我們翻譯這篇文章的理由
本文主要探討了一種心理療法ACT，即接受與實(shí)現(xiàn)療法。當(dāng)我們?cè)诿鎸?duì)不同的心理問(wèn)題或者情緒問(wèn)題的時(shí)候，我們或許應(yīng)該集中精力去做那些對(duì)我們來(lái)說(shuō)更重要的事，去成為我們想成為的人。努力和情緒問(wèn)題共存，因?yàn)榭鞓?lè)不是唯一的答案。
——李蕾
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收拾情緒，負(fù)重前行
作者： John J Donahue
譯者：金殊羽 & 郭嘉寧
校對(duì)：何翔宇
策劃：李蕾 & 何翔宇
It’s better to focus on where you are going than how you are feeling
別讓情緒干擾你前行的方向
The notion that emotional pain and suffering reflect a deviation from a default happy baseline has been referred to as the ‘a(chǎn)ssumption of healthy normality’. But it’s a mistaken assumption. Estimates of the lifetime prevalence of psychiatric disorders indicate that around one in two adults will meet the criteria for a mental-health condition at some point in their lives. Given that psychological pain is so ubiquitous, we should focus less on what might make us happy, and more on achieving a sense of meaning, regardless of how we’re feeling. Psychotherapy should help people manage effective functioning while they are distressed, above and beyond aiming to reduce symptoms such as difficult thoughts, emotions and sensations.
快樂(lè)是正常的，情感上的痛苦是異常的——這一被稱(chēng)為“對(duì)健康常態(tài)的假定”其實(shí)是錯(cuò)誤的。在估算了精神疾病在人的一生中的出現(xiàn)率后發(fā)現(xiàn)，大約50%的成人都在人生的某個(gè)階段達(dá)到了精神疾病的標(biāo)準(zhǔn)。既然情感上的痛苦如此常見(jiàn)，我們就應(yīng)該放下情緒，關(guān)注于如何實(shí)現(xiàn)某種意義，而不是如何使自己更快樂(lè)。心理治療的目標(biāo)不是為人減少消極的想法與情緒等癥狀，而是幫助人們?cè)诮箲]痛苦時(shí)依然能夠照常生活。
Acceptance and commitment therapy (ACT) takes this approach, using mindfulness, acceptance and other behavioural strategies to promote more flexible and value-driven behaviours. The goals in ACT are not necessarily to change or reduce one’s problematic thoughts or emotions, but to foster meaningful and effective behaviours regardless of mood, motivation or thinking. In other words, the primary goal is to promote what therapists call ‘valued living’.
接納與承諾療法（ACT）正是如此設(shè)計(jì)的，通過(guò)正念、接受現(xiàn)實(shí)等行為改造策略，該療法鼓勵(lì)人們變得更加自由，在做事時(shí)以?xún)r(jià)值為導(dǎo)向。ACT的目標(biāo)并不是改變或減少人的負(fù)面想法與情緒，而是讓患者在不論心情、動(dòng)力或想法如何的情況下，都能采取有意義且有效的行為。也就是說(shuō)，ACT的主要目標(biāo)是使患者過(guò)上心理治療師口中的“有價(jià)值的生活”。
Think of valued living as going about your daily life in the service of values that you find important, whereby engaging in these actions creates a sense of meaning and purpose. From an ACT perspective, symptoms of psychiatric disorders, and psychological suffering more broadly, are problematic when they are linked to rigid behaviours that pull us away from valued living. We might not have any control over the pain we experience – in fact, our emotional pain is profoundly human – but one area where we can exert some control is what we do in response to that suffering. Many common responses to difficult thoughts and emotions – such as avoidance, substance abuse, withdrawal and aggression – can alleviate distress in the short term, but also lead to long-term damage in our relationships, our jobs, our freedom and our personal growth – the very areas that provide that sense of meaning and purpose. By letting go of an agenda guided by minimising pain, and recalibrating toward a more value-driven agenda, our choices can be based on who we want to be, rather than how we want to feel.
所謂有價(jià)值的生活，指的是在日常生活中以你所看重的價(jià)值為中心，一切行為都為價(jià)值服務(wù)，由此為生活帶來(lái)意義和目標(biāo)。從ACT的角度來(lái)說(shuō)，當(dāng)心理疾病以及更大范圍的心理問(wèn)題的癥狀導(dǎo)致人的行為死板，無(wú)法過(guò)上有價(jià)值的生活時(shí)，這些癥狀就是有問(wèn)題的。我們或許無(wú)法控制痛苦的情緒——事實(shí)上，痛苦的情緒使我們富有人性——但是我們可以控制如何對(duì)待痛苦。許多常見(jiàn)的應(yīng)對(duì)負(fù)面想法與情緒的方法——如逃避，吸毒，與世隔絕，敵對(duì)行為等——能在短期內(nèi)減少痛苦，但長(zhǎng)此以往，會(huì)對(duì)人際關(guān)系、工作、自由和自我成長(zhǎng)等造成損害——而正是這些方面讓我們感受到生活的意義與目標(biāo)。通過(guò)將目標(biāo)由盡可能減少痛苦改為以?xún)r(jià)值為導(dǎo)向，我們?cè)谧龀鲞x擇時(shí)，可以想想我們希望成為怎樣的人，而不是我們想要擁有怎樣的感受。
In their 2013 study, the psychologists Todd Kashdan and Patrick McKnight of George Mason University in Virginia examined the day-to-day relationships between valued living and wellbeing in a sample of individuals with social anxiety disorder. This is a common but debilitating condition that’s marked by intense fear of social situations that might involve being negatively judged by others. People with social anxiety disorder often want and value positive relationships but considerable distress makes them avoid social interactions, so this is an excellent group in which to examine values and meaning.
在2013年，美國(guó)弗吉尼亞州喬治梅森大學(xué)的心理學(xué)家托德·卡希丹(Todd Kashdan)與帕特里克·麥克奈特(Patrick McKnight)對(duì)一批患有社交恐懼癥的人群進(jìn)行了研究，觀察對(duì)他們來(lái)說(shuō)，過(guò)上有價(jià)值的生活與心理健康的日常關(guān)系。社交恐懼癥是一個(gè)普遍但消耗很大的疾病，其特點(diǎn)為患者會(huì)對(duì)可能受到負(fù)面評(píng)價(jià)的社交場(chǎng)合感到極度恐懼。這一類(lèi)患者往往渴望且看重積極的人際關(guān)系，但由于過(guò)度擔(dān)心而回避人際交往，因此這一人群是研究?jī)r(jià)值與意義的絕佳選擇。
In the study, participants began by identifying their central aim or purpose in life (eg, ‘trying to be a good role model to others’). Then, each day over the next two weeks, they rated their daily efforts and progress toward this goal, and provided daily ratings of their self-esteem, meaning in life, and experience of positive and negative emotions. On days when they reported investing greater effort toward their main life goal, they also tended to enjoy greater wellbeing: they said their life had more meaning, and they scored higher on self-esteem and the experience of positive emotions. Importantly, support was not found for the reverse path – greater wellbeing did not predict greater effort or progress toward strivings. This study highlights that sometimes we need to make the value-guided choice, regardless of how we feel.
在研究中，被試者首先說(shuō)出自己主要的人生目標(biāo)（比如，“努力成為他人的行為榜樣”）。之后，在接下來(lái)的兩周里，他們每天都要評(píng)價(jià)自己為了達(dá)成目標(biāo)所做的努力與進(jìn)步，并對(duì)自己的自信水平、生活意義及感受到的積極與消極情緒進(jìn)行評(píng)估。報(bào)告顯示，在他們?yōu)樽约褐饕娜松繕?biāo)付出了巨大努力的日子里，他們的心理往往也更加健康，他們表示生活更加具有意義，自信心增強(qiáng)，且感受到更多的積極情緒。不過(guò)需要注意的是，沒(méi)有證據(jù)顯示反向推斷是可行的，即心理健康不代表為目標(biāo)做出了努力或進(jìn)步。該研究告訴我們，有時(shí)我們需要放下情緒，讓價(jià)值引導(dǎo)我們做出選擇。
If only it were so easy, though. For this reason, in ACT-based treatments, there is substantial focus on skills and techniques that can assist one in cultivating a more aware, willing and tolerant stance toward difficult feelings and other internal experiences. This stands in explicit contrast to a ‘do X and your distress will alleviate’ approach. The ACT techniques are not in the service of changing emotional states – they are in the service of facilitating valued action.
但事情并沒(méi)有這么簡(jiǎn)單。因此，ACT療法非常重視技巧，這些技巧可以幫助人們以一種更加專(zhuān)注、更加樂(lè)意、更加寬容的態(tài)度面對(duì)痛苦和其他一些內(nèi)在體驗(yàn)。這與“做某件事，你的痛苦就會(huì)減輕”的說(shuō)法形成了鮮明的對(duì)比。ACT療法不是為了改善情緒狀態(tài)，而是為了促進(jìn)采取有價(jià)值的行為。
The effectiveness of ACT across different diagnoses and problem areas shows that committing to the benefits of valued living transcends traditional diagnostic categories. In addition to anxiety disorders, in studies of post-traumatic stress disorder, depression and resilience, chronic pain, suicidal ideation and many more, engaging in behaviours consistent with personally held values has been linked to a range of positive outcomes.
ACT療法關(guān)于不同診斷和問(wèn)題的效果表明，重視有價(jià)值生活的帶來(lái)的益處要優(yōu)于傳統(tǒng)的診療方法。除了焦慮癥相關(guān)研究，對(duì)于創(chuàng)傷后應(yīng)激障礙、抑郁與恢復(fù)、慢性疼痛和自殺意念等其他方面的許多研究都表明，符合個(gè)人價(jià)值觀念的行為會(huì)與一些好的結(jié)果相關(guān)聯(lián)。
Which brings me back to my work as a therapist. While the breadth of exercises and techniques employed in ACT is beyond the scope of this article, there is one exercise I’d like to share that has helped some of my clients see the link between valued living and painful experiences. In this activity (of which there are different variations), the therapist first asks the client to write on an index card some of the internal experiences they are struggling with most – difficult thoughts and judgments, emotions, memories.
這讓我聯(lián)想到了我作為一名治療師的工作。雖然ACT療法采用的訓(xùn)練和技巧超出了本文的探討范圍，但我想分享治療當(dāng)中的一個(gè)訓(xùn)練，它幫助一些患者看到了有價(jià)值的生活和痛苦經(jīng)歷之間的聯(lián)系。在這項(xiàng)訓(xùn)練當(dāng)中（訓(xùn)練有許多種不同形式），治療師首先要求患者在索引卡上寫(xiě)下一些最困擾他們的內(nèi)心體驗(yàn)——包括一些負(fù)面的想法和判斷、情緒和記憶等等。
I ask them, what do you notice when you read that index card? I feel awful, I don’t want this. What do you want to do with the card? I want to throw it in the trash. Then the client flips the card over, and I ask them to write out some of the things that are most important, most meaningful to them – being a parent, caring and supporting others, learning, growing, etc. What do you notice when you read this side? Warmth, it feels right, this is who I want to be. Where is the pain, where is the other stuff? Still here, on the other side of the card. What happens if you push that pain away, escape or avoid it? I push the meaningful stuff away too. In your heart of hearts, what does your experience tell you right now? If I’m going to do the things that are important to me, be the person that I want to be, I also have to make room for the painful stuff.
我問(wèn)他們，你們?cè)陂喿x索引卡時(shí)都有什么感受？“我覺(jué)得很糟。我不想這樣。”你想怎樣處理這張卡片？“我想把它扔進(jìn)垃圾桶?！比缓蠡颊甙芽ㄆ奖趁?，我讓他們寫(xiě)下一些對(duì)他們來(lái)說(shuō)最重要、最有意義的事情——比如為人父母、關(guān)心和支持他人、學(xué)習(xí)和成長(zhǎng)等等。你讀到這一面時(shí)有什么感受？“很溫暖，感覺(jué)很好，這就是我想成為的人?！蹦峭纯嗪推渌挛锒既ツ膬毫?？“它們還在，在卡片的另一面?！比绻惆淹纯嗤崎_(kāi)，選擇一味逃避的話(huà)會(huì)發(fā)生什么呢？“我同時(shí)也把有意義的事物推開(kāi)了?！痹谀愕膬?nèi)心深處，你的經(jīng)歷給你帶來(lái)了哪些收獲？“如果我想要做那些對(duì)我來(lái)說(shuō)很重要的事情，成為我想成為的人，我也必須要承受痛苦的事物?！?/p>
In my experience, this is both an emotionally difficult exercise and also one that helps a person grasp that it’s impossible to disentangle pain and valued living. Sometimes it is hard to engage with those struggles in session, but we regularly return to the rationale of the approach – that maybe a different stance toward pain is necessary. And that is the crux of the work in ACT – opening up to the demons, judgments and suffering that lie underneath, all for the purpose of moving toward that which is meaningful.
以我的經(jīng)驗(yàn)看來(lái)，這不僅是一種情感上的艱難歷練，但也幫助人們認(rèn)識(shí)到我們無(wú)法擺脫生活當(dāng)中的苦難，珍惜生活才更為重要。有時(shí)我們很難面對(duì)這些困擾，但我們總會(huì)回到治療的基本原理——或許對(duì)生活中的苦痛采取一種不同的態(tài)度是十分必要的。這就是ACT療法的關(guān)鍵——對(duì)深藏的負(fù)面情緒、判斷和內(nèi)心的掙扎敞開(kāi)心扉，所有這些都是為了朝著有意義的方向繼續(xù)前行。
The valued path is not necessarily the happy path. Social connectedness sometimes brings us in contact with memories of abuse and trauma. Being a parent stirs up doubts, uncertainty and feelings of anxiety, fear, anger and shame. Advocating for social justice requires repeated exposure to the inequities in our societies and the feelings of helplessness that can come from fighting for an equality that might not exist until after you’re gone. But a growing body of psychological research suggests that the valued path is the more workable one, whereas the happy path can be more of an illusion.
有價(jià)值的生活方式不一定是快樂(lè)的。我們的社會(huì)關(guān)系有時(shí)會(huì)勾起曾經(jīng)遭受虐待和創(chuàng)傷的回憶。為人父母有時(shí)會(huì)讓我們心生懷疑，感受到一種不確定性、焦慮、恐懼、憤怒和羞愧。倡導(dǎo)社會(huì)正義會(huì)讓我們長(zhǎng)期身處社會(huì)的不平等和短期內(nèi)無(wú)法改變現(xiàn)狀帶來(lái)的無(wú)助感當(dāng)中。但越來(lái)越多的心理學(xué)研究表明，有價(jià)值的生活方式更加切實(shí)可行，而快樂(lè)的生活方式可能只是一種幻覺(jué)。
For readers who would like to find out more, I recommend the bookGet Out of Your Mind and Into Your Life (2005) co-authored by the founder of ACT, Steven Hayes, and also Things Might Go Terribly, Horribly Wrong (2010) co-authored by another ACT pioneer, Kelly Wilson. And here is the international directory of ACT therapists, maintained by the Association for Contextual Behavioral Science.
對(duì)于想要了解更多相關(guān)內(nèi)容的讀者，我推薦ACT療法創(chuàng)始人史蒂文·海耶斯(Steven Hayes)與人合著的《走出你的思維，走進(jìn)你的生活》(get out of Your Mind and Into Your Life, 2005)，以及另一位ACT療法的先驅(qū)凱利·威爾遜(Kelly Wilson)與人合著的《事情可能會(huì)變得非常糟糕》(Things Might Go, Wrong, 2010)。這是國(guó)際上ACT治療師的目錄，由情境行為科學(xué)協(xié)會(huì)整理。
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參考閱讀——伴病而行
在未知的某一天，你被診斷出患有慢性疾病。它將會(huì)和你如影隨形，甚至走到人生的盡頭。我們無(wú)能為力，但我們也絕不放棄。或許只有在這樣的時(shí)刻，那些被疾病所掩藏的無(wú)數(shù)的人生的真相才會(huì)真正袒露無(wú)遺，并且賜予我們重生的權(quán)利。
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本文原載于 Aeon
原文鏈接：https://aeon.co/ideas/its-better-to-focus-on-where-you-are-going-than-how-you-are-feeling
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