Episode Transcript
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Speaker 1 (00:17):
Hello and welcome
back to Honoring with Dr Pete.
As you know, we're honoringMary as Mental Health Awareness
Month and all month long we'vegot incredible guests and today
is no different.
I've got my friend andcolleague, Dr Erica Landerviller
.
She is the founder and clinicaldirector of the Behavioral Care
Center of New Jersey.
She specializes in the practicecognitive behavioral therapy,
(00:39):
which you've heard a lot of onthis podcast DBT, motivational
interviewing and ACT, and sheworks with children, adolescents
and families.
So we go way back.
Welcome to the show, Dr Miller.
Speaker 2 (00:51):
Thank you, Dr Pete.
Quite the introduction.
Speaker 1 (00:54):
Well, you earned all
of it.
Wait, when did we meet?
Speaker 2 (00:59):
I was thinking about
this just a few moments ago.
Speaker 1 (01:01):
Yes, correct.
Speaker 2 (01:03):
I was trying to
remember because I feel like
I've known you forever.
Speaker 1 (01:06):
It does feel that way
.
We're like siblings fromanother life probably.
Speaker 2 (01:09):
Absolutely.
Speaker 1 (01:10):
Yeah, I think it was
from ACBS New Jersey.
You and I were kind of leadingthis charge, you and I I mean
you were leading this charge tobring the Association for
Contextual Behavioral Sciencesto New Jersey.
Speaker 2 (01:22):
I think that was both
of us.
I think we both feel reallystrongly about providing good
care and trying to help supportother clinicians who are also
interested in bringing good,solid, mindful, compassionate
care.
Speaker 1 (01:34):
Well, that's exactly,
and Emil, so I'm remembering.
Well, there was like a bar.
There was a bar we had like acandy store once that we did
this at.
Speaker 2 (01:44):
It's about shame at a
chocolate shop.
What can you say about that?
Speaker 1 (01:48):
Well, Tippi, you were
the blame behind that type of
stuff, Like the fact that you soquickly were just like show
them at a chocolate candy store.
Speaker 2 (01:56):
Yeah, there are two
methods to help run those.
I think that we both feelstrongly about you.
Can continue to growintellectually and provide great
care.
Have fun.
Speaker 1 (02:05):
Yeah, yes.
Speaker 2 (02:06):
You don't have to be
either or.
Speaker 1 (02:08):
Or not, either Well,
and how beautiful from a mind,
the dialectic that's it.
Speaker 2 (02:13):
It is both and and
enriching.
Speaker 1 (02:16):
So, uh, describe that
for some listeners that are
just tuning in and maybe don'tknow what DBT is.
I'm going to jump right intothat.
Speaker 2 (02:29):
So the, the, so the
both, and yes, both and so.
DBT dialectical behavior therapywe could not have come up with
a more confusing name for it.
Thanks, marcia.
Thanks, marcia, you'rebrilliant.
And simple language.
So dialectical behavior therapy.
What I love about dialecticalbehavior therapy it felt like a
natural fit for me.
Yeah, behavior therapy.
It felt like a natural fit forme because at its core are
dialectics, and dialectics forthose of you who are new to
dialectics are two things thatappear to be opposite and are
(02:52):
both true, right.
So growing up, my best friendwas my brother.
I love him to death.
He's hilarious and funny andwonderful and man.
If anyone knows how to getunder my skin and say just the
right thing, it's also him.
He knows exactly how to teaseme and he is also my favorite
person who makes me laugh and iswonderful at the same time.
Speaker 1 (03:14):
I love that doctor.
Shout out to the other DrJeffrey Lander.
Speaker 2 (03:18):
That's right.
Speaker 1 (03:18):
Yeah, well, not the
other, dr Lander.
I still have you in the phonethat way though, just so you
know.
Is that okay?
Speaker 2 (03:24):
That's absolutely
okay.
Half the people in my worldstill call me Dr Lander.
Speaker 1 (03:28):
Okay, so you're
married and his mother and her
brother is a wonderful human whoI also know.
He's one of the only sportcardiologists in the state.
And brilliant and funny, justlike you.
Just like you Brilliant andhumor.
Speaker 2 (03:43):
And humility, clearly
, and humor and humility clearly
Wait.
Speaker 1 (03:48):
So you work
predominantly with children and
adolescents.
That's one thing.
That's not similar about youand I.
That's right.
Speaker 2 (03:54):
That's right.
I love working with kids andwith adolescents.
I feel like you can help shiftthe whole trajectory back in
front of them and shore them upand help them be resilient and
face the world ahead that isgoing to have bumps in the road
that are natural.
Speaker 1 (04:08):
You've always done
that Like you've always felt
gravitated towards that.
Speaker 2 (04:12):
So my long story
short.
I started working with kids inmiddle school, Come on.
So my short story starts insecond grade.
It was the first time I was inNew York City with my family and
it was the first time I wasmindful and aware of the
unhoused population and I wasshocked and asked my parents.
(04:36):
We had a conversation about howthat can happen and that night
we came home into our cozy houseand it was a huge thunderstorm.
And I couldn't stop thinkingabout the people I had met.
Today we're like out in therain and I was asking my parents
what happens, where did they go, like?
And uh, wanted to help, stuckwith me and as a kid, the way
they allowed me to start helpingwas working with kids.
(04:57):
Right, they weren't having mehelp out with adults.
So I started in middle schoolreally starting to volunteer and
work in some shelters, and sothey had me helping out with
kids, and so it really startedthat way and then I, just as I
got older, I continued to loveworking with kids and with
teenagers, so that justcontinued.
Speaker 1 (05:17):
You know, one of the
most amazing things about doing
podcasts like this is that, asclose as I feel to you and how
much I love you, like I'm gonnalearn about you tonight, today,
and I love and I'm so glad youshared that, because that's like
that's that, to me, makes somuch sense, because that's and
if I were listening, that's thedepth that you bring to your
work.
And I know that about you, like, and I just know you know,
(05:39):
whenever I refer to you which isoften um, I, I have zero
questions about it I'm like thisis absolutely the person for
you.
Speaker 2 (05:47):
Thank you, I feel the
same way sending people, so
fuck off.
Speaker 1 (05:52):
Sorry, listeners, you
have to just deal with this.
Speaker 2 (05:55):
So much love in there
Too much love.
So parents are struggling.
Parents are struggling, kidsare struggling, parents are
struggling.
Parents have been strugglingfor a long time, and then COVID
happened.
I was actually just at aninteresting training a week or
two ago, talking about theintense spike up in stress that
parents experienced during COVID.
Speaker 1 (06:15):
Yeah.
Speaker 2 (06:16):
Rates of stress have
not returned to pre-COVID levels
.
Speaker 1 (06:19):
That's why, Rory,
because a lot of stuff has
returned.
Speaker 2 (06:22):
A lot of things have
returned.
I mean, that is, one thing thathas not come back down is the
intensity of stress Parents arereporting.
It just sort of has stayed atCOVID levels, even now that the
world has opened up and we'regetting back to life as normal.
Speaker 1 (06:38):
Let me ask you this.
You know, rory, I was trained,and similarly to you, but my
training is a little bitdifferent.
I had a lot more psychodynamicfaculty, and so it was like no
pictures in your office and likethat sort of blank slate Do
your clients know that you'realso a mom?
Or like how is?
How do you integrate that intoyour work?
Speaker 2 (06:55):
They do.
So I was not trained from ablank slate perspective, so kind
of the what was?
What was taught to me in gradschool was what are you sharing
and is it for the best interestof the client who's sitting
there?
Yes, if you're sharing somethingpersonal that's going to be
useful, then you share it.
If you're just like, hey, metoo, that's not useful and
(07:15):
that's not a moment that youshare.
Becoming a psychologist beforeI had a family also made it
impossible, because they watchedan engagement ring pop on my
finger one day.
They watched me become pregnantRight and so, even if I
believed in a blank slate as youare physically changing in a
way that's observable toeverybody, it wasn't an option,
(07:38):
and I also, especially with kidsand the teenagers, you want to
prepare people for transitions.
Speaker 1 (07:43):
Yes.
Speaker 2 (07:43):
And if you're going
to be out maternity leave, you
have to prepare people and youknow going to take care of your
own child and pausing takingcare of someone else can be full
to the person that you'repausing with.
So making sure we hadconversations about it in a way
that felt like the just rightamount of sharing.
Speaker 1 (08:02):
I always say that
this age group that you work
with has the best bull poopymeter.
Speaker 2 (08:07):
The best.
Yes, if you are not genuine.
It's so interesting workingwith kids watching people try to
mimic.
Their language never goes overwell, because they know right.
They see Totally.
Yes, that's clear as day, and Ithink they really appreciate a
genuine person more than someonewho's trying to be cool and
sound like.
Speaker 1 (08:29):
Yeah, I get the same
thing with athletes.
You don't want to sugarcoatanything, just say it like it is
.
So you've also worked in schoolsystems, right?
So before you opened yourpractice, is that right?
Speaker 2 (08:40):
Yeah, I've worked in
lots of different places.
I worked in schools andhospitals and community-based
centers.
New York kind of has thisamazing thing where hospitals
create mini clinics inside ofpublic schools, which is you're
getting kind of hospital careright in your public school,
which is amazing.
Was that through Montefiore?
I did it through Montefiore,but all the hospitals in New
(09:02):
York participate.
There are tons of these clinicsset up for both medical and
mental health treatment.
Speaker 1 (09:09):
And so you were like
what kind of will did you have?
Or did you develop programsLike, what was that like?
Speaker 2 (09:14):
So I started off as a
clinician.
I actually started off as apostdoc, got some training,
stayed on as a clinician andbecame the director of mental
health services in the schoolwhere I work and felt really
strongly.
So DBT, as we were talkingabout before, dialectical
behavior therapy is one of themost effective interventions we
have for our kids, teenagers andadults who are struggling with
(09:37):
really strong emotions andaren't sure what to do with
those emotions.
And when they becomeoverwhelmed with emotion, may
engage in some ways to managethat intensity that aren't so
healthy for them, and so webrought DBT into an elementary
school and with younger kidsGreat.
Speaker 1 (09:54):
Yeah, so cool.
You did that for a while rightBefore you came, because I
actually, so that's when.
That's when I met you, becauseyou had just come back to New
Jersey.
Yeah, that's when we met.
Speaker 2 (10:03):
Yeah, it was a big
jump going from working in a
different population to workingin a private practice in New
Jersey.
Speaker 1 (10:13):
OCD, adhd, I mean
these are things that people
kind of throw around.
Do you see a lot of that inyour practice?
Like you know, what are some ofthe main things that maybe
parents are seeing in their kidswith this high stress these
days?
Speaker 2 (10:39):
about with social
media is there is much more open
dialogue around mental health,and so the positives of that are
that kids are much more awareof the ways that they may be
struggling or that their friendsmay be struggling.
The downside of that issometimes the language of
therapy, the language of mentalhealth, is put out there.
However, it is put out there ina way that isn't necessarily
consistent with how we would useit in the field Absolutely yeah
, and so sometimes I think thatsocial media can present
(11:04):
problems that aren't problemsright, that are typical
developmental experiences tohave Totally Wrapped in labels
that feel scary, and so people'sanxiety goes up.
Instead of, what would be areally beautiful way to use
social media is normalizing someof these experiences instead of
pathologizing them.
Speaker 1 (11:22):
Like give an example,
because I can think of a few of
ways that have.
You know, athletes come inbeing like I can't focus in
class and it's like well, whatclass is it?
It's like world history.
Cool, look, I also can't focus.
Speaker 2 (11:34):
And, by the way, did
you eat breakfast or sleep
Exactly?
It's not ADHD just becauseyou're struggling.
It's not OCD.
I double check my alarm prettymuch every night.
That's not OCD, even though itmight be a repetitive behavior.
So we hear the language right,gaslighting, isn't that somebody
(11:57):
disagreeing with you?
So we hear a lot of thelanguage of therapy, and
sometimes it'sover-pathologizing can happen,
and I find sometimes my job isactually to do the opposite of
what you think it is.
Just normalize the normalexperience.
Speaker 1 (12:12):
Yeah yeah, this is a
little provocative, but
college-aged kids they black outwhen they go out every so often
.
Not healthy, not great, notpermission to do it Right, and
it is developmentally sort of apart of the process.
Speaker 2 (12:29):
It's not substance
abuse, it is healthy youth.
That's right.
But, it is not substance abusein that way, yes, amen.
Speaker 1 (12:37):
Well, you mentioned
technology, so how are you
seeing that in your practice?
Because social media is big.
Speaker 2 (12:42):
Social media is big
and I feel like 100 years older
than I am because I needsomebody who views me.
So trying to stay on top of itas someone who is not an active
user of it can be tricky, and Ithink when we're talking
specifically about kids andteenagers, it is a double-edged
sword, and so I want to becareful not to villainize social
(13:03):
media.
There are some really helpfulthings that come out of it that
we can certainly talk about, butI think specific to kids and
teenagers just thinkingdevelopmentally about where they
are is important as a 10 to 19age range.
that is when they are at thepeak of their risk-taking
behaviors and, as you were justsaying, with college students, a
developmentally appropriate way.
(13:23):
This is the age when you dotake risks and I think what's
tricky with social media issometimes it doesn't look like a
risk or see in the way thatreal life risk-taking can be a
little clearer.
And so the age that we'reintroducing kids to social media
is also an age where they areat the peak of their risk taking
(13:43):
.
They also in terms of measuresof well-being.
They tend to fluctuate the mostbetween the ages of 10 to 19.
So their mood naturally isgoing to be more up and down
between these ages than it willat other times in their life.
So we're going to see theimpact and down between these
ages than it will at other timesin their life.
Speaker 1 (14:01):
So we're going to see
the impact of that on social
media, so parents listen to that.
Your kids will be up and down,that's normal.
I thought there's no problemwith that.
Speaker 2 (14:09):
But I also put myself
in the shoes of parents
listening, and so they're goingto say well, Dr Miller, at what
age should I get my child socialmedia Right?
So I think that there are twodifferent questions here.
I think that there are twodifferent questions here.
I think there is what age areour brains ready to handle
social media and what age do youactually give your child social
media?
Because in a perfect world wewould wait until the prefrontal
cortex, the part of your brainthat's right here, the front of
(14:30):
your head, is fully developed,so that you are ready and can
understand the consequences andcan manage your emotions a
little bit better.
But that would mean we're notstarting social media until
around 20, which is also notrealistic and not going to
happen.
Speaker 1 (14:42):
Because then you're
kind of holding them back a
little bit yeah it's notpossible.
Speaker 2 (14:45):
So I my my partner
does not work with children, and
so I sat him down and maybe notso gently invited him to join
me in watching a documentaryabout social media.
I was like we have to do thisbecause we have children and we
should watch it, and histakeaway was okay.
Well then, they just won't haveit.
We can't do that either.
(15:06):
That's not an option.
Part of social development isgoing to include social media,
and if you are going to havefriends in today's society, you
have to be on social mediabefore your brain is actually
ready to manage social media.
So I don't think it'snecessarily about when are your
kids going to be ready, becauseyou're probably going to give
them access to a phone and tosocial media before they're
(15:28):
actually ready.
Speaker 1 (15:29):
And that's okay.
So then just be okay with that.
Speaker 2 (15:32):
Okay, that's okay.
It does mean we have to be ontop of it, right?
So if we're going to give ourkids access before their brains
are ready to do thisindependently and on their own,
it means having lots of openconversation about social media,
making sure that our kidsunderstand how to be safe online
.
My kiddos in school they'realready starting to talk about
(15:54):
being safe online.
Speaker 1 (15:56):
Oh, I love that.
Speaker 2 (15:56):
Great they started
talking about it.
Nice, I think I love that.
I think great they startedtalking about it.
Nice, I think that's wonderful.
Yeah, you're not sharingpersonal information.
You don't know who's who.
So some basic safetyconversations, I think, are
really helpful.
Something that I think shouldbe a part of that, but often
isn't, is the idea of sourcesand no source.
Speaker 1 (16:13):
Oh good, but from an
early age you think just in
terms of like legitimate sourcesversus fake stuff.
Speaker 2 (16:19):
Yeah, or even just
sometimes you don't know Right.
So there are some sources whereyou can say, ok, I think this
is a legitimate source, butoftentimes the information we
get online, we don't actuallyknow where the source is.
Speaker 1 (16:29):
I'm like stuck on
some site, like a news article
will come across my feed andI'll click on it and then it's
like some dead link, or yes,that's what you're talking about
.
Speaker 2 (16:38):
Yeah, yeah, and our
kids access information so
quickly.
Speaker 1 (16:42):
Very quick yeah.
Speaker 2 (16:43):
And even in person.
It's a helpful conversation tohave If your friend, if your
fellow sixth grader is informingyou about something, about the
way your body works.
They may not actually be theexpert in that either.
It's true Even for in-personconversations.
We want our kids to slow downand just consider the source and
create an environment wherethey are comfortable enough
coming to us to say hey, I heardthis, I saw this online, I
(17:06):
heard this from a friend.
Is that accurate?
Is that true?
Speaker 1 (17:10):
Yeah, yeah, just
check it out.
So you train a lot of healthcare professionals that I know
that about you because I waslucky enough to work with you on
one of your large projects, andso how is that presenting today
?
Like, are you still?
Speaker 2 (17:26):
involved with a lot
of that training of other
healthcare professionals.
Yeah, I really love beingupstream and downstream, so I
think you know it's reallyimportant to me to sit with kids
, with teenagers, young adults,and help them manage through
their difficult moments.
But I also think we can make amuch bigger impact helping other
providers to also be able to dothat.
Speaker 1 (17:43):
Yeah, so sometimes
through continuing ed.
But I know you also superviseother clinicians, so all that
type of stuff you're talkingabout.
That's the upstream, downstream.
Speaker 2 (17:51):
All the upstream,
downstream stuff, and I think
that as I get older, newergenerations come in.
It's also interesting becausethey come in with different
experiences, right, and so theirrelationship to things like
social media is different frommine and it's different from
parents.
And I think something that'sreally hard for parents are our
kids are having these novelexperiences we didn't have right
(18:14):
, right, and so we're trying tohelp them navigate through
situations to the best of ourability, without ever having
been in those same situationsourselves or really
understanding the impact of it.
Speaker 1 (18:24):
I always say that I
only have a couple more years
long before I'm relatable insports.
You know, like you know 18, 25year olds like they're going to
be, like what does a man want totell me about anything?
Speaker 2 (18:34):
You will be the
holder of the historical data.
Speaker 1 (18:38):
We're transitioning
together on that.
Speaker 2 (18:45):
Yes, yes, absolutely.
I think that that's anotherpiece of advice for parents is
to come in with curiosity.
There was a time where I couldkeep up on lingo kids use.
That time has long passed notjust because I've gotten older,
but because the speed that beingonline allows for the
dissemination of new language tobe out there.
I don't speak emoji, that well.
Speaker 1 (19:03):
I love speaking that.
Wait, do you know, darnie andDange, have you heard that?
Speaker 2 (19:08):
Yes, there is a whole
new language, but I would bet
money that the way you useemojis is very different than
the way we're teen-year-olds.
Speaker 1 (19:16):
And you would win.
Yeah, yeah.
Speaker 2 (19:17):
Well, and the reality
is it's hard to know what
they're communicating to eachother.
Amen, because it might mean onething for us and something
totally different for them.
And so coming in with curiosity, without judgment, with just
curiosity, can be immenselyhelpful in trying to-.
Speaker 1 (19:34):
Super helpful, super
helpful and super mindful.
Yes, that was a littlemindfulness.
We always talk about lead withcuriosity, so that's really
really good advice.
And also, you work on bullying,bullying, and has that changed?
Is that still something today?
Speaker 2 (19:51):
You know, I think
what has happened kind of in the
bullying sphere is there was atime where it became something
that everybody wanted to talkabout and when the pendulum
tends to swing in that direction, there's pushback in that
direction and I think,unfortunately, what happened is
the language of bullying wasused inaccurately and so kids
(20:11):
who were engaging in teasing orother unacceptable behaviors but
not bullying it was all labeledas bullying and so people got
sick of it and kind of felt likeit was ridiculous.
But if we're talking about truebullying, right, how we define
bullying, it has to meet certaincriteria.
Bullying needs to be betweenpeople where there is a
difference of power.
That power can be defined byage, by gender, by any kind of
(20:35):
majority group.
You're a part of right.
So there has to be some kind ofdifferential power.
It has to be repeated.
A one-time aggressive incidentis not acceptable, but it's not
bullying, right.
So it's repeated, it's unwantedand there's a difference of
power.
So the way that you can respondto bullying is handicapped a
little bit by the fact thatthere's a difference of power.
There's only so much you can dowhen you're in the less
(20:55):
powerful position.
So the way that I think socialmedia has really blown up Blown.
Speaker 1 (21:03):
Yeah.
Speaker 2 (21:04):
It's definitely been
a concern in the same way that
in real life.
So when I was working incertain areas, I was surprised
to learn that Halloween wassometimes a night for gang
initiations.
Speaker 1 (21:16):
Yeah.
Speaker 2 (21:17):
Because when you're
wearing masks and you are right
no one can see who you are.
It frees you up to do things ina way that you might not.
In other words, when you'reonline, you can be completely
anonymous and do and say things,or even, as yourself, not see
the reaction of the human infront of you in real time, which
might stop you pause.
You have you hold back a littlebit.
So I think that it's allowedpeople to be a little more
(21:39):
aggressive in their bullyingthan when they're in person, and
it also reaches a much wideraudience.
Speaker 1 (21:46):
Well, that's the
craziest thing.
I love that you just brought.
I mean, we just brought thattogether because I think that I
actually was giving a talk thisweek to a bunch of high school
parents of athletes and it waslike I was able to leave
bullying and feel safe at home.
You know, now you go home andit might still be there on
social media Like it's likeincessant, you know.
Speaker 2 (22:04):
Yes, yeah, and your
friends on your team, your
friends in your school, yourfriends in your camp, your
friends in your religioussetting.
They all see all of it.
They're no more.
This is, you know, the place Iget away from.
It Not only is a safe haven,but also where kids don't know.
It follows you everywhere.
Speaker 1 (22:25):
So I've learned a lot
.
This is super helpful.
I wonder, like are there anyother like last tools from your
toolbox that you might share forsome parents out there?
Speaker 2 (22:31):
Yes I would say don't
be afraid to have your kids be
frustrated with you.
It is okay to sometimes be themean parent.
So when we think about thingslike access to their phones,
it's okay to have them charge itin a public space at night,
downstairs in your house or in akitchen and not have it be in
their room.
It's okay to say you know youcan have access to these things.
(22:52):
I will be checking themperiodically and I will be
checking in with you about whatI see.
It is so important to model thebehavior we want to see, so
want them to be able to come offof their phones.
Sitting down to dinner togetherwith no phones at the table this
is a really beautiful way tosay we're taking a break from
phones.
I am too.
I'm not going to take workcalls, I'm not going to answer
(23:15):
anything.
This is a time.
It lets our kids know they'reimportant to us and it preserves
the space where we get to spendsome more meaningful time
together and it models for themwhat we want to see from them.
Speaker 1 (23:24):
Oh my God, so good,
so good.
That's the hope, yeah, I mean.
And yeah, and just tools likelittle small things you can
start with.
I love the phone out of the bed.
I always, I always say nophones in the bedroom period and
so everyone's like well, whatabout my alarm clock?
Buy an alarm clock.
Speaker 2 (23:40):
That's right.
What about if I want to listento music?
We were able to access musicbefore we had phones.
There are so many ways.
Everything your phone doesoutside of social media or
talking to somebody else, we canfind other ways to take care of
it.
Speaker 1 (23:52):
You can absolutely
find some other ways to take
care of it.
Dr Miller, thank you so much.
This was I mean, I love thisand thank you so much for being
here.
So where can people find you?
Speaker 2 (24:05):
you so much for being
here, so where can people find
you?
Yes, so the best way to find meis on our website, which is
wwwbehavioralpairnjcom.
Speaker 1 (24:13):
Wonderful.
So head to the we'll have thatin the show notes too because Dr
Miller is really truly a giftedprovider and just a wonderful
human being and so if you'restuck in that and kind of try to
find your way with yourchildren, you know she is a
place that can help you.
So, as you know, our May isMental Health Awareness Month
and our priority is to get theawareness out there of mental
(24:34):
health and that's what we wanteach time on this podcast.
Approximately one in five teensand adults are affected by
mental illness and it is amission to reduce my mission to
reduce stigma and promotesupport of this.
So there's also lots ofresources at NAMIorg and you can
learn more about that if youhave any challenges, to get some
additional support.
So again, thank you so much forbeing here.
(24:55):
If you like the show, pleaselike, follow and share.
Everything's atofficialdrpetecom and I will see
you next week where we do somemore talking about mental health
for Maine.
So until then, spread a littlekindness and stay well, thank
(25:18):
you.