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TED演讲：改造记忆，选择性忘掉不开心！
创伤后应激障碍会使你的大脑，特别是你的记忆重新布线，并且还能在被搅动的时候重新挖掘出破坏性的情绪反应，这种重复性的伤害，真的困扰了不少人。那么，在科技飞速发展的今天，我们能在不抹去记忆的情况下消除这些触发因素吗？
演讲者：Amy Milton
演讲题目：Can we edit memories?
记忆是一件很平常的事，我们几乎把它当成理所当然。我们都记得今天早上吃了什么早餐，或者上周末做了什么。只有当记忆开始衰退的时候，我们才会意识到它是多么的神奇，我们又是如何让过去的经历来定义我们的。 But memory is not always a good thing. As the American poet and clergyman John Lancaster Spalding once said, "As memory may be a paradise from which we cannot be driven, it may also be a hell from which we cannot escape." Many of us experience chapters of our lives that we would prefer to never have happened.但记忆并不总是件好事。正如美国诗人、神职人员约翰·兰卡斯特·斯波尔丁曾经说过的那样：“记忆可能是一个无法驱赶我们的天堂，也可能是一个无法逃离的地狱。”我们中的许多人都经历过我们希望从未发生过的人生篇章。 It is estimated that nearly 90 percent of us will experience some sort of traumatic event during our lifetimes. Many of us will suffer acutely following these events and then recover, maybe even become better people because of those experiences. But some events are so extreme that many -- up to half of those who survive sexual violence, for example -- will go on to develop post-traumatic stress disorder, or PTSD.据估计，近90%的人在有生之年会经历某种创伤事件。我们中的许多人会在这些事件之后遭受痛苦，然后康复，甚至可能因为这些经历而成为更好的人。但有些事件是如此极端，以至于许多人——例如，多达一半的性暴力受害者——将继续发展成创伤后应激障碍（PTSD）。 PTSD is a debilitating mental health condition characterized by symptoms such as intense fear and anxiety and flashbacks of the traumatic event. These symptoms have a huge impact on a person's quality of life and are often triggered by particular situations or cues in that person's environment.创伤后应激障碍是一种衰弱的心理健康状况，其最明显的症状是强烈的恐惧、焦虑以及一直沉溺在创伤事件中等。这些症状对一个人的生活质量有着巨大的影响，通常是由其所处环境中的特定情况或线索引发的。 The responses to those cues may have been adaptive when they were first learned -- fear and diving for cover in a war zone, for example -- but in PTSD, they continue to control behavior when it's no longer appropriate. If a combat veteran returns home and is diving for cover when he or she hears a car backfiring or can't leave their own home because of intense anxiety,对这些线索的反应在他们第一次习得时可能是具有适应性的——例如，在战区中感到恐惧并隐藏自己寻找掩护——但是在创伤后应激障碍中，当行为不再合适时，他们则继续控制行为。如果一名退伍老兵回到家中，听到汽车回火或因极度焦虑而无法离开家时，他或她就会隐藏自己寻找掩护， then the responses to those cues, those memories, have become what we would refer to as maladaptive. In this way, we can think of PTSD as being a disorder of maladaptive memory.然后对这些线索的反应，这些记忆，就变成了我们所说的不适应。这样，我们可以认为创伤后应激障碍是一种适应不良的记忆障碍。 Now, I should stop myself here, because I'm talking about memory as if it's a single thing. It isn't. There are many different types of memory, and these depend upon different circuits and regions within the brain. As you can see, there are two major distinctions in our types of memory.现在，我应该在这里停下来，因为我在谈论记忆，好像它是一件单一的事情。但不是的。有很多不同类型的记忆，它们依赖于大脑中不同的回路和区域。如你所见，我们的记忆类型有两个主要的区别。 There are those memories that we're consciously aware of, where we know we know and that we can pass on in words. This would include memories for facts and events. Because we can declare these memories, we refer to these as declarative memories.有些记忆是我们有意识地意识到的，我们知道我们知道的，我们可以用语言来传递。这将包括对事实和事件的记忆。因为我们可以声明这些记忆，我们称之为声明性记忆。 The other type of memory is non-declarative. These are memories where we often don't have conscious access to the content of those memories and that we can't pass on in words. The classic example of a non-declarative memory is the motor skill for riding a bike. Now, this being Cambridge, the odds are that you can ride a bike.另一种类型的内存是非声明性的。在这些记忆中，我们常常无法有意识地获取这些记忆的内容，也无法用语言传递。非陈述性记忆的典型例子是骑自行车的运动技能。现在，这里是剑桥，你很可能会骑自行车。 You know what you're doing on two wheels. But if I asked you to write me a list of instructions that would teach me how to ride a bike, as my four-year-old son did when we bought him a bike for his last birthday, you would really struggle to do that. How should you sit on the bike so you're balanced?你知道你在两轮车上干什么。但如果我让你给我写一份指示清单，教我怎么骑自行车，就像我四岁的儿子在我们给他买自行车作为上一个生日礼物时做的那样，你真的很难做到。你应该怎样坐在自行车上保持平衡？ How fast do you need to pedal so you're stable? If a gust of wind comes at you, which muscles should you tense and by how much so that you don't get blown off? I'll be staggered if you can give the answers to those questions. But if you can ride a bike, you do have the answers, you're just not consciously aware of them.你需要多快才能稳定下来？如果一阵风吹来，你应该绷紧哪些肌肉，绷紧多少才能不被风吹走？如果你能回答这些问题，我会很吃惊的。但如果你能骑自行车，你确实知道答案，你只是没有意识到它们。 Getting back to PTSD, another type of non-declarative memory is emotional memory. Now, this has a specific meaning in psychology and refers to our ability to learn about cues in our environment and their emotional and motivational significance. What do I mean by that? Well, think of a cue like the smell of baking bread, or a more abstract cue like a 20-pound note.回到创伤后应激障碍，另一种非陈述性记忆是情绪记忆。现在，这在心理学上有一个特殊的意义，它指的是我们了解环境中的线索及其情感和动机意义的能力。我这么说是什么意思？好吧，想象一下烤面包的味道之类的暗示，或是一个更抽象的暗示，比如一张20磅的钞票。 Because these cues have been pegged with good things in the past, we like them and we approach them. Other cues, like the buzzing of a wasp, elicit very negative emotions and quite dramatic avoidance behavior in some people因为这些线索在过去一直与好事联系在一起，所以我们喜欢它们并接近它们。其他的暗示，比如黄蜂的嗡嗡声，会引起一些人非常消极的情绪和夸张的回避行为。 Now, I hate wasps. I can tell you that fact. But what I can't give you are the non-declarative emotional memories for how I react when there's a wasp nearby.现在，我讨厌黄蜂。我可以告诉你这个事实。但我不能给你的是当我身边有一只黄蜂时，我如何反应的非陈述性情绪记忆。 I can't give you the racing heart, the sweaty palms, that sense of rising panic. I can describe them to you, but I can't give them to you. Now, importantly, from the perspective of PTSD, stress has very different effects on declarative and non-declarative memories and the brain circuits and regions supporting them.我不能让你心跳加速，手心出汗，恐慌加剧。我可以给你描述，但我不能将这些感受传达给你。现在，重要的是，从创伤后应激障碍的角度来看，压力对陈述性和非陈述性记忆以及支持它们的脑回路和脑区有着非常不同的影响。 Emotional memory is supported by a small almond-shaped structure called the amygdala and its connections. Declarative memory, especially the what, where and when of event memory, is supported by a seahorse-shaped region of the brain called the hippocampus.情感记忆是由一个称为杏仁核的小杏仁状结构及其联系所支持的。陈述性记忆，特别是事件记忆的什么、在哪里和什么时候，是由海马状的大脑区域支持的。 The extreme levels of stress experienced during trauma have very different effects on these two structures. As you can see, as you increase a person's level of stress from not stressful to slightly stressful, the hippocampus, acting to support the event memory, increases in its activity and works better to support the storage of that declarative memory.创伤期间所经历的极端压力水平对这两种结构的影响非常不同。正如你所看到的，当你将一个人的压力水平从没有压力增加到轻微压力时，海马体起到了支持事件记忆的作用，它的活动增加了，并且更好地支持了陈述性记忆的储存。 But as you increase to moderately stressful, intensely stressful and then extremely stressful, as would be found in trauma, the hippocampus effectively shuts down. This means that under the high levels of stress hormones that are experienced during trauma, we are not storing the details, the specific details of what, where and when.但是当你增加到中度压力，强烈压力，然后是极度压力，就像在创伤中发现的那样，海马体会有效地关闭。这意味着，在创伤期间所经历的高水平的压力荷尔蒙下，我们并没有储存细节，具体的细节是什么，在哪里，什么时候。 Now, while stress is doing that to the hippocampus, look at what it does to the amygdala, that structure important for the emotional, non-declarative memory. Its activity gets stronger and stronger. So what this leaves us with in PTSD is an overly strong emotional -- in this case fear -- memory that is not tied to a specific time or place, because the hippocampus is not storing what, where and when.现在，当压力作用于海马体时，看看它对杏仁核的作用，杏仁核的结构对情绪化、非陈述性记忆很重要。它的活动越来越强。因此，这给我们留下的创伤后应激障碍是一种过度强烈的情感——在本案例中是恐惧——记忆与特定的时间或地点无关，因为海马体没有储存什么，在哪里和什么时候。 In this way, these cues can control behavior when it's no longer appropriate, and that's how they become maladaptive. So if we know that PTSD is due to maladaptive memories, can we use that knowledge to improve treatment outcomes for patients with PTSD?这样，当行为不再合适时，这些线索就能控制行为，这就是它们变得不适应的原因。所以，如果我们知道创伤后应激障碍是由于记忆不适应引起的，我们能利用这些知识改善创伤后应激障碍患者的治疗效果吗？ A radical new approach being developed to treat post-traumatic stress disorder aims to destroy those maladaptive emotional memories that underlie the disorder. This approach has only been considered a possibility because of the profound changes in our understanding of memory in recent years. Traditionally, it was thought that making a memory was like writing in a notebook in pen:一种治疗创伤后应激障碍的有些激进的新方法正在开发中，它旨在摧毁导致这种障碍的不适应情绪记忆。这种方法之所以被认为是可行的，是因为近年来我们对记忆的理解发生了深刻的变化。根据传统，人们认为记忆就像用钢笔在笔记本上写字： once the ink had dried, you couldn't change the information. It was thought that all those structural changes that happen in the brain to support the storage of memory were finished within about six hours, and after that, they were permanent. This is known as the consolidation view.一旦墨水干了，你就不能改变信息。有人认为，所有发生在大脑中支持记忆储存的结构变化，都是在大约6小时内完成的，之后，它们是永久性的。这就是所谓的整合视图。 However, more recent research suggests that making a memory is actually more like writing in a word processor. We initially make the memory and then we save it or store it. But under the right conditions, we can edit that memory. This reconsolidation view suggests that those structural changes that happen in the brain to support memory can be undone, even for old memories.然而，最近的研究表明，制造记忆实际上更像是在文字处理器中写作。我们最初制作内存，然后保存或隐藏它。但是在适当的条件下，我们可以编辑内存。这种重新整合的观点表明，那些发生在大脑中支持记忆的结构变化是可以撤销的，即使是对旧的记忆。 Now, this editing process isn't happening all the time. It only happens under very specific conditions of memory retrieval. So let's consider memory retrieval as being recalling the memory or, like, opening the file. Quite often, we are simply retrieving the memory.现在，这个编辑过程并不是一直都在进行。它只发生在非常特殊的条件下的记忆检索。所以让我们把内存检索看作是调用内存，或者像打开文件一样。很多时候，我们只是在找回记忆。 We're opening the file as read-only. But under the right conditions, we can open that file in edit mode, and then we can change the information. In theory, we could delete the content of that file, and when we press save, that is how the file -- the memory -- persists.我们以只读方式打开文件。但在适当的条件下，我们可以在编辑模式下打开该文件，然后我们可以更改信息。理论上，我们可以删除该文件的内容，当我们按save时，这就是文件（内存）的持久保存方式。 Not only does this reconsolidation view allow us to account for some of the quirks of memory, like how we all sometimes misremember the past, it also gives us a way to destroy those maladaptive fear memories that underlie PTSD. All we would need would be two things: a way of making the memory unstable -- opening that file in edit mode -- and a way to delete the information.这种重新整合的观点不仅让我们能够解释一些记忆的怪癖，比如我们有时是如何错误地记住过去的，它也给了我们一种方法来摧毁那些构成创伤后应激障碍的不适应的恐惧记忆。我们只需要做两件事：一种方法是使内存变得不稳定——比如在编辑模式下打开文件——另一种方法是删除信息。 We've made the most progress with working out how to delete the information. It was found fairly early on that a drug widely prescribed to control blood pressure in humans -- a beta-blocker called Propranolol -- could be used to prevent the reconsolidation of fear memories in rats. If Propranolol was given while the memory was in edit mode, rats behaved as if they were no longer afraid of a frightening trigger cue.我们在解决如何删除信息方面取得了最大的进展。人们很早就发现，一种广泛用于控制人类血压的药物——一种叫做普萘洛尔的β受体阻滞剂——可以用来防止老鼠恐惧记忆的再巩固。如果在记忆处于编辑模式时给予普萘洛尔，老鼠的行为就好像不再害怕可怕的触发信号。 It was as if they had never learned to be afraid of that cue. And this was with a drug that was safe for use in humans. Now, not long after that, it was shown that Propranolol could destroy fear memories in humans as well, but critically, it only works if the memory is in edit mode.好像他们从来没有习得害怕那个暗示。这是一种对人体安全的药物。不久之后，研究表明普萘洛尔也能破坏人类的恐惧记忆，但关键的是，它只有在记忆处于编辑模式时才能起作用。 Now, that study was with healthy human volunteers, but it's important because it shows that the rat findings can be extended to humans and ultimately, to human patients. And with humans, you can test whether destroying the non-declarative emotional memory does anything to the declarative event memory. And this is really interesting.现在，这项研究是对健康的人类志愿者进行的，但它很重要，因为它表明老鼠的研究发现是可以扩展到人类，并且最终扩展到人类患者的。对于人类，你可以测试破坏非陈述性情绪记忆是否对陈述性事件记忆有任何影响。这真的很有趣。 Even though people who were given Propranolol while the memory was in edit mode were no longer afraid of that frightening trigger cue, they could still describe the relationship between the cue and the frightening outcome. It was as if they knew they should be afraid, and yet they weren't.即使在记忆处于编辑模式时服用了普萘洛尔的人也不会再害怕那个可怕的触发线索，他们仍然可以描述线索和可怕结果之间的关系。就好像他们知道自己应该害怕，但事实并非如此。 This suggests that Propranolol can selectively target the non-declarative emotional memory but leave the declarative event memory intact. But critically, Propranolol can only have any effect on the memory if it's in edit mode.这表明普萘洛尔可以选择性地靶向非陈述性情绪记忆，但保留陈述性事件记忆的完整性。但至关重要的是，普萘洛尔只有在编辑模式下才能对记忆产生影响。 So how do we make a memory unstable? How do we get it into edit mode?那么我们如何使记忆不稳定呢？我们如何进入编辑模式？ Well, my own lab has done quite a lot of work on this. We know that it depends on introducing some but not too much new information to be incorporated into the memory. We know about the different chemicals the brain uses to signal that a memory should be updated and the file edited.我自己的实验室在这方面做了很多工作。我们知道，这取决于引入一些新的信息，而不是过量的新信息，以纳入记忆。我们知道大脑用来发信号通知应该更新内存和编辑文件的化学物质。 Now, our work is mostly in rats, but other labs have found the same factors allow memories to be edited in humans, even maladaptive memories like those underlying PTSD. In fact, a number of labs in several different countries have begun small-scale clinical trials of these memory-destroying treatments for PTSD and have found really promising results.现在，我们的研究主要是在老鼠身上，但其他实验室也发现了同样的因素，使得人类的记忆可以被编辑，甚至像那些潜在的创伤后应激障碍的不适应记忆也可以。事实上，一些国家和地区的实验室已经开始对这些破坏记忆的创伤后应激障碍疗法进行小规模临床试验，而且发现的结果具有很大的可行性。
Now, these studies need replication on a larger scale, but they show the promise of these memory-destroying treatments for PTSD. Maybe trauma memories do not need to be the hell from which we cannot escape.现在，这些研究需要更大规模的复制，但它们也展现了这些记忆破坏治疗创伤后应激障碍的前景。也许创伤记忆以后不会成为我们无法逃避的地狱了。 Now, although this memory-destroying approach holds great promise, that's not to say that it's straightforward or without controversy.现在，虽然这种破坏记忆的方法很有希望，但这并不是说它简单明了或没有争议。 Is it ethical to destroy memories? What about things like eyewitness testimony? What if you can't give someone Propranolol because it would interfere with other medicines that they're taking?破坏记忆是合乎道德的吗？那些已经被看见的事实呢？如果你不能给别人服用普萘洛尔怎么办，因为它会干扰他们正在服用的其他药物，那时又该怎么办？ Well, with respect to ethics and eyewitness testimony, I would say the important point to remember is the finding from that human study. Because Propranolol is only acting on the non-declarative emotional memory, it seems unlikely that it would affect eyewitness testimony, which is based on declarative memory.好吧，关于伦理和目击者的证词，我想说，要记住的重要一点，那就是人类研究的发现。由于普萘洛尔只作用于非陈述性情绪记忆，似乎不太可能影响基于陈述性记忆的已知事实。 Essentially, what these memory-destroying treatments are aiming to do is to reduce the emotional memory, not get rid of the trauma memory altogether. This should make the responses of those with PTSD more like those who have been through trauma and not developed PTSD than people who have never experienced trauma in the first place. I think that most people would find that more ethically acceptable than a treatment that aimed to create some sort of spotless mind.本质上，这些破坏记忆的疗法的目的是减少情绪记忆，而不是完全摆脱创伤记忆。这应该会使创伤后应激障碍患者的反应更像那些经历过创伤但没有发展成创伤后应激障碍的患者，而不是那些一开始就没有经历过创伤的患者。我认为，大多数人会发现，这比一种旨在创造某种纯洁心灵的治疗更符合道德。 What about Propranolol? You can't give Propranolol to everyone, and not everyone wants to take drugs to treat mental health conditions. Well, here Tetris could be useful. Yes, Tetris. Working with clinical collaborators, we've been looking at whether behavioral interventions can also interfere with the reconsolidation of memories. Now, how would that work?普萘洛尔是不是完全没问题的呢？你不能给每个人普萘洛尔，也不是每个人都想吃药治疗精神健康状况。好吧，俄罗斯方块可能有用。是的，俄罗斯方块。与临床合作者合作，我们一直在研究行为干预是否也能干扰记忆的再巩固。现在，研究得怎么样了呢？ Well, we know that it's basically impossible to do two tasks at the same time if they both depend on the same brain region for processing. Think trying to sing along to the radio while you're trying to compose an email. The processing for one interferes with the other. Well, it's the same when you retrieve a memory, especially in edit mode.好吧，我们知道，如果两个任务都依赖于同一个大脑区域进行处理，那么基本上是不可能同时完成的。想一想当你在写邮件的时候试着跟着收音机唱歌。对一个事项的处理干扰了另一个事项的完成度。好吧，当你检索内存时也是一样的，特别是在编辑模式下。 If we take a highly visual symptom like flashbacks in PTSD and get people to recall the memory in edit mode and then get them to do a highly engaging visual task like playing Tetris, it should be possible to introduce so much interfering information into that memory that it essentially becomes meaningless. That's the theory, and it's supported by data from healthy human volunteers.如果我们采取高视觉症状，如PTSD中的闪回，让人们在编辑模式下回忆起记忆，然后让他们做一个像玩俄罗斯方块一样的高吸引力视觉任务，那么应该有可能将如此多的干扰信息引入到记忆中，从本质上说，它变得毫无意义。这就是理论，它得到了健康志愿者的数据支持。 Now, our volunteers watched highly unpleasant films -- so, think eye surgery, road traffic safety adverts, Scorsese's "The Big Shave." These trauma films produce something like flashbacks in healthy volunteers for about a week after viewing them.现在，我们的志愿者看了一些非常不愉快的电影——比如，眼科手术，道路交通安全广告，斯科塞斯的《刮脸大法》。这些创伤电影在健康志愿者看了一周后会产生类似于倒叙的东西。 We found that getting people to recall those memories, the worst moments of those unpleasant films, and playing Tetris at the same time, massively reduced the frequency of the flashbacks. And again: the memory had to be in edit mode for that to work.我们发现，让人们回忆那些记忆，那些不愉快电影中最糟糕的时刻，同时玩俄罗斯方块，会大大减少了倒叙的频率。再说一遍：内存必须处于编辑模式才能被运作。 Now, my collaborators have since taken this to clinical populations. They've tested this in survivors of road traffic accidents and mothers who've had emergency Caesarean sections, both types of trauma that frequently lead to PTSD, and they found really promising reductions in symptoms in both of those clinical cases.现在，我的合作者已经把这个治疗模式带到了临床人群中。他们在道路交通事故的幸存者和紧急剖腹产的母亲身上进行了测试，这两类创伤经常会导致创伤后应激障碍，他们发现这两种临床病例的症状确实有希望得到缓解。 So although there is still much to learn and procedures to optimize, these memory-destroying treatments hold great promise for the treatment of mental health disorders like PTSD. Maybe trauma memories do not need to be a hell from which we cannot escape.因此，尽管仍有许多需要学习和优化的程序，但这些破坏记忆的治疗方法很有希望可以治疗创伤后应激障碍等心理健康障碍。也许创伤记忆不会再成为我们无法逃脱的地狱。 I believe that this approach should allow those who want to to turn the page on chapters of their lives that they would prefer to never have experienced, and so improve our mental health. Thank you.我认为，这种方法应该让那些想翻开人生篇章的宁愿从未经历过的人尝试一下，从而改善大家的心理健康。谢谢大家。
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