April 26, 2016

 The Gorski Comprehensive Addiction Model is a a science-based system that incorporates both chemical and behavioral addictions in a comprehensive biopsychosocial perspective.

THE HUMAN CONDITION: The Gorski Model builds upon a recognition that all addiction is based within the human condition. The human condition is organized and directed by the CORE HUMAN PROCESSES OF PERSONALITY

DEVELOPMENT. The human process begins with an intangible but self-evident primal life force which motivates human beings to survive and thrive in the physical world. The frustration resulting from the collision of the infinite potential of the human spirit with the finite limitation of the physical world results in ANGST, the normal pain of life and living. ANGST is managed by people in one of three ways: DENIAL, it doesn’t exist – everything is beautiful;

DEMORALIZATION, since life hurts I will just give up and stop trying; or MOTIVATION, in spite of the psi of living there is a counterbalancing joy in living that makes it worth while. Motivated people to STRIVE to find safety, security, excitement, and accomplishment in an often difficult and hostile world. They maintain their motivation because of the capacity human beings have for with PASSION. With maturity passion becomes focused into psychological and spiritual practices that help people find peace, serenity, and security without the constant need to strive, perform, and produce.

Many people find that a state of euphoria induced by the addictive use of alcohol and other drugs can give them short term relief from the angst of life. Unfortunately, people who experience this addictive brain response are at high risk of developing addiction. The addictive release leads to obsession I have intrusive thoughts about how good the euphoric response felt. I feel a COMPULSION to repeat the experience.

As the compulsion becomes stronger it turns into CRAVING which turns wanting the addictive release into the need for the addictive release. This creates a self reinforcing pattern of addictive use which is called ADDICTION, which is marked a compulsive pattern of DRUG SEEKING BEHAVIOR.

Over time, the cycle can be described as a EUPHORIC RESPONSE to addictive use, a DYSPHORIC RESPONSE to abstinence, a CRAVING or perceived need to use, DEPENDENCE or being unable to function normally without addictive use, and TOLERANCE the need to use more in order to get the same level of euphoria.

Once the ADDICTION CYCLE BEGINS, addictive THOUGHTS, FEELINGS, URGES, and ACTIONS become engrained in automatic and unconscious habits. These habits attract people who support the addictive way of life or are willing to become committed to enabling it.

These Social and Cultural Reactions to addiction create a permissive environment for early stage addiction when addictive use makes people feel good and be more productive and stigma reaction when people lose control and begin stepping outside of social, cultural and legal limits.

This is all part of the addiction, which is a health crd problem that is best dealt with using a Public health Addiction Policy:

(1) TOXIC SUBSTANCE: Identifying the toxic substances causing the illness;

(2) VULNERABLE HOST: Identifying the people who are predisposed to addiction); and

(3) PERMISSIVE ENVIRONMENT: Changing the societal and cultural norms that make ready access to and heavy regular use of the toxic substances and behaviors socially, culturally, and personally unacceptable.

Gorski Books: http://www.relapse.org

Gorski Training: http://www.cenaps.com

Gorski On Facebook: http://www.facebook.com/gorskirecovery


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Learning To Stand Back Up

December 30, 2014

By Terence T. Gorski,

Life isn’t always perfect. We all flow through the ups and downs of life. The trick is accepting during the down times that we can find a way to get back up. We may need to ask for help and make changes, but there is always a way to get back up.

A young boy once asked his father: Why did God make us in a way that we can fall down?” His father answered: “God made us that way so we can learn to stand back up!”

Gorski Books

Recovery Consciousness

December 20, 2014


By Terence T. Gorski,

Recovery involves developing a new state of consciousness of yourself, other people, and the world around you. Most importantly, it involves developing a new consciousness of what you can do with the help of others. Recovery is possible. It is not always easy, but you can do it. This belief in your ability to recover is part of what I call RECOVERY CONSCIOUSNESS.

Gorski Books: www.relapse.org

Relapse Does Not Mean Failure?

September 1, 2014

The road to long-term recovery Is not always neat and pretty!

By Terence T. Gorski, www.relapse.org

Straight Talk About Addiction

This article challenges three mistaken beliefs that often prevent treatment professionals from dealing effectively with relapse prone clients. These beliefs are:

(1) Relapse is self-inflicted;
(2) Relapse is an indication of treatment failure; and
(3) Once relapse occurs the patient will never recover.

I remember touring a large medical-surgical hospital as part of my consultation with the addiction treatment program that was located in the hospital. The administrator was obviously proud of the hospital he helped to build. He personally gave me the tour.

As he showed me each specialty unit I felt like he was showing off his children. He obviously cared about the patients, greeting some by name as we walked through each unit.

As he showed me the cancer, cardiac, and renal dialysis units. He emphatically told me that the hospital was committed to these chronically ill patients. He stated with pride that no matter how sick, how difficult their recovery, or how many times they needed treatment, he wanted the services of the hospital to be there to help them. “That’s my commitment,” he said emphatically. “And I am a man who keeps my word!”

When we went to the chemical dependency unit, he told me, in no uncertain terms, that the unit did not “enable chemical addicts by admitting them for treatment after relapse.” His position was that if chemical addicts wanted to stay sober they would. “Relapse,” he emphasized, “is a self-inflicted condition!” To provide multiple treatments to people who don’t really want to get well is just enabling their disease. They need to hit bottom!”

Unfortunately, this misguided attitude is still very common. We say that addiction is a disease with a tendency to toward relapse. Unfortunately many treatment centers, and even the counselors who for them don’t act like it is. Even more tragically, these misguided policies of refusing multiple treatments to relapse-prone addicts are being mirrored in insurance company and managed care reimbursement policies that often refuse to pay for multiple treatments. There is even talk of refusing alcoholics the opportunity for liver transplants because their liver disease was self-inflicted.

Currently, most relapse prone patients are unable to get the treatment they need because of three mistaken beliefs:

1. Relapse is self-inflicted;

2. Relapse is an indication
that the Patient Is a failure s who really doesn’t Want to get well. The treatment works, it’s the patient refusing to follow the treatment that causes

3. Once relapse occurs the patient will never recover.

Let’s challenge this triad of mistaken beliefs.

Mistaken Belief #1: Relapse Is Self-Inflicted

Relapse, in most cases, is not self-inflicted. Relapse-prone patients experience a gradual progression of symptoms in sobriety that create so much pain that they become unable to function in sobriety. They turn to addictive use to self-medicate the pain.

These patients can learn to stay sober by recognizing these symptoms as early relapse warning signs, and identifying the self-defeating thoughts, feelings, and actions they use to cope with them, and learning more effective coping responses.

Unfortunately, most relapse-prone patients never receive relapse prevention therapy, either because treatment centers don’t provide it or their insurance or managed care provider won’t pay for it.

Mistaken Belief #2: Relapse Is An Indication That The Patient Is A Failure Who Doesn’t Really Want To Recover!

Relapse is not necessarily a sign thAt the patient or the treatment is inherent entry a failure. It’s more likely that patient is experiencing problems that don’t match the standard package of treatment being offered. Since the problem that is the root cause of the pain in recovery is never addressed, the patient’s risk of relapse goes way up. Look at the statistics.

Between one half and two-thirds of all patients treated for alcohol and drug dependence will relapse, but at least one half of all relapsers will find long-term recovery within five to seven years after their first treatment. The belief that relapse means that both the patent and treatment failed ignores the fact that, for many patients, recovery involves a series of relapse episodes. Each relapse, if properly dealt with in a subsequent treatment, can become the a learning experience which makes the patient less likely to relapse in the future.

Chemically dependent people can be divided into three groups based upon their recovery and relapse history.

– One third of all patients are recovery prone and maintain total abstinence from their first serious attempt.

– Another third are transitionally relapse prone and have a series of short-term and low consequence relapse episodes prior to finding long-term abstinence.

– The final third, the most difficult patients to treat, are chronically relapse-prone patients can’t find long-term sobriety no matter what they do.

Recovery-prone patients in the first group tend to be addicted to a single drug, have higher levels of social and economic stability, and do not have coexisting mental of physical health problems. They are what are often referred to as “garden variety addicts” who have uncomplicated chemical addictions.

Transitionally relapse-prone patients in group two tend to have more severe addictions that are complicated by other problems. They have the capacity, however, to learn from each relapse episode and take steps to alter or modify their recovery programs to avoid future relapses.

Chronically relapse-prone patients in group 3 tend to have many different issues they are struggling with. Here is a list of some of those problems. They may have the primary addiction they are being treated for plus some combination of the following:

– Severe late stage addictions to multiple drugs, especially opiates and methAmphetamine that are powerfully addictive;

– Personality disorders, mental health problems, or physical illness that is no diagnosed or

– Severe post acute withdrawal (PAW) caused by symptoms brain dysfunction caused chronic alcohol and drug poisoning to the brain. These seems become more severe when the person is under high levels of stress.

Many relapse-prone patients fail to recover because these coexisting are not properly diagnosed and treated and they interfere with the primary treatment being given.

Mistaken Belief #3: Once Relapse Occurs The Patient Will Never Recover

Recovery is a process of learning, mostly by trial and error. Almost every recovering alcoholic or drug addict with long-term recover has had one orca short series of relapse episodes. They learned from these experienced and figured out how to put together a meaningful and comfortable long-term recovery.

“Judge not, that ye be not judged.” Matthew 7:1-3

About the Author
Terence T. Gorski is internationally author, trainer, and consultant who is best recognized for his contributions to Relapse Prevention Therapy. The scope of his work, however, extends far beyond this. He is a skilled cognitive behavioral therapist with extensive training in experiential therapies. Gorski has broad-based experience and expertise in the chemical dependency, behavioral health, and criminal justice fields.

Mr. Gorski holds a B.A. degree in psychology and sociology from Northeastern Illinois University and an M.A. degree from Webster’s College in St. Louis, Missouri. He is a Senior Certified Addiction Counselor In Illinois. He is a prolific author who has published numerous books, pamphlets and articles. Mr. Gorski routinely makes himself available for interviews, public presentations, and consultant. He has presented lectures and conducted workshops in the U.S., Canada, and Europe.

For books, audio, and video tapes contact: Herald House – www.relapse.org.
Terry Gorski and other members of the GORSKI-CENAPS Team: www.cenaps.com


Straight Talk About Addiction

Complexity: The Comprehensive Bio-Psycho-Social-Spiritual-Cultural-Economic-Political Profile

September 1, 2014

thBy Terence T. Gorski, Author
President, The CENAPS Corporation

Gorski’s Book, Straight Talk About Addiction,
further explains the implications of the distinction between
the brain and the mind in addiction recovery.

Please view this blog as a work in a progress. See it as a passing glance through a partially opened window of my brain/mind, Forgive me, for the room you are glancing into is still cluttered and poorly organized, yet you will see some interesting things emerge from  this superficial examination of the clutter.  As I said, I have not yet fully explored and organized these ideas. I started this blog with a simple idea and became possessed by something newer and for more complex.
I started to write a simple blog asserting that I believe we have both a physical brain and a nonphysical mind and that both are equally important. I wanted to lash out at the flat-landers who would smash human experience into the single dimension of nerve cells  firing as they rub up against each other and band into the environment. My argument was going to be simple: the brain is an important thing, but it is not the only thing.

The paradigm of the BRAIN-MIND is emerging to explain how the physical brain, connects with and is sensitive to the nonphysical actions of the mind. THE BRAIN is the physical structure that supports the nonphysical actions of the THE MIND. We, as human being, are sentient beings with a neuroplastic brain is capable of reprogramming itself based upon experience throughout the entire human life span.The ability to self-regulate the brain-mind assigns meaning to life experiences which can become culturally based beliefs that cause the development complex shared beliefs and personalities that influences our behavior, relationships, and social structures. This can lead to stress, conflict, violence, pain, trauma, stress-related illness, , addiction, and mental health problems. The Brain-Mind takes note and moves to correct the problems.

Medicines can certainly save lives and ease suffering, but so can our interactions with other people who care about us and have well-developed helping characteristics.  The environment in which we live has a lot to do with health and illness. It is incredibly important in terms of alcoholism and drug abuse. Certain kinds of neighborhoods become the incubators of drugs dealers, crime, and violence. Where we live, who we live with, and the nature of our relationship with those we live with has a lot to do with getting addicted, getting clean and sober, staying clean and sober, or relapsing. All these things have a lot do with addition, mental health, and lifestyle-related chronic illness.
As I thought about it, the environment also has a lot to do with illness injury and accident. Some of the greatest improvement in public health did not come from medicine, that came from improved sanitation, safer cars, and the awareness of and elimination of toxic substances in our homes and workplaces. Medicine, of course, base a place in the treatment of heart disease, but so does nutritional science, stress management, and motivational counseling to keep people going with the big changes demanded of heart-healthy living. The lifestyle and stress-related illnesses are among the most difficulty  to treating and the most relapse-prone..
Chronic Life-style-related Illness
Is the Most Difficult To Treat
And the Most Relapse Prone.
In my opinion, the future direction for improving our ability to treat chronic addiction and other lifestyle-related illness will not come from a revolutionary new treatment for these lifestyle-related problems. I would celebrate if that were to happen, I just don’t believe that it will. The next big breakthrough that I see coming in the treatment of addiction and other lifestyle-related illness will not be revolutionary. It will be evolutionary and it is slowly unfolding before out eyes right now.
Brain-Mind Cascade

The Brain-Mind Cascade

There are evolutionary changes pushing us inevitably toward conquering addiction and other lifestyle-related diseases. The evolution involves examining everything we have ever done that helped out clients. It also involves bring all these success stories, no matter how small, together. We view each little success story as a piece in the puzzle to a complicated life-long chronic disease management process.    Then we put them into a big pile (the big pile is actually a high power computer) and start looking for similarities and complimentary components. (The computer actually does most of the looking. We push a button and let the computer do the hard number crunching in the cyber-space world of correlations and algorithms.)

This will allow us to dramatically increase the amount of data that get analyzed and integrated our current knowledge-base of addictive, mental, and stress-related  illness.  This future direction that I believe holds the most promise. We integrate what we already know and look for new combinations and insights. We do this by  organizing the mountain of data into a new grid. I believe that if we could pull off this comprehensive BIOPSYCHOSOCIAL AND ENVIRONMENTAL synthesis of what we have already know, we will be able to find ways of matching patients to treatments and to prevention strategies that could reduce stress-related and life-style related illness by up to 75% in ten years.  It is possible, but it would take a major effort. The necessary funding would require financial reorganization that would probably fail to gain any political traction.
We would need to bring together everything we have learned that helps people to recover across all areas of study. This would mean mapping out a … well a …  Heck, there is no name for the type of map we would be creating. It would be as big a deal as mapping out the human genome, but at least the genome has a name. I can’t think of a good name for dynamic ever-growing map of the human condition so I will call it a comprehensive human bio-psycho-social-spiritual-cultural-ecnomic-political profile. (This name sounds simple and easy to remember, does it not?)
This task is as challenging, perhaps more challenging than mapping the human genome. It would involve getting dozens of different professionals, working in different areas of speciality expertise, who operate in different profession cultures, who use different specialty language, who compete for the same funds, and who usually dislike communicating  across the professional and specialty lines because they don’t really respect what the other professionals are doing. We need to get several million of these professionals to become committed to a collaboration that could change on multiple levels the health of billions of people and the planet they live on.
This collaboration could change on multiple levels
the health of billions of people and the planet they live on.
All specialties would be important. Collaboration and the willing to learn across disciplines would be the cultural organizing theme.  Since each speciality tends to have it own unique professional jargon, it would mean creating a new common-sense language tha could be understood across disciplines and by the common folk who suffer from the illnesses being studied.. It would involve many cross-walks between different ways of thinking: people doing pure science would have t cross-walk their ideas with people doing clinical work.
The people suffering from the human condition, which is nearly every human being alive at some pint in his or her life, needs to be invited to participate. They would be invited to log  onto smart social networking bulletin boards. These smart bulletin boards will allow people to tell the story of their disease and recovery, to describe their symptoms and related issues, and to report what they found helpful, not helpful, and harmful. There would be social networks linking people together to exchange information.
This would require big computer power — and we have that already. It needs to be designed for easy use by ordinary people who can easily enter their experiences with their disease or conditions. This probably means both key-board and voice-activated input — and we have those already.  The computer will organize the information into a big number analysis. The most difficult part of the model is that a wide variety of social, cultural, spiritual, religious, and political factors which affect the health or illness generating capacity of the environment must be included.
The next big breakthrough in the treatment of
addiction and other lifestyle-related illness
will not be revolutionary. It will be evolutionary and
its is slowly unfolding before our eyes right now.
It it were possible to build  this comprehensive multidimensional map of human existence, interesting links and new approaches to cross-disciplinary treatment would begin to emerge.  The technology s here right now. I am sure I am not the only on generating this idea or some variation, so the idea is coming of age.  The financial resources are there, but would need to be redirected which would force a cultural change in values. So what s missing? The only missing element is an army of willing of professionals who are wiling ton take up the challenge. People don’t like change and most people don;t like to take risks. The fear of launching into a new comprehensive paradigm of total  a comprehensive human bio-psycho-social-spiritual-cultural-ecnomic-political profile could open up a whole new environment paradigm and a new way of doing medicine.
This vision is emerging from studying the trends presented by Jeremy Rifkin in his books The end of Work, The Third Industrial Revolution, and the Zero Marginal Cost Society. tThe world is well into the information age that allows us to do things that seemed impossible just two decades ago.  
It is interesting to see the emerging correlations between brain function and such diverse areas as behavior, stress, personality, addiction, violence, interpersonal communication, individual and collective problem solving, and mental health disorders. Looking at these relationships  raise a very old question: does the physical brain or the non-physical mind determine our ability to control our behavior or does behavioral control result from the proper use of the non-physical mind?
There is another factor pushing the process in the information age. Health care is becoming patient driven as the internet provides readily available and scientifically valid descriptions of symptoms, illnesses, medications, and other treatment modalities. The mutual support groups starting with 12-Step programs are expanding through the internet to include high level patient collaboration and even patient initiated studies. Relatively inexpensive websites with smart bulletin boards organizes and sort information into categories to give a bigger picture that could have ever been seen before.

The answer, of course, is yes! At different times the survival responses of the brain (fight, flight, freeze) plus our deeply conditioned habits take over control and we do things we either are not aware of that, in spite of our awareness, we would prefer not to do. (Have you ever had your mouth take on a life of its own during an argument?). At other times we make conscious rational choices governed by the lifestyle we live and the people places and things we choose to associate with.

Today we are coming to the end of a failed paradigm that the physical brain is all that there is. All of the accomplishments and tragedies of mankind ia causes  by a clump of cells that accidentally at some point became self-aware.  Everything is pointing to a non-physical mind that inhabits and works with the physical brain to allow human beings to survive, thrive, maintain health, manage illness and keep moving forward with courage in to an uncertain future.



The Antidote For Addition

August 23, 2014


By Terence T Gorski, http://www.relapse.org
gorski Gorski Books

There is an antidote for addiction and irresponsibility. The antidote is sobriety and responsibility:

Sobriety is the willingness ability to manage both the pleasant and unpleasant experiences of life without the need to use addictive drugs.

Responsibility is the willingness and ability to live a moral life that contributes to life, health, full vitality, and individual freedom.

Responsible People:
– They tell the truth (They don’t lie);
– They engage in honest exchanges of value (They don’t cheat);
– They value the right to their own property and respect the right of others to their property (They din’t steal); and
– They are willing to admit their mistakes and take responsibility for repairing the damage caused by their mistakes.

Building Sobriety and and Responsibility

Sobriety and responsibility develop as a result of working the 12-Steps and other programs of spiritual and psychological growth.

Additional Resources:

Moral Development In Recovery

Understanding the Twelve Steps

Evaluate Your Level of 12-Step Completionhttp://www.relapse.org/custom/cart/edit.asp?p=78653:

Depression and Suicide – Understanding The Relationship

August 19, 2014


By Terence T. Gorski, Author

People don’t die from suicide. They die from the untreated fatal symptoms of the illness of depression. The core symptoms of depression are related with the brain chemistry balance which creates hopelessness, despair, and suicidal ideation. In other words, death by suicide is most often the fatal last symptom of chronic depression.

So people don’t die from suicide. Suicide is the immediate cause of death, but the illness of depression is what creates the urge to die. Let’s compare this way of thinking to other terminal illnesses.

When people die from cancer, their cause of death can be various horrible things such things as seizure, stroke, or pneumonia. When someone dies after battling cancer, and people ask “How did they die?” you never hear anyone say “pulmonary embolism”, the answer is always “cancer”. A Pulmonary Embolism can be the final cause of death with some cancers, but when a friend of mine died from cancer, he died from cancer. That was it. And when someone has suicide as the immediate cause of death they die from “Depression”. Depression often coexists with alcoholism and other drug addictions. They die from coexisting disorders with depression as the cause of the terminal symptom of depression.

Suicide is not a choice. People don’t make the decision to kill themselves if they are mentally and physically healthy. The word “suicide” gives many people the impression that “it was his or her own decision,” or “he or she chose to die.” Thus is very different from the way that we think about people who die from cancer, chronic heart disease, or AIDES. We see people with these illnesses as fighting to live and being overcome be the terminal symptoms of a progressive illness.

Depressed people fight for their lives against the disease of depression and die from the progressive symptoms of hopelessness and despair.

The real problem is that depression is a misunderstood condition. People somehow assume people suffering from depression choose to be depressed, choose to be hopeless, choose the chronic unbearable pain of depressive illness and ultimately choose to commit suicide when they believed they had other choices. The stigma associated with both depression and it’s terminal stage symptom of suicide is extreme. It causes people to hide their illness due to the feeling of guilt (I must be doing something wrong that causes my depression) and shame (my depression results from being a worthless person somehow inherently dysfunctional). When the illness is hidden and people feel ashamed of having it they are less likely to seek proper diagnosis and treatment.

Many people have little sympathy for people who are depressed and suicidal. Those who commit suicide are generally blamed for the pain their suicide caused to others rather than being empathized with for the pain they suffered that led to despair. In our current cultural misunderstanding of depression we should be able to pull ourselves out of depression by pulling up on our own shoelaces.

Let’s see if we can get a new and more helpful perspective of suicide as the fatal symptom of a long-term battle with the chronic disease of depression.

Depression is an illness, not a choice of lifestyle. It’s not the same as feeling sad, being down, getting discouraged or having a bad day. Depressed people can’t just “cheer up” and get over their depression by somehow choosing to feel better. Just as we can’t choose not to have cancer or use will power to get rid our tumors, we can’t just choose not to be depressed and use will power to get rid of the pain Nd hopelessness. When someone commits suicide as a result of Depression, they die from Depression – an illness that kills millions each year. Depressed people do not voluntarily become depressed nor do they voluntarily stay depressed. Most people suffering from depression fight back against their depression every day. The shame of being depressed, however, stops people from admitting they have an illness and researching all possible treatment options.

There are lifestyles that promote health and well bring and minimize the risk of developing chronic life-style related illness. These healthy lifestyles can delay the onset of depression and prepare a person with skills for managing the symptoms before the depression becomes debilitating. Depression, however, follows the same patterns of prevention as other illnesses. Healthy living and avoiding risk factors can delay the onset of symptoms. Knowing the early symptoms can result in early identification and being open to seeking a combination of biological, psychological, social and spiritual approaches to managing symptom episodes. Relapse prevention and early intervention strategies can lead to shorter episodes of less severe symptoms and radically extend the length and quality of life. The inherent level genetic predisposition, limited lifestyle options, and lack of access to effective diagnosis, treatment, and community support for recovery will make a big difference in the course of the illness and how well it is managed.

It is hard to know exactly how many people actually die from depression each year because the statistics only seem to show how many people die from “suicide” each year and because of the stigma of death by suicide the cause of death is often misrepresented. Another problem that confuses the issue is that not everyone who commits suicide suffers from depression.

But considering that one person commits suicide every 14 minutes in the US alone, we clearly need to do more to battle this illness, and the stigmas that continue to surround it.

Perhaps depression might lose some its “it was his own fault” stigma, if we start focussing on the illness, rather than the symptom. People don’t die from suicide. They die from Depression. Death by suicide is not usually a choice, although some people do consciously and rationally choose to end their lives. This issue involves people with debilitating terminal or disabling illnesses and involves the moral and political issue of “the right to die.” This is a different issue than suicide as an involuntary result of severe depression. The depression removes the choice by creating biochemical brain balances that create chronic pain, hopelessness and despair.

There is hope. There are disease management strategies that help people to manage the CHRONICALLY RELAPSING DISEASE of depression. The key is a healthy lifestyle that prevents or delays or the onset of symptoms, recognizing the symptoms early and knowing treatment options and resources.

The book DEPRESSION AND RELAPSE discusses the management of depression especially when the depression coexists with addiction.

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