關於 health education behavior ，我們在網路上蒐集到這些相關的討論、資訊與評價

整理得很好

【**川普做了哪些40年來其他總統沒做的事?**】中共就是這幾任包括柯林頓，小布希，歐巴馬給搞到為所欲為，不管川普是否連任，這4年能夠把中共搞到崩潰邊緣，他真的不簡單!

**這裡整理幾點，他做了那些前任總統沒做的事?**

**1. 讓反共成為美國共識:**
* 正式公開承認過去幾十年對中政策的錯誤，並將中國與中共分開，認定中共所領導的中國為「有別於民主」的獨裁國家，視其為「新威權主義」

**2. 讓反共成為民主自由國家共識:**
* 呼籲並整合西方國家，在民主自由與極權暴政之間只能選邊站，價值觀勝過經濟誘因
* 在這次疫情，願意第一個出來講真話，讓我們不用活在指鹿為馬的世界，指出就是因為中共隱匿疫情，造成全球染疫超過千萬，死亡超過50萬人，經濟停擺，損失無可計算，四億多全職工作消失不復返，生活模式改變
* 甚至，他點出了 [#宗教自由](https://www.facebook.com/…/%E5%AE%97%E6%95%99%E8%87%AA%E7%9…)，喚醒我們與中共的差別，西方民主國家不要忘記我們的價值觀，行善止惡的重要性

**3. 斷絕中共資金來源:**
* 進行貿易戰，提高關稅，迫使各國紛出走中國
* 提供優惠措施，輔導美企出走中國
* 嚴審中概股，逼迫中企會計公開透明，被迫在自由市場滅頂
* 限制經由香港的資金流動
* 對中國敏感科高科技出口禁令擴展到香港
* 下令美聯邦退休基金撤出中國，禁止用美國公務及老兵的退休基金去投資中國，使其製造武器來威脅美國人/士兵生命，過去幾任總統都是這樣做
* 美國八成假貨來自中港，不但危害智慧產權，消費者安全，更打擊市場公平性，川普對這些產品進行關稅制裁
* 進行《香港自治法》的簽署: 潛在制裁對象還首度包括國際金融機構，可導致中港銀行無法與美國銀行交易、不能使用美元結算，以打擊中港方資金鏈

**4. 斷絕中共技術來源，消滅「中國製造2025」:**
* 抵制中興、華為及與中共及解放軍有關係的中企
* 阻斷中國晶片來源，沒了心臟，所有設備根本出不了中國
* 對美國涉及千人計劃的學者、科學家開鍘，並對源頭中國駐美使館進行公開譴責
* 反制習近平「軍民融合戰略」竊取高科技，針對中國公民和學生進行簽證禁令，禁止具任何解放軍背景公民、學生與研究人員的再入境，撤銷簽證，甚至逮捕，一解放軍軍官以學術研究到美，在機場被捕，面臨最高10年刑期
* 正在進行「年度國防授權法案 (NDAA)」的簽署: 公布竊取美商業機密、威脅國家安全或經濟健康的個人或公司名單，[#向竊取技術的企業實施懲罰](https://www.facebook.com/…/%E5%90%91%E7%AB%8A%E5%8F%96%E6%8…)，包括凍結他們在美國的資產，及禁止美國公民與這些公司和個人進行交易的制裁，還包括加強美國供應鏈的措施，以及擴大與中國導彈防禦系統整合的限制

**5. 5G:**
* 正式宣布華為國安威脅，目前世界已有多國正式宣布不用華為進行5G基礎建設，這對全世界各國國家安全極為重要，菲律賓即因電網用華為設備，中共可遠端停電菲律賓48小時
* 美憂中國監視及竊盜資料，海纜准通台灣，不准通香港

**6. 印太戰略**
* 美國對中國擴張問題，不再只是內容空泛的抱怨，反而是堅強的執行意志。從新加坡李顯龍公開表示，希望華府不要逼新加坡與東協在美、中兩國選邊，很明顯就是針對美國印太戰略在發言
* 美國正在亞太地區部署前所未見的軍力，目前美軍部署在亞太地區的兵力為37.5萬人，占美軍總兵力的28%，其中包括60%的海軍艦艇、55%的陸軍部隊，以及2/3的陸戰隊兵力
* 美國前總統歐巴馬8年任期中，在南海只執行4次航行自由行動，然而川普上任迄今四年已執行22次，是歐巴馬的11倍

**7. 台灣**
* 稱蔡英文為台灣總統，國務卿蓬佩奧公開稱讚台灣在民主自由的貢獻，並支持台灣加入WHO等國際組織
* 台灣被確認是美國印太戰略核心夥伴，公開邀請參加八月南海軍演
* 2016年共和黨首度將《六項保證》納入黨綱
* 《台北法案》: 內容涵蓋台灣對外關係、美台經貿關係和台灣參與國際組織，增強美台雙邊經貿關係，並要求美政府促進台灣國際參與
* 《2018年亞洲再保證倡議法》其中第209條款「對台灣之承諾」重申支持美國與台灣在政治、經濟及安全的合作，規定「美國總統應依來自中國之威脅而定期對台軍售」
* 《台灣旅行法》: 促進兩國高層交流
* 重啟台美FTA談判
* 美方加強參與台灣國艦國造
* 軍售台灣: 18枚MK-48 AT重型魚雷，66架F-16戰機，派里級巡防艦、AAV7兩棲突擊車、人攜刺針飛彈250枚、拖式2B型飛彈769枚、標槍飛彈及迅安系統後續支援，HARM反輻射飛彈50枚、聯合距外武器（JSOW）空對地飛彈56枚、MK48魚雷46枚、標準二型（SM-2）飛彈16枚、MK54輕型魚雷168枚、4艘紀德級驅逐艦AN /SLQ-32（V）3電戰系統性能提升、SRP偵蒐雷達後續維持、MK41垂直發射系統，C-130 運輸機、F-5 戰鬥機、經國號戰鬥機，M1A2T戰車、M88A2裝甲救濟車、M1070A1 重裝備運輸車、M1000 重裝備運輸板車、FIM-92刺針便攜式防空飛彈、122把M2重機槍、216把M240通用機槍
* 進行《台灣防衛法》的簽署: 確保美軍有能力保護台灣安全，包括評估採取有限核武來嚇阻中國

**8. 香港**
* 制裁傷害香港自治的中港官員，包括: 中共政治局常委，負責港澳事務的韓正，加速中共高層內部的分裂
* 通過《香港人權與民主法》，撤銷香港特別待遇，包括禁止出口軍民兩用技術到香港
* 著手撤銷香港在引渡條例、出口管制、旅遊及獨立關稅區地位等領域所享有的特殊待遇
* 進行《香港自治法》的簽署: 對破壞香港自治的中港官員，凍結其在美資產，禁止入境美國；潛在制裁對象還首度包括國際金融機構，可導致中港銀行無法與美國銀行交易、不能使用美元結算，以打擊中港方資金鏈

**9. 新疆**
* 2019年10月，美國宣布將28個打壓新疆穆斯林的中企列入黑名單
* 2020年5月，美國宣布將中國公安部法醫研究所和8家中企列入經濟黑名單，並將33個協助中國政府監控維族，或與中國解放軍及大規模殺傷性武器有關聯的企業、機構、個人列入黑名單
* 通過《2020 年維吾爾人權政策法案》，呼籲禁止在中國境內外對這些族群的任意拘留、酷刑和騷擾，將制裁監禁超過百萬穆斯林的中國官員，制裁手段包括：凍結中國有關官員的在美財產、拒絶他們入境、拒發或取消簽證

**10. 媒體:**
* 今年2月，美國已將新華社、中國環球電視網（CGTN）、中國國際廣播電台（CRI）、《中國日報》發行公司，以及《人民日報》發行商美國海天發展公司列為外國使團
* 今年3月，美國要求削減60位中國籍記者
* 今年4月，白宮史無前例地批評美國之音為中國政府做宣傳。新任執行長在6月初通過國會核准，原本貝內特（Amanda Bennet）在內多名美國之音高管宣佈辭職
* 今年5月，美國限制中國籍記者簽證90天
* 今年5月，川普與推特等社群媒體槓上，怒斥打壓言論自由
* 今年7月，新增4家中共官媒為外國使團，包括: 中央電視台（CCTV）、中國新聞社（中新社）、《人民日報》和《環球時報》，從此需向美國國務院提供在美員工的名單及他們在美租賃或持有的房地產清單

**11. 疫情前，2019年底的美國經濟表現**
* 失業率維持在 3.5%，創 1969 年以來新低
* 執政 3 年美股飆逾 50%，高居歷屆總統第一
* 招聘人數的增加和工資的上漲推動了消費者支出，消費者支出占美國經濟的三分之二以上
* 美國是2019年G7唯一經濟增速將超過2%的國家
* 至2019年12月，美國經濟已連續第126個月持續增長，是有記錄以來最長的經濟增長期
* 美國股市的總市值攀升至創紀錄，1.5倍於其GDP
* 強勁的美國經濟在2019年繼續吸引來自世界各地的投資，使美元匯率升至歷史新高

**12. 國際組織**
* 川普大聲譴責目前「過於以中國為中心」的國際機構，包括WHO等
* 以行動退出世衛及拒絕提供資金後，世衛終於在6月30日承認中國並非第一個告知疫情，也就是中共違反世界衛生條例，並沒有在24小時內告知世衛，也代表全球都有法源依據跟中共求償
* 川普政府的國家安全小組甚至在考慮建立一個全新的國際衛生組織，以使美國能擁有更大影響
* WTO秘書長突然在今年5月辭職
* 川普表示: 聯合國是一個過時的組織。暗示應成立一個以民主自由國家，有共同價值觀為前提的組織，並開始邀請各國參加G11

What did Trump do that the former presidents did not do?

1. Making Anti-CCP a consensus in the United States:
* Formally and publicly acknowledged the mistakes of the China policy over the past few decades, separated China from CCP, and regarded China led by CCP as a dictatorship, different from democracy countries

2. Making Anti-CCP a consensus in the democratic and free nations:
* Appealed the democratic and free nations to stand together against CCP. Western countries is forced by CCP to choose side between persistence in freedom and acceptance of Beijing’s bully tactics, between value and economic incentives.
* In this epidemic, told us the fact that it’s because of the CCP’s deliberate concealment, more than 10 million people have been infected, more than 500,000 people have died, more than 400 million full-time jobs have disappeared, and our lifestyle is forced to be changed.
* Pointed out the importance of religious freedom and awakened us the differences between us and the CCP. CCP is a regime that oppresses her people’s religious freedom. Western democracies should not forget our insistence on freedom and beliefs

3. Cut off the sources of CCP funds:
* Carried out trade wars, raised tariffs, forced the companies and the investment to move out of China
* Provided preferential measures to assist US companies to move out of China
* Passed a bill that would prevent companies that refuse to open their books from listing on Wall Street. This move is aimed to "kick deceitful Chinese companies off US exchanges."
* Restrict the flow of funds through Hong Kong
* Directed federal pension fund to halt investments in Chinese stocks
* Imposed tariff sanctions on Chinese fake products
* Passed the Hong Kong Autonomy Act to require the imposition of sanctions on foreign individuals and banks that participate in China’s oppression of Hong Kong

4. Cut off the sources of high-tech technology and knowledge acquired by CCP, and eliminate the possibility of Made in China 2025:
* Boycotted ZTE, Huawei, and the Chinese companies which are related to the CCP and the PLA
* Block CCP's access to acquire the high-end chips
* Arrested the scholars and scientists involved in the Thousand Talents Program, and publicly condemned the Chinese Embassy accused to lead this program in the US
* Ordered a ban on issuing visas to the Chinese people, students and researchers with PLA background, in order to prevent Xi Jinping's "military-civilian integration strategy" from stealing US high technology
* Signed "National Defense Authorization Act (NDAA)": published a list of individuals or companies that steal US trade secrets, threaten national security or economic health; Penalize the companies that steal technology, including freezing their US assets; Prohibit U.S. citizens from trading with these companies and individuals...and so on.

5. 5G:
* Barred American firms from selling tech and supplies to huawei without first obtaining a license to do so and restricted companies like TSMC, a Taiwan-based firm, from exporting computer chipsets and other key components to Huawei.
* At the same time, warned the world that Huawei products will pose a risk to their national securities. Now, the tide is turning against Huawei, many countries have given up using Huawei equipments on their 5G instructure.
* According to CNN, because of using huawei equipments, the Philippines' power grid is under the full control of the Chinese government and could be shut off in time of conflict
* Denied Google to use a direct connection between the US and Hong Kong, due to a significant risk to security

6. Indo-Pacific Strategy
* The United States is no longer just complaining about the content of China's expansion, but rather a strong will to execute. Li Xianlong from Singapore stated publicly that he hopes that Washington will not force Singapore and ASEAN to choose sides in the United States and China.
* The United States is deploying unprecedented military power in the Asia-Pacific region. Currently, the US military has 375,000 troops deployed in the Asia-Pacific region, accounting for 28% of the total US military strength, including 60% of naval ships, 55% of the army, and around 66% Marine Forces
* During the eight-year term of the former President Obama, only carried out four freedom of navigation operations in the South China Sea. However, Trump has carried out 22 times in the four years so far, which is 11 times that of Obama.

7. Taiwan
* Ignoring CCP’s intimidation, the secretary of State Pompeo publically and officially called Tsai Ing-wen the President of Taiwan. Also, praised Taiwan’s contribution to democracy and freedom, and supported Taiwan’s accession to WHO and other international organizations
* Publicly announced Taiwan is the core partner of the US-Indo-Pacific Plan, and openly invited Taiwan to participate in August Joint Navy Exercise in South China Sea
* Reiterated the "Six Guarantees" for Taiwan in 2016
* Signed "Taipei Act": It aims to increase the scope of US relations with Taiwan and encourage other nations and international organizations to strengthen their official and unofficial ties with this nation
* Signed "Asian Reassurance Initiative Act 2018" : It aims to support the close economic, political, and security relationship between Taiwan and the United States, to faithfully enforce all existing United States Government commitments to Taiwan, to counter efforts to change the status quo and to support peaceful resolution acceptable to both sides of the Taiwan Strait, to conduct regular arms sales To Taiwan
* Signed "Taiwan Travel Law": It aims to encourage the travel of high level United States officials to Taiwan

8. Hong Kong
* In May 27, 2020, announced by the Secretary of State under the Hong Kong Human Rights and Democracy Act that Hong Kong no longer enjoys sufficient autonomy in order to justify special treatment by the US
* In May 28, 2020, announced that the United States would initiate the process of revoking Hong Kong’s favorable treatment under US law
* In July 1st, 2020, passed the Hong Kong Autonomy Act. It’s aimed to provide for mandatory sanctions against individuals, entities and financial institutions in response to China’s National Security Law for Hong Kong.

9. Xinjiang
* China has rounded up at least a million Uighurs in Xinjiang and imprisoned them in what it calls "re-education camps." An investigation found that most of the detainees were imprisoned due to their religious practices and culture, rather than extremist behavior.
* In October 2019, banned the import of products made by a firm in Xinjiang over its use of forced labor, also, blacklisted 28 Chinese entities for their role in the repression of Uighurs and issued visa restrictions on key Chinese officials
* In May 2020, added 33 companies to the United States’ economic blacklist of Chinese companies with ties to China’s military. The Commerce Department explained the banning of these companies, claiming that they are “complicit in human rights violations and abuses committed in China’s campaign of repression, mass arbitrary detention, forced labor and high-technology surveillance against Uighurs, ethnic Kazakhs, and other members of Muslim minority groups in the Xinjiang Uighur Autonomous Region.”
* In signed into a law an act authorizing sanctions against Chinese officials over the mass detention and surveillance of Uighur Muslims in China's western Xinjiang province. The new legislation is the most significant action by any country to punish China over its treatment of ethnic minorities.

10. Media:
* In February, require five Chinese state-run media organizations to register their personnel and property with the U.S. government, granting them a designation akin to diplomatic entities.The five organizations affected are Xinhua News Agency; China Global Television Network, previously known as CCTV; China Radio International; the parent company of China Daily newspaper; and the parent company of The People’s Daily newspaper. All five meet the definitions of "foreign missions" under the Foreign Missions Act, according to the State Department.
* In March, ordered several Chinese media organizations to dismiss 60 U.S.-based Chinese nationals
* In May, reduced the length of work visas for journalists from China employed by non-U.S. media will be to a maximum of 90 days. Chinese reporters can apply for extensions, each one also limited to 90 days
* In the end of May, after Trump's complained reminding, Twitter has flagged a tweet written in March by a Chinese government spokesman that the US military brought the novel Coronavirus to China, as the social media platform ramps up fact-checking of posts.
* In July, announced that four more Chinese media organizations will be treated as foreign diplomatic missions, including: China Central Television (CCTV), China News Service (China News Service), People’s Daily, and Global Times.

11. Before the epidemic, the US economic performance at the end of 2019
* Unemployment rate remains at 3.5%, a new low since 1969
* During Trump’s three years in power, U.S. stocks soared by more than 50%, ranking first among successive presidents
* Increased recruitment and rising wages have driven consumer spending, which accounts for more than two-thirds of U.S. economic output, and its health has helped the economy maintain a stretch of growth that is now in its 11th year.
* In G7 in 2019, the United States is the only country with an economic growth rate of more than 2%
* As of December 2019, the U.S. economy has expanded for a record 126 straight months, the longest time period in the country’s history according to the National Bureau of Economic Research.
* The total market value of the US stock market climbed to a record, 1.5 times GDP
* In 2019, the strong American economy attracts investment from all over the world,bringing the dollar exchange rate to a record high

12. International organizations
* Loudly accused WHO of being very "China-centric" and withdrawn from the WHO by action and refusing to provide funds, the WHO finally admitted on June 30 that it was alerted by its own office in China, and not by China itself, to the first pneumonia cases in Wuhan.
* Trump is even considering to establish a new international health organization to allow the United States to have greater influence
* WTO Secretary-General suddenly resigned in May this year
* Trump even called for reform of outdated United Nations, implying that an new UN organization should based on the common value as democracy and freedom. Hence, he is starting to invite more democratic countries into G7

[以腸道菌為導向的飲食改善憂鬱情緒跟肥胖]

今日一位久未回診的憂鬱症患者A回診，抽血報告有低密度膽固醇過高的問題，自述最近飲控狀況不好，所以不敢回診。

我:「是不是最近有甚麼事造成情緒低落呢?」
A: 「嗯…我有個朋友最近自殺了，也是在同一個身心科醫師治療的病友」
我:「嗯…我了解了，最近有許多自殺的社會新聞，真的很讓人難過⋯⋯那你心情不好的時候會想吃甚麼呢?」
A:「(遲疑了一下小聲說)嗯…燒烤吧，還有吃甜的。」
我:「很好，這些高油高糖的東西也是一種成癮物質，所以在妳憂鬱的時候可以給你的大腦很立即的欣快感，如果它讓妳開心，那我們一周固定一天吃它們吧」
A:「可以嗎?(眼睛一亮)這樣不會破壞減肥計畫嗎?」
我:「當然可以，腸道菌的改變是長時間的，一周吃健康6天吃不健康1天，強過天天不健康不是嗎?別再要求自己一定要多久內瘦多少公斤，我們短期目標先讓血液報告正常再說，健康的胖子絕對強過不健康的瘦子。」
A: 「好，我再努力試試。」

Tammy Wang在成大住院醫師時期輪訓肥胖醫學門診，教授說過一句話讓我印象深刻：「有兩種病人有極高的減肥失敗率，建議先治療好再來減肥，一個是菸癮，一個是憂鬱症。」因為有些身心科藥物的副作用就是代謝症候群包括肥胖，在近年來的研究發現跟藥物影響腸道菌進而影響代謝途徑有關。但是在我的門診，很常見因為憂鬱症或焦慮症而肥胖的患者，其實回想起來都不清楚是肥胖造成憂鬱還是憂鬱導致肥胖。

憂鬱症跟先天基因、後天環境等等有關，和肥胖一樣是多因素疾病，但都擁有許多相同的生理現象跟腸道菌表現。近年來的研究有許多腸道菌跟肥胖和憂鬱的相關整理，發現高糖高脂肪食物造成的發炎反應跟肥胖之後造成的慢性發炎反應，都可能導致憂鬱情緒，因為高糖高脂食物引發的促進發炎激素(Proinflammatory cytokines)跟引起的免疫反應，會藉由通過血腦屏障(blood-brain barrier)影響腦部上的受器，造成憂鬱的情緒跟行為(感冒或感染時會比較情緒低落也跟這個有關)，也會直接破壞血腦屏障的傳輸(很多情緒疾患常見現象)。

另一項研究表明，憂鬱或焦慮患者的血液中跟內毒素LPS結合的抗體比較高，這種毒素在腸道菌破壞時的「腸漏症」常見。於是進入:高糖高脂食物➡️慢性發炎+脂肪囤積加速發炎➡️腸道菌破壞➡️免疫缺失、發炎持續➡️影響大腦的情緒跟行為，因此藉由飲食改變降低發炎的源頭，讓腸道壁的守門員增加、讓神經賀爾蒙恢復正常運輸都有助於一同改善肥胖、憂鬱症跟失衡的腸道菌相。

#那肥胖的飲食介入能改變腸道菌跟憂鬱嗎
在日本一個隨機分配研究，將40名40歲以上的肥胖日本女性(body mass index (BMI) ≥ 25 kg/m2)隨機分為介入組或對照組。介入組包括專業人員進行的每次20分鐘的飲食講座和10分鐘的諮詢課程(包括介紹肥胖跟腸道菌還有飲食的關係)，每2周連續8週，發現與對照組相比，以「對腸道菌有益為導向的飲食」干預組體重、BMI、腰圍和憂鬱量表評分都顯著下降，而自我評估的健康狀況有顯著改善，腸道微生物組的多樣性也顯著增加。

#結論：以腸道菌組成為重點的營養教育可改善肥胖婦女的肥胖和心理健康。

越是自我要求高的人，越容易產生焦慮或憂鬱，也越容易因破戒而自我厭惡或放棄，進入惡性循環。我看過很多因為情緒性飲食變胖的人都有非常溫柔而善感的特質，發洩的方式有很多種，有人會去傷害別人，有人選擇傷害自己，而用吃---某種程度也是傷害自己來發洩的人，其實更加地壓抑善感。我們很容易藉由最簡單的吃來紓壓，是因為身體需要「生存」，壓力賀爾蒙在遠古時代是人類被野獸追趕時會分泌的激素，會加速食物轉化為脂肪儲存以便跑到沒力氣時有熱量可以使用。
所以越壓抑不能吃某樣食物，常常身體越渴望能量的儲存，但是當某些違禁品可以固定一天享用的時候，它也不再有那麼強烈的吸引力。
#別讓身體覺得物以稀為貴而吃下平時不會吃下的違禁品。

提供給同時擁有憂鬱跟肥胖的人一些減脂期的秘訣，希望有幫助:
1️⃣採用有飽足感又不會致發炎的高蛋白、低脂、高纖維飲食。
2️⃣憂鬱情緒出現時，不管想放縱吃甚麼，請先攝取蛋白質食物(例如想吃蛋糕前先吃顆蛋和無糖豆漿)，讓血糖穩定讓胃有飽足，研究顯示高蛋白質的比例可以降低高脂肪食物的傷害。
3️⃣在飲控期間固定每周有一天的放縱日，平常將想吃的違禁品列出來，集中一天想吃甚麼就吃甚麼，當天多走動，盡量早點結束想吃的東西。
4️⃣情緒性飲食有時只是想吃「很多」東西時，可以挑相對健康的食物吃到飽，例如蒟蒻麵、高纖無糖豆漿、豆腐、蔬菜，高蛋白高纖維比高脂高糖食物其實更有飽足感。
5️⃣要吃高糖或高油的東西，請「擇善固執」，例如甜點請吃一塊150那種，不要挑便宜的，因為食物是一分錢一分貨，較貴的甜點相對用料也比較好，添加物通常很便宜，油請挑好的吃，善待自己。
6️⃣找一個人，不管是醫師、家人、朋友，只要有一個可以在妳減肥路途上聽妳傾訴，不管是挫折也好、對自己失望也罷，千萬不要自己一個人面對所有的事，人類本來就是群體動物，即使只有一個也好，千萬先找一個人陪著妳。

Reference:
1. Schachter, Julieta, et al. "Effects of obesity on depression: a role for inflammation and the gut microbiota." Brain, Behavior, and Immunity 69 (2018): 1-8.
2. Uemura, Mayu, et al. "Obesity and mental health improvement following nutritional education focusing on gut microbiota composition in Japanese women: A randomised controlled trial." European journal of nutrition (2018): 1-12.
#圖示為餓了半天被人說不努力而自暴自棄吃鹹酥雞
#正確的飲食介入跟衛教可以醫治身心靈
#憂鬱症患者在藥物治療同時不要放棄飲食改變

《親密戲導演》

American Theatre，2018年11月號。
《演員的親密戲》

擷自內文：
「性愛場景，如同設計武打場，或是舞蹈動作一般，需要同樣細心編排的動作設計，特別是在這個 #MeToo時代。 」

「我在研究所時期也是演員，所以我有親身體驗—那種來自同事的不恰當經驗，一起跟我上台的人，或是導演完全不知道該怎麼處理這些(親密戲)場景，所以他們索性就完全不處理。」Sina說 「如果你有一個比較年長的導演，碰到親密戲他會跟你們說:你們就做吧，就試看各種可能。所以你們就開始在性愛場景中即興，這是非常不舒服的經驗，而且大多數時候非常令人受傷。」

「親密戲的指示，從來沒有在演員Emily與她的女搭檔編排動作設計遇到困難時出現(她們當時在編排一個充滿戲劇衝突的雙人愛情戲)，即使Emily之前演過同性間的愛情戲，她仍然發現自己舉步維艱， 而她的導演除了不斷對著她們大吼舞臺指示「洶湧的情慾」以外，毫無建樹。兩位演員根本沒有辦法自己演完這場戲，而她們發現到了排練最後階段，她們的導演對著她們大喊「就做吧。時候到了。」

「劇場的一切都是假的，」Sina說，「那是一個由演員搬演的假故事，我們必須永遠記得這點，你不應該因此失去自我，你必須在自我跟所做事情之間取得很好的平衡。是的，你必須把自己奉獻給角色，但你也必須要在適當時候離開。」
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前言：
自己日常閱讀時發現這篇文章，其中許多觀念頗為受用，花了幾天翻譯出來，希望能給台灣帶來不同觀念交流、分享，人家對身體以及一切相關觀念，已經好前面了。

雖為英文系畢業，但仍非專業翻譯，謬誤之處歡迎指正。

歡迎轉貼，請勿用做商業用途。
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正文：

Intimate Exchanges
Sex scenes require as much careful choreography as flight or dances, especially in the #MeToo era.

《交換親密》
性愛場景，如同設計武打場，或是舞蹈動作一般，需要同樣細心編排的動作設計，特別是在這個 #MeToo時代。

Adam Noble had been teaching an advanced scene class for just one month when he faced a startling encounter with sexual assault in acting. A student came to him asking for a new scene partner, saying she thought the man she had been working with, on the final scene between Stanley and Blanche in A Streetcar Named Desire, had tried to rape her.

Adam Noble在他的進階場景分析課上遇到一件令他膽戰心驚的表演性騷擾事件，一名學生跟他要求更換場景搭檔，她說她的搭檔企圖在他們一起工作《慾望街車》最後一景Stanley跟Blanche的戲時，企圖強暴她。

Noble immediately offered to serve as a mediator for the two students, who had been rehearsing alone in the young man’s dorm room, in order to clarify what had happened. The situation was resolved as a misunderstanding, and the two were able to continue working together. But for Noble, who had staged his first theatrical flight in 1992, the incident served as a wake-up call.

Noble立即以協調者身分為兩位同學提供幫助(他們一直單獨在男同學宿舍房間單獨排練)，以求能夠釐清事實真相。後來發現整起事件其實是個誤會，兩位同學也因此能夠繼續一起順利工作。但對於Noble來說—他從1992年就設計了他的人生第一場舞台打搏鬥戲—這起突發事件有如一記響鐘。

“We were sending these kids off on their own devices with no foundation for how to approach this stuff,” he recalled. The lack of resources for both students and teachers regarding the staging of intimate scenes was apparent.

「我們讓這些孩子在完全不具備如何處理理這種事的相關基礎知識時候，就放手要他們自己發展，」他這麼回憶。「因此，老師與學生雙方都缺乏排練親密戲的必須知識，這件事是顯而易見的。」

Noble developed a method called Extreme Stage Physicality to provide students with a framework to address what he called in an article for The Flight Master maginize “scenarios of intense physicality” with comfort and confidence. He began teaching ESP to high school, undergraduate, nd graduate students across the country. He found that the methodology was effective for all ages, and the number of reported incidents and problems dropped to zero.

Noble後來發展出了一套他稱之為「極端舞台形體」（ESP)的技巧，他對《The Fight Master》雜誌表⽰這個技巧提供了一組完整架構給學生使用，讓他們在「激烈的肢體情境」中可以感到安心並且擁有自信。他開始在高中、大學、研究所教導這套ESP技巧。他發現這套方法適用於所有年齡層，後來這些單位的性騷擾通報數量為零。

“For me as a director, it had to work for aggression, and it had to work for intimacy,” Noble said. “ It had to work across the board for those moments when the body steps in to fill the void, whether it’s violence or intimacy. Theres’s a point where the text and the words are no longer enough and the body steps in. There had to be a way for them to work on it safely.”

「身為導演，我認為在工作時，必須涵蓋侵略性以及親密性這些面向，」Noble說，「這些都必須要被全面地工作到的，特別是在那些時刻，當你的身體必須要介入來填補空缺的時候，會有那麼一個點，光靠文本跟台詞已經不足以支撐而你的身體必須要介入，在這時候必須要有一個安全工作的方法。」

That way would later be referred to as intimacy choreography, a term first used in 2006 by Tonia Sina, creator of the Intimacy Directors International. While studying movement pedagogy, including flowing and mime, Sina was helping to choreograph intimate scenes in student-directed plays and found what she described as “a hole” in choreography and no resources to help with her work.

那套方法，後來被「國際親密戲導演工作坊」創辦人之一Tonia Sina稱為「親密戲形體排練」。當 Sina在鑽研動作教育學時—其中包含小丑與默劇—一面幫忙在學生執導的劇目中擔任動作設計，就在這時候，她發現了在動作設計這個領域中的「空缺」，而這方面，她發現自己完全沒有任何資源可以幫上忙。

For her thesis he created a technique to help actors improve the conditions of their work as well as the results. Published in 2006, “ Intimate Encounters; Staging Intimacy and Sensuality” drew from her own experience as an actor. While attending graduate school at Virginia Commonwealth University, Sina’s personal life was disrupted due to the lack of structure provided for staging intimate sscenes. While rehearsing Picasso at the Latin Agile, she and her acting partner staged a love scene together, alone-a standard practice for such scenarios- with unnerving results.

她在她的論文創造了一套技巧，來幫助演員精進他們工作的狀態以及成果。2006年，她從自身演員經驗出發，發表了《親密接觸:表演中的親密性及其感官性》。大學就讀維吉尼亞聯邦大學時，Sina的私生活就因為沒有一套擁有完整架構的技巧來排演親密場景，而深受其苦。在排練Picasso at the Latin Agile 時，Sina跟她的表演搭擋需要排練一段愛情戲，而且是獨自排練—一個司空見慣的情況—然後最後結果卻令人不安。

“The second our lips touched it was not rehearing,” Sina recalled. “It was just kissing. We both felt it. We both knew. It ended up spiraling. We ended up leaving our parters for a month and we had a showmance. It caused a lot of mayhem in our personal lives because we couldn’t let these characters go. We didn’t have a safe way to do the intimacy, and we didn’t have a safe way of coming out of it.”

「當我們的嘴唇碰在一起時，那就不是在排練了。」Sina回憶道。「那就只是單純在接吻而已。我們都感覺到了，最後越演越烈，我們都因此而跟各自伴侶分手，在那個演出期間我們的私生活真的變得很混亂，因為我們都不肯放下我們劇中角色。我們沒有一個安全的方法來做親密戲，也沒有一個安全的方法來離開它。」

The two dated for a month, but their romantic relationship ended shortly after the show closed. And while Sina’s experience was consensual, there are many cases in which an intimacy director could have prevented non-consensual encounters and abuses of power, especially for young women in the industry.

他們兩個交往了一個月，但隨著戲告一段落感情也就馬上結束了。儘管Sina的案例是當事者雙方都心甘情願，仍然有非常多的例子不是如此，在那樣的狀況下其實親密戲導演是有大把機會可以防止這種違反自身意願的接觸，以及權力的濫用，特別是對業界年輕女性而言。

“While I was in grad school I was also an actress, so I was experiencing it firsthand- situations that had been completely inappropriate from co-workers, people who had been onstage with me, director and there’s a sex scene and they say, ‘You guys just do it. Just try something.’ So you’re improvising a sex scene with your partner. That’s extremely uncomfortable and very victimizing at times.”

「我在研究所時期也是演員，所以我有親身體驗—那種來自同事的不恰當經驗，一起跟我上台的人，或是導演完全不知道該怎麼處理這些(親密戲)場景，所以他們索性就完全不處理。」Sina說 「如果你有一個比較年長的導演，碰到親密戲他會跟你們說:你們就做吧，就試看各種可能。所以你們就開始在性愛場景中即興，這是非常不舒服的經驗，而且大多數時候非常令人受傷。」

Alcoa Rodies, co-founder of Intimacy Directors Internatial, witnessed and was a victim in such scenarios throughout her career. After almost chipping a tooth when a scene partner decided to intensify a kiss onstage, she was told, “ That’s part of the profession. Get used to it.” Knowing there were hundreds of other women who would gladly take her spot in a show if she left, Rodis thought she had to accept that kind of behavior for the rest of her career.

IDI共同創辦人Alcia Rodis在她自己生涯中，親眼見過幾個案例，並且，也曾經有過身為受害者的經驗。在她的對手演員決定在場上把吻戲變得異常激烈時，她的牙齒幾乎都要裂了，儘管如此，她還是被告知「這行就是這樣。早點習慣吧。」因為Rodis清楚知道如果她選擇離開的話，會有其他幾百位女性會搶破頭想要她的位置，她一度以為她必須要在整個職涯中接受這種狀況。

“We sort of learned that’s not the case, and we don’t have to just take it. We can actually be part of the process and work together,” Rodis said.

「我們後來知道其實並不是這樣的，我們不需要逆來順受。我們其實可以在整個工作過程中同心協力地工作。」Rodis 說。

Sina and Rodies, along with co-founder Siobhan Richardson, created the Pillars, the core protocol of IDI’s work and teaching. A codified process, the Pillars consist of Context, Commumication, Consent and Choreography. (They recently estabished a fifth pillar, Closure, to assist actors in walking away from a character after a performance.) Not having this process, Sina said, can be damaging and dangerous.

Sina跟Rodis，以及創辦夥伴Siobhan Richardson發明了「骨幹」這個IDI在工作及教學上的核心要素草案。其中包含：文本、溝通、同意以及動作(近期還加上了第五個骨幹:收尾。來幫助演員在戲結束之後順利離開他的角色。)Sina說，沒有這些幫助的話，是有可能帶來危害的。

“None of it’s real-it’s theatre,” said Sina. “It’s a fake story that is being portrayed by actors, and we have to keep remembering that. You shouldn’t be losing yourself. You need to have some semblance of yourself and some awareness of what you’re doing. Yes you can commit to the character, but you need to come out again.”

「劇場的一切都是假的，」Sina說，「那是一個由演員搬演的假故事，我們必須永遠記得這點，你不應該因此失去自我，你必須在自我跟所做事情之間取得很好的平衡。是的，你必須把自己奉獻給角色，但你也必須要在適當時候離開。」

IDI currently recommends four certified Intimacy Directors, with 16 candidates in training to become certified. Currently only established movement teachers, choreographers, and directors who have worked directly with a founder are able to apply for training. The organization also offers workshops for actors, directors who want to learn basic consent and choreography, and for stage managers and choreographers wanting to learn more about intimacy direction. In August 2018, a 10-day International Intimacy Pedagogy was held in Illinois.

IDI最近推薦了四位經過認證的親密戲導演，陸續還有其他十六位正在培訓。目前，機構只提供專業的、並且曾和創辦者共事過的動作老師、編舞以及導演可以申請接受培訓。IDI有提供工作坊給演員及導演學習「同意」與「動作」的基礎概念，另有舉辦工作坊，給有意願了解更多關於「如何給予親密戲指示」的舞臺經理與動作設計。2018年8月，他們在伊利諾州舉辦了為期10天的國際親密戲教育學工作坊。

Along with the Pillars, another crucial aspect of intimacy directing is recognizing and respecting traumas in one’s colleagues. All IDI-certified choreographers have completed state-offered metal health certification courses.

除了「骨幹」之外，另有一個至關重要的概念：辨識並且尊重同事的創傷。所有IDI的動作設計都完成了由州政府認證的心理健康課程。

“None of us are therapists, and none of us are counselors,” Rodis said. “But we know what to do if someone is having a metal health crisis, and we know what resources to give them. Because of the nature of the work we’re doing, and because some of us are so new, we’re getting further education on trauma.”

「我們都不是心理治療師，我們也都不是諮商師，」Rodis說「但是，我們知道當有人心理出現危機時該給他們什麼資源。因為就我們現在所做的工作本質上來說，我們都是新手，所以我們有必要持續在創傷這個議題上進修。」

While recognizing that theatre professionals are just that- professionals hired to tell a story- the founders also understand that that job can involve actors putting themselves through traumatic experiences night after night.
“We know what you’re doing is different than going to the office every day,” Rodis said, “If you’re playing Lady Macbeth every night, after a while it’s going to wear on you. So we also offer resources on how to close out at the end of every night.”

正因為知道劇場這個職業就是由一群受聘的專業演員來講一則故事，創辦者清楚的認識到這個工作可能需要演員讓他們自己日復一日、夜復一夜的經歷那些創傷。「我們明⽩你的工作不同於朝九晚五的上班族，」Rodis說，「如果妳每天晚上都在飾演馬克白夫人，過一陣子這個角色其實是會影響到妳本人的，正因為如此，我們也提供方法讓你在每晚演出過後把角色給關起來。」

One such resource is the ability to discuss sexuality and sexual experiences openly and without discomfort- a shift from the norm in American culture, which, as actor/director/teacher Claire Warden observed, has little problem with violence but tends to balk when it comes to sex, leaving directors feeling uncomfortable and embarrassed.

其中一個資源，就是擁有能力來討論性以及性經驗而不會感到不適。談論性這件事，不同於具有多重身份(演員、導演與老師)的Claire Warden觀察到的一個美國文化現象:談到暴力時大家都沒問題，不過一但談到性的時候大家都顯得有點畏畏縮縮的，這其實讓導演們都覺得不舒服與尷尬。

“We’ve got this really skewed view of sex and sexuality and intimacy, and an obsession with it,“ Warden Said, “ A lot of shame, judgment, power, and confusion lies around it, which has made it uncomfortable and awkward to talk about openly.” The root problem, she said, may be that “sexuality and intimacy have kind of blurred into one.”

「我們對於性與親密的相關議題有一種扭曲的觀念，同時卻又深深為其著迷」Warden說，「這同時又有許多羞愧、判斷、權力以及困惑參雜其中，因此讓它成為一個公開談論時會帶來不適與尷尬的議題。」根據她說，其實真正根深蒂固的問題是，我們把「性」與「親密」混為一談。

Intimacy direction was never mentioned when an actor we’ll call Emily(not her real name) was performing in a dramatic two-handler and struggled to choreograph a love scene with her female scene partner. Having never performed a same-sex love scene before, Emily found herself at a loss, and her director- whose only technique was to yell the stage direction “Rolling heat!” Repeatedly- was no help. The two actors were unable to stage the scene on their own and found themselves onstage at the end of rehearsal with the director yelling. “Just do it. It’s time.”

親密戲的指導，從來沒有在演員Emily與她的女搭檔編排動作設計遇到困難時出現(她們當時在編排一個充滿戲劇衝突的雙人愛情戲)，即使Emily之前演過同性間的愛情戲，她仍然發現自己舉步維艱， 而她的導演除了不斷對著她們大吼舞臺指示「洶湧的情慾」以外，毫無建樹。兩位演員根本沒有辦法自己演完這場戲，而她們發現到了排練最後階段，她們的導演對著她們大喊「就做吧。時候到了。」

Emily recalled that “when it came time to do it in performances, fight director friends of mine ho came to see the how said, ‘That look incredibly uncomfortable for you both. You looked like you were in pain and it was obvious.’’’ Her friends asked her where the intimacy director was. Emily had never heard of such a director, saying, “ I wish I’d known about it at the time when all the yelling was happening.”

Emily後來說，「後來真的演出時，我有個舞台搏鬥導演朋友來看演出，到了所謂的『就做吧』片段時，他說『那看起來對妳們兩個都極其不舒服，妳們看起來超痛苦，而且非常明顯。」她的朋友繼續問她親密戲導演在哪。Emily那時從來沒有聽過有「親密戲導演」這種導演，她說「我真希望在所有的吼叫發叫的當下，我能夠知道『其實有親密戲導演』這件事。」

Emily now a director herself, said she is carful to ensure that her actors are comfortable when staging intimate scenes. “I am hyper-aware of my actors’ sensitivity and I’m constantly checking in with them: ‘Are you okay? Are you comfortable with this? Let me know if you’re not comfortable. We don’t have to do this. We can do something else.’ And my actors thank me for it. They’re not used to that.”

現在身為導演的Emily表示:「在排練親密戲時，我總是對我的演員的感受保持超級高的敏感度，我會不停的詢問他們『你還好嗎？你對這個覺得自在嗎？如果有不舒服要讓我知道。我們不一定要這麼做，我們可以有替代方案的。』我的演員總是對此心存感激，他們對這樣的工作方式其實還不是那麼習慣。」

Uncomfortable situations can present themselves with or without directors in the room. Often scene partners are encouraged to stage the scenes on their own, outside of rehearsal, a practice that can lead to feelings of fear and helplessness. Sina was kissed inappropriately- a kiss that hadn’t been choreographed or rehearsed- in front of an audience of 500 people and had to be in character as she received it.

不舒服的狀況不論導演在不在場都有可能發生。通常演員們會被鼓勵私下自己排練，其實，這麼做很容易引發恐懼與無助感。Sina曾在500位觀眾面前被不當的親吻—一個沒被事先設計或是排練過的吻 —而她在被親的同時還要想辦法讓自己「待在角色裡」。

“There are times where it’s, ‘Kiss, but don’t kiss until previews.’ It’s the worst,” Rodis said. “At best it’s a bad story, at worst they start grabbing you, ‘be in the moment.’ That’s the definition of assault.”

「有時候的情況是親，但是在試演前不會真的親，那種是最糟的。」Rodis說，「當那種狀況發生時，你能得到最好的結果是一個爛故事，最糟的結果是你開始被這件事給抓住還要『待在當下』， 這其實就是侵犯的定義。」

Along with establishing the definition of assault, IDI training also defines consent in clear, unquestionable terms that differentiate between that and permission. A director can give permission to touch another actor, but only a fellow actor can give consent.

除了建立侵犯的定義以外，IDI還以清清楚楚、不容模糊的語彙界定了「同意」與「允許」的差異。 導演可以「允許」演員去觸摸對手，但只有對手演員自己才可以真的表示「同意」。

“The conversation is always very professional and technical, so when we’re talking about parts of the body, it’s the biological name of the part of the body.” said Warden. “And we as intimacy directors never ask anything about and never inquire about the actors’, directors’ or anyone else’s personal sexual life, history, story, proclivities, etc.”

「所有的討論都是非常專業的，當我們必須要談論身體的部位時，我們都會用生物學名稱。」 Warden說，「身為親密戲導演，我們絕對不會去問任何演員、導演或是任何人的個人性愛生活、歷史、故事或是性傾向...等等任何事情。」

The language doesn’t change when the workshops contain students, Warden said, though she may move more slowly.

語彙的使用並不會因為工作坊有學生而改變，Warden說，只是她會教的更慢而已。

“A lot of what we’re saying for adults is still, ‘That is not real. None of this is real.’’’ said Sina. “In rehearsal, we don’t add acting to it until the very last minute, We choreograph it like we do anything else. Just do the moves so everyone knows what’s happening. Then they can add the emotion to it when the actors are ready and they feel they know the choreography well enough. And if you can get that to happen for minors, it separates the sexuality from the choreography and allows them to treat it like it is: choreography.”

「即便我們跟成年人都一直在強調『這都不是真的，這一切都是假的。』」Sina說。「排練的時候，我們不到最後一分鐘是不會加上『表演』的。在最後關頭之前。我們都像是處理其他素材一樣，做形體動作讓大家都知道會發生什麼事。一直到演員們都準備好了，對動作都夠熟悉時，他們才會真的帶入感情去演出。如果你能夠讓這些未成年先開始這麼做，慢慢的所有人就能夠把性跟動作設計分開來來看，然後以正確的眼光看它:動作設計。」

The inability to treat intimate scenes as simply choreography is a problem Sina has observed at numerous drama competitions, where students without sexual experience or knowledge, let alone the ability to separate themselves from the characters they were playing, have performed sex scenes. These situations can be traumatizing for people without the knowledge or resources to handle it.

Sina在無數個戲劇比賽上觀察到一個問題，學生們往無法把親密場景當成動作設計一樣來處理，這群學生們沒有性經驗或是相關知識，想當然就無法在性愛戲中把自己跟扮演的人物切割開來看待。這種狀況是非常有可能讓人受創的，特別是對那些沒有相關知識，或是資源來處理這種狀況的人。

“If they’re not being led through it properly, it can be very, very dangerous,” she said. “It’s illegal in our country to do anything sexual with a minor or have two minors do something sexual in front of an adult. It’s very thin line between choreography and a crime when you’re dealing with minors.”

「如果他們沒有被好好引導的話，那真的非常非常的危險。」她說，「根據我們國家的法律，讓一個或多個未成年人在成年人面前做出帶有性愛意味的事情是違法的。所以面對未成年時，在『動作設計』跟『犯罪』之間其實只有一條非常模糊的線。」

Demand for IDI services and training has spiked in the past year, since the #MeToo movement has exposed abuse in the entertainment field, including theatre, and the issues of consent and empowerment in the workplace (not to mention outside of it) have become central.

自從去年#MeToo運動開始後，對IDI這個機構的服務與訓練來說，他們面臨了重要挑戰。在娛樂產業(包含劇場)的職場上(更別提職場外也是)，現在，關於「同意」與「權力」的議題都變得重要無比了。

“At the moment there’s so much need and demand and only so many of us to go around,” Warden said. “I cannot be in every single room and play out there, but what I can do is empower actors or directors or even stag managers to go into a room and say, ‘I would like to offer a way of talking about this.”

「目前來看，親密戲導演的需求與實際從業人數是不成正比的，」Warden說。「很顯然的，我不可能出現在每一個房間裡指導，但我可以做的是賦予演員、導演甚是舞臺經理權力，讓他們能夠在每個房間替自己發聲『我想要提供另外一種工作方式』。」

Also encouraging to Warden is the increased awareness among young students.

對Warden來說，令他欣慰的是年輕一代學生中對這件事情有意識的人數越來越多了。

“My hope, my intentions and my dream is that the next generation of actors, writers, and directors come out with a very different understating of respect and consent with their bodies and each others’ bodies,” Warden said. “And that leads us into an even more free and safe way to creat deep, authentic, risky stories.”

「我的願望、我的本意、以及我的夢想都是下個世代的演員、作家、以及導演都能夠對他們自己以及他人的身體，有一種非常不同於現在的理解、尊重、權利，」Warden說，「這可以讓我們以更自由，同時也更加安全的方式來創造出具深度、真誠、精彩的故事。」

Carey Purcell, New York city-based reporter