Summary · 摘要
This is a compilation piece — a motivational channel has stitched together clips of Maté from several interviews into a nine-minute arc that runs from personal advice through addiction, medicine and finally a definition of trauma. It opens with a line from one of his Downtown Eastside patients: not afraid of dying, more afraid of living. Maté then places himself unusually plainly inside the material. He says he is not an advocate of the massively and, in his view, tremendously overdone use of medications, and in the same breath describes the first days on an antidepressant, when his reaction was that so this is how people can feel normally. The advice that follows is deliberately unheroic: let life come to you rather than forcing it, open your heart instead of relying only on the clever brain, and accept that neither the state of the world nor the state of you is your fault.
The most personal stretch is biographical. He describes an aunt, herself a physician, who had wanted to be a writer but went to medical school to comply with her father’s wishes, and who was sent one way at Auschwitz while her parents were sent to the gas chambers. She saw him more clearly than he could see himself, and quoted Shakespeare’s Polonius to him — advice he says was the best he ever got, though he did not understand it at the time and spent years as a physician with the writing part of him unexpressed. A second mentor appears: a patient who had been an English professor at the University of British Columbia and a well-known Canadian poet, who told him not to worry about not knowing why he wanted to write. From there the compilation cuts to ADHD, where Maté states his adaptation thesis compactly — sensitive children pick up parental stress, do not know what to do with it, and tune out while their brains are developing; it is not a genetic disease but an adaptive response that helps at the time and becomes a problem later, and it is never a conscious adaptation. He adds a general instruction: believe your own truth, deepen your relationship to it, be willing to let it go for a deeper one, and do as much internal work as external work.
The addiction section is the heart of the piece. Measured by how long his patients lived, Maté says, he is a failure: they die of HIV, hepatitis C, infections of heart valves, brain, spine and bloodstream, of suicide, overdose, violence and accident. He reaches for a line he attributes to a great Egyptian novelist — that nothing records the effects of a sad life as graphically as the human body — and notes that these patients lose health, beauty, wealth, relationships and finally their lives, and still nothing shakes them from the addiction. His reframe follows: do not ask what is wrong with the addiction, ask what is right about it — what the person is getting that they otherwise do not have. What they get is relief from pain, a sense of peace, control and calm, very briefly. Heroin, morphine, codeine, cocaine and alcohol are all painkillers, so the real question is not why the addiction but why the pain. He then extends the same logic to a socially approved addiction: if your value depends on how much you help others, the praise works exactly like a hit, because a nagging doubt asks whether they want you or what you give them — and the culture rewards and esteems this while the soul is ground to dust inside.
The last third turns to medicine and to a definition. Maté describes a demonstration he runs with audiences: ask a room of five hundred how many have seen a specialist in the past five years and at least half the hands go up; ask them to keep their hands up if that specialist asked about childhood trauma, their current relationship, stresses at work, or how they feel about themselves as a human being, and the hands go down. Those unasked questions, he says with what he calls full scientific backing, are what drove the person to the doctor in the first place — and unless the source is addressed, medicine is treating symptomatology rather than cause. He then draws the distinction the whole compilation has been building toward: all trauma is stressful, but not every stress is traumatic. The word is used too loosely for difficult experience in ordinary speech and not nearly enough where it matters clinically. Trauma comes from the Greek for wounding, and the wound behaves like a wound: raw and open it screams when touched, which is why old injuries re-erupt in relationships; scarred over it becomes hard, rigid and inflexible, it does not grow, so emotional development stops, and it lacks sensation because scar tissue has no nerve endings. Hence the closing definition: trauma is not what happened to you — not the war, not the abuse, not the pain — trauma is the wound sustained as a result. What happened can never un-happen; the wound can be healed at any time.
这是一部剪辑合集——一个励志频道把马泰在多场访谈中的片段拼成了九分钟的弧线：从个人忠告，到成瘾、医学，最后落在对”创伤”的定义上。开篇是他在温哥华东区的一位病人说的话：我不怕死，我更怕活着。接着马泰罕见地把自己也放进了素材里。他说自己并不主张大规模、在他看来被严重滥用的药物使用，却在同一口气里描述了自己初服抗抑郁药那几天的反应：原来人可以正常地感觉成这样。随后给出的忠告刻意地不英雄主义——让生活向你走来而不是硬逼它，打开你的心而不要只依赖聪明的头脑，并且接受：世界是这个样子不是你的错，你是这个样子也不是你的错。
最私人的一段是传记式的。他讲到一位姑姑，本身也是医生，原本想当作家，却顺从父亲的意愿进了医学院；在奥斯维辛，她被送往一边，父母被送往毒气室的另一边。她看他，比他看自己更清楚，并向他引用了莎士比亚笔下波洛涅斯的那句话——他说那是他得到过的最好的忠告，尽管当时并不懂；此后多年他做医生，身上那个想写作的部分始终没有表达出来。第二位引路人随之出现：一位曾在不列颠哥伦比亚大学任教的英文教授、颇有名气的加拿大诗人，他来看病时告诉马泰，不必担心自己说不出为什么想写。接下来剪辑切到 ADHD，马泰把他的”适应”论点压缩成几句：敏感的孩子接收到父母的压力，不知道拿它怎么办，于是在大脑发育期”走神”出去；这不是遗传疾病，而是一种适应性反应——当时有用，后来成了问题，而且从来不是有意识的适应。他补上一条通则：相信你自己的真理，加深你与它的关系，也要愿意在遇到更深的真理时放下它；并且，你在外部世界做多少工作，就要在内部做同样多的工作。
成瘾部分是全片的核心。马泰说，如果医生的成功以病人活多久来衡量，那他是个失败者：他的病人死于艾滋病、丙型肝炎，死于心瓣膜、脑、脊髓与血液的感染，死于自杀、过量、暴力与意外。他引用一位他称为”伟大的埃及小说家”的话——没有什么比人的身体更直观地记录下一段悲伤人生的后果——并指出这些人失去健康、失去美貌、失去财富、失去人际关系，最终失去生命，却没有任何东西能把他们从成瘾中摇醒。他的重构随之而来：不要问这个成瘾有什么不对，要问它有什么对——这个人从中得到了什么他平时得不到的东西。他们得到的是疼痛的缓解，是片刻的平静、控制感与安宁。海洛因、吗啡、可待因、可卡因、酒精，全都是止痛药；所以真正的问题不是”为什么成瘾”，而是”为什么疼”。接着他把同一逻辑推到一种被社会赞许的成瘾上：如果你的价值取决于你帮了多少人，那份赞美就完全像一次注射，因为心里始终有个啃噬性的疑问——他们要的是我，还是我给的东西？而这种文化奖赏它、推崇它，与此同时灵魂在里面被磨成了灰。
最后三分之一转向医学，也转向定义。马泰描述他在现场做的一个演示：问五百人的会场，过去五年里看过专科医生的请举手，至少一半的手会举起来；再说，如果那位医生问过你童年创伤、当前的亲密关系、工作压力、或者你如何看待自己作为一个人——手就都放下去了。他说，这些没被问的问题——而且他说这话是有充分科学依据的——正是当初把你送到那位医生面前的原因；不处理这个源头，医学处理的就只是症状学，而不是真正的原因。随后他给出整部合集一直在铺垫的区分：所有创伤都是有压力的，但并非每一种压力都构成创伤。日常语言把这个词太随意地用在”困难经历”上，而在真正要紧的健康领域里，它又远远没有被充分理解和使用。Trauma 来自希腊语中”致伤”一词，而这个伤口就像伤口那样运作：当它还是新鲜敞开的，一被碰到就痛得像重新受刑一次，这在亲密关系里天天发生；当它结痂，疤痕组织坚硬、僵直、不再柔韧，而且不生长——于是情感的成长与发育就此停住；它同时又缺乏感觉，因为疤痕组织里没有神经末梢。由此得出结尾的定义：创伤不是发生在你身上的事——不是那场战争，不是那些虐待，不是那份疼痛——创伤是作为结果而留下的那个伤。发生过的永远不会变成没发生过；而那个伤，随时可以被疗愈。
Key points · 要点
- [00:00:00] The opening line, from one of his patients: not afraid of dying, more afraid of living.开场引用他一位病人的话：我不怕死，我更怕活着。
- [00:00:00] He says he is not an advocate for the massive and tremendously overdone use of medications — and yet describes his own first days on an antidepressant, realising this is how people can feel normally.他说自己并不主张大规模、被严重滥用的药物使用——却也描述了自己初服抗抑郁药的头几天：原来人正常时可以是这种感觉。
- [00:00:30] The advice: let life come to you rather than forcing it, open your heart rather than relying only on the clever brain, and accept that the state of the world and even the way you are is not your fault.忠告：让生活向你走来而非硬逼它；打开你的心，而不只是依赖聪明的头脑；接受世界是这个样子、乃至你是这个样子，都不是你的错。
- [00:01:01] His aunt, a physician who had wanted to be a writer but complied with her father’s wishes; at Auschwitz she was sent one way and her parents to the gas chambers.他的姑姑：一位医生，原本想当作家，却顺从父亲的意愿；在奥斯维辛，她被送往一边，父母被送往毒气室。
- [00:01:32] She saw him more clearly than he saw himself and quoted Shakespeare’s Polonius to him — the best advice he ever got, though he did not then understand it, and he spent years as a physician with the writing part of him unexpressed.她看他比他看自己更清楚，并向他引用了莎士比亚笔下波洛涅斯的话——那是他得到过的最好的忠告，尽管当时不懂；此后多年他做医生，身上那个要写作的部分始终未被表达。
- [00:02:03] A second mentor: a patient who had been an English professor at UBC and a well-known Canadian poet, who told him not to worry about not knowing why he wanted to write.第二位引路人：一位曾在不列颠哥伦比亚大学任教的英文教授、知名加拿大诗人的病人，告诉他不必担心说不出自己为什么想写。
- [00:02:33] ADHD as adaptation: stressed, sensitive children pick up the stress, do not know what to do with it, and tune out while their brains are developing.ADHD 是一种适应：处在压力中的敏感孩子接收到那份压力，不知如何处置，于是在大脑发育期”走神”出去。
- [00:02:33] It is not a genetic disease but an adaptive response — adaptive at one point, maladaptive at another, and never a conscious adaptation.它不是遗传疾病，而是适应性反应——在一个阶段是适应，在另一个阶段就变成不适应；而且从来不是有意识的适应。
- [00:03:04] Believe in your own truth and deepen your relationship to it; never be afraid of it, but do not be afraid to let it go if a deeper truth speaks to you.相信你自己的真理并加深与它的关系；永远不要害怕它，但如果有更深的真理向你说话，也不要害怕放下它。
- [00:03:04] Whatever you do out in the world, do an equal amount of work internally — otherwise the outer work will not be as effective.无论你在世界上做什么，都要在内部做同等分量的功课——否则你在外部的工作不会那么有效。
- [00:03:35] Measured by how long his patients live he is a failure: they die of HIV, hepatitis C, infections of heart valves, brain, spine and bloodstream, of suicide, overdose, violence and accident.如果以病人活多久来衡量，他是个失败者：他们死于艾滋病、丙肝，死于心瓣膜、脑、脊髓与血液的感染，死于自杀、过量、暴力与意外。
- [00:04:06] He cites a great Egyptian novelist on the body recording a sad life; these patients lose health, beauty, wealth, relationships and often their lives, and still nothing shakes them from the addiction.他引用一位伟大的埃及小说家关于”身体记录悲伤人生”的话；这些人失去健康、美貌、财富、人际关系，往往还失去生命，却没有任何东西能把他们从成瘾中摇醒。
- [00:04:37] The reframe: do not ask what is wrong with the addiction, ask what is right about it — what is the person getting that they otherwise do not have.重构：不要问这个成瘾有什么不对，要问它有什么”对”——这个人从中得到了什么他平时得不到的东西。
- [00:04:37] What they get is relief from pain and a temporary sense of peace, control and calm — so the question becomes why those qualities are missing from their lives and what happened to them.他们得到的是疼痛的缓解，以及短暂的平静、控制感与安宁——于是问题变成：为什么他们的生活里缺少这些，他们身上发生过什么。
- [00:05:10] Heroin, morphine, codeine, cocaine and alcohol are all painkillers, so the real question in addiction is not why the addiction but why the pain.海洛因、吗啡、可待因、可卡因与酒精全都是止痛药；所以成瘾真正的问题不是”为什么成瘾”，而是”为什么疼”。
- [00:05:10] The socially approved version: if your value depends on how much you help others, a nagging doubt — do they want me or what I give them — turns praise into a temporary hit that must be repeated.被社会赞许的版本：如果你的价值取决于你帮了多少人，那个啃噬性的疑问——他们要的是我，还是我给的东西——会把赞美变成一次必须反复摄取的短暂”注射”。
- [00:05:41] Our culture rewards and esteems that kind of addiction while, in his phrase, the soul is ground to dust inside.我们的文化奖赏并推崇这种成瘾，而用他的话说，灵魂在里面被磨成了灰。
- [00:06:11] The raised-hands demonstration: of five hundred people at least half have seen a specialist in the past five years, but almost no hands stay up when he asks whether that specialist enquired about childhood trauma, their relationship, work stress, or how they feel about themselves.举手演示：五百人里至少一半在过去五年看过专科医生，但当他问”那位医生有没有问过你的童年创伤、你的亲密关系、工作压力、你如何看待自己”时，手几乎全放下了。
- [00:06:41] Those unasked questions, he says with full scientific backing, are what drove the person to that doctor in the first place; without addressing the source, medicine treats symptomatology, not cause.他说——并且是有充分科学依据地说——这些没被问的问题，正是当初把人送到那位医生面前的原因；不处理源头，医学治的就是症状学而非病因。
- [00:06:41] The distinction: all trauma is stressful, but not every stress is traumatic. The word is used too loosely in everyday speech and not nearly enough where health is concerned.区分：所有创伤都有压力，但并非每种压力都构成创伤。这个词在日常语言里被用得太随便，而在关乎健康的地方又远远用得不够。
- [00:07:11] Trauma comes from the Greek for wounding: a psychic wound that leaves a scar and an imprint in the nervous system, the body and the psyche, showing up later in unhelpful ways.Trauma 来自希腊语的”致伤”：一个心灵的伤口，在神经系统、身体与心理中留下疤痕与印记，日后以各种无益的方式显现。
- [00:07:42] A raw, unhealed wound screams when touched — which is why an old injury makes a person react as if being tormented all over again, something that happens in relationships all the time.新鲜未愈的伤口一被碰到就发作——这就是为什么一处旧伤会让人反应得像重新受刑一次；这在亲密关系里天天发生。
- [00:08:13] Scar tissue is hard, rigid and inflexible, so traumatised people tend to be rigid; it does not grow, so trauma often stops emotional growth; and it lacks sensation, because scar tissue has no nerve endings.疤痕组织坚硬、僵直、不柔韧，所以受创的人往往显得僵化；它不生长，所以创伤常常让情感的成长停住；它又缺乏感觉，因为疤痕组织里没有神经末梢。
- [00:08:45] The definition: trauma is not what happened to you — not the war, not the abuse, not the pain — trauma is the wound sustained as a result, and that wound can be healed at any time even though what happened will never not have happened.定义：创伤不是发生在你身上的事——不是那场战争，不是那些虐待，不是那份疼痛——创伤是作为结果而留下的那个伤；发生过的永远不会变成没发生过，但那个伤随时可以被疗愈。
Selected quotes · 摘引
“and what addicts get are relief from us from Pain what they get is the sense of Peace a sense of control a sense of calmness very very temporarily” — 00:04:37
成瘾者得到的，是从疼痛中获得的解脱；他们得到的是一种平静感、一种控制感、一种安宁感——但都非常非常短暂。
“these are all painkillers one way or another they all soothe pain and that’s what the real question and addiction is not why the addiction but why the pain” — 00:05:10
这些东西都以某种方式充当止痛药，它们全都在安抚疼痛；所以成瘾里真正的问题不是”为什么成瘾”，而是”为什么疼”。
“our culture rewards that kind of addiction Big Time values it and and and and esteems it” — 00:05:41
我们的文化大大地奖赏这种成瘾，看重它，推崇它。
“all trauma is stressful but not every stress is traumatic” — 00:06:41
所有创伤都是有压力的，但并非每一种压力都构成创伤。
“it can be healed at any time it’ll never not have happened but if the wound is what happened to people inside as a result that can be healed” — 00:08:45
它随时可以被疗愈。发生过的事永远不会变成没发生过；但如果所谓的”伤”指的是作为结果而在人内部发生的东西，那个是可以被疗愈的。
People & works · 人物与著作
- Gabor Maté — speaker throughout; the clips are drawn from several of his interviews and lectures and assembled by the channel.加博尔·马泰 —— 全片讲者；片段取自他的多场访谈与讲座，由频道方剪辑拼合。
- Maté’s aunt — a physician who had wanted to be a writer but went to medical school to comply with her father’s wishes; at Auschwitz she was sent one way while her parents were sent to the gas chambers. She quoted Shakespeare to him, advice he calls the best he ever got.马泰的姑姑 —— 一位医生，原本想当作家，却为顺从父亲的意愿进了医学院；在奥斯维辛，她被送往一边，父母被送往毒气室。她向他引用了莎士比亚，那是他自称得到过的最好的忠告。
- Shakespeare / Polonius — Maté notes the line is put in the mouth of Polonius and is even hypocrisy in that context, and is a cliché, but that it is nonetheless true. The auto-captions garble the line itself, so it is not quoted here.莎士比亚／波洛涅斯 —— 马泰指出这句话是借波洛涅斯之口说出的，在那个语境里甚至带着伪善，也早已是陈词滥调，但它依然是真的。自动字幕把这句话本身弄乱了，因此本文不作引用。
- An English professor at the University of British Columbia — a patient of Maté’s and a well-known Canadian poet, who told him not to worry about not knowing why he wanted to write. The captions render the name indistinctly (“Warren town”), so it is not asserted here.一位不列颠哥伦比亚大学的英文教授 —— 马泰的病人，也是一位知名加拿大诗人，曾告诉他不必担心说不清自己为什么想写。字幕把名字转写得含混（“Warren town”），故此处不作断言。
- “the great Egyptian novelist” — credited by Maté with the line that nothing records the effects of a sad life as graphically as the human body. The captions mangle the name (“now give them a Foos”), so no identification is claimed.“那位伟大的埃及小说家” —— 马泰将”没有什么比人的身体更直观地记录下悲伤人生的后果”这句话归于他。字幕把名字转写坏了（“now give them a Foos”），故此处不作身份认定。
- Motivation Mentors — the YouTube channel that assembled and published this compilation.Motivation Mentors —— 剪辑并发布这部合集的 YouTube 频道。
Source · 来源
- Original: https://www.youtube.com/watch?v=o4k6T0nKJZQ
- Channel/Show · 频道/节目: Motivation Mentors · published 2023-07-16
- Registered from the Notion「GaborMate 阅览室」播客视频 / 文字讲稿 collection.