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Alexandra Sacks: A new way to think about the transition to motherhood
亚历山大 · 赛克斯: 以新的角度思考从女人到母亲的转变
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当婴儿降生时, 母亲也获得了新生。 但这一自然的 (有时不稳定的) 向母亲角色转换的过程，却常常因为母亲的羞愧感而被掩盖，或被误诊为产后抑郁症。在这个快简短、详实的谈话中, 生殖心理医生 亚历山德拉 · 赛克斯 剖析了成为新母亲的情感纠葛——分享了一个可以帮助描述该过程的术语：孕乳期。
Alexandra Sacks - Reproductive psychiatrist
Alexandra Sacks, M.D. is widely recognized as the leading clinical expert on matrescence: the developmental transition into motherhood. Full bio
Alexandra Sacks, M.D. is widely recognized as the leading clinical expert on matrescence: the developmental transition into motherhood. Full bio
Double-click the English transcript below to play the video.
00:13
Do you remember a time
when you felt hormonal and moody?
when you felt hormonal and moody?
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你是否记得某个时刻曾经感到
心情烦躁和郁郁寡欢？
心情烦躁和郁郁寡欢？
00:17
Your skin was breaking out,
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你的皮肤上正冒出小痘痘，
00:19
your body was growing
in strange places and very fast,
in strange places and very fast,
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身体的特殊部位
开始发育并快速生长，
开始发育并快速生长，
00:24
and at the same time,
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与此同时，
大人们也正期待你以这种新的方式长大。
00:25
people were expecting you to be
grown-up in this new way.
grown-up in this new way.
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00:29
Teenagers, right?
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说的是青少年，对吧？
00:31
Well, these same changes happen
to a woman when she's having a baby.
to a woman when she's having a baby.
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其实，女人怀孕时
也会发生同样的变化。
也会发生同样的变化。
00:36
And we know that it's normal
for teenagers to feel all over the place,
for teenagers to feel all over the place,
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我们知道，青少年感到
困惑和敏感很正常，
困惑和敏感很正常，
00:40
so why don't we talk about
pregnancy in the same way?
pregnancy in the same way?
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我们何不以同样的方式谈论怀孕呢？
00:44
There are entire textbooks written about
the developmental arc of adolescence,
the developmental arc of adolescence,
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市面上有成套的关于
青春期发展曲线的教科书，
青春期发展曲线的教科书，
00:50
and we don't even have a word
to describe the transition to motherhood.
to describe the transition to motherhood.
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而我们甚至没有一个描述
由女人变为母亲的术语。
由女人变为母亲的术语。
00:55
We need one.
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我们需要一个这样的词汇。
00:57
I'm a psychiatrist who works
with pregnant and postpartum women,
with pregnant and postpartum women,
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我是一名与孕妇和产妇
打交道的精神科医生，
打交道的精神科医生，
01:00
a reproductive psychiatrist,
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即生殖心理医生。
01:02
and in the decade that I've been
working in this field,
working in this field,
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在这个领域工作的十年里，
01:05
I've noticed a pattern.
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我注意到了一个模式。
01:06
It goes something like this:
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一般是这样的：
01:08
a woman calls me up,
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一位女士打来电话，
01:10
she's just had a baby,
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她刚生了孩子，
01:12
and she's concerned.
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而且感到很忧虑。
01:13
She says, "I'm not good at this.
I'm not enjoying this.
I'm not enjoying this.
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她说，"我不擅养育孩子，也不喜欢。
01:17
Do I have postpartum depression?"
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我得了产后抑郁症吗？”
01:20
So I go through the symptoms
of that diagnosis,
of that diagnosis,
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接下来，我仔细分析了诊断的症状，
01:23
and it's clear to me
that she's not clinically depressed,
that she's not clinically depressed,
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很显然她没得临床抑郁症，
01:26
and I tell her that.
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我告诉了她诊断结果。
01:27
But she isn't reassured.
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但她依然不放心，
01:29
"It isn't supposed to feel
like this," she insists.
like this," she insists.
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"我不该有这样的感觉，" 她坚称。
01:32
So I say, "OK. What did you
expect it to feel like?"
expect it to feel like?"
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因此我说道 "好吧，那你
认为应该是怎样的感觉呢？”
认为应该是怎样的感觉呢？”
01:36
She says, "I thought motherhood
would make feel whole and happy.
would make feel whole and happy.
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她说，"我曾以为，当了母亲
会让我感到完整和快乐；
会让我感到完整和快乐；
01:41
I thought my instincts
would naturally tell me what to do.
would naturally tell me what to do.
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本能自然而然就会
告诉我应该怎么做；
告诉我应该怎么做；
01:45
I thought I'd always want
to put the baby first."
to put the baby first."
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我曾经也以为，自己会总想着
把孩子放在首位。”
把孩子放在首位。”
01:49
This -- this is an unrealistic expectation
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这种感觉——这是对
从女人转变成母亲的
从女人转变成母亲的
01:53
of what the transition
to motherhood feels like.
to motherhood feels like.
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不切实际的期望。
01:56
And it wasn't just her.
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无独有偶，
01:58
I was getting calls with questions
like this from hundreds of women,
like this from hundreds of women,
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我接到过几百位有类似
问题的女士打来的电话，
问题的女士打来的电话，
02:03
all concerned that something was wrong,
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她们都不约而同地
担心自己出了问题，
担心自己出了问题，
02:06
because they couldn't measure up.
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因为她们无法达到自己的期望值。
02:08
And I didn't know how to help them,
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我不知道如何帮助她们，
02:11
because telling them
that they weren't sick
that they weren't sick
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因为告诉了她们没病的事实，
02:13
wasn't making them feel better.
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并没让她们感觉轻松一些。
02:16
I wanted to find a way
to normalize this transition,
to normalize this transition,
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我想找到一种让这种转变
更加正常化的方法，
更加正常化的方法，
02:21
to explain that discomfort is not always
the same thing as disease.
the same thing as disease.
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能解释这种心理不适
与疾病其实是两码事。
与疾病其实是两码事。
02:26
So I set out to learn more about
the psychology of motherhood.
the psychology of motherhood.
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所以，我开始学习更多
关于母性心理的知识，
关于母性心理的知识，
02:30
But there actually wasn't much
in the medical textbooks,
in the medical textbooks,
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但医学课本对此却鲜有提及，
02:33
because doctors mostly
write about disease.
write about disease.
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因为医生们大部分写的
是关于疾病的知识。
是关于疾病的知识。
02:36
So I turned to anthropology.
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于是，我转向人类学寻找答案。
02:39
And it took me two years,
but in an out-of-print essay
but in an out-of-print essay
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花了两年的时间，
02:42
written in 1973 by Dana Raphael,
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在一篇 丹娜 · 拉斐尔 写于
1973 年的绝版文章中，
1973 年的绝版文章中，
02:46
I finally found a helpful way
to frame this conversation:
to frame this conversation:
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我终于找到了一个有效的
方式来概括这段对话：
方式来概括这段对话：
02:51
matrescence.
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孕乳期。
02:53
It's not a coincidence that "matrescence"
sounds like "adolescence."
sounds like "adolescence."
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"孕乳期" 听起来
很像 "青春期"，但这并非巧合，
很像 "青春期"，但这并非巧合，
02:59
Both are times when body morphing
and hormone shifting
and hormone shifting
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两种情况都是由于身体改变
和激素变化同时作用所致，
和激素变化同时作用所致，
03:02
lead to an upheaval
in how a person feels emotionally
in how a person feels emotionally
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这两种因素造成人在情绪感受
03:06
and how they fit into the world.
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及如何融入生活方面发生剧变。
03:08
And like adolescence,
matrescence is not a disease,
matrescence is not a disease,
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和青春期一样，孕乳期不是病，
03:13
but since it's not
in the medical vocabulary,
in the medical vocabulary,
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但因为这一改变
并不存在于医学词汇中，
并不存在于医学词汇中，
03:15
since doctors aren't
educating people about it,
educating people about it,
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医生也没教给人们这方面的知识，
03:18
it's being confused
with a more serious condition
with a more serious condition
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所以，人们将孕乳期现象
03:21
called postpartum depression.
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和更严重的产后抑郁症混为一谈。
03:24
I've been building on
the anthropology literature
the anthropology literature
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我一直在人类学文献的基础上，
03:26
and have been talking
about matrescence with my patients
about matrescence with my patients
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使用 "推和拉" 的概念，
03:30
using a concept called
the "push and pull."
the "push and pull."
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和病人谈关于孕乳期的问题。
03:33
Here's the pull part.
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“拉”的部分是这样的：
03:35
As humans, our babies
are uniquely dependent.
are uniquely dependent.
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我们人类的婴儿特别依赖他人。
03:39
Unlike other animals,
our babies can't walk,
our babies can't walk,
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和其它动物不同的是，
我们的婴儿不会走路、
我们的婴儿不会走路、
03:42
they can't feed themselves,
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不能自己吃饭，
03:43
they're very hard to take care of.
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照顾它们特别费心。
03:45
So evolution has helped us out
with this hormone called oxytocin.
with this hormone called oxytocin.
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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。
来帮助我们解决这个难题。
03:50
It's released around childbirth
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分娩时身体会释放催产素，
03:53
and also during skin-to-skin touch,
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（与婴儿）皮肤接触时
也会释放催产素，
也会释放催产素，
03:55
so it rises even if you didn't
give birth to the baby.
give birth to the baby.
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所以即便你没在生孩子，
身体也会分泌催产素。
身体也会分泌催产素。
03:59
Oxytocin helps a human mother's brain
zoom in, pulling her attention in,
zoom in, pulling her attention in,
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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，
精力、 把她的注意力“拉”过来，
04:05
so that the baby is now
at the center of her world.
at the center of her world.
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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,
her mind is pushing away,
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但与此同时, 理智
把她从宝宝身上“推”开，
把她从宝宝身上“推”开，
04:13
because she remembers there are
all these other parts to her identity --
all these other parts to her identity --
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因为她想起来自己的
身份还包含了其他内容——
身份还包含了其他内容——
04:19
other relationships,
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其他各种关系、
04:21
her work,
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她的工作、
04:22
hobbies,
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自己的爱好、
04:24
a spiritual and intellectual life,
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精神和知性生活，
04:26
not to mention physical needs:
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更不用说生理需要了：
04:28
to sleep, to eat, to exercise,
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要睡觉、 吃饭、 运动、
04:32
to have sex,
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过性生活、
04:33
to go to the bathroom,
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去洗手间，
04:35
alone --
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一个人去做以上这些事情——
04:36
(Laughter)
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（笑声）
04:37
if possible.
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如果可能的话。
04:39
This is the emotional
tug-of-war of matrescence.
tug-of-war of matrescence.
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这就是孕乳期的情感纠葛，
04:44
This is the tension
the women calling me were feeling.
the women calling me were feeling.
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这就是给我打电话的
女士们所感受到的不安，
女士们所感受到的不安，
04:47
It's why they thought they were sick.
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这就是为什么她们认为自己病了。
04:51
If women understood the natural
progression of matrescence,
progression of matrescence,
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如果女性已经知晓了
孕乳期的自然发展过程，
孕乳期的自然发展过程，
04:55
if they knew that most people found it
hard to live inside this push and pull,
hard to live inside this push and pull,
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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，
在这种“推和拉”的矛盾中生活，
05:01
if they knew that under
these circumstances,
these circumstances,
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如果她们已然知晓：
在这种情形之下，
在这种情形之下，
05:04
ambivalence was normal
and nothing to be ashamed of,
and nothing to be ashamed of,
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矛盾心理是正常的，
没有什么可羞愧的，
没有什么可羞愧的，
05:09
they would feel less alone,
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她们就不会那么孤单无助，
05:11
they would feel less stigmatized,
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也就会少一些自责，
05:13
and I think it would even reduce
rates of postpartum depression.
rates of postpartum depression.
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我认为做到这一点甚至会
降低产后抑郁症的发病率。
降低产后抑郁症的发病率。
05:18
I'd love to study that one day.
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我很乐意有一天能研究这个课题。
05:21
I'm a believer in talk therapy,
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我信奉谈话疗法，
05:23
so if we're going to change the way
our culture understands
our culture understands
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所以，如果我们要改变我们的文化
05:26
this transition to motherhood,
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对女人转变为母亲的看法，
05:27
women need to be talking to each other,
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女人们需要互相交谈，
05:30
not just me.
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而不仅仅是与我交流。
05:32
So mothers, talk about your matrescence
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所以妈妈们，跟其他母亲
谈论你的孕乳期感受吧，
谈论你的孕乳期感受吧，
05:35
with other mothers, with your friends,
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也可以和朋友交流，
05:38
and, if you have one, with your partner,
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如果有条件的话，也要和
伴侣交流自己的感受，
伴侣交流自己的感受，
05:40
so that they can understand
their own transition
their own transition
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这样他们也能知晓
自己的角色转变，
自己的角色转变，
05:43
and better support you.
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会更好地支持你。
05:45
But it's not just about
protecting your relationship.
protecting your relationship.
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但这不仅仅是为了
保护你和周围人的关系，
保护你和周围人的关系，
05:49
When you preserve
a separate part of your identity,
a separate part of your identity,
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当保留你身份中独立部分的同时，
05:53
you're also leaving room
for your child to develop their own.
for your child to develop their own.
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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,
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当婴儿降临时，母亲也会获得新生，
06:02
each unsteady in their own way.
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母子二人都踉跄着探索自己脚下的路。
06:05
Matrescence is profound,
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孕乳期意义深远，
06:07
but it's also hard,
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但也很艰难，
06:09
and that's what makes it human.
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也正是这一点造就了人类。
06:12
Thank you.
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谢谢大家！
06:13
(Applause)
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（掌声）
ABOUT THE SPEAKER
Alexandra Sacks - Reproductive psychiatristAlexandra Sacks, M.D. is widely recognized as the leading clinical expert on matrescence: the developmental transition into motherhood.
Why you should listen
Alexandra Sacks has spent the last decade of her career helping women navigate their emotional lives as a reproductive psychiatrist. She is a regular contributor to the New York Times, and her work has been featured in TIME, NPR and throughout Asia, Europe and Latin America.
Board-certified in psychiatry with specialty fellowship training in women's mental health via New York Presbyterian Cornell and Columbia, Sacks helms a private practice in New York City and serves on the advisory boards for the American Psychoanalytic Association and the Columbia Psychoanalytic Center for Training and Research. In April 2019, Dr. Sacks will publish her first co-authored book, What No One Tells You: A Guide to Your Emotions from Pregnancy to Motherhood (Simon and Schuster).
Alexandra Sacks | Speaker | TED.com