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我们翻译这篇文章的理由 本文主要探讨了一种心理疗法ACT，即接受与实现疗法。当我们在面对不同的心理问题或者情绪问题的时候，我们或许应该集中精力去做那些对我们来说更重要的事，去成为我们想成为的人。努力和情绪问题共存，因为快乐不是唯一的答案。 ——李蕾 👇 收拾情绪，负重前行 作者： John J Donahue 译者：金殊羽 & 郭嘉宁 校对：何翔宇 策划：李蕾 & 何翔宇 It’s better to focus on where you are going than how you are feeling 别让情绪干扰你前行的方向 The notion that emotional pain and suffering reflect a deviation from a default happy baseline has been referred to as the ‘assumption of healthy normality’. But it’s a mistaken assumption. Estimates of the lifetime prevalence of psychiatric disorders indicate that around one in two adults will meet the criteria for a mental-health condition at some point in their lives. Given that psychological pain is so ubiquitous, we should focus less on what might make us happy, and more on achieving a sense of meaning, regardless of how we’re feeling. Psychotherapy should help people manage effective functioning while they are distressed, above and beyond aiming to reduce symptoms such as difficult thoughts, emotions and sensations. 快乐是正常的，情感上的痛苦是异常的——这一被称为“对健康常态的假定”其实是错误的。在估算了精神疾病在人的一生中的出现率后发现，大约50%的成人都在人生的某个阶段达到了精神疾病的标准。既然情感上的痛苦如此常见，我们就应该放下情绪，关注于如何实现某种意义，而不是如何使自己更快乐。心理治疗的目标不是为人减少消极的想法与情绪等症状，而是帮助人们在焦虑痛苦时依然能够照常生活。 Acceptance and commitment therapy (ACT) takes this approach, using mindfulness, acceptance and other behavioural strategies to promote more flexible and value-driven behaviours. The goals in ACT are not necessarily to change or reduce one’s problematic thoughts or emotions, but to foster meaningful and effective behaviours regardless of mood, motivation or thinking. In other words, the primary goal is to promote what therapists call ‘valued living’. 接纳与承诺疗法（ACT）正是如此设计的，通过正念、接受现实等行为改造策略，该疗法鼓励人们变得更加自由，在做事时以价值为导向。ACT的目标并不是改变或减少人的负面想法与情绪，而是让患者在不论心情、动力或想法如何的情况下，都能采取有意义且有效的行为。也就是说，ACT的主要目标是使患者过上心理治疗师口中的“有价值的生活”。 Think of valued living as going about your daily life in the service of values that you find important, whereby engaging in these actions creates a sense of meaning and purpose. From an ACT perspective, symptoms of psychiatric disorders, and psychological suffering more broadly, are problematic when they are linked to rigid behaviours that pull us away from valued living. We might not have any control over the pain we experience – in fact, our emotional pain is profoundly human – but one area where we can exert some control is what we do in response to that suffering. Many common responses to difficult thoughts and emotions – such as avoidance, substance abuse, withdrawal and aggression – can alleviate distress in the short term, but also lead to long-term damage in our relationships, our jobs, our freedom and our personal growth – the very areas that provide that sense of meaning and purpose. By letting go of an agenda guided by minimising pain, and recalibrating toward a more value-driven agenda, our choices can be based on who we want to be, rather than how we want to feel. 所谓有价值的生活，指的是在日常生活中以你所看重的价值为中心，一切行为都为价值服务，由此为生活带来意义和目标。从ACT的角度来说，当心理疾病以及更大范围的心理问题的症状导致人的行为死板，无法过上有价值的生活时，这些症状就是有问题的。我们或许无法控制痛苦的情绪——事实上，痛苦的情绪使我们富有人性——但是我们可以控制如何对待痛苦。许多常见的应对负面想法与情绪的方法——如逃避，吸毒，与世隔绝，敌对行为等——能在短期内减少痛苦，但长此以往，会对人际关系、工作、自由和自我成长等造成损害——而正是这些方面让我们感受到生活的意义与目标。通过将目标由尽可能减少痛苦改为以价值为导向，我们在做出选择时，可以想想我们希望成为怎样的人，而不是我们想要拥有怎样的感受。 In their 2013 study, the psychologists Todd Kashdan and Patrick McKnight of George Mason University in Virginia examined the day-to-day relationships between valued living and wellbeing in a sample of individuals with social anxiety disorder. This is a common but debilitating condition that’s marked by intense fear of social situations that might involve being negatively judged by others. People with social anxiety disorder often want and value positive relationships but considerable distress makes them avoid social interactions, so this is an excellent group in which to examine values and meaning. 在2013年，美国弗吉尼亚州乔治梅森大学的心理学家托德·卡希丹(Todd Kashdan)与帕特里克·麦克奈特(Patrick McKnight)对一批患有社交恐惧症的人群进行了研究，观察对他们来说，过上有价值的生活与心理健康的日常关系。社交恐惧症是一个普遍但消耗很大的疾病，其特点为患者会对可能受到负面评价的社交场合感到极度恐惧。这一类患者往往渴望且看重积极的人际关系，但由于过度担心而回避人际交往，因此这一人群是研究价值与意义的绝佳选择。 In the study, participants began by identifying their central aim or purpose in life (eg, ‘trying to be a good role model to others’). Then, each day over the next two weeks, they rated their daily efforts and progress toward this goal, and provided daily ratings of their self-esteem, meaning in life, and experience of positive and negative emotions. On days when they reported investing greater effort toward their main life goal, they also tended to enjoy greater wellbeing: they said their life had more meaning, and they scored higher on self-esteem and the experience of positive emotions. Importantly, support was not found for the reverse path – greater wellbeing did not predict greater effort or progress toward strivings. This study highlights that sometimes we need to make the value-guided choice, regardless of how we feel. 在研究中，被试者首先说出自己主要的人生目标（比如，“努力成为他人的行为榜样”）。之后，在接下来的两周里，他们每天都要评价自己为了达成目标所做的努力与进步，并对自己的自信水平、生活意义及感受到的积极与消极情绪进行评估。报告显示，在他们为自己主要的人生目标付出了巨大努力的日子里，他们的心理往往也更加健康，他们表示生活更加具有意义，自信心增强，且感受到更多的积极情绪。不过需要注意的是，没有证据显示反向推断是可行的，即心理健康不代表为目标做出了努力或进步。该研究告诉我们，有时我们需要放下情绪，让价值引导我们做出选择。 If only it were so easy, though. For this reason, in ACT-based treatments, there is substantial focus on skills and techniques that can assist one in cultivating a more aware, willing and tolerant stance toward difficult feelings and other internal experiences. This stands in explicit contrast to a ‘do X and your distress will alleviate’ approach. The ACT techniques are not in the service of changing emotional states – they are in the service of facilitating valued action. 但事情并没有这么简单。因此，ACT疗法非常重视技巧，这些技巧可以帮助人们以一种更加专注、更加乐意、更加宽容的态度面对痛苦和其他一些内在体验。这与“做某件事，你的痛苦就会减轻”的说法形成了鲜明的对比。ACT疗法不是为了改善情绪状态，而是为了促进采取有价值的行为。 The effectiveness of ACT across different diagnoses and problem areas shows that committing to the benefits of valued living transcends traditional diagnostic categories. In addition to anxiety disorders, in studies of post-traumatic stress disorder, depression and resilience, chronic pain, suicidal ideation and many more, engaging in behaviours consistent with personally held values has been linked to a range of positive outcomes. ACT疗法关于不同诊断和问题的效果表明，重视有价值生活的带来的益处要优于传统的诊疗方法。除了焦虑症相关研究，对于创伤后应激障碍、抑郁与恢复、慢性疼痛和自杀意念等其他方面的许多研究都表明，符合个人价值观念的行为会与一些好的结果相关联。 Which brings me back to my work as a therapist. While the breadth of exercises and techniques employed in ACT is beyond the scope of this article, there is one exercise I’d like to share that has helped some of my clients see the link between valued living and painful experiences. In this activity (of which there are different variations), the therapist first asks the client to write on an index card some of the internal experiences they are struggling with most – difficult thoughts and judgments, emotions, memories. 这让我联想到了我作为一名治疗师的工作。虽然ACT疗法采用的训练和技巧超出了本文的探讨范围，但我想分享治疗当中的一个训练，它帮助一些患者看到了有价值的生活和痛苦经历之间的联系。在这项训练当中（训练有许多种不同形式），治疗师首先要求患者在索引卡上写下一些最困扰他们的内心体验——包括一些负面的想法和判断、情绪和记忆等等。 I ask them, what do you notice when you read that index card? I feel awful, I don’t want this. What do you want to do with the card? I want to throw it in the trash. Then the client flips the card over, and I ask them to write out some of the things that are most important, most meaningful to them – being a parent, caring and supporting others, learning, growing, etc. What do you notice when you read this side? Warmth, it feels right, this is who I want to be. Where is the pain, where is the other stuff? Still here, on the other side of the card. What happens if you push that pain away, escape or avoid it? I push the meaningful stuff away too. In your heart of hearts, what does your experience tell you right now? If I’m going to do the things that are important to me, be the person that I want to be, I also have to make room for the painful stuff. 我问他们，你们在阅读索引卡时都有什么感受？“我觉得很糟。我不想这样。”你想怎样处理这张卡片？“我想把它扔进垃圾桶。”然后患者把卡片翻到背面，我让他们写下一些对他们来说最重要、最有意义的事情——比如为人父母、关心和支持他人、学习和成长等等。你读到这一面时有什么感受？“很温暖，感觉很好，这就是我想成为的人。”那痛苦和其它事物都去哪儿了？“它们还在，在卡片的另一面。”如果你把痛苦推开，选择一味逃避的话会发生什么呢？“我同时也把有意义的事物推开了。”在你的内心深处，你的经历给你带来了哪些收获？“如果我想要做那些对我来说很重要的事情，成为我想成为的人，我也必须要承受痛苦的事物。” In my experience, this is both an emotionally difficult exercise and also one that helps a person grasp that it’s impossible to disentangle pain and valued living. Sometimes it is hard to engage with those struggles in session, but we regularly return to the rationale of the approach – that maybe a different stance toward pain is necessary. And that is the crux of the work in ACT – opening up to the demons, judgments and suffering that lie underneath, all for the purpose of moving toward that which is meaningful. 以我的经验看来，这不仅是一种情感上的艰难历练，但也帮助人们认识到我们无法摆脱生活当中的苦难，珍惜生活才更为重要。有时我们很难面对这些困扰，但我们总会回到治疗的基本原理——或许对生活中的苦痛采取一种不同的态度是十分必要的。这就是ACT疗法的关键——对深藏的负面情绪、判断和内心的挣扎敞开心扉，所有这些都是为了朝着有意义的方向继续前行。 The valued path is not necessarily the happy path. Social connectedness sometimes brings us in contact with memories of abuse and trauma. Being a parent stirs up doubts, uncertainty and feelings of anxiety, fear, anger and shame. Advocating for social justice requires repeated exposure to the inequities in our societies and the feelings of helplessness that can come from fighting for an equality that might not exist until after you’re gone. But a growing body of psychological research suggests that the valued path is the more workable one, whereas the happy path can be more of an illusion. 有价值的生活方式不一定是快乐的。我们的社会关系有时会勾起曾经遭受虐待和创伤的回忆。为人父母有时会让我们心生怀疑，感受到一种不确定性、焦虑、恐惧、愤怒和羞愧。倡导社会正义会让我们长期身处社会的不平等和短期内无法改变现状带来的无助感当中。但越来越多的心理学研究表明，有价值的生活方式更加切实可行，而快乐的生活方式可能只是一种幻觉。 For readers who would like to find out more, I recommend the bookGet Out of Your Mind and Into Your Life (2005) co-authored by the founder of ACT, Steven Hayes, and also Things Might Go Terribly, Horribly Wrong (2010) co-authored by another ACT pioneer, Kelly Wilson. And here is the international directory of ACT therapists, maintained by the Association for Contextual Behavioral Science. 对于想要了解更多相关内容的读者，我推荐ACT疗法创始人史蒂文·海耶斯(Steven Hayes)与人合著的《走出你的思维，走进你的生活》(get out of Your Mind and Into Your Life, 2005)，以及另一位ACT疗法的先驱凯利·威尔逊(Kelly Wilson)与人合著的《事情可能会变得非常糟糕》(Things Might Go, Wrong, 2010)。这是国际上ACT治疗师的目录，由情境行为科学协会整理。 👇 参考阅读——伴病而行
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