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伴病而行

伴病而行

我们翻译这篇文章的理由

在未知的某一天,你被诊断出患有慢性疾病。它将会和你如影随形,甚至走到人生的尽头。我们无能为力,但我们也绝不放弃。或许只有在这样的时刻,那些被疾病所掩藏的无数的人生的真相才会真正袒露无遗,并且赐予我们重生的权利。

——李蕾

👇

伴病而行

作者:Joseph Trunzo

译者:金殊羽 & 李蕾

校对:王宇琪 & 张松

策划:李蕾 & 何翔宇

The Best Life Possible

艰难时刻也要活到最好

Living with chronic illness is hard. But there are psychological techniques that make it possible to thrive even when ill.

ACT心理技巧能帮你在与慢性病痛相伴的日子里好好过活。

Joseph Trunzo

‘Don’t let what you can’t do interfere with what you can do.’

“不要让我们无能为力之事影响到我们本可以做的事。”

John Wooden (1910-2010)

NCAA basketball coach

Before Donna got her diagnosis, she thought of herself as a musician, a busy professional, a volunteer, a mother, a grandmother. After she got her diagnosis – Parkinson’s disease, at age 58 – she thought of herself as a patient. The time she used to spend engaging in the things that gave her life meaning was eaten up by doctor’s appointments, diagnostic tests and constant monitoring of her symptoms, her energy, her reactions to medication. Her sense of loss was profound and undeniable.

在唐娜得知自己的诊断结果之前,她把自己看做是一个音乐家,一个忙碌的专业人士,一个志愿者,一个母亲,一个祖母。然而58岁被诊断出帕金森氏症后,唐娜就把自己当成了一个病人。过去她花时间在那些赋予她生命意义的事情上面,如今这些时间都门诊检查和对她的症状、能量、药物反应的持续监控吞噬了。这种失落感来的结结实实、彻彻底底

Unfortunately, Donna’s experience is all too common. Heart disease, arthritis, multiple sclerosis, diabetes, depression, cancer, asthma, Crohn’s disease, cystic fibrosis, autoimmune disorders, fibromyalgia, chronic fatigue syndrome, Lyme disease: the list goes on. I would guess that most people know someone close to them who is suffering from one of these debilitating chronic conditions, if not struggling with a diagnosis themselves. Globally, three in five deaths are attributed to one of four major diseases – cardiovascular disease, chronic lung conditions, cancer or diabetes. Moreover, approximately a third of adults suffer from multiple chronic conditions, wreaking untold havoc on healthcare systems and economies across the globe. In developed countries, it might be closer to three in four older adults who suffer from multiple conditions. The proportion of patients with four or more diseases is expected to almost double between 2015 and 2035 in the UK alone. Frighteningly, these statistics don’t even account for chronic illnesses in children, which are on the rise. In sum, this means that billions of people are, at best, not functioning at their highest level and, at worst, are severely debilitated, living limited lives, and requiring chronic medical care.

令人沮丧的是,唐娜的经历太普遍了。心脏病,关节炎,多发性硬化症,糖尿病,抑郁症,癌症,哮喘,克罗恩病,囊性纤维化,自身免疫性疾病,纤维肌痛,慢性疲劳综合征,莱姆病……不胜枚举。我想大多数人的身边都会有患有一两个诸如此类折磨人的慢性病的人吧甚至也许他们自己就在和自己患有的慢性病在做着抗争。在全球范围内,五分之三的死亡都是由四大疾病之一导致的这四大疾病分别是心血管疾病、慢性肺病、癌症糖尿病。此外,大约有三分之一的成年人患有多种长期疾病对全球医疗保健系统和经济体造成了巨大的灾难。发达国家有近四分之三的老年人患有多种慢性疾病2015年至2035年,仅仅在英国,患四种或四种以上疾病的患者比例预计会增加近一倍。令人恐惧的是,这些统计数字还未包含儿童患慢性病的情况而这种情况正在增加。总乐观来讲,这意味着数十亿人每天不能以最好的状态生活悲观来说,他们可能身体严重衰弱,过着严重受限的生活需要长期医疗。

The bigger questions of how to prevent these illnesses or resolve this global health crisis are beyond me. I am not an epidemiologist, public health expert, economist or even a physician. However, as a clinical psychologist, I see many people trying to navigate the daily vagaries of chronic afflictions. I’ve worked with people who have been diagnosed with various forms of cancer, Parkinson’s, cystic fibrosis, Lyme disease, obesity, all manner of cardiovascular diseases, multiple sclerosis, brain injuries, paralysis and many other illnesses. Naturally, I also see people on a regular basis who are dealing with chronic mental health issues, such as depression, anxiety, trauma, bipolar disorder and so forth. The causes of these conditions are varied and multifaceted. The underlying factor for all of them, however, is that, in the absence of a cure, people want to live the best life they possibly can, regardless of their affliction or disability. While each person and each condition presents its own set of challenges, there are some unifying principles in helping people who are suffering from chronic illnesses to live better, more meaningful lives. In my practice, I approach these issues from a therapeutic perspective known as acceptance and commitment therapy, or ACT (said as the word, not the acronym). I encourage anyone dealing with similar issues to learn about this approach, as it has been helpful to my clients and countless others.

如何预防这些疾病或解决这场全球健康危机——这样的大问题是我无法解决的。我不是流行病学家或是公共卫生专家,也不是经济学家或是医生。但作为一名临床心理学家,我看到许多人试图在每天变幻莫测的疾苦中艰难前行。我曾与患有各种癌症、帕金森氏症、囊性纤维化、莱姆病、肥胖、各种心血管疾病、多发性硬化症、脑损伤、瘫痪和许多其他疾病的人一同工作。我自然也经常看到人们面临着慢性心理健康问题,比如抑郁、焦虑、创伤、双相情感障碍等等。造成这些情况的原因有很多所有这些原因都有一个最基本的出发点那就是在没有治愈方法的情况下,无论人们如何受到疾病和伤残的折磨,他们都希望尽可能过上最好的生活。虽然每个人自身的情况不同,面临的挑战也各异,但帮助患有长期疾病的人过上更好、更有意义的生活有一些统一的原则。在实践中,我从治疗的角度来处理这些问题,即接受承诺治疗,或ACT治疗法把它看作一个单词,而不是缩写)。我鼓励任何面临类似状况的人学习这种方法,因为它对我的委托人和其他的许多人都有帮助。

Generally, living as rich and meaningful a life as possible when you are struggling with a chronic illness requires a great deal of psychological flexibility. With chronic illness, rigidity in your thinking and behavior is the greatest barrier to living well with your illness. The only thing you can count on is the fact that you never really know what your day is going to look like, and that things are always changing. How are you going to feel today? This morning? Later this afternoon? What will you be able to do? How much rest will you need? How clear will your head be? How much pain will you have at any given moment today? How bad will the medication side-effects be? Planning – for anything – can be an excruciatingly difficult task and, since we are typically creatures of routine, we hang on to those routines as much as we can. This is generally a good thing – we like structure and predictability, but chronic illnesses can make this quite challenging, and sometimes impossible.

通常,在患长期疾病的情况下,尽可能使自己的生活丰富而有意义需要我们具有较强的心理灵活性。患长期疾病时,思想的僵化和行为的刻板是与疾病平和相处的最大阻碍。你唯一能够依托的就是你不会知道你的全新一天会是什么样子,事物会发生怎样的变化。今天你将会感觉如何?今天早上呢?今天下午的晚些时候呢?你能做哪些事情?你需要多少休息时间?你的头脑会有多清晰?你在今天某个特定的时刻会感受到怎样的疼痛?药物副作用有多严重?为每件事情做好计划可能会是一个令人痛苦的艰难过程,因为我们是典型的习惯于规律生活的生物,我们尽可能地坚持我们的日常生活规律。这通常是件好事,我们喜欢明确的结构和可预测性,但是长期疾病会使这一点颇具挑战性,甚至有些时候根本无法实现。

Psychological flexibility is the idea that we need to be present with what is happening right now, free of judgment, and to respond in a way that moves us forward rather than getting stuck in the emotions or feelings of the moment – anger, frustration, sadness, pain and so forth. While becoming more psychologically flexible might seem like a daunting, if not impossible task, it is not a talent available only to a select few. Rather, it is a skill, and any skill can be learned by just about anyone with enough practice. Below are some approaches that you can use to help you increase your psychological flexibility and, I hope, help you live a more meaningful life, even if you have a chronic illness.

心理灵活性就是说我们需要感知当下正在发生的事情,不去评价它们,并且用一种能够使我们前行而不是深陷于当下消极情绪中的方式去回应它们。这样的情绪有愤怒、挫败感、悲伤、痛苦等等。虽然具备更强的心理灵活性可能看起来是一项能够实现但是很艰难的任务,但它并不是困难到只有少数天赋异禀的人才能做到。它是一项技能,所有的技能都能通过每个人足够的练习而习得。下面是一些能够帮助你提高心理灵活性的方式,我希望即使你患有长期疾病,这些方法也能够帮助你过更有意义的生活。

Be the thinker, not the thought: this phrase refers to how we handle our internal voice, the constantly running commentary that we experience all day, every day, and can never seem to silence. For whatever reason, that inner voice can be very critical, judgmental or even downright cruel. We also tend to listen to it way too much. Since human beings are rather egocentric, if our mind is telling us something, we tend to automatically believe it to be true. This contributes greatly to our perception of reality, and drives our emotional reactions and behaviors, but often in unhelpful directions. For example, if you’re dealing with a chronic illness, you might be plagued by thoughts of being burdensome to your family or loved ones. Be the thinker, not the thought simply means increasing your awareness of the thoughts you are having, being more observant of your own thought processes, putting some distance between the thought and reality, and then making some better decisions about whether or not to engage with them.

做一个主动思考的人,而不是被思想支配的人:它指的是我们在多大程度上能够掌控我们内心的声音——我们对每日每时经历的事情作出的无止息的评论。内心的声音可能十分具有批判性和判断性,有时甚至十分残忍。我们太过于相信它们了。人类以自我为中心,如果我们的思维告诉我们一些事情,我们倾向于无意识地相信它们是真实的。这极大地影响了我们对现实的认知,也对我们的情感和行为有导向作用,但往往导向消极的方向。比如说,你在与长期疾病抗争时,可能会认为自己是家人和所爱之人的负担。做主动思考的人,而不是被思想支配意味着增进你对自己想法的认识,更敏锐的感知想法产生的过程,在思想和现实之间设置界线,最后,对是去遵循还是忽略这个想法做出更明智的判断。

But how does one do this?

但如何去做呢?

I am not suggesting that you try to eliminate or control any of your thoughts; this would be a futile endeavor. Thoughts will arise in your mind, and there they are – trying not to think something actually requires you to think it, so it is simply not possible to do. Instead, you should notice the thought, then try to react in a better way so that you can separate yourself from it. It’s one thing to think ‘I am a burden’ but an entirely different thing to notice yourself having the thought that you are a burden.

我并不建议你试图消除或控制你的任何想法,这是一种无效的努力。想法会在头脑中产生,不去思考一件事实际上会让你更容易思考这件事,所以单纯地让自己不去思考一件事是不可能实现的。你应该做的是:意识到自己有这个想法,然后用一种更好的处理方式来把想法和自己分开来。具有“我是个负担”的想法和认为到你有自己是个负担的想法是两回事。

This difference might seem like semantics, but it’s not. If you notice, then you can decide how to respond. If the thought is helpful to you at the time, then run with it. For example, if you think that it is time for your medication or that your family loves you and takes good care of you, then of course engage with those thoughts. If, however, you’re having thoughts about being a burden, and notice that and decide it isn’t particularly helpful, then you can figure out how much attention and energy you want to give this thought. Maybe simply noticing it and shifting your focus to something more productive would be the best course. Allow yourself to feel what you’re feeling, move through it, and turn your attention to more meaningful pursuits

这区别似乎是在咬文嚼字,但它不是。如果你察觉到了个中区别,你就能够知道如何应对了。如果这个想法对当下的你有所帮助,就采纳它。比如说,如果你认为到了吃药的时候了,或者认为你的家人爱你并精心照料你,你当然应该保有这些想法。但如果你觉得自己是个负担,也发觉自己有这种想法,并认为这种想法对你毫无帮助,你就应该想清楚你应该给予这种想法多大的关注和精力。也许发现这点,并将重心转移到更有益的事物上,是最好的处理方式。让自己感受自己的感受,游刃其间,将注意力转移到更有意义的追求当中。

Be open to acceptance: this is perhaps the most difficult and misunderstood concept of ACT. For many, especially those dealing with a chronic illness, when they hear the term ‘acceptance’, they get upset. They liken it to being told to suck it up, to just deal with it or to stop complaining. In many contexts, this might indeed be the message that’s being sent with this word, but this is not the case from the ACT perspective. In fact, sucking it up and not complaining is often the opposite of acceptance. If you’re doing those things at the request of ‘well-wishers’, you’re probably denying your experience, stifling your natural reactions and avoiding reality.

学会接受现状,这可能是ACT疗法当中最困难和最容易被误解的概念。对许多人,尤其是患有长期疾病的人来说,当他们听到“接受”一词时,他们会感到苦恼。他们认为这意味着去忍受,去认命,去停止抱怨。在很多情况下,这个词所传达的信息的确是这样,但这并不是从ACT疗法的角度所做出的解释。事实上,认命和停止抱怨常常是“接受”的反面。如果你在做好心人所期望你去做的事情,你很可能是在违背自己的意愿,抑制自己的天性并抵抗现实生活。

The nature of chronic illness is that it is ongoing, and in many cases degenerative or permanent. Recognizing when you have little to no control over something can help you to stop struggling against it. Validating – not minimizing or negating – your experience can help you to honestly assess your condition, your options and your choices.

长期疾病的性质是它从不间断,在很多情况下疾病会不断侵蚀你的身体,且无法被医治。认识到自己对一件事几乎没有控制力能够使你停止与它的抗争。合理认知你的经历——而不是轻视或否认它——能够使你如实评价你的身体状况和你所能做出的选择。

Allowing yourself to feel what you’re feeling can help you to move through it, and turn your actions and attention to more meaningful pursuits. This is not to say that, if someone with such an injury had an opportunity to be able to walk again, they shouldn’t pursue it. It is to say that spending all of one’s time and energy trying not to feel a certain way, or trying to change a currently unchangeable situation, is a fantastically inefficient and ineffective way to move through life. There is a time and place to fight your illness, but it is not 24 hours a day, seven days a week. Dropping the moment-to-moment struggle, and accepting where you are and what you can do in this moment can be powerfully transformative. It frees up energy and time to engage with family, friends, hobbies, leisure activities, rest and so forth.

使自己感受到自己当下的感受能够帮助你继续前行,将注意力和行动转移到更加有意义的追求上。这并不是说如果有人受伤,还有重新行走的可能,他们不应该去努力实现。这句话的意思是,如果把所有的时间和精力都花在试图逃避自己特定的感受,或者试图改变一种目前无法改变的状况上,是一种极其低效甚至无效的生活方式。你有时间和空间来与疾病抗争,但不是每时每刻都在进行。放下每时每刻的挣扎,接受你现在所处的位置,了解现阶段你能够做,这是一种有力的改变。它为你空出了与家人和朋友相处的时间,使你有了花在爱好、休闲活动和休息当中的时间。

Stay present: you probably hear a lot about being mindful, meditating, staying focused on the now, not getting stuck in the past or caught up in the future. This is all good and wise, but what does it actually mean? What if your present is painful and difficult, why would you want to stay there? Staying present is another tricky concept.

活在当下:你可能听过很多关于多留心多思考,关注当下,不要沉湎于过去或深陷于未来的说法。这些都是很好很明智的想法,但它实际的含义是什么?如果你当下的生活是痛苦而艰难的,那为什么要“活在当下”呢?活在当下本身就是一个很微妙的概念。

From an ACT perspective, it means paying close attention only to what’s happening in this very moment, in your body, in your mind and all around you. This is a hard thing to do: it does not come naturally because our minds don’t easily allow it. We’re always looking for the next thing that might hurt us, regretting or reliving the past, worrying about the future.

从ACT的视角出发,它意味着我们只需要关注当下这个时刻发生的所有,发生在你的体内,你的意识里和你周围的全部。这并不容易:我们的意识不会轻易允许它自然而然地发生,我们总是在忧虑着下一件可能让我们受伤的事情,后悔或者懊恼着过去,担忧着未来。

The problem is that, when you are not present, it compromises your ability to move through your current situation. A big part of noticing your thoughts, for example, is being present with the moment. Regrets about the past and worries about the future do nothing for your current situation. You need to deal with what’s right in front of you, be it pain, anger, resentment, guilt, joy, fear or love. Whatever it is, it is with you right here, right now. Your job is to try to be present with it, even dig into it, because when it comes to emotions and physical sensations, there is no way over, no way under, and no way around – there is only through. And you cannot move through something if you are not present to it. Not being present is often a form of avoidance, which tends to get us into more trouble than if we just allowed ourselves to feel what we’re feeling in the first place.

问题在于,如果无法着眼当下,那么你摆脱当前困境的能力就会减弱。而自我觉察最重要的部分,举例而言,就是和当下的时刻共处。悔恨过去和担忧未来对你的现状毫无益处。你需要明白眼前的是什么,是痛苦、愤怒、抵抗、负罪、快乐、害怕、还是爱。无论它是什么,它现在就在此地,在此刻。你的职责就是努力和它共处,甚至贯注其中。当我们面对情感和感觉时,我们无路可走、无可逃避,只能穿过。如果不设身处地活在当下,你就无法克服任何事情。不在场往往是一种逃避,比起只去感受我们最初的感受,这会让我们陷入更多的麻烦。

Be here now, not there then: no one wants to be sick but, when we are, we tend to think of what we were like when we were well, or how we hope to be at some point in the future. There’s nothing wrong with remembering or hoping, but when you allow past or future versions of yourself to skew your perception of your present – when you make decisions based on how you felt then versus how you feel now – it can lead to bad outcomes.

现在当下,不是彼时他处:没有人想要生病,但是生病时,我们更倾向于去思考我们好起来的时候是什么样子,或者在未来的某个时候我们是什么样子。回忆或者期望并没有错,但是当你纵容那些过去或者未来的情景来扭曲对现在的看法时——当你基于你感受如何而不是现在你感受如何来做决定的时候——它会带来糟糕的结果。

Perhaps you were an energetic, productive person before you became ill, but now you have a fraction of the energy you did then. If you make decisions about what you can do based on your former energy levels, you’ll set yourself up for major problems. You might be exhausted for the next fewdays or you might hurt yourself, rendering you completely unavailable for any other activity or for your family. Being here now, not there then, is like being present with your current self versus your past or future self. It doesn’t mean you’ll be this way forever, it just means this is where you are right now, so make decisions about your life based on that, not where you were or where you wish to be. Ultimately, this will allow for better decision making and increased functionality.

或许,在生病之前,你是一个充满活力,高效的人,但是现在,你的精力大不如前。此时如果基于自己之前的身体状况来做决定,你将会遇到更严重的问题。接下来的几天你会无法完全融入其他任何活动,无法陪伴家人,并且由此筋疲力尽,甚至受伤。活在当下此时,而不是彼时他处,和现在的你自己相处而不是过去,将来的自己。但这并不意味着你要永远这样活着,它只是意味着这是你当下的所在,所以请你基于当下来做决定,而不是基于你曾经或者希望身处的地方。这些最终都会让你做出更好的决定,成为更完善的自我。

Know what matters: there are few things that will clarify your priorities and values like a chronic illness. It turns your life upside down. The things you thought mattered – such as meeting work deadlines, getting promoted, making a good impression at the neighborhood party – all of a sudden matter a whole lot less. Use this clarity to guide your decisions and your behavior. If your illness has shown you that your family matters most, then every new decision should be geared towards moving you in the direction of that value. In Donna’s case, she rediscovered her love of music for itself, and saw how her mastery of an instrument was only one way to engage with something she valued deeply.

明白什么是重要的:很少有像慢性疾病一样可以让你分清轻重缓急和确认价值观的事情了。它会让你的生活天翻地覆。那些你认为重要的事情——例如在截止日期之前完成工作,获得晋升,在邻里聚会中留下好的印象——突然之间就无足轻重了。利用这种清晰的思考来决策和行动。如果你的疾病让你认识到家庭是最重要的,那么每一个新的决定都应该将你指引到这个价值观的方向上。在Donna的事例中,她重新发现了自己对音乐的爱,并且认识到她对乐器的掌控只是她与珍视的东西互动的方式。

Earlier I spoke of letting go of thoughts that don’t matter or aren’t useful; knowing what matters is how you decide what’s useful to you. The good news is that, while you might have little control over what you think or how you feel, you have 100 per cent control over what matters to you. Is it your health? Stay fully engaged in your treatment. Go to your medical appointments. Get the sleep and rest you need. Say no to things that you know will be too much. Say yes to things that you can manage and that matter. Take an inventory of the major areas of your life – family, health, friends, leisure, spirituality, vocation – and decide what matters to you, and move towards it.

之前我提到过要放弃那些无关或者是没用的想法,明白什么最重要就是你评判有用之物的好方法。好消息是,尽管你可能无法掌控你自己的所想所感,但是你却有100%的把握去掌控那些对你而言重要的事情。是你的健康?那么就全心投入你的治疗、遵循你的医嘱、好好休息和睡觉。对那些太繁复的事情说不,对你可以掌控的重要事情说是。盘点你生命中主要的部分——家庭、健康、朋友、娱乐、精神世界、工作——决定那些对你而言最重要的部分,然后努力向他们靠拢。

It’s important not to confuse values with goals. Goals are achievable and have an end point, whereas values are consistent guideposts in your decision-making process that are never truly attainable. It might be a goal for you to be able to attend an important family event, but being engaged with your family is the value behind the goal. Once you attend the event, it’s over, but you never stop caring about your family. Goals tend to be aligned with your values, but they are not the same thing. When you determine your values, this is where you want to pour your energy. Then you can use this information to guide all your decisions. Does the thought of being a burden help move you closer to what’s important and meaningful? No? Then let it go and move on. When it comes back, just notice it and let it go again. When you have a thought that is consistent with your values, then run with it.

重要的是不要把价值观和目标混为一谈。目标是可以实现并且有终点的,价值却是贯穿在你每个决定之中的始终如一的指路牌,并且永远无法真正被获得。对你而言,参加一个重要的家庭活动可能是你的目标,而背后的价值观则是全心全意对家庭的投入。当你参与活动的时候,目标就已经达成,但是你绝对不会停止照料你的家人。目标总是和你的价值观紧密相连,但是他们并不是相同的,你可以利用这一点来指导你所有的决策。“成为负担”的想法会帮助你更靠近那些重要并且有意义的事情吗?不能?那么放弃他们继续前行。当这种想法回来的时候,你只需要注意并且重新抛开他们。当你拥有和价值观保持一致的想法的时候,就去追随它。

I should clarify what exactly I mean by engagement because you might misinterpret this as always feeling like you need to be doing something. You don’t. You can (and probably should) engage in rest. Take a nap. Say no to things. Stop doing things if it gets to be too much. Give yourself permission to pursue your value of tending to your health and wellbeing. Good self-care is the foundation for everything else you do – nothing else happens if you don’t take care of you, so resting and taking time off is not only okay, it’s necessary. It doesn’t make you lazy, it doesn’t make you useless, it doesn’t make you a burden. It makes you a whole thinking and feeling person who is doing what you need to do to take care of yourself. Embrace it. If your value is rest, then rest. If your values are more ‘action’ oriented, then do so in whatever way you can and that makes sense for you.

我需要澄清的是我所说的“全心全意投入”的含义,因为你可能会误解为你总是需要在做一些事情。并非如此,你可以(可能是应该)全身心地休息,小憩一下,对事情说不,事情太多的话就不要再去做了。允许你自己去追随让你健康和幸福的价值观。好好照顾自己是做其他任何事情的基础——如果你无法照顾自己,什么都不会达成。所以停下来休息不仅仅是可以的,更是必须的。它不会使你懒惰,也不会使你毫无用处,更不会对你造成负担。做关爱自己所需的事情,会让你成为一个全面思考和感知丰富的人。拥抱它,如果你的价值观就是休息的话,那么就去休息。如果你的价值观被更多的行动主导,那么就做你可以做的那些对你有意义的事情。

Pain in the pursuit of valued actions is purposeful. Pain without purpose is suffering. While there is certainly purposeless suffering in the world, and those with chronic illness know this better than most, not all pain has to be suffering. Connecting your pain to a value is critical in helping you lead a richer, more vital, more meaningful life.

在践行对自己有价值的行动的过程中,痛苦是有目的性的,没有目的的痛苦只是煎熬。当然世界上存在毫无目的的煎熬,而那些患有慢性疾病的人对此更是了解,但不是所有的痛苦都必须变成煎熬。把你的痛苦和价值观连接起来,对于过一个更加富足、更加重要、更加有意义的生活而言非常重要。

Above all, ACT is an action-oriented approach, designed to increase your psychological flexibility to help you behave in ways that will improve the meaning and quality of your life. The acronym is no accident. The doing, whatever you decide that might be, is of paramount importance.

总而言之,ACT是一个以行动主导的方法,它旨在增强你的心理调适能力来帮助你通过一些方法提升并完善生活质量和生存意义。这个名称的缩写并不是偶然,你决定做什么,成为什么,是至关重要的。

Chronic illness might have robbed you of much of your abilities. You might feel like a shell of your former self. You might not be able to walk around the block anymore, or even to walk at all. Some days, maybe you can’t even get out of bed. Maybe you’ll never get out of bed again. Your stamina might be gone. You might become incredibly fatigued by the simplest of tasks. Maybe you can’t think clearly, or you can’t be in a room with the lights on. Eating might be a challenge; enjoying food might be a thing of the past. You might be in pain – all the time.

慢性疾病可能剥夺了你很多的能力。或许你会觉得自己变成了之前那个自我的躯壳;或许你再也无法在邻里之间散步,甚至是再也无法行走;有些日子里或许你根本无法离开病床,又或许你永远也无法离开病床;或许你已经失去耐力,哪怕最简单的活动都让你变得难以置信的疲惫;或许你无法再清醒地思考,再也无法待在开灯的房间。吃饭变成了挑战,享受美食永远成为了过去;或许你将永远深陷痛苦,无法自拔。

With chronic illness, you can easily spend all day cataloguing what you can no longer do, but to what end? Does this move you towards your values? Maybe you can’t engage with your friends and family exactly the way you like; but if you can engage with them somehow, no matter how small, that is meaningful. Our lives are ultimately determined by our behaviors – by what we do – and any action, no matter how small it might be, that moves you towards your values is better than doing nothing or shutting yourself down because it’s no longer the way it was or how you ideally want it to be. Maybe you can’t read to your grandchildren anymore. Can they read to you? In what way can you engage with them that’s consistent with your values? While it might not be the ideal way, it is a way, and anything that moves you in that direction, no matter how seemingly small, is going to be better for you and those who love you. When we are actively engaged in value-driven behaviors, life is more meaningful, even if it is different than it was before.

身患慢性疾病,你很容易把一整天的时间都花在列举你再也无法做什么上面,但是什么时候是个头呢?这样做让你和你的价值观更近一步了吗?你可能再也无法按照自己的想法全心全意和你的朋友家人相处,但是如果你还可以以某种方式和他们相处,不论多么平凡,都是有意义的。我们的生命最终被我们的行为——被我们做什么,我们的任何行动——决定,不论他们有多么平凡,都会让你靠近你坚信的价值,你不能只是因为他们不是曾经的样子或者你期待的样子,就彻底封闭自己,什么也不做。或许你再也无法为你的孙辈读书,那么他们可以为你读书吗?怎样和他们相处才能和你的价值观一致?尽管可能不是理想的方式,但是也是一种方式。任何可以让你走向那个方向的方式,不论看上去多么的平凡细微,都会对你和爱你的人更好。当我们积极地去践行价值导向的行为时,生活就会变得更有意义,哪怕它已经和从前的生活截然不同。

You have every right to be angry, frustrated and resentful. No one should tell you otherwise. You feel how you feel, but you don’t have to let those feelings – or your attempts to control them – dictate how you live. If you can become more psychologically flexible, if you can break free of the rigid emotional confines of chronic illness, you can fashion a better and more meaningful life for yourself and your loved ones. You might not have a choice about your illness, but you do have choices about how to live with it. At any given moment, those choices are either moving you towards your values – the things that matter – or they are not. Choose the former – it will lead to a more meaningful life.

你拥有每一次生气、沮丧和怨恨的权利,没有人可以剥夺你的这些权利。你可以感受你的感受,但是你不能让那些感受——或者你想要试图控制他们的努力——来指导你如何生活。如果你有足够好的心理调适能力,你会让自己和你爱的人都过上更加美好也更有意义的生活。你无法选择你的疾病,但你能够选择如何与之共处。在任何时刻,这些选择都会让你靠近你的价值观——那些对你而言重要的事情——或者不能。请选择前者,去过一个更有意义的生活。

原文链接:https://aeon.co/essays/it-takes-psychological-flexibility-to-thrive-with-chronic-illness

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