害羞的小孩需要矯正嗎

To Help a Shy Child, Listen

害羞的小孩需要矯正嗎

Toward the end of the summer, I was seeing a middle-school girl for a physical. The notes from a clinic visit last spring said she was a good student but didn’t talk enough in class. So I asked her: Is this still a problem for you?

今年暑假快結束時，一個上初中的女孩來我這兒進行檢查。去年夏天她曾去了次診所，醫(yī)生的病歷顯示她是個好學生，但在班上發(fā)言不夠多。于是我問她：這對你仍然構成了問題嗎?

I’m shy, she said. I’m just shy.

她說，我有點怕羞，我只是有點怕羞。

Should I have turned to her mother and suggested — a counselor? An academic evaluation? Should I have probed further? How do you feel in school, do you have some friends, is anybody bullying you?

我應當找到她媽媽，然后建議她去咨詢專職輔導員?接受一次學術評估?還是進一步深究下去呢：你在學校感覺怎么樣，你有朋友嗎?有人欺負你嗎?

Or should I have said: Lots of people are shy. It’s one of the healthy, normal styles of being human.

或者我應當這樣跟她們說：很多人生性羞澀。生而為人，這是一種健康、正常的行為方式。

All of these responses, together, would have been correct. A child who is being bullied or bothered may be anxious about drawing attention to herself; a child who doesn’t ever talk in class may be holding back because some learning problem is getting in the way, making her self-conscious. So you do need to listen — especially to a child who talks less rather than more — and find ways to ask questions. Are you happy, anxious, afraid?

這些反應累加在一起，也許是正確的。一個受到欺負或感到煩惱的孩子，也許會對自己招致別人的注意而感到不安;一個在班上根本不講話的孩子之所以這么壓抑，也許是因為碰到了某些學習上的苦惱，令她感到特別不好意思。所以，你需要去聆聽——對于一個特別沉默寡言的孩子來說尤其是這樣——同時也要想辦法提問。你快樂嗎?你焦慮或者害怕嗎?

But shyness is also part of the great and glorious range of the human normal. Two years ago, Kathleen Merikangas, a senior investigator at the National Institute of Mental Health, and her colleagues published a study of 10,000 older children, ranging from 13 to 18 years old. “We found that about half of kids in America describe themselves as shy,” she told me.

可是，羞澀同時也是人類常態(tài)中偉大而又輝煌的一部分。兩年前，美國心理健康研究中心(National Institute of Mental Health)的資深研究員凱瑟琳·梅利康加斯(Kathleen Merikangas)和同事們發(fā)表了一份涉及1萬名年齡在13-18歲青少年的研究報告。“我們發(fā)現(xiàn)，約半數(shù)美國孩子表示自己生性羞澀，”她告訴我。

Common though it may be, our schools — and our broader culture — do not always celebrate the reserved and retiring. “Children who are shy, who don’t raise their hand, who don’t talk in class, are really penalized in this society,” Dr. Merikangas said.

盡管這是如此普遍的一種性格，但我們的學校——以及更廣闊的文化——通常并不會贊美保守與羞怯。“那些性格害羞，上課不喜歡舉手、不喜歡說話的孩子，在社會中真的處于不利地位，”梅利康加斯博士說。

I have heard it said that temperament was invented by the first parent to have a second child — that’s when parents realize that children come wired with many of the determinants of disposition and personality. What worked with Baby 1 doesn’t necessarily work with Baby 2. The analysis of temperament has been a topic of discussion in pediatrics and psychology for decades.

我曾聽說過，氣質這種概念是由第一對生了第二個孩子的父母發(fā)明的——父母發(fā)覺兩個孩子在性情和個性上竟然會如此迥異，令人困惑。對老大適用的那一套對老二可能完全用不上。幾十年來，兒科和心理學就氣質分析這個話題始終在進行著討論。

“Temperament is the largely inborn set of behaviors that are the style with which a person functions, not to be confused with their motivation or their developmental status and abilities,” said Dr. William B. Carey, a clinical professor of pediatrics at the Children’s Hospital of Philadelphia and the author of “Understanding Your Child’s Temperament.”

“氣質主要是與生俱來的那一套行為，它是一個人行事的風格，別把這個跟人們的動機或他們的發(fā)育狀態(tài)和能力混為一談了，”費城兒童醫(yī)院兒科臨床教授威廉·B·凱里(William B. Carey)這樣說道，他著有《理解子女氣質》(Understanding Your Child’s Temperament)一書。

Shyness reflects a child’s place on the temperamental continuum, the part of it that involves dealing with new and unfamiliar circumstances. And starting a new school year may be hard on those who find new situations more difficult and more full of anxiety. What most children need is time to settle in, support from parents and teachers, and sometimes help making connections and participating in class.

羞澀折射出一個孩子在氣質連續(xù)體(temperamental continuum)中的位置，它的部分作用在于應對全新和陌生的環(huán)境。開始一個新學年，對于那些身處新環(huán)境會感覺更艱難、更焦慮的孩子來說是件難事。大部分孩子在適應的過程中需要的是時間以及父母和老師的支持，有時也需要旁人幫助才能在班上交到朋友、成為其中的一份子。

If a child is not more comfortable after a month or so, parents should look at whether more help is needed, said Anne Marie Albano, director of the Columbia University Clinic for Anxiety and Related Disorders. Treatment usually involves cognitive behavioral strategies to help the child cope with anxiety.

哥倫比亞大學(Columbia University)焦慮和相關失調癥診所主任安妮·瑪麗·阿爾巴諾(Anne Marie Albano)說，如果過了一個來月，這個孩子仍然沒有感覺更加自如，家長應當了解是否孩子還需要更多幫助。治療通常包含了各種認知行為手段，以幫助孩子面對焦慮。

All ranges of temperament have their uncomfortable, or even pathological, outer zones. Just as there are children whose rambunctious eagerness to participate makes trouble for them in school or signals the presence of other problems, there are children whose silence is a shout for help.

各類個性都有其不安地帶，這種不安甚至是病態(tài)的。正如有些孩子在參與活動中可以表現(xiàn)出難以按捺的熱情，這讓他們在學校里制造了不少麻煩，或者暗示其存在其他問題，也有些孩子的沉默本身就是一種尋求幫助的吶喊。

I’m struck by the parallels between the ways we discuss shyness and the ways we discuss impulsivity and hyperactivity. In both cases, there is concern about the risk of “pathologizing” children who are well within the range of normal and worry that we are too likely to medicate outliers. By this thinking, children who would once have been considered shy and quiet too often get antidepressants, just as children who would once have been considered lively and rambunctious too often get A.D.H.D. medications.

在探討羞澀的方式和探討沖動多動的方式間存在相似之處，對此我深感震驚。對于上述這兩種情形，人們都存在顧慮，認為有將那些完全處在正常范圍內的兒童“病態(tài)化”之虞，擔心我們動輒就要治療稍微異端的人。這些人認為，醫(yī)生往往輕易給那些表現(xiàn)得害羞、安靜的人開了抗抑郁藥，正如給那些以往表現(xiàn)得活潑鬧騰的人輕易開了醫(yī)治多動癥的藥物一樣。

But the most important question is whether children are in distress. Dr. Merikangas’s study distinguished between the common trait of shyness and the psychiatric diagnosis of social phobia. Over all, about 5 percent of the adolescents in the study were severely restricted by social anxiety; they included some who described themselves as shy and some who did not. The authors questioned whether the debate about the “medicalization” of shyness might be obscuring the detection of the distinct signs of social phobia.

但是，最重要的問題在于孩子們是否確實處在困境中。梅利康加斯博士的研究已經將羞澀的共同特質與社交恐懼癥的精神病學癥狀區(qū)分開來。在研究中，約有5%的青春期少年受到社交焦慮的嚴重制約;這當中包括一些自稱個性怕羞的人，也包括一些并沒有這么覺得的人。作者因此提出了質疑：對羞澀“以醫(yī)療的方式處理”的爭論，或許模糊了社交恐懼癥顯著跡象的識別。

For parents who simply want to help a shy child cope with, for example, a brand new classroom full of brand new people, consider rehearsing, scripting encounters and interactions. “The best thing they can do is do a role play and behavioral rehearsal ahead of time,” said Steven Kurtz, a senior clinician at the Child Mind Institute in Manhattan. Parents should “plan on rewarding the bravery.”

對于那些只是想要幫助害羞的子女面對特殊環(huán)境，比如說全是陌生同學的陌生課堂時，可以考慮排演，設計見面與互動的情節(jié)。“家長最好是能提前進行一次角色扮演，進行行為預演，”曼哈頓的兒童心理研究所(Child Mind Institute)資深臨床醫(yī)生斯蒂文·庫爾茨(Steven Kurtz)說。家長還應當“計劃對孩子的勇敢舉動作出獎勵”。

But don’t take over. “The danger point is rescuing too soon, too often, too much, so the kids don’t develop coping mechanisms,” said Dr. Kurtz.

但不要越俎代庖。“過快、過頻、過多出手相助，這些都是危險點，因為這樣一來，孩子自己就不會鍛煉出應對技巧了，”庫爾茨醫(yī)生說。

Cognitive behavioral therapy relies on “successive approximations,” in which children slowly close in on the behaviors they are hoping to achieve. In that spirit, a parent might arrange to meet another parent on the way to school, so a shy child can walk with another and bond. A teacher might look for the right partner to pair up with a shy child for cooperative activities in the classroom.

認知行為療法依靠的是“逐次逼近法”，兒童逐步通過治療，接近他們希望取得的行為。從這個理念出發(fā)，家長也許可以安排好在上學的路上與別的家庭碰頭，這樣，害羞的孩子也可以跟別的小孩一起走走，學習相處。老師可以為害羞的孩子尋找適合的小伙伴，在學校里共同參與需要協(xié)力進行的活動。

“Probably the worst thing to do is to say, ‘Don’t be shy. Don’t be quiet,’ ” Dr. Merikangas told me. This is not about trying to change the child’s temperament. It’s about respecting and honoring temperament and variation, and helping children navigate the world with their own instruments.

“也許最糟糕的做法，就是對孩子說，‘你別不好意思了，你別老是不說話了，’”梅利康加斯博士告訴我。目的不是要試圖扭轉孩子的個性。而是要尊重并敬畏人們與生俱來的個性與不同，同時幫助孩子們運用自己的力量，在這個世界里馳騁。