Tag Archives: christian psychology

Counseling Adult Survivors of Child Sexual Abuse: Phase 2 mis-steps and correctives


Today Dr. Diane Langberg and I will be offering a 3 hour pre-conference CE training at AACC’s 2015 World Conference here in Nashville, TN. Our focus is on some of the common counselor mistakes made during the phase of processing the abuse history and all that happens as a person tries to see self and history through different eyes. We focus on the relational approach to repair the mistakes we make. I have a small bit on reframing resilience and posttraumatic growth. Our perceptions of recovery and where we (counselors and clients) should be headed sometimes need to be examined.

For those interested in seeing the slides from my portion of the talk, click: AACC WC Pre-conf 2015

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Making the Church a Safe Place for Victims of Trauma


This afternoon I will be speaking at Chelten Church on the topic of “Making the Church A Safe Place for Victims of Trauma.” This 3 hour continuing education seminar (co-sponsored by Biblical Seminary who provides the NBCC approved CEs) will focus primarily on trauma resulting from child sexual abuse. However, other forms of sexual violence and traumas (domestic violence, military trauma) will get a bit of attention as well. If you can’t make it or wish to see what I am talking about, you can download and see the slides: Making the Church A Safe Place For Victims.

Tomorrow, Mary DeMuth will speak on a topic similar to her book. Her talk is entitled, “Unmarked Marriage.”  I suspect the conference organizers will take walk-ins!

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Criticism of Biblical Counseling: Are Joyce’s Concerns Valid?


Katheryn Joyce has recently published a long post about the rise of Biblical counseling and the concerns some have about the movement [read it here].

Most people who have thoughts about counseling and Christianity tend to fall into one of to categories: Those who oppose biblical counseling as dangerous and those who oppose the various versions of Christian psychology as shallow and full of humanistic ideology. Very few people try to maintain identity in both worlds. If you have read my “about me” you will find I’m one of those who does accept the label of biblical counseling and Christian psychology (more on this below)

I encourage both proponents and opponents of Biblical Counseling to read her essay. Let me even take the liberty to suggest some starting questions to keep in mind as you read. While the essay may not answer the questions, having them in mind will keep you from solidifying stereotypes of either sides.§ If you are inclined to reject biblical counseling, consider these questions:

  1. Where might I find a more thorough history of biblical counseling and its various permutations?
  2. What main biblical counseling author voices are missing in this piece? [Note that the mentioned ACBC was, until recently, known as NANC (National Association of Nouthetic Counselors)]
  3. What failures in Christian psychology movement(s) led to the need for a biblical counseling movement?

If you are inclined to defend biblical counseling, consider these questions

  1. Even if some of the bad examples of biblical counseling do not represent you or the heart of the movement, what aspects of the movement may support or encourage some of these distortions?
  2. How might you better communicate “sufficiency of Scripture” to outsiders?
  3. Does biblical counseling seek to eliminate symptoms or improve spiritual responses to symptoms? How might it better acknowledge the body when talking about the causes of mental health problems?
  4. Where does fear of “integration” hinder the maturation of biblical counseling as a movement?

Indeed, these questions have already been asked and answers given in a variety of locations. Readers unfamiliar with biblical counseling should start with websites such as this one, CCEF, ACBC, BCC, and the Society of Christian Psychology to find further and deeper readings on related topics.

Where the Concerns are Valid

Not acknowledging benefits from psychological research. Joyce notes that a good biblical counseling session looks a lot like a good professional counseling session. Why? Well, it is obvious that change happens best in the context of kind, compassionate relationships. Why the similarity? While it is true that psychotherapists didn’t discover empathy, it is true that psychotherapy research has expanded our understanding of the best way to encourage trust relationships in therapy. In addition, some of the cognitive, affective, and dynamic interventions developed from these models are used within biblical counseling. I have absolutely no problem from biblical counseling deriving benefit from interventions developed in other models of therapy. I only desire biblical counselors or acknowledge that benefit. It is clear Jay Adams benefited from Mowrer (and said so to boot). We can do the same. We can admit that Marsha Linehan has revolutionized our understanding of how we work with people exhibiting symptoms of borderline personality disorder.

Emphasizing false dichotomies. Joyce quotes Heath Lambert in this piece (near the end),

“I’m concerned [that] if we say, ‘Oh my goodness, people with hard problems need physicians and need a drug,’ we’re going to lose much of what the Bible has to say about hard problems.”

The quote above is in the context of dealing with difficult or serious mental illness. He worries that if the church creates two categories of problems (normal and special), those with serious problems will no believe that the bible has things to say about those suffering with suicidal ideation or schizophrenia. It seems that some biblical counselors take a negative stance on psychiatry and medical intervention because they fear doing so will hinder the work of the Spirit through the bible. I would argue that this dichotomy does not need to exist. I agree that the bible speaks to everyone, whether they are having difficulty or easy problems. I don’t think that use of medications or medical practitioners has to hinder pastoral care. The message that others get when we suggest that medical intervention need to be avoided is that somehow it is less spiritual to seek a medical intervention. This is patently false. Now, not every medicine is worth taking. Some may create more problems then they solve. But that fact should not cause us to lump all professional/medical care into the same category.

Where the Concerns are Overplayed

Heath Lambert gets it right when he claims that all counseling models will fail, due primarily to the quality of the practitioner. Biblical Counselors do much work that is commendable and successful. Joyce’s piece may suggest that most biblical counselors are ineffective and incompetent. This is not true. Matthew Stanford suggest he has never seen a biblical counselor do well with difficult cases. That may be the experience of my friend, but I can attest to seeing biblical counselors working well with people with serious personality disorders, delusions and other difficult mental illnesses. Now, the truth is, these counselors have succeeded because they did not follow the stereotype and reject learning from professional psychology. Further, these same counselors did not take “sufficiency” to mean that they could only use the bible in considering how to respond to their clients.

Take a moment and read her piece. Review the questions above and keep an open mind to both sides of this story.

[§ I have written on the relationship between Christian psychology and biblical counseling in the Journal of Psychology and Theology, volume 25, 1997. You can buy that essay here.]

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GTRI 2014: Day 8 Kigali


July 8, 2014

Tuesday. Yesterday was a deep dive into Rwanda for GTRI students. They heard directly from Rwandan caregivers and spent time trying to weigh the genocide and its ongoing impact. Today we begin meeting and interacting with trauma healing and recovery caregivers in a conference setting. At a local hotel about 100 Rwandans gathered to kick off the Bible Society’s trauma healing community of practice and the inauguration of the Rwandan Association of Christian Counselors. The purpose of this meeting was to introduce both projects to the public and to invite the media and dignitaries to be present. The Rev. Emmanuel Kayijuka game some opening remarks and an Anglican Bishop offered a brief bible study of John 4:1-3, the woman at the well. He pointed out that she was likely a prostitute and an DSC_0233abused woman, abused by men, by society and desperate. Why else gather water at noon. He also pointed out that after her healing, she became a woman on a mission of healing, seeking social contact for the purpose of evangelism. After these reflections, Dr. Jean Mutabaruka presented a paper looking at the relationship between trauma, PTSD, and complicated grief. He pointed to 12 types of trauma in Rwanda, including sexual/physical/emotional abuse, witnessing violence, discrimination, poverty, etc. At the end, he raised a few general questions regarding the management of the mourning period/process each year.

After the professor finished, both Diane Langberg and I made a few brief remarks in response. Dr. Harriet Hill presented an overview of trauma healing project, in Rwanda and around the world. She showed the latest trailer of a documentary (much about the Congo project) about bible based trauma healing slated to be aired on ABC network this fall. Fun to see people I know in this trailer. David from the Rwandan Bible Society reviewed the progress to date: 2,918 trained people using Healing Wounds of Trauma material. Many of these are able to train others while the rest are better able to care for themselves.

New President: Baraka Credit: Heather Evans

The second half of the day included a presentation by Baraka Paulette Unwingeneye about the efforts thus far to form the Rwandan Association of Christian Counselors. This group of counselors and caregivers have been meeting with us since 2011 and are ready to be birthed. As Baraka said it, it may be like an elephant’s gestation, but now we are near the final month. We had presentations from Narcisse about the needed documents to be filed to make the association official, myself about the benefits and processes to form an associations. Then, those in attendance voted in a president, vice-president, secretary, treasurer, advisors, and conflict managers. This may not sound very moving, but I assure it was!

Fun too

While we come to Rwanda for serious matters, not everything has to be intense. As our day was ending, we quickly changed from our conference clothes to go out for a bit of shopping: the Simba market for coffee and tea, and another market selling typical Rwandan traditional items (clothes, woven bowls, banana leaf art. I looked and looked for a blue African traditional shirt but came up empty.

This marks our last night at Solace. Tomorrow we move on to the conference proper about 50 minutes or so south in Muhanga (Southern Province). Though we are about to begin the training in earnest, I think I am beginning to relax. A year’s worth of planning is now well under way. Despite a few surprises and schedule changes, most everything is working as planned. No problems with transportation, food, water, housing. Meetings planned have more or less happened.

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Some thoughts on international trauma training


In just a few days I will be off to Uganda and then on to Rwanda to do some training with trauma healing workers in both country’s bible societies. In addition, a group of students from our Global Trauma Recovery Institute will join me in Rwanda to learn more about how to help without hurting. In light of this trip, I penned a few thoughts for those who have a heart to do something about the massive trauma needs around the world. Here’s a preview:

Trauma is a hot topic these days. We live in a world where we are aware of terrible traumas happening around the globe in real time. We hear and see tsunamis unfolding, towns being flooded when dikes are breached, mass shootings, bodies strewn about due to ethnic conflict, houses destroyed by errant bombs, and gender violence in almost every corner of the world. While humanitarian efforts to respond to the physical needs of those in trouble are not new, there is a recent push to have charity workers become “trauma informed” so they can also address spiritual and psychological distress.

Trauma is a hot topic not just because we have more evidence of it happening in real time. It is hot because we have better information about the impact of violence and abuse on the human brain, on human interactions, and on the fabric of a society (Mollica, 2006).

Christian counselors, many of whom want to provide cups of cold water to the hurting masses, undoubtedly wish to use their skills to bring hope, healing and recovery to traumatized peoples around the world. But just where should they start?

You can read the rest of my thoughts over at our faculty blog site.

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Counselors talking about themselves? Additional thoughts


 

Last week I described some research supporting counselor self-disclosures, research that suggests clients appreciate disclosures revealing (a) similarities between counselor and client, and (b) vulnerabilities or personal emotions. While this research flies in the face of conventional wisdom in most counselor training programs, I cautioned counselors to ask some questions first before talking too much about self. With this post, I would like to press the caution just a bit more.

Why do counselors talk about themselves?

Why do counselors talk about their personal life with clients? Read the following numbered list to see some of the main reasons (and the sub-points in italics as illustrations of that reason). Then, consider the bracketed sub point as an alternative to self-disclosure.

  1. We want to put clients at ease and we think knowing something about ourselves might help
    • I can see you are anxious about whether taking antidepressants is appropriate for faithful Christians. I take them and it has only helped my faith.
      • [You’re not alone with that question so let’s explore the pros and cons to taking an antidepressant. Why don’t you start by telling me the reasons you’ve heard or thought about for not taking Prozac?]
  2. We believe our personal history will help a client understand, accept, or challenge something about their struggle
    • I know this treatment for panic disorder is difficult for you but I can tell you it works. It worked for me.
      •  
  3. We want to please an inquiring client
    • Yes, I am married and I have 2 children.
      • [Sure, I don’t mind telling you who is in my family, but could you first tell me why that is an important question for you?]
  4. We want to earn their respect and believe that our history will help
    • Well, for starters, I want you to read my book. It is now in its second edition and has been translated into 4 languages. I think you will find it very helpful for your problem.
      • [I’d like for you to start reading about your problem. There are a couple of books out there that I think you might find helpful, including one I wrote. But, feel free to look these over on Amazon and choose the one that seems right for you.]
  5. We like talking about ourselves; our personal stories seem difficult to avoid
    • You and I have a lot in common. My wife has the same problems as your husband. So, I know how lonely you must feel. We’ve tried…
      • [Though you are not saying so, I wonder if you feel lonely in your marriage.]
  6. We see the relationship more like a friendship with mutual sharing
    • I’m so glad to see you today. You are a bright light in a dull day. I look forward to our stimulating conversations. Just yesterday I was thinking about you and wishing to have coffee with you to discuss your career future.
      •  
  7. We want to be seen as human rather than just professional
    • Yes, it has been a stressful day. I could use a back rub after all these sessions today.
      • [You know, some days are harder than others, but I’m curious why you asked this today?]
  8. We want the client to help us in some way
    • I was thinking about your need to work and my need to have someone edit my website. Or, I’m headed out on a mission trip next month. Well, I am if I can get enough donations. I’m about $1000 short thus far but I know God will come through.
      • [neither of these need to be said!]

Is it necessary? Is it helpful?

While self-disclosures may improve client perceptions of counselors, I suspect that empathic, client-centered therapists evoke these same feelings by asking good questions making observant reflections yet still minimizing disclosures, especially those where we initiate them and those that force the conversation to our personal history. There are some disclosures that are in response to client questions (e.g., have you ever struggled with addictions? Are you married? Do you believe in medications? Are you angry with me?) that warrant an answer. When giving this answer, work hard at keeping it brief and returning to the client’s story.

Don’t forget about social media self-disclosures

Clients sometimes “hear” our disclosures through social media. Imagine a client reading, “Well, that was a difficult session, glad I’m done for the day” having been that counselor’s last appointment! Blogs (like this!), Twitter, Facebook, and Instagram can be forms of self-disclosure. Be wary of these. Conventional wisdom says to avoid social media contacts with most clients so as to avoid harm to the counseling relationship. While we need not require an outright ban of these connections, a thoughtful counselor will review connections via social media for potential harm.

Be human

Despite these efforts to avoid letting our selves intrude too far into the session, sometimes life gets in the way. A counselor has a health or a family crisis. Clients have ways of finding this out and often want to ask how things are going. Here it is appropriate to say something brief, thank them for their concern and then start the session. In other situations a client discovers a shared passion for food, a sporting team, a connection through mutual friends. Enjoy these connections, acknowledge them, but be sure not to linger there during the session proper. We are, after all human. Don’t be surprised when counselor and client humanness come into contact.

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Comparing ACA and AACC ethics codes: Multiple Relationships


Continuing our review of the ACA and the AACC codes for counselors, let’s take a look at how both codes address the matter of multiple or dual relationships. (See first and second posts about comparing the ACA and AACC code of ethics for counselors and mental health professionals.)

Multiple or dual relationships between counselor and client (or client’s family) are those that combine the professional relationship with one of another sort. If a counselor of a client is also that client’s pastor, that would be a multiple relationship. Other types could combine counselor and friend, counselor and business partner, counselor and employer, and increasingly possible, counselor and social media “friend.” Both codes are concerned about the formation of dual relationships because they become fertile ground for counselor judgment bias and harm to the client. Both see that once a counseling relationship has been formed, that relationship ought to be clear take priority over all others.

The ACA code of ethics prohibits outright the following dual relationships:

  1. Counselor and sexual partner: Counselors may not have sex with clients or their family members
  2. Counselors may not start counseling work with former sexual partners
  3. Counselors must wait at least 5 years before engaging in sexual activity with former clients (and even then may be prohibited)
  4. Counselors may not provide services to friends and family
  5. Counselors are prohibited from engaging in personal virtual relationships (social media) with current clients

Beyond the sexual arena, the ACA code warns counselors to avoid dual relationships or “extending the boundary” of the counselor or supervisor relationship

Counselors avoid entering into nonprofessional relationships with former clients, their romantic partners, or their family members when the interaction is potentially harmful to the client. This applies to both in-person and electronic interactions or relationships. (A.6.e)

When a counselor agrees to provide counseling services to two or more persons who have a relationship, the counselor clarifies at the outset which person or persons are clients and the nature of the relationships the counselor will have with each involved person. If it becomes apparent that the counselor may be called upon to perform potentially conflicting roles, the counselor will clarify, adjust, or withdraw from roles appropriately. (A.8)

So, notice the focus: avoid “extending the boundary” or what we used to call forming multiple relationships with current or former counselees or their family members. Document when you do so to illustrate informed consent, limiting of potential harm, and efforts made to rectify harm when it unintentionally happens

What about the AACC code?  It begins (ES1-140) with these paragraphs,

Dual relationships involve the breakdown of proper professional or ministerial boundaries. A dual relationship exists when two or more roles are mixed in a manner that can harm the counseling relationship and/or the therapeutic process. This includes counseling, as well as personal, fraternal, business, financial, or sexual and romantic relationships. Not all dual relationships are necessarily unethical—it is client exploitation that is wrong, not the dual relationship in and of itself. However, it remains the responsibility of the counselor to monitor and evaluate any potential harm to clients. (emphasis mine)

While in a counseling relationship, or when counseling relationships become imminent, or for an appropriate time after the termination of counseling, Christian counselors do not engage in dual relationships with clients. Some dual relationships are always avoided—sexual or romantic relations, and counseling close friends, family members, employees, business partners/associates or supervisees. Other dual relationships should be presumed as potentially troublesome and avoided wherever possible. (emphasis mine)

The AACC code then prohibits counseling relationships with family and close friends and warns against those “best avoided” (e.g., business associates, club members, etc.). Finally the code addresses counseling relationships within the church,

Christian counselors do not provide counseling to fellow church members with whom they have close personal, business, or shared ministry relations. Dual relationships with any other church members who are clients are potentially troublesome and best avoided, otherwise requiring justification. Pastors and church staff helpers should take all reasonable precautions to limit the adverse impact of any dual relationships. (ES-140-f)

This wording marks a change from the previous AACC code where dual relationships were more positively addressed. The old rule stated this, “Based on an absolute application that harms membership bonds in the Body of Christ, we oppose the ethical-legal view that all dual relationships are per se harmful and therefore invalid on their face.  Many dual relations are wrong and indefensible, but some dual relationships are worthwhile and defensible.”

Agreements? Disagreements? Both codes ban the ending of counseling relationships for the purpose of changing the professional relationship to different relationship, or to engage in sexual activity with a client or a member of the client’s family. The AACC codes requires 3 years before marrying a former client (assuming all other concerns raised are not an issue) whereas the ACA code requires 5 years before engaging in an intimate relationship. The ACA code as extensive concerns about the teacher/student relationship as well as the supervisor/supervisee relationship. The AACC code says little about these (though some can be inferred). The biggest difference, however, is found in the stronger language banning dual relationships in the ACA code where the AACC code warns against possible harm but leaves the door open as long as the counselor knows they have to prove no harm happened and informed consent.

 

 

 

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GTRI featured in an online, free journal


Our Global Trauma Recovery Institute is featured in the most recent issue of the EMCAPP Journal for Christian Psychology Around the World. Pages 172-211 include an overview of GTRI, two essays by Diane Langberg (The Role of Christ in Psychology; Living to Trauma Memories) and one by me (Telling Trauma Stories: What Helps, What Hurts).

The journal also contains an essay by Edward Welch (www.ccef.org) where he muses his development as a biblical counselor, explores the matter of emotions and some of the stereotypes of biblical counseling. The journal also includes a large number of essays about Paul Vitz as well as a number about the Society of christian Psychology.

Take a look!

 

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Filed under "phil monroe", biblical counseling, Biblical Seminary, christian counseling, christian psychology, counseling, counseling skills, Diane Langberg, Ed Welch, Post-Traumatic Stress Disorder, trauma

What is Global Trauma Recovery Institute all about? Check out this video


At the beginning of 2013, Biblical Seminary launched Global Trauma Recovery Institute to train recovery specialists here and around the world. We’re small but thus far we have taken 20 students through 120 hours of continuing education, another 15 have just begun, and we are now preparing some of those first students to travel to Rwanda to observe and participate in trauma recovery training with local caregivers. Those students we serve are from or located in three continents plus the United States. In addition, we have represented GTRI in trainings in South Africa and Rwanda this year as well as engaged Christian counselors in Romania during one of their trainings. Our hope for 2014 includes more of this kind of training as well as our first immersion trip with students. Think we are just focused on the international scene? No! The “abuse in the church” video on the right hand bar of this site was sponsored by GTRI as well.

Maybe you wonder what we do and how we handle cross cultural challenges. Check out this short 3 minute video below to see our (myself and Diane Langberg) heart for raising up capable recovery specialists here and around the world as they follow Jesus into the world.

Want to support? After viewing the video, please consider supporting us with prayer and even tax-deductible donations. If you do choose to donate, this link will bring you to a donation page. You can give to the seminary’s general fund (without their support, GTRI would NOT exist!) or you can give a specific gift to GTRI. Just note that in the comments section. Your gifts will enable us to serve more international students and to begin the formation of learning cohorts on other continents!

[Note: Link on image is broken, click here to see the video]

GTRI Video Image1

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The power and perversity of labels


English: Photo of Paulo Freire

[Previous version published  in 2006]

That was great!

You are a liar!

We humans have powerful tendencies to label and categorize. It may be something that Adam passed on to us. Notice that Adam got to name the animals as he saw fit. I suspect that being made in the image of God provides us an innate drive to name things as they are?

But what happens when things don’t fit our categories? We either have to expand our definitions or shove square pegs into round holes.

  • The color line comes to mind. Those who are biracial face the repeated question, “What are you?” And the “one drop” rule still is holds power: one drop of African heritage blood in your recent ancestry makes you “Black” in this country.
  • How about those who don’t fit gender stereotypes. I’ve heard the pain of many who were accused of being gay because they didn’t fit someone’s image of a man or a woman. These labels were so powerful that they caused confusion. “If being a man means…(fill in the blank), then I must not be one. Maybe I’m gay.”

The Counselor’s Power to Label

Counselors hold tremendous power when as they label, especially those who represent both the counseling and the Christian worlds. We label right and wrong, righteous and unrighteous. We label idols of the heart. We want our counselees to see themselves and God in proper form. We see how distortions in labels (e.g., God doesn’t love me; I’m incapable of changing) harm and we want to provide healthier labels.

But, HOW and WHEN we label may be more important than whether our labels are actually correct. The temptation for counselors is to label too quickly, before the counselee is ready. If that happens, the counselee is passive and the counselor’s label is just one more among a chorus of opinionated acquaintances.  

Take a look at how Jesus interacts with sinners and self-proclaimed holy men. Who is he more likely to label? Who does he engage with deep questions? What are his means for helping others see themselves? Notice how the Pharisees were quick to label what was authentically Jewish and what was not. Notice that the Lord seems less interested in that and more interested connecting to others. He was not neutral about sin. However, he engages others in novel ways to show them the righteous path and their need for a savior.

Who Does the Labeling Matters

I’ve been enamored with the late Paulo Freire, a liberation theologian from Brazil. He describes how unthinking, impoverished, people become empowered when they are given the power to name things (problems, solutions). They do not, he says (in Cultural Action for Freedom), learn by being filled up with words and labels by dominant culture individuals. If this were the case, then counseling would only be a matter of memorizing the right words and phrases. No, counseling is a dialogue where the counselee is an active, creative subject in the process of change. In Learning to Question: A Pedagogy of Liberation, (by Freire and Faundez), they say,

I have the impression…that today teaching, knowledge, consists in giving answers and not asking questions.

The same could be said about counseling. It is the asking of questions that encourages us to search for answers. Without questions, we may never redefine the problem. When we counselors label (whether we are talking about DSM labels or right/wrong labels) without engaging  the client in the process, we rob them of their words.

What Can We Do?

Freire suggests a three-step dialogical model that may work also in building an effective counseling relationship: Investigate (ask exploratory questions, examine beliefs, myths, etc.), Name (code and decode, a process of un-naming and naming what is going on), and Problematize (identify problem and solutions).

Avoid the Temptation to Give the Gift of Your Knowledge

Freire says that gifts given by oppressors only perpetuate injustice. If the “gift” of your knowledge perpetuates the divide between the counselor (the healthy/wise one) and the counselee (the sick/naive one), then your gift may only serve to perpetuate their illness. This does not mean you should never speak or offer advice. But ask yourself, “does the way I speak to clients encourage and energize (all the better if in the form of a pushback) or cause passivity?

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