TED Residency
Alexandra Sacks: A new way to think about the transition to motherhood
亞莉山卓賽克斯: 用一種新方式來看待進入母親期的轉變
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當寶寶誕生時，媽媽也產生了。但在自然（有時也不甚穩定）的轉換過程中，常常因為羞恥或被誤診為產後憂鬱而沒有拿出來談論。在這場簡短、充滿資訊的演說中，生殖精神病學家亞莉山卓賽克斯詳細說明成為新手媽媽要經歷的情緒拔河，並分享描述這段歷程的詞語：母親期。
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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你是否記得自己有過荷爾蒙作用
且喜怒無常的時候？
且喜怒無常的時候？
00:17
Your skin was breaking out,
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你的皮膚突然起疹子，
00:19
your body was growing
in strange places and very fast,
in strange places and very fast,
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你的身體成長的部位
很奇怪，且成長快速，
很奇怪，且成長快速，
00:24
and at the same time,
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同時，
00:25
people were expecting you to be
grown-up in this new way.
grown-up in this new way.
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大家都期待你以這種
新方式成為一個成人。
新方式成為一個成人。
00:29
Teenagers, right?
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青少年，是吧？
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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生孩子的女性，
也同樣會遇到這樣的狀況。
也同樣會遇到這樣的狀況。
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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我們知道，青少年
覺得紊亂是很正常的，
覺得紊亂是很正常的，
00:40
so why don't we talk about
pregnancy in the same way?
pregnancy in the same way?
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所以，為什麼我們不能
用同樣的方式來談懷孕？
用同樣的方式來談懷孕？
00:44
There are entire textbooks written about
the developmental arc of adolescence,
the developmental arc of adolescence,
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有整本談青春期發展曲線的教科書，
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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而我們甚至沒有一個詞
可以用來描述成為人母的轉變。
可以用來描述成為人母的轉變。
00:55
We need one.
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我們需要一個詞。
00:57
I'm a psychiatrist who works
with pregnant and postpartum women,
with pregnant and postpartum women,
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我是精神病學家，處理的對象
是懷孕和產後的女性，
是懷孕和產後的女性，
01:00
a reproductive psychiatrist,
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我算是生殖精神病學家，
01:02
and in the decade that I've been
working in this field,
working in this field,
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我在這個領域做了十年，
這段時間我注意到一種模式。
01:05
I've noticed a pattern.
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01:06
It goes something like this:
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它大致上是這樣的：
01:08
a woman calls me up,
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一名女子打電話給我，
01:10
she's just had a baby,
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她剛生完孩子，
01:12
and she's concerned.
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她很憂心。
01:13
She says, "I'm not good at this.
I'm not enjoying this.
I'm not enjoying this.
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她說：「這不是我擅長的。
我一點也不樂在其中。
我一點也不樂在其中。
01:17
Do I have postpartum depression?"
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我是否得了產後憂鬱症？」
01:20
So I go through the symptoms
of that diagnosis,
of that diagnosis,
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所以我研究了那次診斷的症狀，
01:23
and it's clear to me
that she's not clinically depressed,
that she's not clinically depressed,
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我很清楚知道，
在臨床上她並沒有憂鬱症，
在臨床上她並沒有憂鬱症，
01:26
and I tell her that.
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我也是這樣告訴她的。
01:27
But she isn't reassured.
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但她沒有感到放心。
01:29
"It isn't supposed to feel
like this," she insists.
like this," she insists.
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她堅持：「正常的感覺
不該是這樣的。」
不該是這樣的。」
01:32
So I say, "OK. What did you
expect it to feel like?"
expect it to feel like?"
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於是我說：「好，
你預期應該有怎樣的感覺？」
你預期應該有怎樣的感覺？」
01:36
She says, "I thought motherhood
would make feel whole and happy.
would make feel whole and happy.
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她說：「我以為身為人母
能讓我覺得完整並快樂。
能讓我覺得完整並快樂。
01:41
I thought my instincts
would naturally tell me what to do.
would naturally tell me what to do.
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我以為我的本能會
很自然地告訴我該做什麼。
很自然地告訴我該做什麼。
01:45
I thought I'd always want
to put the baby first."
to put the baby first."
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我以為我會永遠
想要把寶寶放在第一。」
想要把寶寶放在第一。」
01:49
This -- this is an unrealistic expectation
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對於成為人母的轉變，
01:53
of what the transition
to motherhood feels like.
to motherhood feels like.
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這是很不實際的期望。
01:56
And it wasn't just her.
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她不是唯一一個。
01:58
I was getting calls with questions
like this from hundreds of women,
like this from hundreds of women,
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我接過數百名女性打來的電話，
都是問類似這樣的問題，
都是問類似這樣的問題，
02:03
all concerned that something was wrong,
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她們都覺得有什麼地方不對勁，
02:06
because they couldn't measure up.
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因為她們的期望沒有發生。
02:08
And I didn't know how to help them,
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我不知道要如何協助她們，
02:11
because telling them
that they weren't sick
that they weren't sick
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因為告訴她們說她們沒有生病
02:13
wasn't making them feel better.
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並不會讓她們感覺好些。
02:16
I wanted to find a way
to normalize this transition,
to normalize this transition,
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我想要找一種方式，
來將這種轉變給標準化，
來將這種轉變給標準化，
02:21
to explain that discomfort is not always
the same thing as disease.
the same thing as disease.
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來解釋不舒服的感覺
並不總是等同於疾病。
並不總是等同於疾病。
02:26
So I set out to learn more about
the psychology of motherhood.
the psychology of motherhood.
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所以我開始學習更多
關於母親的心理學。
關於母親的心理學。
02:30
But there actually wasn't much
in the medical textbooks,
in the medical textbooks,
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但在醫學教科書中，
其實沒有多少資訊，
其實沒有多少資訊，
02:33
because doctors mostly
write about disease.
write about disease.
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因為醫生通常寫的題材都是疾病。
02:36
So I turned to anthropology.
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於是我轉向人類學。
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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我花了兩年的時間，在達納拉斐爾
02:42
written in 1973 by Dana Raphael,
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於 1973 年所寫的
一篇已絕版短文中，
一篇已絕版短文中，
02:46
I finally found a helpful way
to frame this conversation:
to frame this conversation:
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我終於找到了一種
有幫助的方式，來建構這談話：
有幫助的方式，來建構這談話：
02:51
matrescence.
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母親期（成為母親的過程）。
02:53
It's not a coincidence that "matrescence"
sounds like "adolescence."
sounds like "adolescence."
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「母親期」聽起來像
「青春期」並不是巧合。
「青春期」並不是巧合。
02:59
Both are times when body morphing
and hormone shifting
and hormone shifting
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這兩段時期都是身體蛻變
和荷爾蒙轉變的時期，
和荷爾蒙轉變的時期，
03:02
lead to an upheaval
in how a person feels emotionally
in how a person feels emotionally
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造成在情緒感受上的混亂，
03:06
and how they fit into the world.
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且不知道要如何融入世界。
03:08
And like adolescence,
matrescence is not a disease,
matrescence is not a disease,
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如同青春期，母親期也不是疾病，
03:13
but since it's not
in the medical vocabulary,
in the medical vocabulary,
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但因為它不在醫學詞彙中，
03:15
since doctors aren't
educating people about it,
educating people about it,
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醫生也沒有去教育大家認識母親期，
03:18
it's being confused
with a more serious condition
with a more serious condition
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所以大家會把母親期會和更嚴重的
03:21
called postpartum depression.
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產後憂鬱症搞混。
03:24
I've been building on
the anthropology literature
the anthropology literature
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我一直以人類學文獻為論據基礎，
03:26
and have been talking
about matrescence with my patients
about matrescence with my patients
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我不斷用一種叫做
「推拉」的概念，
「推拉」的概念，
03:30
using a concept called
the "push and pull."
the "push and pull."
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來和我的病人談母親期。
03:33
Here's the pull part.
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拉的部分如下。
03:35
As humans, our babies
are uniquely dependent.
are uniquely dependent.
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身為人類，我們的寶寶
有著和其他動物不同的依賴性。
有著和其他動物不同的依賴性。
03:39
Unlike other animals,
our babies can't walk,
our babies can't walk,
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不像其他動物，
我們的寶寶不會走路，
我們的寶寶不會走路，
03:42
they can't feed themselves,
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他們無法自己找食物吃，
03:43
they're very hard to take care of.
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他們非常難照顧。
03:45
So evolution has helped us out
with this hormone called oxytocin.
with this hormone called oxytocin.
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所以，演化帶給我們的幫助，
就是一種叫做催產素的荷爾蒙。
就是一種叫做催產素的荷爾蒙。
03:50
It's released around childbirth
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大約在孩子出生時會釋放出來，
03:53
and also during skin-to-skin touch,
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在肌膚接觸的時候也會，
03:55
so it rises even if you didn't
give birth to the baby.
give birth to the baby.
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所以即使你沒有生孩子，
催產素也會升高。
催產素也會升高。
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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催產素能協助人類母親的
大腦聚焦，拉住她的注意力，
大腦聚焦，拉住她的注意力，
04:05
so that the baby is now
at the center of her world.
at the center of her world.
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於是，寶寶就成了她世界的中心。
04:08
But at the same time,
her mind is pushing away,
her mind is pushing away,
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但同時，她的心神也會被推走，
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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因為她還記得她還有
自己身份的其他各部分——
自己身份的其他各部分——
04:19
other relationships,
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她與其他人的關係、
04:21
her work,
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她的工作、
04:22
hobbies,
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她的興趣、
04:24
a spiritual and intellectual life,
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靈性上和知性上的生活，
04:26
not to mention physical needs:
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更不用說還有身體需求：
04:28
to sleep, to eat, to exercise,
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要睡眠、要吃、要運動、
04:32
to have sex,
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要做愛、
04:33
to go to the bathroom,
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要上洗手間，
04:35
alone --
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一個人去——
04:36
(Laughter)
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（笑聲）
04:37
if possible.
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如果能的話。
04:39
This is the emotional
tug-of-war of matrescence.
tug-of-war of matrescence.
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這是母親期的情緒拔河。
04:44
This is the tension
the women calling me were feeling.
the women calling me were feeling.
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打電話給我的那名女子
感受到的就是這種緊張感。
感受到的就是這種緊張感。
04:47
It's why they thought they were sick.
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這就是她們以為自己生病的原因。
04:51
If women understood the natural
progression of matrescence,
progression of matrescence,
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如果女性能了解到
母親期的自然發展，
母親期的自然發展，
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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如果她們能知道，大部分人
都覺得在這種推拉中生活很辛苦，
都覺得在這種推拉中生活很辛苦，
05:01
if they knew that under
these circumstances,
these circumstances,
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如果她們知道在這些情況下，
05:04
ambivalence was normal
and nothing to be ashamed of,
and nothing to be ashamed of,
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感到矛盾是很正常的，
不用為此感到羞恥，
不用為此感到羞恥，
05:09
they would feel less alone,
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她們就不會覺得這麼孤獨，
05:11
they would feel less stigmatized,
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她們就不會感到這麼羞恥，
05:13
and I think it would even reduce
rates of postpartum depression.
rates of postpartum depression.
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我認為這樣甚至還可以
減少產後憂鬱症的發生。
減少產後憂鬱症的發生。
05:18
I'd love to study that one day.
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希望將來我也能研究這題材。
05:21
I'm a believer in talk therapy,
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我是相信「談話治療」的人，
05:23
so if we're going to change the way
our culture understands
our culture understands
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所以，如果我們打算
要改變我們的文化
要改變我們的文化
05:26
this transition to motherhood,
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對於進入母親期的了解，
05:27
women need to be talking to each other,
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女性同胞得要和彼此談談，
05:30
not just me.
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不只是和我談。
05:32
So mothers, talk about your matrescence
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所以，母親們，
去談談你們的母親期，
去談談你們的母親期，
05:35
with other mothers, with your friends,
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跟其他母親談，跟你的朋友談，
05:38
and, if you have one, with your partner,
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如果你有伴侶的話，也跟伴侶談，
05:40
so that they can understand
their own transition
their own transition
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讓他們了解他們自己的轉變，
05:43
and better support you.
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給你更好的支持。
05:45
But it's not just about
protecting your relationship.
protecting your relationship.
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但重點不只是要保護你的關係。
05:49
When you preserve
a separate part of your identity,
a separate part of your identity,
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當你保留了你自己身分的
一部分，分開的一部分，
一部分，分開的一部分，
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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你其實也是留下空間
給你的孩子發展自己的身分。
給你的孩子發展自己的身分。
05:58
When a baby is born, so is a mother,
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當一個寶寶誕生時，
一個媽媽也誕生了，
一個媽媽也誕生了，
06:02
each unsteady in their own way.
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兩者都還站不穩，
只是站不穩的方式不同。
只是站不穩的方式不同。
06:05
Matrescence is profound,
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母親期很深奧，
06:07
but it's also hard,
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但它也很艱難，
06:09
and that's what makes it human.
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那就是身為人類的差別。
06:12
Thank you.
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謝謝。
06:13
(Applause)
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（掌聲）
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