before I realized that I really had a problem.

直到我意識到我有一個問題。

There was something really wrong with me.

這個問題一直在困擾著我。

This was about a year before 9/11, and America wasn't at war yet.

那距離 911 事件發生還有一年， 美國還沒有向阿富汗宣戰。

We weren't talking about PTSD.

當時大家還沒有開始談論 「創傷後壓力症候群」

We were not yet talking about the effect of trauma and war

大家還沒有討論戰爭和精神創傷

on the human psyche.

對人類心理的影響。

I'd been in Afghanistan for a couple of months

我曾經在阿富汗和 北方聯盟一起待過幾個月。

with the Northern Alliance as they were fighting the Taliban.

當時他們正在和塔利班作戰。

And at that point the Taliban had an air force,

當時塔利班他們有空軍，

they had fighter planes, they had tanks, they had artillery,

他們有戰機，有坦克，有大炮，

and we really got hammered pretty badly a couple of times.

而我們的確有幾次受到了重創。

We saw some very ugly things.

我們看到了非常悲慘的事情。

But I didn't really think it affected me.

但我不覺得它影響了我。

I didn't think much about it.

我甚至不會回想起它。

I came home to New York, where I live.

後來我回到我生活的紐約。

Then one day I went down into the subway,

有一天我去到地鐵站，

and for the first time in my life,

人生中第一次，

I knew real fear.

我感受到了真正的恐懼。

I had a massive panic attack.

嚴重的恐慌症突然發作。

I was way more scared than I had ever been in Afghanistan.

這要比我在阿富汗經歷過的 更使我害怕。

Everything I was looking at seemed like it was going to kill me,

我能看到的所有東西 都像將要殺了我一樣，

but I couldn't explain why.

但我不能解釋這是為什麼。

The trains were going too fast.

地鐵看上去開得太快了。

There were too many people.

人群看上去實在是太多了。

The lights were too bright.

燈光太亮。

Everything was too loud, everything was moving too quickly.

所有的事情都太吵、 都動的太快了。

I backed up against a support column and just waited for it.

我靠在一根柱子上 等待這陣恐慌過去。

When I couldn't take it any longer, I ran out of the subway station

當我再也忍受不了的時候， 我跑出了地鐵站，

and walked wherever I was going.

毫無目的地走在路上。

Later, I found out that what I had was short-term PTSD:

後來我發現 我患上了短期的 PTSD：

post-traumatic stress disorder.

也就是「創傷後壓力症候群」。

We evolved as animals, as primates, to survive periods of danger,

我們從動物、人猿演化而來， 在危險情境中生存了下來，

and if your life has been in danger,

如果你的生命處於危險的情境當中，

you want to react to unfamiliar noises.

你會想對不熟悉的噪音作出反應。

You want to sleep lightly, wake up easily.

你會淺眠，而且很容易驚醒。

You want to have nightmares and flashbacks

你就會做噩夢並回憶起

of the thing that could kill you.

那些差點把你殺掉的事情。

You want to be angry because it makes you predisposed to fight,

你會變得很生氣，因為它會讓你 進入準備戰鬥的狀態，

or depressed, because it keeps you out of circulation a little bit.

或者變得絕望，因為它會 讓你有點喘不過氣來，

Keeps you safe.

你會想隨時保持自己的安全。

It's not very pleasant, but it's better than getting eaten.

這並不令人愉快， 但總比死亡要好。

Most people recover from that pretty quickly.

大部分的人很快就可以 從這精神障礙中康復。

It takes a few weeks, a few months.

這個過程要幾週，或者幾個月。

I kept having panic attacks, but they eventually went away.

我一直經歷著這種痛苦的打擊， 但我最後還是康復了。

I had no idea it was connected to the war that I'd seen.

我從不知道他們和我 目睹過的戰爭有聯繫。

I just thought I was going crazy,

我只覺得我快要瘋了。

and then I thought, well, now I'm not going crazy anymore.

然後我只是覺得， 現在我不會再發瘋了。

About 20 percent of people, however,

然而，大概有 20% 的人，

wind up with chronic, long-term PTSD.

遭受著慢性的、 長期的創傷後壓力症。

They are not adapted to temporary danger.

他們不是要去面對短期的危險，

They are maladapted for everyday life,

而是不能適應日常的生活，

unless they get help.

除非他們尋求幫助。

We know that the people who are vulnerable to long-term PTSD

我們知道有些人比較容易得 長期的創傷後壓力症：

are people who were abused as children,

這些人也許是童年時受過虐待，

who suffered trauma as children,

也許是童年時遭受過精神創傷，

people who have low education levels,

也許是沒有受過高等教育的人，

people who have psychiatric disorders in their family.

也許是有精神病的家庭遺傳，

If you served in Vietnam

假如你曾經在越南服役

and your brother is schizophrenic,

而且你有一個患精神分裂症的兄弟，

you're way more likely to get long-term PTSD from Vietnam.

那你在越南回國後，有更大的可能 會患上長期的創傷後壓力症。

So I started to study this as a journalist,

所以作為一個記者， 我開始研究這個問題，

and I realized that there was something really strange going on.

我意識到有一些奇怪的事情存在。

The numbers seemed to be going in the wrong direction.

數據看上去正在往一個錯誤的方向變化。

Every war that we have fought as a country,

每一次我們國家參與的戰爭，

starting with the Civil War,

——從獨立戰爭開始，

the intensity of the combat has gone down.

戰爭的強度開始下降。

As a result, the casualty rates have gone down.

所以，傷亡率也開始下降。

But disability rates have gone up.

但是殘疾率卻開始上升。

They should be going in the same direction,

它們本應該按同樣的方向變化，

but they're going in different directions.

但是它們變化的方向卻相反。

The recent wars in Iraq and Afghanistan have produced, thank God,

感謝上帝，最近在伊拉克和 阿富汗的戰爭僅造成

a casualty rate about one third of what it was in Vietnam.

越南戰爭 1/3 的傷亡率。

But they've also created --

但是它們也造成了，

they've also produced three times the disability rates.

越戰殘疾率的三倍。

Around 10 percent of the US military is actively engaged in combat,

將近有 10% 的美國軍人經歷過戰場，

10 percent or under.

——將近 10% 或者 10% 以下。

They're shooting at people, killing people,

他們在戰場上開火、殺人、

getting shot at, seeing their friends get killed.

中彈、或者看著他們的戰友倒下。

It's incredibly traumatic.

這真的是十分痛苦。

But it's only about 10 percent of our military.

但這只是我們軍隊的 10%。

But about half of our military has filed

然而從政府的檔案中， 我們看到有一半的軍人

for some kind of PTSD compensation from the government.

正在領取創傷後 壓力症候群的救濟金。

And suicide doesn't even fit into this in a very logical way.

從邏輯看來，自殺人數 根本不符合這個數據。

We've all heard the tragic statistic of 22 vets a day, on average,

我們都聽過一個悲慘的統計數據，

in this country, killing themselves.

這個國家平均一天， 有 22 位退伍軍人選擇自殺。

Most people don't realize

多數人沒有意識到

that the majority of those suicides are veterans of the Vietnam War,

這些自殺者的大多數 是從越南戰爭回國的軍人，

that generation,

在那一個年代，

and their decision to take their own lives actually might not be related

他們選擇結束生命的方式

to the war they fought 50 years earlier.

也許和他們在五十年前 參與過的戰爭不太有關連性。

In fact, there's no statistical connection between combat and suicide.

事實上，還沒有戰爭與自殺率 相關性的統計數據。

If you're in the military and you're in a lot of combat,

假如你在軍隊中參與過很多場戰役，

you're no more likely to kill yourself than if you weren't.

你更不會傾向於選擇自殺，

In fact, one study found

事實上，一個研究表明

that if you deploy to Iraq or Afghanistan,

假如你參與過伊拉克或者阿富汗戰爭，

you're actually slightly less likely to commit suicide later.

其實你是更不可能 在以後選擇自殺的。

I studied anthropology in college.

我在大學學習的是人類學。

I did my fieldwork on the Navajo reservation.

我在納瓦霍族遺址做過實地調查，

I wrote a thesis on Navajo long-distance runners.

寫過關於納瓦霍族長跑者的論文。

And recently, while I was researching PTSD,

最近我在研究創傷後壓力症候群的時候，

I had this thought.

我有了一個想法。

I thought back to the work I did when I was young,

我想起我年輕時做過的研究，

and I thought, I bet the Navajo, the Apache, the Comanche --

我在想納瓦霍人、 阿帕奇人、科曼奇人，

I mean, these are very warlike nations --

——這些好戰的民族——

I bet they weren't getting PTSD like we do.

我猜他們不會像我們一樣 患上創傷後壓力症。

When their warriors came back from fighting the US military

當他們的戰士從抵抗美國 軍隊的戰爭中回到家鄉

or fighting each other,

或者從互相攻擊的戰爭中回來，

I bet they pretty much just slipped right back into tribal life.

我猜他們肯定很容易就 重新融入部落生活。

And maybe what determines

也許

the rate of long-term PTSD

決定長期創傷後壓力症的因素

isn't what happened out there,

不是在戰場上發生了什麼，

but the kind of society you come back to.

而是你回到了什麼樣的社會。

And maybe if you come back to a close, cohesive, tribal society,

也許假如你回到一個緊密聯繫的、 團結的、部落化的社會，

you can get over trauma pretty quickly.

你很快就能從精神創傷中康復。

And if you come back to an alienating, modern society,

但假如你回到一個人與人 疏遠的現代的社會，

you might remain traumatized your entire life.

你可能在以後的一輩子 都遭受精神創傷。

In other words, maybe the problem isn't them, the vets;

也就是說，也許問題不在於 退伍軍人本身；

maybe the problem is us.

而在於社會上的我們。

Certainly, modern society is hard on the human psyche

的確，現代社會對人類的精神 帶來了重大的壓力，

by every metric that we have.

這些壓力來自於我們社會上 各種的衡量標準。

As wealth goes up in a society,

隨著社會財富的積累，

the suicide rate goes up instead of down.

自殺率上升而不是下降。

If you live in modern society,

假如你生活在現代社會，

you're up to eight times more likely

你患上抑鬱症的可能性

to suffer from depression in your lifetime

相比於你在貧窮的農業社會生活要高八倍。

than if you live in a poor, agrarian society.

現代社會也許產生了最高的自殺率

Modern society has probably produced the highest rates of suicide

抑鬱症、焦慮症、孤僻症 和受到童年虐待的可能，

and depression and anxiety and loneliness and child abuse

這比例要比歷史任一時代都高。

ever in human history.

我看過一個研究，

I saw one study

它把奈吉利亞的婦女，

that compared women in Nigeria,

也就是非洲最混亂、最暴力、最腐敗

one of the most chaotic and violent and corrupt

最貧窮的國家之一，

and poorest countries in Africa,

和北美的女性進行比較。

to women in North America.

北美的城市女性 是憂鬱症患病率最高的。

And the highest rates of depression were urban women in North America.

她們也是最富裕的群體。

That was also the wealthiest group.

我們回頭來看美軍的狀況。

So let's go back to the US military.

10% 的軍人經歷過戰爭。

Ten percent are in combat.

這裡面有將近 50% 的軍人登記在案， 領取創傷後壓力症候群的補償。

Around 50 percent have filed for PTSD compensation.

所以大概 40% 的退休軍人 並不是在海外受到精神創傷，

So about 40 percent of veterans really were not traumatized overseas

而是回到家後 發現他們被孤立

but have come home to discover they are dangerously alienated

並感到沮喪絕望。

and depressed.

那麼他們遭遇了什麼？

So what is happening with them?

在他們身上究竟發生了什麼，

What's going on with those people,

我們讓 40% 的人， 患上創傷後壓力症，卻不清楚成因？

the phantom 40 percent that are troubled but don't understand why?

也許是這樣的：

Maybe it's this:

也許當時他們在海外，

maybe they had an experience of sort of tribal closeness

經歷過部隊親密的戰友關係。

in their unit when they were overseas.

他們一起吃飯，一起睡覺，

They were eating together, sleeping together,

一起完成任務。

doing tasks and missions together.

他們以生命維護彼此的信任。

They were trusting each other with their lives.

當他們回到家，

And then they come home

他們必須捨棄戰場上的所有情誼，

and they have to give all that up

他們回到社會，這個現代社會，

and they're coming back to a society, a modern society,

這個即使沒有入過伍的人 都覺得艱難的社會。

which is hard on people who weren't even in the military.

所有人在這社會都活得艱苦。

It's just hard on everybody.

而我們卻一直關注 精神創傷、創傷後壓力症，

And we keep focusing on trauma, PTSD.

但對大部分人來說，

But for a lot of these people,

也許這不是精神創傷。

maybe it's not trauma.

我的意思是， 士兵的確是受過精神創傷，

I mean, certainly, soldiers are traumatized

也有士兵接受過治療。

and the ones who are have to be treated for that.

但他們中的很多人——

But a lot of them --

也許困擾他們的只是一種隔離感。

maybe what's bothering them is actually a kind of alienation.

我的意思是，也許我們只是 錯用了詞語去形容他們，

I mean, maybe we just have the wrong word for some of it,

只要改變我們的語言、 我們的認知，

and just changing our language, our understanding,

就能幫助改變現狀。

would help a little bit.

「 戰後孤獨感症候群 」

"Post-deployment alienation disorder."

也許只要這樣稱呼 他們其中的一部分人，

Maybe even just calling it that for some of these people

就能幫助他們停止聯想

would allow them to stop imagining

一個根本沒有發生過的創傷，

trying to imagine a trauma that didn't really happen

這是為了解釋一種 他們正在經歷的感受。

in order to explain a feeling that really is happening.

而事實上，這是一種 非常危險的感覺。

And in fact, it's an extremely dangerous feeling.

隔離感和抑鬱會導致自殺。

That alienation and depression can lead to suicide.

這些人正處於危險中。

These people are in danger.

瞭解成因是非常重要的事情。

It's very important to understand why.

以色列軍隊的 創傷後壓力症比例在1%左右。

The Israeli military has a PTSD rate of around one percent.

有一種理論是說，因為以色列 的所有人都需要服兵役。

The theory is that everyone in Israel is supposed to serve in the military.

當軍人從前線回來，

When soldiers come back from the front line,

他們不是要從軍隊環境回到文明社會，

they're not going from a military environment to a civilian environment.

而是回到一個

They're coming back to a community where everyone understands

人人都瞭解甚麼是當兵的社會。

about the military.

每個人都曾經服役、或者準備去服役。

Everyone's been in it or is going to be in it.

每個人都瞭解他們處於的環境，

Everyone understands the situation they're all in.

就像他們都處於一個大部落。

It's as if they're all in one big tribe.

我們知道假如你用一隻實驗鼠，

We know that if you take a lab rat

讓它受到精神創傷， 再把它獨自放在籠子里，

and traumatize it and put it in a cage by itself,

你可以永無止境地 讓牠保持在精神創傷的狀態。

you can maintain its trauma symptoms almost indefinitely.

但假如你把同樣的實驗鼠 放在有其他老鼠的籠子里，

And if you take that same lab rat and put it in a cage with other rats,

幾個星期後， 牠的表現就會回復正常了。

after a couple of weeks, it's pretty much OK.

9/11事件以後，

After 9/11,

紐約市的謀殺率降低了 40%，

the murder rate in New York City went down by 40 percent.

自殺率也下降了，

The suicide rate went down.

紐約市暴力犯罪率在 911 事件後也下降了。

The violent crime rate in New York went down after 9/11.

即使經歷過之前的戰爭、 患有創傷後壓力症候群的退伍軍人

Even combat veterans of previous wars who suffered from PTSD

也說他們的症狀在 911 事件之後減輕了。

said that their symptoms went down after 9/11 happened.

原因是，假如你讓 整個社會受到精神創傷，

The reason is that if you traumatize an entire society,

我們不會瓦解崩潰並 和別人針鋒相對。

we don't fall apart and turn on one another.

我們會團結起來。

We come together. We unify.

從根本上說，我們部落化了，

Basically, we tribalize,

團結一起的過程讓人感覺很好， 也對我們有益，

and that process of unifying feels so good and is so good for us,

而且它甚至可以幫助那些

that it even helps people

正在精神障礙中掙扎的人們。

who are struggling with mental health issues.

在二戰倫敦被德國轟炸的期間，

During the blitz in London,

精神病醫院的患者減少了。

admissions to psychiatric wards went down during the bombings.

有一段時間，美軍從海外返回的國家

For a while, that was the kind of country

是一個團結的國家。

that American soldiers came back to -- a unified country.

我們團結在一起。

We were sticking together.

我們嘗試去瞭解我們面對的威脅。

We were trying to understand the threat against us.

我們嘗試去幫助自己以至於整個世界。

We were trying to help ourselves and the world.

但情況改變了。

But that's changed.

現在美軍，

Now, American soldiers,

美國的退伍軍人正在回到 一個極其分裂的國家，

American veterans are coming back to a country that is so bitterly divided

兩黨互相指控對方叛國、

that the two political parties are literally accusing each other

是國家的敵人、

of treason, of being an enemy of the state,

或者暗中顛覆國家的 國土安全和福利。

of trying to undermine the security and the welfare of their own country.

貧富差距是有史以來最大的。

The gap between rich and poor is the biggest it's ever been.

現狀還在惡化。

It's just getting worse.

族群關係也很糟糕。

Race relations are terrible.

因為種族的不平等，

There are demonstrations and even riots in the streets

街上有抗議活動，甚至暴亂。

because of racial injustice.

退伍軍人知道任何 一個部落或者連隊

And veterans know that any tribe that treated itself that way -- in fact,

以這樣的方式對待自己的戰友， 都不會存活。

any platoon that treated itself that way -- would never survive.

我們卻已經習慣了。

We've gotten used to it.

退伍軍人曾經離開，現在重新回來

Veterans have gone away and are coming back

以全新的角度看待自己的國家。

and seeing their own country with fresh eyes.

他們看到現在正在發生的事。

And they see what's going on.

這就是他們為之奮鬥的國家。

This is the country they fought for.

難怪他們會絕望。

No wonder they're depressed.

難怪他們會害怕。

No wonder they're scared.

有時我們問自己 我們能不能拯救退伍軍人。

Sometimes, we ask ourselves if we can save the vets.

我覺得真正的問題在於 我們能不能拯救自己。

I think the real question is if we can save ourselves.

假如我們可以，

If we can,

那麼我覺得退伍軍人就能康復。