Summary · 摘要
In this 18-minute TEDxRio+20 talk, Vancouver physician Gabor Maté reframes addiction by refusing to ask “what’s wrong with the addiction?” and asking instead “what’s right about it?” — what the addicted person gets from it. The answer, he argues, is temporary relief from pain: every major drug is a painkiller, so the real question is never why the addiction but why the pain. Drawing on twelve years treating severely addicted patients in Vancouver’s Downtown Eastside (all of whom were abused as children) and on his own compulsions with work and compact-disc buying, he defines addiction broadly as any behavior that brings short-term relief and long-term harm that you cannot stop. The roots, he says, lie not in genetics but in early childhood: the brain develops in interaction with its environment, and trauma or lack of loving attachment leaves the dopamine and endorphin circuits underdeveloped, so the person seeks from the outside what they never received within.
Maté then makes the talk’s central pivot — from the power of addiction to the addiction of power. Society scorns the drug addict while injecting toxins into the Earth through its own addictions to oil and consumerism, and while perpetrators of colonial harm (the people who took the land of the Guarani in Brazil and First Nations in Canada) are themselves addicted — to power, wealth, and acquisition. Surveying Alexander, Napoleon, Hitler, and Stalin, he notes they were physically small outsiders driven by insecurity to fill an inner emptiness from outside. Against them he sets Buddha and Jesus, who refused worldly power because they held it within. His closing prescription: do not wait for the powerful — often the emptiest people — to heal the world; find the light within ourselves and our communities, because human nature is fundamentally cooperative and generous.
在这场 18 分钟的 TEDxRio+20 演讲中，温哥华医生加博尔·马泰重新定义了成瘾：他拒绝问”成瘾哪里出了问题？“，而是反过来问”它哪里是对的？“——成瘾者从中得到了什么。他认为答案是疼痛的暂时缓解：每一种主要毒品本质上都是止痛药，所以真正的问题从来不是”为何成瘾”，而是”为何疼痛”。结合他在温哥华东区贫民区十二年治疗重度成瘾患者的经验（这些患者无一例外在童年遭受过虐待），以及他本人对工作和购买古典音乐唱片的强迫行为，他把成瘾宽泛地定义为：任何能带来短期缓解、却造成长期伤害、且你无法停止的行为。他说，根源不在基因，而在幼年：大脑在与环境的互动中发育，创伤或缺乏充满爱的依恋会使多巴胺和内啡肽回路发育不全，于是人转向外部去寻找他在内心从未得到的东西。
随后马泰完成了演讲的核心转折——从”成瘾的力量”转向”对权力的成瘾”。社会一边鄙视吸毒者，一边通过自身对石油和消费主义的成瘾向地球注入毒素；而殖民伤害的施加者（夺走巴西瓜拉尼人和加拿大原住民土地的人）自己同样在成瘾——成瘾于权力、财富与占有。他考察了亚历山大、拿破仑、希特勒和斯大林，指出他们都是身材矮小的”外来者”，被不安全感驱使，要从外部填补内心的空虚。与之相对，他举出佛陀和耶稣，二者拒绝世俗权力，因为他们的力量在内心。他最后的处方是：不要指望掌权者——往往是最空虚的人——去疗愈世界；要在我们自己和社群之中寻找那束光，因为人的本性从根本上是合作而慷慨的。
Key points · 要点
- [00:00:10] As a doctor in Vancouver, Maté’s severely addicted patients lose their health, beauty, teeth, wealth, relationships, and often their lives — yet nothing shakes them from addiction. To understand why, don’t look at what’s wrong with the addiction — look at what’s right about it: what the person gets is relief from pain, a temporary sense of peace, control, and calm.作为温哥华的医生，马泰的重度成瘾患者失去了健康、容貌、牙齿、财富和人际关系，常常连命也丢掉——但没有什么能动摇他们的成瘾。要理解为什么，不要看成瘾哪里错了——要看它哪里”对”：成瘾者得到的是疼痛的缓解，是暂时的平静、掌控感与安宁。
- [00:02:13] Heroin, cocaine, and alcohol are all painkillers, so the real question is not why the addiction but why the pain. Addiction, in his definition, is any behavior bringing short-term relief and long-term harm that you cannot give up.海洛因、可卡因、酒精都是止痛药，所以真正的问题不是”为何成瘾”，而是”为何疼痛”。在他的定义里，成瘾是任何带来短期缓解、长期伤害、却无法戒除的行为。
- [00:03:14] Addiction is not only drugs. Maté confesses his own workaholism and a compulsion for classical CDs — once $8,000 in a week, once leaving a woman in labor to buy music. The Buddhist “hungry ghosts” can never fill the emptiness inside.成瘾不只是毒品。马泰坦承自己是工作狂，并强迫性地买古典音乐唱片——曾一周花掉八千美元，曾撇下临产的产妇去买唱片。佛教所说的”饿鬼”永远填不满内心的空虚。
- [00:05:47] The pain comes from lives, not genetics: over twelve years all the addicted women he treated had been sexually abused as children, and the men had been traumatized, abused, neglected, and abandoned.疼痛源于人的经历，而非基因：十二年间，他治疗的所有成瘾女性都在童年遭受过性虐待，男性也都经历过创伤、虐待、忽视与遗弃。
- [00:06:48] The brain develops in interaction with the environment, not by genes alone. Mouse experiments on dopamine (motivation) and endorphins (love, attachment, natural painkillers) show early deprivation creates susceptibility; under abuse, these circuits don’t develop.大脑在与环境的互动中发育，而不仅靠基因。关于多巴胺（动机）和内啡肽（爱、依恋、天然止痛剂）的小鼠实验表明，早年的剥夺会制造易感性；在虐待之下，这些回路无法正常发育。
- [00:09:52] Heroin works on the endorphin system, replicating love: one patient said her first heroin “felt like a warm soft hug, just like a mother hugging a baby.” Addiction substitutes from outside what attachment failed to build inside.海洛因作用于内啡肽系统，模拟出爱：一位患者说她第一次用海洛因”感觉像一个温暖柔软的拥抱，就像母亲抱着婴儿”。成瘾是用外部之物，替代依恋未能在内心建立起来的东西。
- [00:10:22] His own story: born to Jewish parents in 1944 Budapest, as an infant he absorbed his mother’s terror under Nazi occupation. He became a workaholic so as to be needed — and unconsciously passed the same message of being unwanted to his children.他自己的故事：1944 年生于布达佩斯的犹太家庭，婴儿时期就吸收了母亲在纳粹占领下的恐惧。他成了工作狂，好让别人”需要”他——却又在无意中把同样”不被想要”的信息传给了自己的孩子。
- [00:12:26] He flips the judgment: society injects toxins into the atmosphere and oceans through its addictions to oil and consumerism — which addiction is greater? We scorn drug addicts precisely because they are just like us. And colonized peoples — the Guarani in Brazil, First Nations in Canada — became heavily addicted because their land and dignity were taken, while the perpetrators are addicted too: to power, wealth, and acquisition.他翻转了这种评判：社会通过对石油和消费主义的成瘾，向大气和海洋注入毒素——哪一种成瘾更严重？我们鄙视吸毒者，恰恰是因为他们和我们一模一样。而被殖民的民族——巴西的瓜拉尼人、加拿大的原住民——之所以重度成瘾，是因为他们的土地和尊严被夺走；施害者同样在成瘾：成瘾于权力、财富与占有。
- [00:14:28] History’s power-addicts (Alexander, Napoleon, Hitler, Stalin) were physically small outsiders driven by insecurity. Power addiction is always about an inner emptiness one tries to fill from the outside.历史上对权力成瘾的人（亚历山大、拿破仑、希特勒、斯大林）都是身材矮小的外来者，被不安全感驱使。对权力的成瘾，永远是关于一个人试图从外部填补的内心空虚。
- [00:16:02] Buddha and Jesus both refused the devil’s offer of earthly power because they held power within — “the kingdom of God is within,” “be a lamp unto yourselves.” Don’t wait for the powerful (often the emptiest) to fix the world; find the light within ourselves, because human nature is actually cooperative and generous.佛陀和耶稣都拒绝了魔鬼给予的世俗权力，因为他们的力量在内心——“上帝的国就在你心里”，“以自己为灯”。不要指望掌权者（往往是最空虚的人）去修复世界；要在我们自己心中寻找那束光，因为人的本性其实是合作而慷慨的。
Selected quotes · 摘引
“if you want to understand addiction, you can’t look at what’s wrong with the addiction, you have to look at what’s right about it” — 00:01:40
「如果你想理解成瘾，你不能看成瘾哪里出了问题，你必须看它哪里是对的。」
“that’s where the real question in addiction is not why the addiction, but why the pain” — 00:02:13
「这正是关键：成瘾真正的问题不是为何成瘾，而是为何疼痛。」
“we are all hungry ghosts in this society” — 00:05:16
「在这个社会里，我们都是饿鬼。」
“We pass on the trauma and we pass on the suffering unconsciously from one generation to the next” — 00:11:23
「我们把创伤传递下去，把苦难无意识地一代一代传递下去。」
“the addiction to power, is always about the emptiness that you try and fill from the outside” — 00:15:29
「对权力的成瘾，永远关乎那个你试图从外部去填补的空虚。」
“the people in power, I’m afraid to say, are very often some of the emptiest people in the world” — 00:17:04
「恐怕我得说，掌权者往往是这世上最空虚的一些人。」
People & works · 人物与著作
- Gabor Maté — speaker; Canadian physician working with severely addicted patients in Vancouver, drawing on his own addictions and 1944 Budapest origins.加博尔·马泰 —— 演讲者；在温哥华治疗重度成瘾患者的加拿大医生，演讲中也剖析了自身的成瘾及其 1944 年布达佩斯的出身。
- Keith Richards — Rolling Stones guitarist whose biography Maté cites: addiction as “looking for oblivion,” “the contortions that we go through just not to be ourselves for a few hours.”基思·理查兹 —— 滚石乐队吉他手，马泰引用其传记：成瘾是”寻找遗忘”，“我们费尽周折，只为几小时不做自己”。
- R.D. Laing — British psychiatrist, cited for the idea that people fear three things: death, other people, and their own minds.R.D. 莱因 —— 英国精神病学家，马泰引用其观点：人害怕三样东西——死亡、他人，以及自己的内心。
- Naguib Mahfouz — Egyptian novelist quoted: “Nothing records the effects of a sad life as graphically as the human body.”纳吉布·马哈福兹 —— 埃及小说家，被引用：「没有什么能比人的身体更鲜明地记录一段悲伤人生的痕迹。」
- Nísio Gomes — Guarani leader in the Amazon, killed in November 2011 protecting his people’s land from farmers and companies (read by Maté in a New York Times article).尼西奥·戈麦斯 —— 亚马逊瓜拉尼人领袖，2011 年 11 月因保护族人土地、对抗农场主与公司而被杀（马泰在《纽约时报》文章中读到）。
- The Buddhist “hungry ghosts”; Buddha and Jesus — invoked as figures who held power within and refused power from without.佛教的”饿鬼”意象；佛陀与耶稣 —— 被援引为内有力量、拒绝外在权力的形象。
Source · 来源
- Original · 原始链接: https://www.youtube.com/watch?v=66cYcSak6nE
- Channel/Show · 频道/节目: TEDx Talks (TEDxRio+20, Rio de Janeiro) · published 2012-10-09