你的心理治疗师是怎么描述你的

But even those institutions have hesitated to share mental health notes. Critics have raised concerns about whether reading notes could prompt anxiety and even rejection of treatment. What will happen if the patient posts the notes on Facebook, inviting comment?
但即便是这些机构，也不愿贸然与心理疾病患者分享病历。批评者担心的是，阅读病历是否有可能让患者感到焦虑，进而抗拒治疗。要是患者把病历放在Facebook上，请人发表看法，又会发生什么事呢？

Proponents of access point out that such notes, which include extensive diagnostic reports, are already available to other doctors and to insurers.
主张允许心理疾病患者查询病历——包括大量诊断报告在内——的人士指出，这类病历已经对其他医生以及保险商开放了。

Although patients have long had the right to their records, the process to obtain copies can be protracted. If a doctor thinks that reading notes would be harmful to the patient or others, they can be withheld.
尽管长期以来患者一直有权获得病历的复印件，但相关程序可能拖拖拉拉。如果医生认为阅读病历会对患者或其他人造成伤害，则可能拒绝提供病历。

Mindful of such pitfalls, the Beth Israel psychiatrists have offered notes initially to only 10 percent of patients. Clinical social workers are making notes more widely available, though some therapists have temporarily opted out. Nina Douglass, a social worker in the ob-gyn clinic, worries about patients with abusive partners. If the abuser insisted on reading the notes, the patient could be in danger.
考虑到此类潜在的困难，以色列堂-女执事医疗中心的心理医生初步只向10%的患者提供了病历。临床社工们正把病历提供给更多患者，但一些治疗师暂时选择了退出。妇科门诊部的社工尼娜·道格拉斯(Nina Douglass)担心，有些患者的伴侣言语恶毒。如果这样的人坚持要阅读病历，可能会将患者置于险境。

“I can imagine that our work can be deepened and enhanced through people reading their notes,” Ms. Douglass said. “But one size doesn’t fit all.”
“可以想见，通过让病人阅读他们的病历，我们的工作能得到深化和加强，”道格拉斯说，“但不能搞‘一刀切’。”

Mental health notes have very different readers: the therapist, who may use them as a memory prompt; other doctors treating the patient; insurers; and now the patient. Writing a note with necessary information for all can be daunting.
心理疾病病历有各种各样的读者：把病历当成记事本来用的治疗师；治疗该病人的其他医生；保险商；现在又多出了患者本人。书写一份包含各方所需信息的病历可能是一项艰巨的任务。

Mr. O’Neill, the social work manager, is pressing therapists to use straightforward descriptions. “I used ‘affect dysregulation,’ and a patient said, ‘What on earth is that? Are you saying I’m totally crazy?’ ” he said. “It just means they can get upset. So why not use the word ‘upset’?”
身为社会工作管理者的奥尼尔一直在敦促治疗师们使用简单易懂的措辞。“有一次我用了‘情绪失调’，一个病人问道：‘这究竟是什么东西？你的意思是我完全疯掉了？’”他说，“其实它只不过意味着患者可能会感到沮丧。那么何不就用‘沮丧’这个词呢？”

Some psychiatrists disagree.
一些心理医生对此各持己见。

“Diagnostic language is used among doctors to describe features of a mental illness,” said Dr. Brian K. Clinton, an assistant professor at Columbia University Medical Center who has written about sharing records. “I would be willing to discuss with a patient what I think. It’s a better way to communicate than a note I wrote for other doctors.”
“诊断用语是医生群体用来描述心理疾病特征的工具。”以病历分享为题写过文章的哥伦比亚大学医学中心(Columbia University Medical Center)助理教授布莱恩·K·克林顿(Brian K. Clinton)博士表示，“我愿意和患者讨论我的想法。比起让患者阅读我写给其他医生看的病历，这种交流方式更好一些。”

But Dr. Michael W. Kahn, an assistant professor of psychiatry at Harvard Medical School who wrote about the project in JAMA, said that if the therapist explained the diagnosis, some patients might feel relieved, knowing their behavior fits a pattern that others also experience.
但在美国医学会杂志(JAMA)上撰文探讨过该项目的哈佛大学医学院(Harvard Medical School )心理学助理教授迈克尔·W·卡恩(Michael W. Kahn)博士说，如果治疗师对诊断加以解释，一些患者或许会感到如释重负，因为了解到其他一些人有着跟他们雷同的行为模式。

Dr. Glen O. Gabbard, a psychiatrist and professor at Baylor College of Medicine, said that opening notes to patients might have a chilling effect on doctors.
贝勒医学院(Baylor College of Medicine)的心理医生及教授格伦·O· 加巴德(Glen O. Gabbard)博士称，向患者公开病历，可能会让医生不愿表达看法。

“A psychiatrist would be less likely to put down anything he is musing about as diagnostic possibilities or write about what he feels the patient is leaving out,” he said.
他说，“心理医生不太可能像从前那样，写下他所考虑到的一切诊断可能性，或者写下他觉得患者并未和盘托出的一些事情。”

Mr. Baldwin’s longtime friends know about his harrowing battles with mental illness: The hospitalizations. The manic episodes. The depression. The anxiety so crippling that two years ago, at a Costco parking lot, he couldn’t get out of the car.
鲍德温的老朋友们都知道他和心理疾病作战的惨痛经历：住院治疗；躁狂发作；抑郁；以及极具破坏力的焦虑——两年前，他甚至在好市多(Costco)的停车场里无法下车。

As he withdrew into his apartment, pints of ice cream, Zoey, and the telephone became his constant companions. During the worst sieges of anxiety, he would call a few friends three, four times a day.
他曾蜷缩在公寓里，成天与冰淇淋、佐伊和电话为伴。压力最大的那些日子，他每天要给少数几个朋友打三四个电话。

That is the man they recall, he recounted in his freshly tidied apartment. Its décor is hopeful: a multicolored rug, violet curtains, a jaunty lime-green wall.
这就是他们记忆中的那个男人——他在刚刚整理过的公寓里讲述着自己的经历。公寓内部的装潢给人以充满希望之感：地毯五彩缤纷，窗帘是紫色的，墙壁是生机勃勃的浅绿色。

And so is Mr. Baldwin. He is trying to lose weight, maybe someday have a new man in his life.
鲍德温本人也是如此。他正努力减肥，期盼着有一天或许会在生活中迎来一个崭新的自己。

He clicked open another therapy note.
他点开了另一份诊疗记录。

Mr. Baldwin “is continuing to try to push himself to get out more and to be more socially connected even while his emotions tell him to do the opposite,” Mr. O’Neill wrote, adding that his patient is “clearly making good, and even courageous, efforts on a number of fronts.”
“鲍德温仍在竭力敦促自己更多地走出去，更多地跟他人交往，尽管从情感上来说，他更愿意反其道而行之，”奥尼尔如此写道。他还说，他的病人“显然正虔诚地，甚至可以说是勇敢地做着多方面的努力。”

Mr. Baldwin, who celebrated his birthday recently with a museum lecture, movie and dinner, flushed with pride.
不久前刚以去博物馆听讲座、看电影、吃大餐的方式庆祝了的生日鲍德温，因为自豪而涨红了脸颊。

“I’m going to email this to my friends,” he said.
“我要把这些话用邮件发给朋友们，”他说。