评论
打印
Back in the 1940s, a man suffered a series of injuries that left him mostly paralyzed and was confined to a hospital bed.
早在20世纪40年代，一名男子遭受一系列伤害，导致他几乎瘫痪，只能躺在病床上。
Over time he grew more irritable and demanding of the staff, and if you asked him why he was there, he'd tell you he just checked into the hospital because he "needed a rest."
随着时间的推移，他变得越来越易怒，对医护人员的要求也越来越苛刻，如果你问他为什么待在医院里，他会告诉你他刚住院，因为他“需要休息”。
He'd tell you he could walk as much as he wanted — he just didn't want to right now.
他会告诉你，他想走多少就能走多少，只是现在不想走。
He seemed to be unaware of his disabilities.
他似乎对自己的残疾一无所知。
Most people's first instinct would be to chalk this up to denial — when someone can't face facts that, to the rest of us, seem objectively true.
当有人无法面对对其他人来说是客观真实的事实时，大多数人的第一反应是否认。
The kind that can sometimes set in when folks get a terminal cancer diagnosis, for example.
例如，当人们得到癌症晚期诊断时，有时会出现这种情况。
But there might have been more going on in this case.
但在这种情况下，可能发生着更多的事情。
Because in some rare instances, people don't just have trouble accepting the truth:
因为在一些罕见的情况下，人们不仅难以接受事实：
Their brains prevent them from even realizing anything has changed.
他们的大脑甚至阻止他们意识到事情已经改变。
There are cases in the medical literature of people who experience some sort of impairment or disability, but don't seem to be able to acknowledge it, or even experience it.
医学文献中有些人经历过某种损伤或残疾，但似乎不能承认，甚至无法体验到。
Doctors call this anosognosia, from the Greek for having no knowledge of a disease.
医生称这种失认症为病觉缺失症，这个词来自希腊语，是说患者对疾病一无所知。
This can happen with both mental and physical conditions, commonly schizophrenia, but we're going to focus on the physical side of things today.
这可能发生在精神和身体状况上，通常是精神分裂症，但我们今天要关注的是身体方面。
And there are examples from stroke to blindness.
从中风到失明都有病例。
But there doesn't seem to be any one cause — instead, it's linked to other things going on in the patient's brain.
但似乎没有一种病因，相反，它与病人大脑中发生的其他事情有关。
Being unaware of blindness is called Anton's syndrome, and it's extremely rare.
无法意识到失明被称为安东综合征，这种病症极为罕见。
As of 2016, only 28 cases have ever been published.
截至2016年，只发表过28个病例。
People with this condition won't be able to accurately tell you whether the lights are on, or how many fingers you're holding up.
有这种病症的人无法准确告诉你灯是否亮着，或是你举起了多少根手指。
If they get it wrong, they'll blame it on not having their glasses or the lights being dim.
如果他们弄错了，会把这归咎于没戴眼镜或灯光昏暗。
The most common cause is a stroke damaging parts of the occipital lobe, the part of the brain that's primarily responsible for processing visual information.
最常见的原因是中风损伤了枕叶，这部分大脑主要负责处理视觉信息。
It's hard to know exactly what it's like for these patients, of course, but it may be that in the absence of real visual information, they hallucinate visual experiences that they presume are real.
当然，很难确切地知道这些病人的病情，但可能是在缺乏真实视觉信息的情况下，他们会产生幻觉，认为这些幻觉是真实的。
Or even that their brains are supplying likely responses to common questions without really checking for visual input.
或者甚至他们的大脑在没有真正检查视觉输入的情况下，对常见问题做出可能性的反应。
If you're holding up fingers it's probably five or less, right?
如果你举起手指，大概是五根或者更少，对吧？
Anosognosia can go hand in hand with stroke whether or not the visual centers are affected.
无论视觉中枢是否受到影响，病觉缺失症都会与中风密切相关。
For example, some patients might lose motor function in one limb or on one side of their body as a result of a stroke.
例如，某些患者可能会因为中风失去一条手臂、一条腿或身体一侧的运动功能。
In one 2004 study, doctors asked these patients to explain why they couldn't perform some physical action, even though they thought they could.
在2004年的一项研究中，医生要求这些患者解释他们不能做一些身体动作的原因，尽管他们认为自己可以做。
Some didn't reply, some say they did it the way they always have, and some said something totally irrelevant, like "I'm a good sportsman."
有些人没有回答，有些人说他们总是这样做，还有些人说一些完全不相干的话，比如“我是名优秀的运动员”
In an earlier study from 1991, researchers recruited people who had had strokes and lost some motor ability,
在1991年的一项早期研究中，研究人员招募了中风患者，
and sorted them according to whether they were aware of their condition.
并根据他们是否意识到自己的病情进行分类。
Those who had anosognosia also had damage to their central gyri or connections to their thalamus.
病觉缺失症患者的中央脑回或丘脑连接也受到损害。
Having damage there suggests that they were losing some of the structures that keep track of where their limbs are and how they're moving.
那里的损伤表明他们失去了一些关注四肢位置和运动方式的结构。
Strokes tend to have cognitive effects as well, so these patients are also probably losing the ability to make inferences and draw conclusions about their conditions.
中风往往也会对认知产生影响，所以这些患者也可能失去对病情作出推论，并得出结论的能力。
Like, if you think your arm is fine but you keep dropping things, you might make the connection that something's wrong.
比如，如果你认为自己的手臂完好，但却不断地掉东西，你可能会认为有什么不对劲。
But if you've had a stroke, that may be more difficult to do.
但如果你中风了，那可能就更难做到了。
What's interesting here is that while many patients with anosognosia overestimate their abilities after stroke,
有趣的是，虽然许多病觉缺失症患者高估了他们中风后的能力，
some will be more realistic when asked about "someone else in their condition."
但当被问及“其他人的病情”时，有些人会更为现实。
They can recognize at some level what's going on with them, but their brains seem better able to do so when it applies to someone else.
他们可以在某种程度上意识到自己在做什么，但当适用于其他人时，大脑似乎更能更好地做到这点。
The good news is that anosognosia isn't necessarily permanent, especially if it's caused by damage to specific parts of the brain.
好消息是，病觉缺失症不一定是永久性的，特别是如果它是由大脑特定部位的损伤引起的。
Sometimes, patients are able to put the pieces together by making inferences over time.
有时，病人过一段时间，通过推断能把这些碎片拼凑起来。
Like, let's return to our blindness example.
比如，让我们回去看失明的例子。
If people keep guessing the wrong number of fingers, they may be able to notice the pattern and improve their understanding,
如果人们一直猜错手指的数目，即使他们仍有视幻觉的主观体验，
even if they still are having the subjective experience of visual hallucinations.
也可能会注意到这种模式并提高理解力。
Some patients may also experience temporary relief using a treatment called vestibular stimulation — referring to the system in your inner ear that helps you maintain balance.
有些病人可能会使用一种叫做前庭刺激的治疗方法，暂时缓解压力。前庭是指内耳帮助保持平衡的系统。
Basically, since it's part of a system that helps you understand where your body is,
大体上来说，因为它是帮助你了解身体位置系统的一部分，
stimulation here can help activate parts of the brain that aren't damaged to help you correct your interpretation of the signals you're getting.
刺激它能帮助激活大脑中未受损的部分，帮助你纠正对各种信号的解释。
In a small study published in the journal Cortex back in 1998, nine stroke patients had their vestibular nerves artificially stimulated with electrodes.
1998年发表在《皮质》期刊上的一项小型研究中，9名中风患者的前庭神经受到电极人工刺激。
And out of six of them who reported anosognosia beforehand, five of them experienced some temporary improvement to their symptoms.
在6名事先报告患有病觉缺失症的患者中，5名患者的症状出现了暂时性改善。
Which offers some hope for treatment — but also supports the interpretation that these patients aren't just in denial,
这给治疗带来了一些希望，但也支持这样的解释，即这些患者不仅是在否认，
because all six of them were adamant in their belief that nothing was wrong beforehand.
因为他们六个人都坚信之前没有问题。
So the good news is that treatment helps, and there's reason to be optimistic even without treatment.
好消息是治疗有帮助，即使不治疗也有理由保持乐观。
But even while people have this condition, it's good to keep in mind that this doesn't seem to be a case of denial or deliberate faking.
但即使人们有这种病症，最好记住，这似乎不是一种否认或故意伪造。
The brain is doing its job of conjuring our reality and experience, but for these patients, it just isn't adding up.
大脑正在做它的工作，召唤我们的现实和经验。但对这些患者来说，只是没有把它们叠加起来。
And our brains work really hard for us, and to keep doing their jobs, they need sleep.
我们的大脑努力地工作着，为了继续工作，它们需要睡眠。
You can learn all about the science of sleep in the documentary series "Curious Minds: The Science of Sleep" on CuriosityStream.
你可以在纪录片“奇特的大脑：睡眠的科学”系列纪录片中了解所有关于睡眠的科学。
CuriosityStream is a subscription streaming service that offers over 2,400 documentaries and non-fiction titles from some of the world's best filmmakers, including exclusive originals.
CuriosityStream是一个订阅流媒体服务，提供2400多部纪录片和非小说类影片，其中包括世界上最优秀的电影制作人的独家原创作品。
That includes a whole section on the mind, and since you're watching Psych, you might enjoy some of those.
有一整节关于心灵的内容，既然你在看《心理科学秀》，可能会喜欢其中的一些节目。
CuriosityStream is available worldwide on platforms from Apple TV to Roku.
CuriosityStream在世界各地的平台上（从Apple TV到Roku）都能收看。
If you're interested, you can get unlimited access starting at just $2.99 a month.
如果你感兴趣的话，每月只需支付2.99美元，就能无限访问。
For SciShow Psych viewers, the first 31 days are completely free if you sign up at curiositystream.com/psych and use the promo code "psych" during the sign-up process.
对于心理科学秀的观众来说，如果你在curiositystream.com/psych注册，并在注册过程中使用促销代码“psych”，前31天就完全免费。
