【TED】不平等和焦虑之间的联系

中英文稿

我相信你已经注意到了摆拍 和没意识到有相机在拍的 人的照片之间的区别。 趁人不注意的抓拍， 它们通常是这样的。 这张照片是在伦敦市中心拍的。 人们正值壮年， 但每个人看起来都很 憔悴、沮丧、焦虑。 有些人看起来很生气。 没有一丝笑容。 但是，如果你看人们摆拍的照片， 就像这张照片一样， 他们勾肩搭背。 他们笑。 我想，这就是我们希望 别人看到的， 这就应该是我们在一起的样子。

不幸的是，数据告诉了我们 一个不同的故事。 在英国，调查显示， 74% 的成年人 感到压力过大或 不堪重负，无法应对， 32% 的人有自杀想法， 16% 的人有过自残。 在美国，情况非常相似： 79% 的人每天都感到压力， 近 60% 的人压力大到麻木。 当媒体上出现新的数据 展示压力、抑郁、自残、 药物滥用、饮食失调的程度时， 人们会有什么反应? 人们只是需要更多的服务、 更多的心理治疗师、更多的 心理学家、更多的精神科医生。 这就好像 受了重伤的时候， 大多数人都只是想让更多的 外科医生把他们 缝起来， 而不是找出问题所在。

关键问题是: 为什么会发生这种情况? 即使是在富裕国家？ 我是一名流行病学家， 这意味着我的职业生涯 一直在研究人群健康和 疾病的原因。 我想告诉你们，不平等是导致 更大程度的焦虑、精神痛苦、 不快乐、抑郁的重要来源。 我希望你们回想一下， 当你们在别人面前感到焦虑、 尴尬、紧张的时候， 那些社交场合的接触， 也许是当你在演讲或 去一个你不认识在场 任何人的派对的时候。 但是，当我们面临被 消极看待的威胁时， 就会产生这些情绪。

这张图表总结了数百项研究， 这些研究让人们承受 不同种类的压力， 同时测量他们的应激激素变化， 主要是皮质醇， 一种中枢应激激素。 研究表明，促使应激激素 水平上升的主要因素 是所谓的“社会评估威胁”—— 对自尊或社会地位的威胁， 来源于别人对你的表现的负面评价。 所以，尽管这些社会压力 是众所周知的， 我们都很熟悉， 但人们没有看到不平等是如何让 我们所有人的社会压力变得更糟的。

在这张幻灯片的 底部，你可以看到 不同的收入群体， 从左边最贫穷的十分之一的人口 到右边最富有的人。 在上面 是对身份焦虑的统计结果， 以及人们有多担心别人 如何看待和评价自己。 最上面的那条线显示了 在更不平等的社会中 所有收入群体的身份焦虑水平。 最下面的线显示了 在更平等的社会中， 身份焦虑的程度要低得多。

我认为我们要处理的问题是， 我们是生活在 一个像这样非常陡峭的社会阶层中， 还是在一个像这样 非常浅的社会阶层中。 我们之间更大的 物质差异增加了社会距离、 优越感和自卑感， 社会内部的社会关系 会因此产生很大的影响。 地位和阶级会变得更加重要。 我们不太可能与不同 阶层背景的人结婚。 社区生活，就像我说过的， 减少了，而暴力也增加了， 因为暴力是由感觉 被人看不起而触发的。 丢面子、不受尊重、羞辱—— 这些都是暴力的导火索。 当然，对于那些对地位问题 更敏感的人来说， 暴力更容易被触发。 消费主义也在上升， 因为我们都在努力 增强自我展示。

各种各样的社会互动措施 都显示出整个社会结构在 不平等的情况下变得更加僵化。 社会流动性下降， 与此同时，我们甚至离我们声称 要为孩子们提供的 平等机会更远了。 所以不平等不仅仅是 不公平或贫穷。 它把我们置于社会关系中， 优等和劣等的关系中。 它把我们从好到坏地排序。 这是一个非常令人反感的过程， 它让底层的人产生了自卑感。 这让我们更常通过社会地位 来评价对方，因此， 我们会更担心别人 如何看待和评价我们。 对于别人如何看待和评判我们， 有两种常见的反应。 一是你几乎接受了你的劣等、 自卑、缺乏自信。 你从社交生活中退出， 因为你发现这一切都太难了， 你变得更容易抑郁。 事实上，越是不平等的社会， 抑郁症的发病率就越高。

另一种常见的反应几乎完全相反。 如果你担心别人对你的看法， 你就会自我吹捧。 你把夸大自己。 你炫耀自己的能力和成就。 你变得自恋而不是谦虚。 我们在更不平等的社会中 也看到了这一点。 下一个图表来自一项心理学家 称之为“自我提升”的研究。 不同国家的人们被问及 他们认为自己在不同特征上 与普通人相比如何。 这表明，在更不平等的社会中， 人们自我膨胀， 他们认为自己更擅长某事; 他们夸张地表现自己。 他们变得自恋。 好像每个人都觉得 自己开车比一般人好。 这种趋势在更不平等的 社会中更明显。

精神疾病在更不平等的 国家也更严重， 因为精神疾病往往由与支配和从属、 优劣感有关的 问题引发或加剧。 最近有一项针对 36 个 经合组织国家（OECD）的研究表明， 这些社会的不平等程度 与 10 种最常见的 精神疾病之间存在紧密联系。 我认为最可悲的是， 对幸福和健康的研究， 以及对健康的研究表明， 最重要的决定因素之一 是我们的社会关系、 我们的社会环境、 我们的友谊。 这就是不平等造成 最大损害的地方。 为了解决抑郁、焦虑、精神疾病 和自残的沉重负担， 我们必须要做的是减少社会中 使我们彼此分离的不平等程度。 在某种意义上，不平等 是我们之间的敌人。

I'm sure you've noticed the difference between posed photographs and pictures taken of people who are unaware of the camera. The pictures where people are unaware -- they often look like this. This picture was taken in central London. People in the prime of life, and yet everyone there looks haggard, depressed, anxious. Some of them look quite angry. Not a smile to be seen. And yet, if you look at pictures of people posed, they put their arms around each other, as in this picture. They smile. That's, I think, how we'd like to be seen, how we think we should be together.

Unfortunately, the data tells a different story. In the UK, surveys have shown that 74 percent of adults have felt so stressed or overwhelmed and unable to cope, 32 percent have had suicidal thoughts, 16 percent have actually self-harmed. In the USA, the picture's very similar: 79 percent felt stressed every day, and almost 60 percent have felt paralyzed by stress. When there are new figures that come out in the media showing levels of stress, depression, self-harm, drug abuse, eating disorders, what's the response? It's simply to demand more services, more psychotherapists, more psychologists, more psychiatrists. It's as if a large majority of the population were being seriously injured and instead of finding out what’s going wrong, we simply want more surgeons to stitch them up.

The crucial question we must ask is: Why is this happening? Why even in rich countries? I'm an epidemiologist, which means I've spent my career doing research on the causes of health and illness in populations. And I want to show you that inequality is a really powerful cause of higher levels of anxiety and mental distress, unhappiness, depression. I'd like you to cast your minds back to when you've felt anxious, embarrassed, nervous in front of other people, the social exposure, maybe when you're making a speech or going to a party where you don't know anyone. But all sorts of situations where we face the threat of being seen negatively cause these sorts of emotions.

This graph is a summary of hundreds of studies of exposing people to different kinds of stress while measuring what happens to their stress hormones, principally cortisol, a central stress hormone. And what it shows is that what most pushes up our levels of stress hormones are what is called "social evaluative threat" -- threats to self-esteem or social status, where others can negatively judge your performance. So although these social stresses are widely recognized and we're all familiar with them, people fail to see how inequality makes them worse for all of us.

In this slide, along the bottom, you've got different income groups, from the poorest tenth of the population on the left to the richest on the right. And up the side, you've got a measure of status anxiety, how worried people are about how they're seen and judged by others. The top line shows levels of status anxiety across all income groups in the more unequal societies. And the bottom line shows the much lower levels of status anxiety in the more equal societies.

I think what we're dealing with is whether we live in societies with a very steep social hierarchy like that, or a much shallower one like that. If you like: bigger material differences between us increase the social distances and those feelings of superiority and inferiority, and that makes a big difference to social relationships within society. Status and class become more important. We're less likely to marry people with a different class background. Community life, as I've said, drops away, and violence also goes up, because violence is triggered by people feeling looked down on. Loss of face, disrespected, humiliated -- those are the triggers of violence. And of course, for people who are more sensitive to status issues, violence is triggered more often. Consumerism also goes up, because we're all trying to enhance our self-presentation.

All sorts of measures of social interaction show the whole social structure becoming more ossified with inequality. Social mobility goes down, and with that, we're even further away from the equal opportunities which we claim to be trying to provide for children. So inequality isn't just about unfairness or poverty. It puts us in social relationships, relationships of superiority and inferiority. It ranks us from better to worse. It's a really invidious process, and it creates those feelings of inferiority at the bottom. It makes us judge each other more by social status, and with that, we become more worried about how we are seen and judged by others. There are two common responses to feeling so worried about how we're seen and judged. One is that you almost accept your inferiority, low self-esteem, lack of confidence. You withdraw from social life because you find it all too difficult, and you become more vulnerable to depression. And indeed, rates of depression are higher in more unequal societies.

The other common response is almost exactly the opposite. If you're worried about what people think of you, you talk yourself up. You big yourself up. You flaunt your abilities and achievements. You become narcissistic instead of modest. We see that, too, in more unequal societies. This next graph is from a study of what psychologists call self-enhancement. People in different countries are asked how they think they compare to the average on different characteristics. And what it shows is, in more unequal societies, people big themselves up, They think they're better at things; they present themselves in an exaggerated way. They become narcissistic. It's like everyone thinking they're better drivers than average. That tendency is greater in more unequal societies.

Mental illness is also worse in more unequal countries, because mental illness is often triggered or exacerbated by issues to do with dominance and subordination, superiority and inferiority. There was a recent study of the 36 OECD countries showing a tight correlation between levels of inequality in those societies and the 10 most common mental disorders. I think the saddest part of this is that studies of happiness and well-being, studies of health, too, show that one of the most important determinants is the quality of our social relationships, our social environment, our friendships. And that is where inequality does its greatest damage. To address this heavy burden of depression, anxiety, mental illness, self-harm, what we have to do is reduce the levels of inequality in society that divide us from each other. Inequality is, in a sense, the enemy between us.