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Moving from Cultural Competence to Antiracism

192 Comments

We’ve all heard about cultural competence in clinical practice. And while it’s important, it’s also not enough.

So today, Thema Bryant-Davis, PhD will get into some first steps in becoming an antiracist practitioner.

 

 

Click here for full transcript
Dr. Bryant-Davis: So, it’s important to know that white therapists can be anti-racist therapists. What I mean by that, as opposed to just cultural competence – cultural competence is often about like, “Have you learned some information about different communities, do you have some sense of your own identity?” But to have an anti-racist stance is more active, it is more intentional, and some directories or mental health networks have started educating communities of color to tell them that it’s a small percentage of psychologists and mental health professionals that are ethnic minority. So as they’re looking for therapists – and you can even have an ethnic minority therapist who does not have that consciousness around being actively anti-racist – so, what these networks are recommending to people when they call to look for a therapist is to ask them, “What are your thoughts about the impact of racism on mental health? What are your thoughts about the impact of white supremacy on mental health?” as a taste test. If the answer is, “I believe people are people,” well then there you have your answer that this is not someone who is going to be able to acknowledge and engage with you because they’re not even willing to acknowledge that it exists and that it has an impact. It’s important to be able to communicate awareness and compassion that these events are happening, and that oppression is a reality now. That historical piece is helpful to know and it is very important to be able to not go into victim-blaming. So when we go in to try to defend and explain people who have said or done harmful things, then it lets the client know, “This is someone who is not really safe for me, they’re not really for me,” and it what it requires from us – and when I say “from us” I mean whenever you’re a part of the majority group – is to release my defensiveness because our usual tendency is to connect with the person we see as a reflection of ourselves. Because if the mom did something bad, then maybe that means I do something bad, so that I need to make it okay. And so, the example that comes to me from my own experience is around working with clients with disabilities as an able-bodied person. I was teaching multicultural psychology, and I had a guest presenter who uses a wheelchair and she was talking about coming across the campus at a place where I used to teach and the invisibility of systematically everyone refusing to look at her. As she came across the campus, no one would look at her. So in my “able-bodiedness”, what my instant defensive instinct, which I didn’t speak on but what came to my mind, was I know what that is because I have done it, in terms of trying not to stare looking away, without ever taking into consideration what would it feel like if everyone does that, if everyone is averting their gaze? Again, that difference between intention and impact – even if you did not intend to be rude or mean, that it is an erasure, and so to be able to sit with that. What I would say for white clinicians, when an ethnic minority client is describing an experience, your instinct may be to try to figure out how they could be interpreting it incorrectly because we want to believe that things are fair and right. Maybe I would do that or maybe my cousin would do that, and we’re not bad people, but instead to really sit with, “What is it this person is saying and what might it be like to have that experience?” and then to respond with that support. I want to say, actually, that that can be very therapeutic and healing in a way that hits on another level than them hearing it from me. What I mean by that is when I’ve had rape survivors who were raped by a man had a male therapist tell them how wrong that was of what happened to them, it registers in another way because this person in some ways they identify with that group. So instead of feeling powerless, like, “Oh I won’t be able to help my ethnic minority clients,” instead, with humility because people have talked about now not just cultural competence but cultural humility which is, “I don’t know everything,” and a continuous learning and an openness and a recognition. So, with humility and compassion, this could really be a therapeutic moment, it could really be healing.

 

What are your biggest takeaways from what you just heard? Please let us know by leaving a comment below.

If you found this helpful, here are a few more resources you might be interested in:

Working with the Trauma of Racism

When Staying Neutral Isn’t the Best Approach

The Same Pandemic, Vastly Different Experiences

 

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192 Comments

  1. Judy Hanazawa, CA says

    Appreciated listening to this and felt a confirmation of my thoughts on the matter. The matter of systemic racism in mental health needs more examination and open discussion and change. I am of Asian ancestry and very aware there is a service gap in meeting the mental health needs both in a culturally competent AND antiracist practice approach when dealing with the impact of racism upon those of Asian ancestry. it is a real need in this time of Covid 19.

    Reply
  2. Eva E, Other, So Cali, CA, USA says

    What I’d like to chime in to this conversation is that one’s appearance can be deceiving, and just because a person is not black or brown does not tell you if one is living with racist discrimination on a daily basis.

    I am a non-while, non-black, non-native American, non-Latinx, less visible ethnic minority. I had a white male psychotherapist for many years to work through my traumas. I don’t blame for people to not know everything. I don’t think people can know what it’s like to live as a person who belong to a certain group unless you are one. Society treat you accordingly just as an example of a person with a wheel chair in a video, consciously or not. During the course of therapy, he saw that I faced many mistreatment in general, attributing them to my not being assertive enough. Yes, I didn’t know how to be assertive, and we worked on that. But after I became assertive, things didn’t change. I continued to be mistreated, and on one occasion, he had to intervene because something that was happening was not legal. He was shocked, and I think that was a wake up call for him how bad things were for me to live in a social status like mine. I am non-black, non-Latinx, non Native-American. He knew my ethnicity and my physical features are not of white ethnic groups, but he didn’t really think I would face as much discrimination as traditionally oppressed groups of people. His knowledge didn’t extend beyond stereotypical understanding of my race and culture.

    Another thing I’d like to point out is the misunderstanding that happens often where the source of suffering and trauma originated from.
    One of the traumas I worked in my therapy was a death of my baby sister when I was a young child. At the point I was in therapy, it had been some twenty years since her passing. He treated it as a typical grief from a loss of a loved one. That wasn’t the issue. I’ve accepted the loss, and I’ve moved on from the grief of a loss of my sister. What he failed to understand was the grief, deep helplessness and frustration that accompanied because of the way she died. Like George Floyd and many Black lives lost in violent mistreatment in the hands of power, my sister did not have to die only if people had listed to my plea for help. I was ignored and no adult was going to lend a hand for my baby sister. I could not articulate my pain in therapy, but if I were a black person, he might have read into more to the predicament in which my sister and I were in. I don’t know. The things is, I’ve come to realize that both white and POC communities assume I can’t possibly suffer from a pain and trauma such as loosing an innocent life to race based violence. Every time a black person dies and I hear the news, I see my sister’s dead body in my head, and the pain and grief is back. I’ve learned that I cannot share my grief in a POC space, either because I’m not seen as a POC, and I’m generally seen to be belonging more or less to the privileged group although I am non-white, and my life experiences have been closer to one of the traditionally oppressed groups. I’ve read some essay by an African American woman born with albinism, and she was navigating through something very similar to my everyday experiences. There is more to Black and White than meets the eyes.

    Reply
  3. Marjorie M, Psychology, CA says

    I think if a therapist – white or otherwise but maybe specifically white – didn’t have that stance in the first place then, seems to me, one of the fundamental tenets of therapy is NOT being met In the first place and that is empathy. It isn’t for a therapist to explain away someone’s experience but rather to sit with and explore that experience. Lovely thoughtful explication above -but perhaps not enough. How is the therapist and agent for change ??

    The bigger question for me – which wasn’t addressed at all and I think poses more serious ethical questions – is how to work with culturally ignorant or even more blatantly racist clients??? What role does a therapist have in educating, rebutting, and refusing to be complicit in reifying racist viewpoints in our clients??? Years ago I worked with a young skinhead and it was a real challenge to navigate the ethical question above…. Do I refuse service because the viewpoints are ugly? Or do I engage and gently try to challenge viewpoints of supremacy, antisemitism, anti black racism, racism against Native Canadians and so on… Being a Jewish woman I am cloaked in white privilege but the antisemitism was not easy to manage in terms of my own feelings of safety. I chose to stick with this client – to develop the therapeutic alliance despite the views which I found nearly impossible to stomach. I attended to her with empathy and presence and through the counselling I gently but firmly challenged those beliefs and highlighted their racist underpinnings. This racist skin head grew out of it. In the end, connecting her violent ideas and racist beliefs to her own childhood trauma of being bullied seemed to lead to an “a ha” moment and soon the ugly web of hatred and racism unraveled as she came to know herself better and accept others more. She was maybe not typical but the point and dilemma here being salient : How do white and other therapists deal with clients who both deserve help and empathy when their views are clearly racist, antisemitic, or any other host of ugly? How do we act as anti racist therapists and still provide safe havens for clients who need help? Big question – more difficult question. But it is in the answer to that question that we will attend to what the difference is between thinking and acting around issues of racism. Just some thoughts 🙂

    Reply
  4. Linda Morse, Teacher, Uxbridge, MA, USA says

    Wow – I’m not a counselor, but I sure needed to hear this – what a perfect way to address how we need to listen better and try NOT to get into the identifying piece (something I constantly do) by using the example of someone in a wheelchair. On a complete sidenote, I discovered Dr. Bryant’s poetry a long time ago and I have found it to be some of the most powerful poetry I have ever read! I found a slim volume of your poetry and I love it after reading it in the Boston Globe. I am a white 60+ year old female educator who is trying to keep learning about how to be anti-racist and proactive in addressing both the teaching of history and white comments coming from an ignorant place….thank you for your insight here and in your poetry!

    Reply
  5. Kimberley Casey-McMahon, Psychology, GB says

    Thank you for this mind-opening insight !

    Reply
  6. Mitra Bishop, Clergy, Ojo Sarco, NM, USA says

    Truly valuable—makes for important insight! Thank you!!!

    Reply
  7. Cindy Nelson, Counseling, Dallas, TX, USA says

    Thank you for pointing out that, although I consider myself a compassionate and culturally aware white therapist, I must always be seeking continuing learning and growing opportunities about others who are different from me, my age, my gender, my race, and my life experience.

    Reply
  8. Brenda M, Social Work, CA says

    Love as a white privileged social worker all Thelma said and how she said and modelled her message. It gives me new place to start and keep aware of my need to continue to learn. Love the move to kindness and compassion in the world. After many years of working and being challenged for using this versus the behavioural systems and theories….I finally feel good about the work I do with clients.
    Thank You

    Reply
  9. Nancy Scott, USA says

    Humilit and compassion is the gift to both therapist and client. The true gift of communion!
    Thank you for sharing your words!

    Reply
  10. Nancy S, Counseling, Chicago, IL, USA says

    I am a retired LCPC. I have drifted from my ability to learn and understand the experiences of others. This short communication presents concepts and issues in therapy that I can apply to my now lay life. I believe that therapists at all levels would grow both professionally and personally by exploring the concepts presented.

    Reply
  11. Anonymous says

    The examples of how it’s therapeutic to acknowledge using Differently a led person and the male therapist with rape survivors made the point quite effectively. This moves it out of feeling apologetic for the aggressions of my race and into the power of harm being named by a member of the oppressive group. Much more powerful for allying with the person in front of me. Thank you.

    Reply
  12. ruth ben-asher, Psychotherapy, IL says

    thank you so much Thema Bryant-Davis for teaching me this important lesson.
    my question is – if a minority client asks me this question and I honestly respond that I know I have been acting in a discriminating way in the past and I acknowledge that it might happen to me again but, hopefully, I will be accountable for it – would that be safe for him/her to be my client or would it be unsafe?

    Reply
  13. Kathleen Weir, Another Field, Gladstone, MI, USA says

    Thank you for using disabilities as an example. My husband had a disability that did cause others to treat him as a child or caused them to ignore him. Most people have compassion and I handled it better when they were overly sensitive to the obvious suffering he went through but there was a meanness in other people that seems to be a part of normal human nature that we came across way too often. He couldn’t swim at the YMCA, he was not given a piece of birthday cake because no one wanted to approach him and had to know others were sharing cake in front of him. There were even medical professionals who claimed that wheel chairs were not allowed in their offices. It was actually a safety issue at times.

    Reply
  14. Anonymous says

    It comes down to NOT identifying with one’s own prejudices or the ones of the victim, but TRULY listening to what caused the injury and using the experience to unravel lack of power in that moment, and response to that moment. We respond how we believe we are able to, based on what we believed at that time. I’ve seen people cower out of prejudice, not from actual immediate threat.

    Reply
  15. Konstanze Streese, DE says

    I agree 100 %!
    This ‘tribal defensiveness’ means that I rather side with a racist perpetrator of my color than with the different color client who I am supposed to help! It’s so absurd: How can I help s.o. when s/he doesn’t experience me being on his/her side.

    Reply
  16. Helen Pitman, Psychotherapy, GB says

    Thank you. As a white therapist, I found your video so simple, empowering, and clear. The example of the disabled person and the male therapist being able to name that his client should not have been raped, were powerful examples of firstly guilt getting in the way versus sitting with and naming the client’s experience. Very helpful.

    Reply
  17. Chris Edwards, Social Work, Springfield, MA, USA says

    What stuck out & is sticking with me is intention versus impact. Thank you for this!

    Reply
  18. Allison Banbury, Counseling, Abingdon, MD, USA says

    I loved the “taste test” language, and appreciate yet another black woman giving her time and energy to help white therapists do better by their clients.

    Reply
  19. Anna Daglish, Counseling, AU says

    What a wonderful podcast. Thank you. Cultural humility. Turning cultural competency into anti-racism. Excellent examples and conversation.

    Reply
  20. Mary E Fogg PhD, Psychology, Gorham , ME, USA says

    First, I so appreciate your consistency in bringing provoking and inspiring material to us in a timely way. This reminds me of how powerful and healing it is to “simply show.” And how important it is to not let my fear and shame stop me from daring to show up. Thank you.

    Reply
  21. Candy Vojvodich, Another Field, Chicago, IL, USA says

    I want more! I want to hear more from Dr. Bryant-Davis!
    I identified with trying to figure out how my clients “interpret/perceive things incorrectly” and I appreciate the reminder that I need to be continuously learning.
    Thanks so much.
    CV

    Reply
  22. Helen Burke, Counseling, Bainbridge Island, WA, USA says

    Thank you for this offering from Dr. Bryant-Davis. I appreciate learning that individuals in marginalized groups seeking therapy are encouraged to directly ask those questions of potential therapists. As a white woman it helps me to see that I could offer to share how I would answer those questions with a client who may not feel comfortable asking.

    Reply
  23. Kate Davis, Psychotherapy, Rockville, MD, USA says

    Wow! Dr. Bryant-Davis shared so many important ideas so succinctly. I’d love to hear more from her. I’ve been reflecting on the idea of “listening”, being present, thinking more about how I don’t know what I don’t know. I’m a white therapist, reading Robin D’Angelo’s White Fragility again, prompted by the events of the past two weeks. Thank you to Dr. Bryant-Davis for your thoughtful presentation of critical ideas and thank you Ruth, for bringing her to us.
    Kate Davis

    Reply
  24. Tania Breard, Other, Huntsville , AL, USA says

    Thank you so much for sharing this, it blessed me in multiple ways. I am a 54 yr. old white Caucasian woman. I have CPTSD. I have been submersed in my own healing, for many years. Most of those have been spent in isolation. Admittedly, many things have not been on my radar. I want to make sure I’m learning, developing and continuing to take responsibility for myself and the person I am to ALL, others. I am digging in to doing my homework. Since I have a great deal of trauma I immediately connected to what you were saying about defending and explaining as well as a person’s natural inclination toward defensiveness. You addressed many components in a short, concise, intelligent and vulnerable connection. I intend to use this to help with my personal challenges and overall efforts to keep taking responsibility for myself. I wish I had people like you in my life. You’re a treasure.

    Reply
    • Shirley Francois, Psy D, LPC, Psychology, DE says

      Tania Breard, Other, Just a thought provoking question that registered in me… In you comments you wrote:… “You addressed many components in a short, concise, intelligent and vulnerable connection.” Would you have used the descriptive “intelligent”, if you were describing a white professional? Sometimes our lenses cause us to think or say or write concepts automatically. Another word I have heard when speaking about an African American professional, (and said to me), along with “intelligent”, is “articulate”, as if that is an oddity. This is not a critic, simply a dialog for clarification. This is me wanting to know… and perhaps others to look at the other side of their words.
      Be well. Stay safe!

      Reply
      • Teresa Sapp, Other, Asheville, NC, USA says

        There are many, many white professionals who are not intelligent, so I think where she was listing out attributes, that’s all she was doing; I think you may want to look at your hidden prejudices first before throwing that stone.

        Reply
      • Lynn Pierson, Psychology, Cincinnati, OH, USA says

        Would you prefer ‘cogent’?

        Reply
  25. Gretchen Mallios, Social Work, San Diego, CA, USA says

    I really appreciate how straightforward and simple Dr. Bryant-Davis made this topic. She conveys it with such commonsense accessibility. Thank you.

    Reply
  26. Jessica Flynn, Psychology, USA says

    Thank you for taking the time to explain this so compassionately and clearly. I’ll be sharing this with my psychologist colleagues!

    Reply
  27. Claire Brown, Counseling, AU says

    A well deserved slap in the face to me! In my arrogance I had always thought “I just see people as people” meant I was ok as a therapist. I will now drop that and actively acknowledge oppression and ask more. Thank you. Claire (Australia)

    Reply
  28. Gretchen Seitz, Other, San Diego, CA, USA says

    This is wonderfully informative and we need more. Thank you so very much.

    Reply
  29. Jane Arthur wellnessworkx@gmail.com, Psychotherapy, Land O Lakes, FL, USA says

    Very helpful piece. Experiencing the recognition of my microaggressions that challenge my preferred view of myself is potent territory.
    Thank you and more please.

    Reply
  30. Shelby Massingale, Social Work, Vancouver, WA, USA says

    When you mentioned the invisibility of the speaker who used the wheelchair it really resonated with me as what it feels like to pass my white coworkers in the hallway and to notice them suddenly looking away, avoiding eye contact, pretending not to hear me when I say hello. Thank you so much for this video, I plan on using it to guide a conversation that I want to have in our large group supervisions.

    Reply
  31. Charmaine Host, Clergy, GB says

    Yes this is helpful and yes to the comment I would like to hear more from her. My own question at the current time is about how easily shame can be triggered and that itself evokes defensiveness. How does one not get sabotaged by this?

    Reply
  32. Sandy Davis, Physical Therapy, Gainesvilke, FL, USA says

    I wish she could continue longer! Excellent

    Reply
    • Sandy Davis, Physical Therapy, Gainesville , FL, USA says

      And we must please promote the best terminology for person first by not labeling or referring to the unique individual by race or disability i. e. the white paraplegic patient is a patient with paraplegia. We must be diligent about the hypersensitivity of these issues.

      Reply
  33. Lois Goss (2), Counseling, Salem, NH, USA says

    All of us can respond to an empathic, compassionate presence.

    Reply
  34. Clive Gifford, GB says

    Are you not just saying that therapists should validate anything patients say rather than ruahing to challenge it and risk alienating them?

    Reply
  35. Rebecca Rosenblum, Psychology, Cambridge, MA, USA says

    Hello Thema! Thank you for this great piece – have shared it this week… hope you are well… Warmly, Rebecca Rosenblum

    Reply
  36. Gail Shulman, Psychotherapy, Cambridge, MA, USA says

    Thank you so much, Thema Bryant-Lewis. I remember with great fondness your days at Cambridge Hospital.

    Reply
  37. Brenda Worley, Psychotherapy, Scranton, PA, USA says

    My takeaway is the need to validate my patients experience, emotions, perceptions… it is their moment. Its also a moment to review my own emotions , experiences and perceptions- and to take ownership .

    Reply
  38. Carol Bode-Hey, Psychology, GB says

    Gosh this was so helpful – I particularly like the idea of cultural humility – much of my anxiety around being anti racist comes from wanting to do it ‘right’ and not knowing enough. This can result in either avoidance (I’ll never know enough so why bother trying) or defensiveness (not acknowledging my own errors because I need others to see me as good). Owning my ‘not knowing’ and listening to others feels achievable (altho like all simple ideas is harder in practice!)

    Reply
  39. Jonathan Suga, Medicine, Ann Arbor, MI, USA says

    This is an excellent piece, worthy of review and passing on. Indeed, understanding the pernicious and often unconscious effects on an individual’s sense of “self”(s) of persistent and subtle or not subtle discounting or active hostility or fear. difficult but necessary.

    Reply
  40. Sheela Aspinal says

    As a minority psychologist thought it was a good beginning to highlight the issues but have encountered several non minority psychologists who are clueless about their internal biases. Have begun to educate my clients as to some of the ways to find empathetic clinicians who truly understand the negative impact of overt racism to microaggressions on people of color.

    Reply
  41. Yerachmiel Donowitz, Counseling, Pikesville, MD, USA says

    There is a difference between intent and impact. Being able to sit with discomfort of impact on person is helpful, especially if it comes from a clinician who can be identified as part of the offending group.

    Reply
  42. Jim Frost, Marriage/Family Therapy, Atlanta , GA, GA, USA says

    Very well done, thank you so much. Jim Frost LCSW, LMFT. Atlanta, Georgia -white therapist who Has been striving to be an anti-racist therapist for 40 years.

    Reply
  43. Victoria Ziskin, Marriage/Family Therapy, CA, USA says

    Thank you for a very useful frame to help us all move forward. Anti-Racist, cultural humility and compassion will hopefully guide us all.
    Appreciate your gentle and thoughtful approach.

    Reply
  44. Stewart Shirey, Social Work, NC, USA says

    Thank you for sharing your insights

    Reply
  45. Eleanor Donaghue, Counseling, Olney, MD, USA says

    To be open and without any preconceptions, as hard as that might be, just listen, listen, listen. I had a similar experience to one Dr. Bryant-Davis shared. Mine was with a gentleman who was to be our presenter for the day. I was taking a 10 day-conference at Harvard. On July 4th we had no holiday instead Harvard had invited a professor from Canada to be the presenter for the day. He was a paraplegic in a wheel chair with a voice impairment. My first impression was so far from what I learned from his presentation. He introduced himself and identified the kinds of experiences he had at the airport etc. He said people would approach him and very loudly ask, “Can I help you?”
    With self-effacing humor, he asked the group , “Why do people think someone is hard of hearing because they are In a wheelchair.” He was one of the best presenters I have experienced (and I love to learn so I take every opportunity I can). His presentation on diversity was powerful. I have not forgotten it and its been a number of years. Putting aside preconceptions, being comfortable and open can help the client to be open, and then just listen, listen, and listen. His presentation on diversity and the model or display he developed was powerful and he was one of the most powerful and effective presenter I have heard. Putting aside preconceptions is a challenge. Thanks Dr. Brant -Davis for helping me pull that memory out and then commit to apply now what he taught.

    Reply
  46. Lisa Brown, Marriage/Family Therapy, USA says

    Thank you! Bearing Witness says I see you, I hear you, I believe you and will carry this pain with you.

    Reply
  47. Mary Lou Bonham, Counseling, Portland, OR, USA says

    Thank you, Dr. Bryant-Davis, for your insight and words. I appreciated the encouragement that we can, while holding a stance of humility and non-defensiveness, be helpful in validating the experience of POC (or “global majority,” a term used in my recent trauma conference by a POC). It’s easy to feel frozen in these times, as white people, instead of mobilized and empowered to step up, learn, grow and do better.

    Reply
  48. Lori Kingsley, DO, Osteopathic Physician, MIDLAND, GA, USA says

    Thank you. So often I think as white physicians or therapists, we doubt our ability to have impact. Our intent may be to help to the fullest extent we can, but by accepting the lie we tell ourselves that as the white majority how could we even help, the impact is hurting our patients. May we all listen, let our minority patients first simply be heard. We must do better.

    Reply
  49. Arthur Pruitt, Counseling, MI, USA says

    I totally agree with Mrs Davis regards to prejudice, but I disagree with the term racism. I think that this is what has caused so many problems in our society and reconstruct the thought patterns of each human beings. Race is a myth in that there are different spices of humans black, white and so forth. There is only one race and that is the human race and according to scientist, factual, that everyone comes from a brown gene. There is no such thing as white people only brown and different shads of brown. This is all factual. I am a Christian, and this is from secular scientist or those who do not believe in God has reported that every human being has come from one woman and one man. Until the truth is talked about there will always be prejudice against other people of different cultures. But over all I do like what Mrs Davis had to say. Thanks

    Reply
    • Brenda Ingram, Social Work, Long Beach , CA, USA says

      Dr. Bryant-Davis not Mrs. Davis. Race is not a myth but socially constructed by whites to separate us based on mostly skin color as a way to support white supremacy . But to deny its existence is to deny its impact on our clients. And that doesn’t help them to trust that the therapist will understand their lived experiences; therefore not be able to help them. So don’t deny racism but listen to understand how it has impacted your clients, just like other types of oppressions, e.g, sexism, ageism, able-bodism, etc.

      Reply
  50. Jeanne Teleia, Marriage/Family Therapy, FR says

    Thank you for this. NICABM trainings for a long time have bothered me for the lack of diversity among presenters. We also need more training in anti-racist therapy. We need more people like Thelma to educate us!

    Reply
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