演讲MP3+双语文稿:抑郁、焦虑和上瘾等心理问题可以用这种方法来治疗？

听力课堂TED音频栏目主要包括TED演讲的音频MP3及中英双语文稿，供各位英语爱好者学习使用。本文主要内容为演讲MP3+双语文稿:抑郁、焦虑和上瘾等心理问题可以用这种方法来治疗？，希望你会喜欢！

【演讲人】Rick Doblin

【演讲主题】迷幻剂竟能治疗抑郁、焦虑和上瘾等心理问题？

【演讲文稿-中英文】

翻译者 Leila Ataei 校对：Hajar Almasi

准备此次演讲比准备LSD治疗还让我害怕。

Preparing for this talk has been scarier for me than preparing for LSD therapy.

（笑声）

(Laughter)

“迷幻剂之于心智，就像显微镜之于生物学，望远镜之于天文学。”这些话是斯坦尼斯拉夫·格罗夫博士说的。他是世界上首屈一指的迷幻剂研究者之一，他也是我的导师。今天，我想和你们分享当明智的使用迷幻剂时，是如何拥有潜力帮助治愈我们，帮助激发我们，并且甚至帮助拯救我们的。

"Psychedelics are to the study of the mind what the microscope is to biology and the telescope is to astronomy." Dr. Stanislav Grof spoke those words. He's one of the leading psychedelic researchers in the world, and he's also been my mentor. Today, I'd like to share with you how psychedelics, when used wisely, have the potential to help heal us, help inspire us, and perhaps even to help save us.

在1950和1960年代，迷幻剂研究在全球各地都很热门，并在精神病学，心理学和心理疗法，神经科学和神秘体验的研究中均显示了巨大的潜力。但迷幻剂从研究环境中泄露出来并被反主流文化，以及反越战运动使用。存在一些不明智的使用。因此引起了强烈的反对。在1970年，美国政府将所有对迷幻剂的使用定为犯罪，并且开始终止所有的迷幻剂研究。这一禁令在全球扩散并持续了几十年。这真是个悲剧，迷幻剂实际上只是个工具，不管它们的结果是好还是坏，取决于它们怎么被使用。

In the 1950s and 60s, psychedelic research flourished all over the world and showed great promise for the fields of psychiatry, psychology and psychotherapy, neuroscience and the study of mystical experiences. But psychedelics leaked out of the research settings and began to be used by the counterculture, and by the anti-Vietnam War movement. And there was unwise use. And so there was a backlash. And in 1970, the US government criminalized all uses of psychedelics, and they began shutting down all psychedelic research. And this ban spread all over the world and lasted for decades. and it was tragic, since psychedelics are really just tools, and whether their outcomes are beneficial or harmful depends on how they're used.

迷幻意思是“心灵显现”，它与LSD、裸盖菇素、美斯卡林，依波加等药物有关。在18岁时，我是个大学新生，我体验了LSD和墨斯卡灵，这些体验让我接触到自己的情感。它们帮助我建立了一种精神联系，不幸的是，我的成年礼并没有产生这种联系。

Psychedelic means "mind-manifesting," and it relates to drugs like LSD, psilocybin, mescaline, iboga and other drugs. When I was 18 years old, I was a college freshman, I was experimenting with LSD and mescaline, and these experiences brought me in touch with my emotions. And they helped me have a spiritual connection that unfortunately, my bar mitzvah did not produce.

（笑声）

(Laughter)

当我想戏弄我父母时，我会跟他们说是他们把我推向了迷幻剂，因为我的成年礼并没有把我变成男人。

When I wanted to tease my parents, I would tell them that they drove me to psychedelics because my bar mitzvah had failed to turn me into a man.

（笑声）

(Laughter)

但最重要的是，迷幻剂给了我一种我们共同的人性，我们与所有生命的统一的感觉。其他人也报告有同样的感受。我觉得这些体验具有潜力成为部落主义、 原教旨主义、种族灭绝和环境破坏的解药。于是我决定把我的人生致力于改变法律以及成为一名合法迷幻剂心理治疗师上。

But most importantly, psychedelics gave me this feeling of our shared humanity, of our unity with all life. And other people reported that same thing as well. And I felt that these experiences had the potential to help be an antidote to tribalism, to fundamentalism, to genocide and environmental destruction. And so I decided to focus my life on changing the laws and becoming a legal psychedelic psychotherapist.

（鼓掌）

(Applause)

如今，在禁止过了半个世纪后，我们正处于迷幻剂研究的全球复兴之中。迷幻剂治疗法在治疗创伤后应激障碍(PTSD)，抑郁，社交焦虑，药物滥用和酗酒和自杀等方面显示了巨大的潜力。迷幻剂心理治疗试图追击问题的根源，只需相对较少的管理，相比之下，今天使用的大多数精神药物,主要是减轻症状， 并意味着需要每天服用。

Now, half a century after the ban, we're in the midst of a global renaissance of psychedelic research. Psychedelic psychotherapy is showing great promise for the treatment of post-traumatic stress disorder, or PTSD, depression, social anxiety, substance abuse and alcoholism and suicide. Psychedelic psychotherapy is an attempt to go after the root causes of the problems, with just relatively few administrations, as contrasted to most of the psychiatric drugs used today that are mostly just reducing symptoms and are meant to be taken on a daily basis.

迷幻剂今天也被用作神经科学工具来研究大脑功能，和用来研究人类意识的永恒之谜。人们正在探索迷幻剂和它们产生的神秘体验,与冥想和正念之间的联系，包括最近发表的一篇,关于终身禅修者在禅修中服用裸盖菇素后显示出了,其长期效果,还有大脑变化的论文。

Psychedelics are now also being used as tools for neuroscience to study brain function and to study the enduring mystery of human consciousness. And psychedelics and the mystical experiences they produce are being explored for their connections between meditation and mindfulness, including a paper just recently published about lifelong zen meditators taking psilocybin in the midst of a meditation retreat and showing long-term benefits and brain changes.

这些药物是怎么作用的？现代神经科学研究已经证明,迷幻剂减少了我们所周知的大脑默认模式网络的活动。这是我们创造自我意识的地方。这是我们的自我，它会根据我们的个人需求和优先事项过滤所有进入的信息。当默认模式网络的活动减少时，我们的自我就从前台转移至后台，我们意识到,这只是一个更大的意识领域的一部分。这跟哥白尼和伽利略用望远镜向人类展示地球不再是宇宙的中心，而实际上是绕着太阳转类似，有比自身更大的东西。对有些人来说，这个意识的转变,是他们最重要和人生中最重要的体验。他们感到与比自己更大的世界的亲密性。他们利他的感觉更强，并且他们对死亡也不那么恐惧。

Now, how do these drugs work? Modern neuroscience research has demonstrated that psychedelics reduce activity in what's known as the brain's default mode network. This is where we create our sense of self. It's our equivalent to the ego, and it filters all incoming information according to our personal needs and priorities. When activity is reduced in the default mode network, our ego shifts from the foreground to the background, and we see that it's just part of a larger field of awareness. It's similar to the shift that Copernicus and Galileo were able to produce in humanity using the telescope to show that the earth was no longer the center of the universe, but was actually something that revolved around the sun, something bigger than itself. For some people, this shift in awareness is the most important and among the most important experiences of their lives. They feel more connected to the world bigger than themselves. They feel more altruistic, and they lose some of their fear of death.

不是所有的药物都这样起作用。MDMA/摇头丸，也称为嗨飞，或莫利，作用原理就就有着本质不同。我可以和你分享马塞拉的故事，她因暴力性侵犯而患有PTSD。马塞拉和我是1984年介绍认识的，当时MDMA仍然非法，但它也开始从治疗圈中泄露出来。玛塞拉曾在娱乐场所尝试过MDMA，在这期间，她过去的创伤意识淹没了她，强化了她自杀的想法。在我们第一次交谈时，我分享说当MDMA用于治疗时，它可以减轻对消极情绪的恐惧，并且可以帮助她走出创伤。我请求她如果我们开始合作，希望她答应我不要自杀。她同意了并且做了承诺。

Not all drugs work this way. MDMA, also known as Ecstasy, or Molly, works fundamentally different. And I'll be able to share with you the story of Marcela, who suffered from post-traumatic stress disorder from a violent sexual assault. Marcela and I were introduced in 1984, when MDMA was still legal, but it was beginning also to leak out of therapeutic circles. Marcela had tried MDMA in a recreational setting, and during that, her past trauma flooded her awareness and it intensified her suicidal feelings. During our first conversation, I shared that when MDMA is taken therapeutically, it can reduce the fear of difficult emotions, and she could help move forward past her trauma. I asked her to promise not to commit suicide if we were to work together. She agreed and made that promise.

在她的治疗环节，玛塞拉能够更流畅，更容易地面对她的创伤。并且，她能够说出,强奸犯告诉过她，如果她把事情说出去，他就杀了她。她意识到囚禁她的是她自己的思想。所以能够分享遭遇、经历、感觉和头脑中的想法解放了她，并且她也能够决定,她想要她的生活继续。在那一刻，我意识到MDMA对治疗PTSD可能非常有效。如今，在玛塞拉接受治疗的35年后，她成为了一名治疗师，培训其他治疗师，帮助人们用MDMA克服PTSD。

During her therapeutic sessions, Marcela was able to process her trauma more fluidly, more easily. And yet, she was able to tell that the rapist had told her that if she ever shared her story, he would kill her. And she realized that that was keeping her a prisoner in her own mind. So being able to share the story and experience the feelings and the thoughts in her mind freed her, and she was able to decide that she wanted to move forward with her life. And in that moment, I realized that MDMA could be very effective for treating PTSD. Now, 35 years later, after Marcela's treatment, she's actually a therapist, training other therapists to help people overcome PTSD with MDMA.

那么，MDMA是如何作用的？MDMA是如何帮到玛塞拉的？患有PTSD的人与没有的人大脑不一样。他们的杏仁核很活跃，这是处理恐惧的地方。他们的前额皮质的活动有所减少，这是负责逻辑思维的地方。他们的海马体的活动减少了，这是我们储存长期记忆的地方。而MDMA会把大脑朝相反的方向改变。MDMA减少了杏仁核的活动，增加了前额皮质的活动，并且增加了杏仁核和海马体之间的连接，将创伤记忆转移到长期存储中。最近，约翰·霍普金斯大学的研究人员在《自然》杂志上发表了一篇论文，他们证明MDMA能释放催产素，爱和养育的荷尔蒙。同样的研究人员也对章鱼进行了研究，章鱼通常是独来独往的，除非在交配季节。但给了它们MDMA之后，它们变得亲社会了。

Now, how does MDMA work? How did MDMA help Marcela? People who have PTSD have brains that are different from those of us who don't have PTSD. They have a hyperactive amygdala, where we process fear. They have reduced activity in the prefrontal cortex, where we think logically. And they have reduced activity in the hippocampus, where we store memories into long-term storage. MDMA changes the brain in the opposite way. MDMA reduces activity in the amygdala, increases activity in the prefrontal cortex and increases connectivity between the amygdala and the hippocampus to remit traumatic memories to move into long-term storage. Recently, researchers at Johns Hopkins published a paper in "Nature," in which they demonstrated that MDMA releases oxytocin, the hormone of love and nurturing. The same researchers also did studies in octopuses, who are normally asocial, unless it's mating season. But lo and behold, you give them MDMA, and they become prosocial.

（笑声）

(Laughter)

在玛塞拉和我治疗几个月后，美国缉毒局开始将使用摇头丸定为犯罪，对其治疗作用则一无所知。所以我来到华盛顿，我来到缉毒局的总部，并且提起诉讼，要求举办一场听证会，这样精神病学家和精神治疗师，将能够提供有关MDMA治疗用途的信息，来让它变得合法。在听证会中间，缉毒局抓狂了，宣布进入紧急状态，并将所有使用MDMA的行为定为犯罪。于是我看到的剩下的唯一让它回归的方式，是通过科学，医学，并通过FDA药物开发流程。

Several months after Marcela and I worked together, the Drug Enforcement Administration moved to criminalize Ecstasy, having no knowledge of its therapeutic use. So I went to Washington, and I went into the headquarters of the Drug Enforcement Administration, and I filed a lawsuit demanding a hearing, at which psychiatrists and psychotherapists would be able to present information about therapeutic use of MDMA to try to keep it legal. And in the middle of the hearing, the DEA freaked out, declared an emergency and criminalized all uses of MDMA. And so the only way that I could see to bring it back was through science, through medicine and through the FDA drug development process.

所以在1986年，我成立了MAPS，这家非盈利的迷幻药制药公司。它花了我们30年的时间，直到2016年，我们才得到了所需提交给FDA的数据，以申请进入大规模第三阶段研究的许可，在获得处方使用的批准之前，这是个需要证明其安全性和有效性的许可。

So in 1986, I started MAPS as a nonprofit psychedelic pharmaceutical company. It took us 30 years, till 2016, to develop the data that we needed to present to FDA to request permission to move into the large-scale Phase 3 studies that are required to prove safety and efficacy before you get approval for prescription use.

托尼是我们一项试点研究中的一个老兵。根据退伍军人管理局的数据，现在有超过一百万的退伍军人患有PTSD。每天至少有20个老兵自杀，其中很多是因为PTSD。托尼所接受的治疗有3个半月长。但在那期间，他只接受了三次MDMA治疗，中间分为12次90分钟的非药物心理疗程，3次在第一次MDMA疗程前作为准备环节，3次在每次MDMA疗程后进行整合。我们把我们的治疗方法称为“内在导向治疗”，在这个过程中，我们支持病人去体验他们大脑或身体里出现的一切。即便有MDMA，这个工作也不容易。我们的很多研究对象都说过，“我不知道他们为什么把这叫嗨飞。”

Tony was a veteran in one of our pilot studies. According to the Veterans Administration, there's over a million veterans now disabled with PTSD. And at least 20 veterans a day are committing suicide, many of them from PTSD. The treatment that Tony was to receive was three and a half months long. But during that period of time, he would only get MDMA on three occasions, separated by 12, 90-minute non-drug psychotherapy sessions, three before the first MDMA session for preparation and three after each MDMA session for integration. We call our treatment approach "inner-directed therapy," in that we support the patient to experience whatever's emerging within their minds or their bodies. Even with MDMA, this is hard work. And a lot of our subjects have said, "I don't know why they call this Ecstasy."

（笑声）

(Laughter)

在托尼的首次MDMA疗程中，他躺在沙发上，戴着眼罩，听着音乐，他可以和治疗师交谈，后者是一组男女联合治疗小组，随时在他需要时响应。在几个小时后，在一个平静和清晰的时刻，托尼分享了他意识到的，他的PTSD是他和朋友联系的一种方式。这是纪念他死去的朋友的一种方式。但他能够通过死去的朋友的眼睛看到自己。他意识到他们不希望他受苦，挥霍他的生命。他们希望他活得充实，而这是他们无法做到的。于是他意识到，有新的方法来纪念他的朋友们，那就是尽可能充实地活着。他还意识到，他是在给自己洗脑，说他服用鸦片是为了止痛。但事实上，他意识到，他是用它们来逃避。于是他决定再也不需要鸦片了，他再也不需要MDMA了，于是他退出了研究。现在已经7年了。托尼没有再受PTSD折磨，他也没复吸鸦片，并且正在柬埔寨帮助那些 没有他那么幸运的人。

During Tony's first MDMA session, he lay on the couch, he had eyeshades on, he listened to music, and he would speak to the therapists, who were a male-female co-therapy team, whenever he felt that he needed to. After several hours, in a moment of calmness and clarity, Tony shared that he had realized his PTSD was a way of connecting him to his friends. It was a way of honoring the memory of his friends who had died. But he was able to shift and see himself through the eyes of his dead friends. And he realized that they would not want him to suffer, to squander his life. They would want him to live more fully, which they were unable to do. And so he realized that there was a new way to honor their memory, which was to live as fully as possible. He also realized that he was telling himself a story that he was taking opiates for pain. But actually, he realized, he was taking them for escape. So he decided he didn't need the opiates anymore, he didn't need the MDMA anymore, and he was dropping out of the study. That was seven years ago. Tony is still free of PTSD, has never returned to opiates and is helping others less fortunate than himself in Cambodia.

（鼓掌）

(Applause)

我们向FDA展示的数据来自我们试验研究的107个人，包括托尼，数据显示23%未接受积极MDMA治疗的人在治疗结束时不再患有PTSD。这对于这些病人群体真是个好消息。然而，当你加入MDMA时，结果翻倍，56%的人摆脱了PTSD。

The data that we presented to FDA from 107 people in our pilot studies, including Tony, showed that 23 percent of the people that received therapy without active MDMA no longer had PTSD at the end of treatment. This is really pretty good for this patient population. However, when you add MDMA, the results more than double, to 56 percent no longer having PTSD.

（鼓掌）

(Applause)

但更重要的是，一旦人们意识到他们不需要压制他们的创伤，而是可以应付，他们就自行恢复了。所以在最后一个疗程结束一年后，为期12个月的后续跟踪中，2/3的人不再患有PTSD。并且在1/3没有好转的人中，许多人的症状在临床上有显著的减轻。

But most importantly, once people learn that if they don't need to suppress their trauma, but they can process it, they keep getting better on their own. So at the 12-month follow-up one year after the last treatment session, two-thirds no longer have PTSD. And of the one-third that do, many have clinically significant reductions in symptoms.

（鼓掌）

(Applause)

根据这些数据，FDA宣布PTSD的MDMA辅助心理治疗为突破性治疗。FDA还宣布裸盖菇素对难治性抑郁症是一种突破性的疗法，并且最近刚刚批准用埃斯氯胺酮治疗抑郁症。

On the basis of this data, the FDA has declared MDMA-assisted psychotherapy for PTSD a breakthrough therapy. FDA has also declared psilocybin a breakthrough therapy for treatment-resistant depression and just recently approved esketamine for depression.

我很自豪地说，我们现在已经开始我们第三阶段的研究。假如结果不负所望，并且他们跟第二阶段研究类似，到2021年底，FDA将会批准PTSD的MDMA辅助心理治疗。如果得到批准，唯一能直接给病人治疗的治疗师将会是通过我们培训项目的治疗师，并且他们只能在临床环境的直接监督下实施MDMA。我们预计未来几十年内，将会出现数千个致幻剂诊所，在这些地方，治疗师将能够使用MDMA，裸盖菇素、氯胺酮等致幻剂治疗潜在的数百万病人。这些诊所也可以发展成治疗中心，人们可以来这里进行迷幻心理治疗，以实现个人成长、夫妻治疗或精神、神秘体验。

I'm proud to say that we have now initiated our Phase 3 studies. And if the results are as we hope, and if they're similar to the Phase 2 studies, by the end of 2021, FDA will approve MDMA-assisted psychotherapy for PTSD. If approved, the only therapists who will be able to directly administer it to patients are going to be therapists that have been through our training program, and they will only be able to administer MDMA under direct supervision in clinic settings. We anticipate that over the next several decades, there will be thousands of psychedelic clinics established, at which, therapists will be able to administer MDMA, psilocybin, ketamine and other psychedelics to potentially millions of patients. These clinics can also evolve into centers where people can come for psychedelic psychotherapy for personal growth, for couples therapy or for spiritual, mystical experiences.

人类现在正在灾难和意识之间举棋不定。迷幻剂复兴可以帮助意识胜利。现在，如果你们都看一下座位下面…开个玩笑！

Humanity now is in a race between catastrophe and consciousness. The psychedelic renaissance is here to help consciousness triumph. And now, if you all just look under your seats ... Just joking!

（笑声）

(Laughter)

谢谢。

Thank you.

（鼓掌）

(Applause)

（笑声）

(Laughter)

（鼓掌）

(Applause)

谢谢

Thank you.

（鼓掌）

(Applause)

科里·哈吉姆：你得在这里多呆一分钟。非常感谢，瑞克。我猜这群观众们都很支持你。

Corey Hajim: You've got to stay up here for a minute. Thank you so much, Rick. I guess it's a supportive audience.

里克·多布林：是的，非常支持。他们很多人也去过火人节。

Rick Doblin: Yes, very. Many of them have also been to Burning Man.

（笑声）

(Laughter)

科里·哈吉姆：有共鸣。

CH: There's some synergy.

里克·多布林：(笑声)

RD: (Laughs)

科里·哈吉姆：在演讲中，你谈到可以使用这些药物来解决一些非常严重的创伤。那么像焦虑和抑郁这些更常见的精神疾病，这些微剂量疗法也有用武之地吗？

CH: So, in your talk, you talked about using these drugs to address some pretty serious traumas. So what about some more common mental illnesses like anxiety and depression, and is that where microdosing comes in?

里克·多布林： 微剂量确实对于抑郁有帮助，我确实知道有人在使用它。但总体上而言，要达到治疗目的，我们更喜欢宏观剂量而不是微观剂量，目的是为了真正帮助人们应对问题根源。微剂量更多的是为了提升创造力，艺术灵感，为了让患者集中注意力…它也会带来情绪的提升。但我认为对于严重的疾病，我们不想让人们认为他们每天都需要药物，但要做更深入、更细致的工作。

RD: Well, microdosing can be helpful for depression, I do know someone that has been using it. But in general, for therapeutic purposes, we prefer macro-dosing rather than microdosing, in order to really help people deal with the root causes. Microdosing is more for creativity, for artistic inspiration, for focus ... And it also does have a mood-elevation lift. But I think for serious illnesses, we'd rather not get people thinking that they need a daily drug, but do more deeper, intense work.

科里·哈吉姆：在美国和北美之外这方面的研究做得怎样？

CH: And what about outside the United States and North America, is this research being done there?

里克·多布林：是的，我们在全球化。我们第三阶段的研究其实是在以色列，加拿大和美国进行的。所以一旦获得FDA批准，它也会被以色列和加拿大批准。我们刚刚在欧洲开始研究。我们其实正要培训一些来自中国的治疗师。

RD: Oh yeah, we're globalizing. Our Phase 3 studies are actually being done in Israel, Canada and the United States. So once we get approval in FDA, it will also become approved in Israel and in Canada. We're just starting research in Europe. And we're actually going to be training some therapists from China.

科里·哈吉姆：太棒了。我们要来个观众投票，看大家是否认为推进这个研究是个好主意，但我感觉我知道答案了，那么… 非常感谢，里克。

CH: That's great. We were going to do an audience vote to see if people felt like this was a good idea to move forward with this research or not, but I have a feeling I know the answer to that, so ... Thank you so much, Rick.

里克·多布林：谢谢，谢谢大家。

RD: Thank you. Thank you all.

（鼓掌）

(Applause)