心理疾患的身体疗法 把旧日伤痛"演"出来

“There’s this cycle of knowing and forgetting,” van der Kolk told me. “We discover trauma. And then when we see how horrifying and how inconvenient it is, we turn on the concept and peel off the messengers.” Without missing a beat, he segued from Janet to World War I and World War II, explaining how the military establishments in both Europe and the United States stigmatized shell shock and combat fatigue, for fear that they would undermine the war effort. It’s willful amnesia, he said, and he had plenty of more recent examples. Just a few years ago, he interviewed a group of foster children at a United States Senate hearing on the state of foster care. “Afterward, I’m sitting with the kids,” van der Kolk said. “And a judge walks past us on his way out, and he says to the kids: ‘You’re all doing so great! Look how terrific you all are!’ And I say, ‘Well, no, why don’t you ask them how they’re doing?’ These are kids that have suffered significant abuse and neglect. A couple of them are suicidal. They have substance-abuse problems. One of them cuts herself. But the judge didn’t want to hear about that any more than we want to hear about what really happens to soldiers when they’re off at war.”
“这是一种认识和遗忘的循环，”范德科尔克告诉我。“我们发现了创伤。然后，当我们认识到它有多么可怕和多么令人为难时，我们会转而攻击这个概念，并排斥将这个概念带给我们的人。”他继续不厌其详地对我讲述从雅内到第一次世界大战再到第二次世界大战的历史，并解释了欧洲和美国的军事权威部门是如何抹黑炮弹休克症和战斗疲劳症的，因为他们害怕它们会削弱战斗力。这是故意的失忆，他说，并且举出了大量近期的例子。就在几年之前，他在联邦参议院关于寄养情况的听证会上问询了一批寄养儿童。“后来，我跟孩子们坐在一起，”范德科尔克说。“一名法官在出门时从我们身边走过，他对孩子们说，‘你们做得非常棒！非常了不起！’于是我说，‘哦不，你为什么不问问他们到底好不好？’这些都是遭受了严重的虐待和忽视的孩子，其中有几个人有自杀倾向，还有人存在物质滥用的问题，一个女孩子喜欢拿刀割伤自己。但法官并不想听到那些，就像在战争结束后，我们一点也不关心士兵们究竟怎么样了。”

Before enlisting in the Army, Eugene earned a bachelor’s degree in art history from the American University of Paris. Now he’s an antique art dealer. He lives in Queens with his wife and 3-year-old daughter but often goes into Manhattan to meet clients and visit galleries. I met him for coffee on the Upper East Side a couple of months after van der Kolk’s workshop. I wanted to know how he felt about the exercise now that some time had passed. Did he think it had any impact on his PTSD?
在从军之前，尤金在巴黎美国大学(American University of Paris)拿到了艺术史学士学位。现在，他是一名古董艺术品经销商。他与妻子和3岁的女儿住在皇后区，经常到曼哈顿去见客户或拜访画廊。在参加范德科尔克的研讨会几个月之后，我约他在上东区喝咖啡。我想知道，经过一段时间之后，他现在对“架构”练习的感觉如何。他觉得这对PTSD有效果么？

What intrigued him most, he said, is how well it worked in the moment. Whatever spell van der Kolk cast lingered into the next day, so that Eugene really saw me, a complete stranger, as the object of his guilt. “I was terrified of you,” he told me. It wasn’t until the following day, when van der Kolk had me forgive him a second time, that the spell finally broke and he was able to face me as just another workshop participant. “It reminded me of that movie ‘The Master,’ with Philip Seymour Hoffman,” he said. “When Amy Adams asks Joaquin Phoenix, ‘What color are my eyes?’ and he says, ‘Green,’ and she says, ‘Turn them blue,’ and you see them change color. It really reminded me of that.”
最令他着迷的，是这种练习的效果立竿见影，尤金说。范德科尔克的“咒语”的魔力直到第二天也没有消退，这让尤金真的将我，一个完全的陌生人，当成了他心怀愧疚的对象。“我很怕你，”他告诉我。然后又过了一天，范德科尔克让我第二次对他表示原谅，那咒语才最终被打破，他终于能够面对我，将我还原为研讨会的普通参与者而已。“这让我想起了菲利普·塞默·霍夫曼(Philip Seymour Hoffman)主演的电影《大师》(The Master)，”他说。“埃米·亚当斯(Amy Adams)问华金·菲尼克斯(Joaquin Phoenix)，‘我的眼睛是什么颜色？’他回答，‘绿色。’她又说，‘请把它们变成蓝色，’然后你就看到那眼睛真的变色了。真的，这确实让我想起了那一幕。”

For a while at least, he said, he felt better. He recalled driving down the Pacific coast with his wife the day the workshop ended and noticing how weird it was not to feel stressed out. For weeks he was able to drive and use the subway with no trouble. “It felt like it sort of repaired my perception somehow,” he said. “I used to always feel paranoid — like, I’d get freaked out going to my doctor because there were all these security guards in the waiting room — and for a while that was lifted.”
他说，至少有一段时间，他感觉好多了。他回忆起研讨会结束那天，他开着车带着妻子沿着太平洋海岸向南行驶，很惊异地发现自己似乎不再被压得喘不过气来了。在几个星期里，他可以毫无障碍地驾驶汽车和乘地铁。“就好像是我的感知功能不知怎的就给修好了，”他说。“我以前总是很疑神疑鬼——比如，就因为候诊室里面有保安，出去看医生都会吓坏我。但这种念头有一阵子没有出现。”

But some of those effects were starting to fade. He was having headaches and memory problems again, and he was trying to figure out what triggered the relapse. He thought it had something to do with a painting he saw. He attended an Asian art fair earlier in the week, and an Arab dealer was selling some contemporary paintings; most of them were of soldiers, but one was of a woman. She looked like me, he said. He remembered staring at it and freezing up. The next day at a client’s house, he misplaced his briefcase. “It was like I threw it out the window,” he said. He spent 20 frantic and embarrassing minutes searching the house in a sweaty panic before he finally found it, right where he’d left it, near a window by the door.
然而，其中的一些疗效开始消退。头痛和记忆问题再次缠上了他，他试图找出是什么触发了复发。他认为这可能跟自己看到的一幅画有关。本周早些时候，他出席了一场亚洲艺术博览会。一名阿拉伯经销商在销售一批当代绘画作品，其中大部分以士兵为题材，只有一幅画表现的是一名女子。尤金说她看起来很像我。他记得自己盯着它，一动也动不了。第二天，在客户的家里，他不知道把自己的公文包塞到哪儿去了。“简直就像我把它从窗户里扔出去了似的，”他说。整整20分钟，他狂躁而窘迫地搜索房子的每一个角落，浑身大汗，恐慌不已。最后他终于找到了包——就在他原先放的地方，门旁边的窗户附近。

Still, he was feeling hopeful. Van der Kolk had suggested some other possible approaches at the end of the workshop. He was planning to try E.M.D.R. next.
尽管如此，尤金表示，他还是挺乐观的。在研讨会结束时，范德科尔克还建议了其他一些可以采取的治疗方法。下一步，他打算尝试一下EMDR。

I asked him how he felt sitting across from me now. He said that he had to go to the bathroom and that his face felt numb around one eye. Ever since the exercise, the area around his right eye — the one he’d squinted at me with — went numb whenever he got nervous. He said he didn’t know why exactly, but he was sure it had something to do with the exercise itself. “I’ve been reading everything I can get my hands on,” he said. “It definitely helped, more than anything else I’ve tried so far. But I still have no idea what he did to me.”
我问他此时此刻坐在我对面的感觉如何。他说，他还是得去趟洗手间，而且，他觉得一只眼睛周围有些麻木。自从进行了“架构”练习后，他一紧张，右眼周围就会发麻——就是他瞟过我的那只眼。他说自己也不知道这是怎么了，不过他确信这与练习本身有关。“我一直在阅读能弄到的所有资料，”他说。“它绝对管用，起码，比我之前试过的所有东西都管用。只是我还没想通其中的玄机。”