Wednesday, March 15, 2017

#Trauma -'She's alive!' By Dr. Pradnya Ajinkya

1] It is three years since my husband and three children went missing and it has not been easy.  I find myself frequently at the hospital emergency. The hospital worsens my situation. The doctors tell me to get over it and that is just what I can't do, Ma'am.

2] I heard a huge sound like the sky crashing into the earth. I could not believe my eyes, as I saw something like a huge fireball rolling down the mountain.

3] When the disaster happened, people scrambled to save their lives.

4] I saw my husband and son rushing home on the bike, but the area was covered with thick, heavy mud. That was the last time I saw them. I was screaming and screaming and screaming for help.

5] A few neighbours along with me were forcefully shifted out to a temporary camp.                  

6] My daughter Ma'am, was left behind. There are no claims that she was killed in the incident. I've been praying daily for some clue to what happened to my ten-year-old daughter who was out playing with her friends. 

7] I want to see her Ma'am. Please let me go and find out where she is. I cannot express the panic that is in my heart. I feel heartfelt sorrow. I am sure she would be found. I can't stop my tears from falling.

8] My family is expecting me to get on with my life since they have made good effort to find out about Monika. They feel it has been three years after returning home. 

9] It is getting a bit uncomfortable living with them. They do not give me my private space to think about my child's fate. 

10] I have been receiving counselling from officers of the Welfare Department to cope with the trauma following the incident. Please listen to me, Ma'am. I harbour hope. I am sure, I am traumatized by the tragedy and need psychological care. Please help me ....... please ....... to solve this mystery .......

Th: I am listening and please be reassured that your problems and fears are being heard. 

C: Thank you Ma'am.
Th: You remember where you were during the critical incident.

C: Yes. I was at home. When I opened the door, on hearing a huge sound, I was shocked to see a huge ball of fire falling down ......
Th: What did you think at that moment?

C: I could see my husband and son being washed away. I was totally numbed. I was screaming for help. I was calling out to Monika. I felt Monika and I would be all alone.
Th: What could be worse than this?

C: I was forced to leave the place before I found my daughter.
Th: What happened to the children who were playing with Monika?

C: Rashi and Jalpa are both dead. But there is no claim about Monika.
Th: There could be a couple of people who went missing?

C: Yes. Quite some numbers. More than 500 people. Monika may be one among them. Yet, I can't forget her Ma'am. I suffer flashbacks and delusions.
Th: Take some additional help to understand  how to deal with the flashbacks and delusions. The initial counselling interventions helped you not to rebound. However, with required extended psychological care you will surely feel better and this may even alter this consistent dynamic. The mind should be given sufficient time to heal itself.

C: Yes.
Th: Taking into consideration the intensity and duration of the trauma, why don't we have a doctor come and check your stress levels regularly? They will screen you for your psychological health and train you for high-stress combat. This can avoid the panic and regular emergency landing in hospitals.

C: Yes.
Th: We will meet often at short intervals and restructure reactions to the memories of the trauma.

C: Yes.
Th: On a 0 to 10 scale how do you feel now?

C: 4. Restructuring the memories can improve the scaling?
Th: Yes. My dear Elizabeth!

Sunday, February 12, 2017

#RELATIONSHIP MINDSETS Trying to talk himself out of trouble By Dr. Pradnya Ajinkya

1] She can trigger me. I am so scared. I never want to be so weak. 

2] I lost it Ma'am. I was already walking the edge. 

3] I know implicitly that she doesn't consider me. It demeans me. See where it has led me. 

4] She believes that she is the epitome of a perfect celebrity who can really never make any mistakes and says and does the right things. 

5] She loads wholly on me. Where do I go? 

6] Fifteen years back, I would have said, 'it can't happen to me.'  

7] Though I recognize her core, I can't deal with this. She makes me helpless. 

8] She breathes in the same statements. I am not in any mental situation to answer her queries. 

9] I was appauled beyond measure on Saturday. She attacked me verbally. She went into a rant, rant and rant. It went on for 6 hours.

10] Her words are really bad and cruel. Dear Ma'am she represents what my demon is.

11] She leads me to believe that I can never change. She cannot find "variability" in my behavior.

12] Then she withdraws and after a while interacts with me and again threatens to leave me. And I see myself in the same mess each time. Ma'am, please help me to find myself.

13] She doesn't care about what I am going through. She doesn't care about what makes me accept her. I don't know her limit of satisfaction.

14] I need an anchor. I can't anchor myself. I am one person. I want to get into a situation where no one can ever break me. Now I have decided to live in my own cylinder.  

15] Her curing is a different matter. I doubt if she is a candidate for counselling? She can't take feedbacks. 

16] I am here with you Ma'am because I don't want to get exploited and don't want to exploit. 

17] She counters that I am a frightened mouse and that I am throwing the blame on her because I am not man enough to take the heat. 

18] She monitors my every move. We separated from each other +yesterday.

19] Let me ask you, 'what might lead her to withdraw and then interact?'


1] They have talked marriage, but are not engaged yet and have no plans to be. 

2] Cycling in an on-again-off-again relationship, their relationship is fraught with distress.

3] Relationship cycling can ruin the health of the members in the relationship.

4] It is believed that the vicious verbal attack happened on  Saturday. The man is helpless and cannot stop the domineering episode. 

5] This leads to two very important questions  : 

a] Does a man ever have the right to tell a woman to not push words on him and expect her to respect that? 

b] To stop inflicting further harm by inducing shame through blame. 

6] This can help victims achieve justice and will hopefully instigate cultural change around this lesser-known side of domestic abuse.

7] In a healthy relationship equality is present and they accept that their partner will also have their own needs. 

8] If you are frightened and worried because you are controlled and you have to give up on the things that are important to you and there is no consideration that you are upset, that's where the line is. 

9] It took a long time for Raghav to recognise that the nice behaviour and abusive behaviour are both a conscious decision.

10] The couple fell in love and it was very romantic to begin with or at least it seemed that way. She slowly began monitoring his every move. As time went on things continued to get worse and unpredictable and they separated from each other. 

11] Some relationships might persist being low in quality. Others might end. 

12] Just telling a man/woman that they are monitered can hurt their psychological performance.

13] It is important to step away from the major overhauls, pick yourself up and instead celebrate smaller wins toward small goals. 

14] Breaking free from an unhappy relationship is no easy task. It is certainly a set back. Professional counsellors also advise to stop and think and then allow yourself to really focus on what you want to accomplish the most and slowly you can always add more.

Thursday, January 12, 2017

Spouse challenge: Whose life is harder? By Dr Pradnya Ajinkya

1] I wish my husband was dead. I know it is an awful thing to say, and if it really happened I know I would feel differently, but wonder if I would really miss him because I really am at the end of my tether. 

2] I was brought up by my family to think that when two people decide to marry, each makes a pledge that the other will be the most important person in their life. Couples may fight between themselves, over big things and small, but partners must learn to stick up and last. It takes a lot of shocks, revelations, compromises, and loads of friction to finally find a win-win, workable marriage. That's just how it is. 

3] My husband is involved in a family business with his father. In laws are kind, considerate, loving and very good souls. 

4] The Eighteen years it took to reach the point where I am today really bothers me. I wish I had been more vocal about the interpretation of my marriage. 

5] I was overwhelmed when my husband told me before marriage that, I am modern and hip in my thinking. You can wear whatever you please after marriage. There will be no restrictions. I am very liberal.  I know all this may sound a little bit harsh, especially given how society has conditioned us. But I want to say all this before we get into the legalities of this beautiful relationship. 

6] I was married to Sanjeev when I was 21 years old. In the sixth month after our marriage, Sanjeev told me that he wanted to do things with other girls and this was his way of buying sexual freedom. 

7] By the time the secret came out, I was emotionally involved with Sanjeev. We stayed married, but he continued to swing regularly. It began to ruin our lives. It was all too consuming. He would be holed up in resort rooms every week end with mixed and matched couples. 

8] It didn't seem normal to me.  He promised to set rules, but fun got in the way. There was one time, when Sanjeev came over with a sexy couple and he was talking to me about signing an agreement for sexual exploration with the couple. He said it would fetch me huge money. 

9] At this point, I decided that even if I loved my husband, I am not willing to give to what my husband was demanding. I made it very clear that I was not comfortable and unwilling. I decided to leave with my 15 year old daughter and 11 year old son. 

10] I am wondering how I will convince my parents and kids that Sanjeev will not be living with us anymore? I am sure they will not  fault me. 

11] I have been trolling around for a good counsellor. Your insights and suggestions would be most helpful.

Therapist: This is your relationship with your husband?

Meeta: No. He is the person I wanted to grow old with, and I love him deeply. We have been together for over a decade and we have been together through my parents with health issues, children, purchasing a home, buying cars and silly everyday things. Even in a dream and thinking of love and family, it's only him. He has this chronic sexual disorder. It is something that he needs and he is happy with. Is it only addiction Ma'am? Why am I not enough?  I am concerned about my emotional and financial survival too. I have lost many important years of career growth, making it difficult for me to get back on my feet. I really don't know if I am contemplating divorce? It's no picnic living without him. He is willing to come to counselling.


1] Any marriage in which the couple involved have different goals and expectations will not be an easy relationship. The temptation to get things easier over time by creating rules and setting boundaries that will protect the existing relationship is not working. It may also mean that your husband should give up relationships that his partner finds threatening. Since it failed, your relationship did not build a foundation that can make both of you happy. Otherwise, both may have tried everything in power to help the partners feel safe and secure. This may mean that security is learned. 

2] The ability to compromise, and to negotiate a set of agreements that both people can function in, is absolutely critical if you are to make this work. Equally critical is a commitment to follow through on the things you say that you will do, and abide by the negotiated agreements in your relationship completely and without fail. 

3] The place where it gets trickier, though, is your husband asking you to become a swinger for fun and a prostitute for money. 

4] The conflicts experienced in which you were not aware initially and the determination to not internalize any acceptance of this alternative lifestyle on an emotional, intellectual, social and financial level will help us to explore your own value systems and the impact on your feelings. 

5] You may have the fear of losing your lover or spouse, yet it is important to gain awareness and acceptance of your own psychological reality and personal limits. 

6] The memory of sitting down to tell your parents and children explaining to them why Sanjeev, how Sanjeev and when Sanjeev  can shudder the family with fear and shame. 

7] To be honest, your husband doesn't think this is a big deal. Couples who openly swap partners with strangers, are becoming a growing trend in a sort of new sexual relationship revolution.

8] It is unclear though when the ritualised custom of selling a wife by public auction first began, but it seems likely to have been some time towards the end of the 17th century. It has also got a legal perspective.

9] Wonder to what extent your husband will introduce his alternative lifestyle to children. This can be too upsetting for the children.  There may not be any evidence of child abuse or neglect and the children may be well adjusted so far, but it is necessary to remove the children from immoral environments. 

10] Making the decision to not move forward in the above sexual exploration, we may consider to focus on what is best for your husband from his perspective without negatively judging his alternative lifestyle. 

11] You'll need to get past some mental roadblocks in thinking your husband's alternative lifestyle has something to do with you or you are not enough. He is probably not wired for monogamy. 

12] It is important to note that many swinger relationships may end up in prostitution and child abuse! 

13] Sanjeev is welcome to my practice. It may mean that we negotiate boundaries that are narrower than what you might otherwise want. Actions can be regulated, but feelings and emotions are a bit trickier, and care should be taken to control and dictate such feelings to be naturally inclined, whether by learning or by hard wiring, to need only one person in his life.  

Monday, January 9, 2017

Case of Ram : Cravings and withdrawals By Dr. Pradnya Ajinkya

Key symptoms : 19 year old male suffering from chronic fatigue, lethargy on not being able to wake up in the morning without close member help. 

Ram: "It started out as having trouble waking up in the morning and feeling tired and sick on waking up for a couple of minutes. I am still feeling sick in the morning on waking up. The tired feeling progressing to extreme fatigue for over an hour on waking up.  I have been a very happy and well looked after child. My mother would wake me up as early as six in the morning for as many as 13 years. All this helped me in the past. However, back in a hostel, I have trouble waking up. It feels like a switch has been turned off and my brain forgot how to wake up early without help. I've always been a heavy sleeper. I would sleep 8 hours at night and could take 3 hours nap. I am concerned that it has been over 2 years and I don't want to cause any damage to my brain, body and future. How can I truly believe that my brain is resistant to waking up without help. Once I am awake I don't yawn or sleep during the day. After an hour on waking, head is not heavy and I do not feel drowsy at any point of time, no chest compression, dry mouth, heart racing. I am not looking for a trial prescription. I want to improve and sincerely hope this doesn't continue. I want to jump out of the bed on my own and want to see this blown out feeling mitigated. But needless to say, I'm very nervous as you know my feelings about the craving for sleep. Otherwise I do not have any kind of stress in my life and I am studying and living in a peaceful area. I eat well, exercise, swim and have a wonderful relationship with my family and friends which I am grateful for."

Primary symptoms:

Lack of confidence

Fear of accomplishment

Fear of goal setting

Mood declined into anxious feelings over excess sleeping

Sinking feeling in the brain on waking up

Therapeutic assessment

1] The average week sleep in hours

2] Figure dropped per week

3] Work for an average of how many sleep hours per week

4] Case: Ram spends half his free time sleeping like:

1] The average time Ram spends in sleeping is how many hours?

2] In a 19 years life span Ram spent how many hours in sleep ?

3] The excess sleep time was enough time to obtain how many achievements by Ram?

4] Ram spend how much time sleeping than spending time with friends, watching television or playing games or reading? 

5] Excess sleeping is more likely to leave Ram passive, tense, and unable to concenterate?

6] Explain craving for sleep can leave Ram in a worse mood.

7] Explain creative thinking, socializing, and individual or group reflection have been replaced by sleep craving. 

8] Explain sleep craving can have a hypnotic and possible addictive effect on the brain.

9] Explain excessive cravings do not necessarily involve physical substances only. 

10] Explain the criteria of sleep dependence.

11] Explain giving up important social, family, or occupational activities for sleep; and reporting withdrawal symptoms when one stops getting it.

12] Explain effects of compulsive sleeping  can be devastating to home life, social relations, and even day-to-day work. 

13] Case study : One 32-year-old IT professional  has a wife, two children, and parents. He rarely goes out any more. He sleeps, sleeps and sleeps.... 

a]  Observations of uncontrolled sleep.

b]  Unsatisfying thirst for more stimulation of sleep.

c] Culture created by sleep provides a fantasy world that makes ordinary life boring. 

d] Relaxation ends when sleep is turned off.

e]  Relaxation occurs as soon as sleep is turned on.

f] Brain changes reinforce this association. 

g] Stress and lowered mood state occur once the sleep is broken, reinforcing the urge to go back to sleep. 

h]  Longer sleep hours, the less satisfaction derived from it.

i] The absence of excess sleep can cause depression, a sense of loss, anxiety, and cravings for more of sleep stimulating effects.

j] Effect of active and passive experience on the brain.

k] Type of learning that takes place while the brain is in a passive state? 

14] Explain many people think that once they are adults and their brains are fully developed their choices don’t affect brain health. 

15] Explain the brain can be shaped by experiences, just as particular muscles respond to particular exercises.

16] Explain it’s true that gross anatomy doesn’t change, but through everyday life, certain neuronal groups are selected to thrive while others die owing to lack of use. If a person is inactive mentally, that individual loses brain cells.

17] Explain sleep craving cannot compete with books, interaction, and real-life experience when it comes to learning. 

18]  Explain through excessive sleep, children may actually fail to develop needed circuitry to master critical-thinking skills.

Please post your comments...

Sunday, January 1, 2017

Out with the old, in with the new Happy New Year MANSI ! By Dr. Pradnya Ajinkya

In a group of 75 children, thirteen year old Mansi feels socially withdrawn and refrains from activities in the presence of peers. It did occur to her to tell her parents and teachers. The peers threatened to beat her for informing the teachers. Parents look up the tormentor's details and decide to speak to their parents. It worked. A few days later Mansi came home with a hand and leg injury. She explained that the children publicly teased her and pushed her and they said it was natural to tease and fight with one another. The parents listened to Mansi and her stories of getting insulted and roughed up in the classroom and pathways and they wondered if it was normal. Mansi can't  help but get negative and disturbed. Even if the children later downplayed, Mansi was not able to leave isolation. The isolation and degradation just followed her like a black hole. She feels that she does not fit in at some point.  Her friends who tormented her explained that Mansi should be taught life skills -- survive and succeed. 

Therapist : It is ugly when children are bullied, socially separated and isolated. With children, the need to be a part of their friends and groups is survival. In the above case the school also can't disclose how they deal with kids involved in bullying and make children feel unsafe. Sometimes Mansi seems to stick to these kids, waiting for acceptance. However, Mansi is uncomfortable in the victim role. The children around want to teach  her life skills by laughing and pointing fingers at her in a way to isolate and exclude her. From a social control perspective, Mansi having experienced the trauma, will never want to go through it again. Part of her is angry. Mansi can make the problem huge. It is important to bring it down to its right size immediately. 

Mansi : 1] Who can help me to change the levels of social behavior and correct the situation?

Therapist :  What do you think has to change in order for them to change?

Don't let it bother you, may not be a right answer. 

Also solitary-passive behaviors do not provide a means for coping with feelings of unease.

Mansi : 2] What is my role in this situation?

Therapist : Balance reassurance with coaching. Many children have gone through similar situations and doing good and okay. 

Mansi : I feel I don't fit into any situation. I feel like a loser.

Therapist : It is a powerful thing to help yourself identify and solve your problems. You will get a tool to aid you the rest of your life. 

Mansi : Shall I ignore these feelings?

Therapist : It is important to feel and do something positive about them.

Mansi : I feel I have a huge problem?

Therapist : Bring it down and cut it to it's right size immediately.

Mansi : How?

Therapist :  By setting limits.......

Mansi : I feel powerless when I am picked on?

Therapist : Set the limit without losing the objectivity.

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Wednesday, November 23, 2016

#psychosocial - Life struggle with the truth By Dr. Pradnya Ajinkya

This is a case of a teacher who stood in front of her 6th grade and told the children that she loved them all the same. That was impossible, because in the first row, was a little girl named Bren. Bren was her daughter. In the school where the teacher taught, she was required to review each child's performance. The teacher wrote that each time I reviewed my daughter's report, I was surprised, "Bren is an excellent student, well liked by her classmates, but is troubled because her mother is her teacher and she must perform well." Bren is second in the birth order. Her elder sister also studies in the same school. Both the children are very close to their father. However, Bren always felt that her father was missing a male child. When she remembered this she cried and cried and cried. Both parents paid particular attention to both the children. The more they encouraged them, the faster they responded. By the end of her education, Bren had become one of the smartest in the group. She was her father's pet child. She graduated from college with the highest of honors. She found a job directly from the campus. A few months later, her mother found a note in her dressing table, from Bren, telling her that she was grateful to her mother and that she was the best teacher she had ever known. The story doesn't end there.  Bren is married to a young and handsome boy. She hugged her papa, and she wisphered in his ears, "Thank you, dear papa, for believing in me. Thank you so much for making me feel important."  Her papa whispered back, "You have it all wrong. You were the one who taught me to be a father and it made a difference. I didn't know how to parent until I met my children.  Treasure every moment that you have. Time is a coin you can spend only once. Use it, invest it, make it count, and treasure it because you will share it with someone special. Wish you a happy married life..." The story doesn't end there. Bren is very anxious at workplace. She decides to quit her job. Her family decides that she meet a counsellor and discuss her hidden issues if any.

Counselling session 

a] This is a picture of me as a child.

b] This is a picture of me and my sister reading.

c] This is a picture of my papa and me.

d] See how my mother's doing such a good job. I am proud of her.

e] This is my husband. He loves me and he can understand me.

f] Yet I feel cold and clammy, my heart is pacing and I have tight pain. I often feel like this under stress and they happen out of the blue. These are constant symptoms at workplace -- tightness across my face.  I obviously feel that I am not good at my job. Situations like this happen day in and day out. So I have decided to have a look at what I would really like to do, apart from the fact that I can't afford to leave my job. My boss tells me that I am the best candidate. Then I almost feel like every one is writing my script for me. 

Therapist : What is the benefit of leaving your job? Do you want to think and write out the benefits? Let's think about what you are going to say before you start writing.

Bren : It is exciting to watch a child begin to write and it is easy for the teacher to provide positive encouragement for the efforts of the child. So what is the level of exictement of the teacher when a child cannot write?

Therapist :  The teacher and the child will have an effective vehicle to accomplish the goal of learning involvement. The teacher will continue to provide positive encouragement for the better efforts of the child.

Bren : Some of these children are fearful before or in the classroom?

Therapist : 1] Some of these children can feel fearful.... Encourage exploration and experimentation with words and language and thoughts and at the same time facilitate communication. 2] For the benefit of all, teachers and children increase familiarity with the other teachers and children. This will free the children of fear at the beginning and they continue to interact with comfort. 3] They learn to greet and say 'hello' and share their experiences by talking and writing. 4] When they imagine new possibilities they learn to transform existing thoughts to construct new visions. 

Bren : Some modifications in my mind can help me?

Therapist : With little creativity, major modifications can be made. 

Bren : I can see numerous 'come-in' benefits into my life. This is a new literary experience....

#Mentalhealth - When you've been hurt By Dr. Pradnya Ajinkya

2012 : For Grace this moment of being away from her parents and studying abroad was a journey of self discovery and progress on. Her parents encouraged her to never be afraid to embrace newness and happily witness it unravel. "You will always be in our thoughts and prayers, wherever you are, whatever you do...." her parents said. She confidently marched ahead, head held high... She believed in herself and the test of each moment. She was a very loving and selfless person and shared all the sweetness from within her. She majored in Economics and was nominated for an award saying she was hard worker and pleasure to be around. She completes all her work in a timely manner and always brings positive attitude to her environment. We are excited to see what her future holds? They were extremely proud of Grace. Her focus and emphasis on doing well in the classroom and outside was a great example. Her friends believed in her and they wanted to last with her for a lifetime. 

2016 :  Madam, It is though I am fearful and scanning a desert with a pair of binoculars. I feel very isolated and decayed. I can see all kinds of devastation ahead of me. Why did I begin that journey? The one reason why I got into this relationship was because I watched my parents marriage, and I was sure I knew I could keep one together. Our marriage was scheduled to be held coming December. One evening when I came back from work and met Sam coming out of the door with a suitcase, I did not realise that he was leaving me. I have not seen him since! It is 11 months now. I can't say he was unfaithful. We were so focussed on our careers. He does not communicate even by email or messages and his phones are on an answering machine now. My neighbours told me that they heard sounds of some strangers arguing in my home while I was away at work. They heard some crash and scream. A lady with a little girl child and police officers were seen leaving from the home.....

1] Is there anything that can be done to ensure that Sam is safe?

2] Did he stray Madam because of sex?

3] Is it cheating or a sign of a deeper problem?

4] I am not able to handle this.............

5] I don't want to lose Sam. To think of him makes me cry to this day.

6] Since his leaving, I have inevitably found myself in conversation with many other similar cases. They tell their tales with an oddly matter-of-fact air.  

7] I remember one evening he sat down to tell me something important. He was beginning to say, "I am sorry..." but he got busy on a call... Something fatal must have happened. In my relationship with Sam, I had experienced emotions and possibilities I never knew existed. Never mind whether my relationship with Sam continued or not, I know I will never feel the same again and about what a marriage could be with someone other than Sam.... 

8] How can I accept that my central relationship is dead?


Experiencing any kind of loss  and finding yourself in this state can completely turn your life upside down. You can keep blaming but the reality is that the closeness and daily interaction in your relationship that once made sense, no longer does. In a partnership you may have dreamt of bigger homes, shared the financial burdens, enjoyed evenings together, read out life stories to each other, and a lot more. Hence the pain feels unbearable, and you are suddenly thrust into an unfamiliar territory. You were not aware that a sudden separation was near and you are never mentally and emotionally ready for this type of life. People with whom you discuss may not know what to say and how to approach the problem. No getting isolated in any manner is important. You should find and adopt practical tools and nurture yourself as an immediate help and timely solution. Learn to honor this void and gather comfort and strength. Find a new passion while you reclaim the existing one. Join a group of people with strength and purpose. Your sorrows can make it difficult to eat and stay hydrated. Avoid gravitating towards unhealthy passions. Drink plenty of water, take long walks and also find some joyful time in a park where you see all age groups of people. It will help you to adjust with different kinds of people and age groups. When you take care of yourself physically, this also will affect your mental and emotional state. If you are having difficulty getting in or out of bed, ask a trusted member to help you in accomplishing the self-care acts. This is considered a huge step towards healing and you deserve it. 

It's an open secret : He left to save his life. Ironically, in an ideal situation whether you are preparing to leave, or threatened to leave,  it's good to write in a small note, if you have difficulty in talking with your partner, and do some planning, before leaving.....  And finally you can't wait for someone to come back. 


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