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Monday, December 23, 2024

Do The Limit

Posted by fxckfeelings on December 17, 2012

In most situations, it’s easy enough to get away from an unpleasant stranger; you can always slip away to the bathroom, the next subway car, or the nearest police station. With family, however, it’s not so easy to escape. If the problem is bad behavior, you may need to take protective action, but if it’s just causing uneasiness with words more than conduct, your best course of action is probably to show great restraint. In either case, you must have enough confidence in your judgment so that you don’t need to talk things out; just do what will cause the least harm, the most safety for the rest of your family, and prevent any police involvement.
Dr. Lastname

I try to be nice to my father because, well, he’s my father, but he hates my wife and he’s always nasty to her, and it makes it hard to fit him into our family life. He just doesn’t get the idea that when you’re openly rude, people don’t want to be around you, and that, even though I’m his son, he’s not entitled to insult my wife during family visits. My wife doesn’t want him in our house, which I understand, and I can’t get him to understand he’s got to behave. He says he should be able to visit and see his grandsons, AND say and do whatever he pleases. I feel torn by having to protect my wife and family from his bad behavior. My goal is to figure out how to get through to him.

That you have the courage to tell your father what he’s doing to your wife is wrong is a good indication of your character. That your father can’t be convinced that being a dickish monster to the mother of his own grandchildren children is wrong, however, indicates very, very bad things, both about his character and your chances of ever getting him to agree to behave himself.

If your father is completely blind to the fact that being rude is, well, rude, telling him to stop being rude is essentially an impossible task; it’s the kind of denial usually reserved for nasty drunks and gay Republicans. So instead of taking on the impossible, take a step back and give yourself a task that’s merely difficult. WAIT! There is more to read… read on »

The Hard Weigh

Posted by fxckfeelings on December 13, 2012

Given how little we control our own urges, it’s not surprising that we also have trouble controlling our reactions to them, but it is odd how often those reactions are totally wrong. Brains have a pretty good track record with instincts; get thirsty when hot, get sleep when tired, get away when near snakes, etc. When people get urges that are humiliating, however, even when they’re doing a good job of controlling them, they wrongly blame themselves, but when they get controlled by noble urges, even when they’re causing terrible harm, they give themselves a pass. So, however much you love or hate your urges, don’t give yourself a hard time about stigma or anti-stigma. Instead, remember your own moral priorities and ask yourself whether you’re doing the right thing with whatever urges, pretty or ugly, that you got, and to avoid snakes.
Dr. Lastname

I have yo yo’d with my weight for ever—I was 8 years old when I remember going on my first diet, and I had binged by lunch time. I have seen a psychologist regularly in the past and a psychiatrist more recently, and been diagnosed with a binge eating disorder as well as melancholic depression. I also have a history of being sexually abused when I was a child and required hospitalization once for an attempted suicide (prior to diagnosis) and have been on various anti-depressants. Last year I decided to press charges against my abuser and the investigation is still taking place. This was very big for me as previously I couldn’t speak about or put into words to anybody what had happened to me, but with the professional help over years, could make a police statement. I have managed to get into a healthy weight range many times in the past, but only when on a program like Jenny Craig or weight watchers, and I resent having to do these programs and can’t commit to them after I have done them once, but I can’t seem to stay in this healthy way of life on my own. I am either losing weight or putting weight on– my thought are always around food, what when and where I can eat next. I hide most of my eating from everyone including my husband. I feel like a drug addict and don’t know how to take control of my eating. I do really well in my career and other areas of my life, I just can’t flip this switch that turns me into a zombie when I want to eat. I read everything I can about these disorders, I talk about strategies with my mental health professional, but when the urge to eat takes over I go into a zone that I can’t switch myself out of. How can I stop this pattern?

Having an eating disorder is rough, but it’s even worse if you give yourself a disorder about your disorder, giving yourself a hard time for having a hard time. It’s especially unnecessary given the fact that it’s harder to find someone with complete control over unhealthy food impulses than it is to find a unicorn.

Almost everyone has trouble controlling eating habits, as evidenced, not just by the multi-billion dollar industry devoted to weight management (which, as you’ve discovered, is no silver bullet), but by the fact that very few people get permanent weight control without surgery. In reality, of course, as much as we try to control our weight, more often, it controls us. WAIT! There is more to read… read on »

The Natural Mystery

Posted by fxckfeelings on November 29, 2012

Whether traumatic or dynamic, having an early and/or intense sexual experience can make you worry that your ability to have solid adult relationships will be damaged. While sexual trauma can make intimacy scary, and sexual overstimulation can distract you from it, there are ways to move past your past. If you have a clear vision of partnership and the discipline to implement it, sexual feelings need never control your life. You may never stop them from causing pain and distraction, but they can never stop you from finding and being a good partner moving forward.
Dr. Lastname

I recently had a severe panic attack that lead me to believing I was molested as a young child. From what I know, I lost my virginity to a man in his 20s when I was 13 years old, or in 7th grade. After visiting with some old friends, I brought up an event which had happened when we were 13 years old that involved men in their late 20s or older, alcohol, and oral sex. She was horrified I brought it up, but to me, it was something that was part of my life, but after heading home that night, I began to think that maybe it wasn’t so normal for young girls to be having sex and that’s when my panic attack sunk in. For some background, I was “raised” by a 15-year-old mother who I believe loved me, but was at times, emotionally abusive and manipulative, and often times neglectful as she also had three other children after me. My father was also very young and inconsistent, I often went months without hearing from him and longer not seeing him. Anyways, eventually I lost my virginity to a man in his 20s which lead to years of promiscuity with much older men. My brother is now in his 20s and I try to gain perspective by mentally placing him next to what I perceive as a 13-14 year old, but I really can’t process the age difference. I don’t necessarily feel like a victim because I felt like such a willing participant, but lately, I’ve had this deep terrifying feeling that this sexual history goes back much further than I can remember. Although I can’t figure out what happened to me as a child, I do have these “flashbacks” that sometimes make no sense and I can’t seem to place them on a timeline, but my mind will immediately discard them and a sense of panic will set in. My goal is to come to terms with my history so I can start processing and begin to heal.

Being forced by a chance perspective to reexamine your basic assumptions about your childhood—whom you could trust, how safe you really were—can create a domino effect of doubt.

You’re now compelled to call your entire sexual history into question and wonder whether anxiety and flashbacks are side effects of the shock, or legitimate signals of unremembered sexual trauma. Between what you do remember and your lack of parental protection as a child, it could mean that you were sexually abused.

It’s never certain, however, that recalling such an experience in therapy can produce healing, and there’s a danger that delving into childhood trauma may make you feel more helpless and trap you in loops of negative thinking that keep the dominoes of doubt in perpetual free-fall. WAIT! There is more to read… read on »

Trust the Facts, Ma’am

Posted by fxckfeelings on November 15, 2012

Whether you’re pushed into a major decision by loving emotions or anger and disappointment, watch out; the forces behind your decision might be pushing you off a cliff. The stronger your feelings, the more important it is to take a deep breath and figure out the risks and benefits of what you’re about to do before doing something major (or, if your feelings are negative, even opening your mouth). In either case, gather facts, do your homework, and map out consequences before push comes to shove and you commit yourself to actions you can’t take back.
Dr. Lastname

My wife and I have three kids, but we’ve felt a little empty since our youngest girl hit ten and stopped being cuddly, so we’re thinking about adopting. My wife is a stay-at-home mom who’s a little moody but loves kids and has been a good parent, and I work hard at a tough career, but I’m usually around all the time on weekends. My goal is to figure out whether we can make adoption work.

Most people think that deciding on a big, emotional commitment requires a big, emotional process; i.e., since nothing causes more emotion than marriage or parenthood, decisions about getting married or having kids should arise from emotional resolutions.

While this might be a common assumption, it’s also a common refrain of this blog that such an assumption is very, very wrong.

Instead of relying on loving emotions to direct your course, consider the conditions necessary to making an adoption work. If certain conditions aren’t met, it won’t. It’s that simple.

Those are the conditions that need your closest attention, not whatever’s percolating in your heart, or, God forbid, your gut (which, as we’ve often said, is where your shittiest decisions originate, pun intended). WAIT! There is more to read… read on »

End Of Transition

Posted by fxckfeelings on November 8, 2012

Although stopping long-term intensive psychotherapy can leave you in a state of mourning and fear, particularly if it occurs during tough times or against your wishes, it’s unrealistic to expect that returning to therapy will make everything right again. Instead, give yourself time to adjust to change and reassess your ability to stay functional and positive. Then, if you think it’s necessary, find a therapist who’s a good, supportive coach and use him or her for a different kind of therapy that keeps your head straight without stirring up your deeper feelings. If you’re certain that you have to be “in therapy” to get helpful support and are helpless without it, then the therapy you’re in is helping you a lot less than you think.
Dr. Lastname

In my early 20s I spent 4 years in therapy (which I think in and of itself says a whole lot about the not good place I was in my head). Therapy ended, not because I was ready, but because I moved. I am now 46, and in the years since I continued to work through a lot of things on my own, with my therapist’s voice in my head, if no longer in actual therapy sessions. In January my grandmother took a turn for the worse, with both health and cognition, and we had to place her in full nursing care. She has always been one of the most influential and positive forces in my life, so I had a hard time dealing with this. It sent me spiraling down into my 4th lifetime episode of depression. I’ve started back on Prozac, which I now realize I need to stay on for the rest of my life to try to prevent future recurrences, and I’ve spent the last 10 months in therapy with my former therapist via phone sessions as we now live 1,000 miles apart. I have finished working through a lot of stuff in that time, meaning I’ve changed my attitudes and perceptions and behaviors, which has changed my life, inner and outer. I wish I’d figured it out 25 years ago, during that first round of therapy, but better late than never. It’s been a hard year. My grandmother died 7 weeks ago. The grief hit me more than I ever imagined. I thought I’d prepared in those months when she was slowly dying, but I was wrong. What is the saying—Where there is no struggle, there is no strength? Good growth has come of the pain—I have returned to college, and I am training for my first full marathon in January. I am at a truly good place in my head and was ready to end therapy, so two weeks ago, with my therapist’s blessing, I had my last session. I knew, though, that ending therapy because I am truly ready is a celebration, but that it would also be a loss. It is currently hitting me harder than I imagined. How do I get through this and find a place of healthy acceptance of this transition?

While it’s unfortunate that stopping intensive psychotherapy after many years is hitting you hard, it’s not surprising. As you well know, loss is painful, be it the death of a loved one or the end of a source of support.

That said, your pain doesn’t mean your psychotherapy has been less complete than you thought or that you stopped it too soon, just that you can be a solid, resilient person and also be very sensitive to loss, both because of temperament and circumstances. WAIT! There is more to read… read on »

Damaged Control

Posted by fxckfeelings on September 24, 2012

Coping with the mental illness of a family member can be agonizing, and when you can’t stop destructive behavior, it feels like defeat. Trying to defeat the symptoms of mental illness, however, is like trying to win a war on weight-gain or terror—difficult, endless, and resulting in gains that are easily lost. If you learn to accept setbacks as part of the process, rather than attack them as tests of your love and will, you’ll do more to sustain morale, including yours and your family’s. Take pride in your willingness to endure a difficult, painful, and sometimes frightening relationship; you won’t win or lose a war, but you’ll gain peace.
Dr. Lastname

I’ve got an adult daughter whom I know is mentally ill—she thinks people are plotting against her, including her very nice husband—and, for the last few years, without my own husband’s help, I’ve desperately tried to persuade her to get treatment before her marriage fell apart and she got arrested for doing something violent and stupid. The harder I tried, however, the more she suspected I was part of the conspiracy. There was a ray of hope 6 months ago when she had a screaming fit one night and got locked up in a mental hospital, but the medication made no difference, and she came out more certain than ever that her husband was her worst enemy, so she left him. My husband says I’m part of the problem because I never take my daughter’s side, but my goal is to restore her to sanity, and I know my husband is in fantasyland if he thinks she’s sane and has a “side” based in reality. I’m getting nowhere, though, and my own marriage is under pressure. What do I do now?

Unfortunately, while there is no surefire cure for paranoia, pushing a paranoid person to get help is a reliable way to make it worse. After all, if somebody thinks the world is against them, disagreeing with that person only confirms their delusions. Call it the paranoia-dox.

If your daughter’s paranoia can’t be helped—and it seems you’ve tried very hard to help her—then I’m sorry, but your husband has the right idea, even if it’s for the wrong reason. By not challenging her feelings of being victimized, your husband avoids the paranoia-dox, which makes it an approach worth trying. WAIT! There is more to read… read on »

Live Free Or Diagnosis

Posted by fxckfeelings on August 30, 2012

If you listen to (other) experts, psychiatric treatment should always begin with objective evidence, which then determines a diagnosis, which directs us to proven, effective treatments. This expert, on the other hand, thinks that “evidence-based psychiatry” would be very nice if we happened to know lots more than we do, but it is one of life’s great ironies that the organ we know the least about is the home of knowledge itself, the brain. Until we can fully wrap our heads around our minds and how they work, scientific thinking in psychiatry is often wishful thinking. It can actually get in the way of making good, practical decisions and accepting the necessity of living with the unknown, be it a mystery illness or the grey mush in our skulls.
Dr. Lastname

I’ve been very confused lately because of what’s going on inside me. My father did some bad things to me while I was growing up—things that I just began remembering a year or so ago (sorry, I can’t label it). Since then, other memories surfaced as well, but not many at all. Most of my memories of my childhood are snapshots that are just little moments in time, separated by years in between that I just don’t remember. Anyway, the thing that distresses me is that sometimes, but not all the time, I’ll feel like I have another part of me who is talking in my head. This came to my awareness mostly after the memories started coming up, although I feel like maybe it happened occasionally before. For instance, recently someone asked me a question, and a child’s voice answered in my head. I have other instances of similar things like that happening. One time it seemed like there were two parts conversing with each other and I was just observing the conversation, per se. That being said, I am educated enough about what happened to me and the consequences of it to know that I think I’m describing DID, but from what I’ve read, I don’t think I have it. I don’t switch to other personalities, and I don’t really lose time or anything like that…but I do know I’m not qualified to make that kind of assessment (and I know you can’t just by reading this letter). But my question does relate to that: is it possible to have the kinds of experiences I’ve described and not have DID? Since I’m pretty sure I don’t have it, I feel like I’m just some crazy, messed up person for no reason. It terrifies me to share this with anyone, but I don’t know what to do anymore, and it’s getting harder and harder to keep going.

Diagnosis in psychiatry is never precise and, when given too much attention, can do more harm than good. Until the day a mental illness diagnosis can be determined by peeing on a stick, all we can currently do is lump symptoms together and try to observe what happens to people who fall within an arbitrary category.

In the short run, knowing you’re not alone might be comforting, but it would tell you very little about what to expect from future symptoms or treatments. Worse, it would get you thinking of yourself as a diagnosis instead of as a person who’s trying to live life in spite of some disturbing, hard-to-understand symptoms.

As such a person, ask yourself what you most want to accomplish in this life, despite whatever’s going on in your head. For most people with traumatic childhoods, it’s always meaningful to be decent to others, whether they’re your kids, relatives, or friends. You know how easily people slip into abusiveness when they’re angry and how much it hurts, so you never take a good, supportive relationship for granted.

Most symptoms that impair the way you function won’t prevent you from being the person you want to be or doing what you really want to do, they’ll just slow you down and force you to work harder to think up alternative methods. A good coach helps you to accept your impairment without getting discouraged or demoralized.

So instead of looking for the ultimate shrink diagnostician, find a therapist who can act as a good coach, who isn’t too upset by symptoms, and is eager to see what you’re capable of, even when you’re distracted by traumatic memories, internal conversations or the sensations of observing yourself.

Consult a psychiatrist at least once or twice to get an overview of possible treatments, including medication. Of course, non-medical treatments almost always pose a lower risk, but many medications are relatively safe and require no more than a few weeks to try out. If your symptoms are sufficiently painful and/or disabling, and non-medical treatment is insufficient, then you owe it to yourself to check out every possibility.

Whatever symptoms you have, you want to do your best to manage them without letting them define your life. Keep up your diagnostic questions until you’re confident you’ve heard what the experts have to say, regardless of how unsatisfying that might be, and then forget about what caused your problems or how they might be categorized.

Your next step is to manage your burden and respect yourself for carrying it, even if the nature of that burden remains a mystery.

STATEMENT:
“My psychological symptoms spook me and leave me feeling distracted and distanced from myself, but they can’t take the meaning out of a good day’s work or a solid friendship. I may never figure out why I feel the way I do, or stop myself from feeling that way, but I can certainly lead my life according to my values regardless of the tricks my head likes to play on me.”

No one was more surprised than I when I suddenly got depressed about a year ago, because it’s not something that ever happened to me before. I lost energy, felt like crying, and got anxiety attacks. There was lots of pressure at work, but my job was safe, and I’ve never been prone to buckling under pressure. Now I could barely get to work and I didn’t give a damn about the projects that I was responsible for. My wife finally forced me to see a psychiatrist, I started to feel better on an antidepressant, and then my internist really surprised me by telling me my testosterone was low and I should try a trial of replacement therapy, which I did. Within 2 weeks I was back to normal and a few weeks later I stopped the antidepressant. So now I wonder whether I was really depressed or not or whether I should have tried antidepressant in the first place. My goal is to figure out my diagnosis so I’ll know what to expect.

Even on that rare occasion when a specific psychiatric diagnosis really matters, it doesn’t matter as much as you think. Yes, it was critical to your recovery that you and your doctors checked out testosterone deficiency as a possible cause of depression; the sudden, unexpected onset of your symptoms raised the odds of your having an unusual and potentially curable cause, which deserved an extensive workup of your hormone levels, vitamin levels, evidence of inflammation, etc., so congrats for making a good decision.

You also discovered that depressive symptoms may have many causes, making depression less of a diagnosis than a cluster of symptoms. So, much like aspirin, antidepressants can improve symptoms, no matter what the cause, if they work at all. (Unfortunately, no matter what the cause, antidepressant trials often fail [35% for each trial] and require lots of time [three to four weeks] before there are noticeable results.)

In addition to lucking out with both the diagnosis and the response to antidepressants, you learned a valuable lesson, which is that anyone can get depression. It wasn’t caused by bad psychological or medical hygiene, just bad luck. Getting depression often doesn’t have a deeper meaning other than that we live in a tough, unfair world where people often get sick for no reason, and sometimes that sickness makes your brain miserable.

Your own observations are the best guide to your prognosis. If you responded rapidly to getting testosterone replacement therapy, then you may be relatively unlikely to get depressive symptoms again (as long as you continue taking the testosterone, which you may need indefinitely). At some point, if you want to experiment with reducing the testosterone treatment, ask your physician about the odds and choose a good time for experimenting, when not too much else is going on in your life.

From what you know, there’s no reason to think that your prognosis—your expected luck—is worse than anyone else’s. You made good choices, which is an essential survival skill when you happen to live in a bad luck world.

STATEMENT:
“I’d love to take my mental health for granted the way I used to, and maybe I will, after enough time of not feeling depressed has passed, but there’s no escaping knowing how easy it is to get sick. I’m proud of having made good decisions and happy to have gotten lucky enough to almost balance the bad luck I had to get sick in the first place.”

Blues Control

Posted by fxckfeelings on August 6, 2012

Like all symptoms of mental illness, anxiety and suicidal feelings seem controllable since they’re related to thoughts and how we look at things, especially since they have the potential to be so destructive. In reality, their primary causes are powerful, mysterious and, whether rooted in past events or biology, are not curable or easily reversible by the best treatments, most loving families, and strongest willpower. What good treatment and a loving family can do, however, is give meaning to the courage it takes to ignore pain and dangerous impulses, giving one comfort, if not control.
Dr. Lastname

How do you get rid of the pain from your child’s suicide? My son died four years ago, and our entire family is still devastated. We are all now living with depression, anger, and our own thoughts of suicide at times. We are all in therapy but it’s moving so slowly, it doesn’t feel like life is moving forward. After a tragedy like this, how do you get your purpose back?

While I can’t imagine anything much worse than having your child suicide, the key to surviving it is to understand how similar it is to having your child die of any other cause. No parents should have to bury their child, no matter how that child’s life ended.

Intuitively, suicide feels like a preventable cause of death, so it seems justified to review the many would-haves and could-haves leading up to it.

Mental health professionals sometimes make things worse by focusing on such possible “causes” as unacknowledged trauma, unshared feelings, or unrecognized calls for help, all of which mean blame. Blame then feeds the depression and anger you talk about, poisoning normal grief with feelings of guilt, regret, and failure. WAIT! There is more to read… read on »

Superpowerless

Posted by fxckfeelings on July 23, 2012

There’s nothing better at inducing helplessness than being molested as a child, but it’s easy to forget that helplessness is a feeling, not a measure of strength and character. If you’ve been traumatized in the past, don’t let the helplessness of this or any other overwhelming experience make you feel like an ineffective victim. Instead, learn to respect your existing effectiveness, regardless of how helpless you felt then or still feel now. You may always feel helpless, but your very survival is proof that you’re stronger than your emotions.
Dr. Lastname

My life is pretty stable now, but I’ve had a lot of major problems this last year and, in the middle of my troubles, I started to remember being molested by a family friend when I was 14, just after I hit puberty and got breasts overnight. I’ve been struggling to get my daughter help for a major health problem, and then I got fired and had to find a new job, and then my mother started to slip into dementia. Now, I’ve got a new job, my daughter is getting good help, and my father is taking good care of my mother, but I can’t get over a rising feeling of helplessness. If it’s because I was molested, my goal is to get over it.

Before you can even try to recover from the helplessness of current crises, you have to get around the sneaky way it has of making you feel personally ineffective, in part by playing on your memories of the helplessness of being molested. After a while, you can feel like you’re drowning, which is about as helpless as it gets.

In other words, you want to move forward, but helpless feelings cause helpless beliefs by awakening helpless memories. Your mind gets stuck in the notion that you couldn’t do anything in the past, you’re not able to do anything now, then things will probably get worse, and you’ll be powerless to prevent it. WAIT! There is more to read… read on »

The Deep Blue Me

Posted by fxckfeelings on July 9, 2012

Depression and life’s miseries have an amazing way of working together to make you feel like a loser who doesn’t belong, has nothing to contribute, and should not get out of bed. That other people are happy just makes you wonder what you did wrong, when it’s just misfortune and depression doing their job really well. The fact is, however, that we create value in life by pursuing what we believe is most important, regardless of whether we get lucky along the way. That’s why you need to assess whether you’ve done your best to live up to your values, disregarding negative thoughts and the failures over which you had no control. Then pain and negative thinking can’t succeed in damaging you, which means you won’t damage yourself.
Dr. Lastname

I’m not even sure where to begin so I’ll try and keep this as short and concise as possible. I come from a broken family– my mother was abusive and distant, and I became that way to the point where it was hard for me to feel genuine love for anyone because I never learned what love is. I got away from my family and had a string of bad relationships (where if I think about it, I am to blame really). I then met and almost immediately married my husband. He went along with it because he loved me, I pushed for it because I was insecure. I didn’t “feel” any real love for him but wanted him to validate my feelings because I believed then that that’s how love grows. For me back then, love = infatuation. I admit I’ve been messed up. I’ve beaten myself up enough. Anyway, our marriage has been rocky with a major indiscretion on my part and several minor ones (chatting/talking on the phone with strangers) on his part. He forgave me for my error and begged me to stay (this was 3 years ago). Only just a few months ago have I realized how fucked up I am and how I’ve let my “feelings” guide me to hell. I’m still trying to rewire myself and it’s hard work. Unfortunately I recently found out that my husband was still talking to random women for hours because “he’s lonely.” What scares me is that even though I am working on my issues, he still feels lonely and it’s likely he will hurt me again. I realize now that I do love him but I can’t always project it the right way or appear to be happy when really I’m feeling like shit. I keep thinking it’s all my fault that he feels lonely and that nothing I will ever do will help this. I’m really tired of dealing with my own crap and now realizing that he has his own set of issues that may or may not be related to me. I’m very confused. How do I stop obsessing over our faults and focus on the good? I don’t want to throw away everything I’ve accomplished because of my ‘moods’. Please help. How can I trust him again and more importantly, trust myself?

There are a lot of smart people out there with high standards, like yourself, who have brains that naturally favor negative thinking and family backgrounds that are full of sad events and broken relationships.

As such, it’s not your fault that your mind tends to put fault on you and call you broken. What’s worse, if you try to be more positive, your brain pushes back by calling your efforts to think happy thoughts a dismal failure (which, of course, they’re not). Brain 1, You 0.

So, instead of trying to focus less on your faults, aim higher by taking pride in your many remarkable accomplishments. After all, if you can’t think differently, you can nevertheless force yourself to think about different things. WAIT! There is more to read… read on »

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