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Love, Sex, and Relationships in Therapy: A Holistic Approach

Cheryl MacDonald
A man and a woman are laying on a bed.

As a therapist and tantric practitioner, I've learned that when people come to discuss their relationships, they're often bringing layers of complex emotions and unmet needs. Over the years, I've seen how love, sex, and relationships are so deeply interconnected that you can't address one without impacting the others. Whether you're working on relationship issues alone or with your partner, considering all three together can be the key to significant change.

In therapy, treating these aspects as a whole is where the real transformation happens. It's not about fixing what's broken; it's about helping you create a life and relationship that feel fulfilling, both emotionally and physically.

Why Love, Sex, and Relationships Must Be Treated As A Whole

Emotional and Physical Intimacy 

One couple I worked with felt stuck in their relationship. What seemed like communication issues was actually an emotional disconnection directly tied to their lack of physical intimacy. One partner felt shut out emotionally, and as a result, the other was pulling away sexually because he didn't know how to express his feelings. Addressing both their emotional and physical intimacy together led to real shifts in their relationship.

Sexual Health and Relationship Satisfaction

Clients often think their sexual struggles are purely physical, but these issues usually point to something deeper. I worked with a couple whose physical relationship had fizzled out over the years. Avoiding the topic entirely, they didn't realize that the emotional disconnect was affecting their sexual health. Bringing their sexual well-being into the conversation revealed unmet needs, allowing them to rebuild that aspect of their relationship.


Individual Growth vs. Couple Dynamics

Individual growth is just as important as relationship growth. Many clients come to work on their relationship as an individual. Thai could be because their partner doesn’t want to come to therapy; it’s something they can’t or don’t want to discuss with their partner or they’re recovering from divorce or a break up and want to get rid of unhealthy relationship patterns. One client of mine kept attracting the same types of men, which ultimately led to her having negative experiences. Through therapy, she realized her relationship with love and sex had been shaped by unhealed early experiences. By focusing on her own personal healing, she was able to have healthier, more fulfilling relationships.

The Benefits of Holistic Therapy for Love, Sex, and Relationships


Integrative Therapy Approaches

Training in Dr. Tammy Nelson's integrative approach, which treats emotional and sexual intimacy together, has shown me how sexual challenges often mirror our emotional struggles. I worked with a couple married for nearly 20 years who loved each other but the physical spark had gone. It was so important to explore both the emotional and physical aspects of their relationship, and this helped them rebuild intimacy from the inside out.

The Role of Tantra in Strengthening Bonds

Tantra is an invaluable tool for couples looking to reconnect on a deeper level. When people hear the word ‘Tantra’ they immediately think about sex, but there is so much more to it than that.Tantra is actually a spiritual practice that aims to integrate the body, mind, and spirit and includes a range of teachings, meditation and rituals. I remember working with one couple, who felt like they’d lost the closeness they once had after years of marriage. They weren’t sure how to get it back, and the pressure to “fix” their sex life felt overwhelming. I introduced them to some simple Tantra-inspired exercises — not focusing on sex itself, but on breathing together and being fully present with each other. Using small, intentional practices can help couples to find their way back to intimacy. It wasn’t magic; it was simple mindfulness.

Working On Yourself NOT Just Your Relationship

One client loved her partner deeply but felt her own needs were constantly on the backburner. Through therapy, she realized that being in a relationship didn't have to mean neglecting herself. We explored her desires, her personal boundaries, and the importance of loving herself as an individual, which ultimately strengthened her relationship. She found that attending to her own needs made her feel more balanced and was better able to be there for her partner.


How Therapy Can Help Individuals Address Love and Sexuality

Unpacking Your Personal Beliefs About Love and Sex

We all have core beliefs about love and sex, often stemming from our upbringing. One of my clients grew up in a strict household where sex was never discussed and surrounded by shame. As an adult, he struggled to enjoy sex due to this subconscious guilt. In therapy, we unpacked these core beliefs, where they came from and allowed him to question and rewrite these narratives. This shift opened up new possibilities for intimacy in his relationship.


Healing Sexual Trauma and Shame

Sexual trauma can have profound effects on relationships, and it's something I approach with great care. One client that I worked with experienced trauma in her teens had never felt comfortable discussing it. In therapy, we worked through her deep-seated feelings of shame and fear, helping her reconnect with her body in a gentle, safe way using Somatic practices. Seeing her move toward self-acceptance and opening up to relationships and intimacy was very emotional.


Improving Self-Esteem and Sexual Confidence

For some clients, the root issue is a lack of confidence. One client came to me feeling self-conscious about her body and unsure how to communicate her desires. We focused on encouraging her to love her body and soul; and building her self-esteem and sexual confidence. Gradually, she began to see herself differently, becoming more confident not just in the bedroom but in every area of her life.

How Therapy Supports Couples in Navigating Love, Sex, and Relationships


Reigniting Desire

Dr. Nelson's practices for reigniting desire have been transformative for many of my clients. Couples often end up feeling like "roommates" rather than romantic partners. We start by helping them reconnect emotionally, then explore practical ways to reignite physical desire. It's about creating a safe space where desire can naturally revive, not about forcing intimacy.


Communicating Your Needs and Boundaries

Communication is everything in relationships, including discussions about sex. Many couples avoid these conversations for years. Therapy will provide a space to practice talking about needs and boundaries. Once they begin, couples often find their connection deepens in their everyday life in unexpected ways, because of that opening up and honesty.


Tantra-Inspired Practices for Connection

Sometimes, the simple practices create the most powerful changes. Incorporating Tantra-inspired exercises focusing on touch, breath, and presence can help to create a sense of closeness that couples may have thought was gone forever.



Why Address Love, Sex, and Relationships Holistically

Understanding that love, sex, and relationships are interconnected helps everything make more sense. Emotional disconnection can lead to physical distance and vice versa. Looking at the bigger picture rather than fixing one problem at a time allows for finding balance.

Our sexual well-being is closely tied to our emotional and physical health but often gets overlooked or ignored. Focusing on your sexual well-being can impact every area of your life. A healthy, fulfilling relationship—whether with yourself or a partner—is the foundation of a happier, more balanced life.

Integrative Therapy that addresses love, sex, and relationships holistically is where rea, sustainable change happens. By integrating techniques from various therapy styles or Tantra practices, you can create opportunities for lasting change—not just in your relationships but in every area of your life.


For more information, email: info@counselingperspective.com


By Cheryl MacDonald March 31, 2025
ADHD isn’t just something that hyperactive little boys have, and it certainly doesn’t disappear when you grow up. For many women, ADHD remains undiagnosed for decades, leading to overwhelm, self-doubt, and frustration. When motherhood enters the mix, these feelings become even more intense—bringing a daily battle with organization, emotional regulation, and the never-ending mental load. If you’re an adult woman with ADHD and also a mum, you are not alone. I see you, and I understand the challenges firsthand. Diagnosed at 35, I know what it’s like to spend years feeling like I struggled to do the most simple of things that other mums breezed through—only to later realize that ADHD had been running the show all along. But once you understand your ADHD, you can work with it—instead of it ruling you. I’ve made it my mission to help women reclaim control over their lives. Through my Balance Quest ADHD Screening & Symptom Management Programme, I guide women just like you in overcoming obstacles and finding strategies that actually work. The Hidden Struggles of Late Diagnosis ADHD in women is often misunderstood or dismissed. Many of us grow up being told we’re just "scatterbrained," "too sensitive," or "lazy"—when in reality, we’ve been living with a neurodevelopmental condition that impacts focus, emotional regulation, and executive function. It’s no surprise that many women don’t get diagnosed until their 30s, 40s, or even later. We spend years masking our struggles, trying to keep up, and wondering why everything feels so much harder than it seems for everyone else. Common Signs of ADHD in Women: • Constantly feeling overwhelmed by daily responsibilities • Difficulty keeping up with schedules, appointments, or deadlines • Struggling with emotional regulation—frequent frustration, anxiety, or low self-esteem • Forgetting things (even important ones) or losing track of time • Being disorganized, despite trying countless planners and systems • Feeling like you’re "always behind" or "never doing enough" Does this sound familiar? You are not broken. Your brain just works differently—and that’s okay. The Invisible Struggles of Motherhood with ADHD If managing ADHD is already overwhelming, motherhood can make this 10X more challenging. The constant demands, unpredictable routines, and 24-7 caring for children can leave ADHD mums exhausted, overstimulated, and feeling like they’re a failure. Here’s how ADHD can impact motherhood: 1. Debilitating Overwhelm Juggling school schedules, meal planning, and managing the household, the never-ending to-do list can feel absolutely impossible to keep up with. ADHD mums often struggle with procrastination and forgetfulness, making keeping on top of things so much harder. 2. Mum Guilt and Staying Calm in Chaos ADHD affects our impulse control and emotional regulation, meaning that irritability, frustration, or overstimulation can hit really hard—especially when kids demand constant attention. Most ADHD mums feel guilty for snapping at their children or struggling to be patient 3. Sticking To Daily Routines Planning ahead, following schedules, and staying organized? Easier said than done. Many ADHD mums really struggle with executive function, making ‘simple’ daily tasks like packing lunches, remembering school events, or sticking to a structured routine feel like an uphill battle. 4. When You Doubt Yourself Many ADHD women have spent their lives masking their symptoms, trying to "keep up" with neurotypical expectations. This can lead to crippling self-doubt and perfectionism, making us feel like we’re constantly falling short as mothers. 5. It Can Become TOO MUCH The constant noise, touch, and chaos of parenting can be overwhelming for ADHD brains, leading to sensory overload, stress, and emotional exhaustion. This can make it difficult to be present, patient, and engaged. Struggling doesn’t mean failing. ADHD mums are some of the most creative, compassionate, and resilient women I know. With the right support and strategies, you can turn ADHD challenges into strengths. How Therapy & The Balance Quest Programme Can Help : I created Balance Quest ADHD Screening & Symptom Management Programme because I know how life-changing it is to finally understand your ADHD and develop strategies that actually work. It’s not about fixing yourself—it’s about working with your brain, not against it. Here’s how we can help: 🔹 Understanding ADHD in Women Every woman’s ADHD experience is completely unique. In personalized sessions, we explore how ADHD affects your daily life and develop strategies tailored to your specific challenges. 🔹 Time Management & Organization We’ll work together to create realistic, ADHD-friendly routines and strategies that help you prioritize, structure, and actually follow through on tasks. No more trying to fit into neurotypical systems that don’t work for you! 🔹 Emotional Regulation & Stress Management Learning to manage frustration, anxiety, and mom guilt is key. We’ll use practical techniques from Cognitive Behavioral Therapy (CBT), mindfulness, and breathwork to help you navigate emotions with more ease. 🔹 Self-Esteem & Confidence Building Years of undiagnosed ADHD can leave women with a damaged sense of self-worth. Therapy can help you reframe negative self-talk, recognize your strengths, and develop self-compassion. 🔹 Career & Work-Life Balance ADHD can make workplace challenges feel overwhelming. We help women advocate for accommodations, improve focus, and develop productivity strategies that actually workwith an ADHD brain. 🔹 Relationships & Communication ADHD can impact personal and professional relationships. Therapy provides tools for setting boundaries, improving communication, and deepening connections with partners, family, and friends. 🔹 Self-Care & Burnout Prevention Many ADHD women struggle with all-or-nothing thinking around self-care. We focus on realistic, sustainable self-care strategies that fit into your life without feeling like another overwhelming to-do. Through one-on-one therapy, ADHD coaching, and structured support programs, we provide the tools you need to take control of your ADHD and build a life that actually worksfor you. You Are Not Failing If you’ve spent years struggling, questioning yourself, or feeling like you’re constantly falling short—please know this: You are not failing. You are not broken. You are simply a woman with ADHD who deserves support and strategies that work for YOU. Being a mum with ADHD is challenging, but you’re also a mum with tons of creativity, love, and resilience. With the right tools, you can learn to manage overwhelm and create a fulfilling life. If you’re ready to take the next step, I’m here to help. Whether you’re newly diagnosed, suspect you have ADHD, or simply want to learn strategies to feel more in control of your life, let’s work together. 📌 Book a session with me at Counselling Perspective (in-person or online) and start your Balance Quest today. 🌟 You don’t have to figure this out alone—because ADHD women deserve support, understanding, and the chance to thrive. For more information: info@counselingperspective.com
By Zina De Mercey February 28, 2025
Women’s Day is more than a celebration, it’s an opportunity to rethink women’s major health concerns: stress, one of the leading causes of health issues. It’s a chance to reflect on healthier ways to cope with it. As women, how many times have you felt challenged by stress? The kind that follows you through the day and keeps you up at night, tightening your chest as you mentally replay overwhelming worries? Despite considerable advances, significant gaps remain in our acknowledgement of stress related to gendered caring roles. While stress is universal, we know that women and men experience it in very different ways. Women are more likely to feel overwhelmed and exhausted by stress. We also know that women are exposed to chronic stress than men. Why it is so? The silent burden of women When it comes to women and stress, the answer to this question partly lies in social constructs, role prescription and emotional labor. Although stress is an unavoidable part of life, for women; it often comes in layers: Being a devoted mother, a family caregiver, a loving and supportive wife, and a successful career woman while maintaining social expectations in terms of beauty, fitness, ageing, and emotional support can beoverwhelming. This, is the invisible burden that women disproportionally carry and that contributes to the strain many women feel daily. As a result, women often internalize stress by developing perfectionist tendencies as a way to cope with the pressure of juggling multiple roles. This situation is further intensified by the disconnection between what’s expected of women and what is it, really, to be a women in today’s world. This snowballing effect leads women to put more pressure on themselves trying to solve this complex equation, relentlessly willing to close the gap between social expectations and reality of womanhood. As a therapist, I have encountered many women facing stressful events struggling with self-defeating beliefs such as “I fail if I can’t do it all” , “ I should stay strong for everyone” or "I should be able to handle everything on my own" . Those thoughts are deeply ingrained in women’s minds and they often reinforce guilt, emotional suppression, and perfectionism;making stress even more overwhelming. What are the causes of women stress? The main identified causes of stress are professional life, financial problems, couple life, and health issues. However, the reality of women balancing multiple roles across professional, personal, and social spheres intensifies stress and exhaustion as they navigate conflicting demands. Here are common sources of stress for women: Work-related stress: In the workplace, women's stress often arises from unexpected sources. On the top of their duties as professionals’, women are expected to demonstrate greater empathy, patience, and emotional control. The glass ceiling and gender biases create additional pressure by imposing higher expectations on women. Maintaining work-life balance also remains a constant source of stress. “Super-women” syndrome: Women often face a “second shift,” balancing professional and domestic responsibilities, which significantly increases stress. Managing schedules, tracking household tasks, and remembering key dates add to their mental load. Parenting further amplifies this stress, as societal expectations and the "Perfect Mother" myth set unattainable standards. Many women feel compelled to meet these ideals, often at the cost of their own well-being. Women face immense pressure to excel in multiple roles at once. This relentless demand fosters resentment, fatigue, and stress, particularly when their efforts go unrecognized. Love & Load: As a couple therapist, I experienced several key stressors that women face in their relationships. Traditional gender norms still expect women to prioritize their relationships and family over personal needs. A women may not engage in pursuing her career, stepping up the laddersfearing relationship strain. The struggle to balance self-identity and relationship expectations, combined with guilt and self-doubt when prioritizing personal goals, often creates internal conflict and increased stress for women. How do we react to stress? While short term stress can be a source of motivation, chronic stress gradually depletes mental, emotional, and physical health. Chronic stress impacts all aspects of well-being: psychologically, it leads to emotional exhaustion and low self-esteem; emotionally, it causes breakdowns and burnout; physically, it weakens immunity and increases health risks; and behaviorally, it fosters withdrawal and maladaptive coping. Early intervention is key to preventing long-term harm. How to better cope with stress? International Women’s Day is an opportunity to pause and reflect on better ways to manage stress through healthy and adaptive coping strategies that enhance women’ quality of life and overall well-being. Here are some healthy strategies to relate to: 1. Separate the Stress from the stressor When experiencing stress, it is important to separate stress from the stressor. Stress is your body’s physiological response that follows a cycle with a beginning, middle, and an end;while the stressor is the external trigger. You don’t have to fix your problem to release stress. Even if the stressor (work deadlines, family conflicts or couple issues) is still present, you can release stress physically and emotionally through simple actions like: deep breathing, crying or sharing a warm hug with a loved one. Visualization can be a powerful tool. Closing your eyes and picturing a safe, comforting space helps your body process stress, relax and reset. 2. Be friend with stress When we experience stress our body respond in different ways, each of them shaping the way we cope with our challenges. Fight Mode: Reacting with frustration, defensiveness, or aggression. Instead of lashing out, try to pause before reacting and reset your response through deep breathing. Flight Mode: Feeling overwhelmed and wanting to withdraw. Try to regain a sense of control by breaking challenges into small, manageable and controllable steps. Befriend Mode: Research shows that this strategy leads to better outcome. Women tend to embrace stress by seeking support rather than fighting or fleeing. They often turn to connection, sharing their worries with their loved ones, which helps regulate the nervous system and alleviate stress. Recognizing different coping mechanisms allows us to adopt a more constructive approach to managing stress and its triggers. 3. Stress as a lever not a threat Instead of seeing stress as a threat, reframe your mindset: Stress is just your body’s reaction to any change that requires an adjustment or a response. Stress prepares you to face your challenge. Instead of seeing stress as a threat, making peace with it allows us to harness its energy, its motivational force, build resilience, and navigate our challenges with greater response. When your heart races, when anxiety increases just think: “My body is just giving me a motivational force to overcome my challenge” or “How can I use this force for good to mitigate my worries?”. Shifting our perspective to see stress as a positive force fosters resilience, turning challenges into opportunities. Trusting our ability to adapt is key. 4. Reframing, Is the glass half-full or half-empty? When worries pile up, stress takes control. That’s the moment to pause and reframe. Ask yourself, “Is the glass half-full or half-empty?” Shift from “I’ll never get through this” to “I’ll take it one step at a time.” Try changing your perspective, identify one potential benefit in the challenge, recall past moments when you successfully managed stress, or focus on a small, actionable step within your control. Reframing is essential because stress has an impact on our cognitive flexibility, it narrows our thinking, distorts our perspective, and makes challenges feel bigger than they are. Remember, you’re doing your best, and that’s enough! 5. Resonance as a stress relief To relentless pressure, we, women need to find our own deep connection to the world to healthily cope with stress. Hartmut Rosa's concept of “Resonance” emphasizes shifting from control to meaningful connection whether in relationships, work, nature, or creativity fostering deeper connection, well-being, and a more fulfilling way of experiencing life. Instead of viewing life as a checklist of tasks, a relentless pursuit of perfection and performance, or a constant drive for efficiency, we should focus on experiencing life purposefully. Rather than seeking validation, we need to connect with what truly matters. Instead of feeling trapped by expectations, we should embrace being fully present in the moment and finding joy in the “here” and “now”. Constantly reminding ourselves that our worth is not defined by external standards. Many activities can help us engage in a form of “Resonance” to ourselves and to the world, including yoga, sound healing, meditation, and gratitude practices. Keeping in mind that true support for women stress comes from all genders, including men, in a shared commitment to balance, equity, and well-being.
By Cheryl MacDonald February 28, 2025
Perimenopause is something that’s rarely talked about and even less understood. This is the time in a woman's life BEFORE Menopause (defined as the cessation of menstruation for at least 12 months), and this is actually when most of the big changes are happening. Even more surprising? That most women over 35 are already in perimenopause, even if they don’t show significant symptoms, this coincides with a woman's drop in fertility. Perimenopause isn’t just about hot flashes and irregular periods. It’s a deeply personal transformation that can shake your confidence, impact your relationships, and make you question your sense of self. I know this not just as a psychotherapist but also as a yoga master, health coach, and the creator of YogaPause (and author of best-selling book by the same name)—a method I developed after years of working with women navigating this life stage.  I’ve spent over two decades guiding women through transitions, and I’m currently writing my research thesis on self-esteem and relationships in women aged 40-55. I see more clearly than ever how perimenopause can challenge our identity. The good news is that you don’t have to go through it alone. Therapy can help you navigate the changes, build your confidence and reframe what you want from life going forward. How Getting Older Affects Your Self-Esteem Perimenopause has a sneaky way of making us question ourselves. It stirs up emotions, shifts our bodies in ways we don’t always recognize, and brings up thoughts like: Who am I now? Do I still matter? What the hell am I going to do with my life now? Here are some of the things that could be chipping away at your self-esteem: 1. Your Body Doesn’t Look The Same Suddenly, the body you’ve known for decades starts to feel foreign. Weight gain, bloating, thinning hair, dry skin—these changes can make you feel very self-conscious. Many of us look in the mirror and don’t recognize ourselves, we’re self-critical and insecure. 2. Brain Fog Ever walked into a room and forgotten why? Or struggled to remember someone’s name mid-conversation? Perimenopause can bring cognitive shifts that leave us feeling less than sharp and doubting our abilities. When you start second-guessing yourself, your confidence takes a big hit. 3. Emotional Sensitivity and Self-Doubt Mood swings, irritability, and feeling emotionally raw are all common. One moment, you feel fine; the next, you're in tears over an advert with an injured hedgehog. When your emotions become unpredictable, it’s easy to start doubting yourself and feeling like you’re “too much” or “not enough.” 4. Women Are Supposed To Be Young FOREVER Society isn’t always kind to women over 40. From media to workplace biases, we get messages that our worth diminishes with age. Many women struggle with feeling invisible, less desirable, or irrelevant—especially in their careers and relationships. This Is How Perimenopause Can Impact Your Relationships: When our self-esteem starts to waver, our relationships feel the strain. I see this time and again in the women I work with. They tell me: I don’t feel connected to my partner anymore. I feel lonely, even when I’m surrounded by people. Here’s some of the ways perimenopause could be affecting your relationships: 1. You’re Pulling Away From Your Partner If you’re feeling low about yourself, it’s easy to pull away—emotionally and physically. Changes in your libido, body image worries, and mood fluctuations can lead to less intimacy and more misunderstandings. 2. Your Grumpy and Irrational Hormonal changes can make emotions feel bigger than normal: Think PMS on Steroids. Small things that never bothered you before suddenly feel overwhelming. If you find yourself snapping at loved ones or feeling unheard, you’re not alone and it’s normal. 3. You Feel Alone In This Many women say, No one understands what I’m going through. This feeling can lead to withdrawing from social circles, avoiding deep conversations, or even drifting away from close friends. Perimenopause is REAL and big and challenging and you need to be supported by other women who understand and can relate. 4. Changing Family Roles At this stage of life, many of us are also dealing with our kids growing up and leaving home, ageing parents, or career transitions. All of these stressors can add to feelings of overwhelm, and lack of purpose or sense of self, making it even harder to prioritize relationships. How Therapy Can Help You Figure Out Who You Are AndWhat You Want From Life 40+ Here’s something I want every woman to hear: You are not losing yourself. You are evolving.Therapy can help you navigate this transition with self-compassion, clarity, and confidence. 40+ can be the best stage of your life - you just need to approach it in the right way. 1. It Can Help You Rebuild Your Self-Esteem Therapy helps you challenge the negative self-talk that can come with ageing. It’s about shifting the focus from what’s changing to what’s still strong within you - or better yet, what’s STRONGER. Learning to redefine beauty, value, and self-worth is an essential part of this process. 2. Understanding and Managing Your Emotions Cognitive Behavioral Therapy (CBT), mindfulness, and breathwork can be powerful tools for managing hormonal mood swings, anxiety, and self-doubt. In my practice, I often integrate yoga and breathwork and nutrition alongside psychotherapy to help women create a mind-body connection that fosters emotional balance. A full life approach is the most effective way to move forward into this next life stage. 3. Strengthening Your Relationships Does your marriage have a whole new range of issues? Feeling disconnected from friends? Therapy can help you identify how your self-esteem impacts your relationships and help you communicate what you need and how you’re feeling with confidence. 4. Accepting Your Changing Body Instead of seeing physical changes as losses, therapy can help shift the narrative to self-acceptance. My YogaPause method combines gentle movement, breathwork, and mindfulness to reconnect women with their bodies in a way that feels empowering rather than defeating. Building physical strength and mental resilience are an essential part of the journey. 5. Finding a New Sense of Purpose Perimenopause isn’t an ending—it’s also a beginning. Many women feel lost in this transition, but therapy can help them rediscover passions, set new goals, and redefine what fulfillment looks like in this next chapter. This can absolutely be the best time of your life. You Deserve Support Perimenopause is more than a biological transition—it’s an emotional, psychological, and deeply personal one. It can feel overwhelming, but help is available. Therapy provides a space to rediscover yourself, strengthen your relationships, and step into this new life phase with confidence. If you’re feeling lost, struggling with self-esteem, or noticing strain in your relationships, reach out. You are not alone.
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