Feel an Argument Coming On? Here are 4 Ways to Help Manage Physiological Arousal

couple having fight
Photo credit inckpen.com


This article was originally written for WellnessFX, a digital health company based out of San Francisco, CA. For the full article, click here.

Can you remember the last time you were in a heated argument? How did you feel? Did your body temperature rise? Did your hands start sweating? Did you possibly say things you regretted saying?

Our bodies have an array of defense mechanisms to keep us safe and most importantly alive. Having a strong understanding of what those signs and warnings are can allow us to reverse the effects in an efficient and responsible manner, allowing for more effective problem solving, communication and ultimately stronger relationships with others.

Dr. John Gottman, who has spent the last 40 plus years researching couple dynamics coined the term diffuse physiological arousal (DPA). DPA is the physiological overload a person experiences when you’re in fight-or-flight mode. It is a sympathetic nervous system (SNS) response.

4 Ways to Help Manage Physiological Arousal

1. Measure Key Biomarkers

Gain an understanding of where your baseline and hs-CRP and cortisol levels stand. (various WellnessFX panels test these biomarkers)

Hs-CRP, or high-sensitivity C-reactive protein, is currently the human body’s best indicator of inflammation. When you’re injured, your body goes through a process of rushing blood to the injured area, allowing immune cells to begin the healing process. Interestingly enough, inflammation is shown to be a crucial marker of depression, whether mild or severe. This study digs into how inflammation can affect people when they’re feeling depressed about any of life’s stressors. Maintaining healthy hs-CRP levels means your body isn’t constantly injured, or in terms of mental health, depressed. Let’s be real when we use words like depression, you don’t need to be diagnosed with depression to experience depressive symptoms. Knowing that your baseline hs-CRP level is optimal predicts that your body is capable of managing those symptoms effectively which in turn keeps one from experiencing depressive symptoms for extended period of time which is one of the indicators that would lead to a depressive diagnosis, as per the ICD-10.

Cortisol levels can give you insight as to how frequently you engage in fight-or-flight mode. When you’re stressed, your adrenal glands secrete cortisol to help bring your body back to baseline. If you’re constantly stressed (aka constantly secreting cortisol), your baseline cortisol levels are going to be high which can have several implications to your body. If your baseline is over 19.5 µg/dL, you may want to seriously consider the next three tips.

2. Work with a Licensed Marriage and Family Therapist (LMFT)

If you’re experiencing any of the aforementioned physiological reactions due to your style of conflict (confrontational, avoidant, etc.) or due to perpetual arguments with a loved one, a marriage and family therapist can certainly help you and your significant other (or you and your family) work through these issues and teach each of you appropriate coping skills to prevent DPA. LMFTs are specially trained to facilitate individuals, couples and families’ presenting concerns from a systemic approach. They can help their client(s) systematically recognize how recurring issues manifest themselves in different aspects of their lives. LMFTs, like most holistic therapists, help their client(s) work on the root cause of the issue while providing tools for symptom management. Psychotherapists trained in Cognitive Behavioral Therapy can also provide effective and evidence-based treatment plans when working with an individual to help the client gain the skills and tools needed to manage stress.

3. Practice Some Form of Mindfulness Meditation

photo credit huffingtonpost.com


Mindfulness meditation can be a beneficial way to reduce stresses like anxiety and depression as noted in a study published in JAMA Internal Medicine. Mindfulness meditation can help one gain a deeper and more personal understanding of how to manage stress by allowing the individual time to explore thought patterns which may provoke stress in a relaxed and non-threatening environment. Being mindful to stress provoking thoughts, with practice, could allow acceptance to replace anxiety, leading to new perspective and meaning to these thoughts. A great way to start if you’re a complete beginner is with the HeadSpace app.

4. Track Your Heart Rate Variability

Tracking your heart rate variability (HRV) can give you a strong sense of how resilient you are to daily stressors. To briefly summarize, HRV is the variation in the time interval between heart rates. Heart rate fluctuations are regulated by the autonomic nervous system (ANS) which works to maintain the body in equilibrium by way of managing blood pressure, heart rate, etc. The ANS consists of the sympathetic branch (fight or flight) which is responsible for speeding your heart rate up and the parasympathetic branch (rest and repair) which is responsible for slowing down your heart rate. Interplay between these two branches gives you an HRV reading. Tracking this measurement can provide you with great insight as to how your own autonomic nervous system functions in response to stress. An easy way to track your HRV is by using the SweetBeat HRV app and a bluetooth chest strap. For more on establishing an HRV tracking routine and what your data means, WellnessFX practitioner Ben Greenfield provides a fantastic introduction (and more advanced resources) to HRV here.

Click here for the full article on WellnessFX’s blog

Cognitive Distortions and Anxiety

negative emotions


Anyone who has experienced anxiety will recognize the symptoms all too well.  Feeling irritable, tired, difficulty concentrating, trouble falling asleep, muscle tension, etc. These are some of the most common experiences reported by people with anxiety. Have you ever found yourself pre-worrying? Or thinking about every possibility that could possibly happen? And then land on the most troubling one and convince yourself of its inevitably? Well, if you have, you’re not alone.

Anxiety Disorders: Common Diagnoses

According to The Anxiety and Depression Association of America, anxiety disorders are most commonly diagnosed in the US, affecting 18% of the population age 18 and over.  Annually, anxiety disorders cost the United States $42 billion, which is one third of the country’s $148 billion mental health bill. With the fast-paced, over-scheduled life that most of us lead, especially in New York, this probably does not come as much of a surprise.

What is Cognitive Behavioral Therapy?

One way of thinking about anxiety is to look at it as a cycle. The most widely used and effective form of therapy for anxiety is Cognitive Behavioral Therapy, or CBT.  According to CBT, in the most simplistic of terms, an event creates a thought, which triggers a feeling, which influences our actions.  For example, your boss sends you a short email, “I’d like to meet with you later this afternoon.” This is the event.  The thought might be, “That’s it.  I’m going to be fired.”  The feelings that follow may be sadness, fear, and of course, any number of anxious symptoms.  The actions that come next are very much determined by the ways in which the information is filtered.  So if you’ve already decided you are going to get fired, you might act by responding with a lengthy email to your boss about all of your hard work.  Or, you might call and text your circle of friends and tell them about all of your fears.  Or, you might begin to have trouble focusing on anything other than the upcoming meeting, pacing and feel a wave of exhaustion.  If you experience anxiety, this is a recognizable scenario.

Recognizing Cognitive Distortions

There are many cognitive distortions, or filters, through which people use to process interactions in the world.  These filters impact people’s experience of anxiety.  The following are 2 common filters that many people experience when they are struggling with anxiety. Click the link above for a more comprehensive list of cognitive distortions.


This is described in the above example.  For example, “my boss wants to meet with me; therefore she is probably going to fire me.” This is an example of catastrophizing something through the “what ifs.”

Black and White Thinking

I refer to this one as the “always” and “never” distortion.  “She is ALWAYS inconsiderate of my feelings.”  “My husband NEVER considers my feelings when he is late.”  The gray is a very uncomfortable place for most people.  Try eliminating “always” and “never” from your vocabulary and replace it with “both, and.”

Challenging Cognitive Distortions

CBT offers a set of tools to challenge these maladaptive distortions.  As with most therapeutic work, recognizing the patterns that exist is an important first step. Once distorted filters are identified, therapists will often have clients keep a thought record to track feelings during times of distress.

Continue to follow the North Brooklyn Marriage and Family Therapy blog for more posts on anxiety disorders and the use of CBT as a helpful collection of tools to combat anxiety symptoms.
By Linda Nelli, LMFT



Before popping THE question, which others should be asked?

forever and always image
Photo Courtesy of Bridal Guide


Will you marry me? This is a question posed all over the world by couples of all races, cultures, sexual orientations, religious backgrounds, etc.  While society has romanticized most facets of marriage and businesses have profited off of most facets of weddings, it’s easy to forget that at the heart of these unions are two people, committing to spend their lives together.  As couple’s therapists, we know the importance of knowing one another deeply before embarking on this journey together.


We’re in love, what else is there to Know?


In a recent NY Times Article, journalist Eleanor Stanford writes about the “13 Questions to Ask Before Getting Married.”  Some couples talk about most topics freely and the lines of communication are open and free flowing.  For others, talking about some of the more taboo subjects, like say, sex, are a little more difficult.  What so often happens with couples that fall into the latter category is that these issues bubbling under the surface do not go away, but rather will need to be addressed later when some of the loving feelings of pre-marriage may have dissipated.  We highly recommend checking out the whole article, the questions posed are open-ended and can be a great way to get a conversation rolling. While they’re all useful, the following 2 seem to come up most in our work with couples, related to conflict resolution and finance.


Question 1: How do we both view and want to tackle debt?


This one is so important.   So often, couples have very different ideas about the way individual debt should be handled.  This is a key thing to discuss with your partner before marriage.  How do we both view debt? Does debt that comes before we were together as a couple become shared debt once we’re married? Or will that be one individual’s responsibility?

How can you address the issue of finances?

It’s important to talk honestly and openly about what debts and savings you are bringing into the union.  Discuss the meaning of money you both share and how you want to handle personal vs. shared bank accounts.  It’s also helpful to talk about the way your parents handled finances.  That gives you a better understanding of where your partner is coming from and can build empathy. Some partners believe all money should be shared once married.  Other believe it should remain separate.  No matter which side you fall on these views are starkly different and should be discussed before becoming a huge divide.

Question 2: How did you learn to argue and resolve conflict? Is it similar to or different from one another?

Communication.  This one is huge.  One of the most common goals of couples in therapy is to gain better “tools” to help solve what Gottman calls, “perpetual problems.” Most of us know these.  These are the problems that tend to be about the same things over and over again, with no resolve and no way to break the argument cycle.  How do we first learn to argue? Our parents.  Ask. Your. Partner. This. Question! We can’t stress enough the importance of knowing your partner’s conflict style by learning about what they saw in their home growing up.  This is a big one.

How can you address the issue of conflict resolution?

The best advice for couples venturing into marriage? Premarital counseling.  According to HealthResearchingFunding.org, couples who participate in premarital counseling have 30% higher marital success rates than those who do not. Premarital counselors are trained to help you and your partner navigate these more difficult conversations while attempting to avoid those perpetual problem cycles mentioned above.  At North Brooklyn Marriage and Family Therapy, we are certified Prepare-Enrich counselors.  This program offers a comprehensive assessment that both you and your partner complete. The therapist then reviews the results, they are shared with the couple and then key issues are addressed.  These topics include finances, conflict resolution, sex, communication, parenting, spiritual beliefs, etc.

It’s OK if these premarital topics have not yet been discussed!

These topics are difficult to talk about for reasons; they’re touchy, they’re uncomfortable and in talking about them we run the risk of getting hurt or hurting our partners.  It’s normal if these things feel tough to discuss. That’s where premarital counseling comes in.  Contact us if any of these things sound like they might be helpful to you and your partner.

Let’s Talk About Sex

birds and bees
photo courtesy penelope trunk


Sex is a natural, important, and intimate component of human interaction. But let’s face it, talking about sex is hard. Whether the conversation is between a parent and child or between romantic partners, most people find it difficult to have open and honest conversations about sex and sexuality. When these conversations do happen, most of them revolve around the risks or potential consequences of sex; a series of “DOs and DONTs” and cautionary narratives about the dangers of sexually transmitted infections, pregnancy, sexual assault, the importance of consent. There is no denying that all of those aspects are extremely important when it comes to understanding sex but they are not representative of the full picture of sex.


Precautions about sex is not the whole story


Rarely do we address the pleasures of sex, individual desires, setting personal boundaries, sensuality, and self-exploration. Not talking about sex does not stop people from having it.  Rather, it limits knowledge and perpetuates the misconceptions and myths about what sex should look and feel like. So, if conversations about sex are limited, where and how do people fill in these gaps?


Pornography = Sex Ed 101?

A March 2016 New York Times Article “When Did Porn Become Sex Ed?” addresses the trends and consequences when adults and teens don’t have honest conversations about what happens after consent. Author Peggy Orenstein discusses how in the absence of information, young people have turned to porn as an instruction manual for sex. As Americans we are often in pursuit to avoid uncomfortable or awkward conversations or deter people from having sex before they are emotionally capable.  It is then that we turn sex into a taboo topic that is riddled with mystery, forcing young people to blindly engage and hope they figure it out as the go along.  The intentions are, for the most part, in the right place: making sure people are being responsible and knowledgeable before they have sex. Yet, ironically, the avoidance and shaming has worked against those intentions, often sending young people into the world ill-prepared and unaware.


How do we talk about sex

Yes, normalizing sex is hard because being honest about such intimate things can be awkward. But the risk of feeling awkward is worth the reward of self-awareness in sex. If you find it hard to talk about sex or find yourself lost in how to have these important conversations you’re not alone. Our therapists can help you explore these feelings in a safe, comfortable, and non-judgmental environment.


By Hillary Geffner



There’s no “I” in Team – Increasing Empathy and Improving Communication in a Changing Workforce

working together photo
Photo credit bill bach rach

According to the BusinessDictionary, the definition of group norms is an “unspoken and often unwritten set of informal rules that govern individual behaviors in a group.” As a systemic therapist, the concept of group norms setting both the tone and functionality of a group is a lesson taught early on in training programs. However, when we think of fostering healthy, empathetic and communicative group norms, we don’t often think, corporate America. However, that seems to be changing.

A more connected workplace

You may have heard of team-building workshops or open office floor plans, like the one recently adopted by Citigroup. This literal knocking down of walls promotes transparency, de-mystifies hierarchical differences and, for better or for worse, increases the need for co-worker collaboration. This last one influenced the push to observe and evaluate group norms to gain and understanding of what makes a group successful or unsuccessful.

A Study in Empathy and Communication

A recent NY Times Magazine article, (Duhigg, 2016), covered a Google-forged initiative titled Project Aristotle set out to study what makes certain work groups successful, versus those that are not. The findings were clear, successful groups had very little to do with similarities in personality, education, gender or extracurricular activities. Success had much more to do with creating an environment in which a group felt “psychologically safe” to communicate thoughts and ideas without fear of embarrassment (Edmonson, 1999). This in turn increases empathy between group members.

What this means for the future of therapy

Gone are the days of putting one’s head down, doing our work and heading home. As more and more workplaces prioritize group projects, open floor plans and increased collaboration, the need to learn more effective ways to communicate is even more pressing. Here at North Brooklyn Marriage and Family Therapy we have seen an increase in requests for therapy for business partners.   As a relational therapist, my work with business partners is very similar to my work with couples, because the needs are basically the same. In any successful partnership, business or personal, individuals must share mutual respect, communicate effectively and be empathetic toward one another. Does any of this sound like it pertains to you? If you find yourself in a partnership, business or otherwise that is lacking in any of these areas, it might be time to reach out to us. We can help open up lines of communication and restore a sense of empathy and connectedness.

By Linda Nelli

Duhigg, Charles. “Work-Life.” The New York Times Magazine, February 28, 2016, 19-75.

Love: Why Can’t I Find it!

DovesWhere is Love?

Sitting at the table next to you is this couple. They seem genuinely interested in what one another has to say.  They laugh a lot and almost seem to be making fun of one another at times.  They seem pleased to be able to tell one another what happened during their respective days.  From where you are sitting their interactions seem easy.  How do I find love like that?

Why does it seem so difficult to find someone who we are attracted to who is attracted to us and like to be around?  Is it really so difficult?  There are some things that may be going on, some of which are too complex to make it onto this list, but here are some ideas to get you thinking about what may be going on.

Do you want a partner?

Society sends all of us the message that we are more valuable when paired up with someone else and it is just not true.  Check in with yourself.  Do you really want someone in your life in that full-time capacity or do you feel like it is the socially appropriate thing to do? As soon as you are a semi-functional adult all sorts of people feel free to ask about your relationship status.  Maybe those questions are subconsciously pressuring you to believe that you need a partner.

You are meeting people who want something different than what you want.

Romantic relationships can take on so many different structures.  I have seen married couples, who have great lives together, but choose to live in different houses.  Some people love to spend lots of time together.  Some couples really long for a looser, less responsible relationship.  Before you conclude that there is something that is wrong with you that is keeping you from love, make sure you are coming in contact with people who want the same thing you want.  One good strategy is having friends that have relationships that look like something you want.

Look for slow love.

Attraction can seem like a mystery when it’s elusive, but we do know some things about the laws of attraction.  There are the things we find attractive instantly, and then there are the things that we find attractive over time.  More superficial things may grab our attention, but they often don’t play out even over a couple of months.  When looking for a partner who will keep your interest over time, it’s better to get to know the person a little bit before deciding if that zing is there or not.  The June 2015 New York Times Article, “For Couples, Time Can Upend the Laws of Attraction” spoke of the joys of slow love.  Swiping left or right may seem like an efficient way of finding love, but real attraction needs a little bit of time to assert itself.

Get some help with your search.

If you long for someone in your life and what you have been doing has yet to work, it may be time to talk with one of our therapists.  We are love experts and can help you identify possible roadblocks within yourself and possible outside obstacles to finding the love you deserve.  At North Brooklyn Marriage and Family Therapy, we have couples therapists that accept a range of different fees to best meet your financial needs.  Call 718-785-9718 to learn more.


Standing your ground in an argument: Is it worth it?


Fighting-CoupleDo you know that frustrated feeling you get in an argument when you just know that you’re right but you are not being heard by your partner? Well, you’re not alone. As a systemic therapist, I see couple after couple with this exact complaint. “If he/she would just change this (insert concern here), we would be fine.”  Like a debate team, partners become skilled at going head to head, point for point in defense of their argument.  And, on a debate team, that’s a useful technique. But in an intimate partner debate that can end in only one result: loss, because after all, there is only one team here.

Digging our feet in the sand: Picking our roles

In couples, hurts can build up and each new slight can affect us deeply.  For example, “It might be nice if you would ask me about my day instead of sulking through the door ignoring me,” meets with “Well I had a long day, too.  I’m exhausted and it might be nice if you could give me some space when I get home.” But of course this is not just about the greetings this couple gives one another. It’s deeper. Neither partner is feeling heard and odds are that some accumulated pain is coloring these responses. While the dialogue here may differ, the debate has been set and inevitably, the debaters will take their stances. The most common roles? The Pursuer v. The Distancer.  In these two positions, the pursuer tends to feel invisible, that no matter how much they push, they’re not being heard.  While the withdrawer often retreats further and further into themselves, often feeling that no matter how they respond, it’s never enough anyway.

So, what can we do differently?

As any good debater will tell you, it feels great to finally beat our opponent.  In intimate relationships, we can forget that this is not our opponent, this is our teammate.  Once partners settle into the roles of pursuer or distancer, it can be difficult to break the cycle; difficult, but not impossible. This is especially true  with two willing partners.  Once couples decide that winning the battle is less important than protecting the relationship, there are a few simple communication techniques that can help partners to lay down their swords.

Setting a time and place:

Decide on a neutral place and time to discuss important topics.  I’ve worked with a couple in the past that saved heated arguments for restaurants so that it would force them to speak respectfully to one another. If out-of-the-house discussions are not possible, just be sure to set aside a time to speak and stick to it. Treat it as importantly as you would a significant business meeting.

How to be heard:

“I Statements” – We are heard much more clearly in an argument when we can label our feelings.  “I felt really hurt when you didn’t call” is a lot more effective than “You’re so unreliable I knew you would forget to call me.” It’s hard to argue when someone tells you how they feel.  We don’t necessarily have to agree with our partner’s feelings, but we can’t dispute that they have them and can hopefully find ways to validate them.

Validating does not meaning having to agree – This is a good skill to practice.  We may not always agree with our partner during arguments, but we can absolutely find ways of making sure our partner feels heard. For example, with the above scenario, “I felt really hurt when you didn’t call,” already puts our partner into a less defensive place.  It leaves us more open to the ability to validate our partner.  We have more room to respond with, “I can understand how my not calling today left you feeling hurt. That was not my intention.” It’s important to end the sentence there and avoid the ever-tempting “…but” at the end. The goal here is connection and empathy, not winning.

Knowing when our Repair Attempts are not working:

Sometimes, despite our best attempts at breaking our negative cycles and changing our communication patterns, we need a little extra help to make lasting changes.  At North Brooklyn Marriage and Family Therapy we have couples therapists that accept a range of different fees in order to best meet your financial needs.  Call 718-785-9718 to learn more.

Photo Credit: http://www.steamenginefinancialcoaching.com/wp-content/uploads/2011/08/Fighting-Couple.jpg

Bringing Home Baby Workshop for Expecting Parents

Bringing Home Baby: Workshop for Expecting Parents

Amazing workshop to help your relationship

The childbirth Ed class for your relationship, the Bringing Baby Home workshop focuses on how to emotionally prepare the couple for baby’s
arrival. Sometimes we’re so busy thinking about how to ready our bodies and our homes for a baby that we forget about preparing our relationship.

In the workshop expecting couples and new parents will gain a sense of empowerment by learning skills to:
Prepare for the transition to parenthood
Maintain relationship satisfaction after having a baby
Promote positive parent-baby interactions
Promote quality involvement for both parents
Reduce the incidence or severity of postpartum mood disorders

The workshop is on Sunday, April 24th and Sunday, May 1st from 9am-4pm with breaks.

Fee is $295 per couple. Materials included.

About the instructor:

Kristen Mosier is a certified Bringing Baby Home educator; she holds a Master’s degree in Marriage and Family Therapy, has training in childbirth education and has authored multiple articles on pregnancy and parenting. A Brooklyn mom herself, she can relate to the joys and challenges of raising a little one in New York City.


To register please call 718-785-9718 or email info@northbrooklynmft.com.

Prepare Premarital Workshop

Premarital Couples Workshop

Falling in love is the easy part; now it’s time to prepare for marriage with the help of an effective, specialized program tailored to your specific relationship needs. First you take a test that analyzes your specific strengths and growth areas as a couple, and then we follow up with a group workshop that supports and fosters a community environment. Using the results of your test, combined with the helpful feedback of a PREPARE/ENRICH professional and your community of fellow couples, you will emerge with new insight and skills to navigate the road ahead as a more united partnership!

With us, you can expect to

Strengthen communication skills
Identify and manage major stressors
Resolve conflict using the Ten Step Model
Develop a more balanced relationship
Explore family of origin issues
Discuss financial planning and budgeting

Establish personal, couple and family goals

Understand and appreciate personality differences

If you and your partner are looking forward to a life together and would like to develop and reinforce the tools you will need to keep that unity strong—please join us this March for our PREPARE/ENRICH workshop.

The workshop takes place on Sunday, March 8th from 11-4pm (with breaks!).

We look forward to seeing you there!

Cost: $300/per couple. Sign up by calling 718-785-9178 or email us at info@northbrooklynmft.com.

For more information about the Prepare inventory go to prepare-enrich.com.

On Empathy

the ability to understand and share the feelings of another.


I think about the experience of empathy a lot. Feeling empathy for another person’s emotional experience is the primary skill of a counselor. Above theories or interventions, if you can sit with a client, in their sorrow, in their anxiety, or in their joy, you are healing. And if you can’t, it’s hard to imagine that the work is being done.

Empathy is sourced in the same part of the brain as self-awareness, the insula. It makes sense. If I cannot bring awareness to my own feelings, if I cannot feel them and name them, how I can do that with another person’s feelings? And it follows that as I practice self-awareness, I develop my ability to empathize, and thus my ability to connect in a deeper sense of humanity. So I think about empathy a lot.

The layman’s understanding of empathy is feeling another person’s feelings. But there is more to it than that; there has to be. In addition to feeling another person’s feelings, going into that space with them and sitting there — without judgment and without expressing our natural and loving desire to fix that person’s problems to return their feelings to neutral — there is also necessary discernment. We cannot go into another person’s space of anxiety and take on that anxiety as our own. It is not sustainable, it is not productive, and it’s not ours to take. Rather, empathy is the ability to feel someone’s sadness around a decision we have made, and be able to stick with that decision. We know it hurts them, we know it’s a hard decision, and it remains one that we must make.

I then wonder why empathy is not on everyone’s mind. Always. A greater sense of how we affect people, and how we can support them, a greater sense of our own internal landscape and reaction patterns, is a whole, additional world of information and understanding. We maintain discernment, we maintain who we are and how we choose to live our lives, while feeling connected, loving, and with heightened understanding. These are some of the gifts of mindfulness meditation — some of the gifts of sitting with someone else’s pain while resisting our need to solve it, and ultimately the gifts of intimacy with humanity. It’s a beautiful thing, it’s why I’m a therapist, and why I teach techniques for developing empathy.

For more information check out some of these resources:

Sarah Larkin Birdsong
, MHC, considers counseling a collaborative practice in communication and connection, and she works with couples, individuals, children, and groups. Her open-minded and accepting approach to counseling helps people heal trauma, process loss, manage stress, make strong decisions and understand relationships better. Read more about Sarah.

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