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As a child, I had many fears. I was afraid of lightning, insects, loud noises and costumed characters.
我从小就是个胆小的人。我怕闪电、昆虫、大的声音和装扮成卡通人物的人。
I also had two very severe phobias of doctors and injections.
我最怕两件事：看医生和打针。
During my struggles to escape from our family doctor, I would become so physically combative that he actually slapped me in the face to stun me.
为了抗拒看家庭医生，我会拼命的挣扎，以致医生要打我耳光才能让我镇定下来。
I was six. I was all fight-or-flight back then, and holding me down for a simple vaccine took three or four adults, including my parents.
当时我才六岁。那时候我精神紧绷，打个疫苗都需要三四个成年人拉住我，包括我的父母在内。
Later, our family moved from New York to Florida just as I was starting high school,
后来，在我准备升入高中的时候，我们举家从纽约搬到了佛罗里达，
and being the new kid at the parochial school, not knowing anyone and being worried about fitting in,
作为一名进入了一所教区学校的新生，我不认识任何同学，很担心融入不了这里，
on the very first day of school, a teacher takes roll and calls out "Anne Marie Albano," to which I respond, "Here!"
开学第一天，有个老师点名时叫了“安妮·玛丽·阿尔巴诺”，我回答：“到！”
She laughs and says, "Oh, precious, stand up. Say D-O-G." And I respond, "Dog?"
她笑着说：“亲爱的，站起来。说D-O-G（狗）。”我回答：“狗？”
The class broke out in laughter along with the teacher. And so it went, because she had many more words to humiliate me with.
包括老师在内，全班一起哄堂大笑。从此以后，老师一直换着法儿的羞辱我。
I went home sobbing, distraught and begging to be sent back to New York or to some nunnery.
我哭着回家，非常难过，求着父母送我回纽约，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 and told me that they would investigate with the monsignor back in New York,
父母听了我的哭诉，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 to transfer to ninth grade on Staten Island.
但在此期间，我还是得每天去学校报到，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, so over the next several weeks,
这些都发生在有手机和电邮之前，所以在接下来的几周，
supposedly, there were letters being sent between the Archdiocese of Manhattan and Miami and with the Vatican,
据说一直有一些信件往返于曼哈顿教区、迈阿密和梵蒂冈，
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 to "Keep her going to school while we find her a spot."
我妈妈也会安慰我说，某些主教希望“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？
Well, after a couple of weeks, one day, while waiting for the school bus, I met a girl named Debbie, and she introduced me to her friends.
过了几周，某天，在等校车的时候，我遇到了一位叫Debbie的女孩，她把我介绍给了她的朋友。
And they became my friends, and, well, the Pope was off the hook.
然后我跟他们都成了朋友，接着就把教皇的事抛在脑后了。
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 stems partly from my own search for self-understanding. And I've learned much.
我花了30年研究孩童焦虑，一部分原因是出于我想了解我自己。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, and by adolescence,
从四岁发病，直到青春期，
one in 12 youths are severely impaired in their ability to function at home, in school and with peers.
1/12的儿童在家里、学校和与同伴相处上都面临困难。
These kids are so frightened, worried, literally physically uncomfortable due to their anxiety.
焦虑导致他们感到恐惧、担心，甚至是生理上的不适。
It's difficult for them to pay attention in school, relax and have fun, make friends and do all the things that kids should be doing.
他们在学校里无法专心、放松、玩耍、交朋友，以及做他们的年龄该做的事。
Anxiety can create misery for the child, and the parents are front and center in witnessing their child's distress.
焦虑让孩子感到痛苦，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, I had to go back to mom and dad and ask them a couple of questions.
因为工作的缘故，我接触了越来越多的孩子，而我也不得不回去问我父母一些问题。
"Why did you hold me down when I was so frightened of getting injections and force them on me?
“我那么害怕打针，可当初你们为什么逼我打针？
And why tell me these tall tales to make me go to school when I was so worried about being embarrassed again?"
我那么担心自己会被嘲笑，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, but we knew that these were things that you had to do.
他们回答：“我们每次看到都很心痛，但我们知道那是你必须要做的事。
We had to risk you becoming upset while we waited for you to get used to the situation with time and with more experience.
我们冒着让你难过的风险，希望等你慢慢习惯后，能够逐渐适应这些状况。
You had to get vaccinated. You had to go to school."
你必须打疫苗，你也必须去上学。”
Little did my parents know, but they were doing more than inoculating me from the measles.
他们当时并不知道，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.
他们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 -- and infectious, even multiplying,
过度焦虑对孩子来说是一种超强病毒--传染力强，甚至会“繁殖”，
such that many of the youth that I see come in with more than one anxiety condition occurring at the same time.
导致我所见到的青少年中，很多人都同时患有多种焦虑症。
For example, they'll have specific phobia plus separation anxiety plus social anxiety all together.
比如，他们对某个事物有极大的恐惧症，还伴有分离焦虑症和社交焦虑症。
Left untreated, anxiety in early childhood can lead to depression by adolescence.
如果不及时进行治疗，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.
甚至还会导致吸毒成瘾和自杀。
My parents were not therapists. They didn't know any psychologists.
我的父母并不是咨询师，也不认识任何心理医生。
All they knew is that these situations may have been uncomfortable for me, but they were not harmful.
他们只知道这些情况让我不自在，但并不会对我造成伤害。
My excessive anxiety would harm me more over the long term
长期下来，焦虑症只会对我造成更大的伤害，
if they let me avoid and escape these situations and not learn how to tolerate occasional distress.
如果他们允许我逃避这些情况，而不学会怎么去面对这些负面的刺激的话。
So in essence, mom and dad were doing their own homegrown version of exposure therapy,
所以，我父母只是在实行家庭版的暴露疗法，
which is the central and key component of cognitive behavioral treatment for anxiety.
这是在认知行为疗法里治疗焦虑症最关键的部分。
My colleagues and I conducted the largest randomized controlled study of the treatments of anxiety in children ages seven to 17.
我和同事们通过一项最大规模的随机对照试验研究了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 are effective for 60 percent of treated youth.
或者服用选择性血清素再摄取抑制剂，只对60%的青少年患者有效。
And their combination gets 80 percent of kids well within three months. This is all good news.
如果两种措施同时使用，80%的患者可以在3个月里康复。这是好消息。
And if they stay on the medication or do monthly exposure treatments as we did in the length of the study, they could stay well for upwards of a year.
如果他们持续服用药物，或是每个月接受暴露疗法，就像我们在实验中采用的那样，他们在1年内都不会复发。
However, after this treatment study ended, we went back and a did a follow-up study of the participants,
但是，在这个疗法实验结束后，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, they remained ill throughout the course of the time.
我们也发现，大约40%的患有焦虑症的孩子，在整个过程中一直处于疾病状态。
We've thought a lot about these results. What were we missing?
我们仔细思考了这些结果。我们遗漏了什么吗？
We've hypothesized that because we were focusing on just child-focused intervention,
据推断，这是因为我们只专注于针对孩童的治疗，
perhaps there's something important about addressing the parents and involving them in treatment, too.
却忽略了父母对他们造成的影响，所以家长们也应该参与治疗。
Studies from my own lab and from colleagues around the world have shown a consistent trend:
我的研究组和其他国家的心理学研究组都揭示了共同的趋势：
well-meaning parents are often inadvertently drawn into the cycle of anxiety.
具有良好初衷的父母常常会不可避免地卷入焦虑的恶性循环。
They give in, and they make too many accommodations for their child, and they let their children escape challenging situations.
面对孩子的焦虑，他们会让步，迁就他们的孩子，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: Your child comes into the house to you crying, in tears. They're five or six years of age.
现在你们设想一下：你的孩子哭着跑回家。他们才5岁或6岁。
"Nobody at school likes me! These kids are mean. No one would play with me."
“学校的小朋友都不喜欢我！他们很坏。他们都不跟我玩。”
How do you feel seeing your child so upset? What do you do?
看到他们难过，你会有什么样的感受？你会做什么？
The natural parenting instinct is to comfort that child, soothe them, protect them and fix the situation.
父母会本能地安慰孩子、哄他们、保护他们，并解决这个问题。
Calling the teacher to intervene or the other parents to arrange playdates, that may be fine at age five.
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，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, they invariably are going to be encountering challenging situations:
对于孩子来说，在成长的过程中，他们总是会遇到具有挑战性的情况：
sleepovers, oral reports, a challenging test that pops up,
去别人家过夜、课堂演讲、突击测验、
trying out for a sports team or a spot in the school play, conflicts with peers...
加入校体育队、或是在校园戏剧里试镜角色，与同学发生矛盾等等。
All these situations involve risk: risk of not doing well, not getting what they want, risk of maybe making mistakes or being embarrassed.
这些情况都包含冒险的因素：表现不好的风险、达不到预期目标的风险、犯错的风险、或者让他们难堪的风险。
For kids with anxiety who don't take risks and engage, they then don't learn how to manage these types of situations. Right?
对于焦虑的孩子来说，如果他们不主动迎接风险，他们就无法学会如何应对这些状况。对吗？
Because skills develop with exposure over time, repeated exposure to everyday situations that kids encounter:
因为这是随着时间累积的能力，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 or the ability to calm oneself down when upset;
自我安慰，或控制情绪；
problem-solving skills, including the ability to resolve conflicts with others;
解决问题，包括解决于同学之间的矛盾；
delay of gratification, or the ability to keep your efforts going despite the fact that you have to wait over time to see what happens.
延迟满足，或者继续努力的能力，尽管你不得不等待一段时间，看看会发生什么。
These and many other skills are developing in children who take risks and engage.
只有通过冒险和直面这些状况，孩子才能拥有这些能力。
And self-efficacy takes shape, which, simply put, is the belief in oneself that you can overcome challenging situations.
他们也会慢慢获得自我效能，简单来说，就是相信自己可以克服这些难题。
For kids with anxiety who escape and avoid these situations and get other people to do them for them,
患有焦虑症的孩子如果总是逃避这些状况或找他人替他们解决问题，
they become more and more anxious with time while less confident in themselves.
他们只会越来越焦虑，同时失去自信。
Contrary to their peers who don't suffer with anxiety, they come to believe that they are incapable of managing these situations.
相比没有焦虑症的孩子，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, to do things for them.
他们会认为他们需要别人，例如父母，来替他们做这些事。
Now, while the natural parenting instinct is to comfort and protect and reassure kids, in 1930,
虽然父母的本能就是安慰、保护和安抚孩子，但在1930年，
the psychiatrist Alfred Adler had already cautioned parents that we can love a child as much as we wish, but we must not make that child dependent.
精神科医师阿尔弗雷德·阿德勒就劝诫过父母，可以尽所能的爱自己的孩子，但不要让他们过度依赖别人。
He advised parents to begin training kids from the very beginning to stand on their own two feet.
他建议父母从一开始就锻炼孩子的独立能力。
He also cautioned that if children get the impression that their parents have nothing better to do than be at their beck and call,
他还警告说，如果孩子们觉得父母除了听命于他们之外别无他法，那就应该注意了，
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, they are always calling their parents or texting distress calls at all hours of the day and night.
如今，患有焦虑症的孩子总是习惯经常打电话给他们的父母，或发短信求救。
So if children with anxiety don't learn the proper coping mechanisms when young, what happens to them when they grow up?
如果患有焦虑症的孩子不在儿时学会正确的应对方式，他们长大后怎么办？
I run groups for parents of young adults with anxiety disorders. These youth are between the ages of 18 and 28.
我为患有焦虑症的青少年的家长成立了一些互助小组。他们的孩子都处于18-28岁的年龄段。
They are mostly living at home, dependent on their parents. Many of them may have attended school and college. Some have graduated.
大部分与父母同住，依赖于他们的父母。很多人上过初中、高中和大学，有些毕业了。
Almost all are not working, just staying at home and not doing much of anything.
但几乎所有人都没有工作，只是呆在家里，整天无所事事。
They don't have meaningful relationships with others, and they are very, very dependent on their parents to do all sort of things for them.
他们没有密切的社交圈，而且非常依赖父母去帮他们完成所有的事。
Their parents still make their doctors appointments for them.
他们的父母至今还帮他们预约看病。
They call the kids' old friends and beg them to come visit. They do the kids' laundry and cook for them.
还会打电话叫他们的朋友来家里玩，帮他们洗衣做饭。
And they are in great conflict with their young adult, because the anxiety has flourished but the youth has not.
却也经常与他们发生矛盾，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, but then resentment, and then more guilt.
这些父母感到极度愧疚，之后是懊悔，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 can help the child, assist them to confront their fears and learn how to problem-solve,
如果家长以及孩子成长过程中的一些关键人物一同帮助孩子克服他们的恐惧，并且学习如何解决问题，
then it is more likely that the children are going to develop their own internal coping mechanisms for managing their anxiety.
那这些孩子就更有可能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 and think about their reaction to their child's anxiety.
现在，我们教导父母用心来思考自己面对孩子焦虑时的反应。
We ask them, "Look at the situation and ask,
我们问他们，“面对这种情况时问自己：
'What is this situation at hand? How threatening is it to my child? And what do I ultimately want them to learn from it?'"
‘现在的情况是什么？对我的孩子会造成多大的危险？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, we want parents to intervene, absolutely.
如果一个孩子被霸凌或受伤，我们肯定会要求父母介入，毋庸置疑。
But in typical, everyday anxiety-producing situations, parents can be most helpful to their child if they remain calm and matter-of-fact and warm,
但在日常会导致焦虑的状况中，父母能给孩子最大的帮助就是保持冷静、理智、态度温和，
if they validate the child's feelings but then help the child, assist them in planning how the child is going to manage the situation.
不去否定他们的感受，但同时帮助孩子思考如何应对这种情况。
And then -- this is key -- to actually have the child deal with the situation themselves.
然后--这是最关键的--要让孩子自己去面对这些情况。
Of course, it is heartbreaking to watch a child suffer, as my parents told me years later.
当然，看到孩子难过，自己也会心疼，我的父母也是在很多年后才告诉我的。
When you see your child suffering but you think you could swoop in and save them from the pain of it, that's everything, right?
当你看到你的孩子难过，但你觉得可以马上让他们摆脱痛苦，这是最重要的，对吧？
That's what we want to do. But whether we are young or old,
我们都想这么做。但不论我们年长还是年少，
excessive anxiety leads us to overestimate risk and distress while underestimating our ability to cope.
过度焦虑都会让我们放大风险和焦虑，同时低估了我们的适应能力。
We know that repeated exposure to what we fear weakens anxiety, while building resources and resilience.
不断接触自己所恐惧的事物会降低我们的焦虑，同时增加我们处理问题的资源和抗压能力。
My parents were on to something. Today's hyper-anxious youth are not being helped by overly protective parenting.
我的父母发现了其中的奥秘。在现在的社会里，过度保护的教育方式并不会改善过度焦虑的问题。
Calmness and confidence are not just emotions. They are coping skills that parents and children can learn. Thank you.
冷静与自信不只是某种情感，还是父母与孩子可以一同学习的应对方式。谢谢。
