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Wednesday, May 28, 2008


The new mental hospitals?

Here's something interesting: the novelist Hanif Kureishi has remarked that university creative writing courses are 'the new mental hospitals'. 'One of the things you notice is that when you switch on the television and a student has gone mad with a machine gun on a campus in America, it's always a writing student.'

Apart from Cho Seung-Hui, I wonder who he's referring to? Anybody know?

Kureishi actually teaches creative writing himself; his main objection seems to be that writing courses give the expectation that a writing career will inevitably follow. That, of course, may be the case - people generally don't join writing classes unless they're at least hoping for a writing career - but in a way, there's an upside to that. A writing course that explicitly promises fame and fortune is telling porkies, but a writing course that lays too much emphasis on the poor chances of publication is only going to discourage the students, including, possibly, talented ones. Of course, there's an old saying that if you can be discouraged from writing, you should be - but that doesn't free anyone from the responsibility not to be careless with people's feelings. I once had a teacher reply to a comment about being stressed by saying, 'Well, not everybody's cut out for the writing life,' which depressed me but didn't put me off; on the other hand, my writing did take a bit of a dip for a while afterwards. A teacher who's overly discouraging may actually hurt the pupil's progress. Ideally, you want a course where the emphasis is on writing as well as you can, for the sake of writing well rather than for career reasons; publication and writing are two separate things. It's helpful to be realistic about your chances of publication when you're sending the manuscript out, but if you're too grittily realistic while you're writing it, chances are you'll have a much tougher time finishing. There's a time and a place.

What I'm really curious about, though, is the 'mental hospitals' remark. It doesn't tally with my experience, and I've been on quite a lot of writing courses. I met one guy who was bipolar and wrote a lot during his manic phases, but that was about it - and that was in an adult-ed centre, not a university. For that matter, the only reason I knew he was bipolar was that he mentioned it when introducing himself; his condition was under sufficient control that he was perfectly able to act well throughout the course. The sickest person I met during a writing course was a housemate who, in retrospect, I'm fairly sure was suffering from undiagnosed depression; that person was a nightmare to live with, and eventually moved out accusing us of plotting against them, but they were taking an entirely different course that had no creative writing component at all.

I'm genuinely curious about Kureishi's different experience. It doesn't seem impossible; for one thing, artistic types are often at greater risk of things like depression (which, along with selective mutism, seems to have been Cho's problem, though it's worth pointing out that mentally ill people are statistically less violent than average, not more). For another, sick or unhappy people often do want to express themselves through art - and indeed, the concept of art therapy recognises that this can be very beneficial. If that's the case, then an arts course might naturally attract a higher proportion of sick students - and the best thing a university can do is be aware of that, make sure the teachers have a good relationship with an on-campus psychiatrist and tell them to keep an eye out for kids who need help. Some problems might get picked up and treated that way, which could only be to the good, given that most mental illnesses work by convincing the sufferer that the way they're feeling is entirely rational, and hence identifying the disease can be difficult.

I saw a documentary about Cho Seung-Hui a while ago, and writing does seem to have been part of it. He began with a degree in business information technology (what's the proportion of illness among engineers, I wonder?), but switched to English, where, almost unable to speak, he poured out his anger in some incoherent plays. After the documentary, I read one of them online, 'Richard McBeef', and while it's notably bad, even by slush-pile standards (and I've read more than one slush pile in my day), what stands out most is that, presumably because of his crippling social anxiety, the boy had no idea how people actually talk. It's an isolated piece of writing, the work of a boy overwhelmed by emotions he couldn't understand. His writing was definitely not saleable, and according to the documentary, a piece he sent to a publisher was rejected a little while before the massacre. Cho's graduation date was approaching, it looked like he wasn't going to make it as a professional writer and his selective mutism made for poor prospects in most other careers; it seems not unlikely that his murder spree was at least in part the extravagant suicide of a boy who couldn't think what else to do with his life.

None of which is any excuse, of course, but it is an example of a sick young man choosing a writing course because it gave him the chance to express emotions that he was unable to express directly. It seems as if the professors did try to help him, but in the end the sickness won - with help, of course, from laws that allow people whose mental health is in question to buy guns, a state of affairs that seems utterly unbelievable to anyone not raised on that right-to-bear-arms rubbish. The writing course caught his eye, but it didn't solve his problems, and thirty-two people were murdered.

So what can writing teachers be expected to do about this? Writing is by no means unique in attracting sick students; there are students on every kind of course, students are people, and people suffer from mental illnesses. (In fact, the statistics on depression alone suggest that 1 in 4 people will suffer from it at some point in their lives, and I've heard even higher estimates; depression is commoner than pneumonia, and is one of the most woefully under-taught issues in modern life; most people can't even recognise the symptoms properly.) In that sense, a writing teacher's responsibility towards sick students is no different from any other teacher's; people may debate how much a university should intervene, but I'd suggest that their responsibility is fairly high, even if students aren't a danger to others: many mental diseases can go undiagnosed for years, they tend to be exacerbated by stress and universities are stressful environments, and a teacher in loco parentis could save a kid a lot of pain if they send them to a doctor at the right moment.

Writing teachers face a particular difficulty, though: the illness may well show up in the work they're supposed to be assessing. Assuming a student isn't too sick to work at all, which should be obvious whatever course they're on, different kinds of brainwork can hide brain dysfunction to varying degrees. A sick mathematics student can probably do his calculations correctly even if he's contemplating suicide. A sick history student may turn in essays with a dark view of human nature showing through the analysis, but at least she has some facts to work on. A sick writing student, though, turns in work that's entirely patterned on the content of his or her own mind. Disordered thinking and damaged affect can't but be evident. In that situation, a teacher faces a number of problems. First, a decision: is this student unwell, or are they just unskilled? (Poor writing can make even sane people seem irrational, and there's a strong taboo against calling people crazy.) Second: assuming the student is sick and I can see it in his or her behaviour as well as the writing, how on earth am I supposed to grade this? Because here's the thing. Grab a maths student who seems to be sinking, and you can say, 'Your work's fine, Jimmy, but you look like you're dreadfully unhappy all the time. Have you thought of seeing a doctor?' But tell Jenny the writing student that she seems terribly unhappy and her writing shows signs of disordered thinking, and what she's most likely to hear is, 'The teacher doesn't like my work. I'm no good.' And that can lead to more despair and less help-seeking - because, after all, Jenny wanted an opinion on her writing, not her mental health, and that's what she was listening for.

If mental health really is a problem in writing courses, what teachers need are clear guidelines. Universities can be expected to have a policy on mental illness among the students, and those should be applied to creative writing courses just like every other course. Education about mental illness in general today is thoroughly inadequate; it's my view that the basics should be taught in school, at about the same age that kids get sex education - after all, the odds of a kid at least meeting somebody mentally ill during their lives are at pretty much the same level of them having sex, and ignorance can lead to non-diagnosis and tremendous, unnecessary suffering. If writing teachers are in a position to spot signs of sickness in their students, what they most need is a clear method of dealing with it. Teachers aren't psychiatrists, and can't deal single-handedly with a mentally ill student, but they're undoubtedly capable of dropping by the relevant office and saying, 'I'm concerned about so-and-so.'

And come to that, there are plenty of published writers, most famously J.K. Rowling, who have suffered from depression, and that hasn't stopped them from having writing careers. Mental illness doesn't preclude good writing; it's more a pastoral issue than a teaching one, in the end. And in that way, writing classes are no different from any other university course.

But are writing courses really full of sick students? Or was Kureishi speaking hyperbolically and just thinking about Cho Seung-Hui? I'd like to know - though, if he's observing teacherly confidentiality, I suspect I may not find out.

I don't have a lot of nice things to say about university creative writing programs, especially MFA's, but calling them mental hospitals is extreme.

Then again, everything else in that article was over-the-top, so I wouldn't take that mental hospital remark too seriously.
What's an MFA? We have different things over here...
My God, I could go on forever on this one... I'll try not to.

I've suffered on and off from depression since I was in my early teens and had a particularly bad patch at uni. This was reflected strongly in my writing, which generally focused on self-harm, suicide and other charming subjects. At least one of my tutors was aware of the problem and was very supportive. He never commented on the subject of my writing as being related to my depression, but he certainly knew.

In my first year I lived with a girl who, in retrospect, I think suffered either from some kind of autism or depression. She was paranoid, needy and completely unable to look after herself. She wrote very explicit pieces in which a small, blonde Jewish girl (which she was) was bullied by other girls she lived with at university. She even wrote a piece where a small, blonde Jewish girl murdered her housemates for bullying her. Critiquing that in class was ... um ... uncomfortable. She had virtually no self-esteem and I think she saw her writing (which was not good) as her one talent, so she poured herself into it and largely recieved only well-masked ridicule from the rest of the course. Which obviously just fed and compounded her problems.

I also lived with an overweight, sex-obsessed girl with an older boyfriend who only wrote about overweight, sex-obsessed girls with older boyfriends. By her own admission, she'd been on and off both antidepressants and cocaine for some time, she'd had several years of counselling and, again, she poured all this into her writing.

Throughout the course I also met a lot of narcissistic types (mostly poets, whether that's relevant) who looked down on the rest of us as not being "true artists" for whatever reason. I met painfully shy people who would produce the most amazing writing but would never say a word in class. I met some wonderfully talented, lovely people who I consider myself lucky to have met. But I will say that by and large, the younger members of my course all had emotional, personal issues of some kind that they often explored in their writing.

I personally think the reason for this is twofold: firstly you can hide behind your fiction. If someone asks you if you are the person in the story, you can say no.

Secondly, writing is incredibly theraputic. You don't have to share it with anyone, you can say whatever the hell you like and burn the paper afterwards if you want to. I've done it. It's a way of getting the troubling thoughts out of your head without necessarily confiding in another person who may judge you for it. I suspect that some (by no means all) mentally ill people gravitate towards writing because of this.

I really could talk about this for hours... I'll stop now though because I think I'm becoming incoherent!
Well, don't stop on my account, I'm finding it fascinating! :-)
I think you also have to be careful about labelling someone as mentally ill just because of what they're writing. I'm a horror writer and have written some pretty nasty, twisted stuff. I used to take college night courses in writing and I remember one of my horror stories evoking a harsh response from an old German woman who told me I was going to hell because of my story! I have to admit I was quite pleased. I'd never had such a vivid response to one of my stories! Maybe I'd feel differently if it was another topic but for horror, it was a great response! (I personally think the worst thing for any story is to illicit no response at all, either bad or good. I see a strong emotional response either way as a signal that I've done my job as a writer - I've affected my reader somehow.)

I don't at all consider myself to be mentally ill but I'm sure someone could read my work and make some assumptions. This can be dangerous. I am not my work, just like a romance novelist doesn't necessarily have a hot, steamy relationship. Just because someone writes something odd and out there doesn't mean they're living it.

Honestly, I haven't chopped up anyone. Just in a story or two. Okay, maybe three. But I swear, only there!
Here via slacktivist (where I generally lurk, so likely no-one here will recognize me at all).

My creative writing professor got worried about me at least once; I know because he kept me after class and asked me about my vignette. We were supposed to write a piece where a character's thoughts ran counter to what they were expressing, so I wrote a short piece about a prostitute. And apparently I wrote it well enough that my professor thought I might be in an abusive relationship.

Which I wasn't. I'm just a Les Miserables fan. All in all, I think the professor was right to ask, but I'm also very glad he was willing to take, "No, I'm cool," for an answer.

In short, I think rms is right. Writers are not their work. It's probably a good thing for professors to take certain students aside and make sure they're not writing from life, but it's a bad idea to try regular psychoanalysis-by-writing. At best, it would inhibit the students and make the class less useful.

I'd also recommend a copy of Elaine Aron's The Highly Sensitive Person, which is about those of us (and I count myself among them) with a nervous system that is more sensitive to outside stimuli and more prone to reflection on inner experience. (Dr. Aron's research estimates this trait is in about 15 to 20 percent of the population.) I read this book and it was like reading the unified field theory of my personal universe.

The downside of this trait is that one's threshold for overstimulation is lower than it is for other people. And if you're not aware of these limitations, you wind up in a state of constant stress that can ultimately manifest as depression and possibly other states that would resemble mental illness. (In my own case, I was taking antidepressants for about a decade of my life.)

Unsurprisingly, a lot of HSPs become artists and a lot of what they say about the artistic temperament can probably be traced to high sensitivity. That's why the myth of the Depressed Artist sort of makes me bristle--the notion that if you took away an artist's depression, you'd take away what makes that person a great artist. My take on it is, well, close but not quite--if you took away the sensitivity that led to the depression, you might diminish the artistic ability, but you can remove the depression and leave the sensitivity, trust me on this one.

I hope this made some kind of sense. Feel free to ask me to clarify.
Lol, well I think that covers most of my crazy-writers-at-uni stories. I will say that I read an article in either the Times or the Guardian a couple of years ago that suggested people who keep diaries and blogs are more prone to depression than those who don't, because they keep retreading and revisiting upsetting and damaging incidents in their lives.

I was also told recently by a hypnotherapist that counselling doesn't work for the same reasons - rather than getting you to change your behaviour, it just makes you talk about your negative behaviour, this reinforcing it. Now, having just finished a course of counselling for my depression, I don't think that's the case (or at least it hasn't been for me) but I find it interesting that people see a link between depression and creativity of any kind.

I think we all know that image of the tortured artist - Van Gogh, Coleridge and Shelley come to mind as troubled people who created wonderful art, and I wonder if this idea has become reinforced in our cultural awareness so that people assume that if you are creative, you must also be a bit ... you know ...

The overweight sex-obsessed girl I mentioned before told me when I went on anti-depressants that she was worried I was only doing it to "fit the mould" of the angsty goth writer. Offensive to me, but telling, I think.
I'd say, on the whole and based on the experiences I've had when people I care about have come down with depression, that if anything, non-productivity is a bigger give-away than dark writing. Or odd behaviour rather than writing; Cho Seung-Hui, for example, may have written dark plays, but he also never spoke, stalked students, took photographs in class and generally made people nervous: the fact that something was up with him was clear from lots of other signs. Illness is illness, not just moping, and people who mistake moping for illness have probably never seen the real thing.

I'd say, based on what I've seen, which is by no means the whole picture, that talking-cure counselling without anti-depressants might lead the patient to keep going over the negative thoughts that they're stuck on anyway - but that would depend on the skill of the counsellor, and a responsible counsellor should also know when anti-depressants are indicated. I've seen CBT have good effects, too, which I'd recommend to anyone reading this who thinks they might be depressed. (Cognitive Behavioural Therapy, ask your doctor. There's info here: http://www.rcpsych.ac.uk/mentalhealthinformation/therapies/cognitivebehaviouraltherapy.aspx)

The idea that depression is necessary for art really, really pisses me off. I agree with Sheila: an introspective nature might be more vulnerable to depression, but saying that we need depression to have art is like saying that we need joint strain to have athletes. They're what happens when it goes wrong, and it's unbelievably callous to argue against treating a disease for any reason.

It's the 'If Van Gogh had had Prozac, we wouldn't have had those wonderful paintings' argument that gets to me. Because, first, it's probably wrong: he might have painted different pictures if he hadn't been depressed, but they would still have been good because he was so talented. And in fact, there would probably be more Van Gogh paintings around if he'd had treatment: he wouldn't have killed himself in his artistic prime.

And second, even if you did think that depression created art, instead of art being produced in spite of depression, then it's morally wrong to ask someone to go through hell so you can have a picture to look at or a book to read. It's just as outrageous as suggesting that we let child abuse go unchecked, because without it, where would be the misery memoirs people so enjoy? We have no right to demand that others suffer so we can enjoy their art; the idea is positively predatory, and shows a coarsened sensibility that's the last thing art needs.

Hm. It's a subject I'm passionate about, because I've seen more than one person I love suffering from depression, and I wouldn't wish it on my worst enemy. But it's artistically silly as well. Your writing self is never the same person as your everyday self, and unhappiness is just as likely to stop people writing as it is to give them ideas. Why listen to people who think creation isn't joyful?
Oh, sorry for the cross-cultural mix-up. A MFA is a master of fine arts degree, usually in writing. It's a 2-year program of writing classes that you take after your 4 year college degree. When you are finished, you are qualified to...teach in an MFA program. I am not kidding. Many graduates think they will teach a little bit while they write, but they teach more and write less.

So, MFA programs are strange and probably not very useful, but far from mental hospitals!
The "depression for art's sake" trope seems to be something that gets seriously reinforced when impressionable young people are introduced to the Romantic poets, the "dead young poet" archetype (of which many gorgeous and depressing paintings were made) -- at least, I've seen more of that, in undergrad literature programs, than I ever saw in a writing program. The writing types tended to be driven, VERY unromantic, and looking for publishing ins and networking ops.

I'm in full agreement that the idea of "being ill for your art" is harmful at best and kind of exploitative at worst.

The year before I got into it, the writing program I attended had a bit of a kerfluffle trying to get themselves considered a full MA instead of an MFA. (They won.) Essentially because they were part-time, despite fulfilling all the requirements that the full-time (or more accurately, "on-main-campus") students were. (Makes it easier to get into a PhD program as well.)

The trap of using writing for therapy was one that we were all warned about on the first day, but I don't think I ever saw it in action -- possibly because the part-time program was full of older, more mature, returning-to-school students? Maybe, maybe not, I'm not sure. (There were myths about a couple who'd hooked up and broken up in the program, writing increasingly scathing, thinly-veiled short stories about each other. I don't have any real reason to doubt the truth of that story...)
(They won.) Essentially because they were part-time, despite fulfilling all the requirements that the full-time (or more accurately, "on-main-campus") students were.

I wrote that wrong. :-) What I'm trying to say is, they were shifted to MFA status because they were part-time (and paying less, I think?); they argued that this was unfair because they were doing all the same coursework as the main-campus students were; and they won their case and were "upgraded" to Master of Arts the year before I got in.
I'm in full agreement that the idea of "being ill for your art" is harmful at best and kind of exploitative at worst.

I'm in full agreement too, and in my own experience of depression, I've found it incredibly hard to be creative when I'm depressed.

It's a subject I always get riled up about, partly because so many women in my family have had depression, and partly because depression itself is a word that gets thrown around a lot, and I really think the meaning has become diluted over the years.
The trap of using writing for therapy

In a way, I'm not sure it's entirely wrong. What I think is wrong, artistically - I don't know enough about art therapy to have an opinion on its therapeutic qualities - is that creating art should be about creating art. Writing a story with the conscious aim of being therapeutic, odds are your focus will be on feeling better rather than writing the story as it needs to be told - and hence, you probably won't be writing the best work you're capable of. It's 'thinking of something other than the thing itself', as Virginia Woolf puts it.

On the other hand, writing a story about an issue or situation you feel strongly about, and seeing where that takes you, probably can have therapeutic side-effects while producing good work. I'd hope that 'don't use writing for therapy' wouldn't scare students off handling subjects they've got strong feelings about; that would be most counter-productive.

When you are finished, you are qualified to...teach in an MFA program.

Seems to me that the big problem there is that an MFA teacher has no experience of writing outside the college environment. You surely need teachers who know what it's like in the rest of the world, otherwise the knowledge they can pass on is mostly how to operate within an MFA environment, which students can probably figure out for themselves. Do you even have to be a published writer before you can teach an MFA?
depression itself is a word that gets thrown around a lot, and I really think the meaning has become diluted over the years.

That is frustrating, isn't it? I've been fortunate enough not to suffer from depression myself - though, like you, I find it harder to write when I'm down - but I've seen people I care about suffer. And the difficult thing is, people who haven't seen the illness tend to assume they understand it better than they do - after all, they were 'depressed' for three whole days once.

This is particularly bad because depression, unlike schizophrenia, doesn't show up in provable delusions. You can be sure there's nobody in the pipes listening to your conversations, however logically the sufferer explains the theory, but when the sufferer is explaining that they're terminally worthless and everything they do will fail and anyway people are bastards, it's much harder to see this as a symptom rather than an opinion, even though it's no more rational than the people in the pipes. So people can get impatient with depressives, because what they say and do sounds so unreasonable, but like it might be susceptible to reason if they'd just listen - which, of course, is not the case until the sufferer gets to a doctor. All of which can hold up the process of seeking medical help, and also isolate the sufferer as people's attempts at reasoning fail and they lose patience altogether, which is dreadful.

It's a language problem, I think: the word 'depression' has two different meanings, and people think they understand the fatal-illness one because they understand the colloquial-expression one. Along with seeing it better taught, I'd like to see it renamed. If we called it 'malignant dysphoric disorder' or something similarly clinical-sounding, perhaps it might help communicate the gravity of the disease, and its difference from a passing mood.
it's much harder to see this as a symptom rather than an opinion

I think you've nailed it - one of the most common reactions I've experience is "what have you got to be depressed about?" It's unfortunate and frustrating, but in a way it's probably unavoidable because a lot of people think they've suffered depression when they haven't. And on the flip side, a hell of a lot of people are depressed and don't realise it.

In the case of people like Cho Seung-Hui, it bothers me to think that if people had a better understanding of the illness, a lot of lives might have been saved. As it was, it seems he was just "that quiet, weird kid" who everyone dismissed as strange but ultimately harmless.
"Do you even have to be a published writer before you can teach an MFA?"

I never had a teacher who hadn't published at least a book of poetry. Some were acquisitions editors, one was the founder and editor in chief of a lit mag. And we had a few guest lecturers -- Julian Barnes was one. This was an accredited program associated with a university -- if you go to, say, something like "[Fill in Random Name] Workshops" which advertises in free circulars on the streets, your teachers might not be as qualified.

"Along with seeing it better taught, I'd like to see it renamed. If we called it 'malignant dysphoric disorder' or something similarly clinical-sounding, perhaps it might help communicate the gravity of the disease, and its difference from a passing mood."

I quite agree with this. I wasn't sure how to put it, exactly. I know that when I was younger (and less disciplined, but oddly, more prolific -- more free time?), it was much easier for me to sit and write when I was mildly unhappy, rather than excited and happy or really sad and homesick -- if I'd read something disturbing or found myself in a quiet, dissatisfied mental place. Which got reduced among my friends to the phrase "oh you only write when you're depressed." Which is obviously a problematic thing to say.

"Depressed" is a mild word for the clinical condition -- too mild, I think. "Depressed" is like a fingerprint in clay -- an imperfection that can mar an object but can also be rubbed or buffed away. Cho was not depressed -- he was seriously impaired.
...laws that allow people whose mental health is in question to buy guns, a state of affairs that seems utterly unbelievable to anyone not raised on that right-to-bear-arms rubbish.

Speaking as a U.S. American, thank you for saying this. Even though I live here, I don't understand the meme. And people to whom the 2nd Amendment is very important think that my not grokking it is analogous to a Fundamentalist not grokking the 1st Amendment's protections on freedom of/from religion.

Ah well.

I agree very strongly with rms and others who have pointed out the distressing tendency of writing teachers to overdiagnose students who write disturbing stuff; I think "it's right to ask 'is something wrong?' but also right to take no for an answer" is a good rule of thumb. At the very least, a teacher needs to be able to assess the whole situation for context beyond the content of the writing.

Sheila, I am grateful for your book recommendation. From your brief description, it sounds like something that both my husband and I should read. I'm also intrigued by the discussion here about whether it's counterproductive to journal one's problems. To what extent is journaling, or talking it out, or counseling, a method of exorcising the terrible feelings, and to what extent is it a retread? I know that for me, remembering an emotional event brings up emotions as strong as reliving it; but attempting not to think about such events doesn't seem to keep them from spontaneously recalling themselves to mind such that I end up brooding on them for the next hour. If journaling/blogging and exploring the issue only causes a "highly sensitive," "introspective" person to uselessly reexperience the destructive feelings, what is there left to do as far as laying the ghosts to rest goes?

(I know that last question comes very close to the folly of requesting psychotherapy on a blog. But I'm genuinely curious to hear what ideas people have here.)
Afterthought on the discussion:

I have a friend who suffers from bipolar disorder, with classic symptoms of depression at the low end of the cycle. Something she said about it really struck me hard. She said that any time she's in problem-solving mode, no matter what the problem is, be it trivial ("the cats knocked over the garbage") or life-threatening ("I can't find a job and I don't know how I'm going to afford my next meal")... there's always a mental voice that pops up and offers "Well, you could always kill yourself!" as a solution.

This isn't "hearing voices". This isn't delusion. This is a mental process. It's very hard to get people who don't suffer from depression to understand it. Even very sympathetic friends can fall into the trap of trying to reason with it. "Of course you shouldn't kill yourself over the garbage spill!" is logical, but logic isn't the answer anymore than "what could you have to be depressed over?" is. The little suicidal voice isn't interested in logic. It's a reflexive mental process caused by some malfunction of the brain, not a reasoned conclusion the sufferer came to after examining all her options.
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