帮助你做出更聪明的食物选择 支持你的直觉。
1568	To sign up, visit zoe.com and use my code STEPHEN10 for 10% off your membership.	报名,访问zoe.com 并使用我的代码STEPHEN10 对于10%的会员。
1569	这是Zoe.com代码STEPHEN10.
1570	Trust your gut.	相信你的直觉。
1571	信任佐伊 信任佐伊 Trust Zoe.
1572	On this point of how we help someone in our lives who's suffering with some of the things	在这一点上,我们如何帮助 在我们的生活中的人 谁的痛苦一些东西
1573	we've talked about today, what is a bad way to try and help someone?	今天我们谈过了 试图帮助别人有什么不好的?
1574	Because in our love for them, sometimes we do things, which even in my own experience	因为我们爱他们,有时我们做一些事情, 即使在我自己的经验
1575	of people that are struggling in my life, I think actually, I think in my pursuit of	那些在我生命中挣扎的人, 我认为,实际上,我想在我的追求
1576	helping them, I've actually hurt them in some way.	我确实在某种程度上伤害了他们
1577	Well, you know, there's this whole sort of area of the addiction field called codependency.	嗯,你知道,有 整个毒瘾领域 叫做编码。
1578	And codependency refers to the ways in which a loved one of the addicted person can actually	代码依赖性是指一个被爱的人 瘾君子实际上能够
1579	enable or make their addiction worse without realizing it and without intending to.	让他们上瘾或让他们更上瘾 却又不觉悟 也无意这样做
1580	And the way that essentially happens is that we can – well, number one, addiction is	基本上是这样的,我们可以 - 好吧,第一,瘾君子是
1581	very often a family systems problem.	经常是家庭系统的问题。
1582	So the person who gets addicted, their addiction affects everybody in the family.	所以那个上瘾的人 他们的上瘾影响了家里的每一个人
1583	And in order to cope and compensate, families can end up in these very strange, maladaptive	为了应付和补偿 家庭可能会陷入这些奇特的,不适应的境地
1584	places.	地点
1585	But they often have difficulty seeing how to get out of those situations or how their	但是,他们往往难以了解如何摆脱这些局面,或如何摆脱困境。
1586	behavior is harming their addicted loved one because in a sense, they themselves get addicted	因为从某种意义上说,他们自己也上瘾了
1587	to the addicted person and then use that addicted person to regulate the way that they feel.	给瘾君子 然后用瘾君子来调节他们的感觉
1588	So for example, I treat a lot of families where like the adult child is deep in their	比如说,我对待很多像成年小孩一样的家庭
1589	addiction.	瘾
1590	The parents know that the money they're giving the child is mostly going to drugs	父母知道他们给孩子的钱 大多是去吸毒
1591	and yet cannot bring themselves to stop giving the money.	却不能放弃给钱
1592	And often they're manipulated by the child, the child saying – well, the adult child	他们经常被孩子操纵,孩子说,嗯,成年的孩子
1593	saying something like, well, if you don't give me money for drugs, I'm going to go	说些类似的话 如果你不给我钱买毒品 我就走
1594	get it off the streets and it's going to be laced with fentanyl and then I'm going	把它从街上弄走 然后它会和芬塔尼一起被绑起来 然后我就走
1595	to die and it's going to be on your hands.	死,它会 到你的手中。
1596	So this kind of like emotional hostage taking.	所以,这种类型的情绪 人质劫持。
1597	But even when it's not that blatant, what can happen is just this very fascinating,	但即使不是那么明目张胆 会发生什么 只是非常迷人,
1598	very twisted and meshed relationship between the addicted person and the codependent person	瘾君子和共同依赖者之间的关系非常扭曲
1599	where again, having the person engage in their addiction in a way is a predictable scenario	如果某人再次以某种方式吸毒成瘾是可以预测的
1600	for the codependent person.	为共同依赖者。
1601	So even though they may say on the face of it, they want this person to stop their addiction,	所以,即使他们可能说 在它的表面, 他们希望这个人停止他们的瘾,
1602	on another level, they really don't.	在另一个层面,他们真的没有。
1603	They get to be the martyr.	他们成为烈士
1604	They get to be the savior.	他们就是救世主
1605	Or they even just get to predict what that person is doing based on their use.	或者他们甚至只能根据他们的用途来预测他在做什么。
1606	I've had experiences in my life and this is why I really wanted to ask this question	我这辈子有经验 所以我才想问这个问题
1607	where I thought I was helping someone and then the minute I withdrew the help and basically	在那里,我以为我在帮助某人, 然后那一刻,我撤回了帮助,基本上
1608	completely gave up, the person got better.	完全放弃了,这个人得到了更好的。
1609	But for six, seven, eight years, this person struggled and the minute I stopped helping,	但六、七、八年来, 这个人挣扎着 我停止帮助,
1610	they got better.	他们变得更好。
1611	So I said to my partner before when I was talking about this, I was like, it's possible	所以我之前跟我的搭档说 当我在谈论这个的时候 我好像,这有可能
1612	to prop someone up in their compulsive behavior and not realize you're doing it.	支持某人的强迫行为 而不意识到你这样做。
1613	In fact, there's three examples which me and my friends are aware of and one of my friends	事实上,有三个例子 我和我的朋友都知道,还有我的朋友
1614	talks openly about this where I was propping him up.	公开地谈论这个,我正准备让他起来。
1615	I was letting him stay at my house.	我让他住在我家
1616	I was providing for him while he was in his struggles.	在他挣扎的时候,我一直在照顾他
1617	The minute I had a difficult conversation with him when he was, I think I was 25 years	我和他谈话的那一刻 我觉得我25岁了
1618	old and he was 30, and I said, you've got to go, you've got to go.	他30岁,我说, 你必须去,你必须去。
1619	You've got to get out of my house.	汝须离我家.
1620	He went back, moved in with his parents in his childhood room.	他回去了,和父母一起搬进他童年的房间.
1621	He built up his whole life again.	又积聚一生.
1622	He's out of the compulsive behaviors.	他脱离了强迫行为.
1623	He's very successful, very rich, living abroad now.	他非常成功,非常富有,现在生活在国外.
1624	I was like, God, if I hadn't have pushed him out my basement, he probably would still	我当时想,上帝,如果我没有把他推出我的地下室,他可能还会
1625	be there.	在那边
1626	I thought I was doing him a favor.	我以为我在帮他忙
1627	And there's another really pertinent example to me quite recently where someone who I've	最近我有个非常相关的例子 有个我见过的人
1628	known for many, many, many years, the minute I said to them, listen, and this sounds really	很多年,很多年,我对他们说的那一刻, 听着,这听起来真的
1629	harsh, right, because I tried paying for their therapy, tried paying for everything for this	严酷,对,因为我试图支付 他们的治疗, 尝试支付这一切
1630	person.	个人。
1631	And eventually I got to the point where I said, honestly, I tried, don't talk to me	最终我说,说实话,我试过,不要和我说话
1632	about this anymore.	关于这个了。
1633	Yeah.	对
1634	I'm done.	我受够了
1635	Just don't message me about it.	别告诉我这件事
1636	Don't talk to me about it anymore.	别跟我提这事了
1637	They got better.	他们好多了。
1638	So Kai Erickson wrote this book on deviance where he studied Puritan societies and found	所以Kai Erickson写了一本关于异端的书 在那里他研究了清教徒社会
1639	that no matter what group of humans you looked at, there were always going to be people who	不管你们看哪组人 总会有人
1640	were on the margins of the society.	处于社会边缘。
1641	He used the word deviance.	他用"离奇"这个词
1642	His point being that groups of humans, we just have these roles and we have these hierarchies	他的意思是,人类群体, 我们只是有这些角色, 我们有这些等级
1643	and there's always somebody on top and always somebody below.	总是有人在上面 总是有人在下面
1644	And when we're occupying a certain niche or when we stop occupying it, we make room	当我们占据了某个位置 或者当我们停止占据它,我们创造空间
1645	for somebody else.	为别人。
1646	So when you stop being the hero and the savior, that person had room to stop being the sick	所以当你不再做英雄和救世主时 那个人有空间不再做病人
1647	victim.	被害者们
1648	Interesting.	有意思,这很有趣
1649	And my last question on this then is how do you approach that conversation with that person?	我最后的问题就是 你怎么去和那个人谈话?
1650	Because so often it's approached through frustration or shame or blame.	因为它经常通过挫折感或羞耻感或指责来接近它.
1651	What's the best way to approach someone who's struggling with a behavior to express	与行为纠缠的人接触的最佳方式是什么
1652	that you're concerned and to, I don't know, offer your help if that's a good thing?	你关心,而且,我不知道, 提供你的帮助 如果这是一个好事?
1653	I think we can always try to find our empathy for them without necessarily doing things	我想我们总能找到同情他们的人 不必做任何事
1654	that would perpetuate or enable that behavior.	这会延续或促成这种行为。
1655	And we need to recognize that for many people with severe addiction, the only thing that	我们需要认识到,对于许多有严重成瘾的人来说, 唯一的事情是
1656	will get them into recovery is real life consequences, real life negative consequences.	让他们恢复是真实生活的后果 真实生活的负面后果
1657	And that our trying to protect them from that is not protecting them at all.	而我们试图保护他们,这根本不是保护他们。
1658	We've got to let them hit the rock bottom.	我们必须让他们撞到岩底
1659	I mean this is a hard one because you have a lot of families now dealing with children	我的意思是,这是很难的 因为你有很多家庭 现在处理儿童
1660	who are severely addicted to opioids for whom, you know, being out on the streets might	他们严重上瘾的类阿片, 你知道, 对于他们,
1661	really result in their death.	真正导致他们的死亡。
1662	So this is not for every situation.	所以这不是每个情况都这样。
1663	But I can tell you in my clinical experience after 25 plus years, the majority of people	但我可以告诉你25年后的临床经验 大多数人
1664	with severe addiction who get into recovery get into recovery as the result of a real	严重成瘾的人,如果进入康复 就会进入康复的状态
1665	life negative consequences, lost their job, lost their partner, ended up in jail, whatever	生活不良的后果,失去工作,失去伴侣,最终关进监狱,不管怎样
1666	it was, until there are those significant consequences, for some people they just won't	在有这些重大后果之前 对有些人来说 他们不会
1667	be able to have the motivation to make a change.	能够有改变的动机。
1668	It goes back to a quote I had a long time ago, some 10 years ago that said, change happens	回到我很久以前的一段话, 大约10年前说, 变化会发生
1669	when the pain of staying the same becomes greater than the pain of making a change.	当保持不变的痛苦 变得比改变痛苦更大时
1670	There you go.	给你。
1671	That's a good one.	这是一个很好的。
1672	I want to talk about digital drugs.	我想谈谈数字药物
1673	One of the subjects that's been a recurring theme on this podcast, inspired initially,	其中一个主题 是一个反复出现的主题 在这个播客,
1674	I think it was mentioned in an episode we had, but then it was such a huge amount of	我认为它被提到 在一集我们有, 但后来如此巨大的数量
1675	the feedback we got in the comments section that I thought we need to talk about this	我们得到的反馈 在评论部分 我认为我们需要谈论这一点
1676	more because clearly there's a lot of people suffering.	更因为显然有很多人受苦.
1677	We also then used a tool which looks at what people are Googling and searching a lot.	然后我们用一个工具 来观察人们在寻找什么
1678	And one of the most popular searches around the subject matter of addiction is pornography	和最流行的搜索 围绕瘾的主题 是色情
1679	addiction.	瘾
1680	It's actually it was number one and four in the search tool that we used.	实际上它是我们使用的搜索工具中的第一名和第四名.
1681	And the phrases people are using are how to stop pornography addiction, how to help someone	人们使用的短语是 如何阻止色情成瘾,如何帮助某人
1682	with pornography addiction, how to rewire my brain, which is sort of all sort of correlated	与色情成瘾, 如何重新连接我的大脑, 这有点 关联
1683	themes.	主题。
1684	So pornography addiction, something you see a lot.	所以色情成瘾,你看到的很多。
1685	Oh my gosh.	天呐
1686	I have to create a little bit of a space actually before I ask this question because I did a	在问这个问题之前 我必须创造出一点空间 因为我做了
1687	porn debate on the show and I got a very long voice note from a good friend of mine who	电视剧的色情辩论 我收到一个很长的语音留言
1688	said just watch the porn debate.	说只要看色情片辩论。
1689	There was two of them in there and a guy and me, Stephen, but I just wish someone had mentioned	里面有两个人 一个男人和我 Stephen 但我希望有人提到
1690	that women get addicted to porn too.	女人也会染上色情片
1691	And then on the episode, one of the top three comments on the episode is I'm a woman.	之后在剧集中,该集前三名的评论之一为"我是女人".
1692	It wasn't mentioned, but I also have a pornography addiction.	也没提到,但我也有色情瘾
1693	And you've also kind of echoed that with the erotic novels that you mentioned, romantic	你还提到的色情小说 也有点浪漫
1694	novels.	小说。
1695	So pornography addiction.	所以色情成瘾。
1696	Yeah.	对
1697	Do you see that often?	你经常看到吗?
1698	And I guess critically, how does one go about overcoming that?	关键是,如何克服这些?
1699	And how do you know it's a pornography addiction?	你怎么知道是色情瘾?
1700	I guess it goes back to the point of harm.	我想这又回到了伤害的地步
1701	Yes.	对
1702	Yeah.	对
1703	So I do think that pornography addiction is one of the biggest addictions and the most	所以我认为色情成瘾是最大的成瘾之一 也是最大的成瘾
1704	silent and the most shameful addictions that we have now in the modern world.	沉默和最可耻的成瘾 是我们现在在现代世界。
1705	We will not infrequently have a patient come in to the clinic who claims to have other	我们不会不经常有病人来诊所 声称有其他病人
1706	problems and it's not until visit three or four that they finally fess up, I'm really	问题要等到三四个人来的时候,他们才开始
1707	here for a pornography addiction.	这儿有色情瘾
1708	There's so much shame around it.	周身多惭愧.
1709	It's so incredibly shameful for people to admit that they are spending their time looking	人们承认他们花时间寻找 实在太可耻了
1710	at these images often associated with compulsive masturbation.	这些图像往往与强迫自慰有关。
1711	Some people, their addiction manifests by actually pursuing partners.	有些人,他们的成瘾表现在 真正追求伴侣。
1712	So dating apps are highly addictive and in meetups.	所以约会的应用 是非常上瘾和相遇。
1713	All of this is related to sex and orgasm, which releases dopamine in the reward pathway,	所有这一切都与性与高潮有关 在奖励路径释放多巴胺,
1714	but it's not just the moment of orgasm.	但不只是高潮的时刻
1715	It's all of the rituals and the buildup and the searching that's related to it.	所有仪式及积聚及寻觅,皆与此有关.
1716	Women can get addicted to pornography as well as men, although I would say that men outnumber	女人和男人都可能会染上色情制品的瘾 不过我想说的是 男人的人数比男人多
1717	women probably, you know, in my clinical experience, I don't know, 10 to 1.	女人可能,你知道,在我的临床经验, 我不知道,10到1。
1718	Women however are much more vulnerable to love addiction, which is also real, right?	但是,妇女更容易上瘾, 这也是真实的,对不对?
1719	The pathological compulsive falling in love with partners and then getting into these	病理强迫 爱上伴侣 然后进入这些
1720	relationships that are really dramatic and not healthy and then falling out of love and	关系是真正戏剧性 和不健康 然后从爱和
1721	then pursuing another love partner.	然后追寻另一个情侣
1722	So these addictions are real.	所以这些瘾是真实的。
1723	They are very harmful for people who get addicted.	对瘾君子非常有害
1724	Ultimately, they're not even about sex, they're about human attachment and the desire for	归根结底,他们甚至不 与性, 他们是人类的依恋和欲望
1725	human attachment and also just as a way to self-soothe and escape our own everyday suffering.	人类的依恋 也是自我安慰 逃避日常痛苦的方法
1726	And I'm particularly concerned about girls and boys who now have access to all kinds	我特别关心现在能接触各种类型的女孩和男孩
1727	of sexual images that would not have been possible for them to get access to a generation	无法接触一代人的性图像
1728	or two ago and now, you know, a child of five with an iPad can accidentally end up on a	或两前,现在,你知道, 一个5岁的孩子 与iPad 可能会意外的结局在一个
1729	that has very graphic sexual images and videos.	里面有非常清晰的性影像和视频
1730	So what's the harm of pornography, watching pornography?	那看色情片有什么害处?
1731	Well there's a lot of potential harms.	有很多潜在的伤害
1732	One of the harms, especially if combined with, you know, compulsive masturbation is that	伤害之一,特别是如果结合, 你知道,强制自慰是:
1733	it's just simply addictive, which means that the more people do it, the more they want	它只是单纯的上瘾, 这意味着人们做的越多, 他们想要的越多
1734	to do it, then they have the come down where they don't feel good and then pretty soon	那样他们就会觉得不舒服 然后很快
1735	it becomes a kind of compulsive repetitive loop where they're spending large amounts	变成一种强迫性的重复循环 他们花了很多钱
1736	of their day engaging in this activity and that in itself is highly debilitating.	在他们的日子里,他们从事这种活动,那本身就是一种严重的破坏。
1737	But other harms I think that are significant are it really does change a person's conceptualization	但我认为其他的伤害是重大的 因为它真的改变了一个人的概念
1738	of what sex is and what sex is for.	性是什么,什么是性别。
1739	And I don't want to get into the whole thing of like, you know, sex is exercise or sex	我不想进入整个事情 像,你知道,性是运动或性
1740	is recreational fun compared with sex, you know, as something that's maybe more sacred	和性相比,是娱乐的乐趣,你知道的, 作为也许更神圣的东西
1741	because I'm not here to judge any of that except to say that if a main pathway for a	因为我在这里不是来评判的 除了说如果一个主要的路径
1742	young person to learn about sex is through watching pornography, that's going to give	年轻人了解性 是通过观看色情, 这将给
1743	them a very distorted view of what, you know, real sex is like.	他们对真正的性爱的看法很扭曲
1744	Not to mention what relationships are like, right, and how sex becomes a part of an intimate	更不用提什么关系 和性如何成为亲密的一部分
1745	relationship.	关系。
1746	I've heard a few people say that pornography lowers our motivation to go out there in the	我听到一些人说,色情 降低了我们的动机 去那里,
1747	world and to pursue getting a job and getting a career and going to the gym, etc., etc.	寻找工作 获得事业 去健身房等
1748	And through the lens of what we've talked about today where dopamine was this motivating	从我们今天谈论的镜头来看 多巴胺是怎样激发的
1749	force for those rats to just reach out and eat the food.	强迫那些老鼠伸手吃东西
1750	If you removed the dopamine from the rat's brain, it wouldn't even eat food in front	如果你把多巴胺从老鼠的大脑中移除, 它甚至不会吃食物在前面
1751	of it and it will starve to death.	将饿死,
1752	When we think about men, you said roughly in your practice about 90% of the people that	当我们想男人的时候,你大概在练习中 说90%的人
1753	come in with a pornography addiction are men.	色情成瘾的人是男人
1754	This all kind of overlaps to create this picture that in the modern world when we think about	这种种重叠 创造了这个图片 在现代世界 当我们思考
1755	why more men are lonely, why they're more often in their basements playing video games	为什么更多的人孤独,为什么他们更经常 在地下室玩电子游戏
1756	now or watching pornography than ever before, why they're having less sex and having sex	现在或观看色情制品 比以往任何时候,为什么他们 做爱和做爱较少
1757	later, why they're struggling to form relationships, why less men are potentially in college at	以后,为什么他们挣扎 形成关系,为什么 减少男性的潜力 在大学
1758	the moment.	现在
1759	Maybe some of the answers are in the fact of just like how men are wired because if	也许有些答案就像男人被绑起来一样 因为如果
1760	they're thinking this through, if men are more likely to have a disposition to these	如果男人更愿意接受这些
1761	kinds of behaviors, then these kinds of behaviors are more likely to impact and demotivate and	那种行为,那么这种行为 更有可能影响和削弱,
1762	destabilize men.	破坏人类的稳定
1763	Is that all like roughly, broadly accurate?	这大概是准确的吗?
1764	I absolutely agree, which is why I've talked about the smartphone as a masturbation machine.	我完全同意 所以我才说智能手机是自慰机
1765	Essentially these devices have become the way that we meet our physical, emotional,	基本上,这些装置 已经变成了我们满足 我们的身体,情感,
1766	sexual, intellectual needs.	性,知识需求.
1767	Taken to the extreme, that would mean that we're no longer relying on other people to	到了极端,这意味着 我们不再依赖其他人
1768	meet those needs.	满足这些需要。
1769	We're meeting the needs ourselves with this technology and with the devices.	我们用这种技术 和装置满足自己的需要。
1770	And I don't think that's a future that anybody wants taken to the extreme, right?	我觉得那不是任何人想要的将来 对吧?
1771	Because we are social creatures.	因为我们是社会生物。
1772	We need to connect with each other.	我们需要互相连接。
1773	Human connection is vital to a thriving life and survival in general.	人与人的联系对于整个生命和生存的繁荣至关重要。
1774	So yes, I have a lot of concerns that pornography is now replacing intimacy with people in real	所以是的,我有很多担心 色情现在正在取代亲密的人 在真实中
1775	life or disrupting our expectations of intimacy with people in real life.	生活或者破坏我们对现实生活中 与人亲近的期望
1776	When you say expectations, do you mean like hard work we have to do to create and find intimacy?	当你说期望,你的意思是像 艰苦的工作,我们必须做 创造和找到亲密?
1777	That too, and also just expectations around sex.	这也是 也只是对性的期望。
1778	So a lot of folks that I work with with sex addiction, as they try to give up pornography,	我和很多人在性瘾方面合作 他们试图放弃色情制品
1779	compulsive masturbation, or whatever they define as their sexually addictive behaviors,	强迫自慰, 或任何他们定义的性上瘾行为,
1780	what they find is that they almost go in the opposite direction and they kind of have zero	他们发现,他们几乎朝相反的方向走 他们有种零
1781	interest in sex, or they just don't have interest in sex with their real life partner,	或者他们只是对与现实生活伴侣的性生活没有兴趣
1782	or they can't enjoy sex with their real life partner, which all kind of makes sense, right?	或者他们不能享受 与真实生活伴侣的性爱, 这都是有道理的,对不对?
1783	When you hijack the reward pathway with this incredibly potent version of sex, you come	当你用这种强壮的性爱 劫持了悬赏之路,你就来了
1784	back down to earth with your actual partner who's got his or her own needs and aging bodies	回到地球 与你真正的伴侣 谁拥有自己的需要 和老化的身体
1785	or whatever it is, it's hard to experience pleasure in that realm.	不管是什么 很难在那个领域体验到快乐
1786	In an attempt to offer people out there now that are struggling with some kind of form	试图为那些 与某种形式挣扎的人提供
1787	of compulsive behavior addiction, a pathway to turn this around, what is step one?	强迫行为成瘾, 扭转这种状况的途径, 什么是第一步?
1788	In your book, I read all these incredible ideas around the wisdom we can learn from	在你的书里,我读了所有这些不可思议的想法 围绕我们可以学习的智慧
1789	addicts, I learned about dopamine fasting, and I also learned about radical honesty and	瘾君子,我学会了多巴胺禁食 我也学会了激进的诚实
1790	the role that that plays.	角色的发挥。
1791	What is the process?	是什么过程?
1792	So someone listening to this right now, they're struggling with one of these addictions, they've	所以有人听这个 现在,他们挣扎 与其中的瘾,他们
1793	got a pornography addiction, they're addicted to gaming, maybe it's food, maybe it's erotic	有色情瘾,他们上瘾 赌博,也许是食物,也许是色情
1794	novels, maybe they're reading Twilight at the moment.	小说,也许他们读 暮暮目前。
1795	What do you say to that person that the step one is?	你对那个人怎么说,第一步是什么?
1796	Step one is really just acknowledging the behavior, that it's problematic and that	第一步就是承认行为 问题在于
1797	it might require some changing in our lives.	这可能需要改变我们的生活。
1798	The next step is being honest with ourselves and maybe another person about why we do the	下一步是对我们诚实 也许另一个人 关于为什么我们这样做
1799	behavior, what we get out of it, what's positive.	行为,我们得到的东西,什么是积极的。
1800	Step three would be honestly making a list of all of the problems with the behavior.	第三步会诚实地列出所有的行为问题
1801	How is it interfering with my goals and as we talked about, my values?	它如何干扰我的目标 和我们谈论的,我的价值观?
1802	What do other people say to me about how it's problematic?	别人怎么对我说它是如何成问题的?
1803	Is one of the problems potentially that it's just not working anymore the way that it used	问题之一是它可能不再像以前那样工作了
1804	to, right?	去,对不对?
1805	I'm developing tolerance, I need more to get the same effect, it's doing the opposite	我渐渐变得宽容,我需要更多的 得到同样的效果,这是相反的
1806	of what I want it to do.	我想让它做什么
1807	And after we've done all that, really done a really honest self-assessment about the	我们做了这么多之后, 真的做了一个非常诚实的自我评估
1808	I recommend a 30-day dopamine fast.	我建议30天的多巴胺快速。
1809	Now, we're not really fasting from dopamine, right, because we're not really ingesting	现在,我们不是真的禁食 多巴胺,对不对,因为我们不是真的摄入
1810	dopamine.	多巴胺.
1811	What we're doing a fast from is whatever that substance or behavior is that is causing	我们做的是禁食 无论是物质还是行为
1812	these kinds of problems potentially.	这种问题可能存在。
1813	Maybe we aren't even really sure, but we think it might be.	也许我们甚至不确定, 但我们认为可能是。
1814	Give it up for 30 days.	放弃三十日.
1815	Why 30 days?	为什么30天?
1816	Well, we know that two weeks is not enough, right?	我们知道两周还不够吧?
1817	We know that from this imaging study, right, that people are still in that dopamine deficit	我们知道,从这个成像研究, 右,人们仍然在多巴胺缺。
1818	two weeks after stopping.	两周后停止。
1819	But 30 days based on clinical experience, not just mine, but that of many other people	但30天根据临床经验, 不只是我的, 还有许多其他人
1820	who do this work, for most people, no matter the drug and no matter sort of the severity	做这个的人,对大多数人来说, 无论药物和严重程度如何
1821	and chronicity, once they get to about 30 days, they begin to feel better.	和慢性, 一旦他们得到大约30天, 他们开始感觉更好。
1822	They begin to come out of that tunnel of constant craving.	他们开始从不断渴望的隧道里出来
1823	They begin to be able to imagine a life in which they would, you know, not necessarily	他们开始能够想象一种生活, 他们将,你知道,不一定
1824	have to rely on this substance or on this behavior.	必须依赖这种物质或行为
1825	What I always tell folks when they're preparing for the dopamine fast is just remember you'll	我总是告诉人们 当他们准备多巴胺快速 只是记住你会
1826	feel worse before you feel better, but that is withdrawal, mediated suffering.	在你感觉好点之前感觉更糟糕, 但这是退出,调解的痛苦。
1827	Once you get through those first 14 days, you'll begin to feel better and potentially	14天后,你就会感觉好点,有潜力
1828	by 30 days, you'll feel much better than you have in a really long time.	30天后,你会感觉 比你在很长一段时间。
1829	Now, this is not to say that 30 days of fasting is going to cure your addiction, not at all,	现在,这不是说30天的禁食 会治愈你的成瘾,一点也不,
1830	but it's the beginning.	但这是开始。
1831	It's the beginning of being able to see causality, getting some insight.	这是能够看到因果关系,获得一些洞察力的开始.
1832	It's an experiment, right?	这是一个实验,对不对?
1833	Our lives are one big experiment.	我们的生活是一个大实验。
1834	What better way to understand the variables in our lives than to change one thing, one	还有什么比改变一件事更好的方法来理解我们生活中的变数?
1835	variable and see what happens.	变量并看会发生什么。
1836	Do we then need to, you talk about this concept of self-binding?	那么我们是否需要,你谈论这个自我约束的概念?
1837	Yes.	对
1838	Self-binding.	自我约束.
1839	Right.	对
1840	What role does that play in all of this?	这一切有什么作用?
1841	Self-binding is a way of acknowledging that if we rely on willpower alone, we will not	自我约束是一种承认的方式,如果我们依靠意志力量,我们就不会
1842	be successful, especially living in this drugified world.	特别是生活在这个被下药的世界
1843	What we need to do is anticipate desire before we're in the throes of desire by creating	我们需要做的是 预测欲望 之前,我们进入 欲望的痛苦 通过创造
1844	both literal and metacognitive or thought, you know, Gdunkin experiment, like barriers	无论是字面上的还是元的 或者是思考的,你知道,Gdunkin实验,就像障碍
1845	between ourselves and our drug of choice.	我们和我们所选择的药物之间
1846	So these barriers can be actual physical barriers, like putting our device into a kitchen safe	所以这些屏障可能是实际的物理屏障,比如把我们的装置放在厨房的保险箱里.
1847	and locking it up over the night, or leaving it outside of our bedroom, or getting the	把它锁在夜里, 或把它留在我们的卧室外,
1848	potato chips, the alcohol, the cannabis out of the house, deleting our contact drug dealer's	薯片 酒 大麻 都从屋里拿出来了 删掉了我们联系的毒贩的
1849	information and telling our drug dealer, don't call me and I won't call you.	和告诉我们的毒贩, 不要给我打电话,我不会给你打电话。
1850	Because these are all cues.	因为这些都是提示。
1851	These are all cues.	这些都是提示。
1852	That's right.	没错
1853	And cues can be physical things.	而提示可以是物理的东西。
1854	So someone I see, cues can also be basically an emotion.	所以,我看到的人,提示 也可以基本上是一种情感。
1855	You talked about Halt, hungry, angry, lonely, tired.	你讲的是Start 饥饿 愤怒 孤独 疲倦
1856	I eat well during the day.	我白天吃得还不错
1857	Like now, as I leave here, there'll be a salad, I reckon, in the green room over there	像现在一样,当我离开这里, 会有沙拉,我想, 在绿色的房间那边
1858	for me.	对我来说。
1859	And the only time where I'm susceptible to not eating well is if it's late.	我唯一容易吃不饱的地方就是晚点
1860	And so when you said the hungry, angry, lonely, tired thing, that is probably the state that	所以当你说饥饿,愤怒,孤独,疲倦的东西, 这可能是状态,
1861	I'm in sometimes when I get home.	我有时回家时也会去
1862	Certainly hungry, certainly tired, probably a little bit lonely as well.	当然饿了,当然累了,也许还有一点孤独。
1863	But certainly those two things.	但肯定有这两件事
1864	And that seems to be when I'm most susceptible to making a regrettable decision as it relates	那似乎是我最容易做出令人遗憾的决定的时候
1865	to my dopamine.	给多巴胺
1866	And I've also wondered if dopamine is responsible for what people almost call like the sugar	我还在想多巴胺是否是 人们几乎称之为糖
1867	cravings that we have.	我们的渴望
1868	So what I've observed is in previous years of my life, when I was eating lots of sugar,	所以,我所观察到的是 在我生命的前几年, 当我吃了很多糖,
1869	I would then go into about like a two week cycle of like binging the sugar.	然后,我会进入一个大约两周的循环 喜欢搅拌糖。
1870	And right now, I'm in like a really great cycle with my food where I have no cravings	现在,我就像一个很棒的循环 与我的食物,我没有渴望
1871	for the sugar.	为糖。
1872	I'm staying in a hotel here in LA, there's a mini bar in the room with Oreos and gummy,	我住在洛杉矶的一家酒店里 房间里有个小酒吧 和Oreos和Gummy在一起
1873	all these chocolates and all these things, and I haven't touched them because for some	这些巧克力和这些东西, 我还没有碰过,因为有些
1874	reason in this like couple of weeks of my life or whatever, I just don't have the cravings	这就像我生命中几个星期的原因之类的 我只是没有欲望
1875	anymore.	现在。
1876	But I kind of suspect that if I start eating them, then the next four weeks will be a car	但我有点怀疑 如果我开始吃它们, 那么接下来的四周将是一辆车
1877	crash.	坠毁。
1878	Why does this happen?	为什么会这样?
1879	Yeah, it's so fascinating.	是啊,它是如此令人着迷。
1880	And I think this is sort of a universal experience.	我认为这是一个普遍的经验。
1881	So first of all, sugar is addictive.	所以首先糖会上瘾
1882	It lights up the same reward pathway as drugs and alcohol, clear dopamine release in the	它照亮了与毒品和酒精相同的奖赏路径 明晰的多巴胺释放
1883	nucleus, accumbens part of the reward pathway in response to sugar.	核糖体,是糖的奖励途径之一
1884	And when we quit sugar, we have a come down, right?	当我们放弃糖, 我们有一个下降,对不对?
1885	We go into withdrawal and it's manifested in all the different ways that we've talked	我们进入退出,它的表现 以不同的方式,我们已经谈过
1886	about.	有关。
1887	And it lasts for about two weeks and one of the most salient symptoms is intense craving	它持续了大约两周 其中一个最突出的症状是强烈的渴望
1888	for sugar.	为了糖。
1889	And it's so amazing how intense it is.	它是如此的惊人 它是多么强烈。
1890	But if we can get through that period and get out of that vortex of addictive craving,	但如果我们能渡过那段时期 走出瘾君子渴望的漩涡
1891	the craving gradually gets better and then eventually goes away, which is by the way	渴望逐渐好转,最终消失,顺便说一句
1892	very paradoxical because whatever our drug is, when we first stop it, we have intense	非常自相矛盾,因为不管我们的药物是什么, 当我们第一次阻止它,我们有强烈的
1893	And we have the feeling that the cravings will only get worse with time.	我们觉得 渴望只会随着时间而恶化
1894	Even though we logically may have experienced otherwise by giving it up before, we have	尽管我们从逻辑上讲也许通过放弃过其他经历,但我们有
1895	the feeling this is going to last forever.	感觉会永远存在
1896	It never does, right?	从来没有,对不对?
1897	With time, the craving goes away.	随着时间的流逝,渴望消失了。
1898	And once we are in that arena where we're not constantly craving, we might have something	一旦我们进入竞技场 我们并不渴望, 我们可能会有东西
1899	that triggers the craving, right?	这引发了渴望,对不对?
1900	But like stress, but generally we're not dealing with a craving.	但像压力一样,但一般情况下,我们不是在处理渴望。
1901	If we were then to re-expose our brains to a little bit of sugar, immediately back in	如果我们是,然后重新暴露我们的大脑 一点点糖,立即回到
1902	the vortex of craving, if we were then to re-expose our brains to a little bit of sugar,	渴望的漩涡,如果我们是 然后重新暴露我们的大脑 一点点糖,
1903	And there's an experiment I love that illustrates this, it's an experiment in rats, where rats	有个我爱的实验能说明这一点 这是老鼠的实验 老鼠的实验
1904	were injected with cocaine, the same amount of cocaine, every day for seven days.	每天七天都注射同样数量的可卡因
1905	And over the course of those seven days, the rats went from kind of hiding in the shadows	在这七天里 老鼠们躲在阴影中
1906	of the cage to progressively running a little bit more and a little bit more, and by day	在笼子里逐渐地跑得越快越快
1907	seven they were in a running frenzy, as measured by these beams of light that they were crossing.	以它们穿越的光束来衡量,
1908	Then there was no more cocaine injected after seven days, and no cocaine or any addictive	7天后没有注射可卡因 没有可卡因或任何瘾君子
1909	substance administered to the rats for a year, which is a rat lifetime, a really long time,	给老鼠服用一年的物质, 也就是老鼠的寿命, 非常长的时间,
1910	that would make you think, oh, you know, that there's no more cocaine in the system, none	这会让你觉得, 哦,你知道, 系统没有可卡因了,没有
1911	of that.	就是这样
1912	And then the rats were injected with a single dose of cocaine and immediately they were	然后老鼠被注射了一剂可卡因 然后他们立刻
1913	plunged back into that running frenzy that you saw on day seven.	回到了你第7天看到的疯狂中
1914	Really important information, because it tells us that there's some kind of permanent latent	非常重要的信息,因为它告诉我们 某种永久潜伏
1915	echo in our brains once we've been exposed to, and especially if we become addicted to,	一旦我们接触过 特别是如果我们上瘾了
1916	a particular substance, such that even with sustained abstinence on the order of years	某种特定物质,即使连续数年持续禁欲
1917	and decades, if we are re-exposed to that drug, we can immediately be plunged into the	几十年后,如果我们再次接触毒品, 我们就可以立即陷入
1918	depths of our addiction.	我们上瘾的深度。
1919	There's no ramp-up period that happens.	没有坡期发生.
1920	Of course, we see this all the time, you know, people with alcohol addiction who are then	当然,我们经常看到,你知道的, 酗酒的人谁是当时
1921	exposed to alcohol and right back to their max use, or even exposed to something like	暴露在酒精中,然后回到他们的最大用途, 甚至接触类似的东西
1922	opioids, and alcohol also works on our endogenous opioid system, so there's some homology or	类阿片,和酒精 对我们的内生类阿片系统, 所以有一些同源性或
1923	similarity between alcohol and opioids, and then immediately being plunged into opioid	酒精和类阿片的相似性,然后立即陷入类阿片
1924	addiction, which then leads them back to their alcohol addiction.	毒瘾,然后导致他们重新酗酒。
1925	It made me think about children.	这让我想起了孩子
1926	It made me think about children, because if I'm a five-year-old and I'm binging on sugar,	这让我想起了孩子, 因为如果我是一个5岁 并且我正在吃糖,
1927	this sets me up for a life where I'm going to be, I mean, based on the analogy, the experiment	这让我过上我将要生活的生活, 我的意思是,根据类比,实验
1928	I just had, based on the experiment I just had there, it sets me up for a life where	我刚刚,根据我刚刚在那里的实验, 它让我生活在那里
1929	I'm going to so easily slip right back into that addiction for sugar.	我会很容易地滑回 上瘾的糖。
1930	And also I know that the brain isn't fully developed when we're children, so maybe the	我也知道当我们还是孩子的时候 大脑还没有完全发育 所以也许
1931	effect is even more lasting and significant.	效果更为持久和重要。
1932	Is any of that true?	是真的吗?
1933	Yeah, it's all true, which is why a big focus of the addiction medicine field is prevention	是啊,这都是事实, 这就是为什么一个很大的焦点 上瘾医学领域 是预防
1934	and trying to make sure that we protect kids' brains from the harms of these addictive	并试图确保 我们保护孩子的大脑 不受这些瘾君子的伤害
1935	substances and behaviors.	物质和行为
1936	Like what?	比如说?
1937	From sugar to digital media, video games, pornography, social media, or any other drug,	从糖到数字媒体,电子游戏,色情,社交媒体,或任何其他毒品,
1938	you know, nicotine, so many kids are vaping now, you know, taking 50-plus puffs a day	尼古丁,现在有很多孩子在排水, 你知道,每天吸50多泡泡
1939	on their nicotine vape, cannabis, alcohol.	他们的尼古丁瓦,大麻,酒精。
1940	What's going on in the brain if a kid is exposed to those things?	如果一个孩子接触到那些东西 大脑里会发生什么事?
1941	So essentially at age five, we have more neurons and neuronal connections than we have in the	所以基本上在5岁时 我们的神经元和神经连接 都比我们...
1942	rest of our adult lives, about 50% more neuronal connections than we'll have it as adults,	我们成年后的余生, 大约50%的神经连接 比我们成年后要多,
1943	which is what makes us such good learners when we're kids.	这使得我们这样好的学习 当我们还是孩子。
1944	Kids can just absorb anything because they're sort of like these totipotent sponges with	孩子们能吸收任何东西 因为他们有点像这些强力海绵
1945	all these neurons and all these neuronal connections.	所有这些神经元 和所有这些神经连接。
1946	But as we age through adolescence to about age 25, we cut back or what's called prune	但随着我们从青春期到25岁, 我们削减或所谓的prune
1947	the neural circuits that we don't use and we myelinate or make more efficient the neural	神经电路,我们不使用, 我们保持或提高神经效率
1948	circuits that we use most often such that by age 25, we are left with the neurological	我们最常使用的电路 这样到25岁时 我们只剩下神经
1949	scaffolding that will serve us for the rest of our adult lives.	脚手架将服务于我们成年后的余生。
1950	That means that if we're engaging in addictive maladaptive coping at a young age, we're	这意味着,如果我们在年轻的时候 进行上瘾性适应不良的应对,
1951	elaborating a neural circuitry based on that maladaptive coping, which is going to set	基于这种适应性不良的应对方法 精心设计了神经电路
1952	us up for addiction in adulthood.	我们成年后上瘾
1953	I always like to emphasize though that because the child and adolescent brain is so plastic	我总是想强调,虽然, 因为儿童和青少年的大脑是如此的塑料
1954	or totipotent or so changeable, that's also a very hopeful message.	或直率或如此可变, 这也是一个非常有希望的信息。
1955	It means that even a young person exposed at a young age to an addictive substance,	意思是,即使年轻人在年轻时接触了一种致瘾物质,
1956	if we can get in there early enough while their brain is still plastic enough, we can	如果我们能早点进去 趁他们的大脑还足够塑料,我们可以
1957	rewire them.	重新连接他们。
1958	Whereas when I treat people in their 70s and 80s who have been smoking pot their whole	当我对待70和80多岁 吸烟的人时
1959	lives or drinking alcohol, mainly it was manageable.	生活或酗酒,主要是可以控制的。
1960	Now all of a sudden they retire.	现在他们突然退休了
1961	They're in their 60s all this time.	他们已经60多岁了
1962	The pot's a lot more potent.	锅的威力大得多。
1963	They can develop these full blown addictive disorders late in life and it's very hard	晚年他们可以患上瘾症 很难
1964	to treat them because they've lost a lot of that plasticity that would allow them to	治疗他们,因为他们失去了很多的可塑性 可以让他们
1965	regenerate new neural pathways once they abstain.	一旦他们弃权,就再生新的神经途径。
1966	What is the most important thing that we didn't talk about that we should have as it	什么是最重要的事情,我们没有谈论 我们应该有它
1967	relates to dopamine?	与多巴胺有关?
1968	Oh my God, we talked about so much.	哦,我的上帝,我们谈论这么多。
1969	I don't even know.	我什至不晓得。
1970	It seems like it was a lot of stuff.	好像是很多东西
1971	I guess based on the questions you're exposed to from the general public, is there anything	我猜根据你从公众那里 接触到的问题来看 有没有什么
1972	that we missed that someone at home right now is going to be screaming at the screen?	我们错过了 家里的人 现在会尖叫 在屏幕上?
1973	Talk about.	说曰.
1974	Yeah.	对
1975	Well, I guess I would emphasize that when I talk about the dopamine fasting, it's an	好吧,我想我会强调 当我谈论多巴胺禁食, 这是一个
1976	early intervention.	早期干预。
1977	It's not an intervention that I would recommend for someone who had repeatedly tried to quit	这不是我推荐给一个 多次试图退出的人的干预
1978	on their own and been unable to.	独自一人却无法做到
1979	Clearly that would be an exercise in futility.	显然,这将是徒劳之举。
1980	That person should go and get professional help.	那个人应该去找专业的帮助
1981	Maybe they need to go to a residential treatment center.	也许他们需要去一个住院治疗中心。
1982	I also wouldn't recommend dopamine fasting or just quitting your drug of choice if you're	我也不建议你禁食多巴胺 或者放弃你选择的药物
1983	at risk for a life threatening withdrawal.	有生命危险 有可能退出。
1984	We could have a life threatening withdrawal from alcohol and benzodiazepines like clonopin,	我们可以有生命威胁 从酒精和苯并二氮杂卓像丁香,
1985	xanax, adamine.	镇静剂 镇静剂
1986	Again, in those cases, go see a professional, get help with a medical detoxification before	在这样的情况下 去找个专业医生 帮个忙
1987	you try to sustain abstinence for a period of time.	你试图保持禁欲一段时间。
1988	I would blanket the whole thing with the caveat.	我会用警告来掩盖一切
1989	Go see the addiction medicine specialist near you.	去你身边看看毒瘾专家
1990	Thank you so much.	非常感谢
1991	You're welcome.	不用谢
1992	It's been so unbelievably thought provoking for me in so many ways.	如此令人难以置信地认为它能激起我很多方面.
1993	I thought I knew what dopamine was.	我以为我知道多巴胺是什么
1994	I thought I had covered all the ground there was to cover on these subjects of compulsive	我想我已经覆盖了所有的地面 在那里要覆盖 这些强制的主题
1995	behaviors, but I was so unbelievably wrong.	行为,但我是如此令人难以置信的错误。
1996	It wasn't until I got into your book and started reading through your work that I was like,	直到我进入你的书 开始读你的作品,我像,
1997	oh my God, most people don't have a clue about dopamine and the role it plays on us.	哦,我的上帝,大多数人 没有一个线索 多巴胺 和它对我们的作用。
1998	This scale analogy is particularly memorable because that helps me to think through many	这个规模类比特别令人印象深刻,因为它有助于我思考很多
1999	of the behaviors that I have in my life that I've either struggled with or have become	我一生中挣扎过的行为
2000	stubborn in various ways, but also it's turned a couple of lights on to some of the	以各种方式固执, 但也把几盏灯打开了一些
2001	things I said about my sugar, eating sugar, and even going to the gym and why my motivation	我说的关于我的糖,吃糖, 甚至去健身房 和为什么我的动机
2002	can seem to fluctuate with the gym sometimes.	有时候会和健身房一起波动
2003	It's so unbelievably important because this little neurotransmitter seems to control so	这太重要了 因为这个小神经递质似乎控制了
2004	much of our lives and we're never taught anything about it, so we become these kind	我们的很多生活,我们从来没有 教它,所以我们成为这样的人
2005	of puppets and the puppet master is this brain which is firing off all of these neurotransmitters	木偶和木偶的主人就是这个脑部 正在发射这些神经递质
2006	that are determining who we are, who we become, and also who we don't become.	这决定了我们是谁,我们变成谁,以及我们没有变成谁。
2007	Thank you so, so, so much.	谢谢你,所以,这么多。
2008	I know you were nervous coming here today, but I have to tell you, you are very brilliant.	我知道你今天很紧张,但我必须告诉你,你非常聪明。
2009	You're exceptionally brilliant in so many ways.	你在许多方面都特别聪明
2010	As I said, you should start a podcast because you're really built for this medium.	正如我说的,你应该开始播客 因为你真的为这个媒介而建。
2011	Thank you.	谢谢
2012	You have a certain warmth and empathy to you while also being incredibly smart and	你对你有某种热情和同情 同时也非常聪明
2013	accessible in the way that you communicate, so please carry on because I don't think,	以你交流的方式开放,所以请继续,因为我不认为,
2014	although you overcame the difficulty of those nerves, I think there's so many hundreds of	虽然你克服了这些神经的难题, 但我认为有这么多的
2015	thousands and millions of people listening now that are so thankful that you did.	现在有成千上万的人在听, 他们非常感激你所做的。
2016	Really thankful that you did.	真的很感谢你做的。
2017	You've just nudged their life a little bit in a better direction.	你刚刚把他们的生活 朝一个更好的方向倾斜了一点。
2018	Thank you.	谢谢
2019	That's worthwhile, so thank you.	这是值得的,所以谢谢你。
2020	We have a closing tradition on this podcast where the last guest leaves a question for	我们有一个封闭的传统 在这个播客 最后一个客人留一个问题给
2021	the next guest without knowing who they're going to be leaving it for.	接下来的客人不知道他们要为谁留下
2022	What is the most recent piece of information that changed your life?	最近改变你生活的信息是什么?
2023	I think the most recent piece of information that was very impactful for me was the realization	我认为最近一件对我很有影响的信息 就是意识到
2024	that we are probably going to be cybernetically enhanced in the future and interfacing with	未来我们可能会在网络上得到加强,并与
2025	technology in a way that's completely seamless and that this is inevitable.	技术是完全无缝的,这是不可避免的。
2026	We're going to become cyborgs.	我们要变成机器人了
2027	Or at least we're going to be surrounded by the technology in a way that's invisible	或至少我们会被技术包围 以隐形的方式
2028	and it's going to be just completely integrated into our lives.	它会完全融入我们的生活
2029	Whether it will actually be under the skin, I think it will be.	不管它是否真的在皮肤下,我想它会。
2030	But I can see in that so much potential good and promise and so much that's really terrifying,	但我能从中看到 如此巨大的潜力和承诺 如此之多的可怕
2031	especially when I think about the way it's going to change us as humans.	尤其是当我想到它会改变我们人类的方式时
2032	My big fear about it is that we will become more and more isolated and that we'll end up	我最大的恐惧是,我们将会 变得越来越孤立,我们会结束
2033	in these little cubicles of our own making scattered alone all across planet Earth.	我们自己制造的小隔间 分散在地球上
2034	I hope it doesn't lead to that, but that's my worry.	我希望这不会导致这种情况,但这是我的担心。
2035	It's interesting when we become connected to the internet and we truly interface with	当我们连接到互联网上 并且真正地连接到
2036	the internet, we really don't need to use our physical being anymore because we can	互联网,我们真的不需要 利用我们的身体了,因为我们可以
2037	experience all the joy and adventure and travel digitally and it just messes with the incentive	体验所有的快乐和冒险 和数字旅行 它只是搅乱了奖励
2038	structures like we've talked about with dopamine.	像我们讨论过的多巴胺那样的结构
2039	It changes our ability to get up and go and to do things.	它改变了我们站起来去做事的能力。
2040	That's a lovely, hopeful ending for us.	这对我们来说是一个美好的、充满希望的结局。
2041	Thank you so much.	非常感谢
2042	Oh, you're welcome.	不用谢
2043	Yeah, thanks for the opportunity to teach people about this information.	是啊,谢谢你有机会 教人们关于这个信息。
2044	I hope it's helpful for people.	唯愿能助众生.
2045	Super helpful.	超级有帮助。
2046	I'm going to link both of these books below.	我要把这两本书连到下面
2047	I've got the Dopamine Nation book, which was the original, I believe.	我得到了多巴胺民族的书, 这是原著,我相信。
2048	And then following that, you released Dopamine Nation workbook,	然后,你发布了多巴明民族工作手册,
2049	which is a practical guide to find balance in an age of indulgence.	这是在宽容时代找到平衡的实用指南。
2050	I highly recommend everybody reads these.	我强烈推荐大家阅读这些。
2051	I'm going to go and reread them on my journey home back to London tonight.	我今晚要回伦敦的路上再读一遍
2052	So I really, really appreciate you reading these books.	所以我真的很感谢你读这些书。
2053	And honestly, everyone needs to go read these books.	老实说,每个人都需要去读这些书。
2054	I'm sure they will.	我相信他们会的
2055	So thank you so much.	非常感谢
2056	Thank you so much.	非常感谢
2057	Do you know that 80% of New Year's resolutions fail by February?	你知道新年80%的决议到2月失败吗?
2058	It's because we focus too much on the end goal,	因为我们太专注于最终目标
2059	and we forget the small daily actions that actually move us forward.	我们忘记了日常的小规模行动 真正推动我们前进。
2060	Those actions that are easy to do are also easy not to do in life.	那些容易采取的行动也容易在生活中不这样做。
2061	It's easy to save a dollar, so it's also easy not to.	易省一钱,故亦不易.
2062	Making one small improvement each day,	每天做一个小小的改进,
2063	one tiny step in the right direction has a big difference over time.	朝正确方向迈出的一小步 随时间推移会有很大的不同
2064	And that is the 1% mindset, which is why we created the 1% diary,	这就是1%的心态, 这就是为什么我们创造了1%的日记,
2065	a 90-day journal designed to help you stay consistent	一个90天的日记,旨在帮助您保持一致
2066	and focus on the small wins and make real progress over time.	并关注小赢家 并随着时间的推移取得真正的进展。
2067	It also gives you access to the 1% community,	这也让你可以进入1%的社区,
2068	a space where you can stay accountable, motivated,	一个你可以负责的空间, 动机,
2069	inspired along with many others on the same journey.	与许多其他人在同一旅程中受到启发。
2070	We launched the 1% diary in November and it sold out.	我们于11月推出1%的日记,并售罄.
2071	So now we're doing a second drop.	所以,现在我们做第二滴。
2072	Join the waitlist at thediary.com and you'll be the first to know	加入Thediary.com的候机名单,你会第一个知道
2073	as soon as it's back in stock.	一旦它又回到库存。
2074	I'll put the link below.	我会把链接放在下面。

该视频共有字幕 2075 条。解锁更多字幕为会员功能，请移动到 价格