科研成果
Coco有话说

古语云：附骥尾以涉千里；攀鸿翮则翔四海。一般认为，高权力者总能惠及亲属或下属，因此，人们会向往与高权力者有更密切的关系。亲社会行为是增进关系的一种途径；但另一方面，高权力者又被认为是资源的占有者，玉汝于成，有更强的能力从容应对问题，很少陷入困境而需要别人帮助。那么，人们是对高权力者更多亲社会行为，还是对普通人更多亲社会行为呢？

对有权力者惠而不费的人情往来，可能带来潜在的收益，因此人们对与高权力者来往乐此不疲；但另一方面，掌权者多资源和渠道解决自己的问题，且人们也要为尊贵者隐瞒弱点。两者是相互矛盾的，民众会如何对待高权力者呢？会更多帮助他们吗？不同文化背景下的人们对待高权力的亲社会行为有差异吗？

依据同情-利他假设和个体追求社会公平的动机，人们会帮助那些唤起自己同情和处于弱势地位的人，而高权力者很难唤起他人的同情，因为高权力者常被认为有足够的资源和渠道去解决问题，处于优势地位，不容易陷于困境，因此人们会对高权力者表现出更少的亲社会行为。

但是，社会交换理论和互惠视角却认为，亲社会行为会带来报酬和互惠，也就是说，人们愿意帮助那些更可能给自己带来潜在收益的个体，因为与高权力者通过亲社会行为来维持和建立关系的潜在收益更高，因此人们会对高权力者表现出更多的亲社会行为。

此外，文化也可能影响人们对高权力者的亲社会行为。一项在印度（高权力距离）的研究表明，人们在实验室情境的短期互动中很少合作；一项来自66国数据的研究表明，权力距离和亲社会行为呈负相关。因此，由于不同文化下的权力距离不同，或许个体对高权力者的亲社会行为也不同，权力距离高的文化下人们的亲社会行为或许更少。

但从另一方面看，高权力者往往有更多的渠道和资源，交好高权力者就有可能获得更高的潜在收益，所以，在高权力距离的文化背景中，人们也可能更有动力通过亲社会行为建立和维持与高权力者的关系。

上述两方面的观点显然是对立矛盾的，但又各有一定的道理。我们通过对中美两国共893名参与者的研究，探讨受助者权力特征是否影响个体的亲社会行为，文化差异是否会导致个体对不同权力特征的人表现亲社会行为的可能性不同。

为验证受助者权力特征假设，研究中所有问题的设置仅对象（高权力/低权力）不同，其余相同。

研究采用的所有材料都由研究者从英文翻译成中文，再由另一位研究者回译成英文，经过反复讨论商议，保证了研究材料的中英文版在语义表达上基本一致。

中国被试均为高校大学生，完成纸质版问卷；美国被试由学生和工作人士构成，他们通过MTurk数据公司在线填答了问卷。我们操纵的研究条件主要是将受助者分为高权力者与普通人两种；然后测量中国被试与美国被试在这两种实验条件下的亲社会行为。

中美被试指向普通人和高权力者的亲社会行为水平如下表所示。

方差分析结果显示，在控制了被试的年龄、性别和身份（学生vs.工作人士）后，受助者权力的主效应显著（p<.001），人们对高权力者表现出更少的亲社会行为。这一方面说明高权力者总是表现得威严强大，能很好地解决问题，因此很难唤醒他人的同情；另一方面，高权力者占有更多的社会资源，人们可能会觉得资源分配不公，这也会使得人们对既得利益者（高权力者）有内隐和潜在的恶意和敌意。

其次，我们看到文化的主效应显著(p<.01)，在高权力距离的文化背景下，个体对高权力者表现出更少的亲社会行为，这一结果与前人的研究结论一致。因为在高权力文化中，对于高权力者的亲社会行为，例如接济很可能被视为是对高权力者威严和权力的损害，因此人们对高权力者的亲社会行为会更加谨慎。

最后，受助者权力与文化的交互作用并不显著(p=.111)。说明受助者权力对个体亲社会行为的影响是相对普适的。总的来说，与普通受助者相比，中美被试都倾向于更少帮助高权力个体；从亲社会行为总量上看，中国被试比美国被试的更少。

我们的研究发现，受助者的权力特征是影响个体亲社会行为的重要因素，相比普通人，高权力者更少获得他人的帮助；不同权力距离的文化也会影响个体的亲社会行为，高权力距离文化的个体的亲社会行为更少。换言之，高权力受助者在高权力距离的文化中，也更少受到人们的亲社会行为。

需要说明的是，我们的研究被试基本都是90后，他们相对而言拥有更平等、更自由的成长环境，以及受到家长的溺爱等独特的成长模式可能也对研究结果具有一定的影响，也许他们更加自我中心，对高权力者不像父辈一样敬畏和尊重。

总之，目前的研究结果虽然显示人们更不愿意帮助高权力者，但其深层原因或心理机制还有待于进一步探讨。

作者简介

傅鑫媛现为中央财经大学社会与心理学院教师
苑明亮现为北京师范大学心理学部在读博士研究生

参考文献：

Fu, X., Padilla-Walker, L. M., Nielson, M. G., Yuan, M., & Kou, Y*. (2020). The effect of target's power on prosocial behavior: A cross-cultural study. The Journal of Psychology. 1-14.
DOI: 10.1080/00223980.2020.1845591

推文作者：朱可可、苑明亮、傅鑫媛
插图：郭震
编辑：彭重昊
排版：彭重昊
本文由亲社会实验室原创，欢迎转发至朋友圈，如需转载请联系后台，征得作者同意后方可转载

KEY POINTS
要点

Breathlessness, chronic fatigue, and other long-COVID symptoms may slowly improve. However, brain fog may worsen with time.
呼吸困难，长期疲劳以及其他新冠长期后遗症（长期新冠）症状可能会缓慢好转，但脑雾却会逐渐恶化。

Although brain fog in long COVID may look like ADHD, Mild Cognitive Disorder, or other neurological disorders, the underlying mechanisms differ.
尽管新冠长期后遗症中的脑雾症状看起来可能像是ADHD（注意力缺陷多动障碍，多动症），轻微认知障碍或其他神经障碍，底层机制却并不相同。

An ADHD medication, Guanfacine, and antioxidant, NAC, were used on a small sample to treat long-COVID brain fog.一种ADHD药物，胍法辛和抗氧化剂NAC在一个小规模样本中被用于治疗新冠长期后遗症脑雾症状。

Future treatments should target brain inflammation to address the currently known causes of long-COVID cognitive deficits.
在应对新冠后遗症认知缺陷症状的当前所知原因方面，未来治疗方案应围绕大脑炎症来治疗。

Sufferers of long COVID experience symptoms that may persist for weeks, months, or even years after contracting the COVID virus. Some researchers and clinicians have listed as many as 200 long COVID symptoms. The most frequently reported symptoms are breathlessness, chronic fatigue, and brain fog. The breathlessness, chronic fatigue, and other symptoms may slowly improve; however, brain fog may worsen with time.

新冠长期后遗症患者所表现出的症状可能会延续数周、数月甚至数年。一些研究人员和临床医生已经列出了高达200种新冠长期后遗症症状。人们报告最多的症状是呼吸困难、长期疲劳和脑雾。前两种和其他症状可能会缓慢好转，但脑雾症状却可能会逐渐恶化。

Brain fog is a foggy term. It is not specific, which makes it challenging to study. Another way of describing the commonly reported cognitive issues is cognitive impairment or deficits. I also don't believe that conceptualizing the post-COVID brain changes as impairments, deficits, or dementias is accurate. Post-COVID cognitive changes may look like other neurological disorders, such as dementia, ADHD, or traumatic brain injury. But it is important to keep in mind that the underlying biological mechanisms may not be identical. This is an important consideration for treatment.

脑雾，是一个并不明确和具体的术语，因此对这一症状的研究也就充满挑战。对于普遍报告的认知问题，另一种描述词汇是认知损伤或缺陷。但我也不认为将新冠后的大脑变化定义为损伤、缺陷或痴呆是精准的。新冠后认知能力变化可能看起来像是其他的神经障碍，如痴呆，ADHD或创伤性大脑损伤等。但需要记住其底层生物机制可能并不相同。这是治疗中的一个重要考量因素。

Many people who suffer from neuro-long COVID indeed perform like those with mild cognitive impairment on neuropsychological assessments. This is certainly concerning enough for researchers to find mechanisms and treatments based on this understanding.

受神经性新冠长期后遗症困扰的人的确在神经心理评估中表现得类似轻微认知损伤患者。这足以引起重视，研究人员需要基于这一发现来寻找致病机制和治疗方案。

These long-COVID symptoms can look like attention deficit disorder (ADHD). The hallmark symptoms of ADHD are difficulty focusing, short attention span, difficulty multitasking, and executive dysfunction. One can use the vague term "brain fog" to also describe a person's experience with ADHD. Pathologies in the brain's dopamine and norepinephrine systems have been proposed as the underlying mechanisms of ADHD. Hence, the management of ADHD symptoms has focused on amplifying the dopamine and norepinephrine brain signals.

这些新冠长期后遗症症状看起来会像是ADHD（注意力缺陷障碍）。ADHD的标志症状是难以集中精力、注意力集中时间短，难以同时处理多项工作以及执行功能障碍（大脑控制情绪、行为和想法的功能存在障碍，其中包括难以规划、启动和完成需要达成某种目标的活动等）。人们也可以用脑雾这一模糊术语来描述ADHD的患病体验。大脑多巴胺和去甲肾上腺素系统疾病被认为是ADHD的底层机制。因此，对ADHD症状的管控一直是基于放大多巴胺和去甲肾上腺素大脑信号这一方法。

A new study
一项新研究

To connect all these observations, a study on a very small sample size tested a currently used ADHD medication for long COVID (N=12).1 Guanfacine was approved for the treatment of ADHD in 2009. It was developed in the lab of Amy Arnsten, one of the authors of this report. The medication is combined with N-acetylcysteine (NAC-600 mg), an antioxidant for treating Traumatic Brain Injury (TBI). Eight out of the 12 patients studied reported improvements in memory, organizational skills, and ability to multitask. No objective tests were used to verify the patients' reported improvements. Two patients were unavailable for follow-up; the other two discontinued the medication due to intolerable side effects, such as low blood pressure and dry mouth.

为将这些发现联系起来，一项在小规模样本(12人)中开展的研究测试了将当前所用的一种ADHD药物用于治疗新冠长期后遗症。2009年，胍法辛被批准用于治疗ADHD。该药物由 Amy Arnsten 的实验室研发。Amy Arnsten也是本报告的作者之一。该药物与N-乙酰半胱氨酸（NAC-600mg）（用于治疗创伤性脑损伤的一种抗氧化剂）共同使用。12位受试者中有8位报告了记忆力、组织能力和多任务处理能力有所改善。但并未开展客观性测验来确认患者所报告的这些改善。两位患者无法参加后期追踪，另外两位因为无法忍受的副作用，比如低血压和口干症而终止服用药物。

This is not a placebo-controlled study and is considered anecdotal. Double-blind and placebo-control studies with much larger samples should be conducted before prescribing ADHD medications to long COVID sufferers. Also, one of the report's authors receives royalties from the U.S. sales of Intuniv (extended-release guanfacine).

该研究并无安慰剂对照组，被认为只是基于主观观察和汇报。在将ADHD药物用于新冠患者之前，需要在更大样本中开展双盲测试和安慰剂对照研究。另外，本报告的作者之一也是美国Intuniv（缓释胍法辛）销售市场中专利使用费受益人之一。

As explained earlier, the proposed mechanism of ADHD cognitive symptoms (attention, focus, and memory) is dopaminergic/adrenergic pathologies. We have begun to understand the underlying mechanisms of long COVID. A recent paper proposed six underlying mechanisms of long-COVID cognitive changes:

如前所述，ADHD认知症状（注意力、聚焦力和记忆力）的致病机制被认为是多巴胺/肾上腺素疾病。我们对新冠长期后遗症的致病机制也开始有了一定理解。一项近期的论文提出了新冠长期后遗症认知能力变化的6种底层机制：

1. Immune system's response to the virus increases molecules such as cytokines and chemokines, which can put the brain on fire (neuroinflammation).

免疫系统对病毒的反应增加了细胞因子和趋化因子等分子数量，这些分子会引发大脑炎症（神经炎症）

1. The virus itself can directly infect the brain.

病毒本身会直接感染大脑。

1. The virus can give rise to an autoimmune response where the brain attacks its own cells.

病毒会引发一种自身免疫反应，让大脑攻击自己细胞。

1. The virus can wake up dormant herpesviruses, like the Epstein-Barr virus, damaging the brain and leading to cognitive impairments.

病毒会唤醒潜伏的疱疹病毒，如EB病毒，这会损伤大脑，引发认知受损。

1. The virus and the resulting biological response can impair blood circulation, which provides the conduit of nourishments to brain cells.

病毒和其所导致的生物反应会损伤血液循环，从而影响对大脑细胞的营养输送。

1. Multi-organ dysfunctions in severe COVID cases can cause hypoxemia (a below-normal level of oxygen in your blood, specifically in the arteries) and metabolic disturbances that deprive brain cells of oxygen and nourishment and, in turn, provoke cell death.

新冠重症患者种的多器官功能障碍会引发低血氧（血液中，尤其是动脉中氧含量低于正常水平）和新陈代谢紊乱，从而导致大脑细胞缺乏氧分和营养物质，从而引发细胞死亡。

Where can we go from here
未来可以依循怎样的研究方向

It would be more beneficial to target the currently known mechanisms of brain changes in long COVID to search for efficient and effective treatments. Specifying the exact brain changes in long COVID using sensitive neuropsychological tests is crucial. The symptoms reported by long COVID patients, such as memory problems, might result from dysfunctions in other faculties, such as attention, default mode network, processing speed, neuroplasticity, neuro-inflammation, etc. Also, following the trajectory of these cognitive symptoms is essential. Cognitive deficits do not always lead to dementia or permanent decline.

建议在寻找高效和有效治疗方法时，应着眼于新冠长期后遗症大脑变化的目前已知致病机制。通过敏感神经心理测试来明确界定新冠长期后遗症中的大脑变化，这一点至为关键。新冠长期后遗症患者所报告的症状，比如记忆问题等，可能来自于其他机能的功能失调，比如注意力、默认模式网络、处理速度，神经可塑性，神经炎症等。另外，追踪这些认知症状的发展轨迹也至关重要。认知缺陷并非都会导致痴呆或永久退化。

As a sufferer of long COVID since 2020, the problem with my long-COVID brain is not one of memory deficit. It is more like the time scale used by the brain is much slower than the actual time. By the time the next moment begins, I am still processing the previous one. Or I stop processing the previous one in favor of hoping to catch the next one fully.

作为自2020年以来新冠长期后遗症患者，我的新冠后大脑的问题并非是记忆缺陷，而更像是我的大脑所采用的时间标尺要比实际时间缓慢。在下一时刻开始之前，我还依旧在处理之前时刻的信息。或者我会为了充分赶上下一时刻，而直接终止对之前信息的处理。

Also, the long-COVID brain struggles with multitasking, tasks requiring a long attention span, and intense focus. The byproduct of this slowing of brain machinery is memory deficits. While using strategies to improve memory would help, addressing the more direct mechanism would be better.

另外，新冠长期后遗症患者大脑会难以同时处理多项任务，或者需要长时间集中注意力的任务，或者精力的高度集中。大脑机器变得迟缓所带来的副产品是记忆缺陷。尽管一些记忆提升策略会有帮助，但如果能针对其更为直接的产生机制，则会更有效。

If you’re the parent of a teen, chances are you have had plenty of occasions to feel frustrated, confused and worried about how s/he is behaving. That is just how parenting teens goes – as they struggle, we do too.

如果你有一个十几岁的孩子，那么可能很多时候你都会感到挫败，疑惑和担忧。这是养育青春期孩子的正常现象——当他们在痛苦挣扎时，我们也同样如此。

The pandemic of COVID-19 has brought myriad parental challenges from distance learning to social isolation. Pandemic parenting has allowed many of us to see first hand more of what our teen’s life is, leaving us even more confused about what’s a normal reaction to a challenging time, and what’s not.

新冠疫情为父母带来了各种各样挑战，从网课到社交隔离等。疫情期间也让我们很多人对自己青春期孩子的生活有了更多的亲身体会，但同时也让我们更加困惑，不知道对这一棘手时期，哪些反应正常，哪些属于不正常范畴。

Teenage angst is the feeling of being overwhelmed, anxious, rejected, or even unwanted. Teens can feel better by understanding what is common, and what are greater concerns than the average teenage development.

青春期焦虑是一种感到无力应付、焦虑、被拒绝甚至被嫌弃的感受。如果青少年们理解哪些是正常现象，哪些远非青少年发育过程中普遍现象，应该引起重视，这会有助于改善他们的感受。

What is Teenage/Teen Angst
什么是青春期焦虑

Angst is a concept derived from existential anxiety referring to anxiety about one’s existence. Teenage angst involves frustration, rebellion, attitude and an overall irritable outlook on life. The teenage years are a period in your child’s life when they move beyond innocent childhood and start to test limits and boundaries as they approach adulthood. Teenage angst can happen as a result of disappointment in being told no when limits and boundaries are denied. Teenagers crave independence and freedom without the true ability to understand or predict all of the responsibilities that get factored in, as brain development is not fully complete until 24 years of age.

Angst（焦虑）是一个源于存在焦虑的概念，存在焦虑是指一个人关于自身存在而产生的焦虑。青春期焦虑包含挫败感、叛逆、不配合和整体上对生活持易怒暴躁态度。青少年时期，孩子离开单纯童年时期，随着接近成年，开始不断测试限度和界限。当被拒绝时，他们会感到失望，然后就可能会让他们感到青春期焦虑。青少年们渴望独立和自由，但却尚无真正能力去理解或预测所涉及到的所有责任，因为大脑直到24岁才会完成发育。

What Causes Teen Angst
青春期焦虑的起因

Teens experience angst for many different reasons.

青少年焦虑的产生有多种不同原因。

Some of these changes are obvious because they affect the size and shape of our teen’s bodies and voices. The fact that our teens struggle at times with these changes is easy to understand because we can see the changes too. Their bodies develop quickly, their voices change, and their skin often becomes an intense focus as their hormones drag their young bodies to adulthood.

一些变化很明显，它们发生于孩子的身体和声音。这些变化有时会让孩子觉得难以应对，因为我们也能看到这些变化，所以我们能很容易理解。随着荷尔蒙将他们的身体拽入成年时期，他们的身体飞速发育，他们声音发生变化，他们通常会对自己的皮肤密切关注。

Other changes are happening internally. Teenagers’ brains go through tremendous growth and rewiring, a phase of growth second only to infancy. As the teen brain neurologically “updates,” the “lower” more emotional regions update before the “higher” more cognitive ones.

但在他们身体内部，也在发生着其他变化。这一时期，青少年的大脑进入仅亚于婴儿时期的飞速发育和重塑期。随着青少年大脑神经系统的升级，较低级的情绪区域的升级要早于较高级的认知区域。

Because of this linear brain development, teens are exposed to intense and mature emotions without the benefit of a fully mature thinking brain. The part of the brain that manages insight, judgment and behavioral control (the prefrontal cortex) will take many more years to fully update.

由于大脑的这种线性发育过程，青少年需要面对强烈和成熟的情绪，但大脑思考能力却尚未完全成熟。负责管理洞察力、判断力和行为控制（前额叶皮层）的大脑区域还需要很多年才能完全升级。

There may also be situational causes of teen angst, like lack of sleep. With all the brain development going on during this time, teens need adequate sleep. NIMH recommends teens get about 9-10 hours of sleep a night. With proper care and support they’ll be a successful adult in no time. Teenagers face a lot of changes throughout this time, from the change of schools, friendships, and even their interests. They begin to find themselves thinking more and more about the future, which can bring on feelings of anxiety and uncertainty.

另外还有一些客观原因，如睡眠不足。这段时期大脑飞速发育，因此青少年需要充足睡眠。美国国家心理健康研究所建议青少年睡眠时间每晚应在9-10个小时。如果得到充分的照顾和支持，他们很快就会成为一个成功的成年人。在这一时期，青少年面临很多挑战，从学校的变化，到友情的变化，甚至自身兴趣爱好也会发生变化。他们开始发现自己开始更多地思考未来，这可能也会带来焦虑感和不确定感。

Teens feelings therefore are intense, driving powerful creativity and motivation, but also frustration and overwhelm. These emotional changes can be scary for teens, and are fundamental to how we understand what is teenage angst.

因此，青少年的感受是非常强烈的，从而会催生强大的创造力和驱动力，但同时也会带来挫败感和力不从心感。这种情绪上的变化对青少年来说会是很可怕的，而且也是我们理解青少年焦虑的基础所在。

Angst can span a gamut from normal insecurity to more acute feelings of anxiety or apprehension that can be accompanied by depression. It can also be a frustrating, painful and frightening challenge for parents as well, as we can struggle to understand what is teenage angst, and what is something more serious.

从正常不安全感，到可能伴随着抑郁感的强烈焦虑感或担忧，青春期焦虑涵盖范围很广。这对父母而言，也可能会是一种令人沮丧、痛苦和可怕的挑战，因为我们可能很难辨别青春期焦虑和更严重问题。

Clarifying the range from normal to more serious can help parents feel more confident navigating this complicated developmental stage.

明确了解从正常现象到更严重问题之间的范畴，这有助于让父母更自信地应对这段复杂的发育阶段。

What Is “Normal” Teen Angst & What’s a Problem
什么是“正常”的青少年焦虑&什么时候需要引起担忧

You know your child best, and witnessing your child’s attitude and behavior change, perhaps seemingly overnight, may come as a shock. While “normal” is subjective and questionable, there are common characteristics and signs of teenage angst. When these behaviors start to become extreme and disruptive and interfere with daily life, is when it starts to become more of a cause for concern, and grounds to seek professional help and support.

你最了解你的孩子，目睹孩子的态度和行为变化，而且甚至可能看起来仿佛一夜之间就发生变化，这可能会让人惊愕不已。尽管“正常”这个词是主观且并不可靠的，但青少年焦虑的确存在一些普遍的特点和迹象。而当这些行为开始变得极端、破坏干扰日常生活时，这就需要引起担忧，或寻求专业帮助或支持。

Here are some of the more common and “normal” signs of teen angst:
以下是青春期焦虑的一些较为普遍和“正常”的迹象：

Changes in interests (such as music, hobbies, activities)
兴趣（如音乐、爱好、活动）发生变化

Changes in friend groups
交友圈发生变化

Changes in clothing style
穿衣风格发生变化

Changes in sleeping patterns
睡眠模式发生变化

Changes in mood
情绪变化

Changes in academic performance
学习成绩发生变化

Being more secretive or dismissive of information
不愿吐露信息，或对信息不屑一顾。

Increase in rebellious behavior and rule-breaking
叛逆行为或不遵守规则行为增多

However, if these behaviors continue or become extreme, it can be a sign of more serious mental health issues such as depression, anxiety and/or self-harm and suicidality, and may require professional help.

但如果这些行为继续存在或变得极端，可能意味着存在一些更严重的精神健康问题，如抑郁、焦虑和/或自我伤害或自杀倾向，而且可能需要专业人士帮助。

Signs That It’s More Than Teenage Angst
比青春期焦虑更严重问题的迹象

If angsty behaviors continue or worsen, you may need to watch for signs of depression, anxiety, or potential for self-harm behavior. Signs may include extreme sensitivity, difficulty concentrating, poor personal hygiene, or avoidance behaviors. There is a lot of overlap in emotional and behavioral changes that occur in a teen experiencing depression, anxiety, self-harm and/or suicidality. Keep in mind they don’t have to experience all of these changes in order for your teen to receive help from a professional.

如果青春期焦虑行为持续存在或恶化，你可能需要留意是否有抑郁症、焦虑或自我伤害行为的迹象。这些迹象可能包括：极端敏感、难以集中注意力，不注意个人卫生，或回避行为。对于有抑郁、焦虑、自我伤害和/或自杀倾向的青少年，不同潜在严重问题所导致的情绪和行为上的变化在一些方面是重叠的。

Potential Signs of Depression
潜在的抑郁症状

Emotional changes such as:
情绪变化示例：

• Crying for no reason
无缘无故哭泣

• Feeling worthless or guilty
感到自己毫无价值或内疚

• Difficulty thinking, concentrating, and remembering things
难以思考/集中精力或记忆里变差

• Irritability and quick to become frustrated or overwhelmed
易怒，很容易就感到挫败或无力招架

• Extreme sensitivity to rejection or need to receive frequent reassurance
对拒绝极度敏感，或需要不断频繁寻求肯定

• Grim and bleak perspective on life
感觉人生前景一片灰暗

Behavioral changes such as:
行为变化示例：

• Changes in sleep patterns, either insomnia or sleeping too much,
睡眠模式发生变化，或是失眠或是睡眠过多

• Marked restlessness and inability to sit still,
很明显无法安静下来，无法安静坐着。

• Changes in appetite, either resulting in weight loss or weight gain
胃口变化，从而导致体重降低或体重增加

• Use of alcohol and/or drugs,
开始饮酒和/或使用毒品

• Noticeable decrease in school performance and enthusiasm,
学习成绩和学习热情明显下降

• Social isolation from both friends and family,
对朋友和家人开始自我隔绝

• Less care of physical hygiene and appearance
对个人卫生和外貌不再那么在意

Potential Signs of Anxiety
潜在的焦虑迹象

Emotional changes such as:
情绪变化示例：

• Fear of being away from parents
害怕离开父母

• Extreme fear about specific things or situations
对特定事物和情形极端恐惧

• Frequent worry and fear about the future
频繁为未来感到担忧和恐惧

• Hyperfixation of their appearance
过度关注自己外貌

• Verbalizing frequently concern that something bad is going to happen
经常说可能会发生不好的事

• Sudden, intense and unexpected fear that often result in physical symptoms
突如其来的强烈恐惧感，且这种恐惧感通常会导致一些生理症状的出现。

Behavioral changes such as:
行为变化示例：

• Sleep problems
睡眠问题

• Chronic complaints of stomach aches or headaches
经常抱怨胃痛或头痛

• Fatigue
感到疲劳

• Avoidance of activities
回避各种活动

• School avoidance and/or refusal
回避和/或拒绝去学校

• Drastic changes in routines
日常生活习惯发生剧烈变化

Potential Signs of Self-Harm & Suicidality
自我伤害&自杀倾向的潜在迹象：

Emotional changes such as:
情绪变化示例：

• Verbalizing feeling trapped or hopeless, either in general or about a specific situation
说感到被困住或无望，这或是在谈论整体感受，或是在谈论某一具体情形

• Frequent mood swings
情绪频繁波动

• Extreme sensitivity to feedback or rejection
对反馈和拒绝极端敏感

• Changes in appetite
胃口变化

• Decrease in motivation or interests
主动性和兴趣降低

Behavioral changes such as:
行为变化示例：

• Social isolation from peers and family
对家人朋友开始自我隔绝

• Talking or writing about suicide – such as making statements like “I won’t be around much longer”
在言语和文字中会谈到自杀，比如会说/写“我很快就会不在了”

• Increase in use of alcohol and/or drugs
饮酒量和/或使用毒品量增加

• Wearing long sleeves, hoodies, pants, etc. in warmer climates to hide physical signs of self-harm (cutting, burning, picking, etc.)
在温度较高天气穿长袖衣服，带帽卫衣，长裤等，以遮住自我伤害痕迹（如割伤，烧伤，指甲抠伤等。）

• Engaging in self-destructive or risky behaviors
采取自我摧毁或危险行为等

• Giving away their possessions without any reason
毫无缘由送出自己的物品

• Sudden burst in happiness (often occurs right before a plan to die by suicide)
突然表现出很快乐（通常发生于计划自杀之前）

10 Tips for How to Help Your Angsty Teen
10条帮助建议

Before you begin jumping to conclusions and forcing your teen to open up to you, you have to take a few minutes for some self-reflection. Are you approachable and nonjudgmental? Are you offering solutions or advice without permission? Are you continuing to bring things up after your teen has asked you to stop? These are some of the more common barriers that my teenage clients share during sessions. Having open and clear communication is the first step in building trust and connection.

在你开始仓促下结论，强迫你的青春期孩子向你吐露心扉之前，你需要先花几分钟时间自我反思一下。你是否亲近随和且不会对别人妄加评判？你是否在没获得允许的情况下提供解决方案或建议？在孩子要求你停止之后你是否还继续在这些话题上喋喋不休？这些都是我在治疗的青少年患者在心理治疗过程中所讲述的较为普遍的障碍。坦诚明确的沟通是建立信任和理解的第一步。

1. Make Time for Them

为他们留出时间

As the world continues to turn, and tension rises, make sure you and your teen find things to do together. Some families may be blended, or welcoming younger sibling(s). It’s normal for the attention to shift, but making a point to make time for your teen is valuable.
生活依旧在继续，压力不断增加，但确保你和你的青春期孩子找到一些可以一起做的事情。一些家庭可能是重组家庭，一些可能即将迎来弟弟妹妹，注意力转移很正常，但特地给你处于青春期的孩子留出时间，这一点极其重要。

Pro tip/专业建议：

showing genuine interest in things that they enjoy goes a long way—yes… even TikTok.
对孩子喜欢的事物发自内心流露出兴趣会带来莫大收益——是的，哪怕是抖音。

1. Encourage Healthy Sleep Habits

鼓励养成健康的睡眠习惯

This one is scientifically backed, but much more difficult to practice. Helping your teen build a sleep routine will help them in the long run! Recalling all of the development that happens to the adolescent brain, overall functioning improves when we have adequate sleep.
这一点是有科学证据支持的，但却很难付诸实践。帮助孩子建立良好睡眠习惯可以让他们长期受益。想一下青春期大脑所经历的发育过程，就会知道当我们睡眠充足时，整体机能都会得到提升。

Pro tip/专业建议：

Model positive sleep habits yourself by using guided meditation for deep sleep, reading a book or drinking some calming tea. Teens already know they need more sleep, but modeling this behavior with them helps them follow through.

以身作则养成良好睡眠习惯，方法可以是在指导下进行冥想，从而获得深度睡眠，或读书，或喝一些具有镇静作用的茶。青少年本身知道他们是需要更多睡眠的，但如果你能以身作则，会帮助他们坚持这一习惯。

1. Give Your Teen the Space They Need

给孩子所需的空间

It may be difficult as their parent or guardian to watch your teen struggle with their feelings, but allowing them the opportunity to problem-solve on their own will encourage them to take one more step closer to independence. As a therapist, I give teens the space that they need during sessions, helping them express their need for space with their parents, while also figuring out ways to cope with their stressors.
当看到孩子在自己感受中挣扎时，父母或其他看护人都会心里不好过，让给孩子独立解决问题的机会，会鼓励他们更进一步走向独立。作为心理医生，在治疗期间，我会给青少年患者们他们所需的空间，帮助他们向他们的父母表达对个人空间的需求，同时也会想办法应对他们的压力源。

Most of the teens I see share a similar desire of wanting space to be able to think and reflect on their own, and at times may have difficulty admitting they may need your guidance. The thing about giving your teen space is that they know they can come to you when they need to. This happens because of the trust and open communication you developed earlier.

我的大多数青少年患者都透露了想要能够让自己思考的个人空间的这一愿望，而且有时很不愿意承认他们“可能”需要你的指引。给青春期孩子个人空间，关键的一点，在于他们知道当他们需要你帮助时他们随时都可以求助于你。这一点的实现，需要你们在此之前就已建立信任和坦诚沟通氛围。

Pro tip/专业建议：

stop pushing when they say “stop” or state they don’t want to talk about it right now.

当孩子叫停或表示现在不想和你再继续讨论这一问题时，就不要再继续逼迫孩子。

1. Ask Your Teen Directly How You Can Help

直接询问孩子你可以如何给予帮助

Your teen usually knows how they want to be helped, and you may be surprised by their response. Most of the time they’re not looking for a solution, per say, but rather space to be heard. Sometimes they just want a hug and to be told that their feelings will pass or are validated. Sometimes they need to drive around with you and grab a snack. It is more than okay for your teen to not know how they can be helped either.

你的青春期孩子通常知道他们需要怎样的帮助，而且他们的回答可能会令你感到惊讶。很多时候他们并不是在寻找一个解决方案，而是想要一个能够被倾听的空间。有时他们只是想要一个拥抱或有人告诉他们这些感受都是暂时的或者都是很正常的。有时他们需要和你兜兜风一起吃点东西。但如果你的孩子不知道自己想要怎样的帮助，也完全很正常。

If they’re not bringing up seeing a therapist, ask them if they think talking to someone who isn’t their parent or guardian might be helpful. Do not be afraid to be the one to begin tough conversations about mental health. If you feel it is helpful, ask your teen if they want to hear how you handled a similar situation when you were their age.

如果他们没有主动说想看心理医生，问他们是否会觉得跟父母或看护人之外的人聊一聊会对他们有帮助？不要害怕主动提起关于精神健康的棘手话题。如果你觉得这会有帮助，可以问孩子他们是否想听听你在他们年龄时是怎样应对一个类似情形的。

Pro tip/专业建议：

even if your situation may not have been handled in the best way, you can share how you wish you could’ve handled it differently knowing the things that you know now.

即使你当年对当时那一情形的处理方式并不理想，你依旧可以告诉孩子，在现在的你看来，希望当时本可以怎样处理。

1. Try Journaling to Express Thoughts & Feelings

尝试用记日记的方式表达想法和感受

Your teen may already be doing this on their own, but if not, encourage them to think about using a journal to express their thoughts and feelings, a great mindfulness practice. Journaling does not look the same for everyone, and allow your teen to develop a style on their own. Offer to help them buy a journal or even self-help workbooks or journal prompt books.

你的孩子可能已经有记日记习惯了，但如果没有，可以鼓励孩子用日记来表达个人想法和感受，这也是一种非常棒的正念练习。不同的人对日记有着不同的理解，因此孩子有自己的记日记方式。主动提议帮他们购买日记本或自励书籍或日记指导书籍。

Again, a major theme is space and privacy, especially when it comes to their journals. Allow your teen the freedom to share what they’ve written or drawn, only if they choose to do so – no snooping!

再说一遍，一个重要的主题是，空间和隐私，尤其是关于他们的日记时。如果孩子愿意，可以听孩子讲他们写下或画的内容。但是，不要偷看！

Pro tip/专业建议：

It is healthy for everyone to find some sort of outlet to not bottle up emotions, and journaling is one of the best ways to do so.

找到一个发泄渠道，不让情绪闷在心里，这对任何人都是健康的，而且记日记就是其中一种最好的方式。

1. Keep It Real

不遮掩实情

Teens are arriving at a point in their lives where some of their childhood fantasies and daydreams no longer feel realistic or possible. Teens are able to have a better grasp on reality and can often tell when adults in their lives are trying to hide things from them. Most of the time, adults do this to “protect” them, but trust me when I say this, your teen knows. They are no longer as naive as they once were, and the less you try to hide from them the better.

在青春期，孩子已经会觉得他们童年时期的一些幻想或遐想已经不再现实或可能。青少年能够更好地理解现实，而且当他们生活中的成年人试图向他们隐瞒时，他们通常也能够识别。大多时候，成年人之所以隐瞒，是想要“保护”他们，但相信我，你的青春期孩子什么都知道。他们已经不再是以前那个天真单纯的孩子，而且，你隐瞒的越少越好。

Of course, having boundaries is equally important and as their parent or guardian your job is not to be their best friend, but rather someone they can rely on. If something they are going through is tough, admit that, hold that space for them.
当然，建立界限也同样重要。作为他们的父母或看护人，你的职责并不是成为他们最好的朋友，而是成为他们可以依赖的人。如果他们在经历的某种情形很棘手，承认这一点，并为他们 “hold space”（这一概念是指在自己内心为别人留出一个空间，仿佛是创建一个安全的，充满爱和共情的容器或茧房，当对方和你在一起时，让对方感到能够自由对你倾诉，感到被理解，被倾听，而且你不会去带着自己看法去批判对方或给出建议）。

Pro tip/专业建议：

sugar coating and bandaids are no longer quick-fixes for heartbreak and stress relief.
裹“糖衣”或贴创可贴般的做法已经无法再对心碎和压力问题快速奏效了。

1. Cultivate an Attitude of Gratitude

培养感恩态度

Chances are your teen is feeling down about themselves in one area of their life or another. This can be feeling insecure about their looks, their friendships, their grades, or even their relationship with their family. Take a few minutes each day to remind your teen how much they matter to you and how much they mean to you.

可能你正处于青春期的孩子正因为生活中某些方面而感到难过，可能是对外貌，友谊/成绩甚至与家人之间关系有种不安全感等。每天花几分钟时间提醒孩子他们对你有多重要，对你有多么意义重大。

Some may tolerate the “mushy-gushy” verbal praise, and others might think you’re weird. However your language is to express gratitude, take some time to show it. Do not just assume your teen knows how much you love and care about them.
一些孩子可能会容忍你的腻腻歪歪情感泛滥的话，一些可能会觉得你有病，但无论你用什么语言来表达感谢，都花时间去展示出来。不要只是假设你正处于青春期的孩子知道你多么爱他/她，多么在乎他/她。

Pro tip/专业建议：

there’s more to be proud about than just good grades in school.
让你对他们感到自豪的，并不只有好的学习成绩。

1. Remember That It Isn’t Personal

別觉得是针对自己

Try your best to not take it personally during this season in parenthood. Chances are your teenager will have some “low-blows” and “painful digs” that hit home, but know that this is one of the most challenging and confusing parts of your child’s life. The way you navigate teenage angst is critical to the relationship you maintain in the future as they enter into adulthood.

在养育孩子的这一阶段，尽量不要觉得孩子都是在故意针对你。可能你的青春期孩子会有一些直击你痛处的“卑鄙招式”和“刻薄嘲讽”，但你要知道这段时间是孩子一生中最具挑战性，最让人困惑的一段时期。你应对孩子青春期焦虑的方式，对未来孩子进入成年后你和孩子的关系至关重要。

Keeping healthy boundaries and learning to let things go will be good for both you and your teen’s sanity. Taking it personally will only build resentment towards your teen.

保持健康界限，学会不计较，这对孩子和你的精神健康都有益处。对孩子的话太在意太当真，只会不断滋生你对孩子的恨意。

Pro tip/专业建议：

Give your teen and yourself the same grace by using affirmations that help you stay calm and help to maintain healthy boundaries. Try repeating phrases such as, “I know in my heart my teen loves and cares about me. I know that they are not trying to offend me.” “I choose to let go of the hurtful and painful things they have said to me and will not take it personally.”

使用可以帮助你保持镇静和维持健康界限的肯定言辞，放自己也放孩子一马。试着重复以下句子或其他类似言辞：

“我内心知道我的孩子爱我在乎我，我知道他们并不是在刻意冒犯我。”

“我选择不计较孩子对我说的那些刻薄攻击的话，而且不会觉得那是在刻意针对自己。”

1. Have a YES day

指定一个“YES”日

Similar to making time for your teen, have a designated day where you say “yes” to just about anything and everything that your teen wants to do. You may be surprised at what your teen says they want to do. Allowing your teen to be in charge of what you two do together for the day can be a really fun and engaging way to gain insight into your teen’s interests and decision making.

就像你特意给孩子留出时间，你也可以特意指定一天作为“Yes” 日，在这一天中，你对孩子想要做的事情都说“Yes”。孩子说的他们想做的事情可能会出乎你的意料。这一天中，让孩子负责规划管理你们共同做的事情，这会很有趣，而且你也可以在这一有趣过程中窥见孩子的兴趣和决策能力。

Pro tip/专业建议：

There could be some limitations and ground rules for what they can and cannot ask for, such as a new piercing or getting a tattoo. You can also create a budget on how much they can spend or how far they can travel. The idea is to allow your teen to experience freedom in a safe and supportive way.

对于孩子的要求，可以规定一些限制和基本准则，比如身体穿孔或刺青等。你也可以规定预算或出门距离。中心思想是，让孩子在安全、被支持的前提下体验自由。

1. Open Door & Code Words

开门政策&暗语

One of the best things you can do for your teenager is to establish an “open door policy” where your teen feels comfortable coming to you to talk about things that are troubling them. The more trust they have with you, the safer they will be in risky or dangerous situations.

父母对青春期孩子最值得建议的行为之一，就是建立“开门政策”，让孩子感到随时都可以毫无压力的来向你倾诉他们的困扰。他们对你越信任，他们在高风险或危险情形中就越安全。

You can even have a code word or phrase that your teen can use when around peers or in a situation where they feel uncomfortable. This often comes with a no-questions-asked, no lecture agreement. Your teen knowing that they aren’t going to be bombarded with questions or lectures will make them more likely to reach out and ask for help when it counts the most. Your teen will most likely open up to you about the situation that caused them to use the code word and chances are they are practicing good judgment by asking for help.

你们还可以约定一个暗语，可以是一个词也可以一句简短的话，让孩子在同伴周围或在自己觉得不舒服的情形中使用。但同时还应注意，对于孩子使用暗语，不要问问题，不要说教。如果你的孩子知道在之后不会被各种问题、说教炮轰，他们就更可能在自己最需要时主动向你寻求帮助。你的孩子很可能会主动向你讲述为什么当时会使用“暗语”而且也很可能，你会发现他们当时寻求帮助的决定是很明智的。

Pro tip/专业建议：

It may be difficult to not ask any questions or limit the lecture, but it is important in building trust and maintaining the open door environment you are trying to establish.

可能很难不去问问题或大肆说教，但对于建立信任和维系你所建立的“开门”政策氛围而言，这一点却至关重要。

Keeping communication lines open can help you and your teen maintain the communication you need to provide critical ballast during this time of transition. Despite their emerging independence, remember your teen still needs your support and love. Inside that alarmingly grown up body is still your vulnerable child and they need you.

保持沟通渠道的畅通，有助于让你和孩子之间保持充分沟通，足以为孩子这段汹涌变迁岁月提供至为关键的“压舱石”的沟通。尽管他们逐渐开始独立，但记住你的孩子依旧需要支持和爱。在他们迅猛发育的身体中，依旧是你那个脆弱的小孩，而且他们需要你。

Trust yourself to judge what is normal teen angst and what is something more serious. You know your child best, and maintaining your connection is one of the most powerful strategies you can employ to weather their angst.

相信你自己可以判断什么是正常青春期焦虑什么是更严重问题。你最了解你的孩子，维持你们之间的紧密关系，是成功应对这段焦虑岁月的最强大策略之一。

KEY POINTS
要点

Fantasies can misguide you in relationships.
幻想在感情关系中会误导你。

It is important to be aware of how past relationships may impact present ones.
了解过去感情经历对当前感情产生怎样的影响，这很重要。

Good relationship choices lead to greater happiness.
良好的感情关系选择会带来更高的幸福度。

A real relationship is often different from how you imagined, but that can make it more satisfying.
一段真实的感情通常与你想象中的不同，但却反而会给人带来更高的满意度。

Frequently, my patients want to form new relationships unburdened by patterns, memories, and fears imported from earlier (usually failed) connections. They want to be fully present in a relationship and resist versions of themselves warped by characters from (what they hope is) a discarded past.

我的患者们在建立新恋情方面，通常想要摆脱过去的（通常失败的）关系模式、记忆和恐惧。他们想要全身心真正投入一段新感情，摆脱（他们希望已成过往的）前任们在他们身上所遗留的各种影响。

But Debbie could only wish to be emotionally independent. “There’ve been a lot of men in my life,” she said. “And none are really gone.” What she meant was that every time she met someone new, she’d react as if they were some warmed-over version of a former guy. She never felt “free,” to use her word, to learn about them on their own terms.

但 Debbie 的问题却是很难实现情感独立。“我生命中有很多男人，”她说，“但他们都阴魂不散。”她的意思是，每当她遇到某位新的男士，都会将其当作自己某位前男友的某种新瓶装旧酒版本而做出反应。用她自己的话说，她从未感到能够“自由”地去将他们视为不同个体去了解他们。

She’d make assumptions as if they were someone she had known; she’d act on those assumptions; the guy would become bewildered, annoyed, and decide that the whole thing just wasn’t worth it. By the time she came to see me, she knew what was going on—that she was in thrall to her old relationships—but she couldn’t help herself.

她会无端假设，仿佛她已经认识他们。她会基于这些假设而做出某些行为，让对方感到疑惑、恼怒，并觉得这样一段恋情并不值得。在她来向我求助之前，她很了解自己问题在哪儿——她完全被囿于往昔感情经历中——但她却无法让自己解脱。

Debbie was attractive, around 35, and divorced. She’d come to the city three years earlier, assuming that she’d make a new start. As a commercial artist with an established client base, it shouldn’t have been hard, at least on its face. But like most people who assume that a change in geography somehow changes them, her relationships remained rocky. As we spoke, she acknowledged that she felt out of control, destined to make choices that would continue to destabilize her.

Debbie 很有魅力，35岁左右，离异。三年前她来到这个城市，觉得自己会有个新的开始。作为有着成熟客户基础的商业画家，这本应不会很难，至少表面看起来应该如此。但如同大多数觉得换个新地方就能让自己脱胎换骨的人一样，她的感情也是一路坎坷。如前所述，她承认她感到失控，感到自己注定做出会继续损害自己的选择。

An affair that had sent her into retreat occurred just when Debbie thought that New York might change the course of her career. She had always been successful as a commercial artist, but, since making the rounds, she’d fantasized that—someday, of course—her work might be shown at MoMA. A few people suggested that she try serious art. It was a heady time. “No one ever before said I was that good.” In her spare time, she took painting classes. She approached galleries.

就在 Debbie 觉得纽约可能会改变她的职业生涯时，发生了一段感情经历，这段经历也让她选择逃离感情。她一直是一位成功的商业画家，但在四处参观后，她幻想着——当然只是未来某天——她的作品也可以在现代艺术博物馆被展览。一些人也建议她尝试严肃艺术。那段时间很让人上头。“之前从未有人说过我是那么厉害。”在她业余时间，她参加绘画课程，她联系各种画廊。

Unfortunately, a gallery owner approached her, although not as she might have wished.

不幸的是，一位画廊老板主动联系了她，尽管并非以她可能希望的方式。

Everard was a former Londoner who had come to New York ten years earlier, intending to work for a big auction house. But then he started an art advisory business on the side. Ultimately, he opened a gallery. When he met Debbie, he clearly had an eye for talent. Nor was he shy about letting her know. Their affair was fueled, in part, by his encouraging her ambitions as a budding, serious artist. He introduced her around. He sold a couple of her pictures. Mostly, though, he allowed her to imagine an alternative, glamorous existence of openings, international buyers, and commissions from MoMA trustees. “I got hooked, I guess, on my fantasies.”

Everard 曾住在伦敦，10年前来到纽约，希望能够在一个大型拍卖行工作。但之后他开始了艺术顾问这一副业。最终，他开设了一家画廊。当他遇到 Debbie时，很明显他能够慧眼识珠。同时他也毫无保留地让她知道他对她的赏识。他们这段感情的动力，部分程度上来自于他鼓励她朝着严肃艺术新星这一宏大志向前进。他给她介绍关系，他卖掉了她的几幅画，最重要的是，他让她能够想象另一种璀璨绚烂的人生：画展、国际买家、来自现代艺术博物馆管理层的委托作画请求等。“我被迷住了，我想，被我自己的幻想迷住了。”

When the affair inevitably ended (Everard found someone else to “encourage”), Debbie couldn’t shake how she’d felt around him. “I still have a hard time living in the real world,” she told me. “I want every guy to make me feel like Everard did—really going somewhere with my art.”

当这段感情不可避免结束后（Everard找到了另一个人去“鼓励”），Debbie 完全摆脱不了和他在一起时自己的那种感受。“我依旧很难活在现实世界，”她告诉我，“我想每个人都能够带给我 Everard 给我带来的那种感觉，也就是说，我的画作有一天真的可以大获成功。”

What interested me, however, was why. Even when she understood the motivations that inevitably led her to a fall, she still allowed them to take hold of her. Why would she give in to stirrings that she knew, from past relationships, did her no good? Perhaps, I think, because she always had. It had become a pattern. She couldn’t tell whether a relationship was based on real, growing affection or just on some high that she got, before it all crashed and burned.

而引起我兴趣的，却是为什么。即使她完全了解这些不可避免让她栽跟头的动机，她依旧让自己臣服于这些动机。为什么她会屈服于往昔恋情的遗留负面影响？我想，可能她一向如此。这已经成为了她的一种模式。她无法分辨一段感情是基于真实的、慢慢发展的爱意，还是只是基于某种宛若吸毒至嗨的状态，而且之后不可避免会轰然崩塌。

The pattern emerged quickly, as soon as she started college. Before she graduated, she'd met a local painter whom, she thought, was the handsomest man she had ever painted. “I married him because he inspired me. Even though we competed.”

这种模式快速浮现，早在刚进大学时就已成形。在她毕业之前，她曾遇到一个当地画家，当时她觉得他时她画过的最帅的男人。“我和他结婚了，因为他激励了我，尽管当时我们之间也存在竞争。”

The problem was that she met someone new. He was a professor of statistics at a local university, and they’d been introduced by a mutual friend.

而问题是，她遇到了另一个人。他是当地一座大学的统计学教授，一位共同的朋友介绍他们认识。

When Debbie started dating him, he seemed nice enough, but (at least from her perspective) there was no spark. “He doesn’t know much about art,” she told me. “He says that if I want to go in the direction of serious painting, then I should try, but he has no basis for encouraging me.” In other words, here was a guy who didn’t fit Debbie’s pattern. In fact, he was the opposite: he didn’t flatter her or push her towards serious art, and he wasn’t likely to hurt her or leave her.

当 Debbie 开始和他约会时，他看起来人很好，但却（至少在她看来）没有火花。“他对艺术并没有很多了解，”她告诉我，“他说如果我想要朝着严肃艺术的方向发展，那么我应该尝试一下，但他并没有鼓励我前行的基础。”换言之，这个人并不符合 Debbie的 模式。实际上，他完全恰恰相反：他没有恭维她，或将她推向严肃艺术，而且他也不可能会伤害她或离开他。

The challenge with Debbie was to help her distinguish between short-term excitement—the pattern that we’d discovered—and what might lead to happiness in the long run. Okay, Larry had not been exposed to art. But, as it turned out, he was really nice to Debbie. He wasn’t selfish, and wasn’t preying on her ego.

在治疗 Debbie 方面存在的挑战是，帮助她区分短期兴奋——我们已经发现的她的行为模式——和长期幸福。好，Larry 没接触过艺术，但是，他却真的对 Debbie 很好。他不自私，而且也没有在利用她的 Ego。

I suggested that Debbie give him a chance. “You could teach him about art. Bring him to some galleries.” The point was not to allow old patterns, deeply rooted in her past and in her fragile ambitions, to derail a promising relationship. “Even if Larry is not, finally, The One,” I said, “at least you’ll have the experience of being with someone who doesn’t recycle your self-defeating tendencies.” I hoped she’d notice the difference, and get to like it.

我建议 Debbie 给他一个机会。“你可以教他艺术，带他去一些画廊。”重点是，不要让深深植根于她过去人生和脆弱志向中的固有模式摧毁一段很有希望的感情。“即使最后 Larry 并非你的真命天子，至少你终于可以有一段不再重复往昔负面模式的感情经历。”我希望她能够注意到这种不同，而且会喜欢上这种不同。

When we seek romantic happiness, we are frequently our own worst enemies. We prefer to live out temporary fantasies rather than pursuing real-life, long-term goals. We tell ourselves, “Don’t settle,” but what we’re really saying is that we don’t want to compromise with our fantasies.

当我们追求爱情时，我们通常是自己最大的敌人。我们更愿意追求短暂的幻想，而非追求切实的、长期的目标。我们告诉自己，“不要将就”，但我们真正想说的却是：“我们不想让自己的幻想妥协。”

At some point, however, we have to learn how to navigate our fantasies, and the best way is to actually see how it feels. If we learn anything from Debbie, therefore, it’s that trying to get past the pull of our fantasies —especially when they are tied up with our greatest ambitions—is far from easy. We can even be aware that we’re falling into our old ways and do it anyway. But if we ever want to be happy for the longer term, without all the usual awful blowback, then we have to try.

但在人生某个阶段，我们都不得不学会如何走出这些幻想，而最佳方式就是看它带给你的真实感受。因此，如果我们从Debbie身上学到任何东西，那就是，摆脱幻想的吸引——尤其这些幻想被与你的宏伟志向捆绑在一起时——远非易事。我们甚至虽然会意识到我们在重蹈覆辙，却依旧会义无反顾去做。但如果我们想要获得长期幸福，不再一如既往地被反噬，那么我们就需要尝试走出这些幻想。

What Is Anhedonia?
什么是“快感缺失”

Anhedonia is the inability or reduced ability to feel pleasure. When a person suffers from anhedonia, they lose interest in the activities, hobbies, or experiences they used to love.
快感缺失，是指感受快乐的能力丧失或减弱。当一个人患有快感缺失时，他可能会对曾经热爱的活动、爱好或体验失去兴趣。

“Anhedonia, a term first used by Ribot in 1896, is a diminished capacity to experience pleasure. It describes the lack of interest and the withdrawal from all usual pleasant activities. Chapman et al. defined two different types of hedonic deficit: physical anhedonia and social anhedonia. Physical anhedonia represents an inability to feel physical pleasures (such as eating, touching and sex). Social anhedonia describes an incapacity to experience interpersonal pleasure (such as being and talking to others).”
快感缺失由 Ribot 于1986年首次使用，是指体验快乐的能力降低。它表述了对所有平时让自己感到愉悦的活动丧失兴趣且不再参与。Chapman 等人定义了两种类型的快感缺失：

生理快感缺失
社交快感缺失

生理快感缺失是指无法感受到生理愉悦，（如饮食、触碰和性活动等）。社交快感缺失是指无法感受到人际交往带来的愉悦（比如与别人共处和交谈）。

It has been associated with many mental disorders, including depression, bipolar disorder, schizophrenia, and substance use disorder. People who have physical conditions like chronic pain and Parkinson's disease may also experience anhedonia.
这已经被认为和众多精神障碍存在联系，其中包括抑郁、双相情感障碍、精神分裂和物质使用障碍等。患有慢性疼痛和帕金森等生理疾病的患者，可能也会有快感缺失体验。

Symptoms of Anhedonia
症状

The symptoms of anhedonia depend on the type.
不同类型快感缺失表现为不同症状：

Symptoms of social anhedonia may include:
社交快感缺失的症状可能包括：

Very few or no relationships at all
几乎没有或完全没有人际关系

Complete withdrawal from existing social relationships
从既有社交关系中完全脱离

A diminished capacity to express emotions
情绪表达能力骤降

Fake emotions in social situations (e.g., pretending to be happy at a celebration)
在社交情形中假装表现出某种情绪（比如在庆祝活动中假装开心）

Preference for being alone
更愿意独处

Symptoms of physical anhedonia may include:
生理快感缺失的症状可能包括：

A complete loss of libido or interest in sexual interactions
完全丧失性欲或对性活动的兴趣。

Frequent illness or other physical health issues
频繁生病或患上其他生理健康问题。

A person with anhedonia may miss out on big life events. By not maintaining their social connections, people with anhedonia may also have strained relationships and even a loss of social connections.
快感缺失患者可能会错过一些重大的人生事件。而且由于无法维持社交关系，他们可能还会陷入紧张的人际关系或甚至失去某些社交关系。

Complications
并发症

Studies show that those with anhedonia are more likely to be at risk of suicidal thoughts, suicide attempts, and death by suicide. This is especially the case among those with post-traumatic stress disorder (PTSD).
研究显示，快感缺失患者更易于产生自杀想法、尝试自杀或自杀死亡。PTSD患者中这种现象更显著。

Research has also shown that anhedonia may be a risk factor for dementia-related diseases, such as Alzheimer’s disease. In a 2019 study, older adults with anhedonia were five times more likely to develop dementia than peers without anhedonia.
研究还显示，快感缺失也可能是痴呆相关症状，比如阿兹海默症等的风险因素之一。在2019年的一项研究中，快感缺失患者患痴呆症的几率是非快感缺失患者的5倍。

Anhedonia has also been associated with a heightened risk of adverse cardiac events among patients with heart conditions.
在心脏疾病患者中，快感缺失也被认为与更高的不良心脏事件风险相关。

What Causes Anhedonia?
什么导致快感缺失？

It's unclear exactly what causes anhedonia. Studies show that it may be closely tied to certain processes in the brain. Researchers found that the part of the brain that controls reward, decision-making, anticipation, and motivation is often involved in anhedonia.
对其起因尚无明确结论。研究显示其可能与大脑中的一些过程密切相关。研究人员发现，大脑中控制奖励、决策、预期和动力的区域通常与快感缺失相关。

They theorized that people with anhedonia may lack the ability to anticipate good things and find motivation. They also have problems accurately judging the effort required to achieve a certain reward.
他们提出这一理论：快感缺失患者可能缺乏预测良好结果或找到动力的能力。他们同时还难以精确判断达成特定奖励所需要付出的努力。

Anhedonia is linked to several mental health disorders. It is considered one of the core features of depression. People with schizophrenia often report both physical and social anhedonia.
快感缺失被认为与数种精神健康障碍相关。它被认为是抑郁症的核心特征之一。精神分裂症患者也通常报告生理和社交快感缺失。

Research has shown that depression in bipolar disorder is also associated with anhedonia. Doctors use the severity of anhedonia to determine how severe a case of bipolar disorder is.
研究显示双相情感障碍中的抑郁症状也与快感缺失相关。医生根据快感缺失的严重程度来判断双相情感障碍的严重程度。

Anhedonia-like symptoms may occur when using recreational drugs or when going through withdrawal. Also, researchers have found that those who already have anhedonia may be more likely to start taking recreational drugs. They may also be more likely to become addicted.
当服用娱乐型药物或在戒瘾阶段时也可能会出现类似于快感缺失的症状。另外，研究人员也发现已经患有快感缺失的人更可能会开始服用娱乐型药物。另外他们也更可能对其成瘾。

Other conditions associated with anhedonia include:
其他与快感缺失相关的疾病包括：

Parkinson’s disease/帕金森症

Chronic pain/慢性疼痛

Diabetes/糖尿病

Eating disorders/饮食障碍

Autism/自闭症

The severity of anhedonia may be linked to the related health condition. A study found that people with schizophrenia, substance use disorder, Parkinson's disease, or chronic pain experience moderate levels of anhedonia. Those with depression have more severe anhedonia.
快感缺失的严重程度可能与相关健康症状有关联。一项研究发现，患有精神分裂、物质滥用障碍、帕金森病或慢性疼痛的患者更可能会产生中度的快感缺失症状。而抑郁症患者的快感缺失症状则较为严重。

Diagnosis
诊断

Medical professionals often use anhedonia as a symptom to diagnose a mental health illness. For example, anhedonia may lead your healthcare professional to look into whether you have depression or bipolar disorder.
专业医疗人士通常将快感缺失作为一种症状来诊断某种精神健康疾病。例如，你如果患有快感缺失，你的医生可能会考虑你是否患有抑郁症或双向情感障碍。

Anhedonia can be measured using a questionnaire. One of the most popular ones is the Snaith-Hamilton Pleasure Scale (SHAPS). It consists of 14 statements about enjoyable situations typically encountered in daily life. This might include food or drinks and interests or pastimes. You're asked to rate how strongly you agree or disagree with statements based on your memories of the past few days.
对快感缺失的评测可以采用问卷形式。其中最普遍使用的是斯奈思—汉密尔顿快感量表（SHAPS）。该量表包含了14项日常生活中常见的愉悦情形，其中包括饮食、兴趣或消遣活动等。你需要根据自己近期情况，对每一项的认同程度打分。

Your healthcare professional may also perform a physical exam and blood tests to ensure your anhedonia is not caused by a physical condition.
你的医生可能还会对你体检和验血，确保你的快感缺失并非因生理疾病而导致。

Treatment
治疗

Treatment for anhedonia depends on the condition or mental disorder it's associated with. For people with depression, antidepressants may be prescribed, while people with schizophrenia are often treated with antipsychotic medications. Treatment may also include psychotherapy.
对快感缺失的治疗取决于与其相关的疾病或精神障碍。对于抑郁症患者，医生可能会开具抗抑郁药物，而精神疾病患者则通常会被开具抗精神病药物。治疗方式也可能会包含心理治疗。

Since anhedonia may be associated with deficits in the reward system of the brain, a different approach may be necessary for its treatment.
由于快感缺失可能与大脑奖励系统缺陷相关，那么其治疗方式可能就需要一种不同的思路。

One study found that positive affect treatment (PAT) resulted in better outcomes than treatment focused on reducing negative feelings. This approach attempts to increase the brain's sensitivity to rewards.
一项研究发现，正面情感疗法（PAT）要比旨在减少负面感受的疗法要更为有效。这一疗法试图增加大脑对奖励的敏感性。

Some medications may be able to help with anhedonia associated with physical conditions. For example, research shows that people with Parkinson’s disease experience a reduction in anhedonia after receiving treatment with dopamine agonist medications such as pramipexole.
一些药物可能会对生理疾病导致的快感缺失有效。例如，研究显示，帕金森患者在服用多巴胺激动剂药物，如普拉克索后，快感缺失症状会减轻。

You should never quit taking your prescribed antidepressant without speaking to your healthcare provider first. Let them know if it's not helping or you’re experiencing unwanted side effects. They will determine whether your medication dose needs to be changed or if you need a new medication (and how to safely make the change).
如果没有先咨询你的医生，则不应停止服用被开具的抗抑郁药物。如果这些药物并没有效果，或给你造成不良副作用，则应告知你的医生。他们会判断是否需要改变你的药物剂量或为你开具新的药物（以及如何安全地切换至新药物）

Summary
总结

Anhedonia is when your ability to feel pleasure is reduced or absent. You lose interest in the things that normally give you pleasure and may withdraw from social interactions.
快感缺失，是指感受快乐的能力降低或缺失。对通常能带给你愉悦的事情，你丧失兴趣，而且可能会不再参与社交互动场合。

Anhedonia has been associated with different mental disorders and physical conditions, including depression, bipolar disorder, and chronic pain. Treatment of anhedonia involves addressing the condition that it's associated with.
快感缺失已经被显示与不同精神障碍和生理疾病相关联，其中包括抑郁、双相情感障碍和慢性疼痛。对快感缺失的治疗需要针对与其相关的具体疾病。

Losing interest in the things you once loved can be difficult to experience. Remember that these feelings can be temporary and that anhedonia is treatable.
对曾经所热爱的事物失去兴趣，这种感觉并不好受。但记得这些感受可能会是暂时的，而且快感缺失是可治疗的。

It's important to let your healthcare provider know what's going on. They can help you figure out what's causing your anhedonia. Your treatment may include medication, therapy, or a combination of both. With the right treatment plan, you can get back to experiencing pleasure in your life again.
告诉你的医生你的真实体验，这至关重要。他们能够帮助你找出快感缺失的原因。你的治疗方法可能包括药物、心理治疗或二者兼用。在合适治疗方案下，你就能够重新体验生活中的乐趣。