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Preparing for this talk has been scarier for me than preparing for LSD therapy.
准备此次演讲比准备LSD治疗还让我害怕。
"Psychedelics are to the study of the mind what the microscope is to biology and the telescope is to astronomy."
“迷幻剂之于心智，就像显微镜之于生物学，望远镜之于天文学。”
Dr.Stanislav Grof spoke those words.
这些话是斯坦尼斯拉夫·格罗夫博士说的。
He's one of the leading psychedelic researchers in the world, and he's also been my mentor.
他是世界上首屈一指的迷幻剂研究者之一，他也是我的导师。
Today, I'd like to share with you how psychedelics, when used wisely,
今天，我想和你们分享当明智的使用迷幻剂时，
have the potential to help heal us, help inspire us, and perhaps even to help save us.
是如何拥有潜力帮助治愈我们，帮助激发我们，并且甚至帮助拯救我们的。
In the 1950s and 60s, psychedelic research flourished all over the world
在20世纪50和60年代，迷幻剂研究在全球各地都很热门，
and showed great promise for the fields of psychiatry, psychology and psychotherapy, neuroscience and the study of mystical experiences.
并在精神病学、心理学和心理疗法、神经科学和神秘体验的研究中均显示了巨大的潜力。
But psychedelics leaked out of the research settings and began to be used by the counterculture, and by the anti-Vietnam War movement.
但迷幻剂从研究环境中泄露出来并被反主流文化，以及反越战运动使用。
And there was unwise use. And so there was a backlash.
存在一些不明智的使用。因此引起了强烈的反对。
And in 1970, the US government criminalized all uses of psychedelics, and they began shutting down all psychedelic research.
在1970年，美国政府将所有对迷幻剂的使用定为犯罪，并且开始终止所有的迷幻剂研究。
And this ban spread all over the world and lasted for decades.
这一禁令在全球扩散并持续了几十年。
And it was tragic, since psychedelics are really just tools,
这真是个悲剧，迷幻剂实际上只是个工具，
and whether their outcomes are beneficial or harmful depends on how they're used.
不管它们的结果是好还是坏，取决于它们怎么被使用。
Psychedelic means "mind-manifesting," and it relates to drugs like LSD, psilocybin, mescaline, iboga and other drugs.
迷幻意思是“心灵显现”，它与LSD、裸盖菇素、美斯卡林，依波加等药物有关。
When I was 18 years old, I was a college freshman, I was experimenting with LSD and mescaline,
在18岁时，我是个大学新生，我体验了LSD和墨斯卡灵，
and these experiences brought me in touch with my emotions.
这些体验让我接触到自己的情感。
And they helped me have a spiritual connection that unfortunately, my bar mitzvah did not produce.
它们帮助我建立了一种精神联系，不幸的是，我的成年礼并没有产生这种联系。
When I wanted to tease my parents, I would tell them that they drove me to psychedelics
当我想戏弄我父母时，我会跟他们说是他们把我推向了迷幻剂，
because my bar mitzvah had failed to turn me into a man.
因为我的成年礼并没有把我变成男人。
But most importantly, psychedelics gave me this feeling of our shared humanity, of our unity with all life.
但最重要的是，迷幻剂给了我一种我们共同的人性，我们与所有生命的统一的感觉。
And other people reported that same thing as well.
其他人也报告有同样的感受。
And I felt that these experiences had the potential to help be an antidote to tribalism,
我觉得这些体验具有潜力成为部落主义、
to fundamentalism, to genocide and environmental destruction.
原教旨主义、种族灭绝和环境破坏的解药。
And so I decided to focus my life on changing the laws and becoming a legal psychedelic psychotherapist.
于是我决定把我的人生致力于改变法律以及成为一名合法迷幻剂心理治疗师上。
Now, half a century after the ban, we're in the midst of a global renaissance of psychedelic research.
如今，在禁止过了半个世纪后，我们正处于迷幻剂研究的全球复兴之中。
Psychedelic psychotherapy is showing great promise for the treatment of post-traumatic stress disorder, or PTSD,
迷幻剂治疗法在治疗创伤后应激障碍，也就是PTSD，
depression, social anxiety, substance abuse and alcoholism and suicide.
抑郁，社交焦虑，药物滥用和酗酒和自杀等方面显示了巨大的潜力。
Psychedelic psychotherapy is an attempt to go after the root causes of the problems, with just relatively few administrations,
迷幻剂心理治疗试图追击问题的根源，只需相对较少的管理，
as contrasted to most of the psychiatric drugs used today that are mostly just reducing symptoms and are meant to be taken on a daily basis.
相比之下，今天使用的大多数精神药物主要是减轻症状，并意味着需要每天服用。
Psychedelics are now also being used as tools for neuroscience
迷幻剂今天也被用作神经科学工具
to study brain function and to study the enduring mystery of human consciousness.
来研究大脑功能和用来研究人类意识的永恒之谜。
And psychedelics and the mystical experiences they produce are being explored for their connections between meditation and mindfulness,
人们正在探索迷幻剂和它们产生的神秘体验与冥想和正念之间的联系，
including a paper just recently published about lifelong zen meditators taking psilocybin in the midst of a meditation retreat
包括最近发表的一篇关于终身禅修者在禅修中服用裸盖菇素后
and showing long-term benefits and brain changes.
显示出了其长期效果还有大脑变化的论文。
Now, how do these drugs work?
这些药物是怎么作用的？
Modern neuroscience research has demonstrated that psychedelics reduce activity in what's known as the brain's default mode network.
现代神经科学研究已经证明，迷幻剂减少了我们所周知的大脑默认模式网络的活动。
This is where we create our sense of self.
这是我们创造自我意识的地方。
It's our equivalent to the ego, and it filters all incoming information according to our personal needs and priorities.
这是我们的自我，它会根据我们的个人需求和优先事项过滤所有进入的信息。
When activity is reduced in the default mode network, our ego shifts from the foreground to the background,
当默认模式网络的活动减少时，我们的自我就从前台转移至后台，
and we see that it's just part of a larger field of awareness.
我们意识到这只是一个更大的意识领域的一部分。
It's similar to the shift that Copernicus and Galileo were able to produce in humanity using the telescope
这跟哥白尼和伽利略用望远镜
to show that the earth was no longer the center of the universe,
向人类展示地球不再是宇宙的中心，
but was actually something that revolved around the sun, something bigger than itself.
而实际上是绕着太阳转类似，有比自身更大的东西。
For some people, this shift in awareness is the most important and among the most important experiences of their lives.
对有些人来说，这个意识的转变是他们最重要和人生中最重要的体验。
They feel more connected to the world bigger than themselves.
他们感到与比自己更大的世界的亲密性。
They feel more altruistic, and they lose some of their fear of death.
他们利他的感觉更强，并且他们对死亡也不那么恐惧。
Not all drugs work this way. MDMA, also known as Ecstasy, or Molly, works fundamentally different.
不是所有的药物都这样起作用。MDMA/摇头丸，也称为嗨飞，或莫利，作用原理就就有着本质不同。
And I'll be able to share with you the story of Marcela,
我可以和你分享马塞拉的故事，
who suffered from post-traumatic stress disorder from a violent sexual assault.
她因暴力性侵犯而患有PTSD。
Marcela and I were introduced in 1984, when MDMA was still legal, but it was beginning also to leak out of therapeutic circles.
马塞拉和我是1984年介绍认识的，当时MDMA仍然非法，但它也开始从治疗圈中泄露出来。
Marcela had tried MDMA in a recreational setting,
玛塞拉曾在娱乐场所尝试过MDMA，
and during that, her past trauma flooded her awareness and it intensified her suicidal feelings.
在这期间，她过去的创伤意识淹没了她，强化了她自杀的想法。
During our first conversation, I shared that when MDMA is taken therapeutically,
在我们第一次交谈时，我分享说当MDMA用于治疗时，
it can reduce the fear of difficult emotions, and she could help move forward past her trauma.
它可以减轻对消极情绪的恐惧，并且可以帮助她走出创伤。
I asked her to promise not to commit suicide if we were to work together.
我请求她如果我们开始合作，希望她答应我不要自杀。
She agreed and made that promise.
她同意了并且做了承诺。
During her therapeutic sessions, Marcela was able to process her trauma more fluidly, more easily.
在她的治疗环节，玛塞拉能够更流畅，更容易地面对她的创伤。
And yet, she was able to tell that the rapist had told her that if she ever shared her story, he would kill her.
并且，她能够说出强奸犯告诉过她，如果她把事情说出去，他就杀了她。
And she realized that that was keeping her a prisoner in her own mind.
她意识到囚禁她的是她自己的思想。
So being able to share the story and experience the feelings and the thoughts in her mind freed her,
所以能够分享遭遇、经历、感觉和头脑中的想法解放了她，
and she was able to decide that she wanted to move forward with her life.
并且她也能够决定她想要她的生活继续。
And in that moment, I realized that MDMA could be very effective for treating PTSD.
在那一刻，我意识到MDMA对治疗PTSD可能非常有效。
Now, 35 years later, after Marcela's treatment, she's actually a therapist,
如今，在玛塞拉接受治疗的35年后，她成为了一名治疗师，
training other therapists to help people overcome PTSD with MDMA.
培训其他治疗师，帮助人们用MDMA克服PTSD。
Now, how does MDMA work? How did MDMA help Marcela?
那么，MDMA是如何作用的？MDMA是如何帮到玛塞拉的？
People who have PTSD have brains that are different from those of us who don't have PTSD.
患有PTSD的人与没有的人大脑不一样。
They have a hyperactive amygdala, where we process fear.
他们的杏仁核很活跃，这是处理恐惧的地方。
They have reduced activity in the prefrontal cortex, where we think logically.
他们的前额皮质的活动有所减少，这是负责逻辑思维的地方。
And they have reduced activity in the hippocampus, where we store memories into long-term storage.
他们的海马体的活动减少了，这是我们储存长期记忆的地方。
MDMA changes the brain in the opposite way.
而MDMA会把大脑朝相反的方向改变。
MDMA reduces activity in the amygdala, increases activity in the prefrontal cortex
MDMA减少了杏仁核的活动，增加了前额皮质的活动，
and increases connectivity between the amygdala and the hippocampus to remit traumatic memories to move into long-term storage.
并且增加了杏仁核和海马体之间的连接，将创伤记忆转移到长期存储中。
Recently, researchers at Johns Hopkins published a paper in "Nature,"
最近，约翰·霍普金斯大学的研究人员在《自然》杂志上发表了一篇论文，
in which they demonstrated that MDMA releases oxytocin, the hormone of love and nurturing.
他们证明MDMA能释放催产素，爱和养育的荷尔蒙。
The same researchers also did studies in octopuses, who are normally asocial, unless it's mating season.
同样的研究人员也对章鱼进行了研究，章鱼通常是独来独往的，除非在交配季节。
But lo and behold, you give them MDMA, and they become prosocial.
但给了它们MDMA之后，它们变得亲社会了。
Several months after Marcela and I worked together,
在玛塞拉和我治疗几个月后，
the Drug Enforcement Administration moved to criminalize Ecstasy, having no knowledge of its therapeutic use.
美国缉毒局开始将使用摇头丸定为犯罪，对其治疗作用则一无所知。
So I went to Washington, and I went into the headquarters of the Drug Enforcement Administration,
所以我来到华盛顿，我来到缉毒局的总部，
and I filed a lawsuit demanding a hearing,
并且提起诉讼，要求举办一场听证会，
at which psychiatrists and psychotherapists would be able to present information about therapeutic use of MDMA to try to keep it legal.
这样精神病学家和精神治疗师将能够提供有关MDMA治疗用途的信息，来让它变得合法。
And in the middle of the hearing, the DEA freaked out, declared an emergency and criminalized all uses of MDMA.
在听证会中间，缉毒局抓狂了，宣布进入紧急状态，并将所有使用MDMA的行为定为犯罪。
And so the only way that I could see to bring it back was through science, through medicine and through the FDA drug development process.
于是我看到的剩下的唯一让它回归的方式是通过科学、医学，并通过FDA药物开发流程。
So in 1986, I started MAPS as a nonprofit psychedelic pharmaceutical company.
所以在1986年，我成立了MAPS这家非盈利的迷幻药制药公司。
It took us 30 years, till 2016, to develop the data that we needed to present to FDA
它花了我们30年的时间，直到2016年，我们才得到了所需提交给FDA的数据，
to request permission to move into the large-scale Phase 3 studies
以申请进入大规模第三阶段研究的许可，
that are required to prove safety and efficacy before you get approval for prescription use.
在获得处方使用的批准之前，这是个需要证明其安全性和有效性的许可。
Tony was a veteran in one of our pilot studies.
托尼是我们一项试点研究中的一个老兵。
According to the Veterans Administration, there's over a million veterans now disabled with PTSD.
根据退伍军人管理局的数据，现在有超过一百万的退伍军人患有PTSD。
And at least 20 veterans a day are committing suicide, many of them from PTSD.
每天至少有20个老兵自杀，其中很多是因为PTSD。
The treatment that Tony was to receive was three and a half months long.
托尼所接受的治疗有3个半月长。
But during that period of time, he would only get MDMA on three occasions,
但在那期间，他只接受了三次MDMA治疗，
separated by 12, 90-minute non-drug psychotherapy sessions,
中间分为12次90分钟的非药物心理疗程，
three before the first MDMA session for preparation and three after each MDMA session for integration.
3次在第一次MDMA疗程前作为准备环节，3次在每次MDMA疗程后进行整合。
We call our treatment approach "inner-directed therapy,"
我们把我们的治疗方法称为“内在导向治疗”，
in that we support the patient to experience whatever's emerging within their minds or their bodies.
在这个过程中，我们支持病人去体验他们大脑或身体里出现的一切。
Even with MDMA, this is hard work.
即便有MDMA，这个工作也不容易。
And a lot of our subjects have said, "I don't know why they call this Ecstasy."
我们的很多研究对象都说过，“我不知道他们为什么把这叫嗨飞。”
During Tony's first MDMA session, he lay on the couch, he had eyeshades on, he listened to music,
在托尼的首次MDMA疗程中，他躺在沙发上，戴着眼罩，听着音乐，
and he would speak to the therapists, who were a male-female co-therapy team, whenever he felt that he needed to.
他可以和治疗师交谈，后者是一组男女联合治疗小组，随时在他需要时响应。
After several hours, in a moment of calmness and clarity,
在几个小时后，在一个平静和清晰的时刻，
Tony shared that he had realized his PTSD was a way of connecting him to his friends.
托尼分享了他意识到的他的PTSD是他和朋友联系的一种方式。
It was a way of honoring the memory of his friends who had died.
这是纪念他死去的朋友的一种方式。
But he was able to shift and see himself through the eyes of his dead friends.
但他能够通过死去的朋友的眼睛看到自己。
And he realized that they would not want him to suffer, to squander his life.
他意识到他们不希望他受苦，挥霍他的生命。
They would want him to live more fully, which they were unable to do.
他们希望他活得充实，而这是他们无法做到的。
And so he realized that there was a new way to honor their memory, which was to live as fully as possible.
于是他意识到有新的方法来纪念他的朋友们，那就是尽可能充实地活着。
He also realized that he was telling himself a story that he was taking opiates for pain.
他还意识到，他是在给自己洗脑，说他服用鸦片是为了止痛。
But actually, he realized, he was taking them for escape.
但事实上，他意识到他是用它们来逃避。
So he decided he didn't need the opiates anymore, he didn't need the MDMA anymore,
于是他决定再也不需要鸦片了，他再也不需要MDMA了，
and he was dropping out of the study. That was seven years ago.
于是他退出了研究。现在已经7年了。
Tony is still free of PTSD, has never returned to opiates and is helping others less fortunate than himself in Cambodia.
托尼没有再受PTSD折磨，他也没复吸鸦片，并且正在柬埔寨帮助那些没有他那么幸运的人。
The data that we presented to FDA from 107 people in our pilot studies, including Tony,
我们向FDA展示的数据来自我们试验研究的107个人，包括托尼，
showed that 23 percent of the people that received therapy without active MDMA no longer had PTSD at the end of treatment.
数据显示23%未接受积极MDMA治疗的人在治疗结束时不再患有PTSD。
This is really pretty good for this patient population.
这对于这些病人群体真是个好消息。
However, when you add MDMA, the results more than double, to 56 percent no longer having PTSD.
然而，当你加入MDMA时，结果翻倍，56%的人摆脱了PTSD。
But most importantly, once people learn that if they don't need to suppress their trauma,
但更重要的是，一旦人们意识到他们不需要压制他们的创伤，
but they can process it, they keep getting better on their own.
而是可以应付，他们就自行恢复了。
So at the 12-month follow-up one year after the last treatment session, two-thirds no longer have PTSD.
所以在最后一个疗程结束一年后的为期12个月的后续跟踪中，2/3的人不再患有PTSD。
And of the one-third that do, many have clinically significant reductions in symptoms.
并且在1/3没有好转的人中，许多人的症状在临床上有显著的减轻。
On the basis of this data, the FDA has declared MDMA-assisted psychotherapy for PTSD a breakthrough therapy.
根据这些数据，FDA宣布PTSD的MDMA辅助心理治疗为突破性治疗。
FDA has also declared psilocybin a breakthrough therapy for treatment-resistant depression
FDA还宣布裸盖菇素对难治性抑郁症是一种突破性的疗法，
and just recently approved esketamine for depression.
并且最近刚刚批准用埃斯氯胺酮治疗抑郁症。
I'm proud to say that we have now initiated our Phase 3 studies.
我很自豪地说我们现在已经开始我们第三阶段的研究。
And if the results are as we hope, and if they're similar to the Phase 2 studies,
假如结果不负所望，并且他们跟第二阶段研究类似，
by the end of 2021, FDA will approve MDMA-assisted psychotherapy for PTSD.
到2021年底，FDA将会批准PTSD的MDMA辅助心理治疗。
If approved, the only therapists who will be able to directly administer it to patients
如果得到批准，唯一能直接给病人治疗的治疗师
are going to be therapists that have been through our training program,
将会是通过我们培训项目的治疗师，
and they will only be able to administer MDMA under direct supervision in clinic settings.
并且他们只能在临床环境的直接监督下实施MDMA。
We anticipate that over the next several decades, there will be thousands of psychedelic clinics established,
我们预计未来几十年内，将会出现数千个致幻剂诊所，
at which, therapists will be able to administer MDMA, psilocybin, ketamine and other psychedelics to potentially millions of patients.
在这些地方，治疗师将能够使用MDMA、裸盖菇素、氯胺酮等致幻剂治疗潜在的数百万病人。
These clinics can also evolve into centers where people can come for psychedelic psychotherapy
这些诊所也可以发展成治疗中心，人们可以来这里进行迷幻心理治疗，
for personal growth, for couples therapy or for spiritual, mystical experiences.
以实现个人成长、夫妻治疗或精神、神秘体验。
Humanity now is in a race between catastrophe and consciousness.
人类现在正在灾难和意识之间举棋不定。
The psychedelic renaissance is here to help consciousness triumph.
迷幻剂复兴可以帮助意识胜利。
And now, if you all just look under your seats ... Just joking! Thank you. Thank you.
现在，如果你们都看一下座位下面...开个玩笑！谢谢。谢谢。
You've got to stay up here for a minute. Thank you so much, Rick. I guess it's a supportive audience.
你得在这里多呆一分钟。非常感谢，瑞克。我猜这群观众们都很支持你。
Yes, very. Many of them have also been to Burning Man.
是的，非常支持。他们很多人也去过火人节。
There's some synergy.
有共鸣。
So, in your talk, you talked about using these drugs to address some pretty serious traumas.
在演讲中，你谈到可以使用这些药物来解决一些非常严重的创伤。
So what about some more common mental illnesses like anxiety and depression, and is that where microdosing comes in?
那么像焦虑和抑郁这些更常见的精神疾病，这些微剂量疗法也有用武之地吗？
Well, microdosing can be helpful for depression, I do know someone that has been using it.
微剂量确实对于抑郁有帮助，我确实知道有人在使用它。
But in general, for therapeutic purposes, we prefer macro-dosing rather than microdosing,
但总体上而言，要达到治疗目的，我们更喜欢宏观剂量而不是微观剂量，
in order to really help people deal with the root causes.
目的是为了真正帮助人们应对问题根源。
Microdosing is more for creativity, for artistic inspiration, for focus ...
微剂量更多的是为了提升创造力，艺术灵感，为了让患者集中注意力...
And it also does have a mood-elevation lift.
它也会带来情绪的提升。
But I think for serious illnesses, we'd rather not get people thinking that they need a daily drug, but do more deeper, intense work.
但我认为对于严重的疾病，我们不想让人们认为他们每天都需要药物，但要做更深入、更细致的工作。
And what about outside the United States and North America, is this research being done there?
在美国和北美之外的地方，这方面的研究做得怎样？
Oh yeah, we're globalizing. Our Phase 3 studies are actually being done in Israel, Canada and the United States.
是的，我们在全球化。我们第三阶段的研究其实是在以色列，加拿大和美国进行的。
So once we get approval in FDA, it will also become approved in Israel and in Canada.
所以一旦获得FDA批准，它也会被以色列和加拿大批准。
We're just starting research in Europe. And we're actually going to be training some therapists from China.
我们刚刚在欧洲开始研究。我们其实正要培训一些来自中国的治疗师。
That's great. We were going to do an audience vote to see if people felt like this was a good idea to move forward with this research or not,
太棒了。我们要来个观众投票，看大家是否认为推进这个研究是个好主意，
but I have a feeling I know the answer to that, so... Thank you so much, Rick.
但我感觉我知道答案了，那么...非常感谢，里克。
Thank you. Thank you all.
谢谢。谢谢大家。
