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As a child, I had many fears. I was afraid of lightning, insects, loud noises and costumed characters. I also had two very severe phobias of doctors and injections. 

我從小就是個(gè)膽小的人。我怕閃電、昆蟲、大的聲音和裝扮成卡通人物的人。我最怕兩件事：看醫(yī)生和打針。

During my struggles to escape from our family doctor, I would become so physically combative that he actually slapped me in the face to stun me. I was six. I was all fight-or-flight back then, and holding me down for a simple vaccine took three or four adults, including my parents.

為了抗拒看家庭醫(yī)生，我會拼命的掙扎，以致醫(yī)生要打我耳光才能讓我鎮(zhèn)定下來。當(dāng)時(shí)我才六歲。那時(shí)候我精神緊繃，打個(gè)疫苗都需要三四個(gè)成年人拉住我，包括我的父母在內(nèi)。

Later, our family moved from New York to Florida just as I was starting high school, and being the new kid at the parochial school, not knowing anyone and being worried about fitting in, on the very first day of school, a teacher takes roll and calls out 'Anne Marie Albano,' to which I respond, [In a Staten Island accent] 'Here!' 

后來，在我準(zhǔn)備升入高中的時(shí)候，我們舉家從紐約搬到了佛羅里達(dá)。作為一名進(jìn)入了一所教區(qū)學(xué)校的新生，我不認(rèn)識任何同學(xué)，很擔(dān)心融入不了這里。開學(xué)第一天，有個(gè)老師點(diǎn)名時(shí)叫了“安妮·瑪麗·阿爾巴諾”，我回答：（紐約斯塔滕島的口音）“到！”

She laughs and says, 'Oh, precious, stand up. Say D-O-G.' And I respond, [In a Staten Island accent] 'Dog?' The class broke out in laughter along with the teacher. And so it went, because she had many more words to humiliate me with.

她笑著說：“親愛的，站起來。說 D-O-G（狗）。”我回答：（紐約斯塔滕島的口音）“狗？”包括老師在內(nèi)，全班一起哄堂大笑。從此以后，老師一直換著法兒的羞辱我。

I went home sobbing, distraught and begging to be sent back to New York or to some nunnery. I did not want to go back to that school again. No way.

我哭著回家，非常難過，求著父母送我回紐約，或者去修女院，我不想再回到那所學(xué)校了。

My parents listened and told me that they would investigate with the monsignor back in New York, but that I had to keep going in each day so I'd have the attendance record to transfer to ninth grade on Staten Island. 

父母聽了我的哭訴，告訴我他們會與在紐約的教父商量，但在此期間，我還是得每天去學(xué)校報(bào)到，因?yàn)橛辛肆己玫某銮谟涗?，我才能轉(zhuǎn)回紐約上初三。

All of this was before email and cell phones, so over the next several weeks, supposedly, there were letters being sent between the Archdiocese of Manhattan and Miami and with the Vatican, and each day, I'd go into school crying and come home crying, to which my mother would give me an update from some cardinal or bishop to 'Keep her going to school while we find her a spot.'

這些都發(fā)生在有手機(jī)和電郵之前，所以在接下來的幾周，據(jù)說一直有一些信件往返于曼哈頓教區(qū)、邁阿密和梵蒂岡，而在此期間，我每天都會哭著去上課，哭著回家，我媽媽也會安慰我說，某些主教希望“讓她繼續(xù)在這里上課，等到我們有空位給她?！?/p>

Was I naive or what?

我當(dāng)時(shí)是不是太單純？

Well, after a couple of weeks, one day, while waiting for the school bus, I met a girl named Debbie, and she introduced me to her friends. And they became my friends, and, well, the Pope was off the hook.

過了幾周，某天，在等校車的時(shí)候，我遇到了一位叫Debbie的女孩，她把我介紹給了她的朋友。然后我跟他們都成了朋友，接著就把教主的事拋在腦后了。

I began to calm down and settle in.

我漸漸開始融入了這個(gè)環(huán)境。

My past three decades of studying anxiety in children stems partly from my own search for self-understanding. And I've learned much. For young people, anxiety is the most common childhood psychiatric condition. These disorders start early, by age four, and by adolescence, one in 12 youths are severely impaired in their ability to function at home, in school and with peers. 

我花了30年研究孩童焦慮，一部分原因是出于我想了解我自己。我學(xué)到了很多。焦慮是最常見的孩童精神疾病。從四歲發(fā)病，直到青春期，1/12的兒童在家里、學(xué)校和與同伴相處上都面臨困難。

These kids are so frightened, worried, literally physically uncomfortable due to their anxiety. It's difficult for them to pay attention in school, relax and have fun, make friends and do all the things that kids should be doing. Anxiety can create misery for the child, and the parents are front and center in witnessing their child's distress.

焦慮導(dǎo)致他們感到恐懼、擔(dān)心，甚至是生理上的不適。他們在學(xué)校里無法專心、放松、玩耍、交朋友，以及做他們的年齡該做的事。焦慮讓孩子感到痛苦，而家長在近距離目睹著孩子的憂慮。

As I met more and more children with anxiety through my work, I had to go back to mom and dad and ask them a couple of questions. 'Why did you hold me down when I was so frightened of getting injections and force them on me? And why tell me these tall tales to make me go to school when I was so worried about being embarrassed again?' 

因?yàn)楣ぷ鞯木壒剩医佑|了越來越多的孩子，而我也不得不回去問我父母一些問題?！拔夷敲春ε麓蜥?，可當(dāng)初你們?yōu)槭裁幢莆掖蜥槪课夷敲磽?dān)心自己會被嘲笑，可你們卻編了那么多的故事騙我去上課？”

They said, 'Our hearts broke for you each time, but we knew that these were things that you had to do. We had to risk you becoming upset while we waited for you to get used to the situation with time and with more experience. You had to get vaccinated. You had to go to school.'

他們回答：“我們每次看到都很心痛，但我們知道那是你必須要做的事。我們冒著讓你難過的風(fēng)險(xiǎn)，希望等你慢慢習(xí)慣后，能夠逐漸適應(yīng)這些狀況。你必須打疫苗，你也必須去上學(xué)?！?/p>

Little did my parents know, but they were doing more than inoculating me from the measles. They were also inoculating me from a lifetime of anxiety disorders. 

他們當(dāng)時(shí)并不知道，他們不只是給我打了麻疹的預(yù)防針，還為我打了避免終身焦慮的預(yù)防針。

Excessive anxiety in a young child is like a superbug -- and infectious, even multiplying, such that many of the youth that I see come in with more than one anxiety condition occurring at the same time. 

過度焦慮對孩子來說是一種超強(qiáng)病毒——傳染力強(qiáng)，甚至?xí)胺敝场?，?dǎo)致我所見到的青少年中，很多人都同時(shí)患有多種焦慮癥。

For example, they'll have specific phobia plus separation anxiety plus social anxiety all together. Left untreated, anxiety in early childhood can lead to depression by adolescence. It can also contribute to substance abuse and to suicidality.

比如，他們對某個(gè)事物有極大的恐懼癥，還伴有分離焦慮癥和社交焦慮癥。如果不及時(shí)進(jìn)行治療，童年的焦慮癥就會導(dǎo)致青春期的抑郁癥，甚至吸毒成癮和自殺。

My parents were not therapists. They didn't know any psychologists. All they knew is that these situations may have been uncomfortable for me, but they were not harmful. 

我的父母并不是咨詢師，也不認(rèn)識任何心理醫(yī)生。他們只知道這些情況讓我不自在，但并不會對我造成傷害。

My excessive anxiety would harm me more over the long term if they let me avoid and escape these situations and not learn how to tolerate occasional distress. So in essence, mom and dad were doing their own homegrown version of exposure therapy, which is the central and key component of cognitive behavioral treatment for anxiety.

如果他們允許我逃避這些情況，而不學(xué)會怎么去面對這些負(fù)面的刺激，長期下來，焦慮癥只會對我造成更大的傷害。所以，我父母只是在實(shí)行家庭版的暴露療法，這是在認(rèn)知行為療法里治療焦慮癥最關(guān)鍵的部分。

My colleagues and I conducted the largest randomized controlled study of the treatments of anxiety in children ages seven to 17. We found that child-focused cognitive behavioral exposure therapy or medication with a selective serotonin reuptake inhibitor are effective for 60 percent of treated youth. 

我和同事們通過一項(xiàng)最大規(guī)模的隨機(jī)對照試驗(yàn)研究了7至17歲兒童的焦慮療法。我們發(fā)現(xiàn)，針對兒童的認(rèn)知行為暴露療法，或者服用選擇性血清素再攝取抑制劑，只對 60 % 的青少年患者有效。

And their combination gets 80 percent of kids well within three months. This is all good news. And if they stay on the medication or do monthly exposure treatments as we did in the length of the study, they could stay well for upwards of a year. 

如果兩種措施同時(shí)使用，80%的患者可以在3個(gè)月里康復(fù)。這是好消息。如果他們持續(xù)服用藥物，或是每個(gè)月接受暴露療法，就像我們在實(shí)驗(yàn)中采用的那樣，他們在1年內(nèi)都不會復(fù)發(fā)。

However, after this treatment study ended, we went back and a did a follow-up study of the participants, and we found that many of these kids relapsed over time. And, despite the best of evidence-based treatments, we also found that for about 40 percent of the kids with anxiety, they remained ill throughout the course of the time.

但是，在這個(gè)療法實(shí)驗(yàn)結(jié)束后，我們對之前的患者進(jìn)行跟蹤研究，發(fā)現(xiàn)過了一段時(shí)間，有很多患者會復(fù)發(fā)。即便在治療效果最好的那一批患者中，也有40 %的焦慮癥兒童持續(xù)表現(xiàn)出了焦慮的病狀。

We've thought a lot about these results. What were we missing? We've hypothesized that because we were focusing on just child-focused intervention, perhaps there's something important about addressing the parents and involving them in treatment, too.

我們仔細(xì)思考了這些結(jié)果。我們遺漏了什么嗎？據(jù)推斷，這是因?yàn)槲覀冎粚Ｗ⒂卺槍⑼闹委?，卻忽略了父母對他們造成的影響，所以家長們也應(yīng)該參與治療。

Studies from my own lab and from colleagues around the world have shown a consistent trend: well-meaning parents are often inadvertently drawn into the cycle of anxiety. They give in, and they make too many accommodations for their child, and they let their children escape challenging situations. 

我的研究組和其他國家的心理學(xué)研究組都揭示了共同的趨勢：具有良好初衷的父母常常會不可避免地卷入焦慮的惡性循環(huán)。面對孩子的焦慮，他們會讓步，遷就他們的孩子，允許自己的孩子逃避那些困難的情況。

I want you to think about it like this: Your child comes into the house to you crying, in tears. They're five or six years of age. 'Nobody at school likes me! These kids are mean. No one would play with me.' How do you feel seeing your child so upset? What do you do? 

假設(shè)：你的孩子哭著跑回家。他們才5歲或6歲?！皩W(xué)校的小朋友都不喜歡我！他們很壞。他們都不跟我玩?！笨吹剿麄冸y過，你會有什么樣的感受？你會做什么？

The natural parenting instinct is to comfort that child, soothe them, protect them and fix the situation. Calling the teacher to intervene or the other parents to arrange playdates, that may be fine at age five. But what do you do if your child keeps coming home day after day in tears? Do you still fix things for them at age eight, 10, 14?

父母會本能地安慰孩子、哄他們、保護(hù)他們，并解決這個(gè)問題。他們或許會打電話叫老師進(jìn)行調(diào)解，約別的父母帶孩子一起玩，這些都是對付5歲小孩的辦法。但如果你的孩子持續(xù)每天都哭著回家呢？你還要繼續(xù)替他們解決，直到8歲、10歲、14歲嗎？

For children, as they are developing, they invariably are going to be encountering challenging situations: sleepovers, oral reports, a challenging test that pops up, trying out for a sports team or a spot in the school play, conflicts with peers ... All these situations involve risk: risk of not doing well, not getting what they want, risk of maybe making mistakes or being embarrassed.

在孩子成長的過程中，一定會面臨各種難題：去別人家過夜、課堂演講、突擊測驗(yàn)、加入校體育隊(duì)、或是在校園戲劇里試鏡角色，與同學(xué)發(fā)生矛盾，等等。這些情況都包含冒險(xiǎn)的因素：表現(xiàn)不好的風(fēng)險(xiǎn)、達(dá)不到預(yù)期目標(biāo)的風(fēng)險(xiǎn)、犯錯的風(fēng)險(xiǎn)、或者讓他們難堪的風(fēng)險(xiǎn)。

For kids with anxiety who don't take risks and engage, they then don't learn how to manage these types of situations. Right? Because skills develop with exposure over time, repeated exposure to everyday situations that kids encounter: 

對于焦慮的孩子來說，如果他們不主動迎接風(fēng)險(xiǎn)，他們就無法學(xué)會如何應(yīng)對這些狀況。對嗎？因?yàn)檫@是隨著時(shí)間累積的能力，在反復(fù)面對這些日常狀況時(shí)，孩子才能逐漸培養(yǎng)出這些能力：

self-soothing skills or the ability to calm oneself down when upset; problem-solving skills, including the ability to resolve conflicts with others; delay of gratification, or the ability to keep your efforts going despite the fact that you have to wait over time to see what happens. 

自我安慰，或控制情緒；解決問題，包括解決于同學(xué)之間的矛盾；延遲滿足，就是在等待的時(shí)候還能堅(jiān)持的毅力。

These and many other skills are developing in children who take risks and engage. And self-efficacy takes shape, which, simply put, is the belief in oneself that you can overcome challenging situations.

只有通過冒險(xiǎn)和直面這些狀況，孩子才能擁有這些能力。他們也會慢慢獲得自我效能，簡單來說，就是相信自己可以克服這些難題。

For kids with anxiety who escape and avoid these situations and get other people to do them for them, they become more and more anxious with time while less confident in themselves. 

患有焦慮癥的孩子如果總是逃避這些狀況或找他人替他們解決問題，他們只會越來越焦慮，同時(shí)失去自信。

Contrary to their peers who don't suffer with anxiety, they come to believe that they are incapable of managing these situations. They think that they need someone, someone like their parents, to do things for them.

相比沒有焦慮癥的孩子，他們會認(rèn)為自己無法應(yīng)對這些狀況。他們會認(rèn)為他們需要別人，例如父母，來替他們做這些事。

Now, while the natural parenting instinct is to comfort and protect and reassure kids, in 1930, the psychiatrist Alfred Adler had already cautioned parents that we can love a child as much as we wish, but we must not make that child dependent. 

雖然父母的本能就是安慰、保護(hù)和安撫孩子，但在 1930 年，精神科醫(yī)師阿爾弗雷德·阿德勒（Alfred Adler）就勸誡過父母，可以盡所能的愛自己的孩子，但不要讓他們過度依賴別人。

He advised parents to begin training kids from the very beginning to stand on their own two feet. He also cautioned that if children get the impression that their parents have nothing better to do than be at their beck and call, they would gain a false idea of love.

他建議父母盡早鍛煉孩子的獨(dú)立能力。他也提醒道，如果孩子覺得自己的父母可以隨叫隨到，他們對愛的認(rèn)知就會有偏差。

For children with anxiety in this day and age, they are always calling their parents or texting distress calls at all hours of the day and night. So if children with anxiety don't learn the proper coping mechanisms when young, what happens to them when they grow up?

如今，患有焦慮癥的孩子總是習(xí)慣經(jīng)常打電話給他們的父母，或發(fā)短信求救。如果患有焦慮癥的孩子不在兒時(shí)學(xué)會正確的應(yīng)對方式，他們長大后怎么辦？

I run groups for parents of young adults with anxiety disorders. These youth are between the ages of 18 and 28. They are mostly living at home, dependent on their parents. Many of them may have attended school and college. Some have graduated. 

我為患有焦慮癥的青少年的家長成立了一些互助小組。他們的孩子都處于18 - 28歲的年齡段，大部分與父母同住，依賴于他們的父母。很多人上過初中、高中和大學(xué)，有些畢業(yè)了。

Almost all are not working, just staying at home and not doing much of anything. They don't have meaningful relationships with others, and they are very, very dependent on their parents to do all sort of things for them. 

但幾乎所有人都沒有工作，只是呆在家里，整天無所事事。他們沒有密切的社交圈，而且非常依賴父母去幫他們完成所有的事。

Their parents still make their doctors appointments for them. They call the kids' old friends and beg them to come visit. They do the kids' laundry and cook for them. And they are in great conflict with their young adult, because the anxiety has flourished but the youth has not. These parents feel enormous guilt, but then resentment, and then more guilt.

父母至今還幫他們預(yù)約看病，打電話叫他們的朋友來家里玩，幫他們洗衣做飯，卻也經(jīng)常與他們發(fā)生矛盾，因?yàn)樗麄兊慕箲]癥變嚴(yán)重了，但心智卻沒有成長。這些父母感到極度愧疚，之后是懊悔，這種懊悔又導(dǎo)致了更多的愧疚。

OK, how about some good news? If parents and key figures in a child's life can help the child, assist them to confront their fears and learn how to problem-solve, then it is more likely that the children are going to develop their own internal coping mechanisms for managing their anxiety. 

那么，好消息是什么呢？如果家長，以及孩子成長過程中的一些關(guān)鍵人物一同幫助孩子克服他們的恐懼，并且學(xué)習(xí)如何解決問題，那這些孩子就更有可能發(fā)展出一套內(nèi)部應(yīng)對機(jī)制來管理自己的焦慮。

We teach parents now to be mindful in the moment and think about their reaction to their child's anxiety. We ask them, 'Look at the situation and ask, 'What is this situation at hand? How threatening is it to my child? And what do I ultimately want them to learn from it?''

現(xiàn)在，我們教導(dǎo)父母用心來思考自己面對孩子焦慮時(shí)的反應(yīng)。我們問他們，“面對這種情況時(shí)問自己：‘現(xiàn)在的情況是什么？對我的孩子會造成多大的危險(xiǎn)？我到底要他們從中學(xué)到什么？’”

Now of course, we want parents to listen very carefully, because if a child is being bullied seriously or put in harm's way, we want parents to intervene, absolutely. 

當(dāng)然，家長們也要明白，如果一個(gè)孩子被霸凌或受傷，我們肯定會要求父母介入，毋庸置疑。

But in typical, everyday anxiety-producing situations, parents can be most helpful to their child if they remain calm and matter-of-fact and warm, if they validate the child's feelings but then help the child, assist them in planning how the child is going to manage the situation. 

但在日常會導(dǎo)致焦慮的狀況中，父母能給孩子最大的幫助就是保持冷靜、理智、態(tài)度溫和，不去否定他們的感受，但同時(shí)幫助孩子思考如何應(yīng)對這種情況。

And then -- this is key -- to actually have the child deal with the situation themselves.

然后——這是最關(guān)鍵的——要讓孩子自己去面對這些情況。

Of course, it is heartbreaking to watch a child suffer, as my parents told me years later. When you see your child suffering but you think you could swoop in and save them from the pain of it, that's everything, right? That's what we want to do. 

當(dāng)然，看到孩子難過，自己也會心疼，我的父母也是在很多年后才告訴我的。當(dāng)你看到你的孩子難過，但你覺得可以馬上讓他們擺脫痛苦，這是最重要的，對吧？我們都想這么做。

But whether we are young or old, excessive anxiety leads us to overestimate risk and distress while underestimating our ability to cope. We know that repeated exposure to what we fear weakens anxiety, while building resources and resilience.

但不論我們年長還是年少，過度焦慮都會讓我們放大風(fēng)險(xiǎn)和焦慮，同時(shí)低估了我們的適應(yīng)能力。不斷接觸自己所恐懼的事物會降低我們的焦慮，同時(shí)增加我們處理問題的資源和抗壓能力。

My parents were on to something. Today's hyper-anxious youth are not being helped by overly protective parenting. Calmness and confidence are not just emotions. They are coping skills that parents and children can learn.

我的父母發(fā)現(xiàn)了其中的奧秘。在現(xiàn)在的社會里，過度保護(hù)的教育方式并不會改善過度焦慮的問題。冷靜與自信不只是某種情感，還是父母與孩子可以一同學(xué)習(xí)的應(yīng)對方式。

Thank you.

謝謝。