TEDxMileHigh
Kim Gorgens: The surprising connection between brain injuries and crime
金 · 喬吉斯: 腦傷和犯罪間令人訝異的關聯
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這是個令人震驚的統計數據：在美國刑事司法系統中有 50％ 至 80％ 的人患有創傷性腦損傷；而一般人的統計不到 5%。 神經心理學家金 · 喬吉斯研究腦外傷和身陷刑事司法系統中，兩者之間的關聯，並且分享更有效，更安全的方法。
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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創傷性腦損傷
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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是頭受到外擊而引起的腦功能中斷。
00:21
And when you hear that definition,
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你聽到這個定義時可能會聯想到
00:23
you might think about sports
and professional athletes,
and professional athletes,
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運動和職業運動員，
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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因為我們常在賽場上看到這種傷害。
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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這的確是公眾意識中
腦創傷定義的形象。
腦創傷定義的形象。
00:37
I myself do research on TBI
in retired and college athletes.
in retired and college athletes.
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我研究退休和大學運動員的腦創傷。
00:41
I stood on a TED stage in 2010,
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我曾經站在 2010 年的 TED 講台上
00:44
talking about concussions in kids' sports.
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談論兒童運動中的腦震盪。
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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身為研究和治療這些傷害的人，
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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我必須說很高興看到
對腦創傷日益增強的意識，
對腦創傷日益增強的意識，
00:56
and specifically, the short-
and long-term risks to athletes.
and long-term risks to athletes.
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特別是對運動員的短期和長期風險。
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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但是今天我想向各位介紹更大群，
然而爭議性並不亞於先前
受創傷性腦損傷影響的人們，
受創傷性腦損傷影響的人們，
01:07
group of people impacted
by traumatic brain injury,
by traumatic brain injury,
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01:10
who don't often show up in the headlines.
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他們不常出現在頭條新聞中。
01:14
I've come to recognize
these inmates and probationers
these inmates and probationers
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我體認到這些囚犯和緩刑者——
01:17
as surprisingly among the most
vulnerable members of society.
vulnerable members of society.
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出乎意料之外——
是社會上極為脆弱的一群人。
是社會上極為脆弱的一群人。
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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在過去六年中，我和同事
一直在進行的研究
一直在進行的研究
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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徹底改變了我們對刑事司法系統
及置身其中之人的思考方式。
01:30
and the people in it.
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01:32
And it may change the way
you think about those things, too.
you think about those things, too.
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它可能也會改變你對此事的看法。
01:34
So I'll start with a shocking statistic:
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因此，我將從令人震驚的
統計數據開始：
統計數據開始：
01:38
50 to 80 percent of people
in criminal justice
in criminal justice
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有 50％ 至 80％
身陷刑事司法中的人們
身陷刑事司法中的人們
01:43
have a traumatic brain injury.
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患有創傷性腦損傷。
01:45
Up to 80 percent.
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高達 80％。
01:49
In the general public,
in this room, for example,
in this room, for example,
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以這裡的一般大眾中為例，
01:52
that number is less than five percent.
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那數字不到百分之五。
01:56
And I'm not just talking about
getting your bell rung.
getting your bell rung.
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我談的不只是頭部受撞擊，
01:58
These are the kinds of injuries
that require hospitalization.
that require hospitalization.
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而是需要住院治療的外傷。
02:04
Most of them are the product
of a physical assault,
of a physical assault,
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其中大多數是身體受攻擊的結果，
02:07
and some of them
are actually sustained in jail.
are actually sustained in jail.
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當中一些實際發生在監獄裡。
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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對於在刑事司法中的女性而言，
所有這些數字都還要更高。
所有這些數字都還要更高。
幾乎每一位刑事司法系統中的婦女
02:16
Almost every single woman
in the criminal justice system
in the criminal justice system
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都遭受過人際暴力和虐待，
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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其中一半以上曾經多次遭受腦傷。
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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因此，這些女性的大腦看起來像
退役的美式足球聯盟球員的大腦，
退役的美式足球聯盟球員的大腦，
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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而她們可能面臨的失智症風險
隨著年齡的增長而增加。
隨著年齡的增長而增加。
02:45
The same risks.
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同樣的風險。
02:49
TBI, together with mental illness
and substance abuse and trauma,
and substance abuse and trauma,
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腦創傷若與精神疾病、
藥物濫用和創傷交互作用，
藥物濫用和創傷交互作用，
02:54
makes it hard for people to think.
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會使人們難以思考。
02:56
They have cognitive impairments like
poor judgment and poor impulse control,
poor judgment and poor impulse control,
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他們有認知障礙，
像是判斷力差、衝動控制能力差，
像是判斷力差、衝動控制能力差，
03:01
problems that make
criminal justice a revolving door.
criminal justice a revolving door.
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使得刑事司法成為旋轉門。
（註：一再進出法院和監獄）
（註：一再進出法院和監獄）
03:05
People get arrested and booked into jail.
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他們被捕、入獄。
03:08
They oftentimes get into trouble
while they're in there.
while they're in there.
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他們經常在監獄裡遇到麻煩：
03:11
They get into fights.
They fall out of their bunk.
They fall out of their bunk.
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打架、從舖位上摔下來。
03:13
And then they get released
and do stupid things,
and do stupid things,
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他們被釋放後做蠢事，
03:15
like forgetting mandatory check-ins,
and they get rearrested.
and they get rearrested.
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像是忘記強制性的報到，
因此再次被捕。
因此再次被捕。
03:20
Statistically speaking,
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從統計上來說，
03:22
they're actually more likely
to be rearrested than not.
to be rearrested than not.
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實際上他們再次被捕的機率比較高。
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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一位同事稱之為
「服每次 30 天的無期徒刑」。
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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這些人通常不知道為什麼
這些對他們來說這麼困難。
這些對他們來說這麼困難。
03:38
They feel out of control and frustrated.
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他們感到無能為力和沮喪。
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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所以，知道腦創傷是很多
這些挑戰中的根源，
這些挑戰中的根源，
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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在科羅拉多州，我們這群人的使命
就是打破這個循環，
就是打破這個循環，
03:53
to jam the revolving the door.
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卡住旋轉門。
03:56
So working together
with my state and local partners,
with my state and local partners,
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因此，我與本州和當地的合作夥伴
03:59
we crafted a plan
to meet everyone's needs:
to meet everyone's needs:
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一起制定了滿足每個人需求的計劃：
04:03
the system, the inmates and probationers,
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系統、囚犯和緩刑者、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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我們在這個計劃中
評估每個人的大腦如何運作，
評估每個人的大腦如何運作，
04:11
so that we can recommend
basic modifications
basic modifications
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以讓我們推薦基本的修改，
04:14
to make this system more effective
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使這個系統更有效、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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我此處說的「更安全」，
意思是不僅對囚犯更安全，
04:24
but safer also for correctional staff.
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而且對懲教人員也更安全。
04:28
In some ways, this is
such a simple approach.
such a simple approach.
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在某方面，這是種簡單的方法。
04:31
We're not treating the brain injury,
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我們不是在治療腦損傷，
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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而是處理潛在的問題，
這些一開始就讓人
陷入麻煩的所有問題。
陷入麻煩的所有問題。
04:39
in the first place.
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04:41
We do quick neuropsychological
screening tests
screening tests
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我們做快速的神經心理學篩檢，
04:44
to identify strengths and weaknesses
in the way an inmate thinks.
in the way an inmate thinks.
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以確定囚犯思維方式的強項和弱項。
04:49
Using that information,
we write two reports.
we write two reports.
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我們用這資料編寫兩份報告。
04:52
One, a report for the system
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其一報告給司法系統，
04:55
with specific recommendations
on how to manage that inmate.
on how to manage that inmate.
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具體建議如何管理該犯人。
04:59
The other is a letter to the inmate
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另一個則是給囚犯的一封信，
05:02
with specific suggestions
for how to manage themselves.
for how to manage themselves.
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關於囚犯如何自我管理的具體建議。
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，倘若我們的測試結果顯示
緩刑者很難記住他們聽到的事情，
05:12
remembering the things they hear,
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05:14
that would be an auditory memory deficit.
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那可能是聽覺記憶缺陷。
05:16
In that case, our letter
to the court might suggest
to the court might suggest
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在那種情況下，我們
可能會在給法院的信中建議
可能會在給法院的信中建議
05:20
that that probationer get handouts
of important information.
of important information.
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發給緩刑者條列重要訊息的講義。
05:23
And our letter to that probationer
would say, among other things,
would say, among other things,
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而我們給那緩刑者的信則會包括
05:27
that they should carry a notebook
to record that information for themselves.
to record that information for themselves.
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他們應該攜帶一本筆記本
來自我記錄這些訊息。
來自我記錄這些訊息。
05:33
Now, most importantly,
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最重要的是，
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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我在這裡暫停一下，要澄清一點：
05:40
This program does not
minimize responsibility
minimize responsibility
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該計劃不會減少責任，
05:43
or make excuses for anyone's behavior.
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或為任何人的行為找藉口；
05:47
This is about changing longstanding
negative perceptions
negative perceptions
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而是要改變長期的負面看法
05:51
and building self-advocacy.
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和倡導建立自我。
05:54
It's actually about taking responsibility.
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這實際上是承擔責任。
05:57
The inmates move from,
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把囚犯們從
05:58
"I'm a total screwup, I'm a loser,"
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「我全搞砸了」，
「我是個失敗者」，
06:01
to, "Here's what I don't do well,
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「這事我做不來」，
06:04
and here's what I have to do about it."
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轉為「這就是我要做的事」。
06:08
(Applause)
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（掌聲）
06:16
And the system comes to see
an inmate's problematic behavior
an inmate's problematic behavior
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系統會將囚犯的問題行為
06:19
as the things they can't do
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視為他們做不來的事，
06:22
versus the things they won't do.
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而不是他們不肯做的事。
06:25
And that change --
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而這種變化——
06:26
seeing behavior as a deficit
rather than outright defiance --
rather than outright defiance --
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將行為視為缺陷，
而不是徹底蔑視——
而不是徹底蔑視——
06:31
is everything in these settings.
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就是這設計的一切。
06:35
We hear from inmates around the country,
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我們聽到全國各地
囚犯的聲音，他們也寫信，
囚犯的聲音，他們也寫信，
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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更重要的是他們想知道如何自助。
06:43
This is an excerpt from a letter
from Troy in Virginia,
from Troy in Virginia,
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這封信是從維吉尼亞州
特洛伊市寄來的，
特洛伊市寄來的，
06:47
an excerpt from a 50-page letter.
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原信長達 50 頁，這是一段摘錄。
06:49
And he writes,
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他寫道：
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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對於我一直以來對付的所有頭部創傷問題，
06:55
What can I do? Can you help me?"
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你能告訴我你的看法嗎？
我能做些什麼？你能幫我嗎？」
我能做些什麼？你能幫我嗎？」
07:00
Closer to home, we have
thousands of stories like this,
thousands of stories like this,
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言歸正傳，我們有
成千上萬這樣的故事，
成千上萬這樣的故事，
07:03
and smart stories, stories
that have a great outcome.
that have a great outcome.
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以及精彩的故事，有很好結果的故事。
07:08
Here's Vinny.
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這是溫尼。
07:09
Vinny was hit by a car when he was 15,
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溫尼 15 歲時被車撞了，
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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從那一刻起，他在監獄裡
度過的時間比在學校裡多。
度過的時間比在學校裡多。
07:17
With some basic skill-building,
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透過一些基本的技能培訓，
07:20
after our assessment revealed
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那是在我們的評估顯示
07:21
that he had some pretty
significant memory impairments,
significant memory impairments,
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他有些非常顯著的記憶障礙之後，
07:25
Vinny learned to use the alarm
and reminder function on his iPhone
and reminder function on his iPhone
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溫尼學會使用 iPhone 上
鬧鐘的提醒功能
鬧鐘的提醒功能
07:29
to track important appointments,
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來記錄重要的約定；
07:31
and he keeps a checklist
to break larger tasks
to break larger tasks
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他還保留一份清單，
把較大的任務分解成
便於管理的小任務。
便於管理的小任務。
07:35
into smaller, manageable ones.
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07:37
And with basic tools
like that under his belt,
like that under his belt,
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憑藉這樣的基本工具，
07:40
Vinny's been out of jail for two years,
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溫尼已經出獄兩年，
07:42
clean for nine months,
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九個月裡無任何司法紀錄，
07:44
and recently back to work.
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最近重返工作崗位。
07:46
(Applause)
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（掌聲）
07:53
What's so striking for Vinny
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對於溫尼來說，最令人讚嘆的是
07:55
is that this is his first time
off of court supervision
off of court supervision
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這是他自 15 年前受傷以來
08:00
since his injury more than 15 years ago.
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第一次脫離法庭的監護。
08:03
He made it out of the revolving door.
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他從旋轉門脫身而出了。
08:07
(Applause)
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（掌聲）
08:13
He says now, "I can do anything.
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他現在說：「我可以做任何事情。
08:18
I just have to work
a lot harder at it." (Laughs)
a lot harder at it." (Laughs)
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我只需要更加努力地工作。」
（笑聲）
08:22
And here's Thomas.
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這是湯馬斯。
08:24
Thomas has some pretty significant
attention and behavior problems
attention and behavior problems
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湯馬斯受傷和昏迷了一個多月後
08:28
after an injury landed him in a coma
for more than a month.
for more than a month.
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有顯著的注意力和行為問題。
08:32
After relearning how to walk,
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他重新學習如何走路後的
第一站是哪裡？
第一站是哪裡？
08:35
his first stop?
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08:36
Court.
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法庭。
08:37
He couldn't imagine a future
where he wasn't in trouble.
where he wasn't in trouble.
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他無法想像不遇到麻煩的未來。
08:40
He now carries a calendar
to avoid being held in contempt
to avoid being held in contempt
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他現在帶著行事曆，
以免錯過開庭日而被判為蔑視法庭；
08:44
for missed court dates,
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08:45
and he schedules a break
into his day every day
into his day every day
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而且他每天都安排休息時段，
08:48
to recharge before he gets agitated.
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讓他在變得激動之前得以充電。
08:53
And nobody knows the revolving door
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沒有人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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更了解旋轉門。
08:59
This is my good friend and colleague
Judge Brian Bowen.
Judge Brian Bowen.
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這是我的好朋友和同事
布萊恩 · 鮑文法官。
布萊恩 · 鮑文法官。
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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鮑文法官原已承擔起
讓司法系統適用於每個人的使命。
讓司法系統適用於每個人的使命。
09:06
and when he heard about this program,
he saw the perfect fit.
he saw the perfect fit.
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獲知這個計畫時，
他看到完美的契合。
他看到完美的契合。
09:11
He actually sits down
with all of his prosecutors
with all of his prosecutors
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他真和所有的檢察官坐下來，
09:14
to help them see that there's basically
two categories of defendants
two categories of defendants
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幫助他們看見在法庭中
被告的兩種基本類型：
被告的兩種基本類型：
09:18
in the courtroom:
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09:20
the ones we're afraid of --
oftentimes, rightfully so --
oftentimes, rightfully so --
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讓我們害怕的——通常理所當然——
09:24
and the ones we're mad at.
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以及那些讓我們抓狂的。
09:26
These are the ones who miss
all of their scheduled appointments
all of their scheduled appointments
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這些人錯過了所有預定出庭日，
09:29
and they blow through
the best-laid probation plans.
the best-laid probation plans.
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因而緩刑計劃告吹了。
09:32
And Judge Bowen believes that,
with a little more support,
with a little more support,
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鮑文法官認為，透過少許支持，
09:35
we could move people
in this latter category,
in this latter category,
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我們可以讓後者，
09:37
the maddening category,
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也就是令人抓狂的那一類人，
09:40
through and ultimately out of the system.
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通過，並且最終退出司法系統。
09:44
He proved that with Navy veteran Mike.
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他與退役的海軍邁克證明了這一點。
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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鮑文法官看到邁克過去
自 70 英尺高處墜落，
自 70 英尺高處墜落，
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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與他長期無法正確地在出庭日出現
及遵守強制性治療的要求，
09:59
for court appointments
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10:00
and complying with mandatory
therapy requirements, for example.
therapy requirements, for example.
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兩者之間的相關性。
10:04
And instead of sentencing him
to more and more jail time,
to more and more jail time,
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鮑文法官沒有判處他
越來越長的刑期，
越來越長的刑期，
10:08
Judge Bowen sent him home
with maps and checklists and handouts
with maps and checklists and handouts
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而是讓他回家，
提供地圖、清單和講義，
提供地圖、清單和講義，
10:14
and recommended instead
vocational rehabilitation
vocational rehabilitation
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並建議改為職業康復治療
10:17
and flexible scheduling
for those therapies.
for those therapies.
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和靈活調度那些療程。
10:21
And this with those supports,
Mike's back to work
Mike's back to work
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在這些支持下，
邁克自從受傷以來
第一次重返工作崗位。
第一次重返工作崗位。
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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10:28
He's repairing relationships
with his family,
with his family,
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他正在修復與家人的關係。
10:31
and just last month,
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就在上個月，
10:33
he graduated from
Judge Bowen's veteran's court.
Judge Bowen's veteran's court.
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他自鮑文法官的軍事法庭畢業了。
10:37
(Applause)
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（掌聲）
10:45
This program shows us
the overwhelming prevalence
the overwhelming prevalence
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這計劃向我們展現
創傷性腦損傷和認知缺陷的盛行，
10:49
of traumatic brain injuries
and cognitive deficits
and cognitive deficits
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10:53
and the accumulation of brokenness
in the criminal justice system.
in the criminal justice system.
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以及殘破積累的刑事司法系統。
10:58
And it highlights the extraordinary power
of resilience and responsibility.
of resilience and responsibility.
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它突顯彈性和責任的非凡力量。
11:04
In Mike and Thomas and Vinny,
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在邁克、湯馬斯和溫尼，
11:06
even Judge Bowen's story,
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甚至鮑文法官的故事裡，
11:07
you saw the transformation made possible
by a change in perception
by a change in perception
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你們看到了透過改變感知
和一些簡單的調整來實現轉變。
11:13
and some simple accommodations.
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11:16
All told, in this program,
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總而言之，在這個計劃中，
11:19
these inmates and probationers
come to see themselves differently.
come to see themselves differently.
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這些囚犯和緩刑者
以不同的方式看待自己。
以不同的方式看待自己。
11:25
The system sees them differently,
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系統以不同的方式看待他們。
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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當你們在社區中遇到他們時，
我希望你們也以不同的方式看待他們。
11:35
Thanks, guys.
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多謝各位。
11:36
(Applause)
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（掌聲）
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