Healing Arts Report
Volume 1, No.
7
HEALING
ARTS: James J. Lynch and
the Institute of HeartMath describe how the heart
experiences emotions
SELF-CARE:
Belleruth Naparstek on developing intuition
SCIENCE
REPORT: Candace Pert on the
chemistry of emotions
HEALTH
RESOURCES: When a patient
receives bad news
Think of all the words and phrases
relating to the heart -- heartthrob, heart-to-heart, take
heart, speak from the heart, follow our hearts, heartsick,
heartbroken, heartache, heart-rending, heartfelt, pulling at
our heartstrings, getting to the heart of it, heartless! Do
you think it's all just a metaphor? No, I heartily agree.
Even our ancestors believed it to be the focus, not only of
compassion and love, but of thought and imagination. Today,
the physical effects of the emotions of the heart are a
medically-proven reality.
For many years researchers have had
the ability to continuously monitor the body for blood
pressure, heart rate, and even more subtle hormonal changes,
all relating to the health of the heart. In addition, they
have developed methods which prove what we've intuited and
expressed in our language all along. By looking into your
heart you can find compassionate solutions to the conflicts
in life.
Healing the Heart
As early as 1977, James J. Lynch,
Ph.D., wrote The Broken Heart and demonstrated that
the simple process of holding a conversation with another
person dramatically affects the body's cardiovascular
system. As professor of psychology and co-director of the
Psychophysi-ological Clinic and Laboratories at the
University of Maryland School of Medicine, many of the
people Lynch first began working with were referred to him
by doctors because of high blood pressure which was
unyielding to medication. These patients were unaware of any
connection between their hypertension and their feelings.
Often they did not believe their feelings were an issue in
any way and they challenged his explanations. Through the
use of monitoring devices, however, they could learn to
sense involuntary changes within their autonomic nervous
system that were related to the emotional content of what
they were discussing.
Seeing His Internal Process
Lynch tells the story of a
physician he calls Michael, who appears to be doing all the
right things for his health, yet his blood pressure is
alarmingly high. Michael wants to get off his medication
because of its side effects.
During his first appointment,
Michael is connected to a blood pressure cuff that
automatically measures his blood pressure at regular
intervals and displays the results on a computer screen they
both can see. The physician's demeanor appears so perfectly
controlled and relaxed that Lynch can barely believe what he
is seeing. Every time Michael speaks, the numbers go higher
and higher. Lynch stops him from speaking and they watch his
pressure go down. Michael speaks and it goes up. Lynch
reminds him to breathe deeply and stop talking and it goes
down again. After three times, Michael wonders aloud how
many of his patients' blood pressure is as erratic when they
come to him. The very process of taking blood pressure
without the patient speaking may disguise the true variation
in readings.
Michael eventually realizes that
when he talks about his past, his body reacts strongly. He
thought he had long ago gotten over a bad divorce. Now he
sees that he apparently has also divorced himself from his
own feelings and this is where they are hiding -- in his
heart. It takes almost eight months of therapy for Michael
to learn to regulate his blood pressure without drugs. He
learns to recognize the feelings that everyday conversation
arouse and how those feelings are sensed by and reflected in
his body. This is how biofeedback can be used temporarily to
help a patient become aware of usually unconscious autonomic
processes.
Feelings and Dialogue
More than any other factor, Lynch
realizes that the patients he is working with do not know
how to recognize that they are having feelings. This lack of
awareness does not allow patients to use feelings
beneficially for their relationships. Instead, suppressed
feelings find other avenues of expression. They often affect
the person's cardiovascular system with high blood pressure
and increased heart rates, which put them at risk for heart
attacks or stroke. Variations in blood pressure during
dialogue occur in most people. Patients with hypertension,
however, tend to show much greater deviations. According to
Lynch, recent research from Johns Hopkins University has
shown that people who respond in this way may be up to
twenty times more likely to have silent heart disease.
Lynch points to the growing body of
research on emotional and psychosocial factors impacting
cardiovascular health. Among the findings he cites
are:
1. The act of speaking elicits
major changes in blood pressure, heart rate, and heart
rhythm.
2. Among coronary artery disease
patients, those who react to communicative stressors are
three times as likely to suffer serious cardiac problems
than those who do not show such reactions.
3. Patients lacking social support
are at two to four times the risk of hypertension and
coronary heart disease than those with support.
4. In a recent review of
twenty-three major studies of 2,024 heart patients in The
Annals of Internal Medicine, psychosocial interventions
added to standard cardiac rehabilitation programs
significantly improved survival and symptom recurrence rates
of the patients for at least two years after being
discharged from the program.
Teaching Patients
Every day Lynch and his staff teach
what they call Transactional Psychophysiology to heart
patients as a routine part of their rehabilitation. The
program includes learning about communication and its
relationship to the cardiovascular system. The patient's
mate is often part of the process, so they both can learn
improved ways to communicate. People with other illnesses
can benefit from the program, too. For them, the effects of
inadequate dialogue may show up in migraine headaches or
digestive problems. Transactional Psychophysi-ology is a
powerful non-drug treatment for stress-linked
diseases.
Lynch teaches that the following
aspects of communication can positively influence blood
pressure and overall health:
1. Talk slowly.
2. Breathe deeply and relax while
talking.
3. Meditate.
4. Learn to feel cardiovascular
reactions when relating to others and recognize them as
signals to be listened to.
5. Learn the difference between
recognizing an emotional issue and altering one's
physiological response to it.
6. See personal struggles in a
spiritual context, for example, ask oneself, `What lesson do
I need to learn? How will this situation make me a better
person?'
The Body Speaks
Lynch explains, "Dialogue is
corporal, not mental. It is as if "the body is a language
itself. Dialogue occurs between bodies." At the time Lynch
wrote The Broken Heart in 1977, "it was the high
water mark for viewing the heart and body as machines.
Loneliness was not even a part of the picture. After all,
machines don't get lonely. But, in fact, communicative life
is an integral part of health."
Lynch expresses concern about the
rise of loneliness and the absence of touch in our society.
According to him, these omissions have devastating effects
on health. Lynch quips, "I hope they never put my books in
the self-help section of the bookstore. It isn't the right
place. You can't work on the communal aspect of life by
yourself or through meditation." Lynch does not see the goal
of treatment as bringing blood pressure down. The object is
to attend to it. Patients are not learning to control the
body but to live in it. He reminds us that we are not apart
from nature. We are a part of nature.
The Big Picture
Lynch explains his understanding of
the difference between emotions and feelings. While we share
the experience of emotions with animals, feelings are rooted
in body sensations and language. Awareness of them is
impressed or repressed through dialogue, by our learning the
language for recognizing and understanding them. He
describes how "... recognition of bodily changes, both as
emotions and as feeling, is intimately connected with
learning to speak."1
It is through dialogue that we come
to understand the world, our place in it, and our
relationship with other people. Lynch compares the person
out of touch with his feelings as suffering terrible
isolation from others and unable to live in his own body.
This is like having no place to live. That person is like a
Jew wandering in the desert. Lynch explains, "To find one's
home and to rediscover one's own body is to discover a life
with others in the Jerusalem of the human heart."
By carrying these thoughts one step
further, Lynch concludes that the most far-reaching aspect
of understanding dialogue, is that, as nations, we can "no
longer believe that political, economic, and philosophical
differences have any bearing on the overall health of our
citizens." As we come to understand the links between
physical health and communal dialogue, we will have to take
responsibility for participating in a process that
contributes to the high incidence of specific illnesses and
increased mortality rates in certain social groups. When we
deny a group the opportunity to participate in dialogue, we
eliminate them from the communal process, make them
outcasts, and contribute directly to their illnesses.
Techniques for Reducing
Stress
Continuing the work of James J.
Lynch, the Institute of HeartMath (IHM) is a scientific
research and education organization founded by Doc Lew
Childre. They have developed proven techniques for providing
stress relief in a very practical way. Numerous
corporations, the U.S. military, and health and education
organizations are using these techniques to improve health
and productivity among their staff. Case studies show that
an individual can retrain emotional and mental habits that
cause worry, anxiety, burnout, and fatigue by learning some
of the Institute's techniques. Instead of venting,
analyzing, or repressing disturbed feelings and thoughts,
they can learn how to release them and increase intuition,
care, energy, and contentment.
Unlike Lynch's early clients who
needed proof of a link between their emotions and their
cardiovascular health, most people who come to a HeartMath
seminar are already aware of the link. They are looking for
methods to reduce burn-out and no matter what their level of
awareness is, they can begin work.
Childre explains that stress is a
response and not the event that triggers it. The situations
we experience as stressful are often the ones about which we
care the most -- doing a good job at work, having our
children do well in school, or sharing family time in spite
of a busy schedule, for example. When we become impatient,
frustrated, or anxious about these things and our inability
to influence these events, our care begins to drain our
emotional energy. This is what Childre calls `overcare.'
Childre points out that the first dictionary definition of
`care' is "a troubled or burdened state of mind" which shows
how far we have moved from `care' as heartwarming
feelings.
Heart Waves Radiate to All
Cells
The amplitude of heart waves or the
heart's electrical energy is forty to sixty times as strong
as brain waves. This means that the heart's electromagnetic
field radiates to all the cells in the body and into the
space several feet away. Our thoughts and feelings cause
immediately measurable changes in the electrical system of
the heart. 2
Childre developed the Cut-Thru
technique to help people shift from the emotional drain of
overcare back to their original heart-felt care. By
monitoring people experiencing different emotions, IHM
researchers have recorded the changing heart rhythms
experienced during times of anxiety and those experienced
while using the Cut-Thru technique.
The heart frequency pattern of
frustration is one of disorder and chaos in the heart's
electrical system. The pattern while using the technique is
coherent. It "is an aligning of the frequencies of the heart
which generates an increase in power. When we are sincerely
feeling love for someone, we feel it in the area of the
heart, then the heart communicates the signal of love to the
brain. The brain then responds by creating balanced hormonal
patterns that regenerate the well-being of the entire
system." Entrainment or a matching of the rhythms of the
heart and brain waves causes a change of perception and
increases intuition.3
With a different perception of a
situation, a person can develop a stress-free response,
which is reflected in the autonomic system.
Changing the Autonomic
Response
The Cut-Thru technique may seem
familiar to those who practice meditation or have
experiences of self-observation, but for those with a
business orientation, the book describes it in a more
familiar language. It is not possible to do justice by
condensing all five steps here. The first two steps
paraphrased below, however, can be used successfully on
their own for easier-to-perceive stress-provoking
interactions.
1. The first challenge is to
recognize the feelings and thoughts of over-caring. They
often feel bad or, if subtle, vaguely disturbing -- for
example, angry thoughts, the temptation to say something
without thinking first, tension in the neck or abdomen,
shallow breathing, or tightening of the throat.
2. Bring these thoughts or feelings
into the heart and hold them there. You may find this is
enough to transform them. If not, homogenize or blend them
in the heart. This disperses the energy enough to allow for
a new perspective of the situation.
For all five steps and a more
complete understanding of the technique, see Cut-Thru by Doc
Lew Childre.3 The Institute of HeartMath also has developed
an "Autonomic Assessment Report," a new noninvasive tool to
help physicians assess a patient's risk for sudden cardiac
death and other conditions.
James J. Lynch's groundbreaking
books, The Broken Heart and The Language of the Heart, will
soon be re-released by Bancroft Press, Baltimore, in updated
versions. For information about future seminars, phone Life
Care Health Associates in Baltimore at 410-321-5781.
For more information about
HeartMath books, tapes, and seminars, phone 800-450-9111,
fax 408-338-9861, or visit their web site at
http://www.heartmath.org.
Developing Intuition
The very concept of intuition is
surprisingly scant in the literature of alternative
medicine. Biologist Rupert Sheldrake explains why when he
explores the topic of the contracted and expanded mind. In
Seven Experiments That Could Change the World,
Sheldrake describes arguments about the nature of the
mind.
Traditionally, all over the world,
the mind is seen as part of a "far larger animate reality."
It is equated with soul, linked to our ancestors, other life
on the planet, life after death, and life shared with
spiritual beings, such as elves, angels, and saints.
Sheldrake says, "By contrast, for more than three hundred
years the dominant theory in the West has been that minds
are located inside heads." He refers to this as a model of
the "contracted mind," confined to the brain and usually
described in terms of mechanistic functioning.
In the area of personal beliefs,
however, the sense of our psyches as existing beyond our
bodies is quite prevalent. Surveys show that more than fifty
percent of the population have experienced telepathy and
other psychic phenomena, while a much greater majority
believe in their existence.4
Using Intuition for Health
Christiane Northrup, M.D., in
Women's Bodies, Women's Wisdom (Bantam Books, New
York, 1994) suggests that most of us have our intuitive
abilities trained out of us by the time we are seven years
old. The bias in our culture is for left-brain rational
thinking. "Our bodies are designed to function best when
we're doing work that feels exactly right to us. If we want
to know God's will for us, all we have to do is look to our
gifts and talents -- that's where we will find it. Health is
enhanced in women (and men) who engage in work that
satisfies them." The possibility of life-threatening illness
sometimes reawakens these skills. She describes a number of
cases where information about their own physical and
emotional health is perceived intuitively by women. Their
perception about their physical bodies is sometimes
confirmed later in surgery.
According to Belleruth Naparstek, a
licensed psychotherapist in Cleveland, Ohio, intuition is a
natural ability. In the same way sports or musicianship may
be an inborn gift, they can also be improved upon through
learning and practice. Naparstek's preferred vehicle for
psychic development is guided imagery.
She says that, "it alters
consciousness, drops us down into the clear, receptive state
necessary for picking up subtle, intuitive signals, changes
the biochemical mix in the bloodstream, shifts brain waves,
and amplifies the human energy field." Naparstek has
produced a series of guided imagery audiotapes which are
designed to replicate these mind states.
In a presentation and workshop at a
Common Boundary conference, Naparstek described some of the
insights she has observed about intuitive ability. From the
many intuitives she has interviewed, she has found that
certain life circumstances shared by many of them
include:
* being gifted from birth
* experiences of trauma, abuse, and
terror states
* near death experiences
* yoga, meditation, or other right
brain practices
* proximity to a powerful
psychic
* falling in love and
heartbreak
* cultivating compassion and
working with an open heart
Recognizing Intuition
Naparstek describes the difference
between logic, experience, and intuition, giving examples
from her own role as a therapist. Some things are obvious
and can be rationally thought out. After years of
experience, some things which may not be obviously logical
make sense because she has observed patterns of behavior
that are very common. On the other hand, intuition is
knowing or having an immediate insight without making use of
rational processes or conscious reasoning.
Sometimes intuition may be needed
to solve a dilemma. For example, Naparstek describes therapy
with a young woman who was in a distressed state, unable to
sleep or cry, ever since an auto accident in which a younger
woman she was supervising had been killed. One session is
usually enough to bring in some kind of healing insight or
feeling. In this case, one session produced no relief. A
week later, during the second session, suddenly, without
thinking, Naparstek asked, "Is there an image that comes to
you from the accident?"
There was an image, which had been
recurring repeatedly. Immediately after the accident, she
turned to the younger woman who had been in the back seat.
Frozen on her face was a horrible toothless grin. Her teeth
had been knocked out by the impact and she was dead.
Naparstek's client was haunted by this image and yet had
been unable to speak of it until the moment she was asked
the question directly. It released a flood of tears and
finally provided a doorway through which the woman could
process and digest the tragedy. This is intuition at
work.
In Naparstek's recently released
book, Your Sixth Sense, she lists twenty-three things
to do to accelerate the development of intuition. Here is a
sampling:
* be playful
* pray
* seek solitude
* practice structured
meditation
* practice gratitude, kindness,
forgiveness
* slow down your pace of living
* get physical exercise
* observe the machinations of your
ego
Belleruth Naparstek, a practitioner
for almost 30 years, makes presentations and gives workshops
across the country. She is author of Staying Well with
Guided Imagery. Your Sixth Sense audiotapes includes four
guided meditations for accessing your own intuitive ability
on two tapes. To make comments, ask questions, or receive a
list of her tapes, call 800-800-8661.
Gut Feelings and the Chemistry of
Emotions
In contrast to the motto from the
popular television show "The X-Files" -- "the truth is out
there" -- Candace Pert, Ph.D., research professor of
physiology and biophysics, announces that, "Truth is in the
gut feelings." According to Pert, the brain is, in fact,
usually the last to know what's going on. In addition, the
body, once thought of as purely physiological, is the
subconscious mind.
Major Conceptual Shift
In an interview with Bill Moyers
for his public television series, Healing and the
Mind, Dr. Pert describes the major conceptual shift that
occurred in the neurosciences and immunology in the last
twenty years. Researchers have confirmed the
interconnectedness and shared structures of the brain, the
immune system, the endocrine system, and all the functions
of the body. Perturbations in any one system affect the
other systems. These discoveries have created the new field
of psychoneuroimmunology. The connectedness of what were
once viewed as separate systems suggests the viability of
using nonconventional forms of healing. In a recent phone
interview, Pert's examples of therapies that could affect
the chemistry of the body included visualization, change of
attitude, light, feelings, exercise, and sound.
Physiology Modulated by
Chemicals
Dr. Pert, an internationally
recognized pharmacologist, has made research observations
which suggest theories supporting what some health care
practitioners have claimed for years-- that emotional states
and physical therapies can alter the course of illnesses
once considered to be entirely biological. According to
Pert, the brain and somatic functions, which used to be
called physiology, are modulated by numerous chemicals.
About sixty of them have been identified to date. Most of
them, and possibly all of them, affect behavior and mood.
Many had been studied within other contexts as hormones,
growth factors, or as components of the immune system.
Pert's original interest in
consciousness focused only on the brain. Her study broadened
to the connection between mind and body when she began
working on finding receptors for opiates in the brain.
Receptors had been hypothetical at that time, but she
discovered ways to measure them. This led to the discovery
that the brain makes its own morphine, and that emotional
states can be created by chemicals called endorphins, which
is short for `endogenous morphines.' Endorphins, peptides,
and other chemicals similar to them are found throughout the
body and are created by it. Furthermore, the chemicals are
picked up by receptors which float around on the surface of
every cell in the body and are indistinguishable from those
identified in the brain. Pert calls this flow of information
a psychosomatic communication network.
According to Pert, the cells are
being told what to do by the chemical messenger molecules.
The cells are given diverse information, such as whether to
divide, activate a gene, or make a particular protein. All
these molecules appear to mediate the intercellular
communication throughout the brain and body. Theoret-ically,
they are the biochemical correlates of emotions. When asked
whether feeling anger is mental or physical, Pert answers,
"It's both.... [emotions] are the bridge between the
mental and the physical, or the physical and the mental.
It's either way." Pert says that because the chemistry of
the messages happen almost spontaneously, it isn't clear
where the messages originate. We may not be talking about
something that occurs only in the physical realm.
Another Energy May Be
Involved
It seems there is another form of
energy involved that has not yet been understood, something
beyond chemical and electrical responses. One example that
seems to indicate qualities outside of the realm of ordinary
material chemical reaction is the phenomenon of multiple
personalities. Sometimes the different personalities clearly
have physical symptoms that are linked with only one of the
personalities, such as allergies or diabetes. These
reactions can be measured in the body -- one personality
making the right amount of insulin and the other, unable to
do so.
As a scientist in the Western
tradition, Pert doesn't use words such as `spirit' or
`soul.' Some might call it Mind with a capital M. She refers
to it as `the information realm,' a subtle energy that has
not yet been identified even though its effects have been
observed. In Pert's new book Molecules of Emotion,
she presents her latest research suggesting the unity of
mind and matter and what it means in terms of our views on
health and medicine. In addition, she tells the gripping
story of her odyssey as a female scientist making
revolutionary discoveries, both professionally and
personally.
Dr. Pert is active on the editorial
boards of many peer-reviewed journals, including Cellular
and Molecular Neurobiology, Peptides, Reviews in the
Neurosciences, and the Journal of Alternative Medicine. Pert
is Research Professor of the Department of Physiology and
Biophysics at Georgetown University Medical School and has
held a number of research positions with the National
Institute of Mental Health. Her new book, Molecules of
Emotion, will be released in September by Scribner. She may
be reached through Georgetown University, 37th and O Streets
N.W., Washington, D.C. 20007.
When Bad News Hits
What can a patient do after being
told that they have a serious medical condition they don't
know anything about? The doctor sorrowfully gives some basic
information and sends the patient out of his office. It may
feel to the patient like being dropped in the middle of the
desert. Patients have described it as frightening,
overwhelming, or just plain confusing. Often, there is no
time to digest what the doctor said and no time to formulate
questions. They may have been given names of national
organizations that deal with the condition or not. They may
be given new medication with little information about what
it does and the long-term consequences of taking it. They
may be told about the need for immediate surgery. Often,
they can't absorb the information anyway -- they are still
trying to take in the diagnosis.
Learn As Much As Possible
How can a patient find out more?
Why should they? Where can busy health professionals and
their patients find reliable information that a layperson
can understand? Even if a practitioner has the time and
ability to convey what is needed for understanding and
comfort, a patient will benefit from learning as much as
possible. Why?
* to know all the options
available, not just what is commonly done by one doctor or
in one part of the country
* to discover which options suit
oneself in terms of preferences, willingness to follow
through on treatment, costs, and availability
* to participate in the process,
sharing in the decisions made
Help For Life-Threatening
Illness
Janice R. Guthrie, founder and
director of The Health Resource, Inc., a company located in
Conway, Arkansas, established the company as a result of her
own rare type of ovarian cancer. She did not feel
comfortable with the only treatment option she was offered.
Through research, she was able to find a physician who had a
special interest in her condition and who welcomed her
participation in the process of decision-making. She gained
a sense of control over her personal health.
This experience inspired her "to do
similar research as a service for others with medical
problems." Within a week, the client will receive over 150
pages of material listing support groups, physicians' names
and locations, professional and grass roots organizations
that could make licensed medical practitioner referrals,
articles from magazines and newsletters, and published
peer-reviewed research from computerized medical data bases.
If clients are not satisfied with the material, they may
return it within
thirty days for a full refund.
Anyone reluctant to spend $250 to $350 for a report should
find that reassuring. In addition, Guthrie states that
customers receive, at no charge, news bulletins about new
treatments for their condition and they are offered a yearly
update service.
One client who received research
from The Health Resource, Inc. said, "I learned enough to
talk with doctors about their philosophy of treatment and
the costs, availability, and usefulness of various tests for
celiac sprue. Since I am responsive to a gluten-free diet, I
feel I now have time to make further decisions. I believe an
intestinal biopsy is invasive, besides being costly.
However, blood tests that would help me improve my immune
system after years of possible malnutrition are worth my
investing in."
Other resources that provide
education and medical searches include Planetree Health
Resource Center at 415-923-3681 in San Francisco and the
World Research Foundation in Sedona, Arizona at
520-284-3300. Each organization has a different price range
and size of report available. Most use approximately the
same computer databases. Planetree will connect clients to
others with the same concerns. World Research Foundation
offers a catalog of books, tapes, and videos on health
topics and an in- house library open to the public.
Contact The Health Resource, Inc.
at 564 Locust Street, Conway, AR 72032. Phone 800-949- 0090,
501-329-5272, or fax 501-329-9489.
Best wishes,
Barbara June Appelgren
END NOTES
1. J. Lynch, The Language of the
Heart (New York: Basic Books, 1985):272.
2. W. Tiller, R. McCraty, and M.
Atkinson, "Cardiac Coherence: A New Non-invasive Measure of
Autonomic System Order," Alternative Therapies 2:1
(1996).
3. D. L. Childre, Cut-Thru (Boulder
Creek, CA: Planetary Publications, 1995):70-75.
4. R. Sheldrake, Seven Experiments
That Could Change the World, (New York: Riverhead Books,
1995):102.
________________________________________
Advisory Board Members
Deborah Crabbe, C.N.M., M.S. Victor
B. Eichler, Ph.D. William Gough, M.S. Marc Micozzi, M.D.,
Ph.D. Joel Shepperd, M.D. Jerry Toporovsky
Healing Arts Report is published
monthly by Zillah, Inc.
Copyright 1997 by Healing Arts
Report
Mailing address: P.O. Box 1728,
Winchester, VA 22601
Editor: BJ Appelgren Publisher:
Bruce Appelgren
Internet Editor: Mark Schulte
Editorial Assistant: Buster Katz
Healing Arts Report presents
educational health-related information and news only. The
material contained herein is intended for general
information and should not be construed as medical advice or
medical opinions. It does not apply to specific medical
conditions, treatments, or other specific factual
circumstances. It does not constitute recommendations for
self-treatment nor is it intended to replace consultations
with qualified medical care providers or information
provided by manufacturers or retailers about their products.
Decisions regarding diagnosis and treatment are to be made
by the reader in the exercise of his or her judgment. The
source of all news and information contained herein is
provided. Healing Arts Report does not test or otherwise
independently verify nor warrant the validity, accuracy,
timeliness, completeness, or utility of its contents.
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