Category: Blog

What are your patterns?

“What fires together, wires together.”

In other words, brain cells that communicate frequently, form stronger connections. Can you now see where your bad habits may be coming from, and why they’re so difficult to break? They get wired into your brain! And the more you do them, the more ingrained they become.

Obviously, some of the patterns we form are good ones. Everyone has good things they do for themselves and others on a regular basis. Here, I’ll invite you to take a few minutes and name several of your good habits. (If you need a few hints, here is my blog about self-care.)

Are you aware of your ingrained patterns that get in your way, hold you back? Welcome to the human condition. We are an odd species that evolved with layers of old, prehistoric brain underneath newer and more sophisticated parts–and the different parts don’t always get along!

Well, the good news is, we have some good things on our side.

First of all, there’s neuroplasticity. That means the brain and nervous system are “plastic”, mold-able, throughout the human lifespan.  Generally speaking, we can grow, change, and learn at any age.

One of the major ways to access neuroplasticity is through mindfulness. Mindfulness means doing with awareness, being fully present to the present moment. In Somatic Experiencing, we use a form of somatically based mindfulness called “dual awareness”.  That means, the therapist guides and supports you to observing what’s happening in your body/nervous system, while being stable and OK in the present moment.  Without being swallowed up by the old pattern.

A good SE therapist will help you really slow things down, really attune to what’s happening within. You’d be amazed how just slowing things down, in the presence of a calm and grounded other person, brings new awareness and insight. Along the way, the process also frees up the energy needed to make and sustain positive changes.

Slowing down, becoming mindful and starting to feel what’s happening underneath, is a process that sometimes requires therapeutic guidance, particularly if the person has a significant amount of trauma energy lurking under there.  People have accessed it through therapy, yoga, physical exercise, meditation, writing, and other ways. When done properly, this process tends to develop a lot more integration and wholeness within the person.  Many people have used it to shed many bad habits, and ended up knowing themselves better!

Shock vs. developmental trauma

Did you know that there are two main classifications of trauma?

They are different in some ways, similar in others. They can overlap or occur separately.

Shock trauma comes from a sudden, singular event, such as a car accident or assault, physical injury, the unexpected death of a loved one, or a natural disaster.  A person’s experience of war may be filled with multiple instances of shock trauma.  Some seemingly routine, innocuous medical procedures can leave the nervous system in a post-traumatic state, even despite the best efforts of the medical staff.

This category of trauma is so named because it usually involves the person experiencing some degree of shock. Medical shock is often associated with physical injury or impact, and it may pose an immediate threat to life. Medical shock requires the immediate attention of a qualified medical practitioner.  It can co-occur with emotional shock, which involves some degree of dissociation and emotional/physical numbness. Emotional shock may occur without medical shock; and it can go unnoticed for a long time. It must be addressed first before deeper trauma healing work can proceed.

Developmental trauma occurs when an infant or child does not receive the nurturing or support s/he needs for his or her nervous system to fully develop.  This is important: A child’s nervous system knows how to “wind up” into distress, but it does not know how to settle or calm itself.  A child’s nervous system is dependent on the caregiver to regulate it.  Over time, nurturing interactions with a calm and loving caregiver, teaches the nervous system how to calm itself and adapt to changing external circumstances.

In my experience, I have found that people don’t always know that they have developmental trauma, or that their nervous systems  are still in need of support.  Developmental trauma often underlies otherwise unexplained cases of depression, anxiety, rigidity, relationship problems, and failure to recover from a seemingly small life event.

Please note that developmental trauma can result from bad parenting, but this is not always the case. Many unavoidable circumstances can cause stress on the child, or stress on the family that they can’t help but pass on to the child. Examples include family illness, a death in the family, poverty, living with war, and some instances of parental grief, anxiety or depression.

These are two distinct types of trauma. It is important for the therapist to understand the differences in how they appear, as well as how to treat them.

Child abuse is an example of shock and developmental trauma occurring together. So is the untimely death of a parent.

The good news is, just like other animals, humans have a remarkable ability to grow, improve and recover, even in adulthood and old age.  We are designed to overcome adversity, and you might be amazed at how much recovery is possible with the proper support. The principle of neuroplasticity refers to the brain and nervous system’s ability to change rather than staying static.  I have seen people in their 50’s, 60’s, and 70’s engage in SE and experience substantial improvements.

So, don’t give up! You can educate yourself about trauma and how to help body, mind and spirit release it.

Learn about Somatic Experiencing!

I’m pleased to announce that I’ll be giving a free presentation for those interested in learning about Somatic Experiencing. Here is the information:

Sovereign flyer

The presentation will be Saturday, March 15th, 2014, from 9AM to noon.

Breakfast is provided; but please do RSVP to Ashley prior to attending. (See flyer for her contact info!)

Emotions in therapy (and life!)

Many times, people come in to therapy because their emotions become overwhelming. They might be too strong, pop up inconveniently or in the wrong circumstances.

Other people come in due to not being able to feel much of anything at all (feeling numb). Or maybe they’re not feeling enough under certain circumstances.

In any case, emotions are often one of the most problematic aspects of being human. It’s quite common to experience the emotion of frustration towards one’s other emotions! What are these things, why do they act of their own accord and what are they doing? Most of all, how do we get them to be more manageable?

Basically, emotions are our experience of our survival energies. They are trying to be our friend: they motivate us towards things that are good for us and away from things that are bad for us. Ideally, that is; they are often led astray, but that’s a topic for another time.

Emotions are made of physical sensations PLUS the limbic (middle) brain’s interpretation of those symptoms. Some examples of sensations are tightness, tension, churning (stomach), tingling, relaxation, opening, spaciousness, temperature, pressure, and the sensations of the facial muscles of a facial expression. Sensations can also include a subjective sensation of energy moving in the body, e.g. a sinking or uplifting feeling.

It’s interesting to note that the same sensation (e.g., excitement) can be interpreted in different ways by the limbic brain.  Example:  Racing pulse plus shallow breath plus “butterflies” in stomach = anxiety/dread (just prior to a test or exam), OR infatuation/positive anticipation (calling someone to ask them on a date).

Emotions become a problem when they become excessive to the situation, or subjectively overwhelming. When they are overwhelming over a long period of time, or extremely intense, they tend to become frozen or numb. This numbness can sometimes be experienced only in regard to specific events/emotions; other people experience a more general, overall lack of emotion. Such an emotional shutdown is a survival mechanism. However, once the numbness wears off, the original emotions are still there, often with increased (excessive) intensity.

An emotion experienced in a healthy way will rise, then relax on its own, in a wave-like motion.  The person will feel it, sometimes strongly; but it won’t be overwhelming, and it will resolve, and be complete. On the other hand, emotions that are stuck, overwhelming, or don’t seem to resolve, often create distress and/or interfere with the person’s functioning.

Somatic Experiencing works with the person’s thoughts, life experiences, sensations, emotions, behaviors, and images to help the body work through its backlog of stuck emotions in a gentle and manageable way. SE uses titration (exposure to manageable amounts) and pendulation (moving in and out of the emotion) to create a gentle and effective way of working with emotions, so they can be released and the person can move on with their life.

Self-care

What do YOU do to take care of yourself?

The fast, hectic pace of modern life doesn’t encourage very much self-care.  Somehow, there’s always the sense that we could have, should have accomplished more.

Workouts are one generally well-accepted form of self-care. But even there, people often orient towards achievement more than self-nurture.  There can be a sense of defeat or self-beratement if they didn’t perform in the workout quite the way they’d hoped to, or lose all the weight they’d wanted to.

Sometimes, what feels like “self-care” is really “let’s just shut off the overwhelm for a little while.”  In other words, a self-numbing strategy.  Examples include shutting off the stress with a drink (or three); overeating; watching TV; procrastination; etc.  Of course, doing any of these things isn’t necessarily bad, nor bad for you. Like anything, it’s how you do it.  

In my opinion, self-care is any non-toxic, non-harmful, legal activity that provides respite, enrichment, growth, healing, and/or fun.

I know there are a million articles and blogs out there about the importance of self-care.  But I suspect that it’s something many of us know intellectually, but perhaps not fully. Not deep in our guts.  Or in somatic terms, we’re not embodying the intellectual knowledge.  We could talk about it and all the reasons why it’s important, but somehow self-care is always the first thing to go when life gets hectic.

Why do I say this? Because in my experience, it’s really difficult to get people to take care of themselves! As a therapist, I have suggested all sorts of “homework”, new habits, follow-up, etc.  By far the number one “not completed” suggestion is any that involves extra self-care.

I will say that there are two reasons why self-care is so important.  On a purely pragmatic level, it makes people more efficient.  Dreams, aspirations, goals, and even daily to-do lists are much more easily achieved when one is in top form.  Stephen R. Covey, the famous author of “Seven Habits of Highly Effective People,” elaborates this concept beautifully.

The second reason involves perhaps a larger perspective:

You have to be important in your own life.

Among all the goals, tasks, to do lists and etc., is there time for you?

Somatic therapy involves being present in the moment, befriending one’s body, emotions, and sensations. It involves a shift: become a human being, not a human doing.

It’s been my experience that making this shift is an integral part of self-regulation, that is, reducing/managing anxiety and depression.  Also, it makes life’s experiences much richer and more enjoyable. Please note that this is not simply a recommendation for hedonism: A well-balanced and regulated nervous system allows more life energy to naturally flow towards life’s work.  Not incidentally, such an orientation towards life is a wonderful thing to pass on to one’s children.

So, instead of saying, “I’d love to….but I can’t….I don’t have time….”  perhaps we could try saying, “How could I make this work?”

Anger

Anger is a major factor in most of what goes wrong between human beings.  Wars, crime, slander, revenge, legal battles, relationship difficulties…so many atrocities have been committed with anger as the driving force.  Historically and currently, the results have been awful.  The emotion of anger can be terrifying for the individual who knows they carry a lot of it within, yet doesn’t know what to do about it. Anger has also increasingly been implicated in chronic disease, such as cardiovascular problems and chronic fatigue, cancer, and digestive ailments. The entire body becomes involved in an anger response; and to make things even more challenging, the neural pathways of intense anger tend to override our thinking or logical brain, making it easy to take actions we’ll later regret.

Yet, when properly regulated, anger is our friend.  It’s a major component of our physical and emotional vitality.  I like to say that it’s just another “flavor” of our life energy, however you choose to define that invisible something that separates us from inanimate objects.  Anger is probably the most feared, misused and misunderstood thing that we humans have going for us. So let’s talk about it a little bit.

The best definition of anger I personally have ever encountered is offered to us by Drs. Larry Heller and Aline LaPierre, in their new book, Healing Developmental Trauma.  They write, “Anger is a life-supportive response intended to impact an unsupportive environment.” (p. 11)

Read that again. It’s beautiful in its nonjudmental simplicity.

http://www.dreamstime.com/royalty-free-stock-photos-black-cat-anger-image22317528

 

This animal is exerting a self-protective response to something s/he deems a threat. As I look into this cat’s eyes, I see not only the strength of “don’t do that to me!”, I also see a little fear, anger’s close cousin.  If you’re familar with cats, you know it’s likely that this cat will back off, as soon as the threat does.

Anger is an intrinsic part of us.  It’s an inescapable part of our biology. It’s the “fight” response in fight or flight. Anger wants to protect us from things that would harm us.  It helps regulate social interactions between tribe members. I would even go so far to say that we can’t live without it.

So then, how does it go so terribly wrong?

At the risk of oversimplification I will suggest that anger goes wrong when we bottle it.

Properly regulated anger rises up just enough to protect the organism, then it subsides as quickly as it rose.  If someone is annoying you, and you say, gently but firmly, “Hey, please don’t do that,” and they stop, and you relax–that is an example of anger. Yes, it can be that mild.

On the other hand, when anger is repressed, it’s likely to become toxic, particularly over a long period of time. Then it is at risk for exploding outwards and causing harm.  There are many life experiences and situations that can cause anger to bottle instead of being properly regulated. Anger can also be particularly dangerous when an insult to the person or community is so terrible that the response generated in them is large (e.g., the murder of loved ones). And yet, not everyone in those awful situations responds with violence.

In therapy, we can work to familiarize ourselves with anger, on the levels of the mind, emotions and body. We can learn how to channel that energy safely and appropriately instead of stuffing it or acting out.  This can bring an immediate sense of completion and relief. If the person may have difficulty not acting out on it, we create a safety plan, some actions and/or external supports designed to prevent them from acting harmfully.

The end goal is for this vital life energy to be well integrated, not “stuffed”.  Depending upon the individual person, this can take some time to accomplish.  The ultimate goal is to be able to move through the world with ease and a relaxed manner, comfortable in one’s own skin.  That is intrinsically related to confidence in one’s ability to set proper boundraies and protect oneself.

Please remember that nothing posted here is intended as therapeutic advice. Treatment plans are individually designed in the context of therapy.  Anger can be a tricky thing to work with, and I believe that people experiencing significant issues in this area should seek professional support and guidance. If you would like to schedule a consultation with me, please feel free to contact me.

What happens during the first appointment?

Sometimes people wonder what it would be like to visit a therapist for the first time. I have found that people often feel more at ease when they have a little information.  Here’s a basic outline of what is likely to happen if you schedule a consultation with me:

You are welcome to contact me via phone or email to schedule our first appointment.  I will let you know whether or not I am able to accept new clients at that time. If I can’t, I can help you find another therapist to work with.  Our appointment will be considered a consultation: a “trial” to see whether it would seem like a good fit for us to work together.  I would not be considered to be your therapist unless we both agree to that, at the end of our appointment.  

To save time on our meeting day, I will ask whether or not it’s okay to email my intake documents, for you to print and fill out at home.  Some people prefer to use email for the sake of convenience. Other people prefer to not use email for privacy reasons–because email can be vulnerable to hacking, or other electronic snooping.  If you’d prefer to not use email, then I’ll ask you to show up about 15 minutes early for our appointment, so that you can fill them out in my office.

My intake documents ask for information like your name, address, phone number, etc. I also ask you to provide basic information about your family, life history and physical/mental health history. All of the information you provide to me is confidential and can only be disclosed under certain circumstances (which are outlined in the privacy documents I will also provide to you). Some examples of those circumstances include: Child abuse (of a child who is currently under age 18), elder abuse, abuse of a disabled person, danger to yourself or others, subpoena or court order, and/or a release of information signed by you.

Here are a few pictures of my office:

 

 

My office does have wheelchair access.  The accessible entrance is via another therapy office in my suite, so if you require wheelchair access, please let me know ahead of time so that I can make sure that access is available when you plan to arrive.  

When you come in for the first time, I do my best to help you feel comfortable and at ease.  We talk about your life circumstances and what brought you to see me.  I do take notes during the first session, to help me form a framework in my head about what’s going on in your life. We talk about what is and isn’t working, and your goals for therapy.  I start to provide you with information about the body and nervous system, and how they might be contributing to your symptoms.  If you haven’t tried somatically based therapy before, I might gently start to introduce you to the method, so that you can try it and see whether or not you feel it’s for you.

By the end of the appointment, we should both have a reasonably clear hypothesis or idea as to what’s going on, and I can outline how I would suggest addressing it. We will let each other know whether or not it feels like a good fit.  I will let you know whether or not I feel I am able to help you. If not, I can help you find someone else to work with.  You would also let me know whether you feel comfortable in working with me and whether or not you wish to proceed.  If we both agree to proceed, we would then schedule our next appointment.

Of course, this is only a general outline. My work is flexible moment to moment according to the client’s needs.

Here is where you can find my contact information, if you’d like to schedule an appointment.

 

Caught In The Vortex

We all know what it’s like to be caught in the vortex.

trama_vortex

In the parlance of Somatic Experiencing (R), the “trauma vortex” refers to that internal state of being stuck in the trauma, or its effects:

*  An anxiety (or panic) attack.

*  Repetitive or obsessive thoughts.

*  Feelings of despair or hopelessness.

*  Seething anger or explosive rage. 

*  Deep depression you just can’t shake.

These are just a few examples; I think everyone has their own version of it. The key word is “stuck.” When someone’s in it, it can be very difficult if not impossible to get themselves out.

The trauma vortex is an unpleasant state within that’s unmanageable. It takes over; or else it lurks beneath the surface, threatening to rise up whenever the person encounters a trigger. The vortex consists of the internalized aftereffects of traumatic experience(s). Some people live within their vortex all the time. Others are relatively okay in between periods of being triggered.  Many people sense it’s there, but they don’t quite have the words to distinguish or describe it.

Somatic Experiencing (R) practitioners help people learn to recognize when their vortex is trying to rise up and swallow them.   We help clients learn how to step outside of it, manage it, and then gradually diminish it. That is, we help our clients get unstuck.  Trauma means being stuck and not finding (good) options, whereas healing means flow, and choices opening up.

For every vortex, there is a countervortex of goodness and strength.  We help our clients discover, access and strengthen those.  No trauma vortex is quite as terrible when one has a good hold on a countervortex.

counter_vortex

Do you remember “Pac-Man”?  When Pac-Man gobbles up the big pill, he’s empowered, and can defeat the ghosts that were chasing him.  He draws his strength from that pill, which is like the countervortex.  The goal is to help the client internalize that strength as a baseline, rather than just for a few moments like Pac-Man. Then, that strength can be used to deconstruct the trauma vortex.

EmpoweredPacMan

(The ghosts are running scared now!)

So if you’re considering coming in for therapy, please know that it’s not all about working in the vortex! In my view, therapy has to be manageable, often gentle–even fun, at least some of the time.  Generally, the first step is figuring out what’s going on. Then we learn how to stabilize and start to experience goodness (countervortex) again.  To do this, we use the body’s own self-regulatory, or homeostatic, mechanisms. Only then is it safe or effective to go after those vortexes, the aftereffects of trauma in the nervous system.

In my experience, freedom from trauma creates ease in one’s body, mind and spirit.  It means being able to be present in the moment and fully embodied.  Some people can get there quickly; others encounter harder work over a longer period of time.  Personally, I think it’s a lifelong journey rather than a static destination.  I don’t think anyone’s ever really “finished” finding and defeating all of the tough stuff inside.  But the skills one learns in dismantling a vortex become lifelong strength, to help the person with each new challenge.

Somatic therapy is NOT….

As I’ve stated previously, I am happy and proud to be a somatically oriented therapist, that is, a therapist whose theory and interventions include awareness of the patterns in the physical body.  To date, Somatic Experiencing (R) is the most effective modality I personally have practiced or experienced. Of course, that’s why I do it, and I continue to study safe and effective ways to help clients learn to intervene in their stuck patterns.

I want to be clear, though. Somatic therapy….

*  Is NOT a magic bullet.  You still have to attend regularly, do the work, and especially, feel your feelings. In my experience, many if not most symptoms are related to the person not knowing how to experience their emotions, or not having the capacity to tolerate them. That is, the feeling seems too big, too much, or too overwhelming.  They either shut the feeling down and become disconnected from it, or become flooded by it, or they may alternate between these two conditions. Just like in any therapy, you have to learn to look within, and learn how to manage your own emotions.  Fortunately, I have a lot of training in how to help people develop this capacity.

*  Is NOT substitute for medications.  Let me repeat this: Somatically based therapy is not a substitute for competent psychiatric assessment and treatment.  As with any kind of therapy, some people will get along fine without meds, and some people will need meds, either on a short- or long-term basis.  I am licensed as a psychotherapist, not an MD, so I can’t prescribe medications or give medical advice. In some cases, my initial or ongoing assessment tells me that treatment is not likely to be safe or effective without a psychiatrist monitoring the client and prescribing medication as needed. In those cases, I am not able to provide treatment to the client unless they are complying with their medication regimen.

*  Is NOT completely distinct from traditional psychotherapy.  For the most part, we still use the same forms, procedures and format. Psychotherapy works because of the two people sitting in the room together, both working towards the goal of the client functioning and feeling better.  (For a discussion of the importance of the therapeutic relationship, see my earlier blog entry.)  However, in somatic therapy, we might be standing up or moving around the room. We might be in silence for several minutes as the client monitors (“tracks”) some of their physical and/or emotional experience. There might be some movements specific to the client’s situation that may help them return to homeostasis.  So in some cases it looks different, but somatic therapy incorporates the same assessment, treatment planning, relationship development and interventions used in standard psychotherapy, while offering additional options.

*  Is neither “conventional” nor “alternative”, is neither “Eastern” nor “Western”.  In my experience and opinion, it’s all of the above.  Theories and practices of somatic psychotherapy include cutting edge neuroscience and plenty of scientific study.  They also include an awareness of Eastern philosophy and intervention styles.  For example, SE(R) uses its own form of mindfulness, which it labels “dual awareness”: The client maintains awareness of being safe in the present moment as they work with their experiences from the past.  Mindfulness is a concept borrowed from Eastern cultures; it’s increasingly becoming incorporated into standard Western psychotherapy.  I refer the reader to the references section of Dr. Levine’s latest book, In An Unspoken Voice.  I’m flipping through his references as I write this; there are many citations of modern scientific and clinical journals.  (This makes sense, as he holds doctorates in both medical biophysics and psychology.) The text of the book also contains references to and explorations of philosophy, Greek mythology and shamanistic practices. I’m glad to be part of a tradition that merges various healing modalities, drawing from the best of all of them instead of putting them at odds with each other.

To sum up, I study and practice this therapeutic orientation because it’s the best and most effective I’m aware of; but it isn’t a magic bullet, and it won’t help those who aren’t invested in helping themselves.

More on working with the body

fI’ve been a helping professional since 1988, and a licensed therapist since 2003.  That’s a reasonably long history of working with people; but my whole world really shifted in January of 2009, when I began studying Somatic Experiencing (R) with my mentor, Maggie Kline.

In learning to read and work with the client’s physical body, I feel as though I were given a whole new pair of super-sharp glasses.  Sometimes my colleagues and I joke that we’ve stumbled upon the owner’s manual for life and the human condition.

Well, okay, not really. But it sure feels like it!   Here’s why:

While the “smart brain” thinks it’s the most important thing around, much of our experience actually comes from our bodies. Even though our conscious brain doesn’t know this.

Humans are distinguished from most other animal species by our neocortex.  This is the most recently evolved part of the brain, the wrinkly part on the surface.  It’s responsible for “higher” and more abstract functions like mathematics, industrialization, and bureaucracy. Okay, it also does more fun things like language, art, design, organized pillow fights, etc.

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The neocortex is really fond of overestimating itself. It thinks it’s the be-all and end-all, and that it’s responsible for the bulk of our conscious life experience. However, research is increasingly demonstrating the role of the body in creating thoughts, emotions and experiences.

Have you ever jumped a few seconds before you consciously know what startled you? That’s your body acting before your “higher brain” has the chance to come online.

In fact, that’s the very same “fight or flight” energy that we work with in Somatic Experiencing (R).  Your body is constantly, constantly monitoring your environment in an effort to protect you, and most of the time, you’re not even aware of it.

Unfortunately for survivors of stress and trauma, the unconscious automatically compares current circumstances to previous situations that were overwhelming in some way.  It tends to get stuck: it always thinks a new version of the same old thing is going to come back and haunt you again! The more overwhelmed your body was when the trauma happened, the more hypersensitive to these old patterns it becomes. Even old patterns you’re not conscious of.

This can lead to all sorts of symptoms that the “smart brain” can’t understand–or cope with.  In fact, our “smart brain” usually gets in the way of symptom resolution. This is why “lower” animals don’t usually suffer from anxiety, depression,  or other “mental health” symptoms! They instinctively follow their body’s needs instead of questioning them, getting embarrassed, or worrying about what their friends will think.  In fact, animals only show signs of traumatic stress when they are somehow blocked from following their healing instincts.

On the other hand, the human neocortex can sometimes repress the symptoms for a while (“think about something else!”). A person can also try to eat, drug, rationalize, or otherwise beat their symptoms into submission. But it’s all still under there somewhere, just waiting  to pop out at an inopportune moment.

Somatic therapists help you learn to safely communicate with your body. When you learn to recognize what it’s “saying”, you and it learn to work together instead of at odds with each other.  Generally, the end goal is a well-regulated nervous system: Developing a state of relaxed ease, but alert, fully present, and able to engage with others.

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(Like this!)

Even though we’re just big fancy animals, it’s vital to include the neocortex, socialization and the human condition in therapy. At the same time, someone can talk and talk, but until they experience a different state of being in their physical body, the changes are too often fragile or superficial.  I’ve seen clients have mood states they’ve struggled with for years, start to shift immediately as we follow the body’s suggestions.  The time it takes varies greatly, usually in direct proportion to the trauma the person has experienced.

So no…I don’t actually have the owners’ manual to life. In any case, I’m sure it’s constantly being revised. I was surprised, though, how much of the human experience clarifies itself when our physical selves are fully included.

 

 

Several new articles published

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