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hello welcome back to the Kings podcast season 2 today we’re here with Dr Rebecca consultant clinical psychologist

and today’s topic is going to be all about anxiety and burnout and we’re very excited to be talking to Rebecca today

would you be able to introduce yourself for the listeners at home please sure I’m Dr Rebecca I’m a clinical

psychologist and clinical neuropsychologist here at Kings I’ve been with Kings probably almost 3 years

at later this year um and I work across the age range with children adolescence

and adults working in with them through a therapeutic point of view but also doing neuropsychological diagnostic

assessments with children who might have any developmental learning or um

cognitive issues so today we really want to talk to you about anxiety um

obviously it’s a huge topic um can you explain a little bit how it manifests

differently in different people because some people may be more anxious than others some people might not have anxiety at all or they do have it and

they don’t realize they have it how can we Define it yeah even what is anxiety in the first place because we ask people

and some people don’t know what it is yes and and it’s a blessing to not have to know what anxiety is and I’m happy

for those people but I think we all experience anxiety at different stages of life um for different reasons um some

people people are more predisposed to experiencing anxiety genetically because they have family members who might have

struggled with it in the past um or still have ongoing issues with it so there’s a genetic predisposition to

experiencing anxiety but for some people it’s life struggles the various different things that they encounter in

their day-to-day that might create stress and therefore anxiety for them but anxiety is based on fear it’s based

on the the idea that your nervous system is activated trying to prepare you to

protect yourself self from often times something that is not an actual threat so from an evolutionary perspective our

bodies were designed to be able to protect ourselves if we were out in the forests and you know in the jungle or

wherever and there’s a sabertooth tiger coming at us the anxiety would activate all the senses and help us know how to

protect ourselves and where to flee or the fight or flight response would dictate that unfortunately though um our

bodies has have still a very Antiquated way of responding um to perceived

threats and which is what we see in our day-to-day um you know what’s going to happen with my exam results am I going

to pass am I not going to pass so there’s lots of anxiety that comes with the unknowns and the uncertainty of life

which is pretty much what we experience in our day-to-day some people have better coping resources and mechanisms

for that um some people are able to be more present in the here and now and don’t don’t think too much about what’s

coming next so that doesn’t activate that fear response as much for them but

other people struggle more with that and that could be for a variety of different reasons it could be temperament based it

could be personality um it could also be how they were raised and what kind of environment they were raised in but

fundamentally um anxiety it can present in so many different ways so some people

will come to me saying you know I’ve been to every single doctor at the hospital um I’ve had issues with my

breathing or I thought I was I have a breathing tumor and I went to see the neurologist and I was having chest pain

so I went to see uh the cardiologist or the pulmonologist and every I’ve done

every test I’ve done has all come back normal and they’re saying that I’ve got a full clean bill of health but there’s

something not right with me one because either I don’t sleep or I get these radiating pains um but their body

sending them a message that something’s not quite right and that usually occurs in people who are not really accessing

or understanding what is going on with them emotionally and so the body then sends signs and symptoms to say no pay

attention we need to work on something so most often uh for people who are not

fully kind of connected with their emotional experience it will come out as what we call psychosomatic experiences

like tummy aches um in kids like not wanting to go to school it could be regular migraines or headaches um you

know sometimes people still nauseous before going to work if they’re really anxious at work but these are not

actually finded by there being in any underlying medical condition to explain it inter I think a lot of people assume

that anxiety is just kind of a mind related um disorder but it is actually quite a physical very much so yeah how

come it manifests that way how so um I don’t know some people may experience their anxiety like in their stomach they

may have because they say IBS is linked to anxiety right so how does the brain

like how does that even happen like so everything starts off in the brain right um and our brain is responsible for all

our hormones our endocrine system our nervous system everything but if our

mind is telling us that there’s a fear or something to be feared it’s going to send signals to all those body systems

to try to activate them for self- protection even when there isn’t a real threat the problem with that is that

prolonged exposure to the stress hormones like cortisol um adrenaline all

of those actually cause damage to um organs in the body and then it creates um a whole Cascade effect of um release

of various like for example in stomach I’m not not a gastroenterologist but I would assume that that’s associated with

a lot more um excretion of gastric juices that causes um heartb birth and

various other symptoms like that um same thing with your nervous system in terms of your um your brain um if you’re under

a lot of pressure and if you’re not sleeping very well which usually occurs when you’re anxious your nervous system

is going to get kind of overloaded very quickly and that’s why people end up having really terrible migraines or even

fainting spells sometimes panic attacks um so the body is very closely related to the mind and that is why sometimes

the body sends the initial message to tell the person that they need to slow down and figure out what it is that’s

going on um sometimes it’s very unconscious we could be going through very like serious period of time in our

lives but we feel like we’re okay we feel like we’re coping until we hit a wall and that’s when burnout in status

set ear where there’s a lot of fatigue restlessness in sleep irritation and

irritability but not really knowing where it’s coming from a lot of my clients report just all of a sudden

getting intense Road Rage or just spping at their family members and they’re not really sure like they haven’t really

done anything or they’ve just stopped exercising they haven’t had the time to go and do nice you know self-care or you

know participate more in family or activities or I really enhancing their their marriage or their relationships

and that’s when the body starts to send those signals um that you need to slow down and my job with my clients is one

to help them uncover what those things are um also to give them sort of strategies on how to cope with the

physiological impact of their anxiety because that takes that can be the hardest thing to handle yeah on a

day-to-day basis because it impacts your functioning at work in school life in relationships so it can be incredibly

overwhelming but in order to understand what goes on cognitively we also have to reduce the symptoms and so my job a lot

of the time is to help people let’s just focus on how we can get you to sleep and let’s focus on how we can get you to

spend more quality time with family and over time once they’re doing more of that there’s more space for them to

access the emotional content to actually understand where some of these stresses are standing from so would you say there

is I everybody experiences anxiety to some level but then how would you know if it’s enough to go see your doctor

very good question so I would say um anxiety should come and go and it comes

and goes in waves right and it should be uh occurring at a time when there it’s

expected to have an emotional response to it so you know a lot of people feel anxious before they travel fairly normal

moving hats you know having a baby even getting engaged getting married all of these things they create stress and

that’s normal to feel anxious uh because you want things to go in a particular way and you have expect for it and you

have a certain outcome that you that you would like or that you have in mind the problem is is that sometimes when you

are not experiencing any of those stresses or they’re not um significant

yet you’re still feeling high levels of anxiety to the point where you just feel miserable and you don’t a feel sense of

satisfaction in your life and you can’t get any Joy from the things that used to bring you Joy that’s when we would be

concerned that anxiety is then becoming unmanageable and the unmanageable anxiety if untreated can lead to

depression and that’s when suicidal thinking and more concerning issues can

occur so I would always say you know and your body should tell you when you need

to seek help I would also say though that before allowing your body to be screaming these messages out to you it’s

really important to slow down and reflect on a daily basis of how am I actually doing and how am I feeling and

what am I satisfied with what am I not satisfied with um what could I do differently How can I make myself feel

better and if you’ve tried all of these different things and if you’ve done good reading and maybe you’ve spoken to a

friend um maybe who’s in the same position you sort out comfort and and support from your network and you’re

still not feeling settled that’s when coming to see a doctor or seeing a

professional to kind of understand it a bit better is the ideal way to go so if

somebody doesn’t really need to see a doctor yet um is there little things that they can do at home or by

themselves that they can actually help their anxiety themselves absolutely it really starts with very basic things um

one is your warning routine so I’m not saying you know we have to do robin shamas 500 a.m. clay we having to be off

at the you know the sunrise or before the sunrise and go for a run or do anything like that but um we need to

slow down think we live the very fast-paced life especially here in Dubai there’s a lot of traffic there are a lot

of stresses that get in the way um of leading kind of a very settled life I would say and when we wake up in the

morning how much time we spend kind of getting ourselves to feel uh settled

calm doing some mindfulness meditation listening to audios as it’s very helpful

I do recommend exercise in the morning for those people who have the time for it it doesn’t have to be intense it it

doesn’t even have to be going to the gym it could be just going for a walk around your neighborhood if the weather permits it could just be doing stretches or

doing you know little yoga video before you start your day um I think it’s

really important especially for those who work from home to make sure that they wake up around the same time every day that they’re consistent in their

morning routine having a good healthy breakfast it’s all Basics and if we go back down to our childhoods we probably

would discover that we probably had a lot of those healthy habits then and then as we get older we’re spending more

time waking up first thing and just checking our phones and then scrolling um you know then all of a sudden like I

don’t have time to get ready and then we get into the car and we’re rushing and we’re driving terribly and we’re

aggressive and that’s when the the anxiety and the stress sort of slowly starts to build over the course of the

day yeah another important thing is is in the evening is your sleep routine um it’s so important that we go to bed at a

predictable time routine creates safety and comfort and that’s why babies and kids Thrive when they’re on routine

because there’s predictability and that makes them feel less anxious and more settled so if you have a similar like

routine at bedtime things that Cal doing things that calm you obviously eating

well not watching too much TV before bed not scrolling on your phone before bed reading a book all the basics we used to

do um I guess in my time it was before devices that Joy um but I think also

another important thing is to make sure that we schedule Pleasant and pleasurable activities weekly so we

should always have something to look forward to in the weekend I think it’s important that we do stuff in the weekday as well whether that be

exercise or catching up with friends or you know if you live close to the beach go for a walk on the beach do little

things that help to ground you spending time in nature is a big one harder to do here but now that the weather’s good

it’s definitely doable um and I would say that we it’s just really really small things every now and then you know

um pamper yourself get a massage or um you know go for a hike do something that

you don’t normally do but sometimes it’s important to do some of these things on your own because when you’re on your own

you have the opportunity to think to reflect to really try to access what is going on for you emotionally and we

don’t do enough of that yeah we don’t know how to slow down especially in living a fast-paced life and so I think

every day we should be just giving ourselves 5 to 10 minutes and it just that’s not a lot just to sit quietly and

think some people like to do their thinking in the bath or in the shower some people like to do it on their drive

to work with no no music playing or anything um some people like to do it kind of just um as

theyve woken up and they just do a little meditation and then just a little self-reflection over what they want or

hope to achieve for the day some people do it through prayer so it really doesn’t matter how you do it but we need

to slow down and give ourselves those 5 to 10 minutes every day just to do a little selfcheck in yeah so it really is

just stripping It Back to Basics really and just taking that time to just do something for you not not for other

people not for work just literally just for you absolutely and we’re not very good at that no and especially as our

lives become bigger and as we become parents and we have kids and we have jobs we have responsibilities we have

Partners we might have have aging parents or family members people visit people love to

visit and there’s all sorts of things that you have to constantly adapt to but if you are always giving to others

around you um which is an important part of life we all give to one another but if we not receiving if we’re not filling

up our cup we’re going to burnout and burnout happens um very quickly and

sometimes it’s a lot harder to come back from when we’ve let it go too far so would you say then that there’s because

it’s not really something I’ve ever linked together is there a link between anxiety and burnout like yes absolutely

absolutely so burnout isn’t just from working really hard burnout can be from

a variety of different things that that are occurring all at once you know people who are experiencing loss or

grief or stress um related to family illness or something like that might

also have a very busy stressful job and might also have kids who have maybe needs or need support or just just need

to be driven around town you know like our lives are really busy but when you’ve got all of that building up it

becomes a cumulative effect of stress and then stress turns into anxiety because there just there’s a feeling of

overwhelm of like I’m actually not coping with this and then when we’re really busy and when we’re already

stressed and when we’re short of time our needs become secondary so we don’t

prioritize it we don’t make the time to exercise or to go visit our friends or to do the things that actually bring us

joy and when that occurs our system is basically screaming at us and we’re not

doing very well and then all of a sudden you get invited out to go out and you’re just too tired to do it yeah or the

weekend comes along and you’ve got all the time of the world but you don’t want to do anything because your body just needs needs rest and then that makes you

sad cuz you feel isolated and withdrawn and then that adds to the anxiety and a knock on effect absolutely that’s why

long periods of burnout and untreated anxiety can lead to depression and so

that’s why we need to be very conscious of the fact that it starts to impact functioning so all of a sudden

relationships start to become really challenging um work relationships even as well work stress or not being able to

cope with the stress or being AF of work all these sorts of things can kind of come as secondary to the fact that you

just haven’t paid enough attention to what your own internal needs are do you find a lot of that in divide the burnout

and the anxiety absolutely I feel like it must be quite common it’s a very work centered work-driven environment here

and and also keeping in mind that Dubai is a place that’s filled with you know

very high functioning intelligent professionals um who come from all walks of life from different cultures where

you know work work is is this is experienced differently and um the mix

of cultures in how we work and how we do things also contributes to that but

because we’re all very high functioning individuals there are higher expectations and because we are living

in a tax-free environment the expectations of those High salaries that we get are also a lot

higher so work life balance is a lot harder to achieve people work a lot

later than than they would let’s say back home where I’m from in Australia um there are things are not as regulated in

terms of what’s kind of acceptable um you know apparently in France I’ve read

that they don’t talk about work on the weekends and it’s like you’re allowed to whereas here I think work never really

stops not especially if people don’t have traditional day jobs that I’m sort of the 9 to-5 people who are Consultants

people who work in real estate they’re always on their phone they’re always working and and you know know in some in

some careers you really need to hustle here yeah um and life in Dubai is really expensive

so a lot of people need to work very hard in order to have a good life here and it balances out because we do have

lovely opportunities to have great life here but it doesn’t um mean that we um

can avoid the stress that comes with it so Dubai stress is very high and we’re not we’re just also talking about things

like how busy the the the roads are at the moment you know get any we it’s

really hard at the moment so people have to add time to their Journeys people get stressed people don’t drive well then

you’ve got py cyclical effect and in addition to to all of that you’ve got um

processes and procedures that are just different to how it is in your home country so sometimes getting things done

that you know in your mind should feel very simple has lots of different steps that go with it that can create stress

um and that’s just I think very typical of the UAE and the Reg um but then it balances out by also

having so many things that are really easy and really accessible like anything can be deliver to your door um you know

whatever you need whenever you want it it’s like that but there are other things that take longer and more

frustrating time consuming irritating and I think with that on top of you know

busy school runs and kids who have loads of activities after school and we’ve got

really highly scheduled lives for ourselves and for for our families and it takes away from the opportunity just

to sit and be and kind of have quiet time and I feel like Dubai really Dubai

it’s a very much like a Work Hard Play Hard kind of Lifestyle especially with some of the younger people here and that

can be problematic in and of itself because the more you play that means in some ways there could be too much

alcohol consumption going out too late at night not sleeping properly not taking care of your health and wellbeing

and then that on top of the stress of work can lead to burnout a lot quicker

how would you balance that though so for some people they may say but by going out my seeing my friend staying late is

my time to chill or get away from work but obviously you can overdo that as well absolutely so how do you you have

this busy you’re working 24/7 and then you’re like I want to go see my friends I know I’m going to finish really late

and then I’m going to be tired for work the next day but if I don’t see my friends I’m not doing anything for me how do you begin to to manage that to

for wellness of your body or for your mind well it’s a really important question because I think it’s twofold I think yes there has to be having fun in

moderation um and making sure that if you do go out you know you’re not going out till 2:00 in the morning and that

you’re maybe not consuming too much alcohol or you’re trying to be careful about what you choose to eat while you’re out but at the same time you need

need to send boundaries with work so that you’re not relying so heavily on going all out uh in party mode when you

have the moment for it because that’s going to be detrimental it doesn’t actually alleviate the stress it creates

a different kind of stress it properly adds to it that him man absolutely and so then sleep deprivation becomes worse

um body image issues if they already exist become worse because maybe eating Foods at various times of the night they

shouldn’t be eating or you know you’re not conscious of what you’re eating and what you’re consuming and then that becomes really problematic in terms of

the energy you have the next day to function so I actually think that it all really starts with making sure that

we’re what we need to give for our jobs but that we’re also being mindful of how we can create boundaries around that um

and you know there are there are expectations that some companies have that are completely unrealistic but

there are also expectations that we sometimes Place upon ourselves and maybe that’s because we want to prove ourselves or we want to be seen as you

know someone who’s a really um High performer all of these pressures can also be internal pressures they may not

necessarily be pressures that are put on you um some people are always on their phones the week weekends responding to emails but they don’t actually have to

be if you’re the type of person who gets emails over the weekend and you have a lot of work stress how can you avoid

that how can you not take that home with you yeah and I know a lot of people here in Dubai try to have two different phones for that they phone and they have

their personal phone and as long as you’re good at making sure you keep that

at home when you’re on the weekends then yeah it’s doable but it’s all about mental trap practice is just asking

yourself you know who’s paying me for this time and if I’m not being paid for this time why am I doing it and is it

end of day stuff you know is it life or death is something terrible going to happen if I don’t respond to this email

will that person maybe even figure out what they need to figure out in the time that takes you to respond yeah sometimes

we don’t actually need to be on this sort of trigger happy straight response

um way of living um because yes although we do appreciate when people are very

responsive to us it actually adds a lot of stress to both parties with these

expectations that kind of unrealistic especially if you’re working with people in different time zones and that happens a lot in with people in Dubai who manage

the minor region let’s say and they’re different time zones they’re they’re they’re on calls late at night but then

they need to then start their day later some of them are on calls till 11: or 12:00 at night but then still start their day at 8:00 a.m. and that’s where

we need to be careful about how we set those boundaries because we’re actually been ending up working the job of two

people rather than just one actually wanted to bring it back to something that you said earlier about anxiety

being based around fear and fear is irrational but is there any type of anxiety that is rational because when me

and Danielle were doing research about this topic we found out so many different anxieties that people we know

have some of them we don’t share um like you know maybe someone’s scared of an

elevator or maybe someone’s scared of the see how do we know what is rational and what isn’t so a lot of the time it’s

based on your previous experiences so if you’ve ever had a stressful or traumatic experience it can sometimes uh solidify

into an ongoing fear um and I would say that that’s not necessarily anxiety

that’s more phobia based and there are multiple different types of anxiety and I should kind of explain that so we’ve

got the obsessive compulsive type of anxiety where a person is unable to stop thinking these intrusive thoughts that

are kind of obsessive that result in them doing a compulsive Behavior like let’s say I’m terrif B of germs and then

the compulsion is to constantly wash my hands that’s a less common I mean very

there’s it’s not as common as generalized anxiety where there are people who are just more affected by all forms of things that might create stress

for them and it’s really more just about difficulty managing stress that leads to anxiety but then you’ve also got um the

type of anxieties like eating disorders are actually not just about eating they are an an expression of anxiety and and

need to control so some people who feel anxious about I don’t know whatever’s going on in their family life might

develop an eating disorder not because of R Body Image issues but because it’s the only way that they can create a

sense of control and ownership over their life and so control of eating helps them feel more secure and that’s

how an eating disorder develops we’ve also got um panic disorder which is an anxiety disorder where the nervous

system is highly activated um and it isn’t responding to cues around the

person to say that everything is okay and what we need to do with those is try to S of understand where these stem from

so a lot of the work I do with anxiety isn’t just about symtom management it’s also going back into someone’s childhood

or their early life experiences and trying to figure out where this might have um kind of come from you know

personally I have a major phobia of sakes I’m terrified of sakes coming from Australia you would imagine that I

didn’t come across things quite often never seen one except in like you know a farm or like in in a zoo but my daughter

is just as terrified my youngest one loves her I mean she’ happily go

tou to get it from you the sopia and that’s what we don’t know some of it’s

genetic she’s never actually seen a snake in the wild neither have I but my

mom was terrified at snakes and so maybe there is a genetic kind of relationship

there um so we we also sometimes don’t understand where that it stems from but

we also really kind of have to respect that it’s there anyway yeah and we can do things about it so a lot of people

have just an innate fear of flying um where does it come from it could be from a movie they watched it could be from an

experience they had on a plane it could also just be that the fear of not being in control you know somebody else is

flying that plane it’s not you um and the the fear of trust being able to trust someone else so there are so many

different elements of anxiety um but yes r anxiety is rational when it comes to

something you know that’s very meaningful for you you know you get a a blood test ad and you’re really worried

that you’re going to get diagnosed with something that makes sense if if there’s something going on but if you are

feeling highly anxious about a blood test that’s just there to check your you

know vitamin D levels that’s not something that’s going to you know be terribly uh like lifechanging for you

but having the same kind of anxiety response as someone who’s waiting for a diagnosis that’s something quite scary

that’s quite different and so it’s it’s logical anxiety can be logical it makes sense to be anxious but the problem is

is that when your anxiety isn’t even when you try to manage it you can’t challenge the thoughts that come with it

and you can’t bring that neurological that nervous system um overactivity down

that’s when it becomes overwhelming and difficult to manage yeah cuz it can be quite debilitating when you have like

those thoughts cuz it can stop people from doing things it can stop people from doing whether it’s just being a simple day-to-day activity or like a

bigger kind of event it does stop people from feeling comfortable to do things so

how can you detail your mind okay I’m being not silly obviously it’s not silly it’s a

real thought but I need to just do it I need to be brave like how can you push yourself to to do it at home like yeah

so I would say that within therapy there are multiple different techniques that we use and cognitive behavioral therapy

is one of the most common use techniques and the the C in CBT

stands for cognitive and that’s the thinking and what we do in that is we understand our thinking Styles if we

have unhelpful thinking or problematic thinking Styles like overgeneralization or pastra

catastrophizing or jumping to conclusions or mind reading fortune telling there were all different types

of unhelpful thinking Styles once we understand what those unhelpful thinking styles are we can then challenge them

with more balanced ways of viewing things and so I do this with my clients with automatic thought records so we’ll

write down what the situation was or what the emotion was what do they experience physically but also what

theyve felt and then write them down how they responded what were the thought patterns that came up then on retrospect

they can look at that thought and think H I think I was jumping to conclusions over there what’s a more balanced way of

thinking about this and then they would come up with a um you know um a more

balanced way but also thinking about like what’s the probability what’s the likelihood that this will actually happen and we often get people to ask

the answer certain questions like if my best friend was sitting next to me and talking to me about this problem what

would I be saying to them how would I be supporting them and why are we not able to do that to us with ourselves so

that’s an important part of the cognitive element so the b in CBT is the behavioral which I spoke about before

which is a lot more related to self-care and exercise and socializing and all of that but a lot lot of clients will say

that anxiety for them is debilitating because it results in analysis paralysis

they just can’t do anything major procrastination difficulty getting started on anything a lot of withdrawal

um just major avoidance and that becomes terrifying because they feel

like they’re constrained by their anxiety and they don’t really know how to get out of it or how to unpack it um

and so an important part of uh anxiety is treat it with respect now we don’t

want to hide from our anxiety we want to respect that anxiety is a normal human emotion um it’s just that it’s sometimes

because of our patterns of behavior because of our maybe perfectionistic traits could be because of our

temperament or how we were raised we have more of a likelihood to think more negatively about things or to be more

fearful about things and you’ll see that the percentages of oh my gosh that’s 80% likely to happen realistically is maybe

only 20% likely to happen but in their mind it’s Amplified yeah and so the the C of restructuring and

thought challenging exercises just help you understand how your mind can be a bit of a bully and be able to talk back

to that voice and with practice we become better and better and better at doing that um but we often need time to

actually reflect and journaling is a good way to be able to get access to the thoughts to to help us understand them a bit better so really it’s about

embracing your anxiety and then understanding it as well not to be as

fearful from it just to say right I’ve got this this is an issue how can I start to understand it and then maybe

it’ll become a bit more manageable hopefully and thinking also about um thoughts negative thoughts as choices I

have a choice right now to engage with this negative thought and take it let it take it me on this journey that it wants

me to go on or I can just stay where I am and I can I can breathe through it I

can let it go and that’s you know that’s from elements of acceptance in commitment therapy um where we use the

analogy of you’re sitting you’re standing on the platform at the train station and the negative thought is the

train and you have a choice if you want to get on that train and go with the thought and let it take you on that

tangent or you can just stay on the platform and decide to wait for a more positive thought to come and so we do a

lot of visual imagery um grounding techniques to help kind of visualize a thought as like a leaf on the water it

comes but it will Flow Away we just need to give it time but the quicker we are to try to avoid the anxiety or to

challenge the thought sometimes we end up diving in and that’s where the problem lies okay well we’d like to end

the podcast with a very special question sure today’s question for you is what is your top secret about managing

anxiety oh what well I’m biased because I’m a cat person and um my cats I call

them my therapy cats um I feel very soothed when I’m around animals especially cats um and Cuddles cuddles

with my kids cuddles with family always get I think you need about eight hugs a

day to survive and like maybe 15 or so Huns a day to

thrive so we need to be having physical contact cuddles with whoever cats dogs

whatever um H and our loved ones I think affection and come the comfort that we get from a really nice tight squeeze um

this is my go-to when I’m feeling overwhelmed am that’s a really lovely tip really ni very thank to Dr Rebecca

for coming on the podcast you so much we hope to see you again time


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