TED2019
Rick Doblin: The future of psychedelic-assisted psychotherapy
瑞克•杜布林: 用迷幻藥協助心理治療的未來
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迷幻藥能否協助我們從創傷和心理疾病中治癒？研究者瑞克•杜布林花了三十年的時間去研究這個問題，結果前景看好。這場迷人的演說中，他深入探究了迷幻藥的科學，並解釋像 LSD、賽洛西賓、MDMA 這類藥物如何影響人的大腦，並說明它們搭配心理治療能改變我們治療創傷後壓力症候群、憂鬱症、藥物濫用等問題的方式。
Rick Doblin - Psychedelics researcher
As the founder of the Multidisciplinary Association for Psychedelic Studies, Rick Doblin crusades for the safe and legal use of psychedelics in therapy. Full bio
As the founder of the Multidisciplinary Association for Psychedelic Studies, Rick Doblin crusades for the safe and legal use of psychedelics in therapy. Full bio
Double-click the English transcript below to play the video.
對我來說，準備這次演講
00:13
Preparing for this talk
has been scarier for me
has been scarier for me
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比準備用 LSD 迷幻藥治療還要可怕。
00:16
than preparing for LSD therapy.
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00:19
(Laughter)
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（笑聲）
00:21
"Psychedelics are to the study of the mind
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「迷幻藥之於大腦相關研究，
00:24
what the microscope is to biology
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就如同顯微鏡之於生物學，
00:27
and the telescope is to astronomy."
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以及天文望遠鏡之於天文學。」
00:30
Dr. Stanislav Grof spoke those words.
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這段話出自
斯坦尼斯拉夫•格羅夫博士。
斯坦尼斯拉夫•格羅夫博士。
00:33
He's one of the leading
psychedelic researchers in the world,
psychedelic researchers in the world,
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他是全世界最出色的
迷幻藥研究者之一，
迷幻藥研究者之一，
00:36
and he's also been my mentor.
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他也是我的導師。
00:38
Today, I'd like to share with you
how psychedelics, when used wisely,
how psychedelics, when used wisely,
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今天，我想與大家分享，
如果明智地使用迷幻藥，
如果明智地使用迷幻藥，
00:43
have the potential to help heal us,
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它有什麼樣的潛能
來協助治癒我們，
來協助治癒我們，
00:46
help inspire us,
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協助鼓舞我們，
00:48
and perhaps even to help save us.
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甚至也許還能協助拯救我們。
00:51
In the 1950s and 60s,
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在五〇、六〇年代，
00:53
psychedelic research flourished
all over the world
all over the world
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迷幻藥研究在全世界興起，
00:56
and showed great promise
for the fields of psychiatry,
for the fields of psychiatry,
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在幾個領域展現出很好的前景，
包括精神病學、心理學與心理治療、
00:59
psychology and psychotherapy,
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01:01
neuroscience and the study
of mystical experiences.
of mystical experiences.
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神經科學，與神秘體驗的研究。
01:05
But psychedelics leaked out
of the research settings
of the research settings
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但是迷幻藥流出了研究環境，
01:08
and began to be used
by the counterculture,
by the counterculture,
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開始被用在反文化
01:11
and by the anti-Vietnam War movement.
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以及反越戰的運動中。
01:14
And there was unwise use.
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有些用法很不明智。
01:16
And so there was a backlash.
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所以受到強烈反對。
01:18
And in 1970, the US government
criminalized all uses of psychedelics,
criminalized all uses of psychedelics,
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七〇年代，美國政府將迷幻藥的
各種使用方式都視為犯罪，
各種使用方式都視為犯罪，
01:23
and they began shutting down
all psychedelic research.
all psychedelic research.
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他們開始終止所有迷幻藥研究。
01:27
And this ban spread all over the world
and lasted for decades.
and lasted for decades.
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這個趨勢開始散播到
全世界，持續了數十年，
全世界，持續了數十年，
01:30
and it was tragic,
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這是一齣悲劇，
01:32
since psychedelics are really just tools,
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因為迷幻藥其實只是工具，
01:34
and whether their outcomes
are beneficial or harmful
are beneficial or harmful
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使用迷幻藥的結果是有益還是有害，
01:37
depends on how they're used.
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取決於如何使用它們。
01:40
Psychedelic means "mind-manifesting,"
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「迷幻」意思是「心靈呈現」，
01:46
and it relates to drugs
like LSD, psilocybin, mescaline,
like LSD, psilocybin, mescaline,
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相關的藥物有 LSD、賽洛西賓、
麥司卡林（仙人掌毒鹼）、
麥司卡林（仙人掌毒鹼）、
01:54
iboga and other drugs.
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伊玻加等等。
01:57
When I was 18 years old,
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當我十八歲時，
01:59
I was a college freshman,
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我還是大學新鮮人，
02:02
I was experimenting
with LSD and mescaline,
with LSD and mescaline,
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我試用了 LSD 和麥司卡林，
02:05
and these experiences
brought me in touch with my emotions.
brought me in touch with my emotions.
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讓我觸及到我的情緒，
02:09
And they helped me have
a spiritual connection
a spiritual connection
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協助我建立靈性的連結；
02:12
that unfortunately,
my bar mitzvah did not produce.
my bar mitzvah did not produce.
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很不幸，我的成年禮
並沒有產生這種連結。
並沒有產生這種連結。
02:16
(Laughter)
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（笑聲）
02:18
When I wanted to tease my parents,
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當我想要捉弄我父母時，
02:20
I would tell them
that they drove me to psychedelics
that they drove me to psychedelics
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我就會告訴他們，
是他們驅使我去使用迷幻藥，
是他們驅使我去使用迷幻藥，
02:23
because my bar mitzvah had failed
to turn me into a man.
to turn me into a man.
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因為我的成年禮沒能
把我變成一個男人。
把我變成一個男人。
02:27
(Laughter)
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（笑聲）
但，最重要的是，
02:29
But most importantly,
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02:31
psychedelics gave me this feeling
of our shared humanity,
of our shared humanity,
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迷幻藥讓我感覺到
我們共有的人性、
我們共有的人性、
02:34
of our unity with all life.
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我們和所有生命的合一。
02:37
And other people reported
that same thing as well.
that same thing as well.
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其他使用者也描述了同樣的感受。
02:39
And I felt that these experiences
had the potential
had the potential
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我覺得這些經歷有潛力
02:43
to help be an antidote
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可以成為解藥，
02:46
to tribalism, to fundamentalism,
to genocide and environmental destruction.
to genocide and environmental destruction.
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協助對抗部落主義、基要主義、
大屠殺，以及環境破壞。
大屠殺，以及環境破壞。
02:51
And so I decided to focus my life
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所以我決定要專注投入心力，
02:54
on changing the laws
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來改變法律，
02:56
and becoming a legal
psychedelic psychotherapist.
psychedelic psychotherapist.
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並成為合法的迷幻藥心理治療師。
03:00
(Applause)
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（掌聲）
03:04
Now, half a century after the ban,
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至今，迷幻藥已經被禁了半個世紀，
03:06
we're in the midst of a global renaissance
of psychedelic research.
of psychedelic research.
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我們正處在迷幻藥
研究的全球復興當中。
研究的全球復興當中。
03:10
Psychedelic psychotherapy
is showing great promise
is showing great promise
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迷幻藥心理治療
展現出很好的前景，
展現出很好的前景，
03:13
for the treatment of post-traumatic
stress disorder, or PTSD,
stress disorder, or PTSD,
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可以治療創傷後壓力症候群、
03:18
depression, social anxiety,
substance abuse and alcoholism
substance abuse and alcoholism
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憂鬱症、社交焦慮症、
藥物濫用、酗酒，
藥物濫用、酗酒，
03:24
and suicide.
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及自殺。
03:25
Psychedelic psychotherapy is an attempt
to go after the root causes
to go after the root causes
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迷幻藥心理治療是在嘗試
找出問題的根本成因，
03:29
of the problems,
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相對不需要很多用藥，
03:30
with just relatively few administrations,
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03:33
as contrasted to most
of the psychiatric drugs used today
of the psychiatric drugs used today
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相對之下，現今所使用的
大部分精神藥物
大部分精神藥物
03:37
that are mostly just reducing symptoms
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多半只是在減輕症狀，
03:40
and are meant to be taken
on a daily basis.
on a daily basis.
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且需要每天服用。
03:45
Psychedelics are now also being used
as tools for neuroscience
as tools for neuroscience
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現今，迷幻藥也被當作
神經科學的工具來使用，
神經科學的工具來使用，
03:49
to study brain function
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可以研究腦部功能，
03:50
and to study the enduring mystery
of human consciousness.
of human consciousness.
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及研究長久以來的謎：人類意識。
03:55
And psychedelics and the mystical
experiences they produce
experiences they produce
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針對迷幻藥以及它們
所產生出來的神秘體驗，
所產生出來的神秘體驗，
03:58
are being explored for their connections
between meditation and mindfulness,
between meditation and mindfulness,
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現在有研究在探究它們
與冥想及正念之間的關聯，
與冥想及正念之間的關聯，
04:02
including a paper just recently published
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包括有一篇近期發表的研究，
04:04
about lifelong zen meditators
taking psilocybin
taking psilocybin
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談到一生都在進行禪修的冥想者，
在冥想修行期間服用賽洛西賓，
04:08
in the midst of a meditation retreat
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04:10
and showing long-term benefits
and brain changes.
and brain changes.
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並展現出長期的益處與腦部改變。
04:15
Now, how do these drugs work?
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迷幻藥是怎麼運作的？
04:17
Modern neuroscience research
has demonstrated
has demonstrated
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現代的神經科學研究指出，
04:19
that psychedelics reduce activity
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迷幻藥會降低所謂
04:22
in what's known as the brain's
default mode network.
default mode network.
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腦部預設模式網路中的活動。
04:24
This is where we create our sense of self.
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我們的自我意識
就是在這裡形成的。
就是在這裡形成的。
04:28
It's our equivalent to the ego,
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自我意識也就同等於自我，
04:30
and it filters all incoming information
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它會過濾所有接收到的資訊，
04:32
according to our personal
needs and priorities.
needs and priorities.
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過濾的依據是我們個人的需求
及重視的優先順序。
及重視的優先順序。
04:36
When activity is reduced
in the default mode network,
in the default mode network,
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當預設模式網路中的活動下降時，
04:39
our ego shifts from the foreground
to the background,
to the background,
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我們的自我就會
從前景轉移到背景，
從前景轉移到背景，
04:44
and we see that it's just part
of a larger field of awareness.
of a larger field of awareness.
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它其實只是更大的
知覺領域中的一部分。
知覺領域中的一部分。
04:49
It's similar to the shift
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哥白尼和伽利略也對人類
造成了類似的轉變，
造成了類似的轉變，
04:51
that Copernicus and Galileo were
able to produce in humanity
able to produce in humanity
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04:54
using the telescope
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他們用望遠鏡展示出
04:55
to show that the earth was no
longer the center of the universe,
longer the center of the universe,
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地球並不是宇宙的中心，
05:00
but was actually something
that revolved around the sun,
that revolved around the sun,
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只是繞著比地球還大的太陽
05:03
something bigger than itself.
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在做旋轉。
05:06
For some people, this shift in awareness
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對某些人而言，這種知覺的轉變
05:09
is the most important
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是最重要的，
05:11
and among the most important
experiences of their lives.
experiences of their lives.
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且是他們人生中
最重要的經歷之一。
最重要的經歷之一。
05:14
They feel more connected
to the world bigger than themselves.
to the world bigger than themselves.
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他們感覺和比他們自身
更大的世界有所連結。
更大的世界有所連結。
05:18
They feel more altruistic,
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他們感覺更無私，
05:20
and they lose some of their fear of death.
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且他們會失去一些對死亡的恐懼。
並非所有藥物都有這種效果。
05:24
Not all drugs work this way.
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05:26
MDMA, also known as Ecstasy, or Molly,
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MDMA，也就是快樂丸，或稱衣服，
根本的運作方式就不同。
05:30
works fundamentally different.
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05:31
And I'll be able to share with you
the story of Marcela,
the story of Marcela,
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我想和大家分享一個
關於瑪賽拉的故事，
關於瑪賽拉的故事，
05:34
who suffered from
post-traumatic stress disorder
post-traumatic stress disorder
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她在受到一次暴力的性侵之後，
05:37
from a violent sexual assault.
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得了創傷後壓力症候群。
05:40
Marcela and I were introduced in 1984,
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瑪賽拉和我在 1984 年認識，
05:44
when MDMA was still legal,
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當時 MDMA 還是合法的，
05:46
but it was beginning also
to leak out of therapeutic circles.
to leak out of therapeutic circles.
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但它也開始流出治療圈。
05:50
Marcela had tried MDMA
in a recreational setting,
in a recreational setting,
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瑪賽拉曾經在玩樂的時候試過 MDMA，
05:54
and during that, her past trauma
flooded her awareness
flooded her awareness
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在那過程中，她過去的創傷
灌滿了她的知覺，
灌滿了她的知覺，
05:58
and it intensified her suicidal feelings.
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強化了她想要自殺的感受。
06:03
During our first conversation,
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在我們第一次的對話中，
06:04
I shared that when MDMA
is taken therapeutically,
is taken therapeutically,
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我提到如果在治療上使用 MDMA，
06:08
it can reduce the fear
of difficult emotions,
of difficult emotions,
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可以減輕難熬情緒的恐懼，
06:12
and she could help move forward
past her trauma.
past her trauma.
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她就可以試著向前走，脫離創傷。
06:15
I asked her to promise
not to commit suicide
not to commit suicide
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我請她保證不要自殺，
06:19
if we were to work together.
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這樣我們才能合作。
06:21
She agreed and made that promise.
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她同意了，也做出了保證。
06:25
During her therapeutic sessions,
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在治療療程中，
06:27
Marcela was able to process
her trauma more fluidly, more easily.
her trauma more fluidly, more easily.
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瑪賽拉可以更順利、
更輕鬆地處理她的創傷。
更輕鬆地處理她的創傷。
06:33
And yet, she was able to tell
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而且她能夠說出
06:36
that the rapist had told her
that if she ever shared her story,
that if she ever shared her story,
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強暴犯告訴過她，
如果她把這件事說出來，
如果她把這件事說出來，
06:40
he would kill her.
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他就會殺了她。
06:41
And she realized that that was
keeping her a prisoner in her own mind.
keeping her a prisoner in her own mind.
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她了解到，就是這一點
讓她一直被困在自己的腦中。
讓她一直被困在自己的腦中。
06:46
So being able to share the story
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所以，能夠分享這個故事，
06:48
and experience the feelings
and the thoughts in her mind
and the thoughts in her mind
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並體驗到她腦中的感受和想法，
06:53
freed her,
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讓她獲得解放，
06:54
and she was able to decide
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她才能夠決定
06:55
that she wanted
to move forward with her life.
to move forward with her life.
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她想要繼續走下去，好好過人生。
06:58
And in that moment,
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在那一刻，
06:59
I realized that MDMA could be very
effective for treating PTSD.
effective for treating PTSD.
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我了解到 MDMA 在治療
創傷後壓力症候群上非常有效。
創傷後壓力症候群上非常有效。
07:04
Now, 35 years later,
after Marcela's treatment,
after Marcela's treatment,
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瑪賽拉的治療是三十五年前的事，
07:08
she's actually a therapist,
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現在她自己也是位治療師，
07:11
training other therapists to help people
overcome PTSD with MDMA.
overcome PTSD with MDMA.
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訓練其他治療師用 MDMA幫助
患有創傷後壓力症候群的病人。
患有創傷後壓力症候群的病人。
07:17
Now, how does MDMA work?
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MDMA 是怎麼運作的？
07:20
How did MDMA help Marcela?
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MDMA 是怎麼協助瑪賽拉的？
07:22
People who have PTSD
have brains that are different
have brains that are different
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創傷後壓力症候群病人的大腦
07:25
from those of us who don't have PTSD.
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和沒有創傷後壓力症候群的人不同。
07:28
They have a hyperactive amygdala,
where we process fear.
where we process fear.
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他們用來處理恐懼的杏仁核
有活動過度的現象。
有活動過度的現象。
07:31
They have reduced activity
in the prefrontal cortex,
in the prefrontal cortex,
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他們用來做邏輯
思考的前額葉皮質，
思考的前額葉皮質，
07:35
where we think logically.
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有活動降低的現象。
07:37
And they have reduced activity
in the hippocampus,
in the hippocampus,
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他們用來將記憶做
長期儲存的海馬迴，
長期儲存的海馬迴，
07:39
where we store memories
into long-term storage.
into long-term storage.
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有活動下降的現象。
07:43
MDMA changes the brain
in the opposite way.
in the opposite way.
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MDMA 會讓大腦發生
和上述相反的改變。
和上述相反的改變。
07:47
MDMA reduces activity in the amygdala,
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MDMA 會降低杏仁核的活動，
07:50
increases activity
in the prefrontal cortex
in the prefrontal cortex
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增加前額葉皮質的活動，
07:53
and increases connectivity
between the amygdala and the hippocampus
between the amygdala and the hippocampus
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以及增加杏仁核
和海馬迴之間的連結，
和海馬迴之間的連結，
07:57
to remit traumatic memories
to move into long-term storage.
to move into long-term storage.
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讓創傷記憶比較不會
被移入長期儲存區。
被移入長期儲存區。
08:01
Recently, researchers at Johns Hopkins
published a paper in "Nature,"
published a paper in "Nature,"
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最近，約翰霍普金斯大學的研究員
在《自然》期刊中登了一篇論文，
在《自然》期刊中登了一篇論文，
08:06
in which they demonstrated
that MDMA releases oxytocin,
that MDMA releases oxytocin,
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在文中，他們說明
MDMA 會釋放催產素，
MDMA 會釋放催產素，
08:09
the hormone of love and nurturing.
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一種與愛及養育相關的荷爾蒙。
08:12
The same researchers
also did studies in octopuses,
also did studies in octopuses,
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這些研究者也做了
關於章魚的研究，
關於章魚的研究，
08:15
who are normally asocial,
unless it's mating season.
unless it's mating season.
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一般來說，章魚在交配季
以外的時間是不社交的。
以外的時間是不社交的。
08:20
But lo and behold, you give them MDMA,
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但，看哪！給牠們 MDMA 之後，
08:22
and they become prosocial.
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牠們變得很喜愛社交。
08:24
(Laughter)
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（笑聲）
08:27
Several months after
Marcela and I worked together,
Marcela and I worked together,
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在瑪賽拉跟我合作的幾個月後，
08:30
the Drug Enforcement Administration
moved to criminalize Ecstasy,
moved to criminalize Ecstasy,
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美國緝毒局將使用快樂丸視為犯罪，
08:34
having no knowledge
of its therapeutic use.
of its therapeutic use.
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完全不知道它的治療用途。
08:37
So I went to Washington,
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所以，我前往華盛頓，
08:39
and I went into the headquarters
of the Drug Enforcement Administration,
of the Drug Enforcement Administration,
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我到了美國緝毒局的總部，
08:42
and I filed a lawsuit demanding a hearing,
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我提出告訴，要求開聽證會，
08:45
at which psychiatrists
and psychotherapists
and psychotherapists
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在聽證會上，精神病學家
以及心理治療師
以及心理治療師
08:48
would be able to present information
about therapeutic use of MDMA
about therapeutic use of MDMA
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就可以提出資訊，說明
MDMA 在治療上的用途，
MDMA 在治療上的用途，
08:51
to try to keep it legal.
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讓它繼續合法。
08:54
And in the middle of the hearing,
the DEA freaked out,
the DEA freaked out,
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在聽證會過程中，
藥品管理局失控了，
藥品管理局失控了，
08:56
declared an emergency
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宣佈緊急狀況，
08:59
and criminalized all uses of MDMA.
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將所有的 MDMA 使用都視為犯罪。
09:02
And so the only way
that I could see to bring it back
that I could see to bring it back
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我能想出唯一的反轉方式，
09:05
was through science, through medicine
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就是透過科學、透過醫學，
09:07
and through the FDA
drug development process.
drug development process.
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及透過食品及藥物管理局的
藥物開發流程。
藥物開發流程。
09:10
So in 1986, I started MAPS
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所以，1986 年，我創立了 MAPS，
09:13
as a nonprofit psychedelic
pharmaceutical company.
pharmaceutical company.
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它是一間非營利的迷幻藥公司。
09:17
It took us 30 years, till 2016,
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我們花了三十年，直到 2016 年，
09:20
to develop the data that we needed
to present to FDA
to present to FDA
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才擁有我們所需要的資料，
可以提交給食品及藥物管理局，
可以提交給食品及藥物管理局，
09:24
to request permission to move
into the large-scale Phase 3 studies
into the large-scale Phase 3 studies
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以取得許可，開始進行
大規模的第三階段研究，
大規模的第三階段研究，
09:28
that are required to prove
safety and efficacy
safety and efficacy
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完成這個階段才能證明
藥物的安全性和效力，
藥物的安全性和效力，
09:31
before you get approval
for prescription use.
for prescription use.
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然後才能取得核准，
做為處方藥來使用。
做為處方藥來使用。
09:34
Tony was a veteran
in one of our pilot studies.
in one of our pilot studies.
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東尼是我們前導研究中的退伍軍人。
09:38
According to the Veterans Administration,
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根據退伍軍人事務部，
09:41
there's over a million veterans now
disabled with PTSD.
disabled with PTSD.
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現有超過一百萬名退伍軍人
都有創傷後壓力症候群。
都有創傷後壓力症候群。
09:44
And at least 20 veterans a day
are committing suicide,
are committing suicide,
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每天至少有二十名退伍軍人自殺，
09:48
many of them from PTSD.
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當中有許多都是因為
創傷後壓力症候群。
創傷後壓力症候群。
09:51
The treatment that Tony was to receive
was three and a half months long.
was three and a half months long.
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東尼要接受三個半月的治療。
09:56
But during that period of time,
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但在那期間，
09:57
he would only get MDMA on three occasions,
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他只被給予三次 MDMA ，
10:00
separated by 12, 90-minute
non-drug psychotherapy sessions,
non-drug psychotherapy sessions,
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分散在十二次各為九十分鐘的
非藥物心理治療療程之間，
非藥物心理治療療程之間，
10:04
three before the first
MDMA session for preparation
MDMA session for preparation
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在第一次給予 MDMA 之前
有三次心理預備療程，
有三次心理預備療程，
10:07
and three after each
MDMA session for integration.
MDMA session for integration.
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每一次用了 MDMA 之後
有三次心理整合療程。
有三次心理整合療程。
10:11
We call our treatment approach
"inner-directed therapy,"
"inner-directed therapy,"
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我們將此治療方式
稱為「內在導向治療」，
稱為「內在導向治療」，
10:15
in that we support the patient
to experience whatever's emerging
to experience whatever's emerging
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在這種治療中，不論病人的
腦中或身體中出現什麼變化，
腦中或身體中出現什麼變化，
10:19
within their minds or their bodies.
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我們都會支持他們去體驗。
10:23
Even with MDMA, this is hard work.
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即使有 MDMA，這工作也不容易。
10:26
And a lot of our subjects have said,
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許多我們的病人都說過：
10:28
"I don't know why they call this Ecstasy."
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「我不知道為什麼
這會被稱為快樂丸。」
這會被稱為快樂丸。」
10:30
(Laughter)
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（笑聲）
10:32
During Tony's first MDMA session,
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在東尼的第一次 MDMA 療程中，
10:34
he lay on the couch, he had eyeshades on,
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他躺在沙發上，戴上了眼罩，
10:37
he listened to music,
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他聽著音樂，
10:39
and he would speak to the therapists,
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跟一男一女組成的治療師團隊說話，
10:41
who were a male-female co-therapy team,
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10:43
whenever he felt that he needed to.
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只要他覺得他需要說什麼就可以說。
10:46
After several hours,
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在幾個小時後，
10:47
in a moment of calmness and clarity,
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在一個平靜、清澈的時刻，
10:50
Tony shared that he had realized
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東尼分享說，他了解到，
10:54
his PTSD was a way
of connecting him to his friends.
of connecting him to his friends.
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他的創傷後壓力症候群是
他用來和他的朋友連結的方式。
他用來和他的朋友連結的方式。
10:59
It was a way of honoring the memory
of his friends who had died.
of his friends who had died.
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用這種方式，他可以
向死去朋友的記憶致敬。
向死去朋友的記憶致敬。
11:04
But he was able to shift and see himself
through the eyes of his dead friends.
through the eyes of his dead friends.
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但他能做出轉換，透過他
已故朋友的雙眼來看他自己。
已故朋友的雙眼來看他自己。
11:08
And he realized that they
would not want him to suffer,
would not want him to suffer,
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他了解到，他們不會希望他
受苦、浪費他的人生。
受苦、浪費他的人生。
11:11
to squander his life.
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11:12
They would want him to live more fully,
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他們會希望他全心過生活，
這是他們無法做到的。
這是他們無法做到的。
11:14
which they were unable to do.
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11:16
And so he realized that there was
a new way to honor their memory,
a new way to honor their memory,
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所以，他了解到，可以用
其他方式來向那些記憶致敬，
其他方式來向那些記憶致敬，
11:20
which was to live as fully as possible.
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那就是盡可能好好過日子。
11:23
He also realized that
he was telling himself a story
he was telling himself a story
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他也了解到，他一直在說服自己，
11:26
that he was taking opiates for pain.
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說他吃鴉片劑是為了止痛。
11:29
But actually, he realized,
he was taking them for escape.
he was taking them for escape.
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事實上，他了解到，
他吃鴉片劑是為了逃離。
他吃鴉片劑是為了逃離。
11:32
So he decided he didn't need
the opiates anymore,
the opiates anymore,
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所以，他下定決定，
他不再需要鴉片劑了，
他不再需要鴉片劑了，
11:35
he didn't need the MDMA anymore,
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他不再需要 MDMA 了，
11:37
and he was dropping out of the study.
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他從研究中退出。
11:39
That was seven years ago.
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那是七年前的事。
11:41
Tony is still free of PTSD,
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至今東尼仍未再患
創傷後壓力症候群，
創傷後壓力症候群，
11:43
has never returned to opiates
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且沒有再服用鴉片劑，
11:46
and is helping others less fortunate
than himself in Cambodia.
than himself in Cambodia.
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他還在柬埔寨協助其他
沒有像他這麼幸運的人。
沒有像他這麼幸運的人。
11:50
(Applause)
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（掌聲）
11:55
The data that we presented to FDA
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我們提交給食品及藥物管理局的資料，
11:58
from 107 people in our pilot
studies, including Tony,
studies, including Tony,
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來自前導研究的 107 位
受試者，包括東尼，
受試者，包括東尼，
12:01
showed that 23 percent of the people
that received therapy without active MDMA
that received therapy without active MDMA
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資料顯示， 23% 接受
非活性 MDMA 治療的受試者，
非活性 MDMA 治療的受試者，
12:07
no longer had PTSD
at the end of treatment.
at the end of treatment.
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在治療尾聲時已不再有
創傷後壓力症候群。
創傷後壓力症候群。
12:10
This is really pretty good
for this patient population.
for this patient population.
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這方式對於這類病人
是真的很不錯。
是真的很不錯。
12:13
However, when you add MDMA,
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然而，當加上了 MDMA，
12:15
the results more than double,
to 56 percent no longer having PTSD.
to 56 percent no longer having PTSD.
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結果超過兩倍，56% 的受試者
不再有創傷後壓力症候群。
不再有創傷後壓力症候群。
12:21
(Applause)
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（掌聲）
12:24
But most importantly,
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但最重要的是，
12:25
once people learn that if they don't need
to suppress their trauma,
to suppress their trauma,
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一旦病人了解到他們
不需要壓抑他們的創傷，
不需要壓抑他們的創傷，
12:29
but they can process it,
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他們可以處理創傷，
12:30
they keep getting better on their own.
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之後他們就會靠自己變得更好。
12:32
So at the 12-month follow-up
one year after the last treatment session,
one year after the last treatment session,
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所以，最後一次治療結束後一年的
十二個月追蹤資料顯示，
十二個月追蹤資料顯示，
12:36
two-thirds no longer have PTSD.
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三分之二的受試者不再有
創傷後壓力症候群。
創傷後壓力症候群。
12:39
And of the one-third that do,
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至於剩下的三分之一受試者，
12:41
many have clinically significant
reductions in symptoms.
reductions in symptoms.
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有許多人的症狀
在臨床也有顯著減輕。
在臨床也有顯著減輕。
12:45
(Applause)
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（掌聲）
12:49
On the basis of this data,
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根據這些資料，
12:51
the FDA has declared MDMA-assisted
psychotherapy for PTSD
psychotherapy for PTSD
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食品及藥物管理局宣佈由 MDMA
輔助的創傷後壓力症候群心理治療
輔助的創傷後壓力症候群心理治療
12:55
a breakthrough therapy.
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是一項突破性治療。
12:57
FDA has also declared psilocybin
a breakthrough therapy
a breakthrough therapy
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食品及藥物管理局也宣佈
用賽洛西賓是一項突破性治療，
用賽洛西賓是一項突破性治療，
13:01
for treatment-resistant depression
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可用於難治型憂鬱症，
13:03
and just recently approved
esketamine for depression.
esketamine for depression.
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3603
且最近核准使用
氯胺酮（K他命）治療憂鬱症。
氯胺酮（K他命）治療憂鬱症。
13:08
I'm proud to say that we have now
initiated our Phase 3 studies.
initiated our Phase 3 studies.
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我能很自豪地說，我們已經
啟動了第三階段的研究。
啟動了第三階段的研究。
13:14
And if the results are as we hope,
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如果結果如我們預期，
13:17
and if they're similar
to the Phase 2 studies,
to the Phase 2 studies,
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如果結果和第二階段差不多，
13:19
by the end of 2021, FDA will approve
MDMA-assisted psychotherapy for PTSD.
MDMA-assisted psychotherapy for PTSD.
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到了 2021 年末，
食品及藥物管理局就會
食品及藥物管理局就會
核准使用 MDMA 輔助心理治療
來治療創傷後壓力症候群。
來治療創傷後壓力症候群。
13:25
If approved,
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如果核准了，
13:27
the only therapists who will be able
to directly administer it to patients
to directly administer it to patients
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唯一能夠直接提供
這項治療給病人的治療師
這項治療給病人的治療師
13:31
are going to be therapists that
have been through our training program,
have been through our training program,
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就是通過我們訓練方案的治療師，
13:34
and they will only be able
to administer MDMA
to administer MDMA
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且他們只能夠在臨床環境中的
13:36
under direct supervision
in clinic settings.
in clinic settings.
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直接監控之下提供 MDMA。
13:41
We anticipate that over
the next several decades,
the next several decades,
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我們預期，在接下來幾十年，
13:45
there will be thousands
of psychedelic clinics established,
of psychedelic clinics established,
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會開設數千家迷幻藥診所，
13:48
at which, therapists will be able
to administer MDMA,
to administer MDMA,
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在這些診所中，
治療師可以提供 MDMA、
治療師可以提供 MDMA、
13:52
psilocybin, ketamine
and other psychedelics
and other psychedelics
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賽洛西賓、K 他命，及其他迷幻藥
13:55
to potentially millions of patients.
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給也許數百萬名病人。
13:58
These clinics can also evolve
into centers where people can come
into centers where people can come
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這些診所也可以再演化成
治療中心，病人可以前往這些地方
治療中心，病人可以前往這些地方
14:03
for psychedelic psychotherapy
for personal growth,
for personal growth,
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接受迷幻藥心理治療，
目的可以是個人成長、
目的可以是個人成長、
14:06
for couples therapy
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夫妻婚姻治療，
14:08
or for spiritual, mystical experiences.
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或靈性、神秘體驗。
14:12
Humanity now is in a race
between catastrophe and consciousness.
between catastrophe and consciousness.
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人類現在陷於大災難和意識之爭。
14:20
The psychedelic renaissance is here
to help consciousness triumph.
to help consciousness triumph.
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迷幻藥復興能夠
協助意識獲得勝利。
協助意識獲得勝利。
14:26
And now, if you all just
look under your seats ...
look under your seats ...
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現在請各位看一下
你們的椅子底下……
你們的椅子底下……
14:30
Just joking!
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開玩笑的啦！
14:31
(Laughter)
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（笑聲）
14:32
Thank you.
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謝謝。
14:33
(Applause)
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（掌聲）
14:35
(Laughter)
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（笑聲）
14:36
(Applause)
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（掌聲）
14:41
Thank you.
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謝謝。
14:42
(Applause)
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（掌聲）
14:48
Corey Hajim: You've got to stay
up here for a minute.
up here for a minute.
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柯蕊•哈金：請你留在台上一會兒。
14:50
Thank you so much, Rick.
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非常謝謝你，瑞克。
14:52
I guess it's a supportive audience.
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這些觀眾挺支持你的。
14:54
Rick Doblin: Yes, very.
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瑞克•杜布林：是的，非常支持。
14:57
Many of them have also
been to Burning Man.
been to Burning Man.
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當中許多人也去過火人祭。
14:59
(Laughter)
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（笑聲）
柯：效果加倍。
15:01
CH: There's some synergy.
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15:03
RD: (Laughs)
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瑞：（笑聲）
15:04
CH: So, in your talk, you talked
about using these drugs
about using these drugs
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柯：在你的演說中，
你談到使用這些藥物
你談到使用這些藥物
15:08
to address some pretty serious traumas.
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來處理一些很嚴重的創傷。
15:10
So what about some more common
mental illnesses
mental illnesses
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那麼比較常見的心理疾病呢，
15:14
like anxiety and depression,
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比如焦慮症和憂鬱症，
15:15
and is that where microdosing comes in?
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微量用藥是不是就可以用在這裡？
15:18
RD: Well, microdosing
can be helpful for depression,
can be helpful for depression,
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瑞：嗯，微量用藥
是可以幫助憂鬱症，
是可以幫助憂鬱症，
15:21
I do know someone that has been using it.
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我確實知道有人在用。
15:23
But in general, for therapeutic purposes,
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但一般來說，針對治療的目的，
15:26
we prefer macro-dosing
rather than microdosing,
rather than microdosing,
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我們會偏好大量用藥
而非微量用藥，
而非微量用藥，
15:29
in order to really help people
deal with the root causes.
deal with the root causes.
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這樣才能真正協助病人
處理根本原因。
處理根本原因。
15:32
Microdosing is more for creativity,
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微量用藥比較是用在創意、
15:35
for artistic inspiration,
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藝術靈感、
15:37
for focus ...
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專注力上……
15:38
And it also does have
a mood-elevation lift.
a mood-elevation lift.
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它還有提升心情的功能。
15:42
But I think for serious illnesses,
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但，我認為，對嚴重的疾病，
15:43
we'd rather not get people thinking
that they need a daily drug,
that they need a daily drug,
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我比較希望病人不要覺得
他們需要每日用藥，
他們需要每日用藥，
15:47
but do more deeper, intense work.
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而是去做更深入、更強的治療。
15:49
CH: And what about outside
the United States and North America,
the United States and North America,
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柯：那麼，在美國和北美以外呢，
15:53
is this research being done there?
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也有相關研究在進行嗎？
15:55
RD: Oh yeah, we're globalizing.
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瑞：有的，我們在全球化。
15:57
Our Phase 3 studies
are actually being done
are actually being done
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我們的第三階段研究其實就在
16:00
in Israel, Canada and the United States.
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以色列、加拿大，和美國進行。
16:02
So once we get approval in FDA,
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一旦食品及藥物管理局核准，
16:04
it will also become approved
in Israel and in Canada.
in Israel and in Canada.
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在以色列和加拿大就會核准。
16:07
We're just starting research in Europe.
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我們剛開始在歐洲的研究。
16:10
And we're actually going to be training
some therapists from China.
some therapists from China.
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我們也即將要訓練
一些中國來的治療師。
一些中國來的治療師。
16:15
CH: That's great.
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柯：那很好。我們
本來要請觀眾來投票，
本來要請觀眾來投票，
16:16
We were going to do an audience vote
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16:18
to see if people felt
like this was a good idea
like this was a good idea
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看看他們是否覺得這是個好主意，
16:20
to move forward with this research or not,
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是否該讓這項研究向前邁進，
16:22
but I have a feeling I know
the answer to that, so ...
the answer to that, so ...
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但我覺得我知道答案會是什麼，
所以……非常謝謝你，瑞克。
所以……非常謝謝你，瑞克。
16:25
Thank you so much, Rick.
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16:27
RD: Thank you. Thank you all.
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瑞：謝謝你。謝謝大家。
16:28
(Applause)
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（掌聲）
ABOUT THE SPEAKER
Rick Doblin - Psychedelics researcherAs the founder of the Multidisciplinary Association for Psychedelic Studies, Rick Doblin crusades for the safe and legal use of psychedelics in therapy.
Why you should listen
Since he was 18, Rick Doblin has devoted himself to becoming a legal psychedelic psychotherapist. In 1986, he founded a nonprofit psychedelic pharmaceutical company -- the Multidisciplinary Association for Psychedelic Studies (MAPS) -- which he has grown from a one-man project to an international psychedelic pharmaceutical company.
Doblin's professional goal is to become a legally licensed psychedelic psychotherapist by developing legal contexts for the safe uses of psychedelics and marijuana as prescription medicines and also for personal growth, spirituality and creativity. Today, MAPS is designing or sponsoring psychedelic psychotherapy drug development research in over a dozen countries and has raised more than $70 million in donations.
Doblin received his master's and PhD in public policy from the Kennedy School of Government at Harvard University, and he was in the first group to be certified by Dr. Stanislav Grof as a Holotropic Breathwork practitioner.
Rick Doblin | Speaker | TED.com