13 Reasons Why

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Stagg737

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Not sure if anyone on here has heard of or seen this show. It came out on Netflix at the beginning of April and I watched it because it seemed like an interesting mystery/suspense series. However, after watching it and seeing the general public/media's response to the series, it seems much more like a commentary on teen suicide, societal norms, and mental health issues. Initially I saw a lot of praise for the show for being so straightforward about such a taboo topic (suicide) for most people, but recently I've been seeing a lot more criticisms about the show, especially from professionals in the mental health field. Does anyone who has seen the show or looked into it have any comments/insight about it? Is this the right way to bring more attention to mental health issues in our society or do people think this will bring more harm than good.

Not looking to get technical, just curious about how psychiatrists and other mental health professionals feel about the show and how they portrayed the issue of suicide.

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Don't waste your time with.it.
I watched 1 episode.
Lots of cliches.
 
--Spoiler Alert--

As a work of fiction, I greatly enjoyed it. It was original, compelling, and very well-acted. I found the character of Tony to be especially intriguing and look forward to seeing more work from the actor who played him in the future. I watched the whole thing in about four days.

As for its portrayal of mental health, I felt mixed about it. Certainly Hannah's understanding of her own suicide, that it was effectively something that happened to her rather than something she did to herself, is a realistic portrayal of teenage depression (and adolescence in general). However, the overall tone of the series did a little bit too much to reinforce and validate this cognitive distortion. The message seemed to be: "she's right; if only people were nicer to her this wouldn't have happened". Obviously, this external locus of control is not something that the mental health community would want society at large to embrace. I did find the general sensitivity expressed toward the complexities and pains of modern teenage life to be appropriately heartfelt, though.

The one element that bordered on absurd was the implication that a high school guidance counselor (who apparently was the only guidance counselor for the entire school) should know how to deal expertly with a severely depressed teenager who was just raped. I don't think my guidance counselor even knew my name...
 
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Don't waste your time with.it.
I watched 1 episode.
Lots of cliches.

I get where you're coming from. It picked up a little more in the 2nd/3rd episodes. Won't spoil anything here, but I was pretty hooked after a few episodes but was disappointed with the end as they kind of cop out a bit.

--Spoiler Alert--

As a work of fiction, I greatly enjoyed it. It was original, compelling, and very well-acted. I found the character of Tony to be especially intriguing and look forward to seeing more work from the actor who played him in the future. I watched the whole thing in about four days.

As for its portrayal of mental health, I felt mixed about it. Certainly Hannah's understanding of her own suicide, that it was effectively something that happened to her rather than something she did to herself, is a realistic portrayal of teenage depression (and adolescence in general). However, the overall tone of the series did a little bit too much to reinforce and validate this cognitive distortion. The message seemed to be: "she's right; if only people were nicer to her this wouldn't have happened". Obviously, this external locus of control is not something that the mental health community would want society at large to embrace. I did find the general sensitivity expressed toward the complexities and pains of modern teenage life to be appropriately heartfelt, though.

The one element that bordered on absurd was the implication that a high school guidance counselor (who apparently was the only guidance counselor for the entire school) should know how to deal expertly with a severely depressed teenager who was just raped. I don't think my guidance counselor even knew my name...

I agree with a lot of this, and it's kind of the criticisms I've been seeing in articles. One being that teens may see this and think of suicide as a way to have their story heard. Another being that in spite of everything that happened to Hannah, she only ever reached out for help once, to someone who is probably not qualified at all to deal with such a major issue (and who obviously mishandled it pretty terribly). I get that the story is supposed to reflect what many teens may feel and how small things can impact their lives greatly, but throughout the story people just kept asking "why did this happen" and there weren't ever any alternatives even suggested. Anyone else feel like that should have been addressed somehow, or is just telling the story enough to raise awareness about mental health?

I'm also wondering what people thought about the portrayal of the school's counselor and his connection to the mental health profession. I had a similar experience as Vagus in the sense that my school counselors were more there for professional help and preparing for college than mental health, and would have had no idea how to handle depression or mental illness in students. Is that something that's common in high schools or even colleges? Do people really look at high school counselors and think they're supposed to be as qualified as psychiatrists or psychologists (another criticism I heard)?
 
The more I think about the show, the more I wonder whether you could make a case for her having borderline personality traits (and less so MDD), albeit not completely personality disordered.

That thought actually crossed my mind as well, glad I'm not the only one. I did think she develop a more consistently restricted and dysphoric affect toward the end, though.

Speaking of BPD, I was intrigued when Hannah's mother made a passing comment that one reason they moved was that there were some "mean girls" at Hannah's last school - would have loved to get the back story there, it was subtle but really made me wonder how long Hannah's character had struggled, regardless of setting.
 
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The more I think about the show, the more I wonder whether you could make a case for her having borderline personality traits (and less so MDD), albeit not completely personality disordered.

This jumped out to me as well and actually it was my wife (who is not a psychiatrist but is an MD) who started the ball rolling by pointing out how extreme some of her responses were. She also had a bad melting pot of instability at home despite coming from a professional family, losing friends much easier than keeping them, and then over time losing a sense of self and agency, with the sexual assault being a nail in the coffin. By the end it had some feelings of a MDE as well, but certainly the line can be blurry between the two in adolescence.

I've heard some mental health folks get up in arms about it, but really felt it was compelling as a fictional show, and as someone in CAP the more discussion about these topics the better. I also really liked the making of 30 min clip after the show where they focused on the differences between cyber bullying and how social media can be so virulent without parents/adults understanding. A lot of the work I do is simply instilling a world view of hope into adolescents and it's one of the best parts of my job.
 
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Just started watching so I can make an informed comment. First episode was a chore to get through (and I just recently got through The Revenant --or as I like to call it, The Passion of Leo DiCaprio -- a movie that asked not why someone committed suicide, but why someone didn't).

Not enough from the first episode to comment and I don't want to read the comments to spoil anything, so I'll keep plowing through. If the show picks up and isn't terribly procedural, I should be able to get through it fairly quickly. Sort of like a mash-up of Kyle-XY and Secrets and Lies, so far. The tone seems set for a younger crowd, though it seems a bit dark for high schoolers and a bit light for college-aged students.
 
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I feel like I'm going to have to watch it just because I'm going to start getting asked about it incessantly.
 
I feel like I'm going to have to watch it just because I'm going to start getting asked about it incessantly.

If you do CAP, for sure. I know I shouldn't, but I feel obligated to watch a handful of popular media things each year to stay "current" in the field, although I've somehow still punted on Inside Out...
 
My adolescent patient was talking about this series yesterday. It was a great opportunity for her to see herself from a different perspective since there were some obvious similarities between her and main character and begin to develop some new strategies for better coping. "That chick was stupid and brought a lot of stuff on herself." "What would you have done on her situation?" For me, this kind of popular media when it is engaging whether well done or poorly done pays benefits cause either way it can get my patients thinking. In fact part of what was helpful for my patient was talking about how the portrayal of a suicidal teen wasn't accurate and thus helping her open up about some of her own reasons. I also find it fascinating how many people in the media raise alarm about teenage kids watching something like this. Awareness of suicide and mental illness has been a part of adolescence at least since I was one and what I saw then and see now is a hunger for real information and help from adults on how to address these issues. Unfortunately much of what they do get are platitudes, slogans, and misinformation.
 
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I have heard C&A docs complaining about an up tick in suicidal kids coming into the ER and they blame this show. Not sure if it is the show, but something is going on.
 
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I just finished it. It took me a while to get through--couldn't straight binge it. It had a lot of build up, and I struggled a bit with the framing of the story.

But I ended up enjoying it in its totality.

I think the part about the counselor (unless high schools have changed) is probably more relevant to how colleges in the US handle sexual assault. I agree with the above, in that I believe my guidance counselors did things like attendance. I actually did go to a guidance counselor once for help, asking if I could do school from home and I just got a "No."

There was something about her narration that seemed discordant with being suicidal to me. It wasn't until they showed the suicide that I had sort of a realization. Her mind was appropriately mature for her age, but I think that relative immaturity led to my not understanding the level of her despair until I saw the actual suicide. Her affect in the narration was sort of cheery almost, but then you see the suicide and have a sense of the psychic pain that I guess I would have assumed would appear more despondently, and maybe it does in older people. Maybe this was very accurate of how it would present in a younger person. Plus, the encounter with the counselor and the realization she would have to continue facing her rapist accelerated the understanding of the suicide. Up until they showed that, it seemed more like an act of hurting others.

But even without that last part, I do remember moving to a new town in sixth grade and through 12th grade (and really actually until moving out of that town), having the sense of living in a fish bowl (almost literally, I had a bully who at school would tell people he could see me getting undressed in my room because my blinds showed my silhouette---somehow that made me the weird one rather than him watching me). I remember my own experiences of trying to keep a lot to myself and that sense of "audience" (being on display, everyone watching).

I think that there is something unnatural about the stratification of people socially by age, as we have in schools. Humans used to live tribally. Young babies through children of all ages were mixed with adults in occupations, tribes, etc. You had apprentices and journeymen. Nomadic groups where the family stayed as a single unit. Basically more heterogeneity of age.

You could see in the show the disconnect between the children and the parents, and I think we take that as some sort of inherent human norm. I don't think it is. I think it's just this particular culture at this particular moment. The adults go to work with adults their age. The kids go to school with kids their age.

I think when you take people of a singular age of particular volatility (teenagers) and combine them into needlessly long interactions with only each other, it's problematic. I mean if you think back on your middle through high school experience, at least for me, a lot of that education could have been distilled down to shorter days, fewer days of the week, and fewer years. A lot of it just seems like a petri dish for problems and not much happening that is terribly constructive. I mean after all that, what do you have to show for it? A high school degree, that is worth what exactly? Not much. There must be a better idea of what to do with the teenage years. It seems unnecessarily drawn out where people have no sense of a goal, like life isn't supposed to actually start until graduation, and in the mean time you have this idle time with a lot of exactly what you'd expect.

I mean when you step back and look at the show, what the hell were these kids doing? The types of things you'd do if you had nothing else to do. They needed something to do. I know the show is unrealistic for a lot of high school students, but it presents an exaggeration rather than an untruth.
 
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I just finished it. It took me a while to get through--couldn't straight binge it. It had a lot of build up, and I struggled a bit with the framing of the story.

But I ended up enjoying it in its totality.

I think the part about the counselor (unless high schools have changed) is probably more relevant to how colleges in the US handle sexual assault. I agree with the above, in that I believe my guidance counselors did things like attendance. I actually did go to a guidance counselor once for help, asking if I could do school from home and I just got a "No."

There was something about her narration that seemed discordant with being suicidal to me. It wasn't until they showed the suicide that I had sort of a realization. Her mind was appropriately mature for her age, but I think that relative immaturity led to my not understanding the level of her despair until I saw the actual suicide. Her affect in the narration was sort of cheery almost, but then you see the suicide and have a sense of the psychic pain that I guess I would have assumed would appear more despondently, and maybe it does in older people. Maybe this was very accurate of how it would present in a younger person. Plus, the encounter with the counselor and the realization she would have to continue facing her rapist accelerated the understanding of the suicide. Up until they showed that, it seemed more like an act of hurting others.

But even without that last part, I do remember moving to a new town in sixth grade and through 12th grade (and really actually until moving out of that town), having the sense of living in a fish bowl (almost literally, I had a bully who at school would tell people he could see me getting undressed in my room because my blinds showed my silhouette---somehow that made me the weird one rather than him watching me). I remember my own experiences of trying to keep a lot to myself and that sense of "audience" (being on display, everyone watching).

I think that there is something unnatural about the stratification of people socially by age, as we have in schools. Humans used to live tribally. Young babies through children of all ages were mixed with adults in occupations, tribes, etc. You had apprentices and journeymen. Nomadic groups where the family stayed as a single unit. Basically more heterogeneity of age.

You could see in the show the disconnect between the children and the parents, and I think we take that as some sort of inherent human norm. I don't think it is. I think it's just this particular culture at this particular moment. The adults go to work with adults their age. The kids go to school with kids their age.

I think when you take people of a singular age of particular volatility (teenagers) and combine them into needlessly long interactions with only each other, it's problematic. I mean if you think back on your middle through high school experience, at least for me, a lot of that education could have been distilled down to shorter days, fewer days of the week, and fewer years. A lot of it just seems like a petri dish for problems and not much happening that is terribly constructive. I mean after all that, what do you have to show for it? A high school degree, that is worth what exactly? Not much. There must be a better idea of what to do with the teenage years. It seems unnecessarily drawn out where people have no sense of a goal, like life isn't supposed to actually start until graduation, and in the mean time you have this idle time with a lot of exactly what you'd expect.

I mean when you step back and look at the show, what the hell were these kids doing? The types of things you'd do if you had nothing else to do. They needed something to do. I know the show is unrealistic for a lot of high school students, but it presents an exaggeration rather than an untruth.
Great points. I have only seen one episode so far, but will say that the girl paying the role did not appear like any of my suicidal teens which was probably just poor acting or a choice by the director to make a point that it is not glaringly obvious when someone is suicidal. I think a more accurate portrayal would also make that point though. I especially like what you said about the separation between adults and adolescents in our society. It is a problem and from my own experience a big part of effective treatment for adolescents is helping them to bridge that gap and develop healthy relationships with adults. Also, letting adoolescnets develop their own culture without guidance is problematic and part of my role as a clinical director at a program for adolescents was to assist and guide the peer culture to ensure that it was positive and safe. For example, I remember when some of the kids thought that they would start their own rebirthing therapy program. had to put a stop to that one pretty quick!
 
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Picked up for a second season. That was bound to happen regardless of whether it's a good idea.

You know after watching it, I wasn't haunted by the suicide. I kept having this nagging feeling in the days after that there was something off with my emotional response--like I didn't feel appropriate emotion. And then I watched Manchester by the Sea (I don't go to theatres--I see things when they become available on streaming), and I realized my emotional response to art is normal. I think the issue with this show was that the narrative was told in a way that was both jumbled and there was also something very tedious about it. I feel like the tediousness and jarring story telling was perhaps helpful in understanding the protagonist's (Clay--is he the protagonist?) feelings---the jumbled confusion, anxiety, anger over someone's death. But it was not helpful in understanding the suicidality of the young woman. Even thinking back to the scene of the suicide, I didn't have the feeling she wanted to commit suicide. If I take the story telling as having adequately told its story, then I almost feel like the young woman's suicide was a way of presenting to the world a perfect story of why someone (a generic person) would commit suicide. It was more head-heavy than heart-heavy, so to speak. For example, she very deliberately recorded the counselor failing her. If you want to make the argument for why she committed suicide, she seemed very resigned when she went to the second party and was already in a state of depression when she was raped--in a way that invites me to make a very awful sounding comment: She sort of lay like dead prey for someone she knew was a predator. Am I not supposed to say that? I think the show makes you think that. I don't know.

It would be interesting to re-edit the series in chronological order and cut out Clay's consternations to see how it would seem to play.

I think art generally takes you out of the tedious day-to-day machinations and sort of has an induction into a nearly singular feeling. You take all the noise away and feel what's behind something. This show seemed to do the opposite. It started with a suicide and made noise and chaos and brought you into tedium that evocative film usually avoids. And as I said, that could possibly be helpful in feeling the response others have to a suicide, but not so much to the feeling of suicidality itself. And some of the contrived rules (the order of who got the tapes, why they couldn't talk about them, etc.), it was just so --I didn't get it, and it also almost felt like one of those dreams you have when you're sick and feverish, where you have some tedious, Sisyphus-like task. It almost felt like what I have felt OCD feeling like. I don't know if it was bad story-telling or necessary to make it a mystery/suspense, or just necessary to draw it out to 13 episodes.
 
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A second season? Wasn't this thing just a show adaptation of a book?
The author blessed the second season. In fact he seemed to be pushing it (he mentioned sometimes wishing he had written a follow up novel and is glad the show is doing what he didn't). They definitely created it leaving an opening for a second season (too many openings; it's a bit sprawling). I think it should have been shorter as a series rather than extending it. But you can't argue with money.
 
Wife read and watched it and talked to me about it. Everything I hear puts me off. I worry about it romanticizing suicide and self-harm and an external locus of control. None of the things I would want a teenager struggling with identity disturbance to be validated by. Replacing the stigma of mental illness with a romanticized version is not necessarily progress.
 
The first half was kind of terrible, but I realized it was mostly because they all acted "teenagy" and I wanted to smack them, but I supposed if I was 13 or 14 then I may like it. The second half was better.

I was also afraid that it would glorify suicide, but I didn't feel like it did after watching all 13 episodes.
 
Wife read and watched it and talked to me about it. Everything I hear puts me off. I worry about it romanticizing suicide and self-harm and an external locus of control. None of the things I would want a teenager struggling with identity disturbance to be validated by. Replacing the stigma of mental illness with a romanticized version is not necessarily progress.

You should watch it then. I don't think it romanticizes suicide at all. It definitely has brought it more to the forefront of people's minds and maybe more kids refer to it when they come to the ED over a short period of time but I think it's pretty clear that not talking about suicide has not been a helpful management for society.
 
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I agree if you come to think of it it doesn't glorify suicide, though some might still feel inspired by the characters (simply like them) and try to imitate all of that. It's very thin ice and the only absolutely positive aspect of the series is that we start talking about suicides
 
Suicide contagion is a definite public health concern when media depicting/reporting on suicide which is why the media reporting guidelines were created.
Unfortunately, our field doesn't really talk about this media public health risk very much, but I'm hoping the series stimulates more dialogue about the ethics of a for-profit company(i.e. Netflix) getting major (both positive and negative) attention(i.e. profit since 03/31/16 release date) for graphically depicting something like suicide attempt that carries some evidence of possible public harm.

Notably, Season 2 is reportedly confirmed by news outlets, and if the clues from season 1 are right then i'm suspecting that this might involve guns and schools(?)
I hope I'm predicting wrong because that would be an equally horrible copycat to happen in real life.

If there's anything i've learned from Big Tobacco, it's that they're not too interested in science when there's millions of dollar at stake.
Thus, I think it's important for all of us to continue the education and discussion around these difficult topics especially with the people who are on the front lines with teens.
https://www.headspace.org.au/assets/School-Support/Talking-to-Young-People-about-13-Reasons-Why.pdf

The final part I hope that's discussed more is the positive messaging side of things and sending more effective suicide prevention messages.
You know it's sad when more money is funneled into marketing psychotropic medications than funding easier access to mental healthcare.
If only American teens and young adults could get confidential counseling as easily as they get birth control stuff from planned parenthood...
 
Suicide contagion is a definite public health concern when media depicting/reporting on suicide which is why the media reporting guidelines were created.
Unfortunately, our field doesn't really talk about this media public health risk very much, but I'm hoping the series stimulates more dialogue about the ethics of a for-profit company(i.e. Netflix) getting major (both positive and negative) attention(i.e. profit since 03/31/16 release date) for graphically depicting something like suicide attempt that carries some evidence of possible public harm.

Notably, Season 2 is reportedly confirmed by news outlets, and if the clues from season 1 are right then i'm suspecting that this might involve guns and schools(?)
I hope I'm predicting wrong because that would be an equally horrible copycat to happen in real life.

If there's anything i've learned from Big Tobacco, it's that they're not too interested in science when there's millions of dollar at stake.
Thus, I think it's important for all of us to continue the education and discussion around these difficult topics especially with the people who are on the front lines with teens.
https://www.headspace.org.au/assets/School-Support/Talking-to-Young-People-about-13-Reasons-Why.pdf

The final part I hope that's discussed more is the positive messaging side of things and sending more effective suicide prevention messages.
You know it's sad when more money is funneled into marketing psychotropic medications than funding easier access to mental healthcare.
If only American teens and young adults could get confidential counseling as easily as they get birth control stuff from planned parenthood...

That literature on suicide contagion is so heavily dated and one cannot possibly just generalize information from the 1960's to present day media. The electronic messages received by teens on a minute to minute basis is completely different then news cycles of past. This area clearly needs more research and certainly there should be very formal thought given to the deception of suicide but I think that did happen with 13 reasons. The making of 30 minute episode (also on netflix) clearly goes over their thought process behind many of the big scenes and was very thoughtful. I'm as big a skeptic of profit motive driving everything as pretty much anyone but I don't think the directors/writers had any financial incentive to glorify suicide (which I absolutely do not think they did). I can see some concerns that if one superficially heard of the show and thought it was actually reasons why a person killed themselves that could be sending the wrong message but the show itself did not play out that way at all.
 
I lost interest after 5 or 6 episodes (probably because I binged on them, maybe will pick it up again later), but thought this was an interesting response: https://www.washingtonpost.com/new...t-to-prevent-suicide/?utm_term=.32865f3332c8 (hopefully did that link right?). Link is to a Washington Post article about a group of students who started a project called "13 Reasons Why Not" in which they share their own difficult experiences over the school's loudspeaker in an attempt to discourage suicide.
 
You know after watching it, I wasn't haunted by the suicide. I kept having this nagging feeling in the days after that there was something off with my emotional response--like I didn't feel appropriate emotion...

Nope, nothing wrong with your emotional response, that suicide scene was a joke. After all the hype I finally watched that scene in particular, and literally burst out laughing. The Chicago Med episode "Monday Mourning" did a far better job at portraying a realistic suicide in its opening scene than whatever the writers/producers of 13 Reasons Why were going for.
 
Nope, nothing wrong with your emotional response, that suicide scene was a joke. After all the hype I finally watched that scene in particular, and literally burst out laughing. The Chicago Med episode "Monday Mourning" did a far better job at portraying a realistic suicide in its opening scene than whatever the writers/producers of 13 Reasons Why were going for.
Well, my feelings changed. When I was watching the suicide scene in live time, I had a huge adrenaline response. The entire show you know that she has already done this. And I guess by the time you got to it, I didn't feel it had built a connection between that act of suicide and what had happened. And true to that, I didn't have the sense that she wanted to commit suicide. I got a very, very anxious feeling from her. It seemed to me that she was terrified of death. I was watching someone kill themselves, and watching them in terror, but not truly getting why they were doing it (even with the 13 reasons--maybe that was the point, that those reasons didn't explain it). There's a comedy called Murder by Death which was a spoof of Agathy Christie novels, and this is the dialogue between the butler and detective:

Jamesir Bensonmum: She murdered herself in her sleep, sir.

Dick Charleston: You mean suicide?

Jamesir Bensonmum: Oh no, it was murder, all right. Mrs. Twain HATED herself.

That was kind of the feeling I got. It was like she was going through the motions of murdering herself and had the reactions of someone being murdered. She did not seem to want it at all.

But when I said that several days later I didn't feel an emotional response, it was more that it didn't linger with me. It was so jumbled. Didn't feel like it was coherent storytelling, which can be a purposeful style of storytelling (movies like Syriana for example which purposefully create narrative confusion to make a point). The show provoked in me a sense of frustration over the seemingly arbitrary rules about why these tapes couldn't be shared, a confusion over what her goal in the suicide was, and a perception of her character's fear of death in the actual suicide scene. Just a lot going on. An "art" film (if that's what it is?) like Manchester by the Sea is tonally and narratively much easier to follow.

I'm reminded of another movie, that through the fog of psychotropics I don't remember as well as I wish I did, that dealt with a possible suicide. It was called Hollywoodland. I remember enjoying it but I don't remember the details. But it dealt with a person's death from 3 possible explanations, at least one of which was suicide. Might be a good watch for anyone who was trying to discover something through this show.
 
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Rather off the topic: I didn't care for it. It seemed that they made Hannah out to be someone who was seeking revenge by her suicide.
 
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