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Combat And Veterans PTSD

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anthony

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Did you know that during your military training, you were actually taught to instinctively have some aspects of PTSD? People here have often said to me that when they went looking across the web for PTSD related content or communities, they are normally vastly about veterans, military and combat related persons who suffer PTSD, with little scope for everyone else who suffer this dreaded disorder. The reason that some people highlight military PTSD, and generally without even knowing it, is because those who have endured combat experience often suffer more of the symptoms on a daily basis vs. someone who may have been abused as a child, involved in an accident or raped, even. Now, DO NOT get me wrong here; I am a firm believer that all PTSD is equal, and I maintain that attitude.

The difference that is assimilated with veterans and civilian PTSD is that military members normally suffer more symptoms daily than those of other reasons. Now take special note of my highlight, "normally suffer more symptoms daily," not always, but generally do. This has nothing to do with the intensity of each person's symptoms with PTSD as such, as a person who was raped may suffer anxiety at extreme levels, depression and social disorders to the point of being scared to leave their home in fear of being attacked again, where a veteran will often suffer more symptoms, but not necessarily at a higher intensity each day.

The reason that military veterans and those in combat roles suffer more symptoms is because of the training they have received. When in basic training, you're taught to eat, sleep, walk, talk, run, drill, weapons, etc., to the level that it is instinctive, and you don't have to think about doing these actions - they are just natural. Military persons will generally eat faster than a person without military training, because of the very initial training endured which teaches you to eat quick and continue on. Why? Because you need to survive on the battlefield, and you don't have the luxury of taking your time to eat, nor do you have the luxury not to eat, or else you fall down and become a casualty.

It's all about your alertness level, and your ability to switch from inactive to active at command from a superior. A normal civilian's alertness levels are low, compared to a military member's. The simple reason for this is that military doesn't have the time to hype a soldier up as such, take them from low to high, which takes a lot of time to achieve, whereas being pre-programmed as such leaves a much lesser effort upon the military in time of need. What this pre-programming does is places those with military training at a level to be dropped into battle and ready to fight, with low levels of soldiers breaking down, and being scared as such. This level elevates the natural human emotion of being scared, and places a soldier in a state of readiness, that when adrenalin kicks in, the soldier will continue to fight and kill the enemy, without hesitation, without question. This isn't an isolated training technique in that it works in conjunction with other tactics we are programmed with, being mateship, look after your buddy, work as a team, don't let the team down, etc. When dropped into combat, nobody dare let down their buddy, their mate; thus, they fight whether they want to or not - adrenalin kicks in and takes over.

If you dropped a civilian into a war zone, they would run the other way. Australian soldiers are always trained to fight into where the shots come from, or the threat as such. This is what makes Australian soldiers instinctively run towards a threat, as opposed to running away from it. Army is more prevalent than other services because of the nature of being the combat soldier, as opposed to Air Force or Naval personnel. Regardless of what country, all Army soldiers are pre-programmed to an extent for this exact conflict; thus they are trained to have certain symptoms of PTSD, being:

Arousal Symptoms:
  • Sleep disturbance (trained to sleep lightly, wake up constantly for piquets and duties)
  • Anger and irritability (bayonet fighting, hand to hand combat)
  • Concentration problems (black or white thinking, no in between)
  • Constantly on the look-out for signs of danger (patrolling, scouting, sentries, enemy awareness, etc.)
  • Jumpy, easily startled (quick reaction to noise, events or incidents, immediate turn into the direction)
Emotions

  • No remorse for the enemy
  • Trained to kill
  • Show no emotions, be strong, fight through
Have a look at the post traumatic stress disorder symptoms for yourself, and without looking at PTSD, look at what symptoms are actually because of military training - or more to the point, are heightened because of your military training.

If you had a level to gauge alertness, readiness and vigilance from 0 - 10, a civilian would be around (1 - 2), where a soldier is actually programmed to sit around the (7) mark, and are basically paused as such, until needed for active duty, at which time your level is raised to (9 - 10). On completion of active duty, you are relaxed back to a (7) again. The problem is that when you leave the military, you are never deprogrammed as such - you are never lowered back to a suitable alertness and vigilance level. This is also two fold in that if the military ever required your services again under war time treaties, they can call on you with little training to raise that alert level to fight again.

Interesting, but factually true. This is why soldiers tend to suffer more symptoms of PTSD on a daily basis than those civilian equivalents who have PTSD, though they don't suffer many symptoms at once; more just the main symptoms.

I want to add this below extract to this post, from The Australian Vietnam Veterans Experience, because I think it depicts exactly what I was trying to say above: that things are different with a veteran, compared to civilian incidents that stem PTSD, because the training one receives in the military has a lot to do with things, compared to not having this particular type of brain washing. You decide...the below does not contain all parts of each topic, just what I have felt are directly related to this thread's topic.

SERVICE TRAINING

The Services use a unique method of training their personnel, especially the army. It is a very rigid and structured form of education. No other form of education has such a powerful influence on the soldier's life. Why is it that you have difficulty remembering your wife or children's birth dates, but you can always remember your Service Number? Why is it that many veterans are competitive, generally have rigid family values, have difficulty maintaining relationships, cannot achieve intimacy, lack motivation, hate being in crowded locations and are social phobics? Setting aside the condition of PTSD, I believe that a precursor to the condition is the nature of the training all service personnel go through. It is suggested that many veterans are concrete thinkers due to their military training. They think in black and white; there are no shades of grey. They are orderly and regimented in all aspects of their lives, function well in a structured environment and don't tolerate fools easily.

One has to appreciate that the Army has one of the best education systems in the world. No other organisation can take recruits from outback Australia, the Steppes of Russia or the hillbillies of the Appalachian Mountains in the US and teach them to kill efficiently. Even in today's society we still can't teach all young children to read and write, but we can teach people to kill. For soldiers, the education process has to be powerful, as society is preparing their soldiers for the worst. By looking at the military system of training it is easy to see how soldiers are programmed. The whole military culture is a programmed entity.

This section looks at the various ways the military experience impacts on the soldiers' lives. It is often argued that many veterans have never been de-programmed. Most people who experience a trauma these days are very likely to receive some form of professional debrief, which is a form of release. Unfortunately, many veterans have never had the opportunity to experience this process as they do not feel they have a problem and therefore don't feel they need professional help.

RECRUIT TRAINING

Basic training is what the name implies: "...going back to basics, starting again, a reprogramming of the individual...brainwashing." From the day you arrive on the recruit course, you are not treated as an individual; you are treated as part of a team. The system uses peer pressure to get rid of non-conforming individuals. It discourages individual thought and initiative, it rewards conformity and compliance. The military doesn't want individuals; no shades of grey or independent thought "...such people would question orders and the structure of the system."

A serial number replaces your name (loss of individuality and depersonalisation) and every correspondence or form of oral communication is answered by a number. You can't talk unless spoken to and even then there is a specific way for addressing an NCO (God). For the duration of your basic training, you spend hours 'square bashing' and there is a purpose for this 'instinctive obedience.' If you look in the Drill Manual you will find that the aim of 'close order drill' is to instill into the individual instinctive obedience. From the day you start marching you march in sections, troops or groups, again, you lose your individualism, you become a part of a team.

Lessons are 40 minute periods with a 10 minute 'smoko' break, (the 'smoko' break being a precursor for future substance abuse habits). The instructor's lesson follows a standard format and always begins with: "In this lesson you will be taught..." "The reason you are being taught this..." and, "At the end of this lesson you will be able to..." etc. The conclusion of the lesson has a summary and students are asked questions just to check they are paying attention. Prior to moving on to the next phase of instruction, the instructor ensures that the fundamentals are understood; if not, you go through it again. Tests and more tests track the recruit through his ordeal. This style of instruction creates concrete thinkers - black or white, but no shades of grey. Grey relates to emotions and the army doesn't want emotional soldiers. All forms of instruction and training have heavy undertones of patriotism, glory and honour. Leave is not a right, it is earned. The slightest deviation from the rules or any hint of insubordination leads to extra duties or disciplinary action even to the extent of a stint at the Holsworthy Correctional Centre or a dishonourable discharge. The concept of a mutiny in the military is a gathering of 3 or more disgruntled diggers critiquing the system.

The army uses a system whereby every unit is co-dependent upon the other; every individual, every small unit ranging to larger formations is co-dependent. You are taught that one weak link will cause the machine to malfunction. Excluding support weapon formations, there are three Sections to a Platoon, three Platoons to a Company, six Companies to a Battalion (four being combat infantry), three Battalions to a Brigade, three Brigades to a Division, three Divisions to a Corp, three Corps to an Army, etc.

Everything in the military is by numbers and mainly in threes. The structure of units and even drill movements or weapon training are by numbers. Rifle drill, marching, and lifting loads all relate to numbers.... "One, two, three, one, two, three, hup." There is constant pressure and tests to weed out the weak, the non-conformists and troublemakers, who are dealt with swiftly. Tact in the instructors is often lacking and too often, to get the recruit to conform, they use sarcasm or other dehumanising behaviours or comments. Twenty pushups or a quick sprint are just a few of the milder tools for conformity.

The gospel according to the Services, "Never question an order until after you carry it out," ensures that personnel don't think and their actions are instinctive. Be it a digger on an M60, a gunner on a 5 inch naval gun, or a pilot in a Canberra bomber, they fire or drop their load when ordered to, they don't think; it's instinctive due the nature of their training. It's ingrained into the individual to obey the order and never to question a superior. A recent example of how instinctive training overrides fear and panic is the recent Blackhawk disaster. The Board of inquiry found that even when the choppers were going down the crew and soldiers went into training mode even though the worst was anticipated. Personnel who were injured instinctively returned to the downed helicopters to rescue their comrades at the risk of their own personal safety.

The military system is very kind to its members; they think of everything. In riot control, a squad or section may be ordered to fire on a crowd of dissenters. This was especially true with the British in the Malayan Emergency. An officer would identify the ringleader and indicate the person to his squad. All squad members would be issued with one round, one of which would be a blank. After the squad fired and killed the ringleader, the Sgt would collect the cartridges. Everyone in the squad would feel that they had the blank and weren't responsible for the death of the ringleader. Some psychological consolation. It is the same for firing squads; we can be ordered to shoot our comrades in arms instinctively, but we're never allowed to question the reason. We thought it seemed right at the time, or it had to be right because a superior said so. This was also the case in Vietnam, bombing villages, killing civilians; ours was never to question, but to carry out orders.

The classic example of this was Lt. William L. (Rusty) Calley Jnr who was held responsible for the My Lai massacre (approximately 500 women, children and old men were murdered by a Company of American Infantrymen). My Lai is the classic example of when soldiers lose their discipline and how cruel men can be when they cross the boundary of sanity.

If you have ever read the book, it is not surprising that there are not many survivors of Charlie Company that committed the atrocity. Many have taken their own lives...I suppose the ghosts of the past do return. Calley received a life conviction for 22 counts of murder but a successful appeal ensured he never served a day in prison. The matter was quietly pushed off the front pages of the newspapers and the American public continued to believe that a nation as great as theirs was still above atrocities and the dark side of war.

Physical fitness is the main method of dehumanising the individual, though the army argues that soldiers need to be fit for combat. What Physical Training (PT) is really about is pushing you to your limits both physically and psychologically. If you break or can't make it, you let your Section down. Weakness is spurned; the winners reap the accolades and baubles. Inter-team and section competition generates a feeling of belonging, comradeship, and your section or platoon is your family and you don't want to let your family down. The system trains you to win - armies don't want losers.

DENIAL AND DESENSITISATION

Looking for possible causes that may be attributable to many veterans' inability to express emotions may also be found in the manner in which the army trains its soldiers. This again relates to the PTSD symptom of numbing and avoidance. When it comes to the preparation for the killing of another human being, denial and desensitisation are the main methods used by the military. Though the Army may not realise it, they have used the eminent Russian Psychologist Pavlov's concept of classical conditioning. He won the Nobel Prize for his work in 1904 teaching a dog to salivate by ringing a bell.

Teaching a soldier to shoot utilises all the concepts of operant conditioning and behaviour modification. That is, the conditioned stimulus was the target popping up, the conditioned response was accurately engaging the target, and the reward for accurate shooting would be qualifying on the range for that shoot. Realistic training and instant feedback ensure success. Pre-Vietnam War days saw soldiers developing their shooting skills by aiming at bulls-eye style targets. These targets were replaced with human shaped targets to make the training more realistic. Immediately after each shoot the targets are marked so that the firer has instant feedback on his firing prowess. Today's training uses electronic visual aids to supply the immediate feedback. On ranges, targets pop up instantly, unexpectedly, and if you score a hit they fall, replicating a real life situation. Every aspect of training is rehearsed, visualised and conditioned in order to develop a reflexive quick shoot style. Due to the nature of the repetitive training, the soldier is conditioned to engage and fire reflexively at the target. This assists the denial stage, whereby the soldier doesn't think that he is shooting another person, merely a target.

BADGING UP

The pressure to conform and perform is immense and for those who do there is always the reward of a badge, medal and promotion. If you fail you are ostracised. Your uniform is immaculate, impeccably creased and starched, you spend hours spit polishing your boots, all brass items are shined until they are worn thin, and then at the completion of your recruit training, the big parade. The Rising Sun hat badge and a Corps posting, then Corps training and another hat badge (if infantry, it is usually the crossed rifles), and then another posting, the Regiment and the 'skippy badge.' Then as a private, the reward of promotion now becomes the carrot to progress through the system. The PR 19 and PR 66s' (reporting on subordinates by superiors) are used to ensure conformity to the system.

Elitism and patriotism are generated via this process and a good soldier never questions, but obeys. Too much faith is placed in the wisdom of the more senior ranks and history has shown that they also are not infallible. The 'God syndrome' forms a part of the soldier's psyche...no other occupation bestows on its employee the capacity to decide life over death...a huge responsibility. In war, the soldier is trained and sanctioned to kill by an act of parliament. The reality is soldiers are programmed to kill; they are at the peak of their physical condition and hyperalert. When it's all over, they are told to go home and lead a normal life.

Reiterating Gary's thoughts, he believed that the nature of military training was designed to stress the warrior class, training to kill in earnest and the need to demonstrate warrior behaviour. Bayonet practice is a classic example of this behaviour. Recruits are lined up, shirts off, rifle with bayonet at the ready, then they run to the dangling sandbag screaming their lungs out. Often they are abused by the instructor because they were not aggressive or violent enough. Rage and anger are encouraged and accepted in the services. You never give up, you never compromise and you must win.

Similarly, Gary felt that drinking, smoking and sport formed the backbone of a soldier's social life. The wet canteens and the mess life encouraged the soldier to drink. In many Battalions, it was part of your duty to attend the mess when you knocked off from duty. On active service the American 'rat packs' were the go. Mini packs of Kool or Camel cigarettes ensured your supply. These were the digger's opiate to relieve the stress and tension of active service. Growing up too quickly and using alcohol and cigarettes to cope with army life encouraged habits which are difficult to break in later years.

ON ACTIVE SERVICE - CONSTANT STRESS AND BOREDOM

How often have you heard someone say "my father served during World War II and he didn't get PTSD?" World War II and Vietnam were totally different conflicts. Australian soldiers fought in North Africa to help the mother country, a legacy of our colonial days, and they fought the Japanese on the Kokoda Trail in order to prevent an invasion of their homeland.

In general terms, WW II saw soldiers of both sides in uniform, boundaries were clearly drawn, and there were rules and codes of conduct for both soldiers and civilians. The enemy were clearly distinguishable and there were clear procedures to follow if you were either captured or wounded. Vietnam was different; it was a guerrilla war. For the young serviceman, their tour was a combination of intense stress, fear and endless boredom - though they did establish a reputation as being formidable opponents and skillful allies. Trinh Duc (a village chief) described the military skills of the Australians:

I firmly believe that the impact of military training and the type of warfare the soldier is involved in has severe consequences in the severity, the nature and the treatment aspects of PTSD. As pointed out, the Australians fought a different war to the Americans. One of mundane search and destroy missions, ambush patrols, the constant stress of slow movement through the bush, taking even several hours to cover a few kilometres, constant stopping, listening for enemy activity and then moving on again. All the time being hyperalert, searching the tree lines for 'hides', listening, watching and waiting. The Americans, on the other hand, often mounted large scale actions supported by immense artillery and air support, were highly mobile and used different tactical doctrine.

By nature of the Australian soldier's experiences, it is felt that any effort for treatment should initially address the nature of the soldier's military training and how that training has influence on his operational style and attitude. The military has developed its own unique client group of programmed, concrete thinkers with rigid perspectives on life. It is felt that therapeutic change can be achieved by taking the veteran through a deprogramming process which encourages him to think in shades of grey, to share his feelings, and to assist him to communicate more effectively. As discussed previously, the military means of education is so deeply ingrained into the soldier to the extent that, even 30 years after the event, he is still living his life in a military manner. That is, how they do everyday things, how they relate to their family members, how they organise themselves at work and socially, how they handle their rage, how they handle their problems, and the list is endless. Coupled to the nature of the training is the nature of their diverse duties in Vietnam.

Having worked professionally with war traumatised and non-war traumatised clients diagnosed with PTSD, I believe the circumstances of war and non-war caused trauma are different. That is, being traumatised in a combat situation could be viewed differently to being traumatised in a car accident. Both traumatic experiences are different by the nature of the event and different due to the extended duration of the stressful event. Couple this view with soldiers being healthy and at their physical peak, the nature of the soldier's training (instinctive obedience, denial, desensitisation, programming, warrior class, etc) then it is feasible to argue that technically they should be prepared for the worst. Yet, over the years more and more Vietnam Veterans are being diagnosed with clinically severe PTSD with delayed onset. However, this trend has seemed to have peaked in recent years.

RESETTLEMENT AND RESENTMENT

It is understandable that Australia's fittest and finest were disillusioned when they returned home. While on active service they had their 'R and R' (Rest and Recuperation) and when they again hit Australian soil they experienced a new 'R and R'...Resettlement and Resentment.

For R and R (in the military sense), it's hard to imagine that one day you're 'in-country,' having seen bloodshed and carnage, and 24 hours later you're back home with your family and friends...and wondering why you can't adjust, or more importantly, you can't relate to anyone, not even your family. How often were you asked by your mates with whom you grew up, "How many enemy did you kill?" It's strange how your childhood friends now had become distant, your own self-realisation that you had little in common with them, and you were now beginning to wonder what you ever saw in some of them. Further, you longed to get back to your unit as you felt you were letting your comrades down and besides, they were someone you had something in common with.

Ever wondered why armies of the world prefer to conscript 18 - 20 year olds for military service? They are impressionable, they are at their peak of fitness, but most of all, their moral conscience hasn't developed. They cannot, or will not, distinguish between right or wrong with regard to taking life and a lawful order. They are at a stage of their development where they are impressionable, their minds can be moulded, they lack the life skills necessary for manhood, they are adventurous, they have few commitments and they are subservient to a higher authority. It is these qualities that make the ideal soldier.

Overall, the nature of military training and their operational service does not prepare the veteran well for family or civilian life. The smoking and alcohol, though significant, are secondary to the other traits they develop while in the service. They bring to the family concrete rigidity in their thinking, rules and regulations, relate to family members as if they're still in the army (don't ask - just tell), rage, and for some, domestic violence and psychological abuse. Children couldn't understand their father's abruptness, rage and coldness, a legacy that has continued into the child's later life, where, even now they still cannot relate to their father and visa versa. The wife, feeling as if she is walking on egg shells, always makes excuses to the children for the father's behaviour, becoming frustrated and taking on the symptomatology of her partner, often suffering from anxiety or depression, and often on some form of medication. Another associated condition of PTSD is a lack of self-esteem or confidence. Many veterans are overly possessive and tend to control their relationships by subtle psychological abuse or at worst, domestic violence. By putting down their partner, they ensure that they will lack the confidence to leave the relationship or even to move on. Unfortunately, the veteran is rarely aware of what is happening; he is the last to realise that he has the problem and not everyone else.

Many veterans present as cold and lacking emotion to their family and this is not surprising. The intimacy soldiers share with their mates in a shell scrape, each depending upon each other for their lives, can never be experienced in a normal relationship. Similarly, the surprise a wife experiences when a veteran shows a lack of emotion when someone close dies. Veterans have experienced death before and have learnt not to show emotions or hurt, which was ingrained into them during their training and while on operational service. It is not unusual that the veteran cannot relate his fears and concerns to his wife, the closest person in his life. It is not surprising that the wife has difficulty accepting that her partner will go to counselling and disclose his inner secrets about his war experiences to a complete outsider. Perhaps the partner doesn't realise that the veteran is only protecting her from the psychological burden he has to carry...as one veteran stated when he was asked, wouldn't it be more appropriate to share his problems with his partner and not a stranger? "That's my shit, I have to carry it and besides, she wouldn't understand." Perhaps many veterans underestimate the capacity of their partners.
 
My dad was in Japan, Borneo, Malaya, Aden, Cyprus and Suez. I recognise the behaviour in the last paragraphs. And in me (NI, Gulf 1, Balkans, Angola). I'm turning into my Dad. Bless him. Oh dear but at least I can be a bit more girly about it.
It does explain, just like my dad, why I can be so stroppy about minor failings.
I think it contributed to his early death at 62. Bollocks I know it did.
Lot of truth in this article, Anthony. Some of it is hard to accept but we have to, don't we?
Because it's a 'lifestyle' thing, as the health nannies like to tell us.
Hyper-vigilance is as bad as smoking, I think. And more of a habit.......
 
Same. My dad lasted til 84, but he had Alzheimers for the last 10 years. Sometimes I think Alzheimers is a custom made disease designed by the body to help forget the past.

My father served the last years of WWII, only at home, but during the submarine incidents and then went on to do 32 years as a Policeman. I remember him talking about the training, and about particular incidents. My mother still refuses to believe he had any symptoms of PTSD. Is it possible that a person who lives with someone who has PTSD for a long while, or is brought up by someone who displays the anger outbursts, the isolating, the hypervigelence, that it becomes a bit of a learned behavior? Do you know where am coming from here???
 
I fully understand what you are talking about Jimmy. Having lived with untreated PTSD father and my in denial Mother.

OK. Here is a very stupid, hypothetical, but perhaps relevant question.

After WWII, the Russians got most of the rocket and aircraft technology from the Germans. The Americans and British got Werner Von Braun (Rocket Scientist)... AND ALL the psychological warfare information the Germans had.

I tend to wonder.

1. Rates of PTSD amongst German troops after WWII. Their fighting statistics were phenomenal. (100% wounded once, 75% wounded twice etc... etc.)
and
2. How much of the info from the Nazis was reincorporated back into Allied training. Psychological warfare works both ways. Both training your own and f'ing up the other guy.

Some of which is probably unobtainable. But it is a tantalizing thought. And would be interesting info.

Wagon
 
Is it possible that a person who lives with someone who has PTSD for a long while, or is brought up by someone who displays the anger outbursts, the isolating, the hypervigelence, that it becomes a bit of a learned behavior? Do you know where am coming from here???

Makes sense. It occured to me a while ago that before the bad stuff I was different to my Dad, significantly. Since then there has been a convergence in behaviour and reaction which I certainly didn't ask for.
I don't want to diss my old Dad but there were aspects of home life that I can most definitely now attribute to his PTSD, the isolating, intolerance, anger, booze.
They started to appear about 15 years or so after his last one, Suez.
And we do imitate our dads whether consciously or not, imprinting, imitation and that. Like you said mate, learned behaviour.
Maybe this pre-disposes some of us to PTSD? Maybe that's why you get blokes who've been through almost identical stuff but don't seem affected? Just glad I managed to identify it before it got too far gone.
Almost like a logic gate:

Dad with PTSD........and.........Kid has bad stuff..........= Kid with PTSD behaviour
Dad less PTSD..........and.........Kid has bad stuff......... = Kid less/maybe PTSD behaviour
Dad with PTSD........and..........Kid less bad stuff......... = Kid less PTSD behaviour
Dad less PTSD..........and.........Kid less bad stuff.......... = Kid no excuse

I know it can't be that hard and fast, but I suspect there is something in it, Jimmy.
 
Addendum. The one thing, analytically, I pulled from Anthony's pdf 'May the Healing Begin', was a pretty no-bullshit TRAP analysis of threats:

The inquiry involves the following four questions that you need to ask:

T. Is the thought 100 percent true?
R. Is the thought 100 percent relevant?
A. Is the thought 100 percent accurate?
P. Is the thought 100 percent proven?

Wipes most of 'em
 
Now thats wierd. Its like spying on me. There is alot there that rings bells, but the last pieces. Thast nailed on. Very good read and very illuminating.
 
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