当一个婴儿出生时,母亲也是如此——但是作为母亲的自然(有时是不稳定的)过程通常会被羞耻或误诊为产后抑郁症而沉默。在这篇简短的、内容丰富的谈话中,生殖心理学家亚力山德拉萨克斯打破了成为一名新母亲的情感拉锯战,并分享了一个可以帮助描述它的术语:“绿化”。

A new way to think about the transition to motherhood

00:01

Do you remember a time when you felt hormonal and moody? Your skin was breaking out, your body was growing in strange places and very fast, and at the same time, people were expecting you to be grown-up in this new way. Teenagers, right?

你是否记得某个时刻曾经感到 心情烦躁和郁郁寡欢? 你的皮肤上正冒出小痘痘, 身体的特殊部位 开始发育并快速生长, 与此同时, 大人们也正期待你以这种新的方式长大。 说的是青少年,对吧?

00:19

Well, these same changes happen to a woman when she's having a baby. And we know that it's normal for teenagers to feel all over the place, so why don't we talk about pregnancy in the same way? There are entire textbooks written about the developmental arc of adolescence, and we don't even have a word to describe the transition to motherhood. We need one.

其实,女人怀孕时 也会发生同样的变化。 我们知道,青少年感到 困惑和敏感很正常, 我们何不以同样的方式谈论怀孕呢? 市面上有成套的关于 青春期发展曲线的教科书, 而我们甚至没有一个描述 由女人变为母亲的术语。我们需要一个这样的词汇。

00:45

I'm a psychiatrist who works with pregnant and postpartum women, a reproductive psychiatrist, and in the decade that I've been working in this field, I've noticed a pattern. It goes something like this: a woman calls me up, she's just had a baby, and she's concerned. She says, "I'm not good at this. I'm not enjoying this. Do I have postpartum depression?"

我是一名与孕妇和产妇 打交道的精神科医生, 即生殖心理医生。 在这个领域工作的十年里, 我注意到了一个模式。 一般是这样的: 一位女士打来电话, 她刚生了孩子, 而且感到很忧虑。 她说,"我不擅养育孩子,也不喜欢。 我得了产后抑郁症吗?”

01:08

So I go through the symptoms of that diagnosis, and it's clear to me that she's not clinically depressed, and I tell her that. But she isn't reassured. "It isn't supposed to feel like this," she insists. So I say, "OK. What did you expect it to feel like?" She says, "I thought motherhood would make feel whole and happy. I thought my instincts would naturally tell me what to do. I thought I'd always want to put the baby first."

接下来,我仔细分析了诊断的症状, 很显然她没得临床抑郁症, 我告诉了她诊断结果。 但她依然不放心, "我不该有这样的感觉," 她坚称。 因此我说道 "好吧,那你 认为应该是怎样的感觉呢?” 她说,"我曾以为,当了母亲 会让我感到完整和快乐; 本能自然而然就会 告诉我应该怎么做; 我曾经也以为,自己会总想着 把孩子放在首位。”

01:37

This -- this is an unrealistic expectation of what the transition to motherhood feels like. And it wasn't just her. I was getting calls with questions like this from hundreds of women, all concerned that something was wrong,because they couldn't measure up. And I didn't know how to help them, because telling them that they weren't sick wasn't making them feel better. I wanted to find a way to normalize this transition, to explain that discomfort is not always the same thing as disease.

这种感觉——这是对 从女人转变成母亲的 不切实际的期望。 无独有偶, 我接到过几百位有类似 问题的女士打来的电话, 她们都不约而同地 担心自己出了问题, 因为她们无法达到自己的期望值。 我不知道如何帮助她们, 因为告诉了她们没病的事实, 并没让她们感觉轻松一些。 我想找到一种让这种转变 更加正常化的方法, 能解释这种心理不适 与疾病其实是两码事。

02:26

So I set out to learn more about the psychology of motherhood. But there actually wasn't much in the medical textbooks, because doctors mostly write about disease. So I turned to anthropology. And it took me two years, but in an out-of-print essay written in 1973 by Dana Raphael, I finally found a helpful way to frame this conversation: matrescence. It's not a coincidence that "matrescence" sounds like "adolescence." Both are times when body morphing and hormone shifting lead to an upheaval in how a person feels emotionally and how they fit into the world. And like adolescence, matrescence is not a disease, but since it's not in the medical vocabulary, since doctors aren't educating people about it, it's being confused with a more serious conditioncalled postpartum depression.

所以,我开始学习更多 关于母性心理的知识, 但医学课本对此却鲜有提及, 因为医生们大部分写的 是关于疾病的知识。 于是,我转向人类学寻找答案。 花了两年的时间, 在一篇 丹娜 · 拉斐尔 写于 1973 年的绝版文章中,我终于找到了一个有效的 方式来概括这段对话: 孕乳期。 "孕乳期" 听起来 很像 "青春期",但这并非巧合, 两种情况都是由于身体改变 和激素变化同时作用所致, 这两种因素造成人在情绪感受 及如何融入生活方面发生剧变。 和青春期一样,孕乳期不是病, 但因为这一改变 并不存在于医学词汇中, 医生也没教给人们这方面的知识, 所以,人们将孕乳期现象 和更严重的产后抑郁症混为一谈。

03:24

I've been building on the anthropology literature and have been talking about matrescence with my patientsusing a concept called the "push and pull."

我一直在人类学文献的基础上, 使用 "推和拉" 的概念, 和病人谈关于孕乳期的问题。

03:33

Here's the pull part. As humans, our babies are uniquely dependent. Unlike other animals, our babies can't walk,they can't feed themselves, they're very hard to take care of. So evolution has helped us out with this hormone called oxytocin. It's released around childbirth and also during skin-to-skin touch, so it rises even if you didn't give birth to the baby. Oxytocin helps a human mother's brain zoom in, pulling her attention in, so that the baby is now at the center of her world.

“拉”的部分是这样的: 我们人类的婴儿特别依赖他人。 和其它动物不同的是, 我们的婴儿不会走路、 不能自己吃饭, 照顾它们特别费心。 所以进化用了一种叫做催产素的激素 来帮助我们解决这个难题。 分娩时身体会释放催产素, (与婴儿)皮肤接触时 也会释放催产素, 所以即便你没在生孩子, 身体也会分泌催产素。 催产素帮助人类母亲的大脑集中 精力、 把她的注意力“拉”过来, 让宝宝成为她当下世界的中心。

04:08

But at the same time, her mind is pushing away, because she remembers there are all these other parts to her identity -- other relationships, her work, hobbies, a spiritual and intellectual life, not to mention physical needs: to sleep, to eat, to exercise, to have sex, to go to the bathroom, alone --

但与此同时, 理智 把她从宝宝身上“推”开, 因为她想起来自己的 身份还包含了其他内容—— 其他各种关系、 她的工作、 自己的爱好、 精神和知性生活, 更不用说生理需要了: 要睡觉、 吃饭、 运动、 过性生活、 去洗手间,一个人去做以上这些事情——

04:37

if possible.

如果可能的话。

04:39

This is the emotional tug-of-war of matrescence. This is the tension the women calling me were feeling. It's why they thought they were sick. If women understood the natural progression of matrescence, if they knew that most people found it hard to live inside this push and pull, if they knew that under these circumstances,ambivalence was normal and nothing to be ashamed of, they would feel less alone, they would feel less stigmatized, and I think it would even reduce rates of postpartum depression. I'd love to study that one day.

4:39

这就是孕乳期的情感纠葛, 这就是给我打电话的 女士们所感受到的不安, 这就是为什么她们认为自己病了。 如果女性已经知晓了 孕乳期的自然发展过程, 如果她们已明白大多数人很难 在这种“推和拉”的矛盾中生活, 如果她们已然知晓: 在这种情形之下, 矛盾心理是正常的, 没有什么可羞愧的, 她们就不会那么孤单无助, 也就会少一些自责, 我认为做到这一点甚至会 降低产后抑郁症的发病率。 我很乐意有一天能研究这个课题。

05:21

I'm a believer in talk therapy, so if we're going to change the way our culture understands this transition to motherhood, women need to be talking to each other, not just me. So mothers, talk about your matrescence with other mothers, with your friends, and, if you have one, with your partner, so that they can understand their own transition and better support you.

我信奉谈话疗法, 所以,如果我们要改变我们的文化 对女人转变为母亲的看法, 女人们需要互相交谈, 而不仅仅是与我交流。 所以妈妈们,跟其他母亲 谈论你的孕乳期感受吧, 也可以和朋友交流, 如果有条件的话,也要和 伴侣交流自己的感受, 这样他们也能知晓 自己的角色转变, 会更好地支持你。

05:45

But it's not just about protecting your relationship. When you preserve a separate part of your identity, you're also leaving room for your child to develop their own.

但这不仅仅是为了 保护你和周围人的关系, 当保留你身份中独立部分的同时, 你也为孩子留出了自我发展的空间。

05:58

When a baby is born, so is a mother, each unsteady in their own way. Matrescence is profound, but it's also hard, and that's what makes it human.

当婴儿降临时,母亲也会获得新生, 母子二人都踉跄着探索自己脚下的路。 孕乳期意义深远, 但也很艰难, 也正是这一点造就了人类。

06:12

Thank you.

谢谢大家!

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