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- Hey everybody today
we're gonna talk about
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complicated grief and how it differs
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from regular grief, but
before we jump into that,
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are you new to my channel?
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Welcome.
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I am a licensed therapist
making mental health videos
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on Mondays and on Thursdays
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so make sure you have your
notifications turned on
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so that you don't miss out.
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But now let's hop in to today's topic.
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And it's important, as
always I wanna define things
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so it's important to first
know that grief itself
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is the natural reaction to loss.
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It's the body and mind's
way of healing wounds
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caused by loss of something precious.
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We tend to think of it
mostly as intense sorry,
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but it can present itself as
a lot of different emotions
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or thoughts or even physical symptoms.
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The important thing to know about grief
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is that while it can feel awful,
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it is a healthy and
adaptive process of healing.
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It's just your brain's way
of making sense of the loss
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and it helps us to learn what we value
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and leads us to reach out
for comfort and relationship.
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So in a way, grief is really
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just a helpful tool for
processing the loss.
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Now complicated grief, on the other hand,
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can feel very similar to grief,
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but it is in fact very different from it.
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While grief is an adaptive process
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of making sense of a loss,
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complicated grief is actually a disruption
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of the grieving process.
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It keeps you from processing a loss.
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It's like a complete roadblock.
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Grief involves positive
feelings and memories
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and complicated grief
generally makes it tough
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to be able to access the memory or loss
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in a way that enables you to have
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a positive or honoring feeling.
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Also grief is a reaction to
losing something you value.
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Complicated grief is a reaction to
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like the negative thoughts
or feelings that we have
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about some element of the loss,
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almost like the loss stirred
something up inside of us
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and it feels icky and the thoughts
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that we have about it are all negative.
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That's where complicated
grief comes out of.
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And overall, if that doesn't make sense
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just know that complicated
grief is really borne
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out of a negative belief or experience
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that we've attached to the loss.
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It could be a negative belief
that we have about ourselves
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or possibly the relationship that we had
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with the person who's passed away
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or is no longer in our lives.
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Instead of processing the loss,
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complicated grief keeps
us stuck in the process,
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unable to do the healing work of grieving.
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A better way of explaining this
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is if we talk about the loss
like it's a physical wound.
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Grieving is the healthy
process of that wound healing.
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It's the cleaning out of the wound
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through experiencing and processing
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the different losses
associated with that wound.
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It feels painful at first, you know.
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If you like have a cut on your leg,
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you put rubbing alcohol
or hydrogen peroxide on it
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and you're like, oo, it really hurts
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and then if we're processing it,
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it can get kind of confusing
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and it can be hard at times,
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but this whole grief process is necessary
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if we want the wound to heal fully.
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Does that kinda make sense?
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In complicated grief, on the other hand,
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is when that wound becomes infected
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or you kind of keep
tearing out the sutures.
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I love the band The Postal Service
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and I just couldn't help
myself, had to add that in.
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But anyways, during complicated grief
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you are still feeling pain and confusion,
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but it's caused, not by the wound itself,
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but by the infection that
has gotten into the wound.
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For example, let's say you have suffered
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the loss of a person or relationship
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that is really important to you.
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The grieving process would be
the emotions and the thoughts
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and the physical responses,
they can often be uncomfortable,
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that come as your mind works
to make sense of that loss.
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Complicated grief is the
interruption of that process.
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So instead of being
able to honor the person
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or thing that was lost, some narrative,
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like I was talking about, all those
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negative thoughts or beliefs
we maybe have about ourselves
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is going to distract and stop that.
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And so instead of the grief narratives
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which are rooted in the
loss and might sound like,
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why did this happen to me
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or I miss the way that they cared for me
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or I don't wanna do this without them.
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Instead a complicated grief narrative
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might be something like
people who cry are babies
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or this is all my fault, I
deserved this, I'm so weak.
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Or even narratives caused
by other losses in our life,
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like everyone is always leaving me
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or is this is always happening.
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Does that make sense?
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It's like instead of
having a healthy thought
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and belief and story, we tell
ourselves about the grief,
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complicated grief prevents it
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and almost makes it personal,
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where we did something to cause it.
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And so of course we're not gonna
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be able to process it and move forward.
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Now as far as the emotions side,
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they may feel very similar,
especially in the beginning.
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When you lose someone or you're grieving,
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you feel sad, angry, hopeless,
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maybe even depressed, but these emotions
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are not rooted in working through the loss
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and over time, it'll become clear
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that you're just stuck in a cycle.
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You're responding to that
maladaptive narrative you had,
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which maladaptive narrative's
just a therapisty way
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of saying that unhealthy story
you keep telling yourself
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about the loss, like all those beliefs
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that we're having, right?
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So we can respond to that
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rather than ever being able to respond to
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the actual loss we're facing,
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which is really why we can't process it.
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Does this all makes sense?
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I hope so.
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So if we think this is happening to us,
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what could have caused it?
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Why would we have complicated
grief versus regular grief?
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Now there are a lot of
things that can cause it.
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It could be, number
one, and the most common
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is unresolved past grief or trauma,
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especially from childhood.
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When you're a kid, sometimes
you experience injuries
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that you don't yet have the language
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or cognition to even process.
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These things can be triggered or resurface
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when something happens in your life.
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And the second cause is loss
you feel responsible for,
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like you did something to cause this.
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Like I said some of those maladaptive
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or negative thoughts that we can have
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can be like, people always leave me,
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this is all my fault, I did something.
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So that can obviously lead
to complicated grief as well.
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And number three it could
be from invalidated loss.
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And invalidated loss occurs
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when you feel your grief
is disproportionate
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to the situation, meaning you really think
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you're overreacting and
you're judging your grief
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instead of allowing yourself to feel it
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and validating the experience.
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And this could be because
of the circumstances
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surrounding the loss or the
ways others react to your loss
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or the culture in your family about grief.
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It can happen when you compare losses
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or when certain emotions
in the grief process
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feel off-limits to you in your mind.
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For example, you feel guilty about anger
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or have a belief system
that makes you feel weak
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for really feeling sad
and missing someone.
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And complicated grief can also occur
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when you find yourself in a situation
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involving delayed grief, so
this is the fourth cause,
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fourth potential cause
of complicated grief.
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And delayed grief is when circumstances
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make it difficult to process
the loss as it happens.
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Maybe you're busy planning a funeral
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or you have to care for
someone else's experience
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of the same loss, so you aren't able
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to fully process your own.
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And I remember, honestly,
when my dad passed away
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my mom was sort of in this weird trance
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during the whole process,
because she had to
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make sure that all the
finances were in order,
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and she had to plan the funeral,
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and she was also consoling me
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and being there for other
members of the family,
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and there was just so much to do
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that I think it almost just distracted her
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from her own loss.
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Another source might be
ambiguous or hidden loss.
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Some losses are invisible,
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like losing a child to miscarriage.
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When loss isn't seen or
acknowledged by others,
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you can end up experiencing complications.
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Or the sixth cause is compounded losses.
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When multiple losses occur
around the same time,
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it can make it challenging
to process each one.
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And number seven, sudden
lingering or violent loss.
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Essentially these kinds of injuries
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are often being experienced
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as what we would call a traumatic loss.
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Recurring losses or losses
that are a disruption
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of some sort of a central
belief or thought you have
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about yourself can create trauma
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and essentially, in the end,
create complicated grief,
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meaning that if the
loss seems to go against
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what you feel you truly are,
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it could be as simple as always believing
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that you are strong and independent.
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But if our grief makes us feel weak
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and lost without someone,
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it goes against what we
believe about ourselves.
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Do you know what I mean?
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And that can lead to complicated grief.
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Okay, enough about that and the causes,
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let's move into how we can know
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if we're struggling
with complicated grief.
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So identifying complicated
grief can be tricky,
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because at times it can look
very similar to regular grief,
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not to mention that we don't
just wanna start thinking
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we have a mental illness when
we're just doing something
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as normal and healthy as a grieving.
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Now since complicated grief is in the DSM,
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remember it's not the end-all be-all,
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but it just gives us
a way to better define
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and diagnose and treat
certain mental illnesses,
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but in the DSM it's called persistent
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complex bereavement disorder, or PCBD,
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and it's included in
the DSM as a condition
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that needs further study precisely because
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it is so complicated.
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And if you remember, I did
a video a long time ago
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about non-suicidal self-injury
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and that was in that
same portion of the DSM,
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under conditions that
need further research.
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And so what that means is
is that we might find it
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in the next update of the DSM.
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Now in order for someone
to struggle with PCBD,
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we must have experienced
the death of a loved one
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at least six months previous
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and at least one of the following symptoms
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has to be happening longer than expected,
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okay, so that has to be going on.
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And then we have to have at
least one of these things, okay.
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And obviously when we're assessing this,
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we have to take into consideration
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a person's social or cultural environment
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because different people of religions
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and backgrounds and cultures
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have different grieving processes
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and what's considered
quote unquote normal.
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Okay, but they have to
have at least one of these.
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Number one, intense
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and persistent yearning for the deceased.
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Number two, frequent
preoccupation with the deceased.
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Three, intense feelings of
emptiness or loneliness.
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Four, recurrent thoughts
that life is meaningless
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or unfair without the deceased.
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And five, a frequent urge to
join the deceased in death.
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And in conjunction with those,
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we also have to have at
least two of the following,
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and these must have been occurring
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and been recorded for at
least one month, okay.
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And the first one is
feeling shocked, stunned,
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or numb since the loved one's death.
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Number two, feelings of disbelief
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or inability to accept the loss.
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Number three, rumination
about the circumstances
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or consequences of the death.
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Number four, anger or
bitterness about the death.
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Number five, experiencing pain
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that the deceased suffered
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or hearing and seeing the deceased.
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Number six, trouble trusting
or caring about others.
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Number seven, intense reactions
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to memories or reminders of the deceased.
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And number eight and finally,
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avoidance of the reminders of the deceased
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or the opposite where we'll
seek out such reminders
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so we can feel closer to them.
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Now in order to diagnose, symptoms
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would need to create substantial
distress for the sufferer
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or impact significantly
on areas of functioning
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and cannot be attributed to other causes.
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Just like all other diagnosis,
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in order for them to be a real issue
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they have to impair our
ability to function.
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I've talked about that a lot
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in all of my other DSM diagnosis videos.
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But also know that grieving can still
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involve complicated emotions
that you may not like,
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but they are about the loss
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and not about you, and not
about the grief itself.
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What I mean is, don't think
it's complicated grief
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just because it's extremely painful
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and there are mixed emotions.
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Trust me, I feel like
everything I've had to grieve,
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every person I've lost in my life
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has created mixed emotions
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and it's been really uncomfortable.
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And these complications
that we're talking about
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when it comes to complicated grief
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are the things that are keeping you
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from healing and grieving, so
the question to consider is
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is what you're experiencing
helping you mourn the loss?
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Or is it keeping you from
even thinking about the loss?
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And if you think you might be
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dealing with complicated grief,
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please reach out to a therapist
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or other mental health
professional in your area.
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They can really help you figure out
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what's interrupting the
grief process for you
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and help you move past it so you're able
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to process the grief you're feeling.
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And one type of therapy
that's known to help with this
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is CBT, or cognitive behavioral therapy.
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In CBT, your therapist will work with you
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to identify the narratives.
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Remember those faulty beliefs or guilt?
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Anyways, they'll help
you identify the ones
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that are interrupting
your grieving process.
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Then they will help you identify
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what these faulty beliefs are rooted in
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and either help you work through them
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or separating them out from the loss
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so that it can be processed separately,
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because let's say it was a trauma
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that's causing your complicated grief,
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we'd wanna process
through that trauma first
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and then get into the grieving process.
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But overall, the important thing to know
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is that complicated grief
is very, very common
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and it can and will get better.
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So please reach out because
if its left untreated,
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complicated grief can lead
to other mental health issues
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that would need their own treatment,
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such as depression or anxiety.
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And finally, I wanna
just get into something
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that you can use today to
help you begin this process.
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And one way to do that is to start
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working through past losses.
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I offer this up as an option
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because it can be easier
to start with something
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you aren't currently struggling with.
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Just like when we go to
process through trauma,
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we may start off with a smaller
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less emotionally charged
portion of that first.
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So take a few minutes and think through
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some of the losses you've
experienced in your life.
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Do you feel like you've done all the work
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of working through those losses?
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If not, maybe carve
out some time this week
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to journal through those losses
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and see what emotions or narratives,
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you know, those nasty
stories we tell ourselves
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about it, see what comes up for you.
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And remember to be
compassionate about this process
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and ensure you're talking
kindly to yourself
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as you work through it.
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Loss is really hard,
so try to pay attention
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to the thoughts you have when you
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start thinking about your loss.
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Are these thoughts about the loss
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or are they things that
might be about yourself
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and what's keeping you from
actually facing the loss?
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Then take some time to
think about the loss itself.
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What do you miss about that person?
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What do you think feel about that loss?
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As you process, just try
to notice any thoughts
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that arise when you think about the loss.
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Those can be clues to
what may be preventing you
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from grieving fully.
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Even identifying these will help you
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make more space in the
process for your loss
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and resolve the complications.
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I hope you found this video helpful.
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If you want to know more
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you can check out the links below
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and let us know in the comments
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if you've ever experienced
complicated grief.
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And if so, how did you
know that's what it was?
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Or how did you work through it?
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Leave those in the comments below
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because you never know
who you're gonna help
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and I will see you next time, bye.
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(gentle music)