Do we have to Hit Rock Bottom to Recover?

The Alcoholics Guide to Alcoholism

There has been much recent debate about whether a person has to hit rock bottom in under to surrender and start recovering, whether one has to go to the bitter end before surrendering to the recover process.

My own experience shows  that we have to concede to our inner selves that we are alcoholic and that we need help from others.

For me it was a “last gasper” rock bottom for many it was a low bottom, I had lost practically everything and for some they had lost little compared to me but they had seen the road ahead and realised it was not going to get any better without accepting help.

This shows there is more to alcoholism than alcohol, that these people realised their negative behaviours and their consequences were causing them as much distress as their drinking. They did not like who they were becoming or the…

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Nearly Everything Hari thinks He Knows About Addiction is Wrong!

The Legacy of Vietnam Re-examined

It is clear that the idea of addiction Hari forwards is without any foundation or substance in relation to the research carried out on Vietnam Veterans over the succeeding decades.

The vast majority of Vietnam Veterans did not come back to the US and suddenly give up drugs and their addictions. This is a myth pushed by Hari for whatever reasons, only he can say?

The vast majority of Vietnam veterans came back from Vietnam to a frequently hostile or indifferent homecoming, some 12% and then 25% continued to abuse illegal drugs, while many others suffered PTSD and drug and alcohol use disorders.

Added together, in even a conservative estimate, it appears that the majority of Vietnam veterans continued to not only have addiction issues but also cross addicted to other substances and alcohol and present as having co-morbid conditions such as PTSD. They also suffered more in terms of suicide ideation and actual suicide than the normal population, had more unemployment, divorce and family related difficulties….

Inside The Alcoholic Brain

The Rat Park of Vietnam and Beyond

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The videos below have been doing the facebook and twitter rounds, often accompanied by this Ted talk by Johann Hari


Essentially these videos suggest addiction is caused solely by environment.

The idea that addiction is caused solely by environment will be critiqued here principally in relation to the example presented in these videos to support their theory of addiction, namely that the vast majority of Vietnam soldiers returning home to the US after service who were previously “addicted” to narcotics, mainly heroin, stopped using heroin when they returned home, never used heroin again and essentially become de-addicted as the consequence of changing environment.

Their “addiction”, in other words, was contextual and related to the environment in which they abused heroin and became “addicted”.  I put addicted in inverted commas as many people meet diagnostic criterion for substance use disorders at some stage in their life…

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Self Compassion Eases the Distress at the Heart of Addiction

This blog was just linked to by an article in The Huffington Post – so good enough for then, good enough to get a reblog! 🙂

Inside The Alcoholic Brain

I can change my brain and behaviour via neuroplasticity by behaving differently towards myself!

Here we look at one study on self compassion in relation to those who have alcohol  use disorders.

It will be a first in a series of blogs about the role of the heart in addiction and recovery.

Why the heart?

I thought this blog was about neuroscience and the brain which is the head? Not completely true. The heart has a role to play in stress and emotion regulation and in craving and helps prompt neuro transmission of various brain chemicals. The heart has a reciprocal relationship with the brain as we will see in later blogs.

We have had a neuroscientific “decade of the brain” so perhaps we need a “decade of the heart”? As we say in recovery circles, recovery is a journey from the head to the heart, which is so true whatever…

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Change of Heart

Just to clarify I will be on a long term break from blogging about research, namely the neuropsychology of addictive behaviour and recovery.

I have found research quite obsessive and difficult not to get kinda addicted to it. I need to step away from it I think.

I have done enough research in 6 years to write three PhDs and a few books.

After a rest period, however, I will be returning to blog about my experience of recovery and helping others in recovery – that is my 6 month project moving forward.

In order to do this properly I have to  lay the ground work.

Basically I have to accept that my recovery has gone off beam and that I need to go back to recovery basics myself in many ways.

 

It is a rare sign of humility for me, appreciating I need a good tune up.

I need to tighten my belt and start spending more time working with others. Especially those in early recovery. In order to be of service to them I need to get myself in fitter spiritual condition.

I did not realise how much my blogs mean to other people which is very humbling so I will continue with this project say from July to December, so hang in there as there will be lots more blogs on the experience of recovery, coming after a rest period to get back to a fitter spiritual condition.

Thank you

Paul

Adieu for Now

Special notice to say that is me for now – I am taking time out.

Six years of constant research has left me tired and in need of a change in my life. I need to get more hands on in helping others.

I am leaving behind a library of info on my blogs which I will maintain long term – all one needs to essentially know about the neuropsychology of addictive behaviour and recovery I believe is there if one roots around – dealing with distress via serenity is the key ultimately.

Hopefully I have helped shine some light on how recovery changes the brain for the better – ultimately long term recovery involves the rational management of our, at times, errant emotions and accompanying cognitive distortions.

Hopefully I have also shown some ways this can be achieved in recovery.

Recovery is possible and even long lasting if one works at it.

We have a distress based condition which requires constant management, a head that can run away with itself and have to be retrieved via letting go of self willed distress and errant thinking. Recovery is a process which can only happen one day at a time.

So we have all only got today.

May this day be filled with serenity, the perfect antidote to distress and with love for the people in your people with hopefully some for yourself too.

Feeling good about yourself, giving yourself a break, are good ways to recover a sense of self that is not distorted and jaundiced by our addiction.

We may have addicted brains but we can have recovering minds which can create for us a life we could never have envisaged

So one step in front of the other and let recovery take you somewhere you have never been before, become a person you have never know nor been before.

God bless all of you on your life journeys, in your recovery discoveries.

Have courage, hope and faith and all will be well!

Thank you for reading, commenting on and following my work. I have enjoyed getting to know some of you and I wish you all well in our lives, your recoveries and in your journeys of discovery.

If you need to contact me I am on facebook and twitter.

Paul x

Powerless over Thinking!

When I first came into recovery I would be plagued by intrusive thoughts about drinking, I would have thoughts about drinking, at certain times of the day in particular, on sunny days etc.

These thoughts used to greatly distress me and I would end fighting with these thoughts which only seemed to make things worse, the thoughts seem to increase rather than decrease and I got increasingly distressed.

I had no control over these thoughts and would get into a terrible emotional state over this. All before I decided it was now a good time to ring my sponsor. I always waited until I was in as much emotional pain as possible before ringing my sponsor!

I thought I could go it alone – that I did not need any help. I was in control of this.

Geez, surely I could control my own thoughts for flips sake!

Hmmm…afraid not!?

In early recovery I was as powerless over thinking as well as my drinking.

It was obvious I had lost control of my thinking like my drinking – it took a lot longer (and I still forget this even today!) to realise I have no  control over my thinking.

It chatters away regardless of my will, my wishes. It I have found is not usually a friend.

So like everything else in recovery I decided to research this! To find out why my thinking seemed out to get me, to negatively affect my recovery. To find out why my thinking did not seem to help me in recovery.

I found out that the idea that abstinence will automatically also decrease alcohol-related intrusive thoughts had been dismissed by research and vast anecdotal evidence.

Practically all therapies for alcoholism e.g  AA, SMART and so on suggest that urges create automatic thoughts about drinking.

This has been demonstrated in research that distress automatically gives rise to intrusive thoughts about alcohol. (1) This reflects emotional dysregulation as these intrusive thoughts are correlated to emotional dysregulation (2).

These thoughts to the recovering/abstinent individual can be seen as egodystonic which is a psychological term referring to behaviors, values, feelings that are not in harmony with or acceptable to the needs and goals of the ego, or consistent with one’s self image.

Other conditions, such as OCD, have these egodystonic thoughts creating the distress that drives a compulsive need to act on them, rather than letting them pass.

In other words, these thoughts are seen as distressing and threatening and compel one to act to reduce this escalating sense of distress. A similar process can happen to those in early recovery.

Thoughts about drinking or using when you now wish to remain in recovery are egodystonic, they are contrary to the view of oneself as a person in recovery.  The main problem occurs when we think we can control these thoughts are that these thoughts mean we want to drink or are going to relapse!

Early recovery is a period marked by heightened emotional dysregulation and the proliferation of intrusive thoughts about alcohol .

In fact,  research demonstrates that alcohol-related thoughts can resemble obsessive-compulsive thinking (3,4).

In fact, one way to measure “craving” in alcoholics is by scale called the Obsessive Compulsive Drinking Scale (5) , thus highlighting certain similarities between alcoholism and OCD.

This finding is also supported by clinical observation and leads to the expectation that among abstinent alcohol abusers, alcohol-related thoughts and intrusions are the rule rather than the exception (6)

Relatively little is known about how alcohol abusers appraise their alcohol-related thoughts. Are they aware that alcohol-related thoughts occur naturally and are highly likely during abstinence?

Or do they interpret these thoughts in a negative way, for example, as unexpected, shameful, and bothersome? Misinterpretations of naturally occurring thoughts or emotional reaction to them  may be detrimental for abstinence (7).

 

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A number of papers and  studies have shown that individuals’ appraisal of their intrusive thoughts as detrimental and potentially out of their control may lead them to dysfunctional and counterproductive efforts to control their thinking.

Alcohol-related thoughts cause an individual to experience strong emotional reactions; however, alcohol abusers will increase their efforts to control their thinking only when they have negative beliefs about these thoughts.

For instance, spontaneous positive memories about alcohol (‘‘It was so nice to hang out at parties and to drink with my buddies’’) may be appraised—and misinterpreted—as ‘‘the first steps toward a relapse’’.

Such an appraisal of one’s thoughts about alcohol as problematic may instigate thought suppression and other efforts to control the thoughts.

These efforts must be assumed to be counterproductive and  will increase rather than prevent negative feelings and thoughts, and they may even demoralize alcohol abusers who are trying to remain abstinent

On the other hand if positive alcohol-related thoughts are not appraised as problematic but as a normal part of abstinence, the awareness of these thoughts might even lead to the selection of more adaptive coping responses, which could help to reduce the risk of relapse, such as talking to someone about them or just simply letting these thoughts go.

 

In one study (8), participants who reported on their thoughts about alcohol in the previous 24 hours, 92% reported experiencing at least some thoughts about drinking that ‘‘just pop in and vanish’’ without an attempt to eliminate them. This suggests that if both suppression and elaboration can be avoided, many intrusive thoughts will be relatively transient.

An “accept and move on’’ strategy provides an opportunity for the intrusion to remain a fleeting thought.

In other words, just let go.

This means the thoughts go, and the distress which activates them, too.

This is recovery a lo of the time.  Getting embroiled in thinking and then letting go, repeat…

That is why helping others is important  -it takes us out of our crazy heads

References

1. Zack, M., Toneatto, T., & MacLeod, C. M. (1999). Implicit activation of alcohol concepts by negative affective cues distinguishes between problem drinkers with high and low psychiatric distress. Journal of Abnormal Psychology108(3), 518.

2. Ingjaldsson, J. T., Laberg, J. C., & Thayer, J. F. (2003). Reduced heart rate variability in chronic alcohol abuse: relationship with negative mood, chronic thought suppression, and compulsive drinking. Biological Psychiatry54(12), 1427-1436.

3. Caetano, R. (1985). Alcohol dependence and the need to drink: A compulsion? Psychological Medicine, 15(3), 463–469

4. Modell, J. G., Glaser, F. B., Mountz, J. M., Schmaltz, S., & Cyr, L. (1992). Obsessive and compulsive characteristics of alcohol abuse and dependence: Quantification by a newly developed questionnaire. Alcoholism: Clinical and Experimental Research, 16(2), 266–271.

5. Anton, R. F., Moak, D. H., & Latham, P. (1995). The Obsessive Compulsive Drinking Scale: A self-rated
instrument for the quantification of thoughts about alcohol and drinking behavior. Alcoholism:
Clinical and Experimental Research, 19, 92–99.

6. Hoyer, J., Hacker, J., & Lindenmeyer, J. (2007). Metacognition in alcohol abusers: How are alcohol-related intrusions appraised?. Cognitive Therapy and Research31(6), 817-831.

7. Marlatt, G. A., & Gordon, J. R. (Eds.). (1985). Relapse prevention: Maintenance strategies in the
treatment of addictive behaviors. New York: Guilford Press

8. Kavanagh, D. J., Andrade, J., & May, J. (2005). Imaginary relish and exquisite torture: the elaborated intrusion theory of desire. Psychological review112(2), 446.

 

The Nightmare of “Drinking Dreams”

This blog uses excerpts from “In dreams…an illness that never sleeps!”

 

A main purpose of this blog  The Alcoholics Guide to Alcoholism is to provide some explanation or answers to the experience of early recovery form alcoholism and addiction.

To provide some insight into  the sometimes very difficult days of early recovery.

The initial days and weeks or recovery were for me some of the most challenging in recovery and I found that recovery got better and better after these at times exasperating and at times frightening and confusing first weeks.

 

If we can hang in there, we find things get better and fairly soon.

So here I will blog for the next week on some of the issues that very much bothered me in early recovery.

I want to give some answers that I wish had been available to me at the time so that you do not have to agonize over psychological processes which are natural, automatic and sometimes unavoidable to the early days of recovery.

I want you to know you are not alone in feeling what you are feeling, experiencing what you are experiencing in early recovery.

Hopefully this week’s blogs can be a guide through some of the issues of early recovery.

We have all gone through what you are going through, and came through as you can too!

Let’ start with “drinking dreams” – having dreams in which I was drinking alcohol was very common in the first weeks and months of recovery.

They used to terrorize my sleeping hours. I would fortunately  always drink to drunkenness in these dreams and rarely at “one of two” and left it at that, although in later recovery I have had this type of dream too.

I would either awake from this drinking dreams, terrified by their content, or would awake in the morning extra tired that I had had  a number of these drink-based dreams in the night.

They greatly troubled me – why was I having them, did I really still want to drink?

Was I actually committed to recovery at all? Was I kidding myself, did I simply just want to drink?

And not want to be in recovery?

Talking to my sponsor and other recovering alcoholics reassured me I was not alone and made me realise that drinking dreams were very common to alcoholics especially in the early  weeks and months of recovery.

In later years I still have the odd drinking dream but this is usually when I am very anxious or worried about something and my anxiety goes and ketches the symbols I am most frightened of, which is my fear of ever drinking again.

In the last year, I have come across a great article to help newcomers in early recovery with understanding “drinking dreams”.

According to this study – drinking dreams in recovering alcoholics is not a sign of wanting to drink again but the very opposite – drinking dreams are the sign of being completely motivated not to drink and stay abstinent and in recovery!

“It is often said that we have an illness of addiction that never rests..

In the early weeks and months (years) of recovery I often had “drinking” dreams  in which I would dream about drinking alcohol. In early recovery these used to scare the life out of me and confuse me greatly. Did I still want to drink?

The study (1) we cite today shows the opposite that “that alcoholics would have more drinking dreams if they wanted to stay sober and that to dream of drinking was a good indicator of continued abstinence.” 

The drinking dreams, I later realised,  would normally occur when I was fearful of anxious. They were fear based dreams not appetitive, i.e. they were not about wanting to drink but about being afraid of drinking again.

That would appear to my greatest fear so when I was anxious about something in my daily life, at night I would have dreams about drinking alcohol.

In these early days, fortunately, in the drinking dreams the drinking would have dire consequences and I would get out of control drunk.

Now if I have the odd drinking dream I simply use it as a prompt to look at what is going on emotionally in my life. I have to say that my dreams have increasingly used other symbols of fear and anxiety in recent years, like buildings collapsing, having to save people’s lives etc etc.

I must also be rigorously honest here and state that many of my fear based and drinking dreams occur when I have not done my step 10 properly or thoroughly. A way to a sound sleep is a sound step 10!

Anyway this study (1)  from a few years ago which looked at the dreams of alcoholics. It showed that the self esteem issues that sometimes plague alcoholics in recovery are also present in their dreams although these lessen as time in recovery increases.

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“This study focused on people who had self-labelled themselves as ‘Alcoholics.’ They all had a previously previous history of severe alcohol use, but were currently abstinent and recovering in Alcoholics Anonymous.

Moore (1962)  found that alcoholics often dreamt of themselves as victims.

Scott (1968)  found alcoholics reported significantly more dreams about drinking, often associated with guilt.

Scott concluded that alcoholic’s dreams depicted problems, conflicts, insecurity, and sadness…alcoholics were “unable to use their dreams therapeutically as do controls … alcoholics incorporate their feelings of helplessness whilst controls are able to integrate strength into their dreams” (Scott, 1968, p.1317).

Cartwright (1974) predicted that the ‘psychologically healthy’ would have greater continuity between their waking and dreaming life. This is due, in part, to the assumed internal emotional and mental equilibrium that exists in individuals with assumed psychological balance. This early literature suggests that alcoholics in early abstinence, or during hospitalization, may report dream content which is more unpleasant in terms of emotion and themes.

Studies have begun to focus on the reason why drinking dreams appear in alcoholism (or other substance misuse disorders).

Choi (1973) compared those who experienced drinking dreams at 3 months, with those who did not and found that 80% of those who had drinking dreams were still abstinent compared to 18% of those who did not.

He concluded that alcoholics would have more drinking dreams if they wanted to stay sober and that to dream of drinking was a good indicator of continued abstinence.

Denzin (1988) points out, using anecdotal reports from AA members, that drinking dreams are usually fearful, and this may reflect waking preoccupation with the fear of returning to active alcoholism, rather than a desire to return to drinking.

 

The 12 steps of Alcoholics Anonymous provide a program of self-help where addiction is ‘accepted’ rather than ‘abstained’ from.

The difference between ‘acceptance’ and ‘abstinence’ is the same as the difference between being highly motivated to not drink and being highly unmotivated to not pick up the first drink or drug (Colace, 2004; Berridge, 2001).

This difference would be clearly observed in the self-construal of the ‘recovering’ alcoholics who took part in this study. If drinking dreams are indicative of where the person is in their recovery process, then wanting to drink intermittently is arguably the most natural of states that an alcoholic may find themselves in.

Drinking dreams are not predetermine indicators of relapse: how they act on may be. Rather, the occasional presence of drinking dreams which are accompanied by unpleasant emotional affect, including guilt and remorse are a common part of the recovery process(Marshall, 1995).

Knudson (2003) suggests dreams are seen as indicators of either the past (retrospective), or the present moment (concurrent), but includes a further prospective function used to make positive change.

Using this model, drinking dreams can be seen as indicators of needing to take prospective action, such as increased access to support, talking about these dreams in AA meetings, or with sponsors and therapists (McEwing, 1991; Marshall, 1995).

 

References

1. Parker, J., & Alford, C. (2009). The dreams of male and female abstinent alcoholic’s in stage II recovery compared to non-alcholic controls: are the differences significant?. International Journal of Dream Research, 2(2), 73-84.

Is My Neediness linked to My Insecure Attachment?

I am reblogging this blog again, from 6 months ago, because I find it still very pertinent to me at the moment and because another blogger commented on it’s pertinence to them in recovery as well. I have been in recovery a decade and have continually come up against the same issues over and over again. which are namely low self esteem issues, feeling less than or unworthy, and issues of trusting others which I believe to be the consequence of my own insecure attachment to my mother when growing up. As I will be blogging this week again about the power scars of the past can still exert on me I thought I would kick off with a well received blog from the end of last year. Unfortunately the issues seem as raw and resonant today as when I wrote this 6 months ago. I think this is because my awareness of attachment issues has risen throughout my recovery and I am probably the best placed I have ever been to delve, more deeply into these issues, however reluctantly. The same record playing in my head has become a bit boring over the months and years. It is also important to realise that there is an “earned attachment” out there with other recovering people too, helping others helps me, showing love helps me receive love etc. A secure base can be found in serving others. This is what I intend to do increasingly over the next 6 months. I intend to keep you all up to date with how it goes too. Perhaps we can only rewire our brains by changing our behaviours – perhaps to get the love we needed as children we have to show that love to others as adults. Perhaps we have to get what we need by giving it away? Paul x

The Alcoholics Guide to Alcoholism

I don’t know about you but I have previously been described on occasion, and still can be, as being a bit needy, a bit grasping of affection, a bit manipulative in attempting to coerce others into given me attention, affection and so on.

It is not a trait that I particularly like in my self. I believe it is directly linked to my insecure attachment based on an uncertain, unpredictable and sometimes conditional relationship I had with my mother, in particular.

My mother was affectionate at times, distant at others. You could never really count on her being there for you.

Her affection  seemed dependent (conditional) on how she felt. Given that she was probably experiencing some form of mental breakdown and had already started taking the Valium that would in later years become full blown dependence would explain her ambivalence to me and my emotional needs.

I have forgiven my…

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Life In Recovery Surveys – Australia, USA and the UK

“Recovery introduced me to myself. The hardest but most rewarding journey I have ever undertaken.”

Recovery from alcohol and drug addiction is now widely recognised as a journey that takes place over time and in a multitude of ways that reflect personal circumstances, supports and resources.”

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The Australian Life in Recovery Survey, conducted by Professor David Best of Sheffield Hallam University and Turning Point in partnership with South Pacific Private, is the largest survey of its kind in Australia.

This survey provides an important first glimpse into the lives of people in recovery through comparisons of key domains of life and wellbeing during active addiction and after seeking recovery.

Additionally, comparisons are drawn to the U.S. version of the survey sponsored by Faces & Voices of Recovery. Just click image below for the findings.

 

The first ever survey in the UK into Life in Recovery is also in the process – please click this link and contribute if you can?

http://www.sheffieldalcoholsupportservice.org.uk/sass/news-and-features/item/283-life-in-recovery-survey-uk-2015

 

Understanding recovery greatly helps with reducing the stigma attached with suffering from an addictive disorder. Please help?

The survey will be open until the 30th June 2015.

 

Life in Recovery Survey UK 2015

 

Please click to refer to the infographic of and the introduction to the survey results from the Australian survey.

https://magic.piktochart.com/embed/6227462-rri-life-in-recovery-australia?wmode=transparent

and click here for the findings and report –

http://www.recoveryanswers.org/blog/life-in-recovery-a-survey-from-australia/

Part 1

WHO WERE THE PARTICIPANTS?

Just over half of those who participated were female (54.6%), and the average age of participants was 43.6 years (although the range was from 15 to 76 years). The vast majority of participants lived in Australia (97.3%) although small numbers of participants completed the survey who lived in the US, Europe, Indonesia and South Africa.

Participants were educated to varying degrees – just over 40% had a university qualification. Occupational status varied markedly across the group with just under half (44.6%) employed full time, 19.8% employed part-time, 5.8% self-employed and 5.4% students. In other words, 75.6% were involved in employment or education with the remainder retired (5.6%), involved in home duties (3.2%) and unemployed or on disability support pension (15.7%).

 

LIFE HISTORIES

Participants were asked about their primary addiction – for 35.3% this was alcohol only

for 11.1% it was drugs only

and for 53.6% it was both drugs and alcohol.

Nonetheless, the primary problem substance was predominantly alcohol (for 66.0% of participants)

followed by heroin and other opiates (14.1%),

methamphetamines (4.2%),

cannabis (3.7%),

cocaine (2.9%),

other amphetamine type substances (1.9%)

and pharmaceutical opioids (1.9%).

Participants had typically experienced lengthy addiction careers – reporting an average of 18.6 years of AOD use (ranging from 1 to 47 years) and an average of 12.5 years of active addiction (ranging from 1 to 47 years).

There was a significant rate of adverse life events reported across the participants with 91.5% reporting life time mental health challenges and 56.8% reporting some current involvement in mental health treatment.

In contrast, current wellbeing was rated positively on the three wellbeing scales…

What this means is that participants were generally in a positive space although some participants had poor wellbeing across all three indicators.

At the time of the interview, 298 participants (52.0% of the overall sample) were receiving help or treatment for mental health problems.

What is clear is that this diminishes over time – while 86.1% of those in the first three years of recovery are receiving some form of help or treatment for emotional or mental health problems, this is the case for 58.0% of those between three and ten years in recovery and 33.5% of those more than ten years into their recovery journeys.”

To be continued…

In a nutshell

Following on from Monday’s blog a visual representation of what I was trying to say.

Love and tolerance of others is our code. the Big Book, page 84.

And we have ceased fighting anything or anyone.

 

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