EVERY SPOKEN WORD
115 min read · 22,612 words- 0:00 – 0:16
Intro
- JSDr Julie Smith
When we change our relationship with uncomfortable feelings, whether that's stress, anxiety, whatever those sort of uncomfortable feelings are, if we're willing to have them and use them to our advantage and take them with us, then they don't hold us back. (wind blows)
- CWChris Williamson
Have you
- 0:16 – 4:49
Impact of SSRI’s on Depression
- CWChris Williamson
seen this most recent study about the impact of SSRIs and the serotonergic, uh, system and how it's related to depression?
- JSDr Julie Smith
Uh, I think that there's been lots of sort of news headlines going on. But I think it's not unusual for there to be headlines about things like medication, so to be fair, it's not something I've hugely engaged with 'cause I'd sort of rather go to the source, of which I haven't been to yet. So, um, yeah. I try, uh, in general, I try to sort of steer clear of, um, some of the headlines, partly because they can get it really, really wrong.
- CWChris Williamson
Yes.
- JSDr Julie Smith
Um, but I- I assume there's a, a brand new study?
- CWChris Williamson
It looks like it, yeah. So this is from theconversation.com. "Depression is probably not caused by a chemical imbalance in the brain." This is the people that have done the study. Uh, "The serotonin, uh, theory of depression has been one of the most influential and extensively researched biological theories of the origins of depression. Our study shows that this view is not supported by scientific evidence. It also calls into question the basis for the a- the use of antidepressants. Most antidepressants now in use are presumed to act on their effects via serotonin. Some also affect the brain, uh, via noradrenaline, but experts agree that the evidence for the involvement of noradrenaline in depression is weaker than that for serotonin." Uh, there's a bunch of mechanisms. Basically things are now up in the air and chemical imbalance is something which appears to be, uh, being criticized, uh, and, uh, looked at with a lot more cynicism.
- JSDr Julie Smith
Yeah, and- and I think it's not the first study to, um, sort of indicate that. And there's been, you know, there are sort of, you know, books written on it and- and things over the years. But I mean, uh, from someone who's- who's not a medic, so I'm a psychologist, so we focus on sort of psychological formulation and looking at how people can, uh, manage their mental health through skills work and- and therapy. Actually, you know, I- it- it does sort of ring true that, you know, there are some people that might come along with the idea that, um, it's something that is wrong with them and, you know, "There's something in my brain that's not right and I need fixing." And- and there's other- other people that d- don't necessarily come along with that, um, conceptual idea of- of things that are happening to them. Um, and often we'll work for, you know, whatever idea somebody has about the origins of their distress. Uh, we tend to, I tend to work from a- an individual basis. So whether there is or there not, there isn't, um, uh, you know, an exact sort of biological cause. Actually, I've never come across anybody... Um, once- once you hear somebody's story, um, and- and everything that they've been through from- from the word go, I- I- I've never, uh, been through that whole process of hearing somebody's story without then thinking, "Of course. Of course you feel this way. Look at everything you've been through. Why wouldn't you? It'd be strange if you weren't suffering the effects of that trauma or, you know, this relationship," or what- whatever that person had been through. So I've always been able to, you know, from the psychological perspective, I've always been able to make sense of people's distress through their life story and what's happened to them and the way that they are, um, uh, sort of choosing to cope with it, and their different sort of coping mechanisms. And- and by adjusting some of those, we can have, y- you know, massive transformations in how people function.
- CWChris Williamson
Well, let's say for a second that the serotonin theory was correct and that is what happens. I'd be very, very surprised if the person with even the worst serotonin in the world, but was getting up on time and had great relationships and was eating and drinking right and trained and got sufficient sunlight and da da da da da da, that- that person's going to be unbelievably resilient. And the same for the person that has the perfect serotonin balance in the brain. If you kill their sleep for two weeks, make them eat terrible food, keep them in a dark space and give them no friends to be around or work that's meaningful to them-
- JSDr Julie Smith
Yeah.
- CWChris Williamson
... I challenge the happiest person on the planet to not feel depressed after that.
- JSDr Julie Smith
E- exactly. And- and it's sort of strange, this idea that, um, you know, you, the chemical balance in your brain is- is the start of everything. Actually, it's also a reflection of what's happening around you and in your life. So yeah, if you- if you change your behavior, you can change your brain chemistry. We, you know, um, while our medication can be really effective at doing that, there are also lots of other things that we can do, that we can take control of, that impact our brain chemistry as well.
- CWChris Williamson
Andrew
- 4:49 – 11:24
You Can’t Control the Mind with the Mind
- CWChris Williamson
Huberman came on the show a couple of weeks ago and he's got this quote where he says, "You cannot control the mind with the mind." And he's just talking about the fact that our brain states are intrinsically linked to the actions that we take, to the way that we do things on a daily basis. And then actually getting out of the mind and into the body is something that's maybe quicker than ending up trying to think our way out of whatever problem it is that we're facing.
- JSDr Julie Smith
Uh, y- yes. Certainly the sort of, uh, the, uh, skills that tap into, um, the physical sensations are often the first that we would teach in therapy, partly because they are quick-acting. They are really easy skills to learn, and ones that you can then use whenever you need to, uh, like the sort of different breathing techniques and, you know, Andrew Huberman talks, um, really well about this, sort of the different ways you can use breathing to kind of calm anxiety and stress and those kind of things, which is really, really helpful. So they're often the first things that would be taught to somebody who came to therapy, for example. I think y- while you can i- you can influence the mind through the mind, it's a- a more long-term strategy. So it's stuff that takes more prac- you know, you can learn a breathing technique in- in 10 minutes, uh, and then use that forever. Um, but also y- you can learn how to change your relationship with your thought patterns or your past, and that's the stuff that takes longer, um, but also has a- an incredible long-term effect.
- CWChris Williamson
What do you think most people get wrong when trying to understand anxiety?
- JSDr Julie Smith
Uh, what do they get wrong? Um, uh, possibly the idea that they can influence it, that it's a feeling like any other. And, um, that it, when you have that feeling, you don't have to be at the mercy of it. There are lots of things you can do to influence the intensity of it and bring the intensity of that down, so that you can function at your best. You know, we can use that threat response, that stress response, to our advantage, and, and it helps us to, to stay alert, to perform, to do what we need to do, to survive, all of those things. But we have to sort of understand the system and work with the system rather than against it. So, if we try, like any other feeling, if we're trying not to have it, and we're trying to squash it or numb it out, then it, that's gonna cause more problems than if we allow it to be there and use it to our advantage.
- CWChris Williamson
What about the opposite? Let's say that somebody was feeling anxious and you wanted to prescribe them a way to make that feeling be as intense as possible, to last for as long as possible. What, what would you get somebody to do, that was feeling anxious, that could make it worse?
- JSDr Julie Smith
Well, that's interesting 'cause there are lots of things that we do that we think make anxiety better, but are actually making it worse. And, uh, th- the number one thing I would say there is avoidance. So, when we feel anxious, our body is telling us to escape and then avoid that thing, right? Because that's how our brains are set up to, to help us survive. And, and that works, right? If, um, if you're in a situation where there is a threat to your survival, it makes sense that you get out of there, get safe, and then don't go back. But in today's society, and where there are lots of psychological threats, your brain works the same. So, if there's a threat to, um, uh, maybe a, sort of, abandonment or rejection, or, um, if you feel that you're gonna be humiliated in, in a situation, um, you have that same response. Your brain says, "This is not safe. Uh, y- you get out of here and you don't go back." But if you do that with your workplace, or social situations, then you don't end up building your confidence in the work situation. You, if you avoid it, uh, it gets harder to go back, right? It gets, it builds up, that an- anxiety, even more. So when we avoid the thing that we fear, the anxiety gets worse over time. And, and often that's why, you know, in treatments, exposure, or graded exposure, is part of, um, overcoming all sorts of anxiety disorders.
- CWChris Williamson
I think people presume that exposure therapy is for a fear of snakes, or something like that, phobias. You know?
- JSDr Julie Smith
Mm-hmm.
- CWChris Williamson
Like real, in your face stuff. But the fact that it exists for emotions as well, for situations, that presentation you've got to give in front of the group, that boss that you hate having a conversation around. And I guess, you know, eh, to a more intense period, even just going out of the house, going to shops, stuff like that. I think a lot of the people that listen to this podcast will be, eh, high functioning individuals. There'll be people that are doing really well. But if they look back to, whatever, five or 10 years ago, and they didn't have the tools that they have, and they realize just how fragile they were at that point, you go, "Well, hang on a second. Yeah. This is, th- there are complete gradients to this, and everybody is always playing at the level that they're at now."
- JSDr Julie Smith
Yeah. And, and that's where we can really learn from all of these incredible tools that are taught in therapy. They're also helpful for everybody else, uh, um, who may not be in therapy, or may not even feel that they need therapy. Actually, if, if there's something you want to master and it makes you nervous, do it as much as you possibly can. Uh, the only way to build your confidence in something, or to reduce your anxiety about something, is to do it more, and more, and more. And, you know, the things that we do every day become our comfort zone. So, if, if you're going to, um, you know, if, if speaking in public is gonna get any easier for you, the only way to do that is do that more often. But we do it in a graded way. So don't expect yourself to go and speak in front of 10,000 people and be okay with that. You build up to it. So you take, um, that, you know, that first sort of layer outside of your comfort zone that feels difficult, feels like a challenge, but is manageable. You do that, and you repeat it again and again and again until that feels like nothing really. It's just easy. And then, you know, then your comfort zone expands, and there's another thing that feels more of a challenge. So you do that. So you work up and up and up, and, and you sort of get closer towards those things that initially feel like a worst case scenario. But when you get closer to it, it doesn't feel so extreme.
- CWChris Williamson
One of the nice things about making progress, I think, is that you can look back at the things that used to be a challenge to you, and barely even remember that they were something that was difficult. You know, you look at them now and it's just, uh, it's absolutely nothing. And yeah, I, I suppose that that exponential growth that you're talking about is precisely because of that. That it starts off with something small, and then you gradually take bigger steps. And then after five or 10 years of doing personal development, you look back and you go, "I can't even believe that, that, I, I, I don't even think about that thing anymore."
- 11:24 – 16:32
Breaking the Cycle of Anxious Thoughts
- JSDr Julie Smith
Yeah.
- CWChris Williamson
Given the fact that thoughts a lot of the time, especially anxious thoughts, cause us to obsess and mentally do thought loops around them, wh- what's a solution to break the cycle of anxious thoughts?
- JSDr Julie Smith
Well, I guess, eh, first of all, uh, the, the don't do is don't try not to have them. You know, if we're, if you're trying not to think about something, you're already thinking about it. And so, uh, if we, you know, thoughts arrive in your mind because your brain is constantly taking in information from your outside world, and then offering up to you ideas of how to interpret that. And, and they are ideas. They're theories, they're concepts, they're stories. Maybe they're influenced by memory as well, a lot of the time. And so, that's where they are one possible perspective. And so, the way that we kind of then shift our relationship with those thoughts is to understand that and acknowledge that even as thoughts arise. So-... you know, one big sort of, sort of biased thought pattern you would have when you're anxious is catastrophizing. So, your mind goes to the worst possible case scenario, and it plays out for you in your mind like a horror movie on repeat. And, and i- i- that becomes the idea that, "This is gonna happen because I've thought it now." And we kinda take on that thought as if it's absolute truth, and we run it over and over again. And then our anxiety gets worse and worse and worse. But if we acknowledge that thought as a catastrophizing thought, which is a bias, right? It's, it's your, your brain offering up the worst-case scenario because you're already feeling anxious, then we take some of the power out of it by acknowledging that it's not a given fact. It's not the one true reflection of reality. It's one possible way of looking at this, and there are others. So, by doing that, you're just stepping back from it, and you're allowing yourself the possibility of seeing things from another perspective. But without that, it's, you know, if we just accept every thought that arrives as fact and a true reflection of reality, then it has much more power over how we feel, then what we do and how we behave, and all of those sorts of things. So, um, I think it's about shifting your relationship with thoughts, not trying to stop them from arriving, but allowing them to arrive, and then seeing them for what they are, which is one story.
- CWChris Williamson
Why do you think catastrophizing would be adaptive?
- JSDr Julie Smith
Uh, because if you're in a, a, a dangerous situation, you know, if we kind of, you know, go back, uh, a thousand years an- and, and you're in a dangerous situation, then if you cannot predict what might happen in this situation, then you might miss something and you're outta there. You know, you're gone. So, actually, i- it is your brain working at its best to keep you a- You know, your brain's sort of main function is not to keep you happy and calm. It's to keep you alive. So, it's there to tell you, "I know what, you know, the worst possible thing that could happen in this situation. I'm gonna present it to you." And then our job is to work out, "Is that likely? Are there other perspectives here? And, and then what am I gonna do about it?"
- CWChris Williamson
So, it's kind of like the, the negativity bias, but projected forwards onto events that haven't occurred yet in an attempt to mean, uh, uh, make sure that we are regularly not going to push ourselves towards something that may end up killing us.
- JSDr Julie Smith
Y- yeah. So, uh, you know, if I go up, uh, onto, um, the cliffs by the coast and I'm walking with my children, and my chi- I'm, I'm already aware by the time we step out the car, and that the cliff's still 50 yards away, but I'm already thinking, "Someone could fall over the edge." And, and that is the way I keep my children safe, right? You, you go to the worst-case scenario and, and that enables you to act in a way that prevents that bad thing from happening. Whereas if you had never had the thought in the first place, you might not put the safety, um, behaviors in place. But I guess the, the trick there then becomes to, uh, to work out which of those sort of thoughts are warranted as a, as a, you know, something that may happen and is likely to happen, or something-
- CWChris Williamson
Small, small child near cliff, probably worthwhile thinking about.
- JSDr Julie Smith
E- exactly, right. And, um, but if it's a, if it's a different situation, um, if it's a, a, you know, I don't know, um, "Oh, ah, I've g- I've got pain in my leg. Maybe there's cancer there." You know, you kinda jump to that worst-case scenario, whereas the possibility of that is less likely. And, and so, w- we can never have certainty, right? It's always ideas that our brain is offering up to us. And, and we have to be able to tolerate that uncertainty of not really knowing exactly what's going to happen, um, but balancing our, our choice of behavior and safety behavior with how we want to live our lives. So, if I feel anxious about going to the supermarket, and the worst-case scenario is, you know, I'm gonna have a, a panic attack in there and feel humiliated, and from that I then make the life choice never to return to a supermarket, um, that's probably gonna significantly impact the quality of my life if I'm not able to get food when I need to and those sorts of things. So, um, it's, yeah, it's always making those sort of judgment calls around, when am I gonna respond to that feeling and when am I going to, um, choo- you know, make choices based on my values?
- 16:32 – 24:22
Can Depression Be Inherited?
- CWChris Williamson
Have you looked at the behavioral genetics stuff around depression and its heritability?
- JSDr Julie Smith
How do you mean?
- CWChris Williamson
So, the... It seems like the heritability of depression from parent to child is a lot higher than I would have thought. Not higher than behavioral geneticists would have thought, because they always knew that it was, everything's highly heritable. Um, but I just think about, you know, when it's the person that's terrified of going to the shops. That seems like such an extreme response, and it seems like the sort of thing that would almost be difficult to learn without being primed prior to that, without having a, a predisposition toward that. And it's just one of the things, since learning about behavioral genetics with Robert Plomin, who is the, kinda the granddaddy of it, a couple of years ago, it really has given me a lot more sympathy, I think, for people that have, uh, differing mental states. And that includes people that are unbelievably extroverted or confident or whatever, because a lot of the things that we have have just been imbued to us through our genes. But that, it doesn't really matter. Whether you do or don't have it, that's the game that you're playing. Those are the rules and the physics of the system that you're working within. You don't get to change that. From the moment that you're born, you don't get to change that. What you do get to change is the top-level stuff in terms of the input, in terms of the environment, in terms of blah, blah, blah. Um, but yeah, it just... The range of ways that humans can mentally show up doesn't surprise me, given the fact that we're so varied when it comes to our genes, our exposures, our environments, and all of that.
- JSDr Julie Smith
Yeah. And, and, do you know, I, I, as a psychologist, we always see, you know, those sort of genetic vulnerabilities as, rather than fate, potentials. And, and so, um, you know, you could come into the room and no one has any idea whether you've got a genet- genetic vulnerability to your situation or not.... so we work the same with everybody. So it's, you know, yes, if, if you have a genetic vulnerability or you don't, we can still impact on the expression of those genes through everything you do and everything you put into your life and everything you take out of it. And so, um, I think sometimes, the danger of, um, sort of making that the dominant path of, uh, a conversation in mental health is that people can feel hopeless about it, you know? That, "I've experienced, you know, bouts of depression throughout my life, therefore it must be inherited, and therefore I'm doomed to have it for the rest of my life." And actually, if that person was to go to therapy and learn some of the arsenal of tools that are available to, to prevent relapse for depression and to, uh, manage mood and, and ... You know? Those things can be transformative, and I've seen that. I've seen people sort of pull them back from situations that you would never believe people could pull themselves back from. And we have no idea whether they had the genetics for that or not. We just did the work and, and made the change. And so I-I think I have to, in my practice, believe that that is possible for everybody.
- CWChris Williamson
I think it's the same as the broken brain serotonin system that-
- JSDr Julie Smith
Mm-hmm.
- CWChris Williamson
... it's incredibly disempowering.
- JSDr Julie Smith
Yeah.
- CWChris Williamson
That was why I loved, um, Johann Hari's Lost Connections.
- JSDr Julie Smith
Mm-hmm.
- CWChris Williamson
It was the first book. I know that there's criticisms of that book and some of the research and stuff. But it was the first book that I'd read that put the lion's share of your mood in your hands.
- JSDr Julie Smith
Yep.
- CWChris Williamson
And I just found that to be, as somebody who was suffering from depression throughout his 20s, I thought it was so great to hear that.
- JSDr Julie Smith
Yeah.
- CWChris Williamson
Because it made me think, "Okay," like, "I've got control over this."
- JSDr Julie Smith
Yeah.
- CWChris Williamson
And, yeah, the same when people walk through the doors of your practice, you know? They need to, they need to believe that they can walk out of there making changes, and they can. I mean, you know, I've had some friends that have been in some pretty dark places, and then they've put the work in, and they come out the other side, and they're unrecognizable. You go, "If that guy can do it, if he can turn it around, then I'm, I'm pretty sure anybody can."
- JSDr Julie Smith
Yeah, and I think in some ways that's been the, the bulk of my work clinically, has been, um, seeing that transformation in people where they arrive in the therapy room believing that, um, they're getting something wrong about life and that they're not, um, th- they're not doing things in the way that everybody else seems to be because they feel terrible, and feeling that they have no real control over that. And, and once they learn that there are things that can really, really help, um, and, you know, some of it's more difficult than others, but actually there are some sort of pretty simple things you can put into your life and make sure you prioritize that can make a huge difference. And, and once people, you know, realize that potential to have some more of the sort of locus of control within themselves and their own choices, um, it- it's just transformative for, for so many people. And, and that's really why I started sort of sharing videos and writing the book and that kinda thing, was to just make some of that, um, education available to people.
- CWChris Williamson
How is stress different from anxiety?
- JSDr Julie Smith
(smacks lips) So, um, when, when we come to sort of stress and anxiety, it's really about how we conceptualize those experiences. So, we have that, that one threat system that we... You know, everyone talks about the fight or flight. And we talk about that when we, we are often discussing kind of anxiety. Uh, but I l- I sort of, I love the, the sort of concept of, uh, let's say, let's say you've got a meeting at work, and you've got an hour before then. You really need to go to the post office so you dash down there. You, you get there, and you know you've got just enough time to, to post that thing and then get, get back to your meeting. But you arrive, and there's a huge line. There's a huge queue that you've gotta get into in order to, um, you know, post your parcel. And you immediately feel this rush of, uh, you know, your heart's pounding, sweaty palms, and you're suddenly hyper-alert. "Am I gonna get back in time for my meeting?" A- and what you're, what's happening there is your brain is increasing your level of alertness. It's- it's using that stress response to enable you to reprioritize if you need to and think about, "Do I need to be here, or do I need to go back and make sure I get to that meeting in time?" So, it's really, um, you know, we would conceptualize that sort of situation as stress, I would say. When we talk about it and use the word anxiety, it might be similar physical sensations, you know, the sweaty palms and the heart pounding, but it's generally going to be more associated with, uh, a threat. So, you know, maybe you were due to speak at that, you know, work meeting in front of 100 people, and you would be absolutely humiliated if you were gonna be late. And so, you know, the idea of public humiliation would fill you with what you would probably call anxiety. You know? That it just feels sort of more threat, threat-based. Um, and so, you know, I think there's, there's still a lot of sort of work going on about understanding whether those two responses are very different biologically, or whether we can find those markers. But I think, really, it's how we conceptualize it. And often when we talk about, um, stress or anxiety or any other feelings, a lot of people ask me, "How do I know if I'm feeling this," or, "How do I know if I'm feeling that?" And often the answer is, it really doesn't matter. If you're feeling something and you give it a word, you give it a label, that's already helping you to cope with it. Whether that label matches other people's label for their feelings or not is not so important. If you're able to give words to how you feel and label those things, um, then you're already helping your brain to sort of process it and understand it and predict, um, what that means for you in the
- 24:22 – 29:48
Recognising Emotions & Thoughts
- JSDr Julie Smith
future.
- CWChris Williamson
I heard about young kids in primary school being taught mindfulness practices, and I think that they were naming them as kind of different characters.... Mr. Blue, or Mr. Green, or the, the nasty pirate, or something like this. And you're right, w- it kind of shows, "Oh, how stupid. The kids are naming their emotions colors, or about pirates." But there's nothing that's inherently any more virtuous about that word than calling it stress or anxiety. The, the, the choice of letters that represent the emotion is totally arbitrary, and-
- JSDr Julie Smith
Yeah.
- CWChris Williamson
... the distancing that you get, this is the beautiful thing of noting when it comes to meditation. You notice a sensation arise in consciousness, you note the fact that it has arisen, and then it falls away. It's the noting-
- JSDr Julie Smith
Yeah.
- CWChris Williamson
... fact that actually matters, it's not the words that you give it.
- JSDr Julie Smith
Yeah. It, it's just like the sort of thought bias labeling. By just giving it a label, what you do is you step back from it. You get a bit of a kind of bird's eye view, which enables you to see it for what it is, which is not who you are, it's a sensation, it's an experience that's sort of washing over you, if you like. And, and by doing that, we're... I mean, um, in the book I talk about, um, the, the... it feels like such an old movie now, but I remember the Jim Carrey movie, The Mask. And, and he kind of... it looks... the, the mask looks like nothing, it's just this kind of old wooden mask. But when he holds it close to his face, it kind of grips around the back of the head, and then it impacts on everything he does, everything he says, everything he feels. And, and it's a bit like that with, with thoughts and emotions. When, when they're sort of here and we can't see anything else, a- and we just absorb that as, that, you know, "That is fact. This is all I'm willing to see and feel," then it impacts on everything. And the idea of kind of giving something a label or, uh, stepping back from it and observing it, so observing that it's an experience that's washing past us. It's like, you know, when Jim Carrey kind of takes the mask off and he just holds it at arm's length, it's just a mask then. It's, it's no longer got the same power. It's still in his hand, it's not far away from his face, but it's just enough distance to give him that perspective to see the thing for what it is.
- CWChris Williamson
I think one of the most important things I've learned about reframing stress, uh, uh, and I guess you could call it anxiety as well, is how much of an effective performance enhancer it is as soon as you stop judging yourself for fearing it. Some of the best performances that I've had, whether it be on the podcast, whether it be at work in my previous job, has been geared by the fact that I'm stressed by it.
- JSDr Julie Smith
Yeah.
- CWChris Williamson
Like, unbelievably stressed. But a lot of it, i- i- if you can learn to be excited by it, and I actually have now. I've got a couple of big things coming up over the next couple of weeks that I'm going to be borderline terrified to do. But there's a part of me that can't wait for that. And I was never an adrenaline junkie.
- JSDr Julie Smith
Yeah.
- CWChris Williamson
I'm not a riding motorbikes and jumping off cliffs, and stuff like that. I'm not, not one of those people. But one of my friends, Bridget Phetasy s- uh, she's a female comedian, and she has a little mantra that she gives herself before she goes on stage. And she says, "I'm not nervous, I'm excited. I'm not nervous, I'm excited." And that reframe for me as well is, "Look, I'm not stressed, I'm excited. I'm not anxious, this means something to me."
- JSDr Julie Smith
Yeah.
- CWChris Williamson
And all of those opportunities, you know, it doesn't matter how many cups of coffee, or nootropics, or special combinations of vitamins I take, I can't replicate the amount of focus and attention that my body's gonna give me by it dumping tons, and tons, and tons of neurotransmitters and hormones into my body. So, I should be thanking it. I should be going, "Look, yeah, it's narrowing my focus, but it's narrowing my focus 'cause this is the thing that I'm focused on."
- JSDr Julie Smith
Yeah. Yeah, absolutely. And it's, it's such a great example. I mean, that's an example of sort of reframing. And, and, again, when we were talking about, um, you know, can we change the mind with the mind and stuff like that, and I think that's an example of when you can.
- CWChris Williamson
Good point.
- JSDr Julie Smith
That, um, you know, you could do all of these sort of, you know, breathing exercises, but if your main aim is to just get rid of that uncomfortable feeling, then you're going to lose. You know, you can, you can bring down the intensity of it, but if you're, I don't know, about to go on live TV, you're gonna feel anxious. It's all brand new to you, and it- there's an intimidating situation. And there is genuine threat that if you don't stay alert and do the job you need to do, you could be humiliated, or you could be upset about it. So, you need that stress. And I think that's where when we change our relationship with uncomfortable feelings, whether that's stress, anxiety, sadness, whatever those sort of uncomfortable feelings are, if we're willing to have them and use them to our advantage, and take them with us, um, then they don't hold us back. You know? And, and when I talk about the sort of TV example, when I, uh, I did that recently, um, I, I felt that stress, and I acknowledged that was gonna help me do a good job, so I took it with me. I didn't, I didn't try to get rid of it. I used the sort of breathing techniques to keep it at a level where I could focus. I noticed a catastrophizing thought, said, "This could go really wrong."
- CWChris Williamson
Might fall over.
- JSDr Julie Smith
And then I brought myse- (laughs) yeah. "This is gonna go terribly wrong." Uh, and then you, you know, you notice it, and then that enables you to let it go and refocus on the thing at hand. So, you know, if you're willing to have that feeling, it will take its natural course, which is to rise and then fall again.
- 29:48 – 41:11
Social Media & Smartphone Usage
- JSDr Julie Smith
- CWChris Williamson
Do you suffer, or have you suffered more with any self-doubt or with dealing with criticism now that you've had all of these extra eyes on you? Obviously going on TV and talking, and then, I mean, TikTok, I wouldn't like to guess how many millions of people you're reaching every month on there. Is that something that's arisen for you, or have you been able to cope with that?
- JSDr Julie Smith
Yeah. I mean, it's, it's a human thing, isn't it? And I think that's what I say about a lot of these tools is, um, they don't make you invincible. They don't ensure that you're gonna have a problem-free life, and you're never gonna be touched by, by doubt, or grief, or stress ever again. They are tools to apply to those situations that you will inevitably face, because they are part of life. And so, um, yeah, I mean, throughout this whole... I, I've never had any ambitions to be a public person. I, I just started sharing the educational aspect of therapy, because I thought...... actually, everyone's finding this really helpful. Let's make it available. Why should people have to pay to come and see people like me to find out basic stuff about how their brain works? And so, I wanted to sort of make it available, but yeah, I mean, then, you know, quiet little introvert who's used to working in a room with one person at a time, that was pretty kind of exposing, and, and you know, you sort of, uh, you then are forced to use the tools and practice what you preach because, you know, putting yourself ... I mean, you probably understand as much as, as I do, you know, putting yourself out there will, um, kind of expose any sort of insecurities, or it will, it will sort of invite that voice of self-doubt, self-doubt to creep in. Um, so yeah, I've had to, you know, use the tools as much as the next person.
- CWChris Williamson
You are spending at least a portion of your time on TikTok, making sure that the videos look right, that they've gone up correctly. You're probably checking comments to see what do people think, what are the issues that they're coming up against, ideas for the new videos, and such forth. How are you mediating your relationship with technology, with social media, with the supernormal stimulus mechanisms that it's giving us, uh, to ensure-
- JSDr Julie Smith
Yeah.
- CWChris Williamson
... that it doesn't, uh, impact your mental health too much?
- JSDr Julie Smith
Um, I've had t- uh, I think something that's hugely helped me is that I had this clear reason for starting that was just to be helpful, and to make some of this really incredible information that's available in therapy available to people who might not have access to therapy so that they could enhance their own mental health. And I h- uh, it's been my mission all the way along to stay close to that. So, you know, each video had to have some thread of value in that fr- so whether it was very entertaining and engaging or not, um, it had to have some level of message there that could be helpful to people and sow a seed. So, um, that's helped a lot, because it enabled me to, um, not worry too much about how I looked or whether it, you know, uh, sounded right, or, you know, those kinda things that, um ... a- especially as, as a female online, there's huge pressures to, um, you know, look certain ways and to sound certain ways and, and all of those sorts of things. So, it always enabled me to sort of come back to that. Whenever those sort of pressures creeped in, I was able to come back to, this is the reason I'm here, is to be helpful, um, that kinda thing. So, I think that always helps me. Um, I think also that I started this a little bit later in life as well, so that I, I already had a firm sense of who I was, or who I am, and, um, my values in life. So, always coming back to what matters most to me. Uh, I'm a parent, so having, you know, uh, children and understanding ... I think I always try to shift to, uh, even when I'm in a difficult scenario, what would I want my children to have the strength to do or believe about themselves in this situation? Um, because I know that they won't do what I say, they'll do what I do. So, I have to live that if I want them to, you know, be confident and to face uncertainty or face criticism with, with self-belief. Then I have to sort of live that out for myself as well.
- CWChris Williamson
One of the things that I've reframed recently around smartphone use was, from it being an addiction, to it being a compulsion. And I think if I actually look at the behavior, for most people, including myself, overusing your smartphone is a lot less like an addiction and a lot more like compulsive behavior. You pull your phone out of your pocket without thinking about it. You're already moving your fingers around the screen without even thinking to the place where you know the thing that you want, that you need to get. Now, yeah, sure, perhaps the reward mechanism that's pulling that through is dopamine-
- JSDr Julie Smith
Mm-hmm.
- CWChris Williamson
... uh, and, but it, it does feel a lot more like a compulsion, and I think that even though this is, again, arbitrary, like we said earlier on, reframing the terminology that you use from addiction to compulsion has really changed ... Uh, this only happened over the last couple of months perhaps, but it's really changed the way that I see my ph- my smartphone use. I think, look, it's just compulsive. You know? It's the same way as if ... Because I spent so long, I did five years at uni and whatever, t- uh, 11 years in full-time education before that. If I put a, a pen in my hand, it starts spinning through my fingers. I don't think about it, and I, I, unless I think about stopping it, I can't stop it. Why is, why is-
- JSDr Julie Smith
Yeah. It's habitual.
- CWChris Williamson
Yeah. It's just a compulsion.
- JSDr Julie Smith
Uh, yeah, yeah. I mean, uh, 'cause I, I, I guess, because of my clinical work, I work ... I sort of have a, uh, a slightly different conceptualization of, of compulsion in the sense that, so within OCD, for example, th- that compul- compulsion is the thing that you feel you have to do because if not, then something bad is gonna happen. So, it's often based on a kinda threat response. But, you know, I would certainly definitely see that that sort of, um ... it could even be the case actually with, with a ph- with a phone that if I don't take my phone with me ... I, I mean, I have that. If I, if I, even if I go out for a run, if I don't take my phone with me, what if, what if something happens at home and, and my husband or the kids need me? And you know, i- i- it could be 20 minutes before I get back (laughs) and you kind of ... And, and, but you know, it wasn't that long ago that that was just something you did. You know? People could live without you for half an hour and, and get through it. But there is that fear of, if I haven't got ultimate connection to everybody I know, something could happen and I won't know about it. There is something about that. And then, then there's a sense of freedom. You know, if you go somewhere and you lose all signal and your phone's just, you know, obsolete, then there is a sense of sort of relief and freedom from that, isn't there? That there is this sort of fear of wha- if I miss something, if I miss an email that's really important, what's gonna happen? And if I, you know ... Um, so maybe there is an element of that, um, but also there is that habitual thing of, um, you just pull it out your back pocket 50 times a day and glance at it because you have been doing that for five years or whatever.
- CWChris Williamson
That's why I don't understand people that go on planes and then connect to the wifi.... you have the opportunity now-
- JSDr Julie Smith
Yeah.
- CWChris Williamson
... of being completely liberated from access to the outside world for-
- JSDr Julie Smith
Yeah.
- CWChris Williamson
... three to 10 hours or something. Uh, that, for me, is bliss. You c-
- JSDr Julie Smith
Yeah.
- CWChris Williamson
... load up a bunch of stuff onto Kindle, read through some things, listen to a podcast, make some notes about stuff. That- that's my favorite time. But yeah, I think, uh, it's very strange the fact that we feel, we, we feel like the world is so interconnected and even safer now than it was 20 years ago. And yet, we, there's this ambient level of anxiety that we need to constantly be contactable and available. Um, there, there's another concept that I loved actually by a guy called Benjamin Hardy, and it's called the gap and the gain. And I've been thinking about this a lot as I was going through your book. So, he talks about the gain being you comparing the place that you're at now to the place that you were at previously, and the gap being you comparing where you are now to the person that you want to be. And he writes about most people live in the gap rather than the gain. And he says it's like running toward the horizon, that every time that you take a step toward it, the horizon moves one step further away. And it- it just made me think that I think a lot of the, a lot of the messages that we get about self-worth and w- what success looks like, especially from social media, is inevitably comparing, uh, living in the gap. It's living in that difference between where somebody else is. And this was really highlighted when I did my first Thanksgiving here in America, uh, in November. And it's, uh, an entire day that's built around gratitude. And you go around the table individually, and you sit there, and you say, "So, so what are the things that you're most grateful for? What were your hugest wins this year? Why are you so happy about things at the moment?" And, um, all of that together just s- it really resonated with me. I think that that's something that a lot more people should try and bring into their life, that model.
- JSDr Julie Smith
Yeah, and I think, uh, it's a lot of what happens in therapy actually is, um, is getting a balance of those things. So sometimes someone will have, um, just a, a natural sort of habit of doing one or the other. And- and what we do is we often notice it. So we'll- we'll- we'll look at a pat- "Oh, look. You know, you keep going there. What's the impact of that?" We'll step back from it, observe it, and then try the opposite and see what the impact of that is. And so we're never trying to completely not do something or only do the other thing. Actually, there's merit in doing all of those at different times with a certain, um, if- if they're constructive. You know, if- if there's a certain goal in mind. So, it is helpful to look back and say, "Look how far I've come." But it's also helpful to look forward and say, "Okay, where next?" And it's often with what sort of flavor are you doing that? You know, are you, are you constantly saying, "I'm not, I'm not there yet, and I'm not there yet." And then therefore you're sacrificing how you feel today and- and being present and potentially being happy in the moment. Um, or are you, are you saying, uh, "You know, uh, that's where I'm aiming for, and here's where I've been. Yes, I'm on the right path. This is what's next." You know, without that, without, um, filling it with kind of self-loathing or self-criticism that- then holds you back. It's always looking at ... I mean, I love looking at all of sort of the psychological work with sort of sports psychology in mind a- and professional athletes, you know. And if you think about, I don't know, we've just had Wimbledon here in- in London, and if you think about a professional tennis player, they will do exactly that with a coach. They will, they will look at how far they've come and- and they will look specifically at what has helped them to come that far, so far and what they need to hold onto. And then they'll look at where they want to go next, what the hurdles are, and how to break those down, and what strengths are gonna help them to get there. And so it's always just balancing those, but I think the key to having that balance is being aware of what you're doing in the first place. It's all about awareness. It's noticing. So rather than being stuck in your head, it's sort of watching what happens in your head, saying, "Oh, wow, look. When I'm constantly thinking about that past event, then I'm held back." Or, "When I'm constantly moving the goalpost for my future, I'm actually, I'm not living in the present and I'm really unhappy." Or, you know, it's- it's only by- by getting that bird's eye view of everything, including what's happening in our own heads, that we can kind of see a way out.
- CWChris Williamson
Talking about
- 41:11 – 51:03
Coping with Bad Days
- CWChris Williamson
things from the past that keep coming up. How can people not be too defined by previous mistakes?
- JSDr Julie Smith
Um, I think y- you know, when it comes to the mind sort of going back and- and that tendency to ruminate, you know, rumination is one of the, uh, big sort of maintaining factors for depression. And- and, um, you know, it will sort of predict relapse and those sorts of things if you have that tendency to go to the past, something you regret specifically, or- or, you know, a painful experience, and then just churn it over and over again. And so that kind of ruminating that happens. Um, I think, again, there is that element of awareness, so being able to notice when you're doing that so that you can choose whether to keep engaging in it or whether to step back and do something different. And, you know, sometimes people will- will employ a really kind of simple tool where once they've noticed that they're doing that thing, they- they literally kind of say, "Stop." And they- they, you know, put their hand up and they say it out loud, and then they activate and they do something different. They move on and they focus on something in the present. So that might be, you know, could be any activity that sort of grounds them in the here and now. Um, or movement and exercise is great for that. That shifts you into your body as opposed to your mind and those kind of things. So, um, but- but yeah, I mean, uh, rumination is, uh, about sort of past events is, uh, a- a really big predictor of, you know, sort of relapse for depression, so it's really important to- to tackle that.
- CWChris Williamson
Given the choice between getting a night sleep or going to the gym in terms of resetting my mood, I would choose going to the gym. I think that I-
- JSDr Julie Smith
You would?
- CWChris Williamson
I have more bleed from night to morning than I do from pre to post-workout in terms of-
- JSDr Julie Smith
Yeah.
- CWChris Williamson
... the way that I am. And-
- JSDr Julie Smith
Yeah.
- CWChris Williamson
Yeah, I think that it's not for everybody, but it, uh, far more people than we'd realize it. That if you go and play a game of...... tennis badly, uh, or something, even with just a friend, like try and focus as you're trying to hit the ball desperately across the court. The fact that you've got something in your hand, it's tactile, there's smells, there's sounds, you're moving, you're sweat. Like just that I think is such a big element of it. And that's what I appreciated about Huberman's work that, yeah, maybe, maybe I think that y- you're probably right on balance that there are elements, especially if you look at CBT and how effective that can be for people, like that is about reframing. You know, I'm not f- I'm not doing a CBT with my hands.
- JSDr Julie Smith
(laughs)
- CWChris Williamson
Um, but that, the definitely getting into the body is something that's interesting.
- JSDr Julie Smith
Yep.
- CWChris Williamson
Another interesting thing that I liked that you did was you talked about turning bad days into good days. And this was something that I was doing when I had low mood throughout my 20s that one of the, the wins that I would put down in my journal was that I had a good bad day. Uh, and it was so funny to see that pop up in your book as well.
- JSDr Julie Smith
Yeah, I mean, I, uh, there's a whole sort of, uh, you know, section there on, uh, you know, shifting from those bad days 'cause often there's that misconception that if you're working on something, that every day should be a little bit better than the last. And, and often, e- this is a, it's a classic sort of example of something that will happen in therapy. Someone will start making progress quite quickly, and they'll see a bit of change just from the fact that they- they're coming to appointments, and they're talking openly, and, and it feels safe and those kind of things. And then, you know, things will happen because life happens, right? And, and you have a bad day or a bad week, and then they feel low. And, and you tell yourself when you're in that place, "I'm back where I started. I'm, I'm back at square one. I've got to start all over again." And, and half of the sort of lesson that you learn is you're not back where you started. You can't undo the progress that you've made so far. Part of that journey of, of being well is having bad days and then bringing yourself back to baseline and, and back up. And, and so, you know, it's not that you work on something and then every day is just neutral and fine. It's that, that you learn these skills to be able to sort of haul yourself back up when you've had a tough day because you know the things that work, and you know the things that will keep you stuck. Um, so it's all about sort of having that awareness of yourself and what works for you so that you can respond to those bad days rather than never having them.
- CWChris Williamson
What about mood pitfalls that people should look out for?
- JSDr Julie Smith
Um, I think, uh, yes, movement is a, is a huge one. And, and actually i- i- in the, you know, when I've worked with people who have, uh, severe depression, um, often in e- in sort of acute hospitals and things, um... At one hospital I worked at, we had the, the, the benefit of having a, a lovely garden, and, uh, in appointments with people, I would, would start by walking around the garden with them as we talked because simply getting your body moving starts to shift things. And it starts to, you know, it doesn't take all your problems away. It doesn't change your, your situation, your circumstances. But it starts to shift your biology and can bring someone to a level where they're more able then to engage in the more complex psychological stuff that's gonna help them longer term. So, you get this incredible shift from, from any form of exercise. And I think it's a, it's such a shame that exercise has been sort of over the years made to seem like it's supposed to be just this ultimate graft where you put yourself through grueling pain in order to look different and be more, you know, aesthetically pleasing to other people because it creates this sort of impression that exercise has to be that way. Exercise can be putting on music and dancing around your kitchen with your family. You know, you can be moving your body in any sort of way, and that's going to help. It's going to, to, uh, m- make your... It's gonna shift your biology. It's gonna shift your, how you feel, um, all of those sorts of things. So, uh, you, I think part of the work that we do is, is helping people to increase their level of movement, um, without it feeling like a chore or something that you've got to endure because when you're already enduring depression, that's, that's enough already.
- CWChris Williamson
I suppose as well there's the f- brutal feedback loop when it comes to mood, that low mood causes people to move less, to do less, to not eat, to not contact other people, which then creates a cycle of worse mood, which is that sort of ever-increasing spiral.
- JSDr Julie Smith
Yeah, absolutely. You get stuck in that cycle of w- you know, low mood gives you the urge to do the things that keep you stuck. So, it will, you know, you'll wake up for whatever reason. It could be, it could be anything that's induced that low mood. It could be, could be something huge like grief, or it could be something like, um, you know, y- you're, you're dehydrated or your child was up a couple of times in the night and so you haven't really had enough sleep, and so you wake up feeling groggy and low. And then you have the urge to call in sick or, um, you know, not meet your friend later on or skip the gym or do all of those things. And you, so you have the urge to kind of close everything down and avoid doing the things that actually in the long term are gonna help you. Um, just being aware of that, again, just knowing that increases the chances that in that moment where you get to choose, you could choose the right thing that's gonna help you in the long term. You won't always, right? Sometimes you'll still go around that cycle, and you'll kind of, you know, suffer the consequences of that moodwise. But sometimes you'll, you'll acknowledge, "Yes, I know that I have the urge to y- not answer my phone to my friends and family when I'm low, but I know where that leads. So today I'm gonna force myself to do it." And then you get the benefits of it.
- CWChris Williamson
What have you come to believe about what a meaningful life consists of?
- JSDr Julie Smith
So, uh, that's a sort of a fairly big, uh, section of the book, and, and it's something that's o- often looked at in acceptance and commitment therapy. Um, I find that a lot of people who come to therapy with...... a limited idea of what's really going on. They'll say, you know, "I, I'm okay, but everything just feels a bit empty. I feel a bit lost. I'm just not really sure where I'm going. There's just no meaning in anything." S- so many times that has happened where life has pulled someone away from what's meaningful to them and what matters most to them, because that's what happens, right? You know, and, and so in therapies like ACT therapy, acceptance and commitment therapy, you just help someone to get clarity on what matters to them and what, what their values are. And that can be quite sort of crudely done. You know, you can write things down on a piece of paper, split your life in, into the different areas, you know, maybe intimate relationships, family relationships, parenting, career, learning, creativity, faith, all of those different things that fill people's lives. And you just write down words, bullet points, ideas, not what you want to happen to you, but the kind of person you want to be in that area of your life through good times or bad. How do you wanna show up? How do you wanna show up as a parent, a colleague, a partner? All of those kind of things. So, it's not a goal that you achieve and then it's done. It's a path that doesn't really end, but you always try to steer close to it. Um, and when you do, when you do this kind of exercise and these kind of values check-ins I put in the book, you, you... okay, you acknowledge, "These are the things that are important to me in this area of my life, and how a- how closely am I living in line with those at the moment?" And if, if the answer is, "Not very much," so if you rate it as really high in terms of how important it is to you, but i- in terms of living in line with it, it's pretty low and there's that gap, it just gives you that indication that you can shift direction. And it might be some small decisions that you make about your day-to-day life that shift that direction so that you feel you're living more in line with the person you want to be and the life that you want to live and the contribution that you want to make.
- CWChris Williamson
A lot
- 51:03 – 55:50
How to Make Large Life Changes
- CWChris Williamson
of people, I think, feel like they have control over the, the surface level stuff that they do, so their maybe habits and the way that they show up on a daily basis, but not the larger direction that their life is, is moving in. What about making large, meaningful changes in life? Is that simply a case of day-by-day steps, or is there, is there something else missing from that?
- JSDr Julie Smith
Um, well, I guess, you know, you can make huge, big, life-changing decisions, um, but often, often, they're broken down into those smaller steps, aren't they? And, and, and actually when you're looking at, um, uh, life decisions in terms of y- your mental health, we, we alwa- that's why, that's why people get so frustrated with therapy, that it takes a long time, right? Because that's how we work. We don't, we don't often sustain big, grand changes and gestures that, that are life-transforming overnight. We... The, the changes we can sustain are those smaller ones that, that enable us to, um, make a, make a shift that we can sustain every day, and then once that becomes habitual, then we can keep that going and without too much effort, and then we can shift onto the next change. So, we create big change m- most effectively and sustainably with lots of small changes that add up.
- CWChris Williamson
I certainly see that in myself. The person I am now versus the person that I was 10 years ago, five years ago, even three years ago is very, very different. And that... I- i- it's so strange how change works, that it does creep up on you. We actually don't-
- JSDr Julie Smith
Yeah.
- CWChris Williamson
... realize that it's happened until you one day... som- something causes you to reminisce about the way that you would have dealt with something previously or about a memory of a situation that you managed to get yourself into and the way that you responded to it, and you go, "I, I... It's really kind of hard for me to recognize that person and that mental state." I always thought it would be cool-
- JSDr Julie Smith
Yeah.
- CWChris Williamson
... if you could, um, take snapshots of the mind in the same way that you can take a photograph, and then you could go back and visit the old texture of your mind from five years ago or 10 years ago because it would be so stark the difference. The things that would've captured your attention, the thoughts and the concerns that you would've had about yourself or the world or whatever, and now you're a million miles away from that. But it's hard to go back and remember that because you're not that anymore, and there isn't that photograph for you to go back and d- and view.
- JSDr Julie Smith
Yeah, and it's, it's like, uh, sort of finding some old journal, isn't it? And then reading about the things that you were worried about, you know, 10 years ago or when you were a kid and you think, "Ugh," y- you know, it s- it seems like such a, a huge period of time between then and now, and, and actually, you know, it's a really useful skill to be able to create future self memories, so where you imagine yourself in the future, uh, in detail, and you look back at the choices that you're making now or are about to make, and you consider how you would feel about that. You know, what, what choices... If you're, if you're putting yourself into sort of five years from now, what choices would you be most proud of, and how would you feel about that, and what would be the focus of your attention, the main focus of your attention in the future self? And, and what, you know, what would you be like and why, and what choices would have held you back and what things would have propelled you forward and, and those sorts of things? And so, that can be really helpful, again, in focusing on the choices you're making today and making sure that they are benefiting you in the long term as opposed to, um, responding to how I want to feel today.
- CWChris Williamson
The best, uh, thought experiment that I think in terms of working out what would be a good way to spend your time or the things that you should focus on is to think, "Okay, at the end of this year, what would have had to have happened for me to look back on this year and consider it a success?" And that little bit of distancing, little bit of future planning, little bit of sort of reflecting, I, I did that with COVID, um, th- during the lockdown. "Okay, what would have had to have happened by the end of lockdown for me to look back and consider it a success?" And it was so good. It was the... By far, all of the planning, all of the journaling, all of that stuff was, uh, good for the daily practice, but in terms of big picture stuff, I just thought, "Well, okay, what, what would I have wanted me to do?" And it's you. It's you. You know, you know you pretty well. You know what you would've wanted you to do. Uh, but it's just that little bit-
- JSDr Julie Smith
Yeah.
- CWChris Williamson
... of distance. It's that little bit of future planning.
- JSDr Julie Smith
Yeah, and it, and it's so useful to be able to ask yourself in any difficult moment, um, “What response would I be most proud of in this situation? How can...” You know, and, and it, it sometimes just gives us that guidepost to, to shift our direction and, and behave and turn up in the way that we want to, um, as opposed to sort of reacting and feeling out of control.
- 55:50 – 56:26
Where to Find Dr Smith
- JSDr Julie Smith
- CWChris Williamson
Dr. Julie Smith, ladies and gentlemen. If people want to follow you online and check out the stuff that you do, where should they go?
- JSDr Julie Smith
Uh, either Instagram, YouTube, um, Dr. Julie, and, uh, yeah, sharing lots of sort of insights from therapy, um, that people can use in everyday life.
- CWChris Williamson
Julie, I appreciate you. Thank you.
- JSDr Julie Smith
And you.
- CWChris Williamson
What's happening, people? Thank you very much for tuning in. If you enjoyed that episode, then press here for a selection of the best clips from the podcast over the last few weeks. And don't forget to subscribe. Peace.
Episode duration: 56:26
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