纽约时报 疫情当前 强迫症患者的困境(4)（在线收听）

Exposure and response prevention therapy is the most effective treatment, experts say.

专家表示，暴露与反应阻断疗法（ERP疗法）是最有效的强迫症治疗方法。

It systematically tests a patient's worries that something will harm them by exposing them in a prolonged, repetitive and intensifying system to things that they fear.

通过让患者长时间，反复及高强度地暴露在他们害怕会伤害到自己的环境中，ERP疗法尝试对患者的担忧展开有序的检验。

When the exposure doesn't cause significant illness or harm, the patients can begin to learn how to better cope.

如若暴露没有造成重大疾病或重大伤害，患者就能开始学习如何更好地应对身边的环境。

But the unusual and urgent focus on sanitation to fight the spread of the virus is also creating concerns for health care professionals involved in the treatment of O.C.D.,

然而，面对当前的抗疫大局，对卫生超乎寻常的迫切关注给提供强迫症治疗的卫生保健工作人员增添了额外的烦忧，

said Bradley Riemann, a psychologist and the chief clinical officer of Rogers Behavioral Health, which has mental health and addiction treatment centers around the country.

开设的心理健康和成瘾治疗中心遍及全国各地的罗杰斯行为健康公司的心理学家兼首席临床官布拉德利·黎曼说。

That's why providing treatment for O.C.D. right now is especially complicated.

正因为如此，当下，为强迫症提供治疗已经成为一个极其棘手的问题。

"This is clearly a time when we have had to change the way we interact with one another and the way we interact with our environment —

“显然，现在我们不改变我们与他人，与环境互动的方式已经不行了——

it's a matter of public safety for all of us," Dr. Riemann said.

这（新冠肺炎）已经成了事关我们所有人的一个公共安全问题，“黎曼医生说。

"But it really collides with the world of O.C.D., and in particular with patients with contamination O.C.D."

“但也确实和强迫症患者，尤其是患有污染强迫症的患者的世界相冲突了。”

Usually, Dr. Riemann and his staff work with patients by asking them to interact with germs,

黎曼医生及其医护团队治疗患者通常采用的都是让他们主动接触细菌，

increasingly extending the amounts of time between washing their hands or otherwise sanitizing.

并逐渐延长两次洗手或其他消毒活动之间的间隔时间。

In some situations, he said, patients are asked to touch toilet seats or bathroom floors, and then are given food to eat before washing their hands.

他说，有时他们还会要求患者触摸马桶座圈或浴室地板，接着给他们食物并让他们吃完之后再洗手。

"As you can see, the world we live in today, that collides head on with that kind of treatment intervention," he said.

“正如大家所见，当下的（疫情）社会现状，与这种干预治疗堪称是迎面撞了个正着啊，”他说。

"It has been very challenging to try to achieve a balance where you are keeping your staff and patients as safe as we all can be, yet still providing effective treatment."

“一方面要尽可能地保证你的（医护）人员和患者的安全，同时还要为他们（强迫症患者）提供有效的治疗，在二者之间求取平衡的难度是非常大的。”

Dr. Riemann said he and other professionals in this field have been conferring daily about ways to dilute exposure therapy

黎曼医生说，他和同行的其他专家最近每天都在讨论降低暴露疗法的强度，

so that it conforms to the public health coronavirus standards while still offering therapeutic value.

使其不仅符合新冠病毒防控的公共卫生标准，还能具备一定的治疗价值。

Connor Kelly-Eiding, 31, was diagnosed with O.C.D. earlier this year, and the coronavirus crisis has made the symptoms feel more acute.

31岁的康纳·凯莉-艾丁今年才被诊断为强迫症患者，新冠肺炎危机则进一步加剧了她的病情。

Ms. Kelly-Eiding, an actress who also works for a women's rights advocacy organization by helping to connect survivors of sex abuse with law firms,

凯利·艾丁女士是一名女演员，也是某女权组织的工作人员，工作内容包括帮助性侵害经历的幸存者联系律师事务所（为其打官司），

has been leaving her apartment with her boyfriend only to go running, and even that is a challenge.

最近，她走出家门唯一的原因便是和男友去跑步，然而即便是跑步，也给他们带来了不小的挑战。

"If we see other people, I become consumed with how we are going to maneuver around them

“如果我们看到（路上）还有别人，那我立马会满脑子想的都是我们怎么才能避开他们，

and I begin to see a cloud of germs surrounding them that I will have to run through," said Ms. Kelly-Eiding, who lives in Los Angeles.

我甚至还会看到他们身边有一团细菌云，而我却不得不从那团云中穿过去，住在洛杉矶的凯利-艾丁女士说。

"I understand intellectually that some of my fears are not based in fact, but many of them are, actually."

“我的有一些担忧确实没有真凭实据，理智上我也是知道的，但还有很多担忧是有的呀。”

She reached out in February to a local O.C.D. association, and last week she began phone therapy to address her fear of germs.

今年2月，她联系了当地的强迫症协会，上周已经开始针对其对细菌的恐惧的电话治疗。

"I'm so grateful that there is help out there," she said.

“我非常感激外面那些爱心人士和爱心机构，”她说。

A silver lining for some people diagnosed with O.C.D. is that the pandemic is showing them how far they have come.

对于部分强迫症患者而言，唯一让他们感到慰藉的是，这次的疫情表明了他们平时的清洁强度有多夸张。

Jeffrey Blitt, 21, a junior at Tufts University in Massachusetts, was studying abroad in Brisbane, Australia,

21岁的杰弗里·布利特是马萨诸塞州塔夫茨大学的一名大三学生，疫情爆发时他正在澳大利亚布里斯班留学，

when he and his fellow students were ordered to return home in March.

三月时，他和同学纷纷收到了返回家乡的命令。

The logistical complications of having to get from one side of the world back to his family home in New Providence, N.J., distracted him from focusing on any fears of germs.

疫情期间，从世界的一端回到位于新泽西州新普罗维登斯的家一路上颇为艰难，这也转移了他对所有细菌的恐惧。

When he was 11 years old, such fears dominated his thoughts so completely

而就在他11岁时，这种恐惧曾彻底控制他的大脑，

that he was not able to go to school and was sent by his parents for residential treatment.

令他无法去学校上学，正因为如此，他被父母送去了（罗杰斯行为健康公司）接受住院治疗。

Since arriving home from Australia, however, even as the grip of the virus has grown more intense,

然而，从澳大利亚回国以后，尽管疫情防控工作变得更为紧张了，

he is taking note of how much progress he has made.

他却注意到自己（的强迫症治疗）已经取得了显著的进步。

"At a certain point in time this would have been some of my worst fears realized," Mr. Blitt said.

“要换作过去，这（细菌）可能才是我最担心的问题之一，”布利特说。

"But my O.C.D. anxiety is almost completely under control.

“但我的强迫症焦虑基本已经彻底得到了控制。

It's almost weird seeing everyone do the things I used to do,

大家都开始看洗手视频了，我妈妈也开始把包裹留在门外了，

like people watching hand-washing videos and my mom leaving packages outside," he said.

看到所有人都在做我以前做过的这些事让人觉得还有点怪怪的，“他说。

Mr. Blitt, who has always relied on humor to help him cope — as a kid he once dressed as a bottle of Purell for Halloween — is still finding ways to laugh.

一直以来，布利特都在用幽默化解自己的困境，小时候他甚至还在万圣节将自己打扮成一瓶普雷尔洗手液，现在，他依然在努力笑对一切。

"More than anything I see a dark humor in it," he said of the ritual hand washing and germ worrying being embraced by his relatives and friends.

“最重要的是，我觉得这事儿还挺黑色幽默的，”谈到亲友们都开始拥戴洗手和担心细菌等习惯时他说道。

"'I think to myself, 'Oh, I was doing all those things and I'm past it and now everyone is doing it.'"

“‘我在心里说道，‘哈，这些事儿我以前都干过，现在我好不容易翻篇了，大家伙儿却又开始了。’”