如何培养能够克服焦虑的孩子 Anne Marie Albano: How to raise kids who can overcome anxiety

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演员: Anne Marie Albano


台词
As a child, I had many fears.
我从小就是个胆小的人。
I was afraid of lightning, insects,
我怕闪电、昆虫、
loud noises and costumed characters.
大的声音和装扮成卡通人物的人。
I also had two very severe phobias
我最怕两件事:
of doctors and injections.
看医生和打针。
During my struggles to escape from our family doctor,
为了抗拒看家庭医生,
I would become so physically combative
我会拼命的挣扎,
that he actually slapped me in the face to stun me.
以致医生要打我耳光 才能让我镇定下来。
I was six.
当时我才六岁。
I was all fight-or-flight back then,
那时候我精神紧绷,
and holding me down for a simple vaccine took three or four adults,
打个疫苗都需要三四个成年人拉住我,
including my parents.
包括我的父母在内。
Later, our family moved from New York to Florida
后来,在我准备升入高中的时候,
just as I was starting high school,
我们举家从纽约搬到了佛罗里达。
and being the new kid at the parochial school,
作为一名进入了 一所教区学校的新生,
not knowing anyone
我不认识任何同学,
and being worried about fitting in,
很担心融入不了这里。
on the very first day of school,
开学第一天,
a teacher takes roll and calls out "Anne Marie Albano,"
有个老师点名时叫了 “安妮·玛丽·阿尔巴诺”,
to which I respond, [In a Staten Island accent] "Here!"
我回答: (纽约斯塔滕岛的口音)“到!”
She laughs and says, "Oh, precious, stand up.
她笑着说:“亲爱的,站起来。
Say D-O-G."
说 D-O-G(狗)。”
And I respond, [In a Staten Island accent] "Dog?"
我回答: (纽约斯塔滕岛的口音) “狗?”
The class broke out in laughter along with the teacher.
包括老师在内,全班一起哄堂大笑。
And so it went,
从此以后,
because she had many more words to humiliate me with.
老师一直换着法儿的羞辱我。
I went home sobbing,
我哭着回家,
distraught
非常难过,
and begging to be sent back to New York
求着父母送我回纽约,
or to some nunnery.
或者去修女院,
I did not want to go back to that school again. No way.
我不想再回到那所学校了。
My parents listened
父母听了我的哭诉,
and told me that they would investigate with the monsignor back in New York,
告诉我他们会与在纽约的教父商量,
but that I had to keep going in each day so I'd have the attendance record
但在此期间, 我还是得每天去学校报到,
to transfer to ninth grade on Staten Island.
因为有了良好的出勤记录, 我才能转回纽约上初三。
All of this was before email and cell phones,
这些都发生在有手机和电邮之前,
so over the next several weeks,
所以在接下来的几周,
supposedly, there were letters being sent between the Archdiocese of Manhattan
据说一直有一些信件 往返于曼哈顿教区、
and Miami
迈阿密
and with the Vatican,
和梵蒂岡,
and each day, I'd go into school crying and come home crying,
而在此期间,我每天都会 哭着去上课,哭着回家,
to which my mother would give me an update from some cardinal or bishop
我妈妈也会安慰我说,某些主教希望
to "Keep her going to school while we find her a spot."
“让她继续在这里上课, 等到我们有空位给她。”
Was I naive or what?
我当时是不是太单纯?
(Laughter)
(笑)
Well, after a couple of weeks, one day, while waiting for the school bus,
过了几周,某天,在等校车的时候,
I met a girl named Debbie,
我遇到了一位叫 Debbie 的女孩,
and she introduced me to her friends.
她把我介绍给了她的朋友。
And they became my friends,
然后我跟他们都成了朋友,
and, well, the Pope was off the hook.
接着就把教主的事抛在脑后了。
(Laughter)
(笑)
I began to calm down and settle in.
我渐渐开始融入了这个环境。
My past three decades of studying anxiety in children
我花了 30 年研究孩童焦虑,
stems partly from my own search for self-understanding.
一部分原因是出于我想了解我自己。
And I've learned much.
我学到了很多。
For young people, anxiety is the most common childhood psychiatric condition.
焦虑是最常见的孩童精神疾病。
These disorders start early, by age four,
从四岁发病,
and by adolescence, one in 12 youths are severely impaired
直到青春期,1/12 的儿童
in their ability to function at home, in school and with peers.
在家里、学校和 与同伴相处上都面临困难。
These kids are so frightened,
焦虑导致他们感到恐惧、
worried,
担心,
literally physically uncomfortable due to their anxiety.
甚至是生理上的不适。
It's difficult for them to pay attention in school,
他们在学校里无法专心、
relax and have fun,
放松、玩耍、
make friends
交朋友,
and do all the things that kids should be doing.
以及做他们的年龄该做的事。
Anxiety can create misery for the child,
焦虑让孩子感到痛苦,
and the parents are front and center in witnessing their child's distress.
而家长在近距离目睹着孩子的忧虑。
As I met more and more children with anxiety through my work,
因为工作的缘故, 我接触了越来越多的孩子,
I had to go back to mom and dad and ask them a couple of questions.
而我也不得不回去 问我父母一些问题。
"Why did you hold me down
“我那么害怕打针,
when I was so frightened of getting injections
可当初你们为什么
and force them on me?
逼我打针?
And why tell me these tall tales to make me go to school
我那么担心自己会被嘲笑,
when I was so worried about being embarrassed again?"
可你们却编了 那么多的故事骗我去上课?”
They said, "Our hearts broke for you each time,
他们回答:“我们每次看到都很心痛,
but we knew that these were things that you had to do.
但我们知道那是你必须要做的事。
We had to risk you becoming upset
我们冒着让你难过的风险,
while we waited for you to get used to the situation
希望等你慢慢习惯后,
with time and with more experience.
能够逐渐适应这些状况。
You had to get vaccinated.
你必须打疫苗,
You had to go to school."
你也必须去上学。”
Little did my parents know,
他们当时并不知道,
but they were doing more than inoculating me from the measles.
他们不只是给我 打了麻疹的预防针,
They were also inoculating me from a lifetime of anxiety disorders.
还为我打了 避免终身焦虑的预防针。
Excessive anxiety in a young child is like a superbug --
过度焦虑对孩子来说 是一种超强病毒——
and infectious, even multiplying,
传染力强,甚至会“繁殖”,
such that many of the youth that I see
导致我所见到的青少年中,
come in with more than one anxiety condition occurring at the same time.
很多人都同时患有多种焦虑症。
For example, they'll have specific phobia
比如,他们对某个事物 有极大的恐惧症,
plus separation anxiety plus social anxiety all together.
还伴有分离焦虑症 和社交焦虑症。
Left untreated,
如果不及时进行治疗,
anxiety in early childhood can lead to depression by adolescence.
童年的焦虑症就会导致 青春期的抑郁症,
It can also contribute to substance abuse and to suicidality.
甚至吸毒成瘾和自杀。
My parents were not therapists.
我的父母并不是咨询师,
They didn't know any psychologists.
也不认识任何心理医生。
All they knew is that these situations may have been uncomfortable for me,
他们只知道这些情况让我不自在,
but they were not harmful.
但并不会对我造成伤害。
My excessive anxiety would harm me more over the long term
如果他们允许我逃避这些情况,
if they let me avoid and escape these situations
而不学会怎么去面对这些负面的刺激,
and not learn how to tolerate occasional distress.
长期下来,焦虑症 只会对我造成更大的伤害。
So in essence, mom and dad were doing their own homegrown version
所以,我父母只是在实行家庭版的
of exposure therapy,
暴露疗法,
which is the central and key component
这是在认知行为疗法里 治疗焦虑症
of cognitive behavioral treatment for anxiety.
最关键的部分。
My colleagues and I conducted the largest randomized controlled study
我和同事们通过 一项最大规模的随机对照试验
of the treatments of anxiety in children ages seven to 17.
研究了 7 至 17 岁儿童的焦虑疗法。
We found that child-focused cognitive behavioral exposure therapy
我们发现,针对儿童的 认知行为暴露疗法,
or medication with a selective serotonin reuptake inhibitor
或者服用选择性血清素再摄取抑制剂,
are effective for 60 percent of treated youth.
只对 60 % 的青少年患者有效。
And their combination gets 80 percent of kids well within three months.
如果两种措施同时使用, 80 % 的患者可以在 3 个月里康复。
This is all good news.
这是好消息。
And if they stay on the medication
如果他们持续服用药物,
or do monthly exposure treatments as we did in the length of the study,
或是每个月接受暴露疗法, 就像我们在实验中采用的那样,
they could stay well for upwards of a year.
他们在 1 年内都不会复发。
However, after this treatment study ended,
但是,在这个疗法实验结束后,
we went back and a did a follow-up study of the participants,
我们对之前的患者 进行跟踪研究,
and we found that many of these kids relapsed over time.
发现过了一段时间, 有很多患者会复发。
And, despite the best of evidence-based treatments,
即便在治疗效果最好的那一批患者中,
we also found that for about 40 percent of the kids with anxiety,
也有 40 % 的焦虑症儿童
they remained ill throughout the course of the time.
持续表现出了焦虑的病状。
We've thought a lot about these results.
我们仔细思考了这些结果。
What were we missing?
我们遗漏了什么吗?
We've hypothesized that because we were focusing
据推断,这是因为我们只专注于
on just child-focused intervention,
针对孩童的治疗,
perhaps there's something important about addressing the parents
却忽略了父母对他们造成的影响,
and involving them in treatment, too.
所以家长们也应该参与治疗。
Studies from my own lab and from colleagues around the world
我的研究组和 其他国家的心理学研究组
have shown a consistent trend:
都揭示了共同的趋势:
well-meaning parents are often inadvertently drawn into
具有良好初衷的父母 常常会不可避免地
the cycle of anxiety.
卷入焦虑的恶性循环。
They give in, and they make too many accommodations for their child,
面对孩子的焦虑,他们会让步, 迁就他们的孩子,
and they let their children escape challenging situations.
允许自己的孩子逃避那些困难的情况。
I want you to think about it like this:
假设:
Your child comes into the house to you crying, in tears.
你的孩子哭着跑回家。
They're five or six years of age.
他们才 5 岁或 6 岁。
"Nobody at school likes me! These kids are mean.
“学校的小朋友都不喜欢我! 他们很坏。
No one would play with me."
他们都不跟我玩。”
How do you feel seeing your child so upset?
看到他们难过,你会有什么样的感受?
What do you do?
你会做什么?
The natural parenting instinct is to comfort that child, soothe them,
父母会本能地安慰孩子、哄他们、
protect them and fix the situation.
保护他们,并解决这个问题。
Calling the teacher to intervene or the other parents to arrange playdates,
他们或许会打电话叫老师进行调解, 约别的父母带孩子一起玩,
that may be fine at age five.
这些都是对付 5 岁小孩的办法。
But what do you do if your child keeps coming home day after day in tears?
但如果你的孩子持续 每天都哭着回家呢?
Do you still fix things for them at age eight, 10, 14?
你还要继续替他们解决, 直到 8 岁、10 岁、14 岁吗?
For children, as they are developing,
在孩子成长的过程中,
they invariably are going to be encountering challenging situations:
一定会面临各种难题:
sleepovers, oral reports,
去别人家过夜、课堂演讲、
a challenging test that pops up,
突击测验、
trying out for a sports team or a spot in the school play,
加入校体育队、 或是在校园戏剧里试镜角色,
conflicts with peers ...
与同学发生矛盾,等等。
All these situations involve risk:
这些情况都包含冒险的因素:
risk of not doing well, not getting what they want,
表现不好的风险、 达不到预期目标的风险、
risk of maybe making mistakes
犯错的风险、
or being embarrassed.
或者让他们难堪的风险。
For kids with anxiety
对于焦虑的孩子来说,
who don't take risks and engage,
如果他们不主动迎接风险,
they then don't learn how to manage these types of situations.
他们就无法学会如何应对这些状况。
Right?
对吗?
Because skills develop with exposure over time,
因为这是随着时间累积的能力,
repeated exposure to everyday situations that kids encounter:
在反复面对这些日常状况时, 孩子才能逐渐培养出这些能力:
self-soothing skills
自我安慰,
or the ability to calm oneself down when upset;
或控制情绪;
problem-solving skills,
解决问题,
including the ability to resolve conflicts with others;
包括解决于同学之间的矛盾;
delay of gratification,
延迟满足,
or the ability to keep your efforts going
就是在等待的时候
despite the fact that you have to wait over time to see what happens.
还能坚持的毅力。
These and many other skills are developing in children
只有通过冒险和直面这些状况,
who take risks and engage.
孩子才能拥有这些能力。
And self-efficacy takes shape,
他们也会慢慢获得自我效能,
which, simply put, is the belief in oneself
简单来说,就是相信自己
that you can overcome challenging situations.
可以克服这些难题。
For kids with anxiety who escape and avoid these situations
患有焦虑症的孩子 如果总是逃避这些状况
and get other people to do them for them,
或找他人替他们解决问题,
they become more and more anxious with time
他们只会越来越焦虑,
while less confident in themselves.
同时失去自信。
Contrary to their peers who don't suffer with anxiety,
相比没有焦虑症的孩子,
they come to believe that they are incapable of managing these situations.
他们会认为自己无法应对这些状况。
They think that they need someone, someone like their parents,
他们会认为他们需要别人,例如父母,
to do things for them.
来替他们做这些事。
Now, while the natural parenting instinct is to comfort and protect
虽然父母的本能就是安慰、保护
and reassure kids,
和安抚孩子,
in 1930, the psychiatrist Alfred Adler
但在 1930 年,精神科医师 阿尔弗雷德·阿德勒(Alfred Adler)
had already cautioned parents
就劝诫过父母,
that we can love a child as much as we wish,
可以尽所能的爱自己的孩子,
but we must not make that child dependent.
但不要让他们过度依赖别人。
He advised parents to begin training kids from the very beginning
他建议父母
to stand on their own two feet.
尽早锻炼孩子的独立能力。
He also cautioned that if children get the impression
他也提醒道,如果孩子
that their parents have nothing better to do than be at their beck and call,
觉得自己的父母可以随叫随到,
they would gain a false idea of love.
他们对爱的认知就会有偏差。
For children with anxiety in this day and age,
如今,患有焦虑症的孩子
they are always calling their parents
总是习惯经常打电话给他们的父母,
or texting distress calls at all hours of the day and night.
或发短信求救。
So if children with anxiety don't learn the proper coping mechanisms when young,
如果患有焦虑症的孩子 不在儿时学会正确的应对方式,
what happens to them when they grow up?
他们长大后怎么办?
I run groups for parents of young adults with anxiety disorders.
我为患有焦虑症的青少年的家长 成立了一些互助小组。
These youth are between the ages of 18 and 28.
他们的孩子 都处于 18 - 28 岁的年龄段,
They are mostly living at home,
大部分与父母同住,
dependent on their parents.
依赖于他们的父母。
Many of them may have attended school and college.
很多人上过初中、高中和大学,
Some have graduated.
有些毕业了。
Almost all are not working,
但几乎所有人都没有工作,
just staying at home and not doing much of anything.
只是呆在家里,整天无所事事。
They don't have meaningful relationships with others,
他们没有密切的社交圈,
and they are very, very dependent on their parents
而且非常依赖父母
to do all sort of things for them.
去帮他们完成所有的事。
Their parents still make their doctors appointments for them.
父母至今还帮他们预约看病,
They call the kids' old friends and beg them to come visit.
打电话叫他们的朋友来家里玩,
They do the kids' laundry and cook for them.
帮他们洗衣做饭,
And they are in great conflict with their young adult,
却也经常与他们发生矛盾,
because the anxiety has flourished but the youth has not.
因为他们的焦虑症变严重了, 但心智却没有成长。
These parents feel enormous guilt,
这些父母感到极度愧疚 ,
but then resentment,
之后是懊悔,
and then more guilt.
这种懊悔又导致了更多的愧疚。
OK, how about some good news?
那么,好消息是什么呢?
If parents and key figures in a child's life
如果家长,以及 孩子成长过程中的一些关键人物
can help the child, assist them to confront their fears
一同帮助孩子克服他们的恐惧,
and learn how to problem-solve,
并且学习如何解决问题,
then it is more likely that the children are going to develop
那这些孩子就更有可能
their own internal coping mechanisms for managing their anxiety.
发展出一套内部应对机制 来管理自己的焦虑。
We teach parents now to be mindful in the moment
现在,我们教导父母用心来思考
and think about their reaction to their child's anxiety.
自己面对孩子焦虑时的反应。
We ask them,
我们问他们,
"Look at the situation and ask, 'What is this situation at hand?
“面对这种情况时问自己: ‘现在的情况是什么?
How threatening is it to my child?
对我的孩子会造成多大的危险?
And what do I ultimately want them to learn from it?'"
我到底要他们从中学到什么?’ ”
Now of course, we want parents to listen very carefully,
当然,家长们也要明白,
because if a child is being bullied seriously or put in harm's way,
如果一个孩子被霸凌或受伤,
we want parents to intervene,
我们肯定会要求父母介入,
absolutely.
毋庸置疑。
But in typical, everyday anxiety-producing situations,
但在日常会导致焦虑的状况中,
parents can be most helpful to their child
父母能给孩子最大的帮助
if they remain calm and matter-of-fact and warm,
就是保持冷静、理智、态度温和,
if they validate the child's feelings
不去否定他们的感受,
but then help the child,
但同时帮助孩子
assist them in planning how the child is going to manage the situation.
思考如何应对这种情况。
And then -- this is key --
然后——这是最关键的——
to actually have the child deal with the situation themselves.
要让孩子自己去面对这些情况。
Of course, it is heartbreaking to watch a child suffer,
当然,看到孩子难过,自己也会心疼,
as my parents told me years later.
我的父母也是在很多年后才告诉我的。
When you see your child suffering
当你看到你的孩子难过,
but you think you could swoop in and save them from the pain of it,
但你觉得可以马上 让他们摆脱痛苦,
that's everything, right?
这是最重要的,对吧?
That's what we want to do.
我们都想这么做。
But whether we are young or old,
但不论我们年长还是年少,
excessive anxiety leads us to overestimate risk and distress
过度焦虑都会让我们 放大风险和焦虑,
while underestimating our ability to cope.
同时低估了我们的适应能力。
We know that repeated exposure to what we fear weakens anxiety,
不断接触自己所恐惧的事物 会降低我们的焦虑,
while building resources and resilience.
同时增加我们处理问题的 资源和抗压能力。
My parents were on to something.
我的父母发现了其中的奥秘。
Today's hyper-anxious youth are not being helped
在现在的社会里, 过度保护的教育方式
by overly protective parenting.
并不会改善过度焦虑的问题。
Calmness and confidence are not just emotions.
冷静与自信不只是某种情感,
They are coping skills that parents and children can learn.
还是父母与孩子 可以一同学习的应对方式。
Thank you.
谢谢。
(Applause)
(鼓掌)