拓宽耐受窗
《心理韧性》拓宽耐受窗,页面无弹窗的全文阅读!
那么，拥有一套在20万年前的威胁下得到优化的身心系统的我们，该如何面对我们的祖先都无法想象的现实挑战呢？又该如何制定有效决策去应对这些挑战呢？我们如何才能以坚韧和机智的品质，用智慧和健康的身心去应对它们，同时不会在心中内化一种信念，认为现代机器能够做得比我们更好？这些是我几年前面对的问题，当时我的身体因为自己无法响应它的基本需求而几乎停止了运转。
我的答案是学会以一种全新的方式来使用我们的生物特性，而这也是MMFT的基础。通过系统性地训练我们的注意力，我们能够拓宽我们的思考脑和生存脑协同工作的耐受窗。事实上，耐受窗是本书相当重要的一个概念。耐受窗越宽，我们就越容易找到动力，在压力中有效行事，继而得到恢复。诚然，我们从穴居祖先那里继承来的神经生物学特性与现代社会格格不入。然而，通过特定方式引导自己的注意力，我们就能学会如何有意识地调节这种天性。当运用意识，以这种方式去调节我们的生理机能时，我们就能够得到我们最优秀的、独一无二的人类品质：我们的同情心、勇气、好奇心、创造力以及与他人的连接。我们可以训练自己做出明智的决策和选择，哪怕是在令人难以置信的压力、不确定性和变数之下。
我们可以在自己的耐受窗范围内上下调节压力水平，随着时间的推移，我们便能让自己保持在一个最佳状态范围之中。[31]我们还可以有意识地整合来自思考脑和生存脑的输入信息，使两者都无法相互压制，也不会绑架我们的选择。在这个耐受窗中，思考脑和生存脑共同形成了一种联合、协作的关系，使得我们可以触及自己的内在智慧，也就是一些人所说的“直觉”。因此，我们的耐受窗宽度决定了我们在各种情形之下做出敏捷和适应性决定的能力，包括在极端压力或危机之下瞬间做出的生死攸关的决策，如何利用自己的时间，如何与人交往以及如何照顾自己的身心等日常选择。
我们习惯性地在自己的思考脑和生存脑之间，以及我们的大脑、自主神经系统和身体之间建立联系，而这些联系对我们的耐受窗宽度有着极大的影响。我们的耐受窗最初是通过我们的基因和早期社会环境间的相互作用而形成的，这种相互作用始于子宫，并一直延续到青春期。我们在应对压力和人际交往方面的大多数默认方法都与早期的社会环境有关，这对我们的耐受窗宽度产生了重要的影响。随着时间的推移，我们的耐受窗也会随着我们不断重复的经历变窄或变宽。我将在本书的第二部分和第三部分详细地探讨这种变化。
耐受窗宽的人准确评估安全与危险的能力更强，这种生存脑的无意识过程叫作神经感知。在安全或遭遇危险的情形下，他们都更有可能做出灵活和恰当的反应。他们最擅长调用自己的思考脑来应对具有挑战性的事情，并能够在之后彻底有效地恢复。他们更可以消化当前环境下的所有信息，不会让自己的注意力被即时出现的主要威胁吸引。他们更能顺应潮流，在挑战性事件中与他人保持联系。
然而，这也是关键所在。即便是那些天生具有宽耐受窗的人也会发现，随着时间的推移，他们的耐受窗会因为慢性压力或创伤没有得到恢复而缩小。当我们让这个系统始终保持“开放”状态，并且从不关闭它时，哪怕最有韧性的人也会发现自己的能力被逐渐破坏。重要的是，由于我们的生物属性与现代社会之间存在错配，即便我们任由自己的旧石器时代属性无意识地发展，这种破坏依然会发生。换句话说，如果我们不通过一些有意识的努力来调节自己的生物特性，那么每个人的耐受窗最终都会缩小。
随着耐受窗的缩小，我们越发觉得自己身处耐受窗之外。在我们的耐受窗之外，思考脑和生存脑处于一种敌对、对抗的关系之中，每一方都试图压制和压倒另一方。在这里，当区隔和压抑自己的情绪、身体感觉及身体需求和局限时，我们可能会控制自己的思考脑，抑或在情绪和痛苦驱动我们决策，导致我们做出冲动的反应性选择时，我们可能会绑架自己的生存脑。我们也更有可能借助食物、咖啡因、烟草、其他药物、成瘾行为，以及暴力、自我破坏或寻求刺激的行为来进行自我疗愈或掩饰自身的痛苦。最后，我们在耐受窗之外也更有可能遭遇创伤。
如果你与那些在过去10年接受过MMFT训练的人一样，或像写论文时期的我一样，那么现在你的默认做法可能是抑制压力或试图找到如何“对付”困难处境的方法。然而，正如我将在本书中探讨的那样，现在你认为能够有效应对生活事件的（以及我们的文化所推崇的）很多手段，比如隔离、压制、忽视、分散注意力，将事情重新定义为“积极的”“没那么糟糕”或坚持下去，实际上可能会让你的压力更大。在本书中，你将了解这些常见的习惯会如何让你失调，损害你的健康，扭曲你的看法，让你忽视重要的信息，无法看到自己走在一条错误的道路上并且亟须改变方向，以及它们如何切断你同自身和支持你的人的关系。
下一章探讨的是我们如何及为何倾向于在思考脑和生存脑之间发展对立的关系，并在这个过程中忽视压力和创伤之间的连续体。第二部分将接着探索耐受窗背后的科学原理，即耐受窗最初是如何形成的，又是如何随着时间的推移而缩小的。这一部分将帮助你更好地理解自己的思考脑、生存脑、自主神经系统和身体以及它们的不同暗示和功能。最后，在第三部分，我将教你在何时、何地及如何通过引导注意力来拓宽自己的耐受窗。我将帮助你学会将自己身体的暗示当作一种信息资源，继而在这些信息的基础之上用自己的思考脑做出最为明智的选择。请不要直接跳到第三部分，因为你需要借助第二部分的内容才能理解第三部分的工具和技术。
我们的神经生物学系统被设计成了一个紧密结合的整体，其中我们身心系统的各个部分都有其独特的功能、能力和洞察力。只有当思考脑和生存脑像盟友一样运作时，我们才能释放这种协同的潜力。当选择在思考脑和生存脑之间发展一种同盟关系时，我们不仅可以在自己的耐受窗内行事，而且可以从之前的慢性压力和创伤中得到治愈和恢复，也会因此而拓宽自己的耐受窗。
[1]1995年12月14日，波斯尼亚和黑塞哥维那内战中的交战各方在巴黎签订《代顿和平协定》，终止了长达3年8个月的战争。——译者注
[2]军中小鬼（army brat）用来指代父母就职于美国军队的儿童，他们经常随父母搬家，因此不知道哪里是自己的“故乡”。——译者注
[3]躯体化是指用躯体症状来表达精神不适的一种心理现象。躯体化障碍是一个连续疾病谱，从症状发生于潜意识层面、不由意志控制，到症状发生于意识层面、可受意志控制。——译者注
[4]莱姆病在1976年得到认定，是一种由蜱虫传播的、伯氏疏螺旋体感染导致的疾病。这种疾病会引发神经、心脏和关节方面的异常。莱姆病是美国报道的最常见蜱传播性疾病。患者通常在夏季和早秋发病，多数病人生活在丛林地区。——译者注
[5]Pat Ogden, Kekuni Minton, and Clare Pain, Trauma and the Body: A Sensorimotor Approach to Psychotherapy (New York: Norton, 2006), chap. 1.
[6]Stephen W. Porges, The Polyvagal Tbeory: Neuropbysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation (New York:Norton, 2011), chap. 1.
[7]Robert C. Scaer, The Trauma Spectrum: Hidden Wounds and Human Resiliency(New York: Norton, 2005), 205; Bruce S. McEwen and Elizabeth Norton Lasley, The End of Stress as We Know It (Washington, D.C: Joseph Henry,2002), chap. 1.
[8]仓鼠轮是饲养宠物仓鼠时放在笼子中供仓鼠跑动的轮子，仓鼠可以在其中一直不停地奔跑，但永远不会前进。——译者注
[9]这是源于美国的两项旨在保护黑人和女性权益的人权运动。——译者注
[10]American Psychological Association, “Stress in America: State of Our Nation”(2017), 1.
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[12]German Lopez, “America's Unique Gun Violence Problem, Explained in 17 Maps and Charts.” Vox (November 5, 2017), vox/policy-andpolitics/2017/10/2/16399418/us-gun-violence-statistics-maps-charts; Nurith Aizenman, “Gun Violence: Comparing the U.S. to Other Countries.,” NPR,Morning Edition (November 6, 2017), npr.org/sections/goatsandso da/2017/11/06/562323131/gun-violence-in-US.
[13]Max Fisher and Josh Keller, “Only One Thing Explains Mass Shootings in the United States,” New York Times, November 8, 2017, A15.
[14]Rachel E. Morgan and Grace Kena, “Criminal Victimization, 2016,” Bureau of Justice Statistics (Department of Justice, 2017).
[15]Peter Wagner and Bernadette Rabuy, “Mass Incarceration: The Whole Pie 2017”(Prison Policy Initiative, 2017),prisonpolicy .org/reports/pie2017.html;“World Prison Populations,” news.bbc.co.uk/2/shared/spl/hi/uk/06/prisons/html/nn2pagel.stm.
[16]这项研究指的创伤事件包括任何符合DSM-5（《精神障碍诊断与统计手册》第五版）创伤后应激障碍诊断标准A的事件。比如：经历灾难、事故、火灾、接触危险化学物质、暴露于战斗或战争现场，遭遇身体攻击或性暴力；意外目睹身体攻击、性暴力、尸体或残肢；在暴力、事故、灾害中遭遇危险与伤害，或家人、亲密朋友的死亡。
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[18]J. R. Cougle, H. Resnick, and D. G. Kilpatrick, “PTSD, Depression, and Their Comorbidity in Relation to Suicidality: Cross-Sectional and Prospective Analyses of a National Probability Sample of Women,” Depression and Anxiety 26, no. 12 (2009): 1151-1157; I. R. Galatzer-Levy et al., “Patterns of Lifetime PTSD Comorbidity: A Latent Class Analysis,” Depression and Anxiety 30, no. 5 (2013): 489-496.
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[20]Kessler et al., “Lifetime Prevalence and Age-of-Onset Distributions”; R. C.Kessler et al., “Anxious and Non-Anxious Major Depressive Disorder in the World Health Organization World Mental Health Surveys,”Epidemiology and Prychiatric Sciences 24, no. 3 (2015): 210-226; L. J. Andrade et al, “The Epidemiology of Major Depressive Episodes: Results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys,”International Journal of Methods in Prychiatric Research 12 (2003): 3-21; J.M. Twenge et al. “Birth Cohort Increases in Psychopathology among Young Americans, 1938-2007: A Cross-Temporal Meta-Analysis of the MMPT,”Clinical Psychology Review 30 (2010): 145-154; Nock et al., “CrossNational Analysis”; Scott Stossel, My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind (New York: Vintage, 2014), 213; S. Lee et al.,”Lifetime Prevalence and Inter-Cohort Variation in DSM-IV Disorders in Metropolitan China,” Psychological Medicine 37 (2007): 61-71; B. H.Hidaka, “Depression as a Disease of Modernity: Explanations for Increasing Prevalence,” Journal of Affective Disorders 140, no. 3 (2012): 205-214.
[21]P. S. Wang et al. “Twelve Month Use of Mental Health Services in the United States,” Archives of General Psychiatry 62, no. 6 (2005): 629-640; Jean M.Twenge, Generation Me: Why Today's Young Americans Are More Confident,Assertive, Entitled-and More Miserable Than Ever Before, Revised and Updated (New York: Atria, 2014), 140-143; Stossel, My Age of Anxiety,300-301; R. C.Kessler et al. “Prevalence, Severity, and Comorbidity of Twelve-Month DSM-IV Disorders in the National Comorbidity Survey Replication (NCS-R),” Archives of General Psychiatry 62, no. 6 (2005): 617627; Kessler et al., “Anxious and Non-Anxious Major Depressive Disorder”;R. C. Kessler et al., “Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication (NCS-R),”Archives of General Psychiatry 62, no. 6 (2005): 593-602; Benoit DenizetLewis.“The Kids Who Can't,” New York Times Magazine, October 15, 2017.
[22]Steven M.Southwick and Dennis S. Charney, Resilience: The Science of Mastering Life's Greatest Challenges (Cambridge, UK: Cambridge University Press, 2012), 14; L. Saad, “Few Americans Meet Exercise Targets: SelfReported Rates of Physical Exercise Show Little Change since 2001,” January 1, 2008, gallup/pol/103492/few-americans-meet-exercise-targets.aspx; D. S. Hasin, F. S. Stinson, E. Ogburn, and B. F. Grant, “Prevalence,Correlates, Disability and Comorbidity of DSM-IV Alcohol Abuse and Dependence in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions,” Archives of General Psychiatry 64, no. 7 (2007): 830-842.
[23]Gabrielle Glaser, “America, It's Time to Talk about Your Drinking,” New York Times, December 31, 2017.
[24]Stossel, My Age of Anxiety, 176, 97; Benedict Carey and Robert Gebeloff, “The Murky Perils of Quitting Antidepressants after Years of Use,” New York Times,April 8, 2018; National Institute on Drug Abuse, “Popping Pills: Prescription Drug Abuse in America,” drugabuse.gov/related-topicstrends-statistics/infographics/popping-pills-prescription-drug-abuse-in-america; U.S.Substance Abuse and Mental Health Services Administration, “Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings.”NSDUH Series H-44 (Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012); National Center for Health Statistics, “Health,United States, 2013: With Special Feature on Prescription Drugs” (Hyattsville,MD: U.S. Government Printing Office, 2014); United Nations Office on Drugs and Crime, “World Drug Report” (New York: United Nations, 2011).
[25]Amanda Erickson, Opioid Abuse in the U.S. Is So Bad It's Lowering Life Expectancy. Why Hasn't the Epidemic Hit Other Countries?, “Washington Post, December 28, 2017; Lenny Bernstein,” U.S. Life Expectancy Declines Again, a Dismal Trend Not Seen since World War I, Washington Post,November 29, 2018; Josh Katz, “Just How Bad Is the Drug Overdose Epidemic?” New York Times, October 26, 2017,nytimes/interactive/2017/04/14/upshot/drug-overdose-epidemic-you-draw-it.html.
[26]Dan Keating and Lenny Bernstein, “U.S. Suicide Rate Has Risen Sharply in the 21st Century,” Washington Post, April 22, 2016; Adeel Hassan, “Deaths from Drugs and Suicide Reach a Record in U.S.” New York Times, March 7, 2019; Bernstein, “U.S. Life Expectancy Declines Again”; Anne Case and Angus Deaton, “Mortality and Morbidity in the 21st Century,” Brookings Papers on Economic Activity(Spring 2017): 397-476.
[27]Denizet-Lewis, “The Kids Who Can't”; Jamie Ducharme, “More Than 90%of Generation Z Is Stressed Out. And Gun Violence Is Partly to Blame,” Time,October 30, 2018.
[28]American Psychological Association, “Stress in America” (2010), 5-12;Stossel, My Age of Anxiety, 300; Seth Stephens-Davidowitz, “Fifty States of Anxiety,” New York Times, August 7, 2016,.
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[31]Ogden et al., Trauma and the Body, chap. 2.