TEDGlobal 2012
Elyn Saks: A tale of mental illness -- from the inside
艾琳．薩克斯: 一個來自精神病患內心深處的故事
Filmed:
Readability: 4.1
4,034,245 views
「我可以徹底毀了你的辦公室嗎？」這是 艾琳．薩克斯 有次問她醫生的問題，而這並不是個玩笑話。2007 年時，法學學者薩克斯自告奮勇述說藉由藥物控制與治療，但卻無時無刻存在的思覺失調症親身體驗。在這個強而有力的演說中，她請我們以清楚、誠實且富同情心的方式看待精神病患。
Elyn Saks - Mental health law scholar
Elyn Saks asks bold questions about how society treats people with mental illness. Full bio
Elyn Saks asks bold questions about how society treats people with mental illness. Full bio
Double-click the English transcript below to play the video.
00:16
So I'm a woman with chronic schizophrenia.
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我是一位患有慢性思覺失調症的女性。
00:18
I've spent hundreds of days
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我曾有數百天
00:20
in psychiatric hospitals.
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待在精神病院裡，
00:21
I might have ended up spending
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我即可能大半輩子
00:23
most of my life on the back ward of a hospital,
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會待在醫院的後病房裡，
00:25
but that isn't how my life turned out.
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但我的生活並沒有變成那樣。
00:27
In fact, I've managed to stay clear of hospitals
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事實上，我成功地避開醫院
已將近三十年了，
00:31
for almost three decades,
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00:32
perhaps my proudest accomplishment.
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這也許是我最自豪的成就。
00:34
That's not to say that I've remained clear
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這並不是說我已全然擺脫
00:36
of all psychiatric struggles.
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所有與精神病的困鬥。
00:38
After I graduated from the Yale Law School and
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我從耶魯法學院畢業後
00:40
got my first law job, my New Haven analyst, Dr. White,
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得到我的第一份法律工作，
我的紐哈芬分析師懷特博士
我的紐哈芬分析師懷特博士
00:43
announced to me that he was going to close his practice
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告訴我他即將在三個月之內，
00:46
in three months, several years
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關閉他的事務所，
這離我計畫離開紐哈芬早了幾年。
00:48
before I had planned to leave New Haven.
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00:50
White had been enormously helpful to me,
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懷特博士給我莫大的幫助，
00:52
and the thought of his leaving
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想到他的離去，
00:53
shattered me.
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粉碎了我。
00:55
My best friend Steve,
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我最好的朋友史提夫
00:57
sensing that something was terribly wrong,
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察覺某事極不對勁，
00:59
flew out to New Haven to be with me.
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飛來紐哈芬陪我。
01:00
Now I'm going to quote from some of my writings:
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現在我要引用一些我寫的東西：
01:02
"I opened the door to my studio apartment.
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「我打開我公寓套房的門，
01:05
Steve would later tell me that,
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史提夫後來告訴我，
01:07
for all the times he had seen me psychotic, nothing
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在他所看過我發病的時候，
沒有一次能預備他那天所見的狀況。
01:10
could have prepared him for what he saw that day.
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01:12
For a week or more, I had barely eaten.
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約莫一個禮拜或更久，
我幾乎沒有進食。
我幾乎沒有進食。
01:15
I was gaunt. I walked
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我枯瘦憔悴，走路時
01:17
as though my legs were wooden.
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雙腿像木頭一樣，
01:19
My face looked and felt like a mask.
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我的臉看起來、
感覺起來都像一張面具。
感覺起來都像一張面具。
01:22
I had closed all the curtains in the apartment, so
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我拉上公寓所有的窗簾，
所以日正當中時
01:25
in the middle of the day
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01:26
the apartment was in near total darkness.
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公寓裡幾乎是全然的黑暗。
01:28
The air was fetid, the room a shambles.
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空氣惡臭，房間一團亂。
01:30
Steve, both a lawyer and a psychologist, has treated
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史提夫是律師也是心理學家，
01:34
many patients with severe mental illness, and to this day
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曾治療許多患有精神重症的病患，
01:37
he'll say I was as bad as any he had ever seen.
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至今，他還是會說我是他看過最嚴重的。
01:39
'Hi,' I said, and then I returned to the couch,
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『嗨！』我說，然後回到長沙發上，
01:43
where I sat in silence for several moments.
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我坐在那裡不發一語好一陣子。
01:45
'Thank you for coming, Steve.
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『 謝謝你來，史提夫。
01:46
Crumbling world, word, voice.
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崩解的世界、文字、聲音。
01:51
Tell the clocks to stop.
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叫時鐘停頓。
01:52
Time is. Time has come.'
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時間是。時候到了。』
01:54
'White is leaving,' Steve said somberly.
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『 懷特要離開了 』，史提夫悶悶地說。
01:57
'I'm being pushed into a grave. The situation is grave,' I moan.
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我悲嘆：
『 我正被推進墳墓，這情況就如墳墓。』
『 我正被推進墳墓，這情況就如墳墓。』
02:01
'Gravity is pulling me down.
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『 重力把我拉下去，
02:02
I'm scared. Tell them to get away.'"
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我害怕，叫他們走開。』」
02:05
As a young woman, I was in a psychiatric hospital
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年輕時，我曾因三個不同情況
02:08
on three different occasions for lengthy periods.
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在精神病院待了頗長的時間。
02:11
My doctors diagnosed me with chronic schizophrenia,
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我的醫師診斷我患有慢性思覺失調症，
02:14
and gave me a prognosis of "grave."
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且預後嚴重。
02:16
That is, at best, I was expected to live in a board and care,
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也就是說：
我頂多是預計住在護理機構
我頂多是預計住在護理機構
02:20
and work at menial jobs.
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做一些卑微的工作。
02:21
Fortunately, I did not actually
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幸運地，我實際上
02:23
enact that grave prognosis.
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並沒有讓嚴重的病情發生。
02:25
Instead, I'm a chaired Professor of Law, Psychology
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取而代之的，我是法學、心理學
02:28
and Psychiatry at the USC Gould School of Law,
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與精神病學首席教授，任職於南加大古爾德法學院。
02:31
I have many close friends
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我有很多親近的好朋友，
02:32
and I have a beloved husband, Will, who's here with us today.
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還有心愛的先生威爾，
他今天也在現場。
他今天也在現場。
02:35
(Applause) Thank you.
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（掌聲）謝謝。
02:42
He's definitely the star of my show.
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他絕對是我生命中的要角。
02:45
I'd like to share with you how that happened, and also
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我想跟你們分享那歷程，
02:48
describe my experience of being psychotic.
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並且描述我患病的經歷。
02:51
I hasten to add that it's my experience,
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我先說，那是我個人的經歷，
02:53
because everyone becomes psychotic in his or her own way.
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因為每個人轉變成病患的狀況不同。
02:56
Let's start with the definition of schizophrenia.
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讓我們從思覺失調症的定義開始。
02:59
Schizophrenia is a brain disease.
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思覺失調症是一種腦部疾病
03:01
Its defining feature is psychosis, or being
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其決定性特徵是精神失常，
03:04
out of touch with reality.
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或與現實脫節。
03:05
Delusions and hallucinations
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妄想和幻覺，
03:07
are hallmarks of the illness.
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都是這疾病的特徵。
03:09
Delusions are fixed and false beliefs that aren't responsive
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妄想是牢固且不真實的信念，與證據不符，
03:11
to evidence, and hallucinations are false sensory experiences.
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而幻覺則是不真實的感知經驗。
03:15
For example, when I'm psychotic I often have
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舉例來說，當發病時
03:18
the delusion that I've killed hundreds of thousands
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我常妄想，我以意念
03:20
of people with my thoughts.
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已殺了數十萬人。
03:21
I sometimes have the idea that
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有時候我認為
03:23
nuclear explosions are about to be set off in my brain.
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核爆即將在我腦袋中引發。
03:26
Occasionally, I have hallucinations,
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偶爾，我有幻覺，
03:28
like one time I turned around and saw a man
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例如有次我回頭看到一個男人
03:30
with a raised knife.
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高舉著刀。
03:31
Imagine having a nightmare while you're awake.
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想像在你醒著時做惡夢，
03:34
Often, speech and thinking become disorganized
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通常，說話與思維變得雜亂無章
03:37
to the point of incoherence.
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到了語無倫次的程度。
不確切的聯想包含
03:39
Loose associations involves putting together words
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將聽起來很像的詞語組合起來，但並無意義。
03:42
that may sound a lot alike but don't make sense,
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03:44
and if the words get jumbled up enough, it's called "word salad."
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如果字詞夠紊亂，那稱為「語詞沙拉」。
03:47
Contrary to what many people think, schizophrenia is not
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思覺失調症並非許多人想的
03:51
the same as multiple personality disorder or split personality.
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多重人格或人格分裂，
03:55
The schizophrenic mind is not split, but shattered.
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病患的心智不是分裂的，
而是粉碎的。
而是粉碎的。
03:58
Everyone has seen a street person,
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大家都見過街頭遊民，
04:01
unkempt, probably ill-fed,
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蓬頭垢面，可能營養不良，
04:03
standing outside of an office building muttering
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站在辦公大樓外
04:05
to himself or shouting.
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自言自語或大吼大叫，
04:07
This person is likely to have some form of schizophrenia.
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那人可能患有某種思覺失調症。
04:10
But schizophrenia presents itself across a wide array
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但思覺失調症患者
04:12
of socioeconomic status, and there are people
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存在各個社會經濟階層，
04:15
with the illness who are full-time professionals
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有些病患是全職、
04:17
with major responsibilities.
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擔負重要職責的專業人士。
04:20
Several years ago, I decided
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數年前，我決定
04:21
to write down my experiences and my personal journey,
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記錄下我的經驗和個人歷程，
04:24
and I want to share some more of that story with you today
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我今天想跟大家多分享一些故事
04:27
to convey the inside view.
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來傳遞病情的內觀。
04:28
So the following episode happened the seventh week
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接下來這段發生在耶魯法學院，
04:31
of my first semester of my first year at Yale Law School.
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我第一年、第一學期的第七週。
04:34
Quoting from my writings:
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引用我的札記：
04:36
"My two classmates, Rebel and Val, and I had made the date
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「我和兩位同學──瑞貝爾和薇爾相約，
04:40
to meet in the law school library on Friday night
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週五晚上到法學院圖書館碰面
04:43
to work on our memo assignment together.
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一起做我們的法律備忘錄作業，
04:45
But we didn't get far before I was talking in ways
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但我們有任何進展前，
04:47
that made no sense.
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我開始語無倫次。
04:48
'Memos are visitations,' I informed them.
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我告訴他們：『備忘錄就是訪視，
04:51
'They make certain points. The point is on your head.
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他們建立某些論點，
重點在你的腦袋，
重點在你的腦袋，
04:54
Pat used to say that. Have you killed you anyone?'
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派特曾說過，你殺過人嗎？』
04:56
Rebel and Val looked at me
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瑞貝爾和薇爾盯著我
04:58
as if they or I had been
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就像他們或我
05:00
splashed in the face with cold water.
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臉上被潑了冷水，
05:02
'What are you talking about, Elyn?'
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『艾琳，妳在說什麼？』
05:03
'Oh, you know, the usual. Who's what, what's who,
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『噢，你知道，如常，
誰是什麼，什麼是誰，
誰是什麼，什麼是誰，
05:06
heaven and hell. Let's go out on the roof.
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天堂、地獄。去屋頂吧，
05:08
It's a flat surface. It's safe.'
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那表面是平的、安全的。』
05:10
Rebel and Val followed
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瑞貝爾和薇爾跟著我
05:12
and they asked what had gotten into me.
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他們問我怎麼了，
05:13
'This is the real me,' I announced,
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我說：『這是真正的我』，
05:15
waving my arms above my head.
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我舉手過頭揮舞著。
05:16
And then, late on a Friday night, on the roof
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然後在週五的深夜，
05:19
of the Yale Law School,
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耶魯法學院的屋頂上，
05:20
I began to sing, and not quietly either.
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我開始大聲地唱歌，
05:23
'Come to the Florida sunshine bush.
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『來佛羅里達的陽光灌木叢，
05:26
Do you want to dance?'
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你要跳舞嗎？』
05:27
'Are you on drugs?' one asked. 'Are you high?'
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有人問：
『妳嗑藥了嗎？在嗨嗎？』
『妳嗑藥了嗎？在嗨嗎？』
05:30
'High? Me? No way, no drugs.
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『嗨？我？
不可能，沒嗑藥，
不可能，沒嗑藥，
05:32
Come to the Florida sunshine bush,
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來佛羅里達的陽光灌木叢，
05:35
where there are lemons, where they make demons.'
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那裡有檸檬，
他們在那裡製造魔鬼。』
他們在那裡製造魔鬼。』
05:38
'You're frightening me,' one of them said, and Rebel and Val
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其中一人說：『妳嚇到我了』，
05:41
headed back into the library.
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瑞貝爾和薇爾往圖書館去，
05:42
I shrugged and followed them.
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我聳聳肩，跟著他們。
05:44
Back inside, I asked my classmates if they were
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回到圖書館內，我問同學
05:48
having the same experience of words jumping around
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是否也見案件字跳來跳去，
05:50
our cases as I was.
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就像我一樣。
05:51
'I think someone's infiltrated my copies of the cases,' I said.
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『我認為有人潛入了我這份案件，
05:55
'We've got to case the joint.
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我們得把那關節裝箱，
05:57
I don't believe in joints, but
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我不相信關節，
05:59
they do hold your body together.'" --
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但他們確把身體連接起來。』
06:00
It's an example of loose associations. --
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這是一個散漫聯想的實例。
06:02
"Eventually I made my way back to my dorm room,
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「我終於回到宿舍房間，
06:05
and once there, I couldn't settle down.
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但我無法安穩下來，
06:07
My head was too full of noise,
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我的腦袋充滿了噪音，
06:09
too full of orange trees and law memos I could not write
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充滿了柳橙樹和
寫不出的法律備忘錄，
寫不出的法律備忘錄，
06:13
and mass murders I knew I would be responsible for.
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還有因我而有的大屠殺。
06:15
Sitting on my bed, I rocked back and forth,
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我坐在床上前後搖著，
06:19
moaning in fear and isolation."
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在恐懼和孤立裡呻吟。」
06:21
This episode led to my first hospitalization in America.
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這導致我第一次在美國住院治療，
06:24
I had two earlier in England.
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之前在英國有兩次。
06:26
Continuing with the writings:
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繼續我的札記：
06:28
"The next morning I went to my professor's office to ask
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「隔日早上我到教授辦公室
06:30
for an extension on the memo assignment,
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要求延繳備忘錄作業，
06:32
and I began gibbering unintelligably
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我開始語無倫次
06:34
as I had the night before,
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就像前晚一樣，
06:35
and he eventually brought me to the emergency room.
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最後他送我到急診室，
06:37
Once there, someone I'll just call 'The Doctor'
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到了那，有個人，
就稱他『那個醫生』
就稱他『那個醫生』
06:41
and his whole team of goons swooped down,
162
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1967
與他整隊暴徒猛撲過來，
06:43
lifted me high into the air,
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1409
把我高舉在空中，
06:44
and slammed me down on a metal bed
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重摔到金屬床上，
06:46
with such force that I saw stars.
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力量之大到讓我眼冒金星。
06:48
Then they strapped my legs and arms to the metal bed
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然後用厚厚的皮帶，
06:51
with thick leather straps.
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把我手腳綁在床上。
06:52
A sound came out of my mouth that I'd never heard before:
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嘴裡冒出我從未聽過的聲音，
06:56
half groan, half scream,
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半呻吟、半尖叫、
06:58
barely human and pure terror.
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幾乎沒人性、純粹的驚駭。
07:01
Then the sound came again,
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然後那聲音又來了，
07:03
forced from somewhere deep inside my belly
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從我腹腔深處強力湧上
07:05
and scraping my throat raw."
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刮得我喉嚨都破了。」
07:06
This incident resulted in my involuntary hospitalization.
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這導致我非自願的住院治療，
07:10
One of the reasons the doctors gave for hospitalizing me
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違我意住院，醫生的理由之一
07:14
against my will was that I was
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是因為我是「嚴重殘疾」。
07:15
"gravely disabled."
177
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07:17
To support this view, they wrote in my chart that I was unable
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為了支持這說法，
我病歷上寫著
我病歷上寫著
07:20
to do my Yale Law School homework.
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1792
無法完成耶魯法學院作業。
07:22
I wondered what that meant about much of the rest of New Haven.
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我不知這對大數紐哈芬人意味著什麼。
07:25
(Laughter)
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（笑聲）
07:26
During the next year, I would
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後來的一年間，
07:29
spend five months in a psychiatric hospital.
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我在精神病院待了五個月。
07:31
At times, I spent up to 20 hours in mechanical restraints,
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3479
有時，被機械束縛多達 20 小時，
07:34
arms tied, arms and legs tied down,
185
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手臂被綁著、
手和腿都被束縛，
手和腿都被束縛，
07:38
arms and legs tied down with a net tied
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被網子綁著手腳
07:40
tightly across my chest.
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在我胸前緊緊地交錯。
07:42
I never struck anyone.
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我從未攻擊任何人，
07:44
I never harmed anyone. I never made any direct threats.
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從未傷害任何人，從未直接威脅人，
07:47
If you've never been restrained yourself, you may have
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2774
若你未曾被綑綁過，
07:50
a benign image of the experience.
191
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2697
你對這經歷的想像
可能是良性的，
可能是良性的，
07:53
There's nothing benign about it.
192
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1975
這一點都不良性。
07:55
Every week in the United States,
193
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在美國，
07:56
it's been estimated that one to three people die in restraints.
194
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每週預期有 1-3 人死於束縛，
07:59
They strangle, they aspirate their vomit,
195
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他們被勒著，
他們吐出嘔吐物，
他們吐出嘔吐物，
08:02
they suffocate, they have a heart attack.
196
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他們窒息，
他們心臟病發。
他們心臟病發。
08:04
It's unclear whether using mechanical restraints
197
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2526
不明確的是，使用機械縛具
08:07
is actually saving lives or costing lives.
198
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實際上是救命還是害命。
08:09
While I was preparing to write my student note
199
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2794
當我正準備為耶魯法律期刊
08:12
for the Yale Law Journal on mechanical restraints,
200
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2200
撰寫有關機械縛具學生筆記，
08:14
I consulted an eminent law professor who was also
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2352
我詢問了一位著名法學教授，
08:17
a psychiatrist,
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1085
他也是一位精神科醫師，
08:18
and said surely he would agree
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1713
他說，他當然同意
08:19
that restraints must be degrading,
204
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2296
束縛一定是有辱人格、
08:22
painful and frightening.
205
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1536
痛苦且恐懼的。
08:23
He looked at me in a knowing way, and said,
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2111
他以理解的方式看著我說：
08:25
"Elyn, you don't really understand:
207
489897
2329
「艾琳，妳並不真的了解
08:28
These people are psychotic.
208
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1738
這些人精神失常，
08:29
They're different from me and you.
209
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1521
他們和你我不同，
08:31
They wouldn't experience restraints as we would."
210
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他們對束縛的感受不同與我們。」
08:34
I didn't have the courage to tell him in that moment that,
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2834
當時我沒有勇氣告訴他，
08:36
no, we're not that different from him.
212
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2001
不，我們和他沒什麼不同，
08:38
We don't like to be strapped down to a bed
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2358
我們不比他喜歡被綁在床上
08:41
and left to suffer for hours any more than he would.
214
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2330
痛苦好幾個小時。
08:43
In fact, until very recently,
215
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2152
事實上，直到最近，
08:45
and I'm sure some people still hold it as a view,
216
509924
1982
我確信仍有些人抱持這看法，
08:47
that restraints help psychiatric patients feel safe.
217
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3032
束縛可讓精神病患感到安全。
08:50
I've never met a psychiatric patient
218
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2432
我從未遇過哪個精神病患
08:53
who agreed with that view.
219
517370
1394
會同意這個看法。
08:54
Today, I'd like to say I'm very pro-psychiatry
220
518764
2711
今天，我很贊成精神病治療
08:57
but very anti-force.
221
521475
1503
但我很反暴力。
08:58
I don't think force is effective as treatment, and I think
222
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2991
我不認為暴力是有效的療法，
09:01
using force is a terrible thing to do to another person
223
525969
2737
我認為對有可怕疾病的人
09:04
with a terrible illness.
224
528706
1359
施暴很糟糕。
09:05
Eventually, I came to Los Angeles
225
530065
2721
後來，我來到洛杉磯
09:08
to teach at the University of Southern California Law School.
226
532786
2498
南加大法學院教學。
09:11
For years, I had resisted medication,
227
535284
2320
我抗拒服藥數年，
09:13
making many, many efforts to get off.
228
537604
1990
花了許多許多的努力做到，
09:15
I felt that if I could manage without medication,
229
539594
2675
我覺得如果我可不吃藥來控制，
09:18
I could prove that, after all,
230
542269
2038
我最終可以證明
09:20
I wasn't really mentally ill, it was some terrible mistake.
231
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2750
我不是真有精神病，
那是個可怕的錯誤。
那是個可怕的錯誤。
09:22
My motto was the less medicine, the less defective.
232
547057
3307
我的座右銘是
少吃藥就少缺陷。
少吃藥就少缺陷。
09:26
My L.A. analyst, Dr. Kaplan, was urging me
233
550364
3088
我洛杉磯的分析師卡普蘭博士
09:29
just to stay on medication and get on with my life,
234
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2500
力勸我持續服藥、享受生活，
09:31
but I decided I wanted to make one last college try to get off.
235
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3475
但我決定再試最後一次戒藥。
09:35
Quoting from the text:
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1432
從文中引用：
09:36
"I started the reduction of my meds, and within a short time
237
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3640
「我開始減少用藥，在短時間內
09:40
I began feeling the effects.
238
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2112
我開始感受到效果，
09:42
After returning from a trip to Oxford, I marched into
239
566611
2841
牛津之行後，
我走進卡普蘭的辦公室，
我走進卡普蘭的辦公室，
09:45
Kaplan's office, headed straight for the corner, crouched down,
240
569452
3377
直接走到角落蜷伏下來，
09:48
covered my face, and began shaking.
241
572829
2233
掩面且開始顫抖，
09:50
All around me I sensed evil beings poised with daggers.
242
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3155
感覺惡靈拿著匕首，圍繞著我，
09:54
They'd slice me up in thin slices
243
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2168
他們會把我削成薄片
09:56
or make me swallow hot coals.
244
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1642
或要我吞熱煤炭。
09:57
Kaplan would later describe me as 'writhing in agony.'
245
582027
3377
卡普蘭後來描述我
『痛苦地扭動』，
『痛苦地扭動』，
10:01
Even in this state, what he accurately described as
246
585404
3085
即使在這狀態下，
他準確描述了
他準確描述了
10:04
acutely and forwardly psychotic,
247
588489
1691
急性且加重的精神失常。
10:06
I refused to take more medication.
248
590180
2013
我拒絕再吃更多的藥，
10:08
The mission is not yet complete.
249
592193
2800
這任務尚未達成。
10:10
Immediately after the appointment with Kaplan,
250
594993
2618
與卡普蘭會面後，
10:13
I went to see Dr. Marder, a schizophrenia expert
251
597611
2298
我去見思覺失調症專家馬德醫師，
10:15
who was following me for medication side effects.
252
599909
2308
他在追蹤我藥物的副作用，
10:18
He was under the impression that I had a mild psychotic illness.
253
602217
3021
他印象中我有輕微的精神失常。
10:21
Once in his office, I sat on his couch, folded over,
254
605238
3428
在他辦公室裡，
我折身坐在沙發上，
我折身坐在沙發上，
10:24
and began muttering.
255
608666
1639
開始喃喃自語：
10:26
'Head explosions and people trying to kill.
256
610305
2230
『頭爆炸了，人們想殺人。
10:28
Is it okay if I totally trash your office?'
257
612535
2465
我可以徹底毀了這辦公室嗎？』
10:30
'You need to leave if you think you're going to do that,'
258
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2632
馬德說：『如果妳想這樣，
10:33
said Marder.
259
617632
983
妳必須要離開。』
10:34
'Okay. Small. Fire on ice. Tell them not to kill me.
260
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3152
『好，小小，火在冰上，
告訴他們不要殺我，
告訴他們不要殺我，
10:37
Tell them not to kill me. What have I done wrong?
261
621767
1648
告訴他們不要殺我，
我做錯了什麼？
我做錯了什麼？
10:39
Hundreds of thousands with thoughts, interdiction.'
262
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2577
千百個想法，制止。』
10:41
'Elyn, do you feel like you're
263
625992
1735
『艾琳，妳覺得
10:43
dangerous to yourself or others?
264
627727
1497
妳對危害自己或他人嗎？
10:45
I think you need to be in the hospital.
265
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2415
我認為妳需要進醫院，
10:47
I could get you admitted right away, and the whole thing
266
631639
1857
我可以馬上幫妳辦入院，
10:49
could be very discrete.'
267
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1135
而整件事可以是很謹慎的。』
10:50
'Ha, ha, ha.
268
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1681
『哈，哈，哈，
10:52
You're offering to put me in hospitals?
269
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2337
你要讓我進醫院？
10:54
Hospitals are bad, they're mad, they're sad.
270
638649
2943
醫院不好，
他們是瘋狂的、悲哀的，
他們是瘋狂的、悲哀的，
10:57
One must stay away. I'm God, or I used to be.'"
271
641592
3664
人們必須遠離，
我是上帝，或我曾經是。』
我是上帝，或我曾經是。』
11:01
At that point in the text,
272
645256
1583
在文中此處，
11:02
where I said "I'm God, or I used to be," my husband
273
646839
1905
當我說：
『我是上帝，或我曾經是，』
『我是上帝，或我曾經是，』
11:04
made a marginal note.
274
648744
1025
我丈夫做了旁注，
11:05
He said, "Did you quit or were you fired?"
275
649769
1607
他寫說：
『妳辭職或是被解雇了？』
『妳辭職或是被解雇了？』
11:07
(Laughter)
276
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2231
（笑聲）
11:09
"'I give life and I take it away.
277
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3752
『我賜予生命又將其帶走，
11:13
Forgive me, for I know not what I do.'
278
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1697
原諒我，因我不知在做什麼。』」
11:14
Eventually, I broke down in front of friends, and
279
659056
3314
終於，我在朋友面前崩潰了，
11:18
everybody convinced me to take more medication.
280
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2508
每人都說服我多吃點藥，
11:20
I could no longer deny the truth,
281
664878
1946
我不能再抗拒這個事實
11:22
and I could not change it.
282
666824
1522
而且我無法改變它。
11:24
The wall that kept me, Elyn, Professor Saks,
283
668346
2649
那道隔離我，艾琳．薩克斯教授
11:26
separate from that insane woman hospitalized years past,
284
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3113
和曾是精神病院瘋女人的牆，
11:30
lay smashed and in ruins."
285
674108
2111
碎倒而成一片廢墟。」
11:32
Everything about this illness says I shouldn't be here,
286
676219
2673
這病情都表明我不該在這，
11:34
but I am. And I am, I think, for three reasons:
287
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2874
但我是在這，
我想，有三個原因：
我想，有三個原因：
11:37
First, I've had excellent treatment.
288
681766
2392
第一，
我接受了極佳的治療。
我接受了極佳的治療。
11:40
Four- to five-day-a-week psychoanalytic psychotherapy
289
684158
2946
數十年且持續中，
每週 4-5 天的
每週 4-5 天的
11:43
for decades and continuing, and excellent psychopharmacology.
290
687104
2984
精神分析心理治療，
和卓越的精神藥物。
和卓越的精神藥物。
11:45
Second, I have many close family members and friends who know me
291
690088
4044
第二，
我有許多了解我、知道我疾病的
我有許多了解我、知道我疾病的
11:50
and know my illness.
292
694132
1254
親近家人和朋友。
11:51
These relationships have given my life a meaning
293
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2324
這些關係給予我生命意義、
11:53
and a depth, and they also helped me navigate
294
697710
2167
深度，他們也幫助我
11:55
my life in the face of symptoms.
295
699877
1968
面臨症狀時指引我人生方向。
11:57
Third, I work at an enormously supportive workplace
296
701845
3168
第三，
南加大法學院的工作環境，
南加大法學院的工作環境，
12:00
at USC Law School.
297
705013
1585
很具強大支持性。
12:02
This is a place that not only accommodates my needs
298
706598
3025
這裡不僅遷就我的需求，
12:05
but actually embraces them.
299
709623
1391
且事實上是接納了它們。
12:06
It's also a very intellectually stimulating place,
300
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3031
這也是個非常激發智力的地方，
12:09
and occupying my mind with complex problems
301
714045
2592
用複雜的問題占據我的心智，
12:12
has been my best and most powerful and most reliable
302
716637
3433
是對抗我的精神病
最佳、最有力
最佳、最有力
且最可靠的防禦。
12:15
defense against my mental illness.
303
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1720
12:17
Even with all that — excellent treatment, wonderful family and
304
721790
3303
即使如此，
優良的醫療、很棒的家人及朋友、
優良的醫療、很棒的家人及朋友、
12:20
friends, supportive work environment —
305
725093
1916
支持的工作環境，
12:22
I did not make my illness public
306
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2333
我之前並沒有公開我的疾病
12:25
until relatively late in life,
307
729342
1433
直到較晚的時候，
12:26
and that's because the stigma against mental illness
308
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2519
因為精神病的污名如此強大，
12:29
is so powerful that I didn't feel safe with people knowing.
309
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2608
讓人知道使我感到不安全。
12:31
If you hear nothing else today,
310
735902
2416
如果你今天許多內容都沒聽進去，
12:34
please hear this: There are not "schizophrenics."
311
738318
3434
那請聽聽這個：沒有精神分裂的人，
12:37
There are people with schizophrenia, and these people
312
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3151
是人患有思覺失調症，
12:40
may be your spouse, they may be your child,
313
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2095
這些人可能是
你的配偶、你的孩子、
你的配偶、你的孩子、
12:42
they may be your neighbor, they may be your friend,
314
746998
2424
你的鄰居、你的朋友、
12:45
they may be your coworker.
315
749422
1424
你的同事。
12:46
So let me share some final thoughts.
316
750846
2856
讓我分享一些最後的想法，
12:49
We need to invest more resources into research and treatment
317
753702
3432
我們在精神病的研究和治療上，
需要投注更多的資源。
12:53
of mental illness.
318
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1240
12:54
The better we understand these illnesses, the better
319
758374
2056
我們越了解這些疾病，
12:56
the treatments we can provide, and the better the treatments
320
760430
2208
我們越能提供更好的治療，
提供越好的治療，
12:58
we can provide, the more we can offer people care,
321
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2440
才能給予不施暴、更好的照護。
13:00
and not have to use force.
322
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1448
13:02
Also, we must stop criminalizing mental illness.
323
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2952
還有，必須停止精神病罪惡化，
13:05
It's a national tragedy and scandal that the L.A. County Jail
324
769478
4048
洛杉磯郡監獄是
美國最大的心理醫療機構，
美國最大的心理醫療機構，
13:09
is the biggest psychiatric facility in the United States.
325
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全國的悲劇與恥辱。
13:12
American prisons and jails are filled with people who suffer
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美國監獄和拘留所充滿著
受嚴重精神病折磨的人，
13:15
from severe mental illness, and many of them are there
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13:18
because they never received adequate treatment.
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多數人是因從未獲得妥適治療。
13:20
I could have easily ended up there or on the streets myself.
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我也可能在那落腳或流落街頭。
13:23
A message to the entertainment industry and to the press:
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一個給娛樂事業與媒體的訊息：
13:27
On the whole, you've done a wonderful job fighting stigma
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整體上，
你們於多面的汙名和歧視對抗
你們於多面的汙名和歧視對抗
13:31
and prejudice of many kinds.
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做得很好。
13:32
Please, continue to let us see characters in your movies,
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請繼續讓我們在你們的電影、
13:35
your plays, your columns,
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戲劇、專欄裡看見
13:38
who suffer with severe mental illness.
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受嚴重精神疾病折磨的人物。
13:39
Portray them sympathetically,
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富同情心地描繪他們，
13:41
and portray them in all the richness and depth
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將他們豐富有深度的經歷
13:44
of their experience as people and not as diagnoses.
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如常人般描繪，而非病患。
13:47
Recently, a friend posed a question:
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最近，一個朋友問：
13:50
If there were a pill I could take
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如果有一種藥丸我可以服用，
13:51
that would instantly cure me, would I take it?
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立即治癒我，我會吃嗎？
13:53
The poet Rainer Maria Rilke
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詩人里爾克
13:56
was offered psychoanalysis.
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被提供心理分析時，
13:57
He declined, saying, "Don't take my devils away,
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他拒絕了，說：
「別帶走我的魔鬼，
「別帶走我的魔鬼，
14:00
because my angels may flee too."
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因我也可能失去我的天使。」
14:01
My psychosis, on the other hand,
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相反的，我的精神失常，
14:04
is a waking nightmare in which my devils are so terrifying
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是醒著的夢魘，有可怕的魔鬼
14:06
that all my angels have already fled.
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嚇走我的天使。
14:08
So would I take the pill? In an instant.
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我願意吃那藥丸嗎？
我會立刻吞下去。
我會立刻吞下去。
14:12
That said, I don't wish to be seen as regretting
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雖說如此，我不希望被視為
14:15
the life I could have had if I'd not been mentally ill,
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因精神病而對生命感到遺憾，
14:17
nor am I asking anyone for their pity.
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也不渴求任何人的憐憫，
14:20
What I rather wish to say is that the humanity we all share
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我比較想說，共有的人性
14:23
is more important than the mental illness we may not.
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比不是人人共有的精神病更重要。
14:25
What those of us who suffer with mental illness want
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受精神病折磨之苦的人
14:28
is what everybody wants:
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要的和每個人一樣：
14:29
in the words of Sigmund Freud, "to work and to love."
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引用佛洛伊德：「去工作、去愛」
14:32
Thank you. (Applause)
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謝謝。（掌聲）
14:35
(Applause)
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（掌聲）
14:35
Thank you. Thank you. You're very kind. (Applause)
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謝謝，謝謝你們，你們真好。（掌聲）
14:40
Thank you. (Applause)
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謝謝。（掌聲）
ABOUT THE SPEAKER
Elyn Saks - Mental health law scholarElyn Saks asks bold questions about how society treats people with mental illness.
Why you should listen
As a law scholar and writer, Elyn Saks speaks for the rights of mentally ill people. It's a gray area: Too often, society's first impulse is to make decisions on their behalf. But it's a slippery slope from in loco parentis to a denial of basic human rights. Saks has brilliantly argued for more autonomy -- and in many cases for a restoration of basic human dignity.
In 2007, deep into her career, she dropped a bombshell -- her autobiography, The Center Cannot Hold. In it, she reveals the depth of her own schizophrenia, now controlled by drugs and therapy. Clear-eyed and honest about her own condition, the book lent her new ammunition in the quest to protect the rights and dignity of the mentally ill.
In 2009, she was selected as a MacArthur Fellow.
Read more on io9.com: I’m Elyn Saks and this is what it’s like to live with schizophrenia »
Elyn Saks | Speaker | TED.com