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You may have heard that facing your fears is the best way to conquer them.
你可能聽說過，直面恐懼是戰(zhàn)勝恐懼的最好方法。
As it turns out, this is actually pretty scientific advice, and is the basis for a technique called exposure therapy.
事實上，該方法是科學(xué)的，是暴露療法的基礎(chǔ)。
This kind of therapy has been used in some form or another since the 1950s,
這種療法自20世紀50年代以來就以某種或另一種形式被使用過，
and it's designed to help people overcome intense fears and anxieties by exposing them to whatever they're afraid of.
它旨在通過讓人們接觸害怕的事物從而幫助人們克服強烈的恐懼和焦慮情緒。
And while that might sound totally counterintuitive, it's all based on some pretty basic and well-tested psychology.
盡管聽起來可能不可思議，但這一切都基于一些非常基本且經(jīng)過測試的心理學(xué)內(nèi)容。
In general, there's nothing wrong with being afraid.
一般來說，恐懼沒有錯。
After all, fear is a big part of what's kept humans around for so long.
畢竟，人類情緒的主要部分就是恐懼。
But people with conditions like post-traumatic stress disorder or phobias experience extreme levels of fear that make it difficult to live their lives.
但患有創(chuàng)傷后應(yīng)激障礙或恐懼癥的人會經(jīng)歷極度的恐懼，這種恐懼讓他們的生活變得艱難。
Exposure therapy is designed to help people overcome those kinds of debilitating fear.
暴露療法旨在幫助人們克服這種極度恐懼。
And it's centered on the idea that fears can be learned and unlearned.
這一療法的中心思想在于恐懼可以習(xí)得也可以不習(xí)得。
This is related to a concept in psychology called conditioning—specifically, Classical or Pavlovian conditioning.
這與心理學(xué)中的條件作用概念有關(guān)——具體地說，經(jīng)典條件作用或巴甫洛夫條件反射作用。
It was named after famous experiments done by Ivan Pavlov in the 1890s, and it involves a stimulus becoming associated with a specific outcome.
巴甫洛夫條件反射作用是以伊凡·巴甫洛夫在19世紀90年代的著名實驗命名，該實驗涉及與具體結(jié)果相關(guān)的刺激。
In Pavlov's experiments, dogs learned that whenever someone rang a bell, they got food.
在巴甫洛夫的實驗中，狗知道只要有人按鈴，它們就能得到食物。
So they came to associate the bell with food, and developed a positive reaction to it.
所以狗把鈴鐺和食物聯(lián)系起來，并對它產(chǎn)生了積極的反應(yīng)。
In that case, they salivated in anticipation of being fed.
在這種情況下，狗會因期待得到食物而流口水。
Other experiments showed that this type of conditioning can be true for negative stimuli, too.
其他實驗表明，這種條件作用也適用于消極刺激。
Like, if someone is bitten by a dog, they might associate dogs with pain and fear and develop a phobia of them.
例如，如果有人被狗咬了，他們可能會把狗與疼痛、恐懼聯(lián)系在一起，并對狗產(chǎn)生恐懼。
These results have been duplicated in tons of experiments over the years,
多年大量的實驗結(jié)果與此是一致的，
but what's most important for exposure therapy is that these associations can also be extinguished, or unlearned, through conditioning.
但對于暴露療法來說，最重要的是，這些聯(lián)系也可以通過條件作用消失，或不為人知。
So if someone with a phobia of dogs had repeated exposure to the animals without being bitten, their link between dogs and pain would likely disappear.
因此，如果一個害怕狗的人多次接觸狗而沒有被咬傷，那么狗和疼痛的聯(lián)系可能就會消失。
This process is the same no matter where the association comes from, too.
不管這種聯(lián)系從何而來，其過程都是一樣的。
So no matter where someone learned to fear something, facing their fear in a controlled environment can still help them extinguish it.
所以無論人的恐懼來自何處，在可控的環(huán)境中直面恐懼依然可以幫助他們消除恐懼。
And that's a big part of what exposure therapy is based on: controlled, safe, fear extinguishing.
暴露療法基于這幾個重要部分：控制，安全，消除恐懼。
It's about either teaching someone to overcome a fear, or to manage and process their anxieties in a more helpful way.
要么教會人們克服恐懼，要么以一種對他們更有益的方式管理和處理他們的焦慮。
There are a few different types of this therapy, and the exposure part can take several forms.
這種療法有幾種不同類型，暴露部分可以采取幾種形式。
For one, a fear can either be imagined or experienced in vivo, meaning in real life.
首先，恐懼在現(xiàn)實生活中要么被想象，要么被體驗。
Some fears, like fear of spiders, are safe for in vivo exposure.
有些恐懼，比如對蜘蛛的恐懼，在現(xiàn)實生活中是安全的。
Others, like the fear of combat that some veterans experience, typically aren't safe and practical to repeat in real life,
另一些恐懼，比如老兵對戰(zhàn)斗的恐懼，在現(xiàn)實生活中通常是不安全和不現(xiàn)實的，
so these rely on imagined or even virtual reality exposure.
所以對于這些恐懼，需要采用想象甚至虛擬現(xiàn)實暴露療法。
There are also different strategies for how much and how fast to expose patients to their fears.
在多大程度上及多快地讓病人暴露在恐懼中，也有不同的策略。
Most exposure therapy involves what's called graded exposure—or starting small and gradually ramping up.
大多數(shù)暴露療法都涉及到所謂的逐級暴露，或者從小處著手逐步加大。
Often, it begins with imagined exposures and advances to in vivo.
通常，一開始采用的是想象療法，然后向現(xiàn)實遞進。
For example, a therapist might guide a patient in thinking about a spider,
例如，治療師可能會引導(dǎo)病人想象蜘蛛，
and in performing relaxation techniques like slow breathing to manage their fear response.
用緩慢呼吸等放松技巧管理他們的恐懼反應(yīng)。
Then, when the imaginary spider doesn't cause fear anymore, the patient will look at a real spider behind glass.
然后，當(dāng)病人對想象里的蜘蛛不再恐懼時，讓病人看玻璃后面的真實蜘蛛。
Eventually, they might move to looking at the spider without glass, and potentially to even touching and holding it.
最終，病人可能會脫掉眼鏡看蜘蛛，甚至有可能觸摸和握住蜘蛛。
Another technique is called flooding. Unlike graded exposure, it involves facing the most feared scenario all at once.
另一種療法被稱為泛濫療法。與逐級暴露不同，泛濫涉及同時面對最可怕的場景。
While this is much scarier for the patient at first, if performed correctly,
雖然一開始對病人來說很可怕，但如果操作正確，
it also results in them realizing they don't need to respond to their fears in such an extreme way.
病人也會意識到，他們不需要以如此極端的方式來表現(xiàn)出恐懼。
However, because this is more difficult for both the patient and the psychologist, graded exposure therapy is used most often.
然而，由于泛濫療法對患者和心理學(xué)家來說都比較困難，逐級暴露療法被使用得最多。
Of course, like all types of therapies, exposure therapy isn't equally helpful for everyone.
當(dāng)然，就像所有類型的療法一樣，暴露療法并不是對每個人都有效。
And in some cases with phobias and PTSD, it's even been reported to make fears worse.
在一些患有恐懼癥和創(chuàng)傷后精神緊張性精神障礙的案例中，甚至有報道說暴露療法會加深病人的恐懼。
Scientists speculate that this might happen if the therapy isn't performed correctly, or for long enough.
科學(xué)家們推測，如果治療方式不正確，或者持續(xù)時間不夠長的話，就可能會發(fā)生這種情況。
Also, in general, it's especially difficult to treat social anxiety with exposure therapy—although it has helped plenty of people.
而且，總的來說，用暴露療法治療社交焦慮癥尤其困難——盡管暴露療法在很多人身上有效。
It isn't clear why it's harder, but it could be because social interactions happen every day.
目前還不清楚為什么會更難，但可能是因為社交互動每天都在發(fā)生。
This means it's more difficult to isolate and control the severity of interactions, which is necessary for patients to process their fears.
這意味著互動的嚴重程度隔離和控制起來更難，而這對于處理患者恐懼是必要的。
Overall, though, exposure therapy is highly effective, and this has been shown by numerous studies.
總的來說，暴露療法非常有效，并且已經(jīng)大量研究證實。
Like, one 2010 meta-analysis of 13 different studies examining 675 total patients with PTSD found that 86% showed significant improvement after exposure therapy.
比如，2010年13項不同的研究對675名創(chuàng)傷后應(yīng)激障礙患者進行了分析，結(jié)果發(fā)現(xiàn)86%的患者在接受暴露療法后明顯好轉(zhuǎn)。
And a 2007 meta-analysis of 300 patients across 21 studies reported similar success in treating specific phobias.
2007年21項針對300名患者的分析發(fā)現(xiàn)，暴露療法在治療特定恐懼癥方面取得了類似的成功。
While it's most commonly used to treat PTSD and phobias,
雖然暴露療法最常用來治療創(chuàng)傷后應(yīng)激障礙和恐懼癥，
exposure therapy has also been shown to effectively treat panic disorder, obsessive compulsive disorder, and generalized anxiety disorder.
研究表明，暴露療法可以有效地治療恐慌癥、強迫癥和廣泛性焦慮癥。
Research is even showing that virtual reality therapy is just as effective as in vivo exposure.
研究甚至表明，虛擬現(xiàn)實療法和活體暴露療法一樣有效。
Which could be a big deal for people who can't safely face their fears in real life.
這對于那些在現(xiàn)實生活中無法安全面對恐懼的人來說可能是頭等大事。
Now, this doesn't mean you should rush out to the woods and find a spider to expose your arachnophobic friend to.
現(xiàn)在，并不是說你應(yīng)該跑到樹林里找一只蜘蛛朋友向它暴露你的蜘蛛恐懼癥。
Like other kinds of therapy, exposure therapy is meant to be done by a trained professional in a controlled environment.
和其他類型的治療一樣，暴露療法應(yīng)由訓(xùn)練有素的專業(yè)人員在受控的環(huán)境下進行。
But if your friend wants to learn more about how it works? Hey, maybe you could show them this video.
但是如果你的朋友想了解更多關(guān)于暴露療法的工作原理？嘿，也許你可以給他們看這個視頻。
Thanks for watching this episode of SciShow Psych!
感謝收看本期心理科學(xué)秀！
If you'd like to learn more about fear, you can watch our episode on what might be humanity's deepest, darkest fear.
如果你想了解更多關(guān)于恐懼的知識，可以觀看我們的節(jié)目——人類最深、最黑暗的恐懼可能是什么。
