TEDMED 2015
Melissa Walker: Art can heal PTSD's invisible wounds
梅丽莎・沃克尔: 艺术能够治疗创伤后应激障碍的无形伤痕
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创意艺术治疗医师梅丽莎・沃克尔说：伤疤让受害者保持沉默。但是艺术能够帮助治愈那些受心理创伤之苦的人，帮助他们敞开心扉。在这个启发人心的演说中，沃克尔讲述了面具制作是如何让饱受折磨的军人们发现是什么缠绕着他们，并最终走出阴影。
Melissa Walker - Creative arts therapist
Melissa Walker helps military service members recover from traumatic brain injury and mental illness. Full bio
Melissa Walker helps military service members recover from traumatic brain injury and mental illness. Full bio
Double-click the English transcript below to play the video.
00:12
You are a high-ranking
military service member
military service member
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你是一个高级军官，
00:16
deployed to Afghanistan.
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现服役于阿富汗。
00:19
You are responsible for the lives
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你要对上百个
00:22
of hundreds of men and women,
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男兵女兵的生命负责。
00:24
and your base is under attack.
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你的基地遭到袭击。
00:27
Incoming mortar rounds
are exploding all around you.
are exploding all around you.
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散落的炮弹
在你的身边爆炸。
在你的身边爆炸。
00:32
Struggling to see
through the dust and the smoke,
through the dust and the smoke,
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在尘埃和烟雾中，
你挣扎着想看清，
你挣扎着想看清，
00:35
you do your best to assist the wounded
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去尽最大努力帮助伤者，
00:38
and then crawl to a nearby bunker.
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并爬到附近的掩体。
00:41
Conscious but dazed by the blasts,
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时而有意识，
时而为爆炸所迷茫，
时而为爆炸所迷茫，
00:44
you lay on your side and attempt
to process what has just happened.
to process what has just happened.
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你躺下，尝试
思考刚刚发什么了。
思考刚刚发什么了。
00:49
As you regain your vision,
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当你重新获得
你的视觉的时候，
你的视觉的时候，
00:52
you see a bloody face
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你看到了一个
流血的脸庞，
流血的脸庞，
00:54
staring back at you.
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盯着你。
00:57
The image is terrifying,
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这个画面让人恐惧，
01:00
but you quickly come to understand
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但是你很快明白，
01:02
it's not real.
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这不是真的。
01:06
This vision continues to visit you
multiple times a day and in your sleep.
multiple times a day and in your sleep.
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这个画面在白天和夜里
多次出现，并持续侵扰着你，
多次出现，并持续侵扰着你，
01:11
You choose not to tell anyone
for fear of losing your job
for fear of losing your job
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你决定闭口不谈，
害怕会失去工作，
害怕会失去工作，
01:14
or being seen as weak.
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或被当成弱者。
01:18
You give the vision a name,
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你给这个画面
取了一个名字，
取了一个名字，
01:20
Bloody Face in Bunker,
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掩体下血腥的脸，
01:22
and call it BFIB for short.
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简称“掩体血脸”。
01:25
You keep BFIB locked away in your mind,
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你把“掩体血脸”
封锁在你的脑海里，
封锁在你的脑海里，
01:29
secretly haunting you,
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不为人知地侵扰着你，
01:30
for the next seven years.
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整整七年。
01:35
Now close your eyes.
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现在闭上你的眼睛，
01:39
Can you see BFIB?
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你能看到“掩体血脸”吗？
01:43
If you can, you're beginning
to see the face
to see the face
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如果你可以，
你就能够看到
你就能够看到
01:46
of the invisible wounds of war,
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战争无形创伤的样子，
01:48
commonly known
as post-traumatic stress disorder
as post-traumatic stress disorder
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称作“创伤后应激障碍”
01:51
and traumatic brain injury.
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或者创伤性脑损伤。
01:54
While I can't say I have
post-traumatic stress disorder,
post-traumatic stress disorder,
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虽然我没有得过
创伤后应激障碍，
创伤后应激障碍，
01:57
I've never been a stranger to it.
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但是我对它并不陌生。
01:59
When I was a little girl, I would visit
my grandparents every summer.
my grandparents every summer.
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当我还是个小女孩的时候，
我会在每个夏天拜访祖父母，
我会在每个夏天拜访祖父母，
02:04
It was my grandfather
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我的祖父，
02:06
who introduced me to the effects
of combat on the psyche.
of combat on the psyche.
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他告诉我了战争的心理影响。
02:10
While my grandfather was serving
as a Marine in the Korean War,
as a Marine in the Korean War,
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当我祖父在朝鲜战争
服役海军的时候，
服役海军的时候，
02:14
a bullet pierced his neck
and rendered him unable to cry out.
and rendered him unable to cry out.
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一颗子弹穿过他的脖子，
让他无法叫出声。
让他无法叫出声。
02:19
He watched as a corpsman passed him over,
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他看见医护兵
从他身边走过，
从他身边走过，
02:21
declaring him a goner,
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以为他已经无药可治，
02:23
and then leaving him to die.
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把他留下等待死亡。
02:26
Years later, after his
physical wounds had healed
physical wounds had healed
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几年过后，
当身体的伤痊愈，
当身体的伤痊愈，
02:29
and he'd returned home,
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他回到家，
02:31
he rarely spoke of his
experiences in waking life.
experiences in waking life.
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他却很少在清醒的时候
说过自己的经历，
说过自己的经历，
02:35
But at night I would hear him
shouting obscenities
shouting obscenities
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但是晚上，
我能够听到他的怒号
我能够听到他的怒号
02:38
from his room down the hall.
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从走廊尽头的房间里传来。
02:41
And during the day I would announce myself
as I entered the room,
as I entered the room,
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白天我会提醒他，
然后进入房间，
然后进入房间，
02:44
careful not to startle or agitate him.
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小心翼翼地，
生怕惊吓或激怒他。
生怕惊吓或激怒他。
02:48
He lived out the remainder of his days
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他就这样，
度过了剩下的日子，
度过了剩下的日子，
02:51
isolated and tight-lipped,
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孤独和紧张的，
02:53
never finding a way to express himself,
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找不到一个表达自己的方式，
02:56
and I didn't yet
have the tools to guide him.
have the tools to guide him.
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那时候我还没有找到
能够引导他的方式。
能够引导他的方式。
03:01
I wouldn't have a name
for my grandfather's condition
for my grandfather's condition
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我也不知道
他那种疾病的名字，
他那种疾病的名字，
03:04
until I was in my 20s.
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直到我20岁的时候。
03:06
Seeking a graduate degree in art therapy,
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攻读艺术治疗的学位，
03:09
I naturally gravitated
towards the study of trauma.
towards the study of trauma.
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我自然而然地
倾向创伤的研究，
倾向创伤的研究，
03:14
And while sitting in class learning
about post-traumatic stress disorder,
about post-traumatic stress disorder,
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当我在教室
学习创伤后应激障碍时，
学习创伤后应激障碍时，
03:17
or PTSD for short,
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简称PTSD,
03:20
my mission to help service members
who suffered like my grandfather
who suffered like my grandfather
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帮助像我祖父一样
的军人的目标
的军人的目标
03:24
began to take form.
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开始在我心中确立。
03:27
We've had various names
for post-traumatic stress
for post-traumatic stress
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创伤后应激障碍有很多名字，
03:29
throughout the history of war:
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在战争历史上：
03:32
homesickness,
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乡愁，
03:34
soldier's heart,
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神经性循环衰弱，
03:36
shell shock,
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炮弹休克症，
03:38
thousand-yard stare, for instance.
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目光呆滞等等。
03:41
And while I was pursuing my degree,
a new war was raging,
a new war was raging,
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在我攻读学位的时候，
一场战争爆发，
一场战争爆发，
03:45
and thanks to modern body armor
and military vehicles,
and military vehicles,
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感谢现代装备和军用交通工具，
03:48
service members were surviving
blast injuries they wouldn't have before.
blast injuries they wouldn't have before.
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军人爆炸受伤
的存活率达到历史新高。
的存活率达到历史新高。
03:53
But the invisible wounds
were reaching new levels,
were reaching new levels,
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但是无形伤疤也达到新高，
03:56
and this pushed military doctors
and researchers
and researchers
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这使得军医和研究人员
03:59
to try and truly understand the effects
that traumatic brain injury, or TBI,
that traumatic brain injury, or TBI,
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尝试真正理解创伤性脑损伤，
也就是TBI，
也就是TBI，
04:05
and PTSD have on the brain.
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和PTSD对脑的影响。
04:08
Due to advances
in technology and neuroimaging,
in technology and neuroimaging,
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因为科技的进步
和神经影像的发展，
和神经影像的发展，
04:12
we now know there's
an actual shutdown in the Broca's,
an actual shutdown in the Broca's,
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我们现在知道脑部的
布罗卡氏区，就是大脑语言部分
布罗卡氏区，就是大脑语言部分
04:15
or the speech-language area of the brain,
after an individual experiences trauma.
after an individual experiences trauma.
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会在个人创伤经历后停止工作。
04:21
This physiological change,
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这个生理变化，
04:23
or speechless terror as it's often called,
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就是经常被称作的失语症，
04:26
coupled with mental health stigma,
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伴随心理创伤，
04:28
the fear of being judged
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怕被歧视和误解
04:30
or misunderstood,
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的那种恐惧感，
04:31
possibly even removed
from their current duties,
from their current duties,
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即使调离了军人岗位，
04:34
has led to the invisible struggles
of our servicemen and women.
of our servicemen and women.
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都有可能造成
的无形的痛苦。
的无形的痛苦。
04:39
Generation after generation of veterans
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一代一代的退伍军人
04:43
have chosen not to talk
about their experiences,
about their experiences,
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都选择对他们
的经历闭口不谈，
的经历闭口不谈，
04:46
and suffer in solitude.
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一个人受苦。
04:50
I had my work cut out for me
when I got my first job
when I got my first job
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我的第一份工作非常适合我，
04:53
as an art therapist at the nation's
largest military medical center,
largest military medical center,
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是在国家最大的军用医疗中心，
沃尔特-里德陆军医疗中心，
沃尔特-里德陆军医疗中心，
04:57
Walter Reed.
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担任一名艺术治疗医师。
04:59
After working for a few years
on a locked-in patient psychiatric unit,
on a locked-in patient psychiatric unit,
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在一个心理疾病部门
工作几年后，
工作几年后，
05:03
I eventually transferred to the National
Intrepid Center of Excellence, NICoE,
Intrepid Center of Excellence, NICoE,
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我被调到国家优秀勇士中心，
NICoE，
NICoE，
05:08
which leads TBI care
for active duty service members.
for active duty service members.
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NICoE在军人TBI
看护有领先地位。
看护有领先地位。
05:12
Now, I believed in art therapy,
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我相信艺术治疗，
05:14
but I was going to have
to convince service members,
to convince service members,
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但是我需要说服一些军人，
05:18
big, tough, strong, manly military men,
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强壮的男子气概的军人，
05:21
and some women too,
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和一些女兵，
05:23
to give art-making as
a psychotherapeutic intervention a try.
a psychotherapeutic intervention a try.
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让他们尝试把艺术
当作心理治疗。
当作心理治疗。
05:28
The results have been
nothing short of spectacular.
nothing short of spectacular.
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结果非常可观。
05:34
Vivid, symbolic artwork
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被我们的军人创造了
05:36
is being created
by our servicemen and women,
by our servicemen and women,
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那些生动，
具有象征性的作品。
具有象征性的作品。
05:39
and every work of art tells a story.
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每一件作品讲述着一个故事。
05:43
We've observed that the process
of art therapy bypasses
of art therapy bypasses
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我们发现艺术治疗的过程
05:46
the speech-language issue with the brain.
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绕过了脑部的失语症。
05:49
Art-making accesses the same sensory
areas of the brain that encode trauma.
areas of the brain that encode trauma.
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艺术创作接触到了
被封锁的大脑创伤。
被封锁的大脑创伤。
05:54
Service members can use the art-making
to work through their experiences
to work through their experiences
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军人能够用艺术创作
表达他们的经历
表达他们的经历
05:57
in a nonthreatening way.
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通过一个无害的方式。
06:00
They can then apply words
to their physical creations,
to their physical creations,
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他们能够把文字
用在创作上，
用在创作上，
06:03
reintegrating the left
and the right hemispheres of the brain.
and the right hemispheres of the brain.
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重新连接左半边
和右半边大脑。
和右半边大脑。
06:08
Now, we've seen this can work
with all forms of art --
with all forms of art --
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我们发现各种形式
的艺术都可以，
的艺术都可以，
06:12
drawing, painting, collage --
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绘画，素描，拼贴，
06:15
but what seems to have the most impact
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但是似乎影响最大的
06:18
is mask-making.
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是面具制作。
06:21
Finally, these invisible wounds
don't just have a name,
don't just have a name,
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最终，这些无形的伤疤
不仅仅有了一个名字，
不仅仅有了一个名字，
06:25
they have a face.
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还有了脸。
06:29
And when service members
create these masks,
create these masks,
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当军人创造这些面具的时候，
06:31
it allows them to come to grips,
literally, with their trauma.
literally, with their trauma.
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真的，他们能够抓住创伤。
06:35
And it's amazing
how often that enables them
how often that enables them
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他们能够打破和开始修复创伤，
06:38
to break through the trauma
and start to heal.
and start to heal.
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真令人惊奇。
06:42
Remember BFIB?
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记得“掩体血脸”吗？
06:46
That was a real experience
for one of my patients,
for one of my patients,
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那是一位我的病人
的真实经历，
的真实经历，
06:49
and when he created his mask,
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当他创作面具的时候，
06:50
he was able to let go
of that haunting image.
of that haunting image.
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他能够摆脱画面的困扰。
06:54
Initially, it was a daunting process
for the service member,
for the service member,
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刚开始，对军人来说，
这是一个吓人的过程，
这是一个吓人的过程，
06:57
but eventually he began
to think of BFIB as the mask,
to think of BFIB as the mask,
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但是最后，他开始把
“掩体血脸”当成面具，
“掩体血脸”当成面具，
07:00
not his internal wound,
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而不是他的内心世界。
07:02
and he would go to leave each session,
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他离开治疗时，
07:04
he would hand me the mask,
and say, "Melissa, take care of him."
and say, "Melissa, take care of him."
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他给我那个面具，并说：
“梅丽莎，照顾好他。”
“梅丽莎，照顾好他。”
07:08
Eventually, we placed BFIB in a box
to further contain him,
to further contain him,
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最后，我们把“掩体血脸”
放在盒子里，
放在盒子里，
07:12
and when the service member
went to leave the NICoE,
went to leave the NICoE,
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当那个军人
离开NICoE的时候，
离开NICoE的时候，
07:15
he chose to leave BFIB behind.
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他选择留下“掩体血脸”。
07:18
A year later, he had only seen BFIB twice,
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一年后，他只见到“掩体血脸”两次，
07:20
and both times BFIB was smiling
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而且“掩体血脸”在笑，
07:22
and the service member
didn't feel anxious.
didn't feel anxious.
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军人不再感到紧张。
07:26
Now, whenever that service member
is haunted by some traumatic memory,
is haunted by some traumatic memory,
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现在，当那个军人
被创伤记忆所侵扰时，
被创伤记忆所侵扰时，
07:29
he continues to paint.
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他会继续绘画。
07:32
Every time he paints
these disturbing images,
these disturbing images,
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每一次他画这些
令人不安的画面时，
令人不安的画面时，
07:34
he sees them less or not at all.
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他很少或者不会看到它们。
07:39
Philosophers have told us
for thousands of years
for thousands of years
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哲学家告诉我们上千年来，
07:42
that the power to create
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创造的力量，
07:44
is very closely linked
to the power to destroy.
to the power to destroy.
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是和摧毁的力量
紧紧相关的。
紧紧相关的。
07:47
Now science is showing us
that the part of the brain
that the part of the brain
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现在科学告诉我们
07:50
that registers a traumatic wound
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造成创伤的大脑部分
07:52
can be the part of the brain
where healing happens too.
where healing happens too.
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也是发生修复的部分。
07:55
And art therapy is showing us
how to make that connection.
how to make that connection.
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艺术治疗展示我们
如何将它们连接起来。
如何将它们连接起来。
08:00
We asked one of our service members
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我们让一个军人
08:02
to describe how mask-making
impacted his treatment,
impacted his treatment,
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去形容面具制作
是怎样影响他的治疗的，
是怎样影响他的治疗的，
08:05
and this is what he had to say.
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这是他的回复－
08:07
(Video) Service Member:
You sort of just zone out into the mask.
You sort of just zone out into the mask.
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（音频）
军人：你好像进入了面具中，
军人：你好像进入了面具中，
08:10
You zone out into the drawing,
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你进入了绘画中，
08:12
and for me, it just released the block,
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对于我来说，它释放了积压，
08:16
so I was able to do it.
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所以我能够做下去。
08:19
And then when I looked at it
after two days, I was like,
after two days, I was like,
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然后当我在两天后看着
它的时候，我说：
它的时候，我说：
08:23
"Holy crap, here's the picture,
here's the key, here's the puzzle,"
here's the key, here's the puzzle,"
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“我的天哪，这就是那个画面，
就是那个钥匙，就是那个谜团，”
就是那个钥匙，就是那个谜团，”
08:26
and then from there it just soared.
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然后它就这样离开。
08:28
I mean, from there
my treatment just when out of sight,
my treatment just when out of sight,
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我的意思是，
治疗就这样结束了，
治疗就这样结束了，
08:32
because they were like,
Kurt, explain this, explain this.
Kurt, explain this, explain this.
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因为他们让我解释一下这些，
08:34
And for the first time in 23 years,
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然后23年来第一次，
08:36
I could actually talk about stuff
openly to, like, anybody.
openly to, like, anybody.
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我能够像普通人一样
谈论这些事情。
谈论这些事情。
08:39
I could talk to you about it
right now if I wanted to,
right now if I wanted to,
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如果我想，我现在
就能够告诉你们，
就能够告诉你们，
08:42
because it unlocked it.
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因为它的封锁被解除了。
08:45
It's just amazing.
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太神奇了。
08:46
And it allowed me to put 23 years of PTSD
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它能够把我23年的PTSD
08:52
and TBI stuff together in one place
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和TBI抛之脑后，
08:58
that has never happened before.
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从来没有过。
09:02
Sorry.
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不好意思。
09:03
Melissa Walker: Over the past five years,
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梅丽莎 沃尔克：过去的五年里，
09:05
we've had over 1,000 masks made.
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我们制作了一千个面具。
09:09
It's pretty amazing, isn't it?
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很神奇，对吗？
09:12
Thank you.
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谢谢。
09:13
(Applause)
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（鼓掌）
09:19
I wish I could have shared
this process with my grandfather,
this process with my grandfather,
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我希望我能够跟
我的祖父分享这个过程，
我的祖父分享这个过程，
09:23
but I know that he would be thrilled
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我知道他会很激动，
09:27
that we are finding ways
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因为我们发现了
09:28
to help today's and tomorrow's
service members heal,
service members heal,
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帮助现在和未来军人治愈
09:33
and finding the resources within them
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和找到内心痛苦
的源头的方法，
的源头的方法，
09:36
that they can call upon
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让他们能够自省
09:38
to heal themselves.
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并自我治愈。
09:41
Thank you.
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谢谢。
09:42
(Applause)
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（鼓掌）
ABOUT THE SPEAKER
Melissa Walker - Creative arts therapistMelissa Walker helps military service members recover from traumatic brain injury and mental illness.
Why you should listen
Melissa Walker is a creative arts therapist at the National Intrepid Center of Excellence, a directorate of Walter Reed National Military Medical Center. She works with active duty service members suffering from traumatic brain injury and psychological health conditions.
Dedicated to helping recovering service members safely express their deep thoughts and emotions in a creative environment, Walker designed the Healing Arts Program at the National Intrepid Center of Excellence in 2010, where she engages her patients in mask-making, a powerful mechanism for helping them express their invisible wounds. Walker received her Master's Degree in art therapy from New York University.
Melissa Walker | Speaker | TED.com