The military had little to offer. "They are not even trying to help," he would tell friends and relatives. "You say, ‘I have horrible diarrhea, and I can't stop going to the bathroom.' And they say, ‘Stop going to the bathroom.' Or you say, ‘I have a horrible time with the subway; the noise just terrifies me.' And they say, ‘Well, New York is pretty noisy.' " One doctor prescribed an anti-anxiety medication, but it was so strong that Eugene started walking into walls. He tried talk therapy and group therapy. Neither did anything to relieve the uncomfortable tingling up his spine or the constant feeling that he was about to be attacked from behind.
军队帮不上什么忙。“他们甚至根本没有尝试过提供帮助，”他这样告诉亲戚朋友们。“你跟他们说，‘我腹泻很严重，简直离不开卫生间。'结果他们回答，‘那就别去卫生间。'你跟他们抱怨，‘我很怕乘地铁；那些噪音让我惊恐万分。'他们却说，‘没错，纽约是怪嘈杂的。'”曾有一位医生给他开了些抗焦虑的药物，可是那药效果太过猛烈，以至于尤金开始犯迷糊，走着走着都会撞到墙上。他也尝试过谈话治疗和团体治疗。但这些都未曾缓解他不安的惊惧，也没能消除他总感觉随时会被人背后偷袭的那种恐慌。
He was nearly a full decade into this private war by the time he came to sit across from van der Kolk in the room overlooking the Pacific and to tell a group of strangers how he killed an innocent man.
在这场“与自己的战争”中，他几乎已经孤军奋战了整整10年，直到此刻——他来到这个俯瞰太平洋的小房间里，坐在范德科尔克的对面，向一群陌生人坦承，自己怎样杀死了一个无辜的人。
Mosul reminded Eugene of a movie, he said: an old western in which the bad guys take over some small town, and all the townsfolk hide indoors and tumbleweed blows across the screen. In this movie, though, the bad guys were crazy terrorists who not only fired on Eugene and his team constantly but also strapped explosives to themselves, wandered into residential areas and detonated.
在摩苏尔的经历让尤金想起了一部电影，那是个很老的西部片，他说，坏人们占据了小镇，所有的居民都躲在屋里，关门闭户，银幕上只有大风卷着草团吹过。不过，在尤金的故事里，坏人们是疯狂的恐怖分子，他们不仅不断地朝尤金和他的队伍开枪，还会往自己身上绑上炸药，潜入居民区然后引爆。
Eugene was on the security detail for a bomb patrol when a man drove up without yielding for inspection. Eugene signaled to him to stop, but the man kept his foot on the gas. Eugene signaled a second time, and a third.
当时尤金正在一个炸弹巡逻队中执行安保任务，一名男子驾车而来，却拒绝接受检查。尤金做手势叫他停车，但该男子仍旧将脚踩在油门上。尤金第二次对他示意，然后是第三次。
Stop. Stop. Stop.
停车。停车。停车！
The man kept driving. So Eugene opened fire. His team searched the car afterward but found no bombs. As Eugene left the scene, he saw the man's mother. She ran over to the car, distraught.
但那名男子仍在向前开。于是尤金开枪了。事后，他的小队搜查了那辆车，却没有发现炸弹。正当尤金要离开现场时，他看到了那名男子的母亲。她向汽车跑去，悲痛欲绝。
As he told us this, Eugene stared into the empty space between him and van der Kolk. His face was red and contorted, and it was easy to imagine that he was not so much remembering what happened as reliving it. I wondered what torments had led him to submit to such an experiment. I wondered how it could possibly work.
讲到这里，尤金的目光落在他和范德科尔克之间的虚空里。他脸色通红表情扭曲，很容易想象，他在回顾那段情节时，记忆并不十分清晰。我暗想要怎么样的痛苦，才会迫使他愿意参加这么一项实验，更好奇这种治疗到底怎么能产生效果。
"What do you want the mother to know?" van der Kolk asked. Again, Eugene covered his face and broke into loud sobs.
“你想让那位母亲知道些什么？”范德科尔克问道。尤金再次捂住了脸，大声哭泣起来。
"I'm sorry," he said. "I'm so, so sorry. There are not words for how sorry. . . ." He buried his face in his hands again. "Do you want to look at her?" van der Kolk asked. Eugene couldn't seem to speak, but he lifted his head and squinted at me with one eye. It was too much. He tucked his chin into his chest, wracked by sobs.
“对不起，”他说。“我真的非常，非常抱歉。我无法用语言来表达我的歉意……”他又把脸埋在掌心里。“你想看着她吗？”范德科尔克又问。尤金一时说不出话来，但他还是抬起头，用一只眼睛飞快地瞟了我一眼。只是这已经超出了他所能承受的限度。他埋下头，哭得不能自已。
"The witness sees how truly sorry and how upset you are," van der Kolk said. I kept my eyes focused on Eugene, so I didn't see van der Kolk's face. But Kresta would later tell me that watching him was like watching a wizard or a magician or a superfast computer. She could see him tracking Eugene's facial expressions, tone of voice and changes in posture and responding to each in microseconds, posing a question or remarking "the witness sees."
“你真心的悔恨和难过，见证人都看到了，”范德科尔克说。我一直凝视着尤金，所以我看不到范德科尔克的表情。但后来克雷斯塔告诉我，看着他，就好像是看着一个巫师或魔法师，又或者像一台超高速电脑。她留意到，他一直密切关注着尤金的面部表情、语调和姿势中的变化，并在几微秒内就对它们作出相应的反应，时而提出问题，时而旁白“见证人看到了”。
Van der Kolk instructed me in a low, steady voice. "Tell him that you forgive him," he said. "Tell him you understand that it was a crazy time, and you know that he didn't mean to do what he did. He was very young, and both of you were trapped in the same hell. Tell him you forgive him. And that you are O.K. now." I repeated the words. I tried to make them sound genuine. I found myself hoping, fervently, that Eugene could hear me.
范德科尔克以低沉平稳的声音指示我。“告诉他，你原谅他，”他说。“告诉他你明白那时候是非常时刻，你知道他不是故意的。他还很年轻，你们都同样被困在地狱中饱受折磨。告诉他你原谅他，你现在已经没事了。”我重复着这些话，尽力让它们听起来发自肺腑。我发现自己热切地盼望尤金能够把我的话听进心里。
For a man who speaks to more than 15,000 people a year, van der Kolk has a surprisingly hard time projecting his voice. His thick Dutch accent is easy enough to decipher if you're sitting right next to him, but it is difficult to penetrate from even a few feet away. As is often the case, the first audience comment at a recent lecture he gave in Philadelphia was "We can't hear you!" Van der Kolk asked a sound technician to turn up the volume and promised the 200 or so attendees that he would speak as loudly as he could. There were some grumbles, even from people in the front row, who still couldn't hear him. But van der Kolk is effusively charming and, as usual, managed to win the group over quickly.
说起来令人难以置信，作为一个每年听众总数可达1.5万以上的人，范德科尔克并不擅长演讲。他带着厚重的荷兰口音，如果你就坐在他旁边的话倒是也不难听懂，但哪怕只隔开几英尺远，你就会觉得不知所云了。所以情况经常会像他在费城的最近一次讲座这样，听众们对他的第一条评论是：“我们听不清！”范德科尔克请求音效师帮他调高音量，并向与会的200来人承诺，他会尽可能地大声。但还是有听众们听不到他在说什么，即使有些人已经是在前排，于是颇有些抱怨的声音。但范德科尔克总是那么热情洋溢，令人倾倒。与往常一样，他很快就征服了听众。
"Everybody hunch their backs forward and droop their heads, like this," he said, demonstrating. "Now try saying: ‘Oh, I'm feeling great! I'm very happy today!' " The audience laughed. "See, it's impossible to feel happy in that position." To drive the point home, he asked us to do the opposite: sit upright, assume cheerful expressions and then try to feel bad.
“请大家弓起后背并低头，就像这样，”他一边说一边亲身示范。“现在请试着说：‘哦，我感觉好极了！我今天非常开心！' ”场下出现了笑声。“你看，在这种姿势下，你是不可能感到幸福的。”为了彻底表明自己的观点，他让我们摆出相反的姿势：坐直身子，展现欢快的表情，然后试着去感觉难过。
The mind follows the body, he said.
心随体转，他说。
Trauma victims, van der Kolk likes to say, are alienated from their bodies by a cascade of events that begins deep in the brain with an almond-shaped structure known as the amygdala. When faced with a threat, the amygdala triggers a fight-or-flight response, which includes the release of a flood of hormones. This response usually persists until the threat is vanquished. But if the threat isn't vanquished — if we can't fight or flee — the amygdala, which can be thought of as the body's smoke detector, keeps sounding the alarm. We keep producing stress hormones, which in turn wreak havoc on the rest of our bodies. It's similar to what happens in chronic stress, except that in traumatic stress, the memories of the traumatic event invade patients' subconscious thoughts, sending them back into fight-or-flight mode at the slightest provocation. Therapists and patients refer to this as being "reactivated." In the short term, patients avoid the pain it causes by "dissociating." That is, they take leave oftheir bodies, so much so that they often cannot describe their own physical sensations. This happens a lot in therapy, van der Kolk says.
范德科尔克总喜欢说，创伤受害者的精神与身体脱节了，而这是由大脑深处被称为杏仁核的结构开始的级联反应造成的。在遇到威胁时，杏仁核会激发出“战或逃”反应，其中涉及大量激素的释放。这种反应通常会持续到威胁消除为止。但如果威胁一直没有消失——如果我们不能反抗也不能逃跑——那么杏仁核这个“人体的烟雾探测器”就会不停地拉响警报。于是我们就不断地制造应激激素，进而大肆破坏我们身体的其余部分。这与慢性应激的过程非常相似，区别只在于在创伤应激中，关于创伤事件的记忆侵入了患者的潜意识中，哪怕是最轻微的刺激都会令他们回到“战或逃”模式。治疗师和患者将其称为被“激发”。短期内，患者会通过“游离于世外”的方式来回避它所引发的痛苦。也就是说，他们会将自己的精神从躯体上抽离开，以至于无法准确地描述自己的身体感觉。这在治疗中屡见不鲜，范德科尔克说。
In the long term, they become experts in self-numbing. They use food, exercise, work — or worse, drugs and alcohol — to stifle physical discomfort. The longer they do this, the more difficult it becomes to remain present in any given moment. "That's why the guy at the end of ‘The Hurt Locker' is so utterly incapable of playing with his kid," van der Kolk says.
长此以往，他们往往会成为自我麻木的高手，用食物、运动、工作——或者是更糟糕的毒品和酒精——来遏杀身体上的不适。这样做的时间越长，他们就越难以在哪个时刻不游离。“这就是电影《拆弹部队》(The Hurt Locker)结尾时那人根本无法与自己的孩子一起玩耍的原因，”范德科尔克说。
The goal of treatment should be to resolve this disconnect. "If we can help our patients tolerate their own bodily sensations, they'll be able to process the trauma themselves," he says. In his own patients, particularly those suffering from treatment-resistant PTSD, yoga has proved an especially good way to do this. So has emotional freedom technique, or tapping. With a therapist's guidance, the patient taps various acupressure points with his or her own fingertips. If done correctly, it can calm the sympathetic nervous system and prevent the patient from being thrown into fight-or-flight mode. Ultimately, van der Kolk supports almost any therapy that involves paying careful attention to patients' physiological states, like psychomotor therapy, or getting up and moving around through theater, dance and even karate. For patients with acute PTSD from isolated traumatic memories (think car accidents or single-episode assaults), van der Kolk is a fan of eye movement desensitization and reprocessing, or E.M.D.R., in which a therapist wiggles fingers back and forth across the patient's field of vision and the patient tracks the fingers while "holding in mind" the traumatic memory. Proponents say the technique enables patients to process their traumas so that they pass into memories and stop invading the present. Van der Kolk likes to point out that he came to the technique as a skeptic. "It's this weird treatment," he said. "You ask people to remember what happened to them, and you wiggle your finger in front of their eyes and have them follow it. Crazy." More than 60,000 therapists around the world have now been certified in E.M.D.R., though the practice remains controversial, with critics and supporters debating the validity of each new study. Van der Kolk places his faith in what he sees in his own patients, he says. For them, E.M.D.R. has been a godsend.
治疗的目标应该是解决这种脱节问题。“如果我们能够帮助患者耐受自己的身体感觉，他们就可以自己处理所受到的创伤，”范德科尔克解释道。在他自己的患者，尤其是那些难治性PTSD患者中，瑜伽在这方面的效果被证明尤其值得称道。情绪释放术(emotional freedom technique)又被称为穴位按摩，效果也不错。在治疗师的指导下，患者们使用自己的指尖点按不同的穴位。如果方法正确，它可以平复交感神经系统，防止患者陷入“战或逃”模式。归根结底，范德科尔克对所有密切关注患者生理状态的疗法几乎都抱着支持的态度，如精神运动疗法、起立并在剧场中漫步、舞蹈，乃至空手道。对于从孤立的创伤记忆（如车祸或一次性的袭击）中罹患急性PTSD的病人，范德科尔克也很赞成采用眼动脱敏与再加工疗法（eye movement desensitization and reprocessing，简称EMDR)。在这种疗法中，治疗师在患者的视野前来回晃动手指，并要求患者一面将“思绪停留”在创伤记忆上，一面用目光追随着治疗师的手指。支持者称，这项技术可促使患者加工创伤事件，并将其转化为过去的记忆，从而使它们不再侵犯当前的日常生活。范德科尔克很喜欢指明的一点是，最初接触这项技术时，他也是满腹狐疑。“这真是种古怪的治疗，”他说。“你教人们记起自己的遭遇，还在他们的眼前晃动手指，让他们的眼睛跟着转。这太疯狂了。”目前，世界各地已经有超过6万名治疗师获得了EMDR治疗认证，但人们对这种疗法一直存在争议，批评者和支持者对每一项新研究正确与否都争论不休。范德科尔克说，他更相信从自己患者身上观察到的结果。对于他们而言，EMDR简直是天赐的福音。
Van der Kolk's most vocal critics tend to have the same complaint: He overstates his case. There is far less evidence for therapeutic tapping or theater or massage therapy than for cognitive behavioral therapy or even exposure therapy. And while the National Institutes of Health and the Department of Defense have begun studying the benefits of yoga and E.M.D.R., van der Kolk's own studies have been criticized for a lack of rigor and small sample sizes; there were just 88 people in his 2007 study of E.M.D.R. and 64 people in his 2014 study of yoga. "Anyone is going to tell their therapist that they're doing better if they like their therapist," says Patricia Resick, a clinical psychologist and researcher in the use of C.B.T. for post-traumatic stress at Duke University. "You need an independent assessor." There is a standard in the field, Resick says, speaking broadly of his methodology. "If he wants to be taken seriously, he has to do studies that live up to that standard." (Van der Kolk points out that his E.M.D.R. and yoga studies both had blind raters.)
范德科尔克最为人诟病的地方似乎集中于一点：他过分夸大了自己病例的代表性。有关治疗性穴位点按、剧院疗法以及按摩疗法的证据都远远少于认知行为疗法，甚至还比不上暴露疗法。虽然美国国立卫生研究院(National Institutes of Health)和国防部都已经开始研究瑜伽和EMDR的效益，但批评者指出，范德科尔克自己的研究缺乏严谨性，样本也过小；他2007年的EMDR研究只涉及了88人，2014年的瑜伽研究也只入组了64人。“只要喜欢自己的治疗师，任何人都乐意告诉他们自己的感觉越来越好，”杜克大学(Duke University)的临床心理学家、研究使用认知行为疗法治疗创伤应激的帕特里夏·雷斯尼克(Patricia Resick)说。“你需要独立的评估。”在谈到范德科尔克的大致研究方法时，雷斯尼克表示，该研究领域自有其标准。“如果他希望人们把他当回事儿，他就需要完成符合这一标准的研究。”（对此，范德科尔克指出，他的EMDR和瑜伽研究均设有不知情的评价者。）
Van der Kolk has also been charged with oversimplifying neuroscience to support his clinical work. He likes to divide the brain into distinct regions — rational and emotional — that he says are "not all that connected to one another." He says the techniques he favors are capable of accessing the emotional brain, where the amygdala resides, whereas C.B.T., exposure therapy and talk therapy aren't necessarily capable of doing so. Van der Kolk has scores of fMRI scans showing that when faced with a trauma — or in the case of PTSD, with a traumatic memory — the prefrontal cortex becomes muted, the speech center becomes muted and the amygdala becomes hyperactive. But a vast majority of neurobiologists say the so-called rational and emotional brains are much more integrated than his model suggests. In fact, the two communicate regularly through a multitude of circuitous loops that researchers have only just begun to map. And the scans that van der Kolk uses offer a bird's-eye view of the brain — too sweeping to justify such detailed inferences. "He has a lot of interesting and important ideas, but the relatively weak connection to the brain detracts from his message," says Joseph LeDoux, a neuroscientist at New York University. "This happens in a lot of fields now. Everybody wants to use the brain to justify certain things. But sometimes what the brain does is more important than how it does it."
此外，也有人指责范德科尔克将神经科学过度简单化，以支持自己的临床工作。他喜欢将大脑划分为理性与感性两个截然不同的区域，用他的原话说是：“它们的相互联系并非那么紧密。”他声称自己所热衷的技术可以作用于杏仁核所在的“情绪脑”，而认知行为疗法、暴露疗法和谈话治疗却未必有这神通。范德科尔克手中有大量的功能性磁共振成像扫描资料显示，在面对创伤时（对于PTSD患者则是面对创伤记忆时），前额叶皮层、语言中枢都沉寂下来，而杏仁核却变得异常活跃。但绝大多数的神经生物学家都认为，所谓的理性脑和情绪脑并非如他的模型显示的那样彼此孤立，而是一个更为融合的有机体。实际上，它们经常通过众多迂回曲折的神经回路彼此通讯，而科研人员在这方面的研究才刚刚起步。范德科尔克所使用的扫描图提供的是大脑活动的概况，要是想解释如此细节的问题，它们未免太过笼统。“他提出了很多十分有趣也非常重要的想法，但与脑部的关联并不紧密这一点是一大败笔，”纽约大学(New York University)的神经科学家约瑟夫·勒杜(Joseph LeDoux)说。“这种现象在当今的很多领域都层出不穷。每个人都希望扯上大脑来证明些什么。然而有时候，大脑能做什么比它是怎么做的更加重要。”
Some of van der Kolk's closest colleagues have suggested that his exaggerations are by design. It's not so much that he abhors conventional therapies or thinks his own methods are ironclad. It's that he is trying to persuade people to be more open-minded. Indeed, when I pressed him on C.B.T., he acknowledged that it might have some uses, perhaps for anxiety or obsessive-compulsive disorder. And despite his contention that Prozac is less effective than E.M.D.R. at treating PTSD, he is not antimedication.
范德科尔克的一些最亲密的同事指出，他的夸张其实是刻意为之。他并没有那么厌弃传统疗法，也并不认为自己的方法无懈可击。他只是试图说服人们保持一种更加开通的态度。事实上，当我就认知行为疗法追问他时，他承认这种疗法在焦虑症或强迫症的治疗中大概还是可以派上用场的。而且，虽然他认为百忧解(Prozac)治疗PTSD的效果不如EMDR，但他并不是绝对地反对用药。
But there is a larger issue, too. "Testing a therapeutic technique is not like conducting a drug trial," says Frank Ochberg, a professor at Michigan State University and clinical psychiatrist who specializes in PTSD. "With a drug trial, everyone gets the exact same pill or the exact same placebo. With therapy, you can't separate the tools from the person using the tools. There's no good experimental technique for measuring a therapist's kindness, wisdom or judgment."
不过，还有一个更大的问题。“测试治疗技术与进行药物试验不同，”密歇根州立大学(Michigan State University)的教授、专门从事PTSD研究的临床精神病学家弗兰克·欧什博格(Frank Ochberg)说。“在药物试验中，所有受试者得到的是完全相同的药丸或完全一样的安慰剂。而对于治疗技术而言，就无法将工具与使用工具的人割裂开来。目前还没有足够成熟的实验技术来衡量治疗师的友善程度、智慧或判断力。”
For his part, van der Kolk says he would love to do large-scale studies comparing some of his preferred methods of treatment with some of the more commonly accepted approaches. But funding is nearly impossible to come by for anything outside the mainstream. In the wake of the Sept. 11 terrorist attacks, he says, he was invited to sit on a handful of expert panels. Money had been designated for therapeutic interventions, and the people in charge of parceling it out wanted to know which treatments to back. To van der Kolk, it was a golden opportunity. We really don't know what would help people most, he told the panel members. Why not open it up and fund everything, and not be prejudiced about it? Then we could study the results and really learn something. Instead, the panels recommended two forms of treatment: psychoanalysis and cognitive behavioral therapy. "So then we sat back and waited for all the patients to show up for analysis and C.B.T. And almost nobody did." Spencer Eth, who was then the medical director of behavioral health services at St. Vincent's Hospital in Manhattan, gathered data on the mental-health care provided to more than 10,000 Sept. 11 survivors. The most popular service by far was acupuncture. Yoga and massage were also in high demand. "Nobody looks at acupuncture academically," van der Kolk says. "But here are all these people saying that it's helped them."
至于范德科尔克，他表示自己很希望能进行一些大规模的研究，将他比较偏爱的治疗方法与已经获得普遍接受的其他一些方法进行比较。只是，想要做些主流之外的事情，几乎是不可能弄到资助的。他回忆道，在9·11恐怖袭击之后，他曾应邀参与四五个专家小组。他们已经拿到了一笔指定用于治疗干预的经费，于是负责人征求他们的意见，问他们应该拿这些钱来支持哪些治疗。对范德科尔克来说，这是一个千载难逢的好机会。我们确实不知道什么方法可以最大限度地为人们提供帮助，他对小组成员这样说道。那我们为什么不彻底放开成见，资助所有的疗法呢？这样我们就可以研究所得的结果，从中真正获得一些知识。可惜事与愿违，专家小组推荐了两种形式的治疗：精神分析和认知行为疗法。“于是我们坐等患者来接受分析和认知行为治疗。结果几乎是无人问津。”斯潘塞·艾斯(Spencer Eth)当时在曼哈顿的圣文森特医院(St. Vincent's Hospital)行为健康服务部门担任医疗主任，他搜集了关于1万多名9·11幸存者接受心理健康医疗服务的资料。截至目前，最受欢迎的服务是针灸，瑜伽和按摩的呼声也甚高。“没人把针灸抬入学术的大雅之堂，”范德科尔克说。“但所有这些人都说它很有用。”
Van der Kolk is always evaluating his own clinical experiences for clues to what works best. "Maybe I should have done E.M.D.R. with Eugene instead of that structure," he said not long after the California workshop. "I'm not sure how much good it will do."
一直以来，范德科尔克都在借助评估自己的临床经验来寻找最佳疗法的蛛丝马迹。“或许我该对尤金用EMDR，而不是构造练习，”在加州的研讨会后不久，他对我说。“我不太确定它会有多大效果。”
Back at the Trauma Center in Boston, van der Kolk and his colleagues are working on what he sees as the next step: redefining trauma itself. "We have a tendency now to label everything as PTSD," he says. "But so much of what we see is the result of long-term, chronic abuse and neglect. And that produces a different condition than one-off, acute traumatic incidents." Van der Kolk and his colleagues call this chronic form of traumatic stress "developmental trauma disorder"; in 2010, they lobbied unsuccessfully to have it listed in the Diagnostic and Statistical Manual of Mental Disorders as a condition separate from PTSD. They're hoping that with more data, they might finally prevail. Formal acceptance, van der Kolk says, is the key to getting support.
回到波士顿的创伤中心，范德科尔克及其同事们正投身于他信奉的下一步研究：重新定义创伤本身。“如今我们总是倾向于把什么都贴上PTSD的标签，”他说。“但是，我们今天所见的很多症状都是长期、慢性的虐待和忽视的结果。由此产生的疾病与一次性的急性创伤事件有所不同。”范德科尔克及其同事们将这种创伤应激的慢性形式称为“进行性创伤障碍(developmental trauma disorder)”。2010年，他们曾经试图游说 《精神疾病诊断与统计手册》(Diagnostic and Statistical Manual of Mental Disorders)的编制机构将其从PTSD中分离出来，作为一种单独的疾病列入，但未能成功。他们希望在更多数据的支持下，最终将得偿所愿。来自官方的正式接受是争取支持的关键，范德科尔克说。
"There's a grant to give more than $8 million to help survivors of the marathon bombing," van der Kolk mentioned one afternoon. "That's psychotic. Yes, it was horrible, and yes, those people are suffering and deserve help. But we have tens of thousands of children being traumatized every day, right in the same city — a couple million across the country — and no one is offering to help them." I asked why he thought that was. He told me about Pierre Janet, a psychiatrist at the Salpêtrière Hospital in 19th-century Paris. Janet published the first book on what was then called hysteria but which we now refer to as PTSD. He, too, became enmeshed in a dispute with his peers. He, too, was forced out of his laboratory.
“帮助波士顿马拉松爆炸案幸存者的专项拨款达800万美元以上，”范德科尔克在一天下午提到。“简直是精神错乱！没错，爆炸案非常可怕，而且，那些人也的确备受煎熬，值得救助。然而，就在这同一座城市里，每天都有数以万计的儿童遭受创伤，如果把统计范围扩展到全美，这个数字可达两百万，却没有人向他们伸出援手。”我问他认为其中的原因何在。他对我讲述了19世纪巴黎萨伯特慈善医院(Salpêtrière Hospital)的一名精神科医生皮埃尔·雅内(Pierre Janet)的故事。雅内出版了第一本关于当时被称为“歇斯底里”的PTSD的著作。他也陷入了与同行的争论之中，也被迫离开了自己的实验室。
"There's this cycle of knowing and forgetting," van der Kolk told me. "We discover trauma. And then when we see how horrifying and how inconvenient it is, we turn on the concept and peel off the messengers." Without missing a beat, he segued from Janet to World War I and World War II, explaining how the military establishments in both Europe and the United States stigmatized shell shock and combat fatigue, for fear that they would undermine the war effort. It's willful amnesia, he said, and he had plenty of more recent examples. Just a few years ago, he interviewed a group of foster children at a United States Senate hearing on the state of foster care. "Afterward, I'm sitting with the kids," van der Kolk said. "And a judge walks past us on his way out, and he says to the kids: ‘You're all doing so great! Look how terrific you all are!' And I say, ‘Well, no, why don't you ask them how they're doing?' These are kids that have suffered significant abuse and neglect. A couple of them are suicidal. They have substance-abuse problems. One of them cuts herself. But the judge didn't want to hear about that any more than we want to hear about what really happens to soldiers when they're off at war."
“这是一种认识和遗忘的循环，”范德科尔克告诉我。“我们发现了创伤。然后，当我们认识到它有多么可怕和多么令人为难时，我们会转而攻击这个概念，并排斥将这个概念带给我们的人。”他继续不厌其详地对我讲述从雅内到第一次世界大战再到第二次世界大战的历史，并解释了欧洲和美国的军事权威部门是如何抹黑炮弹休克症和战斗疲劳症的，因为他们害怕它们会削弱战斗力。这是故意的失忆，他说，并且举出了大量近期的例子。就在几年之前，他在联邦参议院关于寄养情况的听证会上问询了一批寄养儿童。“后来，我跟孩子们坐在一起，”范德科尔克说。“一名法官在出门时从我们身边走过，他对孩子们说，‘你们做得非常棒！非常了不起！'于是我说，‘哦不，你为什么不问问他们到底好不好？'这些都是遭受了严重的虐待和忽视的孩子，其中有几个人有自杀倾向，还有人存在物质滥用的问题，一个女孩子喜欢拿刀割伤自己。但法官并不想听到那些，就像在战争结束后，我们一点也不关心士兵们究竟怎么样了。”
Before enlisting in the Army, Eugene earned a bachelor's degree in art history from the American University of Paris. Now he's an antique art dealer. He lives in Queens with his wife and 3-year-old daughter but often goes into Manhattan to meet clients and visit galleries. I met him for coffee on the Upper East Side a couple of months after van der Kolk's workshop. I wanted to know how he felt about the exercise now that some time had passed. Did he think it had any impact on his PTSD?
在从军之前，尤金在巴黎美国大学(American University of Paris)拿到了艺术史学士学位。现在，他是一名古董艺术品经销商。他与妻子和3岁的女儿住在皇后区，经常到曼哈顿去见客户或拜访画廊。在参加范德科尔克的研讨会几个月之后，我约他在上东区喝咖啡。我想知道，经过一段时间之后，他现在对“架构”练习的感觉如何。他觉得这对PTSD有效果么？
What intrigued him most, he said, is how well it worked in the moment. Whatever spell van der Kolk cast lingered into the next day, so that Eugene really saw me, a complete stranger, as the object of his guilt. "I was terrified of you," he told me. It wasn't until the following day, when van der Kolk had me forgive him a second time, that the spell finally broke and he was able to face me as just another workshop participant. "It reminded me of that movie ‘The Master,' with Philip Seymour Hoffman," he said. "When Amy Adams asks Joaquin Phoenix, ‘What color are my eyes?' and he says, ‘Green,' and she says, ‘Turn them blue,' and you see them change color. It really reminded me of that."
最令他着迷的，是这种练习的效果立竿见影，尤金说。范德科尔克的“咒语”的魔力直到第二天也没有消退，这让尤金真的将我，一个完全的陌生人，当成了他心怀愧疚的对象。“我很怕你，”他告诉我。然后又过了一天，范德科尔克让我第二次对他表示原谅，那咒语才最终被打破，他终于能够面对我，将我还原为研讨会的普通参与者而已。“这让我想起了菲利普·塞默·霍夫曼(Philip Seymour Hoffman)主演的电影《大师》(The Master)，”他说。“埃米·亚当斯(Amy Adams)问华金·菲尼克斯(Joaquin Phoenix)，‘我的眼睛是什么颜色？'他回答，‘绿色。'她又说，‘请把它们变成蓝色，'然后你就看到那眼睛真的变色了。真的，这确实让我想起了那一幕。”
For a while at least, he said, he felt better. He recalled driving down the Pacific coast with his wife the day the workshop ended and noticing how weird it was not to feel stressed out. For weeks he was able to drive and use the subway with no trouble. "It felt like it sort of repaired my perception somehow," he said. "I used to always feel paranoid — like, I'd get freaked out going to my doctor because there were all these security guards in the waiting room — and for a while that was lifted."
他说，至少有一段时间，他感觉好多了。他回忆起研讨会结束那天，他开着车带着妻子沿着太平洋海岸向南行驶，很惊异地发现自己似乎不再被压得喘不过气来了。在几个星期里，他可以毫无障碍地驾驶汽车和乘地铁。“就好像是我的感知功能不知怎的就给修好了，”他说。“我以前总是很疑神疑鬼——比如，就因为候诊室里面有保安，出去看医生都会吓坏我。但这种念头有一阵子没有出现。”
But some of those effects were starting to fade. He was having headaches and memory problems again, and he was trying to figure out what triggered the relapse. He thought it had something to do with a painting he saw. He attended an Asian art fair earlier in the week, and an Arab dealer was selling some contemporary paintings; most of them were of soldiers, but one was of a woman. She looked like me, he said. He remembered staring at it and freezing up. The next day at a client's house, he misplaced his briefcase. "It was like I threw it out the window," he said. He spent 20 frantic and embarrassing minutes searching the house in a sweaty panic before he finally found it, right where he'd left it, near a window by the door.
然而，其中的一些疗效开始消退。头痛和记忆问题再次缠上了他，他试图找出是什么触发了复发。他认为这可能跟自己看到的一幅画有关。本周早些时候，他出席了一场亚洲艺术博览会。一名阿拉伯经销商在销售一批当代绘画作品，其中大部分以士兵为题材，只有一幅画表现的是一名女子。尤金说她看起来很像我。他记得自己盯着它，一动也动不了。第二天，在客户的家里，他不知道把自己的公文包塞到哪儿去了。“简直就像我把它从窗户里扔出去了似的，”他说。整整20分钟，他狂躁而窘迫地搜索房子的每一个角落，浑身大汗，恐慌不已。最后他终于找到了包——就在他原先放的地方，门旁边的窗户附近。
Still, he was feeling hopeful. Van der Kolk had suggested some other possible approaches at the end of the workshop. He was planning to try E.M.D.R. next.
尽管如此，尤金表示，他还是挺乐观的。在研讨会结束时，范德科尔克还建议了其他一些可以采取的治疗方法。下一步，他打算尝试一下EMDR。
I asked him how he felt sitting across from me now. He said that he had to go to the bathroom and that his face felt numb around one eye. Ever since the exercise, the area around his right eye — the one he'd squinted at me with — went numb whenever he got nervous. He said he didn't know why exactly, but he was sure it had something to do with the exercise itself. "I've been reading everything I can get my hands on," he said. "It definitely helped, more than anything else I've tried so far. But I still have no idea what he did to me."
我问他此时此刻坐在我对面的感觉如何。他说，他还是得去趟洗手间，而且，他觉得一只眼睛周围有些麻木。自从进行了“架构”练习后，他一紧张，右眼周围就会发麻——就是他瞟过我的那只眼。他说自己也不知道这是怎么了，不过他确信这与练习本身有关。“我一直在阅读能弄到的所有资料，”他说。“它绝对管用，起码，比我之前试过的所有东西都管用。只是我还没想通其中的玄机。”