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You may have heard that facing your fears is the best way to conquer them.
你可能听说过，直面恐惧是战胜恐惧的最好方法。
As it turns out, this is actually pretty scientific advice, and is the basis for a technique called exposure therapy.
事实上，该方法是科学的，是暴露疗法的基础。
This kind of therapy has been used in some form or another since the 1950s,
这种疗法自20世纪50年代以来就以某种或另一种形式被使用过，
and it's designed to help people overcome intense fears and anxieties by exposing them to whatever they're afraid of.
它旨在通过让人们接触害怕的事物从而帮助人们克服强烈的恐惧和焦虑情绪。
And while that might sound totally counterintuitive, it's all based on some pretty basic and well-tested psychology.
尽管听起来可能不可思议，但这一切都基于一些非常基本且经过测试的心理学内容。
In general, there's nothing wrong with being afraid.
一般来说，恐惧没有错。
After all, fear is a big part of what's kept humans around for so long.
毕竟，人类情绪的主要部分就是恐惧。
But people with conditions like post-traumatic stress disorder or phobias experience extreme levels of fear that make it difficult to live their lives.
但患有创伤后应激障碍或恐惧症的人会经历极度的恐惧，这种恐惧让他们的生活变得艰难。
Exposure therapy is designed to help people overcome those kinds of debilitating fear.
暴露疗法旨在帮助人们克服这种极度恐惧。
And it's centered on the idea that fears can be learned and unlearned.
这一疗法的中心思想在于恐惧可以习得也可以不习得。
This is related to a concept in psychology called conditioning—specifically, Classical or Pavlovian conditioning.
这与心理学中的条件作用概念有关——具体地说，经典条件作用或巴甫洛夫条件反射作用。
It was named after famous experiments done by Ivan Pavlov in the 1890s, and it involves a stimulus becoming associated with a specific outcome.
巴甫洛夫条件反射作用是以伊凡·巴甫洛夫在19世纪90年代的著名实验命名，该实验涉及与具体结果相关的刺激。
In Pavlov's experiments, dogs learned that whenever someone rang a bell, they got food.
在巴甫洛夫的实验中，狗知道只要有人按铃，它们就能得到食物。
So they came to associate the bell with food, and developed a positive reaction to it.
所以狗把铃铛和食物联系起来，并对它产生了积极的反应。
In that case, they salivated in anticipation of being fed.
在这种情况下，狗会因期待得到食物而流口水。
Other experiments showed that this type of conditioning can be true for negative stimuli, too.
其他实验表明，这种条件作用也适用于消极刺激。
Like, if someone is bitten by a dog, they might associate dogs with pain and fear and develop a phobia of them.
例如，如果有人被狗咬了，他们可能会把狗与疼痛、恐惧联系在一起，并对狗产生恐惧。
These results have been duplicated in tons of experiments over the years,
多年大量的实验结果与此是一致的，
but what's most important for exposure therapy is that these associations can also be extinguished, or unlearned, through conditioning.
但对于暴露疗法来说，最重要的是，这些联系也可以通过条件作用消失，或不为人知。
So if someone with a phobia of dogs had repeated exposure to the animals without being bitten, their link between dogs and pain would likely disappear.
因此，如果一个害怕狗的人多次接触狗而没有被咬伤，那么狗和疼痛的联系可能就会消失。
This process is the same no matter where the association comes from, too.
不管这种联系从何而来，其过程都是一样的。
So no matter where someone learned to fear something, facing their fear in a controlled environment can still help them extinguish it.
所以无论人的恐惧来自何处，在可控的环境中直面恐惧依然可以帮助他们消除恐惧。
And that's a big part of what exposure therapy is based on: controlled, safe, fear extinguishing.
暴露疗法基于这几个重要部分：控制，安全，消除恐惧。
It's about either teaching someone to overcome a fear, or to manage and process their anxieties in a more helpful way.
要么教会人们克服恐惧，要么以一种对他们更有益的方式管理和处理他们的焦虑。
There are a few different types of this therapy, and the exposure part can take several forms.
这种疗法有几种不同类型，暴露部分可以采取几种形式。
For one, a fear can either be imagined or experienced in vivo, meaning in real life.
首先，恐惧在现实生活中要么被想象，要么被体验。
Some fears, like fear of spiders, are safe for in vivo exposure.
有些恐惧，比如对蜘蛛的恐惧，在现实生活中是安全的。
Others, like the fear of combat that some veterans experience, typically aren't safe and practical to repeat in real life,
另一些恐惧，比如老兵对战斗的恐惧，在现实生活中通常是不安全和不现实的，
so these rely on imagined or even virtual reality exposure.
所以对于这些恐惧，需要采用想象甚至虚拟现实暴露疗法。
There are also different strategies for how much and how fast to expose patients to their fears.
在多大程度上及多快地让病人暴露在恐惧中，也有不同的策略。
Most exposure therapy involves what's called graded exposure—or starting small and gradually ramping up.
大多数暴露疗法都涉及到所谓的逐级暴露，或者从小处着手逐步加大。
Often, it begins with imagined exposures and advances to in vivo.
通常，一开始采用的是想象疗法，然后向现实递进。
For example, a therapist might guide a patient in thinking about a spider,
例如，治疗师可能会引导病人想象蜘蛛，
and in performing relaxation techniques like slow breathing to manage their fear response.
用缓慢呼吸等放松技巧管理他们的恐惧反应。
Then, when the imaginary spider doesn't cause fear anymore, the patient will look at a real spider behind glass.
然后，当病人对想象里的蜘蛛不再恐惧时，让病人看玻璃后面的真实蜘蛛。
Eventually, they might move to looking at the spider without glass, and potentially to even touching and holding it.
最终，病人可能会脱掉眼镜看蜘蛛，甚至有可能触摸和握住蜘蛛。
Another technique is called flooding. Unlike graded exposure, it involves facing the most feared scenario all at once.
另一种疗法被称为泛滥疗法。与逐级暴露不同，泛滥涉及同时面对最可怕的场景。
While this is much scarier for the patient at first, if performed correctly,
虽然一开始对病人来说很可怕，但如果操作正确，
it also results in them realizing they don't need to respond to their fears in such an extreme way.
病人也会意识到，他们不需要以如此极端的方式来表现出恐惧。
However, because this is more difficult for both the patient and the psychologist, graded exposure therapy is used most often.
然而，由于泛滥疗法对患者和心理学家来说都比较困难，逐级暴露疗法被使用得最多。
Of course, like all types of therapies, exposure therapy isn't equally helpful for everyone.
当然，就像所有类型的疗法一样，暴露疗法并不是对每个人都有效。
And in some cases with phobias and PTSD, it's even been reported to make fears worse.
在一些患有恐惧症和创伤后精神紧张性精神障碍的案例中，甚至有报道说暴露疗法会加深病人的恐惧。
Scientists speculate that this might happen if the therapy isn't performed correctly, or for long enough.
科学家们推测，如果治疗方式不正确，或者持续时间不够长的话，就可能会发生这种情况。
Also, in general, it's especially difficult to treat social anxiety with exposure therapy—although it has helped plenty of people.
而且，总的来说，用暴露疗法治疗社交焦虑症尤其困难——尽管暴露疗法在很多人身上有效。
It isn't clear why it's harder, but it could be because social interactions happen every day.
目前还不清楚为什么会更难，但可能是因为社交互动每天都在发生。
This means it's more difficult to isolate and control the severity of interactions, which is necessary for patients to process their fears.
这意味着互动的严重程度隔离和控制起来更难，而这对于处理患者恐惧是必要的。
Overall, though, exposure therapy is highly effective, and this has been shown by numerous studies.
总的来说，暴露疗法非常有效，并且已经大量研究证实。
Like, one 2010 meta-analysis of 13 different studies examining 675 total patients with PTSD found that 86% showed significant improvement after exposure therapy.
比如，2010年13项不同的研究对675名创伤后应激障碍患者进行了分析，结果发现86%的患者在接受暴露疗法后明显好转。
And a 2007 meta-analysis of 300 patients across 21 studies reported similar success in treating specific phobias.
2007年21项针对300名患者的分析发现，暴露疗法在治疗特定恐惧症方面取得了类似的成功。
While it's most commonly used to treat PTSD and phobias,
虽然暴露疗法最常用来治疗创伤后应激障碍和恐惧症，
exposure therapy has also been shown to effectively treat panic disorder, obsessive compulsive disorder, and generalized anxiety disorder.
研究表明，暴露疗法可以有效地治疗恐慌症、强迫症和广泛性焦虑症。
Research is even showing that virtual reality therapy is just as effective as in vivo exposure.
研究甚至表明，虚拟现实疗法和活体暴露疗法一样有效。
Which could be a big deal for people who can't safely face their fears in real life.
这对于那些在现实生活中无法安全面对恐惧的人来说可能是头等大事。
Now, this doesn't mean you should rush out to the woods and find a spider to expose your arachnophobic friend to.
现在，并不是说你应该跑到树林里找一只蜘蛛朋友向它暴露你的蜘蛛恐惧症。
Like other kinds of therapy, exposure therapy is meant to be done by a trained professional in a controlled environment.
和其他类型的治疗一样，暴露疗法应由训练有素的专业人员在受控的环境下进行。
But if your friend wants to learn more about how it works? Hey, maybe you could show them this video.
但是如果你的朋友想了解更多关于暴露疗法的工作原理？嘿，也许你可以给他们看这个视频。
Thanks for watching this episode of SciShow Psych!
感谢收看本期心理科学秀！
If you'd like to learn more about fear, you can watch our episode on what might be humanity's deepest, darkest fear.
如果你想了解更多关于恐惧的知识，可以观看我们的节目——人类最深、最黑暗的恐惧可能是什么。
