# Biofeedback & Hypnotherapy Treatment



## spider (Sep 26, 2001)

Hello all,Just wanted to give you an update on the biofeedback/hypnotherapy I have been recieving at Stanford Hospital. The first couple sessions I went in and they gave me a battery of tests, a two hour multiple choice "subjective" test asking all kinds of personal questions. Everything from how many times I have moved to how much of an imagination I had as a child. Then they hooked me up to all these wires to monitor my brainwave activity, muscle tension, heart rate, and body temp. From these tests they told me I don't recover from stressful situations completely, and that I tend to "make mountains out of molehills" All of this can be directly effecting my physical state, making me nauseous, and have both C & D. They usually find this in people that have IBS, Migranes, and other physical problems.Since then I have gone in about every week for the passed 5 weeks for hypnotherapy. My doctor monitors how well I am relaxing by monitoring my heart rate and anxiety level. Every time I go into the DRs office, I am super agitated and this is my "default" mode that I have come to get used to. Walking around with a lot of anxiety, but just being USED to it is my reality. By the time I am done with the hypnotherapy, I am usually able to relax quite a bit and sometimes actually find that I am hungry.He made me a personal tape to listen to daily which helps me relax but I tend to fall asleep every time I listen to it. I usually wake up before the end, which means i am absorbing it in my subconcious, which is okay. My only problem is that I haven't been able to get very deep into hypnosis because my anxiety level is so high (he says.) It is so wierd, because i don't always feel agitated or like i have this anxiety but when I go into the office, it shows up on the screen like crazy. My doc tells me that i look like "a swan on the lake" on the outside, but inside me is all this chaos. I can't say that I feel it has helped me too much yet. I do think we need to start targeting more of the anxiety, than the physical symptoms of IBS. I am going to continue going before I submit to taking any meds for my anxiety. (PS anyone heard of buspar??)


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## eric (Jul 8, 1999)

Spider, it sounds like its helping you a lot from your post. Things like this " I am usually able to relax quite a bit and sometimes actually find that I am hungry." are slow gradual changes that slowly take place that overall make you fell better. Could you say that before?"My only problem is that I haven't been able to get very deep into hypnosis because my anxiety level is so high"This may take some time for you as you break down the anxiety and learn and build on relaxation techniques and how the body responds to them, which in turn your symptoms benefit from.Hang in there even after yoou stop HT you still improve and you should really be helped with how the biofeedback teaches you how to relax. Did you read the how and why HT works I posted." can't say that I feel it has helped me too much yet. I do think we need to start targeting more of the anxiety, than the physical symptoms of IBS."If you target the anxiety the physical symptoms of the IBS get better (for a lot of reasons in IBS) and if you target the physical symptoms generating the anxiety you get better. They sometimes go for the main symptom first.Sounds like your doing good.


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## eric (Jul 8, 1999)

Spider, you should read through Mike's Informational posting thread as there is some information there that would also help you.


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## zayaka26 (Jul 5, 2001)

Spider, don't give up on it. Hopefully you will se results soon. I saw a psych about two months ago and he wanted me on Paxil (which I did not) and asked me to go for some therapies during the month of December (I have some two weeks off and he thought that was a good time). To make my story short, I decided to try Mike's tapes. In the beggining I could not afford them, then I made some arrangements (finally my economical situation made a 360 turn) and even though the therapies were going to be covered completely by my insurance I did not want to go through the "driving in the morning to go to therapy thing" because that would a trigger for me. Also, why put myself to added stress when I could try this from my own home AND I can do it whenever I want. Oh, yes... I did not want to get up early during my vacation time.







I am not trying to say you should do as I did; this is just my particular case and I just wanted to share it. I am happy you are giving this a shot and certainly hope that you can get a lot of benefits from this.


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## AZmom1 (Dec 6, 1999)

Spider,It sounds like you're well on track. You do not need to get into a deep state of hypnosis for it to be effective. Perhaps as your "default mode" lowers, you will get into a deeper state.Is your hypnotherapist doing gut-specific hypnotherapy as part of your program? When I first had hypnotherapy in 1989, it was for panic attacks and stress. At the time I didn't know I had IBS. It helped, but not like Mike's gut-specific therapy. Talk to your therapist about it. Dr. Palsson at UNC gives his protocols to qualified therapists that want to learn how to treat IBS with proven techniques.AZ


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## spider (Sep 26, 2001)

Thanks for all your responses and support. I am still charging away with the tapes, and I haven't submitted to the meds. I am attributing my recent angst to the holidays and hectic traveling (and random eating on the road). It is very interesting that you mentioned Dr. Palasson because my Hypnotherapist has worked with him and he gave me his email address!!! Dr. Palasson showed me this site http://www.ibshypnosis.com which has been helpful as well.My therapy is gut specific, we have just started addressing the anxiety,since it seems to be getting a little in the way.I was wondering if any of you have felt a flushing feeling on the lower left side of your head and down into your neck while you deeply hypnotized. My dr. keeps asking me to look for it (Vega nerve) and I haven't felt it yet.I will keep you posted and keep on the tapes.


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## AZmom1 (Dec 6, 1999)

Spider,It sounds like you found a good hypnotherapist and is trained in the proper techniques for IBS. Could you post his name and city where he practices? It could be helpful to others.AZ


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## eric (Jul 8, 1999)

Spider, I am friends with Dr Paulsson.







He does research at the UNC the top IBS research center.







Here is an article for you.with permission from Olafur S. Palsson, Psy. D. Research Associate, UNC-CHAPEL Hill Department of MedicinesThe Effects of Hypnosis On Gastrointestinal Problems Olafur S. Palsson, Psy. D. Research Associate, UNC-CHAPEL Hill Department of Medicines Hypnosis is a treatment method, which still carries an aura of mystery,that unfortunately continues to be promoted by misrepresentations in movies and stage shows for entertainment. In reality, there is little mysterious about hypnosis anymore. It is a well-researched clinical technique which was formally accepted as a treatment method by the American Medical Association and the American psychological Association over thirty years ago. Clinical hypnosis is currently used by thousands of clinicians in the U.S. to treat both psychological and medical problems. Until recently, the possibilities of using hypnosis to treat gastrointestinal problems had received little attention. In the last 15 years, however, research has shown that hypnosis can influence gastrointestinal functioning in powerful ways, and that in particular, it is effective in helping patients with irritable bowel syndrome and to control nausea and vomiting. How Hypnosis Works: Hypnosis is a special mental state in which a person's focus of attention becomes narrow and intense like the beam of a bright flashlight in a dark room. This state is usually created with the aid of a hypnotist,who guides the person systematically to relax, focus only on one thing, and to allow things to happen by themselves. Whatever the mind focuses on while in this special mental state of hypnosis holds the entire attention. Therefore, people tend to experience things they think of, imagine or remember, more vividly and clearly than under usual circumstances. This is why people can sometimes recall things from their distant past under hypnosis even though unable to do so in the normal waking state (research has shown, however, that such hypnotically enhanced recall can be highly contaminated by the person's imagination). The narrow hyperfocus of this mental state is also why therapists using hypnosis are frequently able to help people make strong positive changes in their emotions and physical functioning. Hypnosis can work like a magnifying glass on the mind's effects on the body and emotion. Clinical hypnosis relies on suggestions, imagery, and relaxation to produce its therapeutic effects. Hypnotic suggestions are things that the hypnotist verbally suggests may happen while the person is under hypnosis. Due to the focused and receptive state of the hypnotized person, these suggestions happen almost automatically and without conscious decision or effort. If you, for example, receive the suggestion under hypnosis that your arm may be getting heavy, you will very likely feel it becoming heavy, without trying to do anything to make it happen. This "automaticity", the feeling of things happening by themselves, is by some considered the hallmark of hypnosis, and is often surprising to people experiencing hypnosis for the first time. Hypnotic imagery consists of picturing mentally events or situation or place in a way that has a desired positive physical or mental effect. For example, patients undergoing surgical or dental procedures are sometimes taught to enter a hypnotic state and go to a pleasant place in their mind. When successfully applied, the person gets completely engrossed in the vivid enjoyable imagery and is therefore happily unaware of the unpleasantness of the procedure. The hypnotic state is naturally accompanied by relaxation, and the physical relaxing effects are often deliberately strengthened further by clinicians through suggestions and relaxing imagery. Some of the benefits that come from hypnosis treatment are likely to result partly or entirely from the fact that hypnosis is a powerful relaxation method. Over decades of research and clinical experience, hypnosis has proven to have many valuable therapeutic uses. In psychotherapy, hypnotic techniques can speed the therapy process in various ways - for example by facilitating patients' self-understanding, extinguishing unfortunate habits, uncovering repressed or forgotten memories, reducing anxiety and phobias, and helping people to adopt a new and more adaptive outlook. In medicine and health psychology, hypnosis is used to reduce pain and discomfort associated with medical procedures such as childbirth, treatment of burns, and surgery where chemical anesthesia cannot be used effectively. It is also used to treat chronic pain and psychosomatic problems and counter unhealthy habits that contribute to illness. In dentistry, hypnotic analgesia is an effective needle-less alternative to topical anesthetic drugs, reduces bleeding and discomfort in oral surgery, and is used to treat teeth grinding and temporomandibular disorder. In recent years, the effects of gastrointestinal functioning and GI symptoms have been studied extensively. The Effects of Hypnosis on Gastrointestinal Functioning: The hypnotic state itself, without any particular suggestions, seems to slow down the gut, and clear-cut and specific changes in GI functioning can be induced in individuals by directing thinking or inducing specific emotional states under hypnosis. For example, one study(1) found that when healthy volunteers were hypnotized and simply instructed to relax, the orocaecal transit time (the time it takes material to pass through the GI tract from the mouth to the first part of the colon) was lengthened from 93 to 133 minutes. Another study(2) found that being in a hypnotic state decreases muscle movements in the stomach. The same study demonstrated that the emotional state of happiness, created under hypnosis, suppresses gastric muscle activity but anger and excitement increase muscle movement in the stomach . A pair of other studies(3) showed that when volunteers were guided to use imagery of eating a delicious meal while they were under hypnosis, gastric acid secretion was increased by 89%, and that acid production of the stomach could also be deliberately decreased during hypnosis using hypnotic instructions. Close to fifty published studies have reported on the therapeutic effects of hypnosis on nausea and vomiting problems related to chemotherapy, after surgery, and during pregnancy. Overall, this substantial body of literature indicates that hypnosis can be a powerful aid in controlling nausea and vomiting. Hypnosis may also be helpful in preventing gastrointestinal problems from recurring after they have been treated with medication: One study(4) of thirty patients with relapsing duodenal ulcers who had been successfully treated with a course of medication, found that only 53% of the patients who received preventive hypnosis treatment had a relapse within one year. In contrast everybody (100%) in a comparison group receiving no hypnosis relapsed in the same period of time. In 1984, researchers in Manchester in England published a study(5 )report in the journal Lancet, showing that hypnosis treatment dramatically improved the symptoms of IBS patients who had failed to benefit from other treatment. The researchers had randomly divided patients with severe IBS problems into two groups. Fifteen patients were treated with seven hypnosis sessions. Fifteen comparison patients were treated with seven sessions of psychotherapy, and those patients also received placebo pills (pills with no medically active ingredients) which they were told were a new research medication for IBS symptoms. Every patient in the hypnosis group improved, and that group showed substantial improvement in all central symptoms of IBS. The control group showed only very modest improvement in symptoms. Partly due to these dramatic results with treatment-refractory patients, a dozen other studies have followed, including three U.S. studies. The general conclusions from most of these studies are that hypnosis seems to improve the symptoms of 80% or more of all treated patients who have well-defined "classic" IBS problems, especially if they do not have complicating factors such as psychiatric disorders. The improvement is in many cases maintained at least for a year after the end of treatment. What is particularly remarkable is that this high rate of positive treatment response is seen even in studies where the participating patients all have failed to improve from regular medical care. The dramatic response of IBS patients to hypnosis treatment raises the question of exactly how this kind of treatment influences the symptoms in such a beneficial way. Four studies to date, two in England and two in the U.S., have tried to discover how hypnosis treatment affects the body of IBS patients. Since it is well known that many people with IBS have unusual pain sensitivity in their intestines, which is thought to be related to the clinical pain they experience, much of the focus of these studies has been on assessing the impact of this kind of treatment on intestinal pain thresholds. The two English studies both measured intestinal pain sensitivity with balloon inflation tests. The second study also measured muscle tone, to see if hypnosis relaxes the smooth muscles of the GI tract. No overall changes in pain sensitivity were detected, and gut muscle tension was also unchanged after treatment (except a subgroup of unusually pain-sensitive patients had lessened pain sensitivity in the second study(7). . In 1995-1996, during my post-doctoral fellowship in the Division of Digestive Diseases and Nutrition at UNC-Chapel Hill, we conducted the first U.S. study(8) on hypnosis for IBS under the direction of Dr. Whitehead. We evaluated the effects of a highly standardized treatment protocol, delivered verbatim following written scripts, on rectal pain thresholds and muscle tone. Seventeen out of the 18 patients we treated with hypnosis showed significant improvement in their clinical symptoms. However, we found, like the English researchers, that gut pain thresholds and muscle tension were unchanged after treatment. In a second study(9,) which I conducted with co-investigators at the Eastern Virginia Medical School, we used the same treatment protocol but this time measured autonomic nervous system functioning and blood levels of a gut hormone called vasoactive intestinal peptide. These are regulators of GI functioning in the human body, and the aim was to see if they would change due to treatment. Again, we found no changes in our physical measures after treatment (with the exception of reduction in sweat gland reactivity) even though 21 out of 24 treated patients were clinically improved. It should be noted, though, that in both our studies, we found clear improvement in the psychological well-being of our patients after treatment. In summary, it is clear from our work and other research that hypnosis treatment substantially improves all the central symptoms of IBS in the majority of patients who receive such treatment (see the effects of our two studies on clinical symptoms in the Figure). What happens in the body of these patients to cause such improvement, however, remains a mystery. Future prospects: In light of the many studies which have shown hypnosis treatment to be effective for such problems as IBS and nausea and vomiting, the question may be raised why this kind of treatment is not more widely available or generally offered to patients with such GI problems. One limitation is the fact that not everybody is equally hypnotizable. Research has consistently shown that at least 15% of people are practically non-hypnotizable, and even those who are able to enter a hypnotic state vary greatly in how well they respond. Interestingly, the ability to be hypnotized is a stable mental trait. In other word, if you are highly hypnotizable now, you will most likely be so also in thirty years. Fortunately, the majority of people are sufficiently hypnotizable to have a potential for enjoying at least some of the medical and psychological benefits of clinical hypnosis. Furthermore, the idea of being hypnotized does not agree with all people. Even individuals who are sufficiently hypnotizable, may not like the idea of "letting go", may have difficulty trusting a therapist to guide them in hypnosis, or may have other concerns about the hypnosis experience. Fortunately, other forms of psychological treatment for gastrointestinal problems - in the case of IBS especially cognitive-behavioral therapy -- have also been found to be effective and are good alternatives. Finally, an obstacle which has barred many patients from receiving help for gastrointestinal disorders with hypnosis is the fact that in the U.S. the technique is more commonly used by psychologists and other mental health professionals than by physicians. Many mental health professionals who use hypnosis are not accustomed to treating gastrointestinal disorders, and therefore reluctant to take on treatment of such problems. As the reliably beneficial effects of hypnosis on gastrointestinal functioning become better known both to health professionals and the general public, this benign and comfortable form of treatment will hopefully become a more popular treatment option for GI patients - especially for those who have not received much relief from standard medical management. As far as IBS is concerned, we have been making an effort in the last two years to encourage clinicians across the country who have adequate training in hypnosis to provide such treatment for IBS. We have done this by providing them, free of charge, with the complete standardized treatment protocol which has proven effective in our research. To date, more than eighty licensed health professionals, practicing in almost all states, are started using our protocol, making it a little bit easier for patients in many geographical locations to receive help with hypnosis. References 1. Beaugerie, L., Burger A.J, Cadranel J.F, Lamy, P., Gendre J.P., & Le Quintrec, F. (1991). Modulation of orocaecal transit time by hypnosis. Gut, 32, 393-394. 2. Whorwell PJ; Houghton LA; Taylor EE; Maxton DG. Physiological effects of emotion: assessment via hypnosis. (1992). Lancet, 340, 69-72 3. Klein K.B., & Spiegel, D. (1989). Modulation of gastric acid secretion by hypnosis. Gastroenterology, 96, 1383-1387. 4. Colgan, S. M. , Faragher, E. B. , & Whorwell, P. J. (1988). Controlled Trial of Hypnotherapy in Relapse Prevention of Duodenal Ulceration. The Lancet, 1(8598), 1299-300. 5. Whorwell, P.J., Prior, A., & Faragher, E.B. (1984). Controlled trial of hypnotherapy in the treatment of severe refractory irritable bowel syndrome. Lancet, 2, 1232-1234. 6. Prior A., Colgan, S.M., Whorwell P.J. (1990). Changes in rectal sensitivity after hypnotherapy in patients with irritable bowel syndrome. Gut, 31, 896-898. 7. Houghton, L.A., Larder, S., Lee, R., Gonsalkorale, W.M., Whelan, V, Randles, J., Cooper, P., Cruikshanks, P., Miller, V., & Whorwell, P.J. (1999) Gut focused hypnotherapy normalises rectal hypersensitivity in patients with irritable bowel syndrome (IBS). Gastroenterology,116: A1009. 8. Palsson, O.S., Burnett, C.K., Meyer, K., and Whitehead, W.E. (1997). Hypnosis treatment for irritable bowel syndrome. Effects on symptoms, pain threshold and muscle tone. Gastroenterology, 112, A803. 9.Palsson, O.S., Turner, M.J., & Johnson, D.A. (2000). Hypnotherapy for irritable bowel syndrome: Symptom improvement and autonomic nervous system effects. Gastroenterology, 118,(4) A174.


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## norbert46 (Feb 20, 2001)

Spider, you are really doing good even if you don't fully realize it! Please totally forget about pills, they only help at the expense of other bad side effects(sex loss,appetite gain,cold and hot flashes, foggy thinking, emotional distress and other bad things that I can't fully explain)also when you stop the meds there is a "rebound" effect where you return to the old "crappy" feeling but even worse! You are using a therapy that will gradually return you to being as normal as possible and there will always be spikes in our anxiety because of bad things(deaths,job loss, money problems). Like AZ I also did the same thing you are now doing, and finally after coming to this site I got Mike's hypnotape program and it continued the previous therapy to completely stop the IBS/D and anxiety. You are headed in the right direction and it takes time to undo years of anxiety induced problems. Good luck, Norb


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## spider (Sep 26, 2001)

I hope no one is TOO dissappointed...but I folded, and started taking Remeron for my anxiety. I have heard that this anti-depressant is supposed to help with IBS/Anxiety/nausea without as many side effects as the SSRIs. I couldn't tolerate the SSRIs well, so my Doctor has been trying to get me on Remeron for a while now. So I decided, after some time of bad anxiety, to give it a whirl. I am sick of my emotions taking over me to the point where I don't want to do anything. It has been very taxing, I can't begin to explain. Also, I have had a big problem with weight loss/no appetite, and one of the side effects of Remeron is increased appetite (I can definatly use the lbs.) I am still doing the hypnotherapy. My hypnotherapy Doctor thinks it is reasonable that I try a med while I am doing hypnotherapy, because my anxiety levels are so high, it is hard for me to go deep into hypnosis. I feel like I have hit a brick wall, and I am still in a place where I can do something about it before it gets worse and search all avenues to health. For the last 6 months I have been fighting some instinct (& my Doctor)that has been telling me to at least give Remeron a try.Anyhow, I will let you know how it goes...So far I have tolerated it better than the SSRIs(except it makes you really tired the first week) but it has only been a few days.Keepin my fingers crossed!Spider


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## eric (Jul 8, 1999)

Hey, spider no worries, no one is disappointed. Let us know how your doing?


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## spider (Sep 26, 2001)

Hello,Things have been going cool for me so far on the meds. It has only been 7 days and I seem to be tolorating it okay. The only drag is that I am really tired, which is a common side effect during the first weeks. But I have been trying to excersise and get outside to stay awake. . My anxiety & nausea is still pretty bad, especially at work...but it has calmed down after the hectic holidays. I never can tell if I get anxious at work and then I have to run to the bathroom or I feel myself getting D, and THEN get axious and have to run to the bathroom. It just seems like I am always sick. I m so tempted to quit my job and move to the mountains, just to see if it would make me feel better.!!!I have been doing the hypno, but I haven't seen my doc in over three weeks, he was away for the holidays. The other day I had a REALLY good hypnosis session, where I felt as if I was floating..which is a sign of going really deep. I am seeing him again next week.For those of you in the San Francisco BAY area, My Hypno Doc is Dr. Wickram at Stanford University Hospital. I will let you know how things pan out. Spider


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## eric (Jul 8, 1999)

Gald things are going well spider keep us updated on how you progress. The side effects of the drug should ease for you if not go away.


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## norbert46 (Feb 20, 2001)

Spider, I was more concerned with you taking the benzo drugs not the antidepressants. I've tried them all and couldn't function on Remeron, the smallest amount of Remeron hit my histamine receptors hard enough to put me asleep for over 24hours straight. I took it for several doses and the MD said stop because I couldn't go to work and the work put the pressure on the MD to get me back on the job? I had a friend who was on it for depression and eventually he developed a "tingling" in his hands and arms so watch for "side effects". Sounds like you are doing good on the hypnosis, stay with Mike's tapes and all this should have a positive effect. I really believe that being able to get deeper hypnotized with the therapist will enable the tapes to work better on you, I had that same experience! Good luck, Norb


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## spider (Sep 26, 2001)

Thanks for getting back. I am still finding myself really tired on Remeron. It has been a little over a week. Um...yeah Im not anxious because I want to sleep all the time. I am going to see my doctor this week to let her know what is going on. Isn't there just some easy answer......???


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## eric (Jul 8, 1999)

Norb, he's not doing Mike's tapes but is seeing a HT specialist in person.Spider hang in there it could be a side effect of the med.Personally I would use the med short term to get everything under control and then look at beating IBS without drugs. It can be done but it takes a lot of work sometimes.keep us posted.


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## norbert46 (Feb 20, 2001)

Sorry Spider and Eric, I guess I didn't fully understand the circumstances. But I also did go to a very good Psychologist a few years back and I still have the Hypnosis tape we made during one of his sessions that I was given to take home for reinforcement. The HT worked great but was only aimed at anxiety and not gut specific for IBS. I can well imagine how good it would be to receive personal HT from Mike, those folks in the UK are lucky! Good luck, Spider


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## spider (Sep 26, 2001)

Hello., Just keeping you updated on what's goin on...Last night I went to the first Hypno session since I have been on the meds> MY anxiety levels were HALF of what they were at my last session. Usually I would go in there and my Anxiety levels would register at 90% as soon as I hooked on the machine. Yesterday it was at 60 when i walked in and we brought it down to 40 by breathing & biofeedback.







Thats all cool, but I am still experiencing severe drowsiness. BAD. My friend had to literally drag me out of bed this morning after 10 hours rest . I have also been REALLY irritable about work, in relationship, everything because I am so dang TIRED all the time. Sure I don't have anxiety anymore but I have exchanged it for sedation. I plan on discussing this with my doctor on friday.Oh yeah, by the way Im a "She" not a "He"...I'm just trying to sound tough with my name


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