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IngeMissmahl_2010G-_给阿富汗人带来心灵宁静_
So I want to tell you a story -- an encouraging story -- about addressing desperation, depression and despair in Afghanistan , and what we have learned from it, and how to help people to overcome traumatic experiences and how to help them to regain some confidence in the time ahead -- in the future -- and how to participate again in everyday life. 我想给大家讲个故事,很鼓舞人心, 是有关解决 阿富汗的绝望和抑郁的故事, 以及我们从可学到 如何帮助人们 克服创伤经历留下阴影的办法, 及如何帮助他们找回自信 和对未来的自信 以及如何重新参与到日常生活中。
depression:n.沮丧;洼地;不景气;忧愁; despair:v.绝望;失去希望;丧失信心;n.绝望; Afghanistan:n.阿富汗(国家名称,位于亚洲); overcome:vt.克服;胜过;vi.克服;得胜; traumatic:adj.外伤的;创伤的;n.外伤药; regain:vt.再次得到;重新获得,恢复;返回;n.恢复;收复;收回 confidence:n.信心;信任;秘密;adj.(美)诈骗的;骗得信任的; participate:v.参加;参与;
So, I am a Jungian psychoanalyst , and I went to Afghanistan in January 2004, by chance , on an assignment for Medica Mondiale. 我的职业是心理分析师, 由于偶然的机会,我在2004年7月去了趟阿富汗, 去做一项医学调查。
psychoanalyst:n.精神分析学家;心理分析学家; by chance:偶然;意外地; assignment:n.分配:(分派的)工作,任务:
Jung in Afghanistan -- you get the picture. 这就是荣格在阿富汗— 你们看到了这张照片。
Afghanistan is one of the poorest countries in the world, and 70 percent of the people are illiterate . 阿富汗是世界上最贫穷的国家之一, 百分之七十的人民都是文盲。
illiterate:adj.文盲的;不识字的;没受教育的;n.文盲;
War and malnutrition kills people together with hope. 战争和营养不良不仅扼杀了他们的生命, 还扼杀了希望。
malnutrition:n.营养失调,营养不良;
You may know this from the media , but what you may not know is that the average age of the Afghan people is 17 years old, which means they grow up in such an environment and -- I repeat myself -- in 30 years of war. 你可能从各种媒体中知道了这点。 但是你可能不知道的是 阿富汗人的平均寿命是17岁, 这意味着 我再重复一遍 他们从小生长在长达30年的战争中。
media:n.媒体;媒质(medium的复数);血管中层;浊塞音;中脉;
So this translates into ongoing violence , foreign interests, bribery , drugs, ethnic conflicts , bad health, shame, fear and cumulative traumatic experiences. 他们的生活环境是 持续的战争, 外国利益集团的觊觎、商业贿赂、 毒品、宗教冲突、 糟糕的健康状况、羞愧、恐惧 以及持续的创伤经历。
ongoing:n.发展; adj.持续存在的; violence:n.暴力;侵犯;激烈;歪曲; bribery:n.[法]贿赂;受贿;行贿; ethnic:adj.种族的;人种的; conflicts:n.冲突; v.抵触; cumulative:adj.累积的;
Local and foreign military are supposed to build peace together with the donors and the governmental and non-governmental organizations . 当地和外国部队 的任务仅仅是与捐款人、 政府和非政府组织一起建立起和平的秩序。
military:adj.军事的;军人的;适于战争的;n.军队;军人; supposed:adj.误信的;所谓的;v.认为;假设;设想;(suppose的过去分词和过去式) donors:n.捐赠人(donor的复数);[电子]施主; non-governmental:非政府的;非官方的; organizations:n.组织,构造,有机体(organization的复数);组织机构;
And people had hope, yes, but until they realized their situation worsens every day -- either because they are being killed or because, somehow , they are poorer than eight years ago. 人民有一些希望, 但是当他们认识到 他们的处境每日都在恶化— 或许是被射杀 或许, 变得比8年前更加贫穷。
worsens:vi.恶化;变得更坏;更坏;vt.使恶化;使变得更坏; somehow:adv.以某种方法;莫名其妙地;
One figure for that: 54 percent of the children under the age of five years suffer from malnutrition. 有一个数字能够说明这种情况: 五岁以下的儿童中有百分之五十四的人都饱受 营养不良症的折磨。
under the age of:在年龄之下;16岁以下;
Yet, there is hope. 然而,他们仍然是有一丝希望的。
One day a man told me, "My future does not look brilliant, but I want to have a brilliant future for my son." 一天,一个阿富汗人告诉我, “我的前途并不光明, 但是我希望我的儿子能有灿烂的前程。”
This is a picture I took in 2005, walking on Fridays over the hills in Kabul, and for me it's a symbolic picture of an open future for a young generation. 这是我在2005年拍的一张照片, 那天是周五,我在喀布尔山上散步时拍下了它。 对我来说,这是一张有象征意义的照片 象征着年轻一代的远大前程。
symbolic:adj.象征的;符号的;使用符号的;
So, doctors prescribe medication . 作为医生,是要开药方的。
prescribe:v.给…开(药);让…采用(疗法);开(处方);命令; medication:n.药;药物;
And donors are supposed to bring peace by building schools and roads. 捐赠人的责任就是 实现和平, 重建道路和学校。
Military collect weapons, and depression stays intact . 军队没收了武器, 但是绝望仍然在那里,
intact:adj.完整的;原封不动的;未受损伤的;
Why? 为什么会这样呢？
Because people don't have tools to cope with it, to get over it. 因为人们没有掌握解决、 克服绝望的手段。
cope:v.处理;n.大圆衣;
So, soon after my arrival, 所以,我一到那里,
I had confirmed something which I had already known; that my instruments come from the heart of modern Europe, yes. 就证实了一些我之前了解到的信息, 虽然我使用的治疗手段来自先进的欧洲,
instruments:n.器械;仪器;器具;手段(instrument的复数)
However, what can wound us and our reaction to those wounds -- they are universal . 但是,我们可以设想,那些伤害我的, 以及我们对创伤的反应— 对所有人都是一样的。
reaction:n.反应,感应;反动,复古;反作用; wounds:n.(身体上的)伤,伤口; v.使(身体)受伤; (wound的第三人称单数和复数) universal:adj.普遍的;全体的;全世界的;共同的;
And the big challenge was how to understand the meaning of the symptom in this specific cultural context . 最大的挑战是 如何去理解症状在这种特殊文化中的 特殊意义。
symptom:n.症状;征候;征兆; specific:adj.特殊的,特定的;明确的;详细的;[药]具有特效的;n.特性;细节;特效药; cultural:adj.与文化有关的;文化的;与艺术、文学、音乐等有关的; context:n.环境;上下文;来龙去脉;
After a counseling session , a woman said to me, "Because you have felt me, I can feel myself again, and I want to participate again in my family life." 在一次咨询中,一位女士对我说, “因为你说出了我的感受,我也重新找回了自己, 我愿意重新参与到 家庭生活中。”
counseling:n.咨询服务;v.建议;劝告;商讨;(counsel的现在分词形式) session:n.会议;(法庭的)开庭;(议会等的)开会;学期;讲习会;
This was very important, because the family is central in Afghans' social system. 这非常重要, 因为家庭 是阿富汗社会的核心。
No one can survive alone. 任何人都无法脱离他人生存。
And if people feel used, worthless and ashamed , because something horrible has happened to them, then they retreat , and they fall into social isolation, and they do not dare to tell this evil to other people or to their loved ones, because they do not want to burden them. 如果人们感觉自己被利用了,没有价值,感到很羞愧, 那是因为很多可怕的事情发生在他们身上, 之后他们就会退缩,变得孤立于社会之外, 并且他们不敢把他们这种罪恶的感受 告诉他们所爱的人或者其他人, 他们不想连累这些人。
worthless:adj.无价值的;不值钱的;卑微的; ashamed:adj.惭愧;尴尬;因惭愧而不情愿; horrible:可怕的,极讨厌的, retreat:v.撤退;退却;后退;退缩;n.撤退;退却;退缩;退避; evil:adj.邪恶的;不幸的;有害的;讨厌的;n.罪恶,邪恶;不幸; burden:n.负担;责任;船的载货量;v.使负担;烦扰;装货于;
And very often violence is a way to cope with it. 通常人们用暴力来解决这些困扰。
Traumatized people also easily lose control -- symptoms are hyper-arousal and memory flashbacks -- so people are in a constant fear that those horrible feelings of that traumatic event might come back unexpectedly , suddenly, and they cannot control it. 精神上受创伤的人容易失去控制—— 其症状就是易激惹和不断回想过去—— 所以这些人生活在持续的恐惧中 发生创伤事件时恐怖的体验 会没有预兆地, 突然地再现, 没有办法控制。
Traumatized:adj.心理受到创伤的;v.使受创伤(traumatize的过去式和过去分词); symptoms:n.症状;征候;征兆;(symptom的复数) flashbacks:n.倒叙(flashback的复数形式);(痛苦的往事的)重现;急转; unexpectedly:adv.出乎意料地,意外地;
To compensate this loss of inner control, they try to control the outside, very understandably -- mostly the family -- and unfortunately , this fits very well into the traditional side, regressive side, repressive side, restrictive side of the cultural context. 为了弥补这种内在的失控感, 他们就会试图控制外界事物, 这很容易理解,他们通常控制的就是家庭— 不幸的是, 在他们的控制之下, 整个文化变得更加传统, 更加落后和压抑, 有了更多的约束。
compensate:v.补偿,赔偿;抵消; inner:n.内部;射中接近靶心部分的一发;adj.里面的;向内的;内部的;接近中心的; understandably:adv.可理解地; unfortunately:adv.不幸地; traditional:传统的,惯例的, regressive:adj.回归的;后退的;退化的; repressive:adj.镇压的;压抑的;抑制的;
So, husbands start beating wives, mothers and fathers beat their children, and afterward , they feel awful. 丈夫开始打妻子, 爸爸妈妈打孩子, 打过之后,他们又感觉很糟糕。
afterward:adv.以后,后来;
They did not want to do this, it just happened -- they lost control. 他们并不希望这样做,但是事情就那么发生了。 一句话,他们失去了控制。
The desperate try to restore order and normality , and if we are not able to cut this circle of violence, it will be transferred to the next generation without a doubt. 我们竭尽全力在做的 修补和复原工作, 如果无法打破这个暴力循环, 这种暴力毫无疑问会传给下一代。
desperate:adj.不顾一切的;令人绝望的;极度渴望的; restore:v.恢复;修复;恢复(某种情况或感受);使复原; normality:n.常态;[化学]当量浓度;[化学]规定浓度; transferred:v.(使)转移,搬迁;(使)调动;(transfer的过去分词和过去式)
And partly this is already happening. 事实上,事情已经在这么发生了。
So everybody needs a sense for the future, and the Afghan sense of the future is shattered . 所以每一个人都要心系未来。 阿富汗人未来的观念 是非常弱的。
shattered:adj.受到严重打击的; v.(使)破碎,碎裂; (shatter的过去式和过去分词)
But let me repeat the words of the woman. 但是让我重复一遍那位女士的话。
'"Because you have felt me, “因为你说出了我的感受,
I can feel myself again." 我重新找回了自己。”
So the key here is empathy . 所以关键是共享情绪。
empathy:n.神入;移情作用;执着;
Somebody has to be a witness to what has happened to you. 需要有人目睹 你所经历的。
witness:n.证人;目击者;证据;v.目击;证明;为…作证;
Somebody has to feel how you felt. 需要有人体会你的感受。
And somebody has to see you and listen to you. 需要有人关注你,倾听你。
Everybody must be able to know what he or she has experienced is true, and this only goes with another person. 每个人都必须知道, 发生在他们身上的事情已经发生了。 在别人身上也有可能发生。
So everybody must be able to say, "This happened to me, and it did this with me, but I'm able to live with it, to cope with it, and to learn from it. 每个人都要能够说, “这件事确实发生了,它对我造成了影响, 但是我可以和它和平共处,我能够处理好它, 并且从中学习,
And I want to engage myself in the bright future for my children and the children of my children, and I will not marry-off my 13 year-old daughter," -- what happens too often in Afghanistan. 我想为我的孩子 打造一个光明的前程 以及我孩子的孩子, 我不会把13的女儿嫁出去。” —这种事情在阿富汗经常发生。
engage:v.吸引,占用;使参加;雇佣;使订婚;预定;
So something can be done, even in such extreme environments as Afghanistan. 所以我们能够做一些事情, 即使在阿富汗这样极端的环境中也是可以做的。
extreme:adj.极端的;极度的;偏激的;尽头的;n.极端;末端;最大程度;极端的事物;
And I started thinking about a counseling program. 我开始设想开展一个咨询项目。
But, of course, I needed help and funds . 当然我需要助手和资金。
funds:n.[会计]资金,现金(fund的复数);基金;v.资助(fund的三单形式);提供资金;
And one evening, 一天晚上,
I was sitting next to a very nice gentleman in Kabul, and he asked what I thought would be good in Afghanistan. 在喀布尔,当我坐在一位善良的绅士旁边时, 他问我,你认为什么对阿富汗最有帮助。
And I explained to him quickly, 我飞快地向他讲,
I would train psycho-social counselors , 我想培训心理社会咨询师,
counselors:n.辅导员;顾问(counselor的复数形式);
I would open centers, and I explained to him why. 我想开办培训中心,然后我向他解释了为什么产生这种想法。
This man gave me his contact details at the end of the evening and said, "If you want to do this, call me." 就在那个晚上那位先生给了我他的联系方式 并且说,“如果你决定开始做,请打我的电话。”
contact:n.接触,联系;v.使接触,联系;
At that time, it was the head of Caritas Germany. 当时,他是慈善德国（Caritas Germany）的负责人。
So, I was able to launch a three-year project with Caritas Germany, and we trained 30 Afghan women and men, and we opened 15 counseling centers in Kabul. 所以我得以与慈善德国携手启动了为期三年的项目, 我们训练了30个阿富汗人, 在喀布尔开设了15个咨询中心。
launch:v.发射(导弹,火箭等); n.发射;
This was our sign -- it's hand-painted , and we had 45 all over Kabul. 这是我们的宣传标牌,是手绘的。 我们在喀布尔有45个这样的标牌。
hand-painted:adj.手工漆的,手工涂的;
Eleven thousand people came -- more than that. 一万一千人来到这些咨询中心,或许更多。
And 70 percent regained their lives. 其中百分之七十的人重新找到了生活重心。
regained:v.重新获得,恢复;回到(原位);返回;(regain的过去分词和过去式)
This was a very exciting time, developing this with my wonderful Afghan team. 这是个激动人心的经历, 与我的阿富汗团队一起完成。
And they are working with me up to today. 至今我们仍然在一起工作。
We developed a culturally-sensitive psycho-social counseling approach . 我们找到了符合当地文化的、 心理社会咨询方法。
approach:n.方法;路径;v.接近;建议;着手处理;
So, from 2008 up until today, a substantial change and step forward has been taking place. 所以,从2008年上半年至今, 我们取得了 实质性的进步。
substantial:adj.大量的;实质的;内容充实的;n.本质;重要材料;
The European Union delegation in Kabul came into this and hired me to work inside the Ministry of Public Health, to lobby this approach -- we succeeded. 喀布尔的欧盟代表团 来到这里邀请我去工作 到公共健康部门 推广这种方法。 我们成功了。
European Union:n.欧洲联盟; delegation:n.代表团;授权;委托; Ministry:n.(政府的)部门; lobby:n.大堂;门厅;民众接待厅;游说;v.游说(从政者或政府);
We revised the mental health component of the primary health care services by adding psycho-social care and psycho-social counselors to the system. 我们重新阐释了 主要的健康关怀服务中的心理健康部分 在系统中加入了心理社会关怀 以及心理社会咨询。
revised:v.改变;修改;复习;温习;(revise的过去分词和过去式) component:n.成分;部件;组成部分;adj.构成的; health care:n.卫生保健;
This means, certainly, to retrain all health staff. 这就意味着有必要重新教育那些健康关怀服务人员。
retrain:vt.重新教育;再教育;vi.再训练;再教育;
But for that, we already have the training manuals , which are approved by the Ministry and moreover , this approach is now part of the mental health strategy in Afghanistan. 我们已经有了培训手册, 通过了部里的审核, 此外,这种方法 成为了阿富汗心理健康战略的一部分。
manuals:n.手册,指南;说明书(manual的复数); approved:adj.被正式接受的,被正式认可的; v.赞成; (approve的过去分词和过去式) moreover:adv.而且;此外; strategy:n.策略;行动计划;部署;战略;
So we also have implemented it already in some selected clinics in three provinces, and you are the first to see the results. 因此我们已经在 三个省中挑选出来的诊所中试用了这种方法, 这是试验的结果,第一次对外公布。
implemented:v.使生效;贯彻;执行;实施;(implement的过去式和过去分词) clinics:n.诊所(clinic的复数形式);
We wanted to know if what is being done is effective . 我们希望了解到所做的是否有效。
effective:adj.有效的,起作用的;实际的,实在的;给人深刻印象;
And here you can see the patients all had symptoms of depression, moderate and severe . 从图表中我们可以看出, 所有的病人都有抑郁的症状, 或轻或重。
patients:n.接受治疗者,病人;(patient的复数) moderate:v.缓和; adj.适度的; n.持温和观点者(尤指政见); severe:adj.极为恶劣的;十分严重的;严厉的;苛刻的;
And the red line is the treatment as usual -- medication with a medical doctor. 红线表示采用惯常的治疗手段—— 也就是药剂师开药。
treatment:n.治疗;疗法;对待;处理;讨论;
And all the symptoms stayed the same or even got worse. 所有的症状都没有改善、 甚至加重了。
And the green line is treatment with psycho-social counseling only, without medication. 绿线表示仅仅采用了心理社会咨询的治疗方法, 而没有吃药的效果。
And you can see the symptoms almost completely go away, and the psycho-social stress has dropped significantly , which is explicable , because you cannot take away the psycho-social stresses, but you can learn how to cope with them. 你可以从图上看到,症状基本消失了, 心理社会压力迅速地下降, 这个结果也是可以解释的, 因为你不能消除所有的心理社会压力, 但是人们能够学会如何减轻这种压力。
significantly:adv.意味深长地;值得注目地; explicable:adj.可解释的,可说明的;
So this makes us very happy, because now we also have some evidence that this is working. 我们看到这个结果非常开心, 因为我们有了证据来证明 我们的方法是有效的。
evidence:n.证据,证明;迹象;明显;v.证明;
So here you see, this is a health facility in Northern Afghanistan, and every morning it looks like this all over. 如图所示, 这是阿富汗北部的一处健康服务中心, 每天早上的情境都有点类似这样,
facility:n.设施;设备;特别装置;特色;场所;天资;
And doctors usually have three to six minutes for the patients, but now this will change. 但是医生一般只有三至六分钟来诊断一个病人。 现在这种情况将得到改善。
They go to the clinics, because they want to cure their immediate symptoms, and they will find somebody to talk to and discuss these issues and talk about what is burdening them and find solutions, develop their resources , learn tools to solve their family conflicts and gain some confidence in the future. 病人会去到诊所里, 因为他们想治愈那些短期的症状, 在那里他们会发现有人可以交流 讨论他们的病情 讨论让他们感到压迫的因素是什么 然后寻找治疗的办法,发掘他们自身潜藏的资源, 学习解决家庭冲突的办法 建立对未来生活的信心。
issues:n.重要议题;争论的问题;v.宣布;公布;发出;(issue的第三人称单数和复数) burdening:v.使载重;加重压于;加负担于(burden的现在分词);n.配料;载重; resources:n.[计][环境]资源; v.向…提供资金(resource的第三人称单数);
And I would like to share one short vignette . 我想与大家分享一个小故事。
vignette:n.装饰图案; vt.把…印放为虚光照,晕映; n.Vignette)人名; n.梗概,简介,花絮;
One Hazara said to his Pashtun counselor, "If we were to have met some years ago, then we would have killed each other. 一个哈拉扎人对他的普什图咨询师说, “如果我们很多年前相遇, 我们会杀死彼此。
And now you are helping me to regain some confidence in the future." 现在你却来帮助我 让我对未来树立信心。”
And another counselor said to me after the training, "You know, I never knew why I survived the killings in my village, but now I know, because I am part of a nucleus of a new peaceful society in Afghanistan." 一个咨询师在培训结束后对我说, “我一直不知道为什么村里的人都被杀死了,唯有我活了下来。 现在我知道了, 因为我是 阿富汗新和平社会的一份子。”
nucleus:n.核,核心;原子核;
So I believe this kept me running. 我相信正是这些话语激励着我不断前进。
And this is a really emancipatory and political contribution to peace and reconciliation . 这的确是一种解放和政治运动 其目的是实现和平和解。
emancipatory:adj.解放的;有助于解放的; contribution:n.捐款;捐资;定期缴款;贡献;促成作用;稿件; reconciliation:n.和解;调和;和谐;甘愿;
And also -- I think -- without psycho-social therapy , and without considering this in all humanitarian projects, we cannot build-up civil societies. 我认为, 如果没有心理社会疗法, 如果在人道主义活动中不考虑 心理、社会的因素 文明社会就无法建立起来。
therapy:n.治疗,疗法; humanitarian:adj.人道主义的;博爱的;基督凡人论的;n.人道主义者;基督凡人论者; build-up:n.组成;逐渐增加或积累;堆起;adj.内建的; civil:adj.公民的;民间的;文职的;有礼貌的;根据民法的;
I thought it was an idea worth spreading, and I think it must be, can be, could be replicated elsewhere . 我认为这个观念值得传播, 也必须得以传播, 能够在其他地方重复使用。
replicated:重复的; elsewhere:adv.在别处;到别处;
I thank you for your attention. 谢谢你们。
(Applause) （掌声）