http://www.nytimes.com/2015/07/1 ... americans.html?_r=0
AMERICANS are a pretty anxious people. Nearly one in five of us — 18 percent — has an anxiety disorder. We spend over $2 billion a year on anti-anxiety medications. College students are often described as more stressed than ever before. There are many explanations for these nerves: a bad job market, less cohesive communities, the constant self-comparison that is social media. In 2002 the World Mental Health Survey found that Americans were the most anxious people in the 14 countries studied, with more clinically significant levels of anxiety than people in Nigeria, Lebanon and Ukraine.
To be clear, research suggests that anxiety is at least partially temperamental. A recent study of 592 rhesus monkeys found that some of them responded more anxiously than others and that as much as 30 percent of early anxiety may be inherited.
Yet what is inherited is the potential for anxiety, not anxiety itself. Life events obviously play a role. Another, less obvious factor may be the way we think about the mind: as an interior place that demands careful, constant attention.
Humans seem to distinguish between mind and body in all cultures, but the sharp awareness of mind as a possession, distinct from soul and body, comes from the Enlightenment. It was then, in the aftermath of the crisis of religious authority and the scientific revolution, that there were intense debates about the nature of mental events. Between 1600 and 1815, the place where mental stuff happened — the “thing that thinks,” to use Descartes’s phrase — came to seem more and more important, as George Makari, a psychiatrist and psychoanalyst, explains in his forthcoming book, “Soul Machine: The Invention of the Modern Mind.”
From this, Mr. Makari writes, was developed the psychological mind and psychoanalysis and an expectation that personal thoughts and feelings are the central drivers of human action — not roles, not values, not personal sensation, not God. In the United States, the enormous psychotherapeutic and self-help industry teaches us that we must pay scrupulous attention to inner experience. To succeed and be happy, we are taught, we need to know what we feel.
Not everyone else believes this. Take response to psychiatric illness. Americans believe that excessive sadness makes us sick. Sadness is not the only symptom needed to meet criteria for a diagnosis of depression, but it is the one that characterizes the illness for us. That is not true in many other parts of the world. When the anthropologist and psychiatrist Arthur Kleinman carried out fieldwork in China in 1980, just before its borders were opened to the world, people who met criteria for depression complained mostly of chronic pain. They were often sad, just as those in the United States with depression often experience pain. But in that China, bodily pains — and not inner states — justified seeking care.
Americans think that the primary symptoms of schizophrenia are the quasi-auditory hallucinations that often accompany the disorder. When I interviewed people with schizophrenia who heard voices, they were clear that to hear voices meant that you were crazy. Anthropologists have shown that in other parts of the world, people are more likely to identify inappropriate behavior, rather than hearing voices, as schizophrenia’s primary symptoms, and that invisible voices are not always the mark of madness. A few years ago in southern India, I came to know a woman whose active hallucinations would mark her as very ill on a standard assessment. Yet neither her husband nor her father mentioned her hallucinations as a worry. Her problem, they said, was that she sometimes shouted.
Pixar’s new film “Inside Out” is about an 11-year-old girl forced to move across the country when her father joins a start-up in San Francisco. Riley leaves behind her beloved hockey team. Her new house seems cramped and ugly. She’s lonely, and decides to run away, back to Minnesota.
“Inside Out” tells this story from the point of view of her mind. Five emotions (fear, joy, sadness, disgust and anger) sit at a control panel in the aptly named headquarters. These emotions determine what she does. Anger grabs hold of the controls when her father insists she eat her broccoli. The plot hinges on a tussle between Joy and Sadness (Joy doesn’t want Sadness to touch Riley’s memories) in which the two are accidentally swept out of the control room. They get lost in Riley’s mind, wandering around the subconscious and imagination land (both of which are very large) while Anger is left in charge (a bad idea). In the end, Joy discovers how important sadness is for human connection, and Riley creates a good new life in San Francisco. As the movie ends we see a new, improved and more complex control panel, now with a button marked “puberty.”
It’s a charming movie. It is also distinctly American. It is based on a particular model of the mind that we take for granted, but that is in fact as culturally idiosyncratic as the way we dress. I’m not suggesting that the basic science of emotion depicted in the movie is wrong. Emotions do seem to be crucial in organizing human thinking. I’m suggesting that there is something deeply cultural about the way this mind is imagined, and that it has consequences for the way we experience thoughts and feelings.
Our high anxiety, whatever the challenges we face, is probably one of the consequences.
美国人非常容易焦虑。有近五分之一（18%）的美国人患有焦虑症。我们每年花在抗焦虑药物上的费用达到20亿美元（约合124亿人民币）。经常见到有人说，现在的大学生承受着空前的压力。对于这些焦虑的原因，有很多解释：糟糕的就业市场，社区凝聚力下降，因为使用社交媒体而进行持续的自我比照。2002年，世界心理健康调查(World Mental Health Survey)计划发现，在14个被调查国家中，美国人是最为焦虑的，达到临床显著水平的人群比尼日利亚、黎巴嫩和乌克兰都多。
需要明确的是，研究者认为焦虑的人至少部分具备喜怒无常的特征。最近一项对592只猕猴进行的研究显示，有些猕猴的焦虑反应比其他的要大，而有30%的早期焦虑症可能是遗传导致。
但是，遗传自父母的是焦虑的潜在可能，而非焦虑本身。生活中遭遇的事情显然会对引发焦虑起到一定作用。此外，相对不那么明显的影响因素可能还包括我们对心灵的认知：即把它看做一个需要小心和持续关注的内部所在。
在所有文化中，人类似乎都会对身心加以相区别，但非常清晰地意识到心灵的存在、把它和灵魂与肉体相区别，是从启蒙运动时期开始。随着宗教权威遭遇挑战和科学革命诞生，当时出现了有关心灵本质的激烈辩论。1600年到1815年间，心智产生的地方——用笛卡尔的话说就是那个“会思考的东西”——似乎变得越来越重要。就像精神病医生和精神分析学家乔治·马卡里(George Makari)在其即将出版的著作《心灵机器：现代心智的诞生》(Soul Machine: The Invention of the Modern Mind)中所描述的。
马卡里在书中写到，这些地方发展出心理学上的心智和精神分析，以及一种期待：人类行为的核心驱动力是个人的思想和感情——而不是角色、价值观、个人感官，或上帝。美国存在一个规模庞大的心理疗法和自救产业，教育我们必须予内心体验以小心谨慎的关注。我们被教导，为了取得成功和保持快乐，需要明白自己的感受。
并非所有人都相信这一点。就拿对精神疾病的反应来说。美国人认为过度悲伤会让人生病。仅凭悲伤这一个症状，不足以做出抑郁的诊断，但对我们来说，它是出现疾病的特征。在世界上很多地方并非如此。人类学家和精神病学家亚瑟·克莱茵曼(Arthur Kleinman)于1980年——即中国正式对外开放前夕——在中国进行田野调查时发现，具备抑郁症状的人主要抱怨自己有慢性疼痛。他们常常感到悲伤，和患抑郁症的美国人经常感受到的痛苦一样。但是在当时的中国，只有身体上疼痛——而非内心的悲伤——才有资格寻求治疗。
美国人认为精神分裂症的主要症状是病患看起来出现了幻听，它经常是和精神失调同时出现的。当我采访有幻听症状的精神分裂症患者时，他们很清楚，出现幻听就意味着你疯了。人类学家已经证明，在其他国家，人们更倾向于把不当行为，而非幻听，作为精神分裂症的主要症状，他们还认为，听到并不存在的声音并不总代表着疯狂。几年前，我在南印度见到一个女人，以标准评估，她时常出现的幻听症状已经说明她患有严重的精神疾病。但不管是她的丈夫还是她的父亲，都没有在提到她的幻听时表示出担心。他们认为，她的问题是有时会大喊大叫。
皮克斯(Pixar)的新电影《头脑特工队》(Inside Out)讲述了一个11岁女孩的故事，她因为父亲加入位于旧金山的一家创业公司而被迫搬到美国另一端。莱莉(Riley)离开了自己喜爱的冰球队。她的新家看起来又拥挤又丑陋。她感到孤独，于是决定逃回到明尼苏达州。
《头脑特工队》从她的思维角度讲述了这个故事。电影中，五种情感（恐惧、喜悦、悲伤、厌恶和愤怒）坐在名副其实的“总部”（headquarter，字面意思为“头所在的区域”。——译注）控制室里。这些情感决定着莱莉的行动。当父亲坚持要她吃花椰菜时，愤怒就会牢牢掌握掌控所有情绪。电影情节随着喜悦和悲伤之间的剧烈冲突（喜悦不想让悲伤触碰莱莉的记忆）而不断推进，这个过程中，二者意外地被排挤出控制室。它们从莱莉的头脑中消失了，在无意识和想象之地（两个地方都非常广阔无边）流浪，而愤怒则掌握了控制权（不是什么好事）。最终，喜悦发现了悲伤对于人类情感联结的重要性，莱莉也在旧金山创造了美好的新生活。电影结尾时，出现了一个改良后的、更加复杂的新控制面板，上面有一个标注着“青春期”的按钮。
这是一部非常好看的电影。它也具有明显的美国特征。这部电影是基于一种独特的思维模式，我们对它习以为常，但它实际上在文化上非常有特殊性，就像我们衣着方式一样。我不是说，这部电影描述的基本情感原理是错误的。情感似乎的确对人类组织思维至关重要。我是说，我们对于这种思维的想象有深厚的文化属性，它们会对我们体验思想和情感的方式产生影响。
不管我们面临的挑战是什么，我们的严重焦虑，可能就是这种影响的后果之一。
T. M. 鲁尔曼是斯坦福大学的人类学教授，也是《纽约时报》观点撰稿人。
