General Question

ANef_is_Enuf's avatar

How do you "fire" your therapist?

Asked by ANef_is_Enuf (25204points) February 14th, 2011

Also, aside from firing your current therapist.. how do you go about finding a replacement?
I hate to see 8 months of therapy go down the drain and then move on to someone that isn’t any “better.” The idea of starting over from scratch is daunting enough, but is there anything specific to look for when finding someone new?

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42 Answers

snowberry's avatar

I have done this, and this is how I went about it.

Sit down with a pencil and paper, and come up with as many “WH” as you can. Ask “How did you decide to get into this field? What schools have you attended to contribute to your degree? What certificates do you have, and have you ever personally experienced what I’m dealing with? Do you participate in continuing education classes, and how often? What interests you in the field of psychology and counseling?

I filled up an entire page of questions. Have your questions printed out before hand, one page for each interview. Be sure to include room for his name and phone number.

Before you begin your interview, inform your prospective therapist that you want to interview him or her, and ask if this would be a good time.

snowberry's avatar

As far as how to “fire” them, just say that it’s time for you to move on, and thank them for their time.

mrlaconic's avatar

Identify what it is that you are not getting from your current and make sure to express what you are looking for to your potential new one during a consultation

Neurotic_David's avatar

To fire your therapist: call up and cancel your next appointment(s). No further drama need ensue on this one.

To hire a new therapist, well, I’m going against conventional wisdom on this one. For most people, I don’t believe in long-term therapy. I believe it’s ineffective, can be a crutch, and can retard personal growth. If you want to stay in therapy, then I hope you have a specific goal (or set of goals) you want to achieve. Then you have to lay those out with the therapist, set a timeline for achieving them, and work within that framework. If you’re still in therapy 6 or 12 months later and two or more of your goals are not achieved, then I think it’s reasonable to label the therapy as counterproductive (for a plethora of reasons).

Finding someone is a crapshoot. Internet searches are often misleading. It’s embarassing to ask friends (because you have no idea which one of your friends has ever been in therapy, and if they were, whether they want to talk about it or not). You can’t ask co-workers. So what I’ve done in the past is a combination of working through who’s on my health care plan and internet searches, combined with “how convenient is this to my work?”.

Disclaimer: I’ve fired every one of my therapists. None of them are good enough. They all think I’m so brilliantly self-aware, yet I’m not able to get over some of my fears. And they haven’t helped. So taking advice from me on therapists is probably a bad idea. :)

tinyfaery's avatar

Trying to find a good provider for your mental health services is extremely difficult. Not because therapists lack training or because they are generally ineffectual, but because each individual needs something different. Simply asking questions of a new therapist will not give you much information about how the two of you will relate to one another. Neither will one or two sessions. Honestly, the whole process of finding a therapist needs to be overhauled.

I looked for years, on and off, for a therapist that actually “got me”. She was recommended to me by my psychiatrist. Do you have friends or family members that are in therapy? Maybe they can recommend someone for you. You can also ask your current, soon to be ex-therapist. She knows you fairly well by now. If you explain to her why you feel you need to move on, she might be able to recommend someone else. (It shouldn’t be too awkward. Your therapist wants whats best for you.)

As far as firing your therapist, my only advice is to not think about it like that. Just tell him or her the truth.

ANef_is_Enuf's avatar

@Neurotic_David not necessarily, because I feel the same way that you do, for the most part. I’ve been in and out of therapy for the majority of my life, and like you, I have fired every one of my therapists. However, it is usually early on in the process and I know that it is going nowhere.
This situation has been unique, for me. I have been playing with the idea of finding someone new since early on, but this particular therapist has helped me to understand a lot of things that no other therapist has managed to help me with.
However, I’m not making any progress. In fact, a lot of my issues seem to be getting worse. I know that the work has to come from within me, but I don’t feel like she is giving me a proper spring board, and I feel like that is what I need from her. That’s why I’m in this. I’ve never been one to hesitate when it comes to dumping my therapist if I don’t feel like they are doing what I need them to do, so this is the first time I’ve felt like this. I can’t decide where to go from here. I’ve also never been with someone for such a long stretch of time before I decided not to see them anymore, so that factors in.

Neurotic_David's avatar

So Neffie, your answer kind of cements for me my first reaction to your post. Maybe you shouldn’t fire this one.

Like a marriage, we can think of our relationship with a therapist as worth working hard for. If you’ve been with her for 8 months, and that’s longer than you’ve been with anyone, and she gets you like others have not, then perhaps you’re running away too quickly (maybe because it’s the easy thing to do, maybe it’s because you’ve conditioned yourself to do this with other therapy experiences, etc.).

So here’s an idea: bring your mobile device into your next session, and show her this thread. Or print it out and bring it with you. Then tell her, “help me not fire you” or something similar. Give her a chance to help you both get out of the rut you feel, or better yet, give her a chance to analyze why you feel you want to fire her. Then maybe (just maybe!) you’ll eclipse this plateau.

snowberry's avatar

Wow, Great ideas folks. I hope this helps her.

ANef_is_Enuf's avatar

Yes, I think a huge, huge part of why I’m having such a difficult time is that I like her. We get along well, she does seem to understand me. I would say that I’ve had a great experience with her, especially compared to my past therapists.
However, I feel more like I’m going to visit a friend, than I am going to see her to fix my issues. I feel like I’ve been running in place for a long time, but I am willing to ride it out a bit longer. Thanks for all of the advice, this has been very helpful.

markferg's avatar

No need for the dramatics of ‘firing’ anyone. Just stop going. Would be polite to cancel any further appointments. I went to a chiropractor for a few sessions and didn’t find it useful after the first couple of visits, so I just didn’t book any more sessions and stopped going.

I suppose it depends on the nature of the ‘therapy’. From what I hear about US ‘therapists’, they just sound like emotional blackmailers constantly grooming victims.

JilltheTooth's avatar

@markferg : Just FYI, US therapists are like any others, some are good, some are not, I’m wondering where you got your information for such a gross generalization.

marinelife's avatar

I told my therapist that he could not offer what I needed any longer, but you don’t have to so that. You can just stop making appointments.

As to deciding who you want to work with next, you have to meet them and evaluate their manner. Ask what their philosophy of therapy is, ask how they will proceed with you.

JLeslie's avatar

@ANef_is_Enuf Maybe you need someone more oriented towards Cognitive Behavioral methods? I only say this because you say she feels like a friend. Possibly is not questioning your thought process enough or not giving you different ways to approach the issues you struggle with? Possibly she has a little bit of counter transference and identiies with you too much. Just ideas. Obviously I have no idea what type of therapy you have been involved in.

I have had two really good therapists in my life, most of them didn’t help me much. I don’t stick with the ones who are not helping. I also don’t go to therapsts for months and months on end. But, I don’t have chronic mental health issues. I usually go during very stressful times in my life. Only once was I really in a growth stage of my life and was very depressed for a longish period, back when I was a teen. I actually don’t like Cognitive Behavioral much for myself, but it has extremely good success rates for a variety of difficulties.

If part of your problems has to do with the past, generally I think when therapists dwell on dredging up the past and making it live more in the present it is detrimental.

ANef_is_Enuf's avatar

@JLeslie I do need CBT. I know that I do. You’re spot on with that. I wonder if it would be useful to ask her to refer me to a behavioral therapist, while I continue the talk therapy with her.

augustlan's avatar

I would first ask her for some concrete CBT practices to overcome each specific issue. If that’s not her field of expertise, then by all means ask her to refer you to someone else for that. Maybe you can cut down on the talk therapy while increasing the CBT stuff. Good luck!

Simone_De_Beauvoir's avatar

I’ve been having an issue about this as well. My current therapist has been helping since 2004 and he’s pretty much saved my life a couple of times. I feel very indebted to him and feel guilty about wanting a different person these days. I know he doesn’t really understand anything about sexuality or gender issues nor does he have the time (he’s a very busy psychiatrist) to talk about ‘conventional’ issues plaguing my life. I am considering finding a psychologist which I see to talk and keeping this guy (who I see every 3 months anyway, just for meds) without needing to fire him. I just don’t know how to tell him that I am considering seeing someone for therapy.

wundayatta's avatar

I think it would help to tell her your frustrations, and say that you want to learn some techniques that will help you deal with whatever it is you want to deal with. CBT is well-known, but it isn’t for everyone. There is much research showing that CBT achieves results.

However there is an alternative, Acceptance and Commitment Therapy. Instead of fighting your demons, as CBT teaches you, ACT teaches you to make healthy contact with thoughts, feelings, memories, and physical sensations that have been feared and avoided. I believe that mindfulness is one of the tools it uses.

My therapist sent me through CBT and ACT and I ended up with my own version of mindfulness. For me, the concept alone is enough, although I do practice it in many non-traditional ways.

I think I had about two and a half years of therapy with my therapist. Before I hired her, I interviewed her and asked her what her style was. I think she said it was based on something that places a lot of importance on family history, but she uses many different techniques. Whatever works. She was flexible and that appealed to me.

I haven’t seen her in months. I slowly increased the amount of time between appointments until it is now open-ended. I can go back for “tune-ups” at any time.

I would ask your therapist to do some specific things for you. You would have to communicate clearly what you are looking for. Have you even told her you see her as a friend more than anything? That you don’t feel like you’re getting anywhere?

One of the nice things about therapists is that you can tell them anything and they won’t be bothered by it. You can tell them they are no good, and it’s no big deal. You can tell them any of your plans without worrying that they will be insulted. It’s their job to take what you dish out, as long as it is part of your progress. I.e., abuse for abuse’s sake is not cool.

Talk to her. See what you can work out. If it doesn’t work out, ask her to help you get what you want.

Coloma's avatar

My experience with therapy is limited to some marriage counseling years ago, of which it was too late to fix the issues, for me anyway, and, a year post-divorce individual therapy that was primarily for support and validation while I attained insight on my own.

In both instances I loved my therapist and found the whole experience very helpful.

In my opinion, if one is constantly firing and hiring therapists it seems the ‘problem’ may be in expecting a magic fix to one’s issues. While not every therapist is going to be a good fit, all in all, the job of a therapist is to re-parent you in a safe environment and lead you to your own insights. They cannot do the work for you.

I think many people become addicted to therapy as a way to AVOID really doing what needs to be done. It’s akin to a spiritual ‘seekers’ addictive seeking.

Don’t get me wrong, I am not saying that there cannot be differences that might lend themselves to finding a new counselor, but….if one is constantly seeking new therapists it might just be that the ‘problem’ lies not in the therapist but in the patients idea that they know better than the therapist.

It is very common for patients with certain personality disorders to not follow through with the therapists recommendations. Self sabotage and arrogance are usually the culprits.

A truly good therapist will terminate a client and not continue to waste their time and money if no progress is being made.

The marriage counselors did this after 6 months of couples therapy.
They said ’ we are graduating you guy’s, we have given you all the tools you need and now it is up to you.’

I have an ex friend that refused to take her therapists advice and put down all the psych books and get real with her feelings.

It is very common for certain personality disordered types to not follow the therapists advice and continue to complain that they are not being helped.

I dunno..but, if one is constantly running to a new therapist it seems to me that the ‘problem’ is with the patient, not the therapist.

It all comes down to how ready someone really is to face their stuff and actually DO something about it, instead of getting stuck in the never ending story.

Therapists are not God, they don’t have a pocket full of miracles.

They cannot force anyone to wake up and do the work necessary for growth and life altering change.

JLeslie's avatar

@ANef_is_Enuf Your therapist will most likely say she can be more CBT oriented if that is what you prefer. I am not saying she can doot well or not, but most therapists tend to feel they can do both, and adjust to what the patient seems to need. It might be hard to shift gears with this same therapist though. I don’t know. I don’t know what your diagnosis is, but of it is phobias or anxiety, you might seek out a specialist in those categories.

klutzaroo's avatar

Honestly, if you keep going to people and nothing ever gets resolved there are two things you need to do. 1) Find someone who practices “brief therapy.” Their goal is to get you in, look into your problems, set goals, achieve them, and get you on your way. They’ve been taught to not draw out the process of change any longer than necessary. They won’t abandon you or anything, but they’re not going to keep you coming and keep you stuck. 2) Be prepared to work. No one can do anything for you. If you’re not doing the work, you won’t get anywhere even if Jesus himself descended from heaven and took the job. Assuming, that is… yeah. Lol. You must be prepared to do the work to fix whatever you feel needs to be fixed. If you don’t and aren’t, you might as well save your money and time because you’re not going to get anywhere.

If you’ve quit therapy several times in the past before they had a chance to actually help you, “it is usually early on in the process and I know that it is going nowhere,” its a sign that there’s something wrong with the way you’re approaching therapy, not the therapists.

To fire a therapist, just tell them that you don’t feel like you’re getting anywhere and that you need a change. The therapist will likely see it for what it is, changing therapists and looking for the one with the magic solution for all your problems without you actually having to do any work. She’s probably more than prepared for it.

I don’t really agree with the idea that CBT is your best option. Not at all.

All this is coming from someone who has actually practiced therapy in the past. Currently working on going into a different field (probably going a different way to get to a similar place) since I was in the wrong therapy program and feel like I wasted 2 years career-wise even if I learned a lot. Simply couldn’t come to terms with the methodology as taught by teachers who were so wrapped up in their personal drama that they couldn’t spare the time to help me with it. You can discount what I say as mean or whatever, but as I’m a little more in tune than the average person on the internet who hasn’t been in the other chair… Its up to you.

WillWorkForChocolate's avatar

Call me and I’ll give you free therapy over the phone. I’ll listen to your issues and concerns, I’ll offer suggestions and I’ll even make you cry so you can “get it out”. Then I’ll mail you a huge box of Godiva chocolates and a prepaid credit card to shop with. That’s all you really need. Talking, empathy, a good cry, then chocolate and shopping!!!!

klutzaroo's avatar

@WillWorkForChocolate Are you suggesting that no one is actually in need to therapy and that all they need is chocolate and someone to talk at? That you’re better than someone trained to help people work on their problems? Seriously?

Coloma's avatar

@klutzaroo

I think she is being humorous, that’s my take. ;-)

WillWorkForChocolate's avatar

@klutzaroo No, I was trying to make Neffie smile. Unclench.

JLeslie's avatar

Not that spending time with some friends, venting, getting empathy and chocolates would hurt. :)

@ANef_is_Enuf I have some additonal advice, spend time around people who live as you want to live, not those who think just like you, and empathasize too much. I truly believe we can rewire out brains, science is proving it. I am assuming you are not very extreme in your difficulties, not psychotic, and we become our surroundings generally. Misery loves company can be a horrible thing to live by. Not sure if this helps. Be around the happy people. Fake it til you make it is a part of Cognitive Behavioral, in my opinion, eventually the behavior becomes a part of your life.

gene116's avatar

“My insurance company dropped me, can I still come to sessions pro bono?” See how quickly they kick you to the curb…

ANef_is_Enuf's avatar

Firstly, it isn’t that no therapist has ever helped me and that I habitually drop them. I have been through a lot of ups and downs over the years, all relating back to the same issues. I have “fired” a lot of therapists that I knew from the start were just not a good match for me. That was early on in the process, and I do feel that finding someone that you mesh well with is important. I have also stopped going to therapy when I was doing well, I’ve had one therapist in the past that I was with for about a year which took me from rock bottom to living the best years of my life. I have had therapy work for me in the past.
This time I just let the issues grab hold before I recognized that I was getting sucked under, and by then it was “too late.” So to speak. I also know that I have to do the work. I know that I have to be the one that ultimately changes my own path, but I go to therapy seeking a plan of action. I need help getting that ball rolling, and if that hasn’t started in 8 months time.. then I’m concerned. I’m not sure that chatting every week (which is essentially what we do) is the right course of action for me.
I don’t ignore my therapist’s advice. **In fact, my therapist doesn’t GIVE me any advice. All we do is talk.**
I don’t expect her to work miracles.
I don’t expect her to magically “fix” what is “wrong” with me.
However, I do expect her to help me to come to starting points and develop solutions and a plan of action that will work for me. I don’t think that is unreasonable. My current therapist is excellent at decoding the past, which has been an interesting experience. I’ve learned a lot about how I got to be where I am – but there is zero focus on the future. No advice, no plans, no suggestions, no clue where to go from here. And that is what I really need help with.
Assuming that I just don’t want to do the work, or that I don’t have a healthy approach toward therapy seems like a huge leap to conclusions. The therapists that I’ve abandoned early on included one that spent our first two sessions talking through the entire time I was there about his recent divorce with his wife (I was 18 at the time, and it had no relevance to my situation.) Another example was a psychiatrist that had me on 6 prescriptions at one time, one of which was double the maximum dosage (now.. I don’t know what the maximum was at the time), and thought the best solution to counteract my feeling overmedicated – was to add another script.
I’m not compulsively going around hiring and firing therapists, but I don’t see any point in seeing a therapist if I don’t think that they can help me. I may as well be throwing my money out the door. And therapy isn’t something new to me, so it isn’t like I’m going in there expecting a magic bullet. I know what it takes to get better, and I know what I want to take home from my therapist.
I know that my concerns with my own therapist are legitimate. This isn’t me trying to weasel out of my own responsibility to do what it takes to improve my mental health.

klutzaroo's avatar

One of the main forms of brief therapy is called “solution focused” therapy.

ANef_is_Enuf's avatar

@klutzaroo thank you, that sounds like something I should look into.

klutzaroo's avatar

Link with a therapist finder.

The whole site has a lot of good info.

JLeslie's avatar

@ANef_is_Enuf I had no impression you drop your therapists constantly, just the opposite. It seems like you have stayed loyal maybe longer than you should have. Your goal to focus on the future sounds like an excellent one. Go with your gut! Trust yourself. Try a new therapist. You can always go back to this one, you don’t have to feel like it is a break up never to be able to go back. This is her job. Spending months on the past is not typical in therapy, not in productive therapy, in my opinion, especially since you seem level headed and wanting to improve.

With the new therapist rehashing the past should not take more than one or two sessions making clear you are there to work on the present and future.

klutzaroo's avatar

Oh, if she was giving you advice, she would be practicing bad therapy. Same as if she was telling you what to do.

JLeslie's avatar

@klutzaroo But, a good therapist should point out flaws and inconsistencies in her thinking, challenge her, and help her overcome fears that maintain her inability to acheive what she wants.

@ANef_is_Enuf I was watching Oprah recently and she stated this great quote, not her quote, I don’t remember who said it. “Forgiveness is letting go of the idea that the past could have been different.” I don’t know if it helps you, but I think there is brilliance in that statement.

ANef_is_Enuf's avatar

@klutzaroo perhaps “advice” was a bad word choice, I was just taking that from what @Coloma was saying about some people not wanting to take their therapist’s advice. I was just trying to express that it doesn’t apply to me. I am genuine in wanting solutions, I am genuine in wanting to get better, I am very dedicated to changing my current course. I’m just not sure how.
What I hope to gain from going to therapy is to learn how to move forward, while dealing with the thing that holds me back. Just as @JLeslie said, I’m looking for a challenge. I need an outside perspective. I also think that I would benefit from CBT. It is commonly used in treatment for OCD and obsessive compulsive spectrum disorders, so I don’t think it is unreasonable for me to think that I should consider adding that to my current therapy, even if I don’t seek it as a replacement for talk therapy. Do you?

@JLeslie, that is a wonderful quote.

JLeslie's avatar

@ANef_is_Enuf :) I just think too often we think forgiveness is saying what the other person did to us is ok. It isn’t, they might suck. Forgivenss is for you. Call it whatever you want, it does not need to be called forgiveness. If you tend to be OCD, the obsessive brain, unfortunately, in my opinion, keeps writing the horrors and dissapointment, engraving them deeper and deeper into our memory. A little bit of memory fog can be a good thing. Allowing memories to fade, changing your focus will help you feel better I think. All of my friends who are addicts and/or obsess about how they have been dissapointed, live in the past, and live with tremendous shame. If you have tremendous shame and regret, I promise there is nothing you have done, or that has been done to you, that you have to feel so badly about (assuming you have not murdered anyone in cold blood). You would be amazed at how understanding people can be, and how they don’t dwell on what happened in your past, but focus on you now. The friend and family member you are now.

MyNewtBoobs's avatar

I like the referral method – asking your city’s LiveJournal forum, friends (I know which of my friends have been in therapy, and they all know I’ve been in therapy – to know me is much scarier if you don’t know I’m getting help), family doctors, other doctors, whatever.

YARNLADY's avatar

Taking therapist advice might be something like this related example. My GP doctor says I need to exercise more, and I agree, but I don’t get up and take my walks. Do I fire my doctor because I’m not losing weight?

ANef_is_Enuf's avatar

@YARNLADY not “taking advice” isn’t the problem.

Kardamom's avatar

I like the idea of having a list of questions to ask or interview your next potential therapist.

Make sure that the therapist specializes in working with people who are suffering from the same condition/problem/symptoms that you have. And that they have the correct educational qualifications for that type of therapy. And how long they have been helping people and what their goals are for helping people (long term maintenance, brief goal oriented action etc)

Ask them about the success rate of his/her patients that have a similar problem. Ask how long does it generally take for someone to be able to stop the therapy and be able to successfully move forward.

Let them know that a certain personality type (for the therapist) is important for you and try to explain what that type is (talkative, explanative, compassionate, positive, lets you talk, pays attention to your concerns, can talk you down from scary situations, gives concrete examples for exercises for you to follow, or whatever it is that you think is important) because if you don’t feel comfortable with the therapist, no matter how smart they are, it won’t do you any good if you feel weird.

Ask each candidate if they think cognitive, talk and medical therapy in combination is the best course of action for you and why.

Do you have phobias that interfere with your being able to continue down the path and conquer your problems? If so, does the therapist think you should go to a separate phobia therapist to deal with the phobias as separate entities or should one therapist deal with everything? And ask them why they think this?

Do you have something like OCD which may require medication to deal with that, before you can work on any of the other problems that you need to work on? If so, does this therapist have the training and ability to deal with all of it, or should you see someone who deals with the OCD type of thing as a separate entity?

Are your problems something like PTSD? If so, ask them if you need to be treated with medications, talk and cognitive therapy and should you see different people for each of these things?

Do you have anything like alcoholism or drug dependency which would make it necessary for you to have a life long partner to assist you with remaining sober (like the partners that you get at AA)? If so, how will the new therapist accomodate the partner into the therapy?

It’s funny, when I read your initial posting for this question, I just get the feeling that you are so with it and together that YOU should be a therapist. I just hope that you are able to either get the current therapist to help you in a more productive way or that you are able to fine one or more in combination that can help you. Good luck and please keep us in the loop. : )

klutzaroo's avatar

If you think CBT will help you, go for it. From what you’re saying, I’d suggest moving to SF therapy. I’ve got some issues with CBT, but if you feel like its something that would be helpful… go for it.

aLittleBit's avatar

I strongly suggest that you find a therapist who specializes in YOU! The Therapeutic relationship is a central factor to the recovery process. It is not imperative that the therapist/ patient relationship be a “feel good” experience. In truth, when the negative Transference rears its ugly head CHANGE begins. TRUST is key. Transference is inevitable and, in my most humble opinion, the guide through the fog. Most importantly, the connection between the therapist and patient and therefore, the Transference that develops out of that connection are the catalyst for the undoing of the “Defense Mechanisms” which we create during our formative years.

Put in simpler terms…Find a therapist with whom you are challenged to become the Healthier You. If he or she specializes in OCD, even better! Seek the person inside of the therapist and go from there! After that, ...Get plenty of rest, take two aspirin and call me in the morning.

akane66's avatar

Almost every point I have seen in this thread has been refuted and justified by other sources. I’m not saying that everyone is “wrong” and that the other sources are “right”, (or vice versa) ..but that this whole thread illustrates the need to exercise using one’s own judgement as opposed to getting caught in the trap of relying on a therapist to do the same.

I, myself would not choose a therapist who saw fit to function as a “parent” or give advice, but others may find that useful. There are also PLENTY of bad therapists out there…caveat emptor. The goal is to rely on one’s OWN sense of self, and the only way to do that is to practice trusting that sense of self. I believe that one needs to trust oneself before one can trust another person, including a T. This does not guarantee that no mistakes will be made, but that’s life.

To me, a therapist is there to offer a different perspective, not “give advice” that I’m required to follow like a child. If personal growth doesn’t come from within oneself, no amount of “browbeating” by a therapist is going to produce lasting results. This is why I prefer an existentialist or client-centered therapist. BTW other studies have shown (I got a few from PubMed with good p values).. that ANY type of therapy works if there is a good fit with the therapist. I do not like CBT, personally, I had to take a class in it, and it’s not for me.

I any event, I will be using the money I would have spent on therapy for a trip to Europe, and to me, this feels absolutely right for now. (Please remember that this is what works for ME…but getting out is the best decision I have ever made! I feel free!

Trust yourself, one way or another, you will find the answers you are looking for.

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