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    心理健康:陌生的自己(下)

    來源:經濟學人 編輯:Helen ?  可可英語APP下載 |  可可官方微信:ikekenet
      


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    The most striking of these profiles is of Naomi Gaines.

    五個人中最引人注目的是娜奧米·蓋恩斯。

    In 2003, when she was a 24-year-old mother of four, she jumped off a bridge into the Mississippi river with her young twin boys, one of whom drowned.

    2003年,當她還是一個有著四個孩子的24歲母親時,她帶著年幼的雙胞胎兒子從橋上跳入密西西比河,導致其中一個孩子溺亡。

    Her problems, as a poor black woman, started young.

    作為一個貧窮的黑人女性,她的問題從很小就開始了。

    She grew up in a sprawling public-housing complex in Chicago that was partly controlled by gangs.

    她在芝加哥的一個龐大公共住宅區中長大,那里的部分區域受幫派控制。

    Her mother had an abusive boyfriend and the pair took drugs.

    她的母親有一個殘暴的男朋友,兩人都吸毒。

    Mental illness was never discussed, her mother tells Ms Aviv.

    她的母親告訴艾薇芙,沒有人談論過精神疾病。

    “In our family, if you feel a little down you just take a nap.

    “在我們家,如果有人心情不太好,打個盹就行了。

    That’s the solution: take a nap.”

    這就是解決辦法:打個盹。

    Ms Gaines moved in and out of hospital before her leap from the bridge.

    蓋恩斯在跳橋前曾多次去過醫院。

    But the litany of diagnostic labels she was given was alienating, and she did not take her medication.

    但醫院給她的一連串診斷結果讓她感到陌生,而且她沒有服用藥物。

    “Where is the sensitive side of psychiatry?” she asked.

    “精神病學就這么不體貼嗎?”她問道。

    After the jump she was committed to a secure institution as “mentally ill and dangerous” and started to take an antipsychotic.

    跳橋事件后,她因“患有精神病且很危險”被關進了一家安全機構,并開始服用抗精神病藥物。

    She was charged with second-degree murder and sent to prison.

    她被指控犯有二級謀殺罪,并被送進了監獄。

    Things began to change: she read voraciously and became the prison’s library clerk.

    事情由此開始發生變化:她如饑似渴地讀書,成了監獄的圖書館管理員。

    She was assigned a therapist.

    她被分配了一名心理治療師。

    But in 2010 she was taken off the antipsychotic “due to cost”, and was soon put in solitary confinement for 60 days.

    但在2010年,她“由于費用問題”停用了抗精神病藥物,并很快被單獨監禁了60天。

    She was released 16 years after her crime.

    她在犯罪的16年后獲釋。

    Ms Aviv writes sensitively about the limits of diagnosis in a case like this one.

    艾薇芙細膩地寫到了在這種情況下診斷的局限性。

    “Psychiatric insight can save a life,” she acknowledges.

    她承認,“精神病學的洞察力可以拯救一條生命”。

    Yet a narrow medical outlook “may also blind doctors and family members to certain beliefs—a relationship to God, a new understanding of society and one’s place in it—that are essential to a person’s identity and self-worth.”

    但狹隘的醫學觀“也可能使醫生和家人忽視某些信仰,比如與上帝的關系、對社會和個人社會地位的新理解,而這些對一個人的身份和自我價值至關重要。

    She scrutinises the racial biases seemingly inherent in the American health-care system: according to one study, 40% of second-year medical students think black Americans are less liable to feel pain.

    她仔細研究了美國醫療保健系統中似乎固有的種族偏見:一項研究表明,40%的二年級醫學生認為美國黑人更不容易感受到疼痛。

    She sees the limits of antidepressants, even if some drugs can reshape lives for the better.

    她看到了抗抑郁藥物的局限性,即使一些藥物可以改善生活。

    The subtlety of Ms Aviv’s book is also its flaw.

    艾薇芙這本書的微妙之處也是它的缺陷。

    Her five profiles feel disparate and disconnected.

    她對五個人的描述給人的感覺截然不同且互不相干。

    A chapter set in India is the weakest; the author is best when she is on home ground.

    以印度為背景的一章是最弱的;以家鄉為背景的篇章寫得最好。

    A case study that was originally a New Yorker profile—of a woman called Laura who was prescribed pill after pill—has the strongest sense of purpose.

    一個最初在《紐約客》上描述的案例研究--一個叫勞拉的女人被開了一次又一次藥--目的感最強。

    Ms Aviv’s withering assessment of the over-prescribing “biochemical” model of health care is powerful, as is her horror at the treatment Ms Gaines received at the hands of doctors and prison guards.

    艾薇芙對過度開藥的“生化”醫療保健模式的尖銳評價很有力,她對蓋恩斯在醫生和獄警手里接受的治療表現出的恐懼也是如此。

    More moments of clarity like these would have made for a better book.

    如果這本書有更多這樣清晰的描寫會變得更好。

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