TEDxMileHigh
Kim Gorgens: The surprising connection between brain injuries and crime
金·乔吉斯: 脑部损伤和犯罪之间的惊人联系
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这是一个令人震惊的统计数据：美国刑事司法案件中有50％至80％的人经受过创伤性脑损伤。在一般公众中，这个数字不到百分之五。神经心理学家金·乔吉斯分享了她对脑损伤和人们刑事犯罪行为之间联系的研究。同时她也分享了一些让司法系统更加高效和安全的方法。
Kim Gorgens - Neuropsychologist
Kim Gorgens studies the brain's response to injury -- and advocates that we mind our (gray) matter. Full bio
Kim Gorgens studies the brain's response to injury -- and advocates that we mind our (gray) matter. Full bio
Double-click the English transcript below to play the video.
00:12
A traumatic brain injury, or TBI,
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创伤性脑损伤，又称TBI，
是由于头部受到外部重击
而导致的大脑功能紊乱。
而导致的大脑功能紊乱。
00:15
is a disruption in brain function
caused by an external blow to the head.
caused by an external blow to the head.
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00:21
And when you hear that definition,
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当你们听到这个概念时，
你们可能会想到职业运动员，
00:23
you might think about sports
and professional athletes,
and professional athletes,
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因为这是我们在球场上
经常看到的损伤。
经常看到的损伤。
00:26
since it's the kind of injury
we're used to seeing on the playing field.
we're used to seeing on the playing field.
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00:31
And this imagery has really come
to define TBI in the public consciousness.
to define TBI in the public consciousness.
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这的确是公众意识中
脑损伤的形象。
脑损伤的形象。
00:37
I myself do research on TBI
in retired and college athletes.
in retired and college athletes.
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我自己也在研究退役和
大学运动员的创伤性脑损伤。
大学运动员的创伤性脑损伤。
2010年我站在TED舞台上，
00:41
I stood on a TED stage in 2010,
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谈论儿童运动中的脑震荡。
00:44
talking about concussions in kids' sports.
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00:48
So I have to say, as someone
who researches and treats these injuries,
who researches and treats these injuries,
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所以我不得不说，
作为研究和治疗这些损伤的人，
作为研究和治疗这些损伤的人，
我为人们对创伤性脑损伤
意识的增强感到高兴。
意识的增强感到高兴。
00:52
that I've been really gratified
to see the growing awareness of TBI
to see the growing awareness of TBI
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尤其是有关运动员的
短期和长期风险。
短期和长期风险。
00:56
and specifically, the short-
and long-term risks to athletes.
and long-term risks to athletes.
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01:01
Today, though, I want to introduce you
to a larger but no less controversial
to a larger but no less controversial
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不过，今天我想介绍一个
涵盖面更广但富有争议的，
涵盖面更广但富有争议的，
受到创伤性脑损伤影响的人群，
01:07
group of people impacted
by traumatic brain injury,
by traumatic brain injury,
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他们不经常出现在头条上。
01:10
who don't often show up in the headlines.
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01:14
I've come to recognize
these inmates and probationers
these inmates and probationers
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我逐渐认识到囚犯和缓刑犯
出乎意料地，
是社会上最脆弱的群体之一。
是社会上最脆弱的群体之一。
01:17
as surprisingly among the most
vulnerable members of society.
vulnerable members of society.
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01:23
For the last six years, my colleagues
and I have been doing research
and I have been doing research
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在过去的六年里，
我和我的同事一直在做研究，
我和我的同事一直在做研究，
这完全改变了我们
对刑事司法系统
对刑事司法系统
01:27
that has completely changed the way
we think about the criminal justice system
we think about the criminal justice system
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以及相关人员的看法。
01:30
and the people in it.
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我们的研究也可能改变你们
对这些事情的看法。
对这些事情的看法。
01:32
And it may change the way
you think about those things, too.
you think about those things, too.
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所以我先从一个令人震惊的
统计数据开始：
统计数据开始：
01:34
So I'll start with a shocking statistic:
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01:38
50 to 80 percent of people
in criminal justice
in criminal justice
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50%到80%的深陷刑事案件的人员
曾经受到过脑损伤。
01:43
have a traumatic brain injury.
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01:45
Up to 80 percent.
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高达80%。
01:49
In the general public,
in this room, for example,
in this room, for example,
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然而，在普通民众中，
这个数字不到百分之五。
01:52
that number is less than five percent.
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01:56
And I'm not just talking about
getting your bell rung.
getting your bell rung.
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我说的不仅仅是头部受到了撞击。
我说的这些损伤需要住院治疗。
01:58
These are the kinds of injuries
that require hospitalization.
that require hospitalization.
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02:04
Most of them are the product
of a physical assault,
of a physical assault,
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大部分是由于身体受到攻击引起的，
02:07
and some of them
are actually sustained in jail.
are actually sustained in jail.
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他们中的一些人实际上
已经被关进了监狱。
已经被关进了监狱。
所有这些数字对于
触犯刑事法律的女性而言更高。
触犯刑事法律的女性而言更高。
02:11
All of these numbers are even higher
among the women in criminal justice.
among the women in criminal justice.
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刑事案件中几乎每一个女性，
02:16
Almost every single woman
in the criminal justice system
in the criminal justice system
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都曾遭受过暴力和虐待。
02:21
has been exposed to interpersonal
violence and abuse.
violence and abuse.
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02:26
More than half of these women have
been exposed to repeated brain injuries.
been exposed to repeated brain injuries.
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这些女性中有一半以上
脑部反复遭受重击。
脑部反复遭受重击。
02:32
In this way, these women's brains look
like the brains of retired NFL players,
like the brains of retired NFL players,
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这些女性的大脑看起来就像是
退役的美国橄榄球联盟球员的大脑，
退役的美国橄榄球联盟球员的大脑，
而且随着年龄的增长，
她们可能面临着同样的痴呆症风险。
她们可能面临着同样的痴呆症风险。
02:39
and they'll likely face the same risks
for dementing diseases as they age.
for dementing diseases as they age.
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02:45
The same risks.
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同样的风险。
02:49
TBI, together with mental illness
and substance abuse and trauma,
and substance abuse and trauma,
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脑损伤，与精神疾病、
药物滥用和创伤交织作用，
药物滥用和创伤交织作用，
使得人们难以思考。
02:54
makes it hard for people to think.
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他们有认知障碍，比如较差的判断力
和较差的冲动控制能力，
和较差的冲动控制能力，
02:56
They have cognitive impairments like
poor judgment and poor impulse control,
poor judgment and poor impulse control,
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这使得刑事司法成为一道旋转门
（意味着一再进出法院和监狱）。
（意味着一再进出法院和监狱）。
03:01
problems that make
criminal justice a revolving door.
criminal justice a revolving door.
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03:05
People get arrested and booked into jail.
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人们被逮捕并被关进监狱。
他们经常在那里遇到麻烦。
03:08
They oftentimes get into trouble
while they're in there.
while they're in there.
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他们打架。
他们从床铺上掉下来。
他们从床铺上掉下来。
03:11
They get into fights.
They fall out of their bunk.
They fall out of their bunk.
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然后他们被释放，
做一些愚蠢的事情，
做一些愚蠢的事情，
03:13
And then they get released
and do stupid things,
and do stupid things,
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就像忘记强制登记一样，
他们会重新被捕。
他们会重新被捕。
03:15
like forgetting mandatory check-ins,
and they get rearrested.
and they get rearrested.
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从统计学上讲，
03:20
Statistically speaking,
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他们更有可能重新被捕。
03:22
they're actually more likely
to be rearrested than not.
to be rearrested than not.
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03:26
A colleague calls this "serving
a life sentence 30 days at a time."
a life sentence 30 days at a time."
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一位同事称之为
“每次服30天的无期徒刑”。
“每次服30天的无期徒刑”。
03:34
And oftentimes, these folks don't know
why this is so hard for them.
why this is so hard for them.
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通常，这些人不知道
为什么这对他们来说如此困难。
为什么这对他们来说如此困难。
他们感到失控和沮丧。
03:38
They feel out of control and frustrated.
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在得知创伤性脑损伤
是这些挑战的根源之后，
是这些挑战的根源之后，
03:41
So knowing that TBI is at the root
of so many of these challenges,
of so many of these challenges,
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我们科罗拉多州的一个小组的
任务就是打破这个循环，
任务就是打破这个循环，
03:48
the mission for a group of us in Colorado
has been to disrupt that cycle,
has been to disrupt that cycle,
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堵住这扇旋转的门。
03:53
to jam the revolving the door.
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03:56
So working together
with my state and local partners,
with my state and local partners,
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因此，通过和我所在的州和地方
的合作伙伴合作，
的合作伙伴合作，
我们制定了一个
满足每个参与者需求的计划：
满足每个参与者需求的计划：
03:59
we crafted a plan
to meet everyone's needs:
to meet everyone's needs:
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司法系统，囚犯，缓刑犯
04:03
the system, the inmates and probationers,
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和我的研究生。
04:05
my graduate students.
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04:07
In this program, we assess
how each person's brain works
how each person's brain works
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在这个项目中，我们评估
每个人的大脑是如何工作的
每个人的大脑是如何工作的
以便我们建议做出基本的修改，
04:11
so that we can recommend
basic modifications
basic modifications
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使得这个系统更有效
04:14
to make this system more effective
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并且更安全。
04:17
and safer.
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04:18
And here when I say "safer,"
I mean safer not only for the inmates,
I mean safer not only for the inmates,
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在这里，当我说“更安全”时，
我的意思是不仅对囚犯更安全，
我的意思是不仅对囚犯更安全，
对于惩教人员也更安全。
04:24
but safer also for correctional staff.
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04:28
In some ways, this is
such a simple approach.
such a simple approach.
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在某些方面，
这是一种非常简单的方法。
这是一种非常简单的方法。
我们不是在治疗脑损伤，
04:31
We're not treating the brain injury,
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我们把处理
让人们陷入困境的根本问题
让人们陷入困境的根本问题
04:34
we're treating the underlying problem
that gets people into all of this trouble
that gets people into all of this trouble
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放在第一位。
04:39
in the first place.
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04:41
We do quick neuropsychological
screening tests
screening tests
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我们做快速的神经心理检查，
以囚犯的思维方式
找出优点和缺点。
找出优点和缺点。
04:44
to identify strengths and weaknesses
in the way an inmate thinks.
in the way an inmate thinks.
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04:49
Using that information,
we write two reports.
we write two reports.
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利用这些信息，
我们写了两份报告。
我们写了两份报告。
一，给司法系统的报告，
04:52
One, a report for the system
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关于如何管理那个囚犯的具体建议。
04:55
with specific recommendations
on how to manage that inmate.
on how to manage that inmate.
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04:59
The other is a letter to the inmate
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另一封是给犯人的信，
关于如何管理自己的具体建议。
05:02
with specific suggestions
for how to manage themselves.
for how to manage themselves.
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05:07
For example, if our test result suggests
that a probationer has a hard time
that a probationer has a hard time
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例如，如果我们的测试结果
表明一个缓刑犯很难
表明一个缓刑犯很难
记住他们听到的东西，
05:12
remembering the things they hear,
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那可能是听觉记忆缺陷。
05:14
that would be an auditory memory deficit.
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在这种情况下，
我们给法院的信可能会建议
我们给法院的信可能会建议
05:16
In that case, our letter
to the court might suggest
to the court might suggest
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给那个缓刑犯有关重要信息的手册。
05:20
that that probationer get handouts
of important information.
of important information.
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我们给那个缓刑犯的信中会说，
05:23
And our letter to that probationer
would say, among other things,
would say, among other things,
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他们应该随身携带
一本笔记本来记录这些信息。
一本笔记本来记录这些信息。
05:27
that they should carry a notebook
to record that information for themselves.
to record that information for themselves.
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05:33
Now, most importantly,
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现在，最重要的是，
我在这里停下来想澄清一点。
05:35
is that I pause here
to be really clear about one point.
to be really clear about one point.
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05:40
This program does not
minimize responsibility
minimize responsibility
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这个计划并没有逃避责任，
或者为任何人的行为找借口。
05:43
or make excuses for anyone's behavior.
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05:47
This is about changing longstanding
negative perceptions
negative perceptions
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这主要是改变长期以来的负面看法
并倡导自我重建。
05:51
and building self-advocacy.
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05:54
It's actually about taking responsibility.
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实际上是要承担责任。
05:57
The inmates move from,
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囚犯们从
“我彻底搞砸了，我是个失败者。”
05:58
"I'm a total screwup, I'm a loser,"
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转变为“我做得不好，
06:01
to, "Here's what I don't do well,
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但这就是我要改进的。”
06:04
and here's what I have to do about it."
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06:08
(Applause)
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（掌声）
06:16
And the system comes to see
an inmate's problematic behavior
an inmate's problematic behavior
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司法系统逐渐认识到
囚犯的问题行为
囚犯的问题行为
是因为他们做不到，
06:19
as the things they can't do
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而不是因为他们不想做。
06:22
versus the things they won't do.
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这一变化——
06:25
And that change --
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把行为看成是一种缺陷
而不是彻底的蔑视——
而不是彻底的蔑视——
06:26
seeing behavior as a deficit
rather than outright defiance --
rather than outright defiance --
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就是这一系列设计想达成的目的。
06:31
is everything in these settings.
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06:35
We hear from inmates around the country,
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我们收到了来自全国囚犯的来信，
他们写信，更重要的是，
他们想知道如何帮助自己。
他们想知道如何帮助自己。
06:38
and they write, and more than anything,
they want to know how to help themselves.
they want to know how to help themselves.
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这是一封来自弗吉尼亚州
一位名叫特洛伊的囚犯的信件摘录，
一位名叫特洛伊的囚犯的信件摘录，
06:43
This is an excerpt from a letter
from Troy in Virginia,
from Troy in Virginia,
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从长达50页的信中摘录的。
06:47
an excerpt from a 50-page letter.
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他写道，
06:49
And he writes,
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“你能告诉我你对我经历过的
所有头部创伤有什么看法吗？
所有头部创伤有什么看法吗？
06:51
"Can you tell me what you think
of all the head traumas I've dealt with?
of all the head traumas I've dealt with?
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我能做什么？你能帮我吗？”
06:55
What can I do? Can you help me?"
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07:00
Closer to home, we have
thousands of stories like this,
thousands of stories like this,
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言归正传，
我们有上千个这样的故事，
我们有上千个这样的故事，
精彩的故事，有很好结果的故事。
07:03
and smart stories, stories
that have a great outcome.
that have a great outcome.
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07:08
Here's Vinny.
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这是维尼。
维尼15岁时被车撞了，
07:09
Vinny was hit by a car when he was 15,
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从那时起，他在监狱里呆的时间
比在学校里多。
比在学校里多。
07:12
and from that moment forward,
spent more time in jail than in school.
spent more time in jail than in school.
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通过一些基本技能的培训，
07:17
With some basic skill-building,
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那是在我们的评估显示
07:20
after our assessment revealed
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他有相当严重的记忆障碍之后，
07:21
that he had some pretty
significant memory impairments,
significant memory impairments,
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07:25
Vinny learned to use the alarm
and reminder function on his iPhone
and reminder function on his iPhone
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维尼在他的iPhone上学会了
使用闹钟和提醒功能。
使用闹钟和提醒功能。
跟踪记录重要的约定，
07:29
to track important appointments,
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07:31
and he keeps a checklist
to break larger tasks
to break larger tasks
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他还做了一份清单，
以把更大的任务
以把更大的任务
变成更小的，可管理的任务。
07:35
into smaller, manageable ones.
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多亏了这样的基本工具，
07:37
And with basic tools
like that under his belt,
like that under his belt,
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维尼已经出狱两年了，
07:40
Vinny's been out of jail for two years,
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九个月内没有犯罪记录，
07:42
clean for nine months,
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最近又开始工作了。
07:44
and recently back to work.
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07:46
(Applause)
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（掌声）
07:53
What's so striking for Vinny
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对于维尼来说，最让人惊叹的是
这是自他15年前受伤以来
07:55
is that this is his first time
off of court supervision
off of court supervision
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首次在脱离庭外监管。
08:00
since his injury more than 15 years ago.
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08:03
He made it out of the revolving door.
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他从司法旋转门中脱身了。
08:07
(Applause)
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（掌声）
08:13
He says now, "I can do anything.
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他现在说，“我能做任何事。
08:18
I just have to work
a lot harder at it." (Laughs)
a lot harder at it." (Laughs)
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我只需要更努力的工作就行了。”
（笑）
（笑）
这是托马斯。
08:22
And here's Thomas.
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08:24
Thomas has some pretty significant
attention and behavior problems
attention and behavior problems
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托马斯自受伤、昏迷了一个多月后，
开始产生一些相当严重的
注意力和行为问题。
注意力和行为问题。
08:28
after an injury landed him in a coma
for more than a month.
for more than a month.
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08:32
After relearning how to walk,
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在重新学会走路之后，
他的第一站？
08:35
his first stop?
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法庭。
08:36
Court.
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他无法想象没有麻烦的未来。
08:37
He couldn't imagine a future
where he wasn't in trouble.
where he wasn't in trouble.
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08:40
He now carries a calendar
to avoid being held in contempt
to avoid being held in contempt
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他现在带着日历
以避免因为缺席庭审
而被判蔑视法庭，
而被判蔑视法庭，
08:44
for missed court dates,
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他每天都安排时间休息，
08:45
and he schedules a break
into his day every day
into his day every day
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使他在焦躁不安前平静下来。
08:48
to recharge before he gets agitated.
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08:53
And nobody knows the revolving door
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没有人更了解旋转门
比坐在法庭最前排的人。
08:55
better than the person sitting
at the front of the courtroom.
at the front of the courtroom.
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这是我的好朋友和同事，
布莱恩·伯恩法官。
布莱恩·伯恩法官。
08:59
This is my good friend and colleague
Judge Brian Bowen.
Judge Brian Bowen.
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09:02
Now, Judge Bowen was already on a mission
to make the system work for everyone,
to make the system work for everyone,
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现在，伯恩法官已经承担起
让司法系统为每个人工作的使命，
让司法系统为每个人工作的使命，
当他听说这个项目时，
他觉得非常合适。
他觉得非常合适。
09:06
and when he heard about this program,
he saw the perfect fit.
he saw the perfect fit.
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09:11
He actually sits down
with all of his prosecutors
with all of his prosecutors
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他和所有的检察官坐在一起，
帮助他们发现
基本上有两类被告人
基本上有两类被告人
09:14
to help them see that there's basically
two categories of defendants
two categories of defendants
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在法庭上：
09:18
in the courtroom:
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我们害怕的那些——
通常，是这样的——
通常，是这样的——
09:20
the ones we're afraid of --
oftentimes, rightfully so --
oftentimes, rightfully so --
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还有那些让我们很抓狂的人。
09:24
and the ones we're mad at.
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09:26
These are the ones who miss
all of their scheduled appointments
all of their scheduled appointments
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他们错过了所有预定的出庭日，
因而搞砸了缓刑计划。
09:29
and they blow through
the best-laid probation plans.
the best-laid probation plans.
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鲍恩法官认为，
如果能得到更多的支持，
如果能得到更多的支持，
09:32
And Judge Bowen believes that,
with a little more support,
with a little more support,
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我们可以调动后一类人，
09:35
we could move people
in this latter category,
in this latter category,
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令人发狂的那类人，
09:37
the maddening category,
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通过，并最终退出司法系统。
09:40
through and ultimately out of the system.
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09:44
He proved that with Navy veteran Mike.
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他与海军老兵迈克证明了这一点。
鲍恩法官看出了以下两者的相关性：
一是迈克曾从70英尺高摔下，
一是迈克曾从70英尺高摔下，
09:48
Judge Bowen saw the correlation between
Mike's history of a massive 70-foot fall
Mike's history of a massive 70-foot fall
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二是他长期以来无法按时
09:54
and his long-standing pattern
of difficulty showing up on the right day
of difficulty showing up on the right day
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出现在庭审上。
09:59
for court appointments
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还有，例如无法遵守
强制性治疗的相关性。
强制性治疗的相关性。
10:00
and complying with mandatory
therapy requirements, for example.
therapy requirements, for example.
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10:04
And instead of sentencing him
to more and more jail time,
to more and more jail time,
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伯恩法官不是判处他
越来越多的监禁，
越来越多的监禁，
而是让他回家，
给予地图、清单和手册，
给予地图、清单和手册，
10:08
Judge Bowen sent him home
with maps and checklists and handouts
with maps and checklists and handouts
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并建议改为职业康复
10:14
and recommended instead
vocational rehabilitation
vocational rehabilitation
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以及灵活的治疗计划。
10:17
and flexible scheduling
for those therapies.
for those therapies.
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10:21
And this with those supports,
Mike's back to work
Mike's back to work
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有了这些支持，
迈克又开始工作了，
迈克又开始工作了，
这是他在服役期间
受伤之后的第一次。
受伤之后的第一次。
10:25
for the first time since his injury
while he was in the service.
while he was in the service.
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他在修复与家人的关系，
10:28
He's repairing relationships
with his family,
with his family,
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就在上个月，
10:31
and just last month,
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他从伯恩法官的老兵法庭“毕业”了。
10:33
he graduated from
Judge Bowen's veteran's court.
Judge Bowen's veteran's court.
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10:37
(Applause)
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（掌声）
10:45
This program shows us
the overwhelming prevalence
the overwhelming prevalence
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这个项目向我们展现了
创伤性脑损伤和认知缺陷无处不在，
10:49
of traumatic brain injuries
and cognitive deficits
and cognitive deficits
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以及刑事司法系统中的种种不足。
10:53
and the accumulation of brokenness
in the criminal justice system.
in the criminal justice system.
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10:58
And it highlights the extraordinary power
of resilience and responsibility.
of resilience and responsibility.
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它强调了非凡的韧性和责任感。
11:04
In Mike and Thomas and Vinny,
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在迈克、托马斯、维尼，
甚至是鲍恩法官的故事中，
11:06
even Judge Bowen's story,
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你们看到了认知改变以及
一些简单的调整
一些简单的调整
11:07
you saw the transformation made possible
by a change in perception
by a change in perception
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所带来的转变。
11:13
and some simple accommodations.
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11:16
All told, in this program,
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总之，在这个项目中，
这些囚犯和缓刑犯
对自己的看法改变了。
对自己的看法改变了。
11:19
these inmates and probationers
come to see themselves differently.
come to see themselves differently.
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11:25
The system sees them differently,
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司法系统对他们的看法改变了，
11:29
and when you meet them in the community,
I hope you see them differently, too.
I hope you see them differently, too.
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当你们在社区里遇到他们时，
我希望你们也能以
不同的方式看待他们。
不同的方式看待他们。
11:35
Thanks, guys.
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谢谢你们。
（掌声）
11:36
(Applause)
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ABOUT THE SPEAKER
Kim Gorgens - NeuropsychologistKim Gorgens studies the brain's response to injury -- and advocates that we mind our (gray) matter.
Why you should listen
As a neuropsychologist working in the field of brain injuries, Kim Gorgens has seen firsthand the damage sports-related impacts can do. And as chair of the State of Colorado Traumatic Brain Injury Trust Fund Board and a member of the Brain Injury Legislative Collaborative, she’s working to shape Colorado law around youth sports injuries.
Gorgens, an assistant clinical professor in the University of Denver Graduate School of Professional Psychology, also is the president-elect of the Colorado Neuropsychological Society and has an appointment to the American Psychological Association’s Council on Disability in Psychology.
Kim Gorgens | Speaker | TED.com