How How Relationships Heal Inflammation, Trauma, and Your Nervous System - Transcript

Dr. Mark Hyman
When you're in a conflictual relationship, your physiology changes to a state of disease. Cortisol goes up, your inflammatory cytokines go up, your microbiome can change.

A whole series of things happen in your body that make you more sick. Before we jump into today's episode, I want to share a few ways you can go deeper on your health journey. While I wish I could work with everyone one on one, there just isn't enough time in the day. So I built several tools to help you take control of your health. If you're looking for guidance, education, and community, check out my private membership, the HymanHive, for live q and a's exclusive content and direct connection.

For real time lab testing and personalized insights into your biology, visit Function Health. You can also explore my curated doctor trusted supplements and health products at doctorhymen.com. And if you prefer to listen without any breaks, don't forget you can enjoy every episode of this podcast ad free with Hyman Plus. Just open Apple Podcasts and tap try free to start your seven day free trial. If you're in a conflictual relationship with someone, your inflammatory genes are turned on.

Literally, not just your emotions are inflamed, but your biology turns on the inflammation.

Simon Sinek
Like fight or flight kind of stuff?

Dr. Mark Hyman
Not fight or flight. Just if you're like in a shitty relationship or if you're fighting with someone or you have a conflict, you turn on inflammatory genes that then increase expression of cytokines that cause inflammation and that cause disease. And all chronic disease from depression to heart disease to diabetes to obesity to Alzheimer's are all inflammatory diseases. Conversely, if you have a connected, loving relationship with somebody, it turns on anti inflammatory genes.

Simon Sinek
And inflammation is the core of like everything.

Dr. Mark Hyman
Yeah. And they've studied with entrainment, know, you have where if you sit with someone and you have an authentic connection that you can put EEG and EKGs on, basically brain waves and heart waves. Mhmm. You can see the heartbeat of someone you're having a deep connected relationship with in your brain waves. Wow.

It's wild. So it's not just a feel good thing on an emotional level. It's a physiological response that happens of being in connection. If you take animals and put them in, you know, cages and separate animals and feed them exactly the same thing and have everything else the same, the one that's isolated versus the ones that are connected will shrivel and die and get sick. Right?

And so humans are the same way and we've gotten in a situation where friendship and connection is sort of like

Simon Sinek
Okay. So why aren't doctors prescribing to spend more time with friends? I do. Like, Doctor, I'm suffering from X, Y and Z. Okay, I'd like you to try and get an extra hour of sleep, go to bed a little earlier, I'd like you to stop eating before, don't eat past 08:00 at night and I want you to spend at least three hours a week with a friend.

How come that's not on a prescription?

Dr. Mark Hyman
It should be. I prescribe it. In fact, I actually based on this work that I did in Haiti, I met a pastor after Rick Warren who wrote The Purpose Driven Life and had a church with 30,000 members. I met him, he came to my office and we started talking and I said, Hey, you know, Rick, tell me about your church because I really I'm a Jewish doctor from New York, don't know much about evangelical Christian churches. We got 30,000 people.

Like, wow. It's a lot of mega church. He's like, yeah, we got 5,000 groups that meet every week, small groups in the church to help each other live better lives. I'm like, Oh, this isn't a mega church, this is thousands of mini churches. Yeah.

And I had that the light bulb moment, I'm like, I just come back from hate. I said, Why don't we put a healthy living program into the groups and see what happens?

Simon Sinek
Yeah.

Dr. Mark Hyman
He said, Great idea, because I was baptizing my church last week and after about the eight hundredth person, I'm like, Man, we're a fat church and I'm fat and we got to do something about it. And so we put a program together through the small groups where people were just helping each other. There was no doctor, nutritionist, health coach, nobody. There was just a curriculum. We had a big rally, sort of a big event where we talked about and Rick talked about the biblical rationale for why God wants us to be healthy.

I gave a bunch of speeches and talked about how God lives in you, why are you feeding him crap and things like that. Mean You know, if Jesus came to dinner what would you feed him? Know, big mac fries and a coke? And they got it.

Simon Sinek
Ain't that the truth? Ain't that the if Jesus came to dinner, what would you feed him?

Dr. Mark Hyman
Exactly. So they got it. I said, you know, if you feel like crap, how are you gonna serve God? How are you gonna serve each other? You've gotta take care of your body.

And so they got it and they did this together in community. Was jogging for Jesus and they all these incredible. It was incredible. And they lost together a quarter million pounds in the first year and they did it together. And then I took that same model and I applied it at Cleveland Clinic where we created small groups where people helped each other.

And we had we did research on this and published it. There were three times better health outcomes on validated metrics of health outcomes compared to one on one visits for the same condition with the same doctors. So the doctors at our clinic could see them in one on one or they support them in a group. The group was three times as good as seeing the doctor one on one in terms of health.

Simon Sinek
But why aren't these things then being implemented across medical field?

Dr. Mark Hyman
We're trying.

Simon Sinek
Why we going to the doctor with our friends to deal with similar issues? Everything's so siloed, literally.

Dr. Mark Hyman
It is essential. I think you know, the models of support, whether it's coaching, whether it's one on one coaching or support, whether it's group models, they have to be the thing that's gonna change because our our we we get healthy together or we get sick together. So the quote from Benjamin Franklin is we must all hang together or surely we'll all hang separately. I mean And I think that's kind of where we're at in society. That's kind of where

Simon Sinek
we are. Yeah. I'm very glad that we are talking about this because I have a lot of respect for your work and the fact that you're validating all this friendship stuff that I'm doing from a physician standpoint. Yeah. Not a kumbaya is nice.

No. No.

Dr. Mark Hyman
There's so much science on this. We we wrote a book about this work called the Daniel Plan after Daniel from the Bible who resisted the king's temptation of rich food and was better for it. And and we talked about the five f's, you know, food, fitness, focus, which is your mental fitness,

Simon Sinek
faith, and friends. Why aren't friends number one?

Dr. Mark Hyman
Well, they were maybe in there somewhere. I don't know.

Simon Sinek
I don't

Dr. Mark Hyman
know the order. It was like No. No. Food probably is friends. But the whole point is friends are such a key part of our well-being, whether it's understanding the blue zones or how whether it's AA or Weight Watchers, it's how we change.

Simon Sinek
I mean, AA, all of these things, Weight Watchers, they're all community based things.

Dr. Mark Hyman
100%.

Simon Sinek
And one of the problems we have in our society is community things you know, bowling leagues don't exist anymore. Mhmm. You know, church attendance is down. And church attendance and faith are not the same thing. You can have faith and not go to church and you can go to church and not have faith.

The church would rather that they're overlapping but the idea of doing things in commune, in community, this is why I love things like Comic Con or Burning Man or whatever your

Dr. Mark Hyman
Now you've never been to Burning Man.

Simon Sinek
I have been to Burning Man. You have? Yeah. Or Sturgis, is that what it's called? Yeah, it's called the motorcycle thing.

Dr. Mark Hyman
Yeah, Hells Angels.

Simon Sinek
Like all of these things. Politics aside, I don't care what it is Going to church, doing things in community with people who have common interests. One of the questions I'm getting since I've started talking about friendship, it's amazing how many people are coming up to me who are of all ages, of all income levels who are saying to me, I don't know how to make friends. I struggle to make friends.

Dr. Mark Hyman
Because we're afraid to be authentic. I mean that's the hard part, right? Have you ever struggled to make friends? When I was a kid, didn't have any. I was a weird kid.

I just was in my head, read a lot of books, was a little weird and kind of a nerd. And I just didn't And

Simon Sinek
you had a lot of health issues when

Dr. Mark Hyman
you were younger. Really. It came later, yeah.

Simon Sinek
When I

Dr. Mark Hyman
was in my 30s. Okay, okay. And I just I was living in Toronto in the seventies. It was a spiritual wasteland, and I was did not kind of relate to anybody. And it wasn't until I left and went to college and went to Cornell that I found other people who were like, oh, wow.

You, you know, you actually think like me and you read the same books, you do the same things. And in fact, I actually my first real friend I met on the top of a mountain in the Canadian Rockies. We were backpacking and it was a week out in the middle of nowhere by myself. And he was a week out. And we crossed over on Badger Pass in Alberta in Banff National Park, and we just had this kind of moment of connection.

And we both found out we're gonna be at Cornell in Oh, no kidding. Paul. He was in Ithaca College. I was at Cornell. We climbed this mountain the first night called Brachypod Mountain.

It was like 11,000 feet. It was like this kind of kind of kind of prototypical pointy top mountain. We sat on the ridge and watched the sunset at 11:00 at night and then ran down the screen. And we just had this extraordinary experience. And we got back and we got together and, you know, we didn't know if we were gonna be friends or not.

But we became like brothers.

Simon Sinek
We're friends today?

Dr. Mark Hyman
He's my best friend. Yeah. We forty No kidding. Forty six years later. Wow.

Yeah. Forty six years later, we do mountain bike trips all over. We we're we're very close. And, you know, we help each other. And when one's down, the other picks one up.

When I'm down, he picks me up. When he's down, I pick him up. And we've had this really sustained, deep, authentic, intimate relationship Yeah. For forty five years. That's amazing.

And we love each other, we hug each other, we cry together, and we laugh together. And, you know, it was a place where where I could say and be and do anything. And it was a remarkable experience for me to actually feel seen and loved. It was like the first person who loved me who didn't actually have to love me like my parents. Right.

Simon Sinek
They didn't have to love you. They chose

Dr. Mark Hyman
to love you. I mean, that was like and that friendship for me has been like an anchor in my life throughout all the troubles and tribulations and successes and diseases. And, you know, his wife committed suicide. I went through three divorces. I got very sick.

He You're

Simon Sinek
such an overachiever.

Dr. Mark Hyman
Yeah. I know. Right?

Simon Sinek
The the

Dr. Mark Hyman
I'm an expert at relationships. I

Simon Sinek
mean, what if W. C. Fields say quitting smoking is the easiest thing I've ever done? I've done it hundreds of times. That's Marriage is the easiest thing I've ever done.

I've done it four times.

Dr. Mark Hyman
I got it right though.

Simon Sinek
Here's something I discovered about close friendships which is we always talk about close friends as the person you would call in when you're in need, when you need help, the person you can cry with, the person you know we the person when you're in pain. And I actually think that's true. That's a level of close friendship that you can call that person when you when in a time of struggle or need. But I think there's even a closer level of friendship which is when you can call somebody when something amazing happened.

Dr. Mark Hyman
And they're not jealous.

Simon Sinek
And there's no jealousy and you can call them and what you're doing is bragging but not really. You just need to tell someone about this amazing thing that you accomplished or that was given to you or that you won or whatever it is and if you told anybody else they'd be like they think you were bragging but to that friend they have unbridled joy with you and for you And what I've learned is the number of people I would call with good news is actually smaller than the number of people I would call with bad news.

Dr. Mark Hyman
That's interesting. But you can call me with good news. Oh, thank you. But you know

Dr. Alexandra Solomon
what I mean?

Simon Sinek
Like a friend of mine called me recently about something amazing that happened in his life. And he was I was the first person he called. And we and I had no jealousy. And I was like, was felling like a parent, you know? I was so proud of him for what he did.

And you realize that that was actually more intimate than being there in pain. And so I started making lists of who are the people I would call for the insanely good things.

Dr. Mark Hyman
And it's a smaller number. Well, it's important to take an inventory of your life and your friends. And if you don't have good friends, it's really important to cultivate them, to invest in them, to find them. And there's ways to do that. I mean, there's ways to put yourself in environments and situations.

And part of it's like who you are. Right? For me, you know, I wear my heart on my sleeve, and I'm just who I am. Like, when we met Oh, I remember. It was a weekend, and I just got through this very intense emotional process.

I, you know, worked for a lot of this trauma that I was had experienced as a kid, and I was just, like, kind of, like, in this altered state, then I met you. I remember. I remember. And I think that's why we became You put it on your sleeve. Because I just shared authentically, we just then had this connection.

And it was that's kind of what I'm talking about is in order to actually create friendship, you have to be open. You have to open

Simon Sinek
your heart. Know I think? I think people sometimes treat

Dr. Mark Hyman
And not be afraid of being judged.

Simon Sinek
I think people sometimes treat friendships like bad food. Right? So I don't get that. So so here's what I mean. Like, like, you know, I just had this conversation with a friend of mine just just very recently.

She's in a relationship and. She's If she's afraid of being alone, she knows the relationship is imperfect. She knows that if she were in a different place in her life, she wouldn't be with this person. But that partner fills a space for her for where she's at. She's more afraid of the loneliness than being in an imperfect relationship.

Dr. Mark Hyman
Yeah, been there.

Simon Sinek
And I don't know how healthy that is.

Dr. Mark Hyman
The devil you know is better than they And she can

Simon Sinek
rationalize it, like they go on adventures together and they laugh a lot together, which is all true. But then, now as I'm talking to you, it kind of sounds like cake, which is, I know I shouldn't eat this, but it's so tasty and so chocolatey and just so good. And I'll worry about it later. Yeah. -You know, what's it now?

What's another little piece? I'm just having a little piece of cake. And it The good I can I can can enjoy the goodness so much that I can ignore the badness? -Yeah. -And -We tolerate a lot.

-Tolerate a lot. And, you know, this is one of the downsides of human beings, which is we're incredibly adaptable people. We're incredibly adaptable

Dr. Mark Hyman
Oh, I did that for so many years in relationships. I was like, oh, it's good enough. It's all this bad stuff. I just rationalize away.

Simon Sinek
So how do we okay, you're a doctor. You know, one of the things I'm taught one of the things that I'm exploring in this friendship book is how to make friends. Yeah. How to foster friendship. That's the thing I think most of us fall down on.

How to navigate tension in friendships, and how to end friendships. How to recognize that I really like this chocolate cake, but I think I need to not be in friendship or in relationship with this chocolate cake. And maybe we'll just hang out now and then. Know? Because I do have fun with you, and I do like you, But this is not healthy.

Dr. Mark Hyman
At a certain dose.

Simon Sinek
At a certain There's a certain dosage. And I've adopted wholeheartedly, by the way, just as a quick aside, you know, something you say regularly, which is treat sugar like a recreational drug. That's right. Know? That's right.

So I enjoy sugar, but I know to do it just occasionally. You know, it's okay. I don't I read once, and you can affirm whether this is correct or not, that when people stress about eating dessert, the cortisol released from the stress about eating the cake is actually worse for you than the chocolate cake. It might be, yeah.

Dr. Mark Hyman
It might be.

Simon Sinek
So if you're going have a little piece of chocolate, just enjoy it.

Dr. Mark Hyman
Well, you're right, Simon. The greatest pharmacy is the one between your ears. And it can actually kill you, or it can heal you, literally. I mean, that's how voodoo works. It's not like they just kind of put a hex on you and you die.

Mean, people actually happens. So I I think how we think about things matters. So if you you wanna eat a cookie, eat that cookie and love Just enjoy it. And enjoy every bite.

Simon Sinek
And treat it like a recreational drug. Just have one, two at the most. You know, one of one of my tricks, if there's, a bowl of M and M's Yeah. If you take a handful of M and M's and throw them in your mouth, that counts as one. That's one mouthful.

And then you take another handful and put them in mouth. That's two. But if I have one M and M, that's also one. And if I have another, because you count mouthfuls, not M

Dr. Mark Hyman
and M's.

Simon Sinek
And so if you just go from handful to one or two, you're drastically reduced the sugar intake. Anyway, but we digress. How, how have you ever, I want to understand the health issues of staying in unhealthy friendships or unhealthy relationships, where we know and when we're in the dark parts of the night, we'll admit to ourselves out loud, This is not a good relationship and I shouldn't be in this, but I fear the alone more than the thing that I'm in. Talk about the physiological impact of being in an unhealthy relationship.

Dr. Mark Hyman
Yeah, well, we sort of touched on it before, but when you're in a conflictual relationship, your physiology changes to a state of disease. Cortisol goes up, your inflammatory cytokines go up, your microbiome can change. I mean, a whole series of things happen in your body that make you more sick. And we see we see this happening. You know, we see people who are in bad relationships just do poorly and get sick more often.

And so I think I think the data is there. It's just really the question is, how do we how do we navigate a world where friendship is not of value? It just it just seemed like the last thing on the totem pole, you know? And after work, after success, after social media, after whatever else we're doing, exercise, food, it's something we invest in. And it's a crisis.

It's a it's a severe crisis. I mean, I don't you probably saw the articles in New York Times about men and friendships, and it was just it was just so heartbreaking. And for me, it's it's it's a bit of value I've had my whole life, and I've intentionally invested in friendships. And when COVID happened, you know, we're all isolated. We're all alone.

And in September 2020, my wife and I split up. I had just had back surgery. I was alone. It was COVID. And what did I do?

I sent an email to my closest men friends, six other men who I've, you know, done men's work with, mentors with, done medicine journeys with. And I said, hey, guys, like, can we start a little Zoom once a week for an hour maybe? And they're like, How about we do two hours every week? You know? And we've been going for it's plus four years now.

And it's it's remarkable to have this container. And what's been interesting to watch is that even though these these are all my close friends for forty years, thirty years, that the the depth of our friendship has gotten more profound, the more vulnerable we've gotten, the more we open our hearts, the more we share our fears, the more we share our successes, the more we share whatever is going on in our life doesn't matter. There's always something with one of us. And it's it's it's to me, it's like an anchor. And most of us don't have that.

And in Okinawa, one of the blue zones, there's a called a Moai, which is when you are born, you're stuck together with like three or four other kids, babies. And that's your basically group for your life. Amazing. Yeah. And you you're there throughout everything.

Simon Sinek
You didn't even pick the friends. I mean, this happens with like the Marine Corps or any boot camp for You that know, these become lifelong friendships because you go through hardship together. Or in the Israeli army, one of the reasons they're historically been very successful is when you go through boot camp, that's your unit for the rest of your Yeah. That's for the rest of your military career

Dr. Mark Hyman
Yeah.

Simon Sinek
Is that you don't get split up. Yeah. And they but so what I think is really interesting is these friend groups aren't chosen. They're kind of like arranged marriages. Like you're just thrown together by zip code or by, you know, in the case of babies, Oh, you're born on the same day?

You're friends. Yeah, exactly. Right? And I think what's really interesting about that, which is, you know, sometimes just like, I think sometimes we overanalyze, you know, who should be a friend. Am I is that right?

Dr. Mark Hyman
Well, mean, we have we have to I'm trying

Simon Sinek
to think I mean, maybe I disagree with myself as I'm saying the

Dr. Mark Hyman
words It are depends on the situation. When you're if you go through shit with somebody, even if you don't you don't have all the same background, you can get close, right? Yeah. And I mean, I was in Haiti. Was thrown in

Simon Sinek
Yeah. Because we we know that shared hardship produces cortisol. I mean, hardship produces oxytocin. So when you go through shared hardship with someone, it creates a bond of Yeah. -It creates bonds.

But now that I think about it, I'm gonna go back on what I said, which is I also know friendships and have had friendships where time is the only bond. Where we really don't -That's not enough. -We Like, we used to grow together, but now, you know, it's sort of grown apart. And, you know, we have fun, I guess, you know?

Dr. Mark Hyman
But sometimes being friends is actually calling people out. In other words, when you see like, if you're growing

Simon Sinek
But I think we stay in friendships unnecessarily simply because, Oh, but we've been friends for thirty years. Like, so what? So what? If it's no longer, it's like you wouldn't stay in a marriage that is dysfunctional just because you've been married. And yet we seem to have a different standard for like nobody says when you say, you know, I've been married

Dr. Mark Hyman
to my

Simon Sinek
wife for twenty five years, but, you know, we've struggled for a lot of years, and quite frankly, I think we've just decided mutually You know, it's amicable, but we've decided to call it quits. Nobody says, I think you should stay in the marriage. You've been married for twenty five years. Like, I think you should try and go another twenty five. Nobody says that.

But part of the friendship. But we say that in friendship. Like, how can you end the friendship? You've been friends for twenty five years.

Dr. Mark Hyman
Well, you can if it's if

Simon Sinek
it's But I'm saying people it's a different standard. Time becomes the only bond.

Dr. Mark Hyman
It's true. But sometimes when you drift apart or some people change, like, you're changing and you're growing or I was changing and growing and your friend isn't and you see this sort of hard split happening, you've wanted two choices. You can either go, Okay, well, we're just moving apart. That was a nice while it lasted. Or you can actually kind of go in for.

Kind of a surgical spiritual surgery. And sometimes it's painful. But I've done this with friends where I've seen them be in bad relationships or be in a job they didn't like or doing things that were contracting their life and becoming smaller when they were expansive, open beings when I knew them earlier. And I had a choice where I was going to just kind of let this happen here. Was I going to go in for a surgery?

And I was I going to do a spiritual surgery on this person? And and some of those people are over to it, some of them are not. Yeah. But, know, I had to drug them. Literally, I had to give him MDMA.

I had to, like, literally spend hours acid and and basically get him to really see how his life was a little extreme contracted. And and he needed that, you know, like and he needed to kind of break the cycle of his pattern of thinking. And now, you know, he's lost 40 pounds He's out of the relationship. He's free. He's got out of his job.

He's, you know, kind of the time of his life. He's exploring his own development. He's growing. He's like all of his fears around money and this and that. I mean, it's it's amazing to see a transformation, but it wouldn't have happened if I hadn't have leaned in

Simon Sinek
Yeah. Yeah.

Dr. Mark Hyman
As a friend.

Simon Sinek
I I have a friend who sat down with me to give me some life advice. Yeah. And the conversation started like this. I need to tell you something, and you need to hear this. And I need you to know that you're not gonna like what I have to tell you.

But I love you. He didn't say that. He said, You're not gonna like what I have to tell you, and I recognize that you may be so angry with me for telling you this that you might end the friendship with me. And I want you to know that I'm willing to risk our friendship to tell you this because you need to hear

Dr. Mark Hyman
it. Well, then how did

Simon Sinek
that land for you? I mean, he picked the right person because I'm like, yeah. I mean, you're not gonna lose the friendship, but bang, you know, game on. Right? And he gave me something that was very hard to hear that I that needed to be said, and I love him even more for risking the whole friendship out of love.

Like, was willing to throw away the friendship because he cared about me so much to tell me this. And that is that's a high bar.

Dr. Mark Hyman
I mean, think that speaks to what you know It's a remarkable thing. Finds friendship, you know, in my mind. What defines friendship is the ability to be authentically who you are and to be authentic and transparent with your friend. Just like your friend was. Yeah.

Right?

Simon Sinek
I mean, gave me the whole preamble.

Dr. Mark Hyman
Yeah. And that's that's a that's a it's a very scary thing for people to actually let down their guard. Yeah. Right? To be open and to risk.

And and it's fearful. But but that's what creates real friendships. Yeah. I think so. That's what creates real friendships.

Simon Sinek
And another friend of mine is struggling. Yeah. I'm I'm like, I'm so attuned to friends these days. Another friend of mine is struggling with one of her friends. And she asked herself, If I was in a marriage, and my marriage just a romantic relationship, a long term romantic relationship, and the relationship was struggling, we wouldn't just break up.

We would we would get help. We would seek therapy, couples counseling. Yeah. And so she went to her friend and said, This attention has been going on for too long. We're gonna go to therapy together.

Dr. Mark Hyman
Friends therapy.

Simon Sinek
Again, why do we instinctively understand that if a marriage or a relationship is struggling that we expect people to at least try to at least try the couples therapy before you call the whole things quit. Before you call the whole thing quits. And yet we don't do that with friendships. When we have tension with friendships we're quicker to end the friendship or sit in weird tension or avoid the person than to go to the therapy with the person to try and work through the struggles. We may still end up breaking up.

Dr. Mark Hyman
Yeah.

Simon Sinek
But let's at least put in a put in the effort to rescue this friendship that we claim we care about.

Dr. Mark Hyman
Yeah.

Simon Sinek
I love the idea of friendship counseling.

Esther Perel
It used to be that when people came to couples therapy, they came actually for their children. They didn't come to couples therapy. They came and slowly we would identify that there was something maybe in the relationship that also was interacting with the challenges that the child was having. Couples therapy really became a discipline of its own in the center that it is today when the expectations around intimate relationships began to rise. The more we expect from the couple and the more we need couples therapy to help us with those expectations.

When the couple was not the central unit of the family, but because the family was more important than the couple and people stay together for the family. Yeah. Today, not the children and not the family, it really will keep people together. They may keep them a few more years, but ultimately what keeps people together is the quality of the relationship between the two people.

Dr. Mark Hyman
Yeah. Right.

Esther Perel
So therefore couples therapy becomes a much more sought after practice. I don't just do communication. You know, I was thinking and I was editing another podcast session and it's an incredible session. It's the first session of season five that I'm producing now. And they come in and he says, you know, we are both people who like things to be done, who like to do things our way.

And I said, that's okay. That's interesting. But what is, what I'm hearing also is that you are two people who like other people to do things your way.

Dr. Mark Hyman
Yeah. That's what they meant, right?

Esther Perel
So then I ask, you know, how did you learn, you know, to say yes and how did you learn to say no? And he begins to tell me a whole story of how basically his father would continuously belittle him, lecture to him, be contemptuous. You know, we would start with the conversation son and then what followed was often, you know, berating him for all the things that he wasn't doing right and living up to expectations. And she grows up with a drug addicted mother, father who commits suicide, and she is the adult in the house from that little From which was young. Raises her two children.

And they say to me at one point, we fight about everything. We don't communicate. And I say, I don't think you fight about everything at all. Actually, I think you're fighting about the same thing all the time. The moment he experiences you as saying to him, you're incompetent.

You're not doing it well. You're not doing it right. He is in that original wound of him Yes. Of his. And the moment he says, you're not gonna tell me what to do.

You know, I'm doing it. I I'm I'm I'm out of here, and I'm and he goes for a break. You think I'm once again all alone with all the responsibilities and the four children on my shoulders, and I will always be alone, and I will never have anybody by my side. And you fight about that original wound. That's what every argument is actually about.

Dr. Mark Hyman
The same story over and over.

Esther Perel
You know? And that was so illuminating for them that it wasn't about the chore chart that they had she had made, and it wasn't about the kids and it wasn't about Yeah. Hispard. It was about, you know, I don't wanna be inadequate And I don't want to be alone. Those were the themes that each one was really and then we started to work.

So that becomes different than just communicating. How do you say things nicer?

Dr. Mark Hyman
Yeah, yeah. How do you get people to kind of move past those really primordial conditionings of childhood? That's the $64,000 question.

Esther Perel
I think the most important thing is that you teach people two things. When I say teach, it means you help them see two things. You help them separate the past from the present. The fact that this brings back vividly the experience of back then doesn't mean that it is actually what used to happen back then. The past and the present sometimes feel like they come together into one, but they are not.

And the second thing is that you then say, At seven you were helpless. At seven you couldn't respond. At seven, you couldn't just leave the house and say, this is dangerous for me to be here. Know, whereas now you are an adult and you have choices. And then you go and you basically help them, first of all, through the body to separate the past from the present.

In this moment, I get that tension, like I wanna start fighting. Like this man was a master of defiance, you know, but he got all his confidence through defiance, which means that it was pseudo confident. And when she would actually say, go ahead and do things. I'm with you. I support you.

Then he would start to talk about all his doubts. He was always sure only when he was in opposition. When he was in a fight and he knew what he wanted. But when he had somebody who was actually loving and giving, then he didn't know what to do with himself. And you go through the body and you track the feeling because a feeling is also embodied, you know, then you articulate the experience.

And then, you know what I really did with them? I really had a lot of fun. They had a lot of fun. I said, Lay down flat on the floor. And then I said, Now continue the argument.

Dr. Mark Hyman
You know

Esther Perel
that you can't fight when you're lying flat?

Dr. Mark Hyman
Yeah. Or wait, if you take your clothes off, I think that's another thing I've heard from couples. Everybody take their clothes off. It's hard to have a fight.

Esther Perel
You know, it's like we are meant to fight in straight up position like balance, you know? So then it opened up a completely different and it went from the fighting to the action behind the fighting, which is often the fear of loss, which is often will you leave me? Will you be there for me, etcetera. And then you go deeper, deeper, deeper. And that takes some time.

Dr. Mark Hyman
That's so beautiful. Esther, you've been at the front seat of literally probably hundreds if not thousands of relationships in ways that most people don't ever have insight into by simply the virtue of your job just like I've seen so many people who've been sick you've seen so many people who've had relationship challenges. So in that perspective, looking back after decades of doing this, what do you define as the success of relationships day to day? Like what are the keys to a successful relationship and what are the things that really destroy relationships?

Esther Perel
Yep. I will start with what destroys them.

Dr. Mark Hyman
I'm taking notes.

Esther Perel
Will really refer to the work of John Gottman and John and Julie Gottman here on what destroys them. They have a wonderful way of kind of separating between the masters and the disasters. And they talk about the four horses of apocalypse. Yeah. And basically what will kill relationships is chronic criticism, defensiveness, stonewalling, and the killer of them all is contempt.

Because contempt, and this we know also in large scale traumas, is contempt is the dehumanizing. Dehumanizing. Contempt is whatever you feel or think is irrelevant and doesn't matter. You don't even reach me. So those four horses of apocalypse, I think kind of summarize things well.

One thing is lot of things, defensiveness.

Dr. Mark Hyman
Criticism, defensiveness and stonewalling basically shutting down, right? Yes.

Esther Perel
Walled off and contempt, which is basically the, you know, shame is on the shame is one side and contempt shame is contempt for oneself and contempt for the other. It goes in both directions.

Dr. Mark Hyman
Yeah. I

Esther Perel
think when I once wanted to write a paper, I wanted to write a paper about what are creative couples because we talk about lasting couples. We talk about stable couples, but we rarely talk about what is creative couples or what you may include in successful couples. And what was fascinating is what you said before. The majority of people, when I said, do you know couples who have a spark? Couples who inspire you?

And people would on occasion come up with one, maybe two, often none. It was really scary to them because if I said, can you come up with entrepreneurs, with artists, with writers, with intellectuals, people have lists of people that inspire But here is everybody wanting to be in a relationship and not many people, you know, can think about, yeah, I like that. I want to do this. I never wrote the paper because what people ended up saying seemed rather banal to me as in that's, I know that. But then I've been sitting on this thing for years thinking actually, maybe it's not that known.

But what they said was this, that was very interesting. This is not in order. One is admiration. Admiration for your partner. It's not respect.

It's different. Admiration always implies a level of idealization is I look up to you. I admire you for who you are as a person, as a human being, more than just in your role as a partner, as a parent, as a, you know, so that was one big one. Two, the relationship is basically a foundation with wings. Meaning there's a solid anchor of trust and that solid anchor of trust interacts with the ability to take risks in life and in the relationship and to be playful.

It's what I often have looked at the combination between or the integration between our need for security and safety and predictability and reliability and our need for change and novelty and exploration and discovery. These two fundamental human needs. I think that the best relationships have a nice balance between what is togetherness and what is separateness. They have people have their own lives. But before I even continue, I think the best thing to say is this, there is no one size fits all.

Dr. Mark Hyman
It's all, yeah. Yeah.

Esther Perel
I can't tell you one, it's like you with health. It's not like you have a sense in health that it's an interaction of different parts.

Dr. Mark Hyman
Of course.

Esther Perel
If it is more of this or more of that, you know, some couples have Venn diagrams that are completely overlapping. They do everything together. They spend all their time together, and it works beautifully. Yeah. And some other very creative and successful couples are much more differentiated.

And actually, they have a strong core, but with big individual lives, you know, separate. Yeah. So Yeah. There is no one size fits all. I really would love that to be actually my opening line to your question before I even say what makes for success.

People who feel free in a relationship that makes for success. For sure, people who feel oppressed or under surveillance or who have to constantly lie or hide or, you know, not say what they bought or what is, you know, that kind of stuff. Those are major differences that I would add to the Gottman list. You know, it's a degree of autonomy matched with a deep sense of belonging. These two together is a beautiful dance.

Dr. Mark Hyman
It's beautiful. But I think there's some really practical ways that you talk about for people to achieve whatever it is their best relationship is right? Boundaries, routines, rituals. You know, what are the kinds of things that you help people establish within the relationship to build that foundation, that structure? Because it's not something that we know automatically.

It's not something we actually are taught. How do you help people build those structures in those relationships that help them get to that?

Esther Perel
So it's very interesting. This couple that I was mentioning before where he kind of walled himself off with no needs because he was all alone and there was nobody who could help him anyway.

Simon Sinek
And

Esther Perel
she is like permeated by all these voices. I thought that I had done a rather limited session with them. I really thought, I didn't really reach them. I didn't really go underneath the noise, etcetera. And then I get a letter today that you never know, you know, you never know about how much some of the tiny things that I did that I thought were almost slightly, you know, they were not Basically, would say, it's one thing to say, how about you tell Esther about this versus shutting your partner up and talking for them?

Of course you want to bring something up, but you also want to let them tell their own story. Yeah. How about when you have a problem or a question about sex or about children, you don't first go to your mother and grandmother, but you also go first to your partner.

Dr. Mark Hyman
Yeah.

Esther Perel
And you set a boundary with all the people from your family so that you can create a more sacred space with your partner. The boundary is not always inside the relationship. It's between the relationship and the outside world. How about you are able to make a request that isn't a protest? So say what you need rather than what the other person is or is not doing.

Just make a request and stick to that. And adding up these things, basically they write to me three weeks later and say, there's been a fundamental shift. We haven't had a single fight. I was able to no longer go and talk to my mother about everything. He feels much more open to me because I'm much less critical with him.

And I appreciate his openness and that makes me more fond of him and that makes him more asexual with me and more expressive of his desire for me. And it becomes the opposite of the escalation in the negative direction is now kind of escalating the going up in the positive direction. That's the work.

Dr. Mark Hyman
Yeah, it's so powerful. So powerful. One of the things that you've learned after decades of working with couples and relationships that are sort of nuggets of wisdom that you would lead people with about that could help them with relationships that they may be struggling with? What are the things that people should anchor to? And of course, there's your book, Maiden in Captivity and the State of Affairs and your podcasts and all that, which is great.

People should dive into that in your TED talks, but I'm just wondering if you could kind of distill down what you've really learned.

Esther Perel
The first thing I would say, and I think I have really, really learned it from, you know, the millions of people that listen to Where Should We Begin is that you're not alone. These days, on the one hand, we have unprecedented expectations of our couples' lives, but at the same time, we are also in a machine of fake news on social media. So people curate and posture and filter, and you kind of don't know where is the truth. You know, when people lived in the village, you heard the fights of the neighbors and you heard the frolic of the neighbors. Now your best friends can come and tell you that they're breaking up and you never saw it coming.

Nobody tells you the truth about what goes on in the couple's relationships. Then you're left thinking these are Everybody's

Dr. Mark Hyman
doing great.

Esther Perel
They're doing great and we are alone with our problems. And so I think really, Where Should We Begin showed me that when you listen deeply to the stories of others, you see yourself in front of your own mirror and you don't feel as alone and you get the tools for the conversations that you want to have. I think that's the first thing I really realize that this is a unit that doesn't talk. Friends talk to friends, couples often talk to nobody about what's really going on. They may be struggling with infidelity.

They may be struggling with infertility. They may be struggling with bipolarity and mental health issues. They may be struggling with unresolved grief. They may be struggling with economic hardships, with unemployment, with addictions. And they won't talk about it to anybody because they have to present themselves a certain way.

And it breaks my heart sometimes to see how alone people are with some of these major, major challenges. So that's the first thing I've really learned is to make sure that that's part of the game too, is to give people a tool to make hard conversations less difficult. The second thing that I have really learned is this couple that I was describing where I thought, oh my God, this is, you know, they really came in to say, we need you to tell us, are we broken? Are we beyond repair? And I thought, at the end of the session, I thought, I don't know where this is going.

And I have been so many times surprised by people where I think there's not much left here. And then when you change one thing, like this woman, she stopped trying to change him. And she went ahead and took responsibility for her contribution. And she changed a few things about her own behavior. It just unleashed a cascade of changes for better.

That is a real important piece. Sometimes it looks like everything is interconnected and it's like impossible heap of nuisance. And yet if you make one shift, it has the power because systems are interdependent parts to activate everything else. That's the second thing that is very important. Third thing that there is a big difference between what you feel inside and how what you experience inside affects the people around you.

You may be depressed and feel weak and hopeless and helpless and anedonic. But when you are in relationship with those who love you, you often wield all the power. Because you activate everybody around you to try to make you feel better, to give you advice,

Dr. Mark Hyman
to try to

Esther Perel
lift you up. And in the end, they feel defeated and deflated So like power doesn't always come from the top down. Power comes from the bottom up, from places that are not nearly that obvious. I think we really don't understand enough the complex you know, interplay of power dynamics in relationships. If you want to change the other, change yourself.

And maybe the last thing I would say is beyond most issues that people argue about, there generally are three themes, control and power, care and closeness, and respect and recognition. Whose priorities matter? Who has the power here? Can I trust you? Do you have my back?

Yeah. And do you value me?

Dr. Mark Hyman
Yeah. Those are huge.

Esther Perel
These are the three major themes that many, many couples basically struggle about, but it comes in the forms of talks about sex and money and family and immigrants and but that's not the the issue. It's not the issue. It's the emotional crucible in which those issues play off.

Dr. Alexandra Solomon
How do we know if we're in a toxic relationship versus a healing relationship? Well, step one is you're in projection. You're not aware of your own integrated pain, your partner's pain, and you're blaming one another essentially and trying to have that person meet your needs and refusing to meet your own needs, which is a big one. I want you to say all the things. Yeah.

Dr. Mark Hyman
Yeah. Well, that I think that's the first fallacy relationship that our partner's job is to meet our needs. That is not their job.

Dr. Alexandra Solomon
Ding. Ding.

Dr. Mark Hyman
Ding. Job. That's our job.

Dr. Alexandra Solomon
Yes. Yes. And that points to which is very useful information. So when we see that in ourselves, we don't have to shame ourselves. We can look at that and go, okay.

So for example, me. I had this unmet need in my childhood. So my greatest unmet need from my perspective as a child was that I I just needed a safe and stable place. So before I did this healing work, I was running around looking for a man to give me a safe and stable place but refusing to give it to myself.

Dr. Mark Hyman
Yes.

Dr. Alexandra Solomon
And that that was my inner 10 year old running my love life and sex life. And most of us who haven't done any relational healing work have a ten year old, a 12 year old, a seven year old running our love life and our sex life. Yep. Which is I didn't get this need met, and I'm gonna find someone who reminds me of the person who didn't meet the need. And I'm gonna play out my unfinished business with my parents with them and hope that they meet the need even though I'm refusing to meet it myself.

So, yes, step one, owning your needs, which, by the way, actually makes it easier for other people to meet your needs. That's the kind of, like, mind bending part of that. When you when you come to someone and you're not saying, I need you to do this or else, and you say, you know, I recognize it's my responsibility to create a safe and stable place for me, and I will always be the one to do that for myself. And if I you know, I always come back to at least aiming to do that for myself. I know it's my responsibility.

But can you help me? Different energy. Right? And so moving into a healing relationship is taking ownership of your own work. And then who are the people in your life, whether it's romantic partners, friends, family members, who empower you to do your own work.

They can't do it for you, but they can love, support, encourage, and empower you to do your own personal development work to, as the cliche, become a better person through them loving you, supporting you, and you doing your own work. A toxic relationship is one in which you feel consistently disempowered from doing your healing work.

Dr. Mark Hyman
Yeah. You know, it's interesting. I I I found a new framework that's really helped me in my current relationship which has really been extraordinary and that is there's me, there's her, there's us and then there's this third entity which is the the stuff that we bring into the relationship. You know? The traumas, the triggers, the fears that aren't really who we truly are, but are

Dr. Alexandra Solomon
Mhmm.

Dr. Mark Hyman
Things that we've brought in. And instead of being obstacles, there are opportunities to actually together hold them outside of the container of the relationship and look at them and be curious about them and explore them without judgment, without fear or without having to have a certain outcome, but just in an honest, clear and curious way go, gee, this is coming up for me. And instead of me going, oh, that means you don't like me, or that means blah blah blah, it's like, oh, okay. This is interesting. Where is that from?

What's that about? You know, how am I showing up that's creating that? Or where is that a place where we can learn about what's driving us and how do we become free from it? It's a very different framework, you know, because often Yes. People sort of in relation to Doug in, you know, I'm not meeting you're not meeting my needs.

You're not meeting my needs. It's like it's like, I'm not gonna do what you want me to do until you do what I wanna do. And it's like this crazy, weird dynamic that just doesn't get anywhere. And it's it's like it's it's it's like if you look at love as a container for creating your own spiritual evolution, then it becomes a very different perspective on how to actually be in the relationship. It's not about them fixing you or you fixing them.

It's about being curious together about how to evolve together Yes. And individually.

Dr. Alexandra Solomon
Yes. And what you just described so beautifully is what we touched on earlier, which is this idea of undifferentiating, unblending from your reaction but still looking at it and sharing about it. Curiously, one of my good friends, Sadi Simone, is an amazing Buddhist teacher, and he says, the quality of your curiosity is the quality of your liberation. And I love that. It's what you're saying.

It's can I create enough space Mhmm? To look at what I'm feeling, not disassociate from it, not disconnect, not shove it down. No. Have it leak out sideways. But can I just have enough space so we can be curious about what's here and learn how to grow from it and shift from when I win, you lose or vice versa, this win lose power struggle, yep, into how do we compassionately and creatively get both of our needs met?

Takes creativity. Yeah.

Dr. Mark Hyman
Or how do we how do we actually realize that our happiness isn't really about the other person meeting our needs, but us becoming whole human beings and meeting each other as two whole human beings in the It's context of something we don't really have a model for. We're not certainly, you know, did not have that model No. For As a boy, it certainly isn't modeled in our culture, it's certainly modeled in books and movies and TV and so we're kind of flying blind a little bit and what's really exciting is that there's this sort of emerging consciousness around love and sexuality and redefining what love is that kind of is exploring a Dome Leader way of thinking about it. I read a book called All About Love by Bell Hooks, who's recently died, a woman who was really insightful talking about the nature of love. And kinda was great because it kinda taught me that a lot of the ideas, concepts, the beliefs, conditioning, the norms are kinda fabricated, and what would love look like if we kinda shed those?

And we asked ourselves, you know, what do we want? How do we create a different way of being with someone? And to use all those opportunities, whether they're triggers or things that cause us to kind of have some physical sensation or body of fear or disconnect as a gift, as an opportunity to look at ourselves and to look at what's happening and to be able to transmute that into a really different way of relating to somebody.

Dr. Alexandra Solomon
Yes. Yes. And we need skills. It's about upskilling. Right?

I didn't know about conscious communication. Right? I didn't know about regulating my nervous system. I didn't know about being hijacked by my emotions, my reactions, and my triggers or how to get space from that. Like, that's my aim is to upskill my clients.

Right? Not just the somatic healing work, but also to give them and upskill them in relationships, in sex. Like, what are the skills we actually need to succeed? Because and, also, this healing relationship is not about perfection, but you do want as you're as you're sharing, what is the vision and intention for your relationship? It might look totally different.

Is it that you want to spiritually evolve together? Is it that you wanna create a safe space to do your own healing such that your relationship becomes a healing presence for your kids, for your family, for your community? Like, what is the intention of even being with one another? Like, why are you together? So that when you forget, because Lord knows you will, hopefully, one of you can remain in your mature adult and can help to empower the other to remember why we're here, to remember what is the style of communication we've agreed on.

We don't use name calling. We don't use raise voices. I love you, but I won't allow that. That's not within our framework. We have different skills.

We have a different intention. And learning how to repair after rupture. Because even if you have all the best intentions, me and my husband have, we still I still act like a petulant child sometimes. And I think, oh, wow. Still got work to do.

But I have the

Esther Perel
skills now

Dr. Alexandra Solomon
to repair. Yeah.

Dr. Mark Hyman
Exactly. Yeah. I think that's right. I think, you know, a lot of us, it's almost like, you know, we wouldn't imagine getting in a car where, you know, everything was unpredictable, where the car would swerved right, would swerved left, the brakes would slam on, the gas would go forward, you know. It would flip around backwards.

I mean, we wouldn't we'd be terrified. But that's exactly how we navigate emotionally in relationships. It's like Yes. Like some crazy person driving the car. Right.

And, you know

Dr. Alexandra Solomon
And blaming and blaming the other person in the passenger seat for, you know, how it's driving. Exactly.

Dr. Mark Hyman
And and so learning how to kinda get ahold of the control, the control switches on our amygdala, which is our ancient we call it our fight or flight response. But in medicine, we learned there were the four F's, feeding, which is our baby around food, fight or flight, and reproduction. That was the fourth f.

Dr. Alexandra Solomon
I thought you were gonna say thorn. Flight, fight, freeze, flight, fawn. But no, I like that. The fourth f. Yes.

Very important.

Dr. Mark Hyman
And so our behavior really is often triggered by these ancient survival mechanisms that aren't really serving us anymore. Yes. And I'm sort of curious about a lot of these ancient techniques around, you know, embodied sexuality and there's more and more talk about it, there's more courses that people can take, you know, there's things that actually help people discover that and I'm super curious about it and exploring it myself, I think that, you know, it's sort of almost criminal that we don't have a cultural narrative of how to get through these challenging aspects of love, relationship and sexuality, and that's why your work is so important, it sort of gives people a roadmap, you know, to figure things out, which really we don't have a language for, we don't have a framework for, and yet it exists. I mean it's been there throughout historical cultures, know, whether it's Tantra or other ways of thinking about love relationship, healing the mind, perception, Buddhism, all of it. Know, think a friend of mine wrote, Susan Pai wrote, Four Noble Truths of Love.

You know, it's like, It's all about how get do out of this sort of projection of our conditioning, our trauma, our lineages, and bring that into relationship and actually start to heal that? That's really what seems like the work that we have to do, because right now we're in such a divisive society, there's so much conflict, you know, not just in relationship, in love relationships, in family relationships, but in society as a whole. Mean, it's just sort of staggering to me the amount of conflict. I mean, there always was, I guess, throughout history, but it just seems to be ramped up and polarized more than I've ever known. Mean America didn't seem to be to America's before, and now it seems to be completely to America's, which is so tragic.

Mhmm.

Dr. Alexandra Solomon
Yeah. I mean, Ken Wilbur, I mentioned earlier, describes expansion of consciousness as the ability to expand what we are aware of and care for. So to both be aware of and caring of. And I think that for me, that looks like and what I see people learn how to do through the somatic healing work is hold more complexity with care. That I can make a mistake, I can hurt myself or someone else, and I can still be a good human being.

I'm still worthy of love. I'm still I can have a really period of low of depression and be overcome with sadness, and I'm still valuable. I still have value. There's this complexity, this ability to hold more with more care. And I think if we each were able to do that on an individual level, we'd be able to hold more complex human beings in front of us that people can say something you don't like and still be worthy of love and belonging.

People can have a different opinion to you and still be worthy of your time and connection. You know?

Dr. Mark Hyman
Yeah. It's so true. I mean, I I deal with all sorts of people as a doctor. I can't choose who comes in my office. I can't choose what they believe, what their religious beliefs are, their political beliefs.

And at the end of the day everybody's a human being, and that's where I start. And you know, I remember one day my office had a Muslim, a Christian, a rabbi, I had a top Republican, a top Democrat, it was like the United Nations of Medicine or something. And I was like, You know what, this is all so crazy, we're all just struggling with the same things, we all care about the same things, we all want to be happy, we all want our families to be good, we all want to live in a better world. I mean, you know, all have different views of how to get there for sure, but I think that our common humanity has been forgotten, that just really breaks my heart, and it seems to me that your work is really about getting connected to your own humanity and your own center of universe where you're actually an embodied human that's looked at yourself carefully, that's healed the things that need to be healed, that's learned how to love yourself and others in a more integrated way. It's the most important work we have to do.

Remember reading a quote, I can't remember the exact one, Dalai Lama, but essentially it's like, we want to heal the world, we have to start with ourselves, you know, and I think it may seem like a narcissistic pursuit, but it really isn't. If we don't take care of ourselves, we can't be there in the world to show up for others. Know? I think that's what it's all about.

Dr. Alexandra Solomon
Yeah. And the body doesn't discriminate. You know? Your body if whatever mistakes you make, you know, your body's just striving. Even when even when we're sick, the body's always striving to try and deal with the toxins and the stress and everything to try and create homeostasis, it's like our body doesn't discriminate.

And what's so beautiful about the body is it's always right here right now. Your body is never anywhere else but right here right now. And that's what I really love about this powerful path of body based healing. And I think that when we get in touch with our body, we do become more present. And when we're connected to our body, I believe we're connected to the gift of getting to be alive, of you, this moment, this body, this life, exactly as it is right now.

And that's, for me, has been the most profound pathway or gateway into better sex and liberation and truly allowing myself to be seen by my husband, which I found excruciatingly vulnerable. Right? I knew how to do the fourth f, but did I know how to make love, how to be seen? No. That took me learning and developing and better relationships, learning how to love my darkness and and still say, wow.

Okay. That was not kind or I lost my temper there, and I'm still worthy of love and belonging to take responsibility for. And then that allows me to do it with other people. I look, okay. Wow.

That person lost their temper. They didn't feel good. Okay. They're still worthy. Can we repair?

So it's like all of this work internally that does bleed outward and that is really tangible. That's what I love about the body too is you have an experience of it. It's not just ideology. It's not just concept. You feel it in your own way through your own lens, whether it's or religious or secular, and then you have that experience.

And no one or nothing can take it from me.

Dr. Mark Hyman
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