害羞的小孩需要矫正吗

To Help a Shy Child, Listen

害羞的小孩需要矫正吗

Toward the end of the summer, I was seeing a middle-school girl for a physical. The notes from a clinic visit last spring said she was a good student but didn’t talk enough in class. So I asked her: Is this still a problem for you?

今年暑假快结束时，一个上初中的女孩来我这儿进行检查。去年夏天她曾去了次诊所，医生的病历显示她是个好学生，但在班上发言不够多。于是我问她：这对你仍然构成了问题吗?

I’m shy, she said. I’m just shy.

她说，我有点怕羞，我只是有点怕羞。

Should I have turned to her mother and suggested — a counselor? An academic evaluation? Should I have probed further? How do you feel in school, do you have some friends, is anybody bullying you?

我应当找到她妈妈，然后建议她去咨询专职辅导员?接受一次学术评估?还是进一步深究下去呢：你在学校感觉怎么样，你有朋友吗?有人欺负你吗?

Or should I have said: Lots of people are shy. It’s one of the healthy, normal styles of being human.

或者我应当这样跟她们说：很多人生性羞涩。生而为人，这是一种健康、正常的行为方式。

All of these responses, together, would have been correct. A child who is being bullied or bothered may be anxious about drawing attention to herself; a child who doesn’t ever talk in class may be holding back because some learning problem is getting in the way, making her self-conscious. So you do need to listen — especially to a child who talks less rather than more — and find ways to ask questions. Are you happy, anxious, afraid?

这些反应累加在一起，也许是正确的。一个受到欺负或感到烦恼的孩子，也许会对自己招致别人的注意而感到不安;一个在班上根本不讲话的孩子之所以这么压抑，也许是因为碰到了某些学习上的苦恼，令她感到特别不好意思。所以，你需要去聆听——对于一个特别沉默寡言的孩子来说尤其是这样——同时也要想办法提问。你快乐吗?你焦虑或者害怕吗?

But shyness is also part of the great and glorious range of the human normal. Two years ago, Kathleen Merikangas, a senior investigator at the National Institute of Mental Health, and her colleagues published a study of 10,000 older children, ranging from 13 to 18 years old. “We found that about half of kids in America describe themselves as shy,” she told me.

可是，羞涩同时也是人类常态中伟大而又辉煌的一部分。两年前，美国心理健康研究中心(National Institute of Mental Health)的资深研究员凯瑟琳·梅利康加斯(Kathleen Merikangas)和同事们发表了一份涉及1万名年龄在13-18岁青少年的研究报告。“我们发现，约半数美国孩子表示自己生性羞涩，”她告诉我。

Common though it may be, our schools — and our broader culture — do not always celebrate the reserved and retiring. “Children who are shy, who don’t raise their hand, who don’t talk in class, are really penalized in this society,” Dr. Merikangas said.

尽管这是如此普遍的一种性格，但我们的学校——以及更广阔的文化——通常并不会赞美保守与羞怯。“那些性格害羞，上课不喜欢举手、不喜欢说话的孩子，在社会中真的处于不利地位，”梅利康加斯博士说。

I have heard it said that temperament was invented by the first parent to have a second child — that’s when parents realize that children come wired with many of the determinants of disposition and personality. What worked with Baby 1 doesn’t necessarily work with Baby 2. The analysis of temperament has been a topic of discussion in pediatrics and psychology for decades.

我曾听说过，气质这种概念是由第一对生了第二个孩子的父母发明的——父母发觉两个孩子在性情和个性上竟然会如此迥异，令人困惑。对老大适用的那一套对老二可能完全用不上。几十年来，儿科和心理学就气质分析这个话题始终在进行着讨论。

“Temperament is the largely inborn set of behaviors that are the style with which a person functions, not to be confused with their motivation or their developmental status and abilities,” said Dr. William B. Carey, a clinical professor of pediatrics at the Children’s Hospital of Philadelphia and the author of “Understanding Your Child’s Temperament.”

“气质主要是与生俱来的那一套行为，它是一个人行事的风格，别把这个跟人们的动机或他们的发育状态和能力混为一谈了，”费城儿童医院儿科临床教授威廉·B·凯里(William B. Carey)这样说道，他著有《理解子女气质》(Understanding Your Child’s Temperament)一书。

Shyness reflects a child’s place on the temperamental continuum, the part of it that involves dealing with new and unfamiliar circumstances. And starting a new school year may be hard on those who find new situations more difficult and more full of anxiety. What most children need is time to settle in, support from parents and teachers, and sometimes help making connections and participating in class.

羞涩折射出一个孩子在气质连续体(temperamental continuum)中的位置，它的部分作用在于应对全新和陌生的环境。开始一个新学年，对于那些身处新环境会感觉更艰难、更焦虑的孩子来说是件难事。大部分孩子在适应的过程中需要的是时间以及父母和老师的支持，有时也需要旁人帮助才能在班上交到朋友、成为其中的一份子。

If a child is not more comfortable after a month or so, parents should look at whether more help is needed, said Anne Marie Albano, director of the Columbia University Clinic for Anxiety and Related Disorders. Treatment usually involves cognitive behavioral strategies to help the child cope with anxiety.

哥伦比亚大学(Columbia University)焦虑和相关失调症诊所主任安妮·玛丽·阿尔巴诺(Anne Marie Albano)说，如果过了一个来月，这个孩子仍然没有感觉更加自如，家长应当了解是否孩子还需要更多帮助。治疗通常包含了各种认知行为手段，以帮助孩子面对焦虑。

All ranges of temperament have their uncomfortable, or even pathological, outer zones. Just as there are children whose rambunctious eagerness to participate makes trouble for them in school or signals the presence of other problems, there are children whose silence is a shout for help.

各类个性都有其不安地带，这种不安甚至是病态的。正如有些孩子在参与活动中可以表现出难以按捺的热情，这让他们在学校里制造了不少麻烦，或者暗示其存在其他问题，也有些孩子的沉默本身就是一种寻求帮助的呐喊。

I’m struck by the parallels between the ways we discuss shyness and the ways we discuss impulsivity and hyperactivity. In both cases, there is concern about the risk of “pathologizing” children who are well within the range of normal and worry that we are too likely to medicate outliers. By this thinking, children who would once have been considered shy and quiet too often get antidepressants, just as children who would once have been considered lively and rambunctious too often get A.D.H.D. medications.

在探讨羞涩的方式和探讨冲动多动的方式间存在相似之处，对此我深感震惊。对于上述这两种情形，人们都存在顾虑，认为有将那些完全处在正常范围内的儿童“病态化”之虞，担心我们动辄就要治疗稍微异端的人。这些人认为，医生往往轻易给那些表现得害羞、安静的人开了抗抑郁药，正如给那些以往表现得活泼闹腾的人轻易开了医治多动症的药物一样。

But the most important question is whether children are in distress. Dr. Merikangas’s study distinguished between the common trait of shyness and the psychiatric diagnosis of social phobia. Over all, about 5 percent of the adolescents in the study were severely restricted by social anxiety; they included some who described themselves as shy and some who did not. The authors questioned whether the debate about the “medicalization” of shyness might be obscuring the detection of the distinct signs of social phobia.

但是，最重要的问题在于孩子们是否确实处在困境中。梅利康加斯博士的研究已经将羞涩的共同特质与社交恐惧症的精神病学症状区分开来。在研究中，约有5%的青春期少年受到社交焦虑的严重制约;这当中包括一些自称个性怕羞的人，也包括一些并没有这么觉得的人。作者因此提出了质疑：对羞涩“以医疗的方式处理”的争论，或许模糊了社交恐惧症显著迹象的识别。

For parents who simply want to help a shy child cope with, for example, a brand new classroom full of brand new people, consider rehearsing, scripting encounters and interactions. “The best thing they can do is do a role play and behavioral rehearsal ahead of time,” said Steven Kurtz, a senior clinician at the Child Mind Institute in Manhattan. Parents should “plan on rewarding the bravery.”

对于那些只是想要帮助害羞的子女面对特殊环境，比如说全是陌生同学的陌生课堂时，可以考虑排演，设计见面与互动的情节。“家长最好是能提前进行一次角色扮演，进行行为预演，”曼哈顿的儿童心理研究所(Child Mind Institute)资深临床医生斯蒂文·库尔茨(Steven Kurtz)说。家长还应当“计划对孩子的勇敢举动作出奖励”。

But don’t take over. “The danger point is rescuing too soon, too often, too much, so the kids don’t develop coping mechanisms,” said Dr. Kurtz.

但不要越俎代庖。“过快、过频、过多出手相助，这些都是危险点，因为这样一来，孩子自己就不会锻炼出应对技巧了，”库尔茨医生说。

Cognitive behavioral therapy relies on “successive approximations,” in which children slowly close in on the behaviors they are hoping to achieve. In that spirit, a parent might arrange to meet another parent on the way to school, so a shy child can walk with another and bond. A teacher might look for the right partner to pair up with a shy child for cooperative activities in the classroom.

认知行为疗法依靠的是“逐次逼近法”，儿童逐步通过治疗，接近他们希望取得的行为。从这个理念出发，家长也许可以安排好在上学的路上与别的家庭碰头，这样，害羞的孩子也可以跟别的小孩一起走走，学习相处。老师可以为害羞的孩子寻找适合的小伙伴，在学校里共同参与需要协力进行的活动。

“Probably the worst thing to do is to say, ‘Don’t be shy. Don’t be quiet,’ ” Dr. Merikangas told me. This is not about trying to change the child’s temperament. It’s about respecting and honoring temperament and variation, and helping children navigate the world with their own instruments.

“也许最糟糕的做法，就是对孩子说，‘你别不好意思了，你别老是不说话了，’”梅利康加斯博士告诉我。目的不是要试图扭转孩子的个性。而是要尊重并敬畏人们与生俱来的个性与不同，同时帮助孩子们运用自己的力量，在这个世界里驰骋。