hill.ellen Posted November 8, 2019 Posted November 8, 2019 Hi I have a three year old cocker spaniel who is very intelligent and friendly. She is good with people and other dogs but unfortunately she is terrified about being left alone. We have tried leaving her slowly, minutes first and then getting longer but as soon as we leave she howls. The longest we have left her is 1 1/2 hours but she howled the whole time. Any ideas?
Adrienne Farricelli Posted November 9, 2019 Posted November 9, 2019 Hello and welcome to the forums, Sorry to hear you are dealing with a dog who is terrified of being alone. Have you ever recorded her behavior when you are absent? If so, is she mostly howling or is she also pacing, panting, acting restless, drooling, having accidents in the home, scratching at windows or doors? Does she also act nervous when you start getting ready to go outside? Does she follow you from room-to-room? Also, is she showing this behavior only when you leave? When everybody leaves? Some dogs are attached to one particular individual, others do well as long as they have company. If she is suffering from separation anxiety and goes straight away to howling as soon as you leave, she may need a gradual behavior modification protocol. This would entail very gradually adjusting her to very brief absences (starting with sit/stays/ down/stays as you go to different rooms and then progressing to going out the door) ensuring she is under threshold https://www.braintraining4dogs.com/members/archive/threshold-levels/ without advancing to longer absences until she appears comfortable for that level of time. This might not be easy to implement if you work and don't have time for helping her adjust at her pace. You can find some examples of behavior modification protocols for separation anxiety in this thread: https://www.braintraining4dogs.com/forum/showthread.php?130-Thundershirt While many dog owners give their dogs a stuffed Kong or other goodie upon leaving, it's important to provide this regularly as well when you are relaxing at home, so that it doesn't become a clear predictor of you leaving and therefore losing its value. It's also important not leaving the dog alone for too long in the initial stages as this can undo any progress. Also, important is to mix briefer absences with the longer ones so that your dog doesn't get stressed in knowing that the exercise gets progressively more difficult. In some cases, dogs may need medications for their separation anxiety in order to pave the path for learning to take place. Working with a veterinary behaviorist may be recommended for some moderate to severe cases.
hill.ellen Posted November 9, 2019 Author Posted November 9, 2019 Thank you so much for your prompt reply. I will do my best to answer your questions to give you more understanding. My husband and I are retired so we are with the dog for the majority of the time so she has never been used to a regular routine of absence. She has always been upset when she is left her in the house alone even when we are working in the garden. She paces and howls if she loses sight of me through the windows. She will allow us to leave her as long as she is not alone but it doesn’t happen very often. On the few occasions when we have had to leave her alone for a short time we have videoed this and she paces and howls consistently. We tried to confine her to one room but that was worse as she was frantic and weed. We have consulted a behavior specialist who gave us a programme to follow similar to what you suggested leaving her for short intervals then progressively getting longer. She allowed the training to take place with praise and a treat but when we left the house she again reacted badly. She will ignore treats and Kongs when she is upset but is very responsive to treats with scent work and other training when we are with her. We have never tried medication preferring to try behavior modification instead. She will settle in her bed easily with us each day but tends to lack confidence when alone. She can’t find her own settle switch. Sorry this post was so long but I have tried to give you the full picture.
hill.ellen Posted November 9, 2019 Author Posted November 9, 2019 Since writing the above reply I have read through the links you suggested and I can see immediately that I need to start again with much more patience and understanding of her threshold. I will endeavor to follow your suggestions and let you know how she does. Thank you again for your advice, it is much appreciated.
Adrienne Farricelli Posted November 10, 2019 Posted November 10, 2019 Thank you for the details, they are very helpful! The fact you are both retired offers an advantage. Many people who work or are away from home a lot, struggle with behavior modification for separation anxiety because it requires gradually desensitizing to very brief absences. Indeed, to get started, they often have to start while on vacation and sometimes have to take time off work purposely for the task. In the meanwhile, they are often forced to hire a pet sitter or take the dog to day care (if the dog fares well with that-some do not), or if the dog does well being left with one owner, he or she watches the dog while the other owner is out and about. Many times when behavior modification for separation anxiety doesn't work it's because the dog may need smaller steps and a more gradual approach. It is important to prevent as much as possible rehearsal of the problem behavior as that causes stress and the fear of separation to intensify. Setbacks can be common if too long absences are started too soon. If she doesn't take treats when left alone, that is often a sign that she is over threshold. Slow and steady wins the race with these dogs. It also helps to raise these dogs' confidence with brain games and giving these dogs a routine which is reassuring to them.
hill.ellen Posted November 10, 2019 Author Posted November 10, 2019 Thank you for your reply. This morning I took her out for her normal walk and after a short break I started some basic training from your course. She took very well to the airplane game, the eye contact and touching the post it notes - all under 11 secs. So after another little break I went on to asking her to stay and moving away from her for very short periods. This all went well until she heard me open the door and she got up from her settle/ stay position to follow me so I went back to just moving around the house and that worked well, I will continue to lengthen the exercise tomorrow but a good start.
Adrienne Farricelli Posted November 10, 2019 Posted November 10, 2019 She sounds like a very smart girl eager to learn! Brain games (especially those that encourage her to play at a distance from you such as the Treasure Hunt game) and obedience exercises should help boost her confidence over time. Stays are challenging to train to dogs who want to always be around. These dogs need micro steps as often when we train these things we set goals that our dogs don't really understand. To us, being out of sight for 5 seconds is hardly any time at all, while to them, if they're stressed by their owners leaving, they're stressed whether it's 1 second or 1 hour. Desensitization exercises involving the door being opened/closed are likely needed, but we must gauge how she does carefully. If she follows you, it's sign she's not ready yet for that step, so we need to proceed at a slower pace maybe we can try just walking towards the door back and forth. It's good you went back to just moving around the house so to get her back to a more relaxed state. It helps to also teach them to lie on a mat away from us and our feet (many "Velcro dogs" like sleeping near our feet so that they can easily detect our movements). Separation anxiety is something that takes time to work on. Some owners see improvements in as little as 1 month others can take up to a year. The use of medication along with behavior modification is more likely to bring quicker results for moderate to severe cases.
hill.ellen Posted November 12, 2019 Author Posted November 12, 2019 Since my last post I have read a few of your posts and can see that she suffers from isolation anxiety rather than separation anxiety which is easier to cope with I believe. I have continued the small step training today and she allowed my to get to the door, go outside with me counting to 10, 20, 30 and finally trying 40 but then she was waiting at the door although not barking. She then ran back to her bed in the kitchen to get her treat - am I becoming too predicated? Just in case, I stopped the training, gave her praise and threw a few treats for her. She then settled down next to me for an hour or so. I think this could be progress.
Adrienne Farricelli Posted November 13, 2019 Posted November 13, 2019 If she was doing fine, but then at 40 she got up, most likely she's not ready for that length of time and/or she started predicting that the exercise was getting longer and longer in duration and started to get a tad bit worried. It's a good idea to sometimes mix in briefer "outings" within the longer ones so that she doesn't get increasingly worried about the exercise getting harder. Then, once the exercises get longer and closer to one minute, it helps to have her hold a down/stay on the mat or just keeping her free behind a baby gate with something tasty (to keep occupied, but also to make great things happen contingent upon you leaving) as explained in step 3. If she won't eat, it means that she isn't still comfortable enough, and needs to be worked at a slower pace). Always good to end the exercise on a positive note. You can also end a session by giving her a stuffed Kong to enjoy on a mat so to encourage a bit of independence rather than settling right next to you.
hill.ellen Posted November 13, 2019 Author Posted November 13, 2019 You are definitely right about her predicting the time as she seems to know when it is a training exercise rather than the real thing and will allow me to go so far and then she gets worried. She has never taken to a Kong as she doesn’t seem to be able to get the treats out and then she gets frustrated and barks at it! I will mix it up and slow it down today.
Adrienne Farricelli Posted November 14, 2019 Posted November 14, 2019 (edited) With Kongs, it can be a bit tricky for some dogs. I wished they had some instructions included because several dogs I boarded and trained had problems with Kongs as well initially. I had to make them really really easy to "de-stuff' at first, until they learned to enjoy the challenge. At first, I would just put a little smear of plain canned pumpkin (not the pie mix) right on the edge, then I would progress to put a little more on the edge and inside easily in reach, and then moved on to placing some kibble inside (which was loose and easy to get out) and only after some time I would start adding inside some pumpkin on the bottom topped with kibble and then finally cookies on top of it all to work out. A Kong Wobbler may work better for some dogs as they are easier to empty since all the dog needs to do is just to nudge it around and/or paw it. Even with this, I had to sometimes teach dogs how not to get too frustrated by simply tossing treats in the dog's direction when he or she managed to tilt it. Making it extra full helps the kibble come more easily out. But then, dogs with separation anxiety or separation distress may not be yet relaxed enough to lie down and work on something that keeps them occupied so I would take that as a sign that she is still somewhat over threshold. I would experiment with a variety of food options and gradually increase the challenge. With a dog I had with pretty severe anxiety, I started with treasure hunts. I would start to toss treats/kibble around the room in a treasure hunt style --see here: https://www.braintraining4dogs.com/members/brain-training/elementary/the-treasure-hunt/ and tell the dog to "leave it" until I opened the door and said "go!" This built enough anticipation and the dog had fun eating and I would count how long I would expect him to eat it all and return just as he was finishing up. The goal of this was that great things were happening contingent upon my leaving, then once I cam back, things got boring again. It took some experimenting to find treats that were high value enough for him to feel like eating and he wouldn't eat at first the longer lasting treat (a bully stick) but after a few days, he started enjoying that as well. Let me know how things progress in the next few days. Edited November 14, 2019 by Adrienne Farricelli
hill.ellen Posted November 15, 2019 Author Posted November 15, 2019 Hi not a great day today. She had her walk and a treat while I was grooming her then I needed to do some work in the garden where she could see me. I asked her to settle in her bed in the kitchen and moved outside. She started barking at the window but not howling as she would do when I leave. She continued to bark so I ignored her and when she became quiet for a few seconds I praised her but she then started again. I took this as her being demanding as her bark was different and not as distressed. When I eventually came in she settled down and relaxed. I did a small amount of brain training and treasure hunt games with her during the afternoon and she was fine although she is still following me everywhere even when I try to change direction and purpose to distract her it rarely works.
Adrienne Farricelli Posted November 16, 2019 Posted November 16, 2019 (edited) Thanks for the update, If she was struggling with your brief desensitization by the door exercises, going out in the yard without her could have been too much, but this is not surprising in a dog with anxiety. It is also important to do the desensitization exercises by the door that leads to the yard if you haven't done that yet. You would do the same exercises as you do with the front door. However, it would be important to to not expose her to situations she's not ready yet that trigger anxiety, so it would be best when you are not doing the exercises if another family member can be with her while you work in the yard. However, if she usually howled and now is barking, it could truly be you are dealing with some frustration rather than whole full-blown anxiety which is quite different (and can be a sign of improvement). The fact she sees you through the window can make it extra tempting to be by your side and causing her to protest about not being taken along. It can get really frustrating for them because if they are taken sometimes out in the yard and other times not, they struggle with this inconsistency which triggers barrier frustration. Most dogs love to spend time in the yard, especially when their owners are out with them, so it feels like a double whammy sort of punishment (being away from the owner, not taken out in a fun place) from their perception. In all honesty, even dogs who don't have separation anxiety struggle when their owners work in the yard without them and they see them through a window. If therefore you want to tackle this form of barking, as mentioned it helps to do the desensitization exercises here too. Start with very short absences and increase gradually over time (mixing in some briefer times), preventing your dog as much as possible from getting stressed. Use high-value foods to give during your absences and keep working until she learns to better cope with them, but this can take some time to accomplish considering that the desire to be out in the yard with you is very strong. And when you don't do the exercises, having her with a family member who keeps her busy in a different room (so that she doesn't see you through the window) can help a lot. It can even be made into a fun routine she might look forward to eventually with practice. As you get ready to go out in the yard, your family member prepares some brain games or gives her an easy food puzzle to solve. Once you come back, the exercises are done (you can schedule your return right when she has finished her food puzzle). I have used walkie-talkies for this task (asking my helper if the dog is almost done eating so I could strategically return with good timing). After some time, the helper/family member can also be gradually "weaned" meaning, he might get up briefly to leave the room while the dog is occupied so to gradually have the dog depend less and less on his subsidiary presence too. Is she still follows you everywhere, you can also remove value to her following. I do this by starting to walk randomly in circles or back and forth until the dog gets tired and then I go about with my duties once the dog has given up. Dog goes back to following? I resume my aimless wandering. I don't want to have a dog always underfoot to control all my moves in an obsessive/anxious manner, no thank you, I don't need a shadow who may also become a tripping hazard. It can take a little bit, but most dogs grow bored of this and get the idea. It can help to praise your dog once she gives up and even walk to her and hand feed her a treat if she settles nicely, but be careful to do this very calmly, as you don' want to trigger her getting up again and being back to following you around-- but even if does happen, worse comes to worse, another rep of aimless wandering should help settle her again. Edited November 16, 2019 by Adrienne Farricelli
hill.ellen Posted November 16, 2019 Author Posted November 16, 2019 Hi today I put some of your points into practice and saw an improvement. I varied the time intervals mixing up long and short stays out of the front door and got up to 50 with her staying quietly in her bed then I went out the back door and walked past the window and although she was looking puzzled she stayed until I returned after a few seconds. I worked at moving around randomly when she followed me but I have to admit I gave up before she did but later in the day when I went upstairs she followed me to the foot of the stairs and waited for me to return knowing that I was going nowhere. It felt like progress today.
hill.ellen Posted November 16, 2019 Author Posted November 16, 2019 I am so delighted I had to tell you how she did tonight. I took your advice and randomly moved around in circles for almost half an hour and she was perplexed. She laid down next to the door waiting for me to leave the room but when I sat down for a short time she gave up and settled back in her bed. I got up again and she followed so I did the same random circling. She gave up before me and settled down. The third time I got up - now over an hour since the first time, she didn’t even look up never mind get up. So happy with her response. I am looking forward to more fun tomorrow - thank you.
JMFS Posted November 17, 2019 Posted November 17, 2019 That's Excellent progress! I did something similar with Gertie. She started by my side in the kitchen and I have a strict No Dogs in the Kitchen rule. With practice I got her to stay at the end of the cabinet, but every time I went into the pantry or mud room to get something she'd hop up and trot over to be by my side. Repeated trips to the pantry and then practice with the mud room in a short time with Nothing of interest happening (and me not disappearing) she now chills out at the end of the cabinet as I scurry about the kitchen areas and out into the mud room. We've even transitioned from barricading her behind a modified Ex Pen to letting her hang out in the bedroom while we're out. I hope to expand her domain while we're out, room by room so we can eventually let her roam the house. My husband built the house to where Every last room can be cordoned off, except the kitchen into the living room. There's not even a good way to position a baby gate to close those rooms off from one another. Ah well, next house. :D Anyway, I'm enthused to have read about your progress. You're Really working with her to get such great results in so short a time. Pat yourself on the back because you deserve it - this is Not an easy issue to conquer and you're dominating it. :)
hill.ellen Posted November 17, 2019 Author Posted November 17, 2019 Thank you. I feel I am going very slowly but it is amazing how she can change so quickly. We should never underestimate their abilities. Today she went into another room and had a quiet half hour away from me. This is something that she rarely chooses to do and I am hoping it might be as aresult of the previous day’s training- let’s hope so.
Adrienne Farricelli Posted November 18, 2019 Posted November 18, 2019 Glad to hear you are seeing progress! With dogs who get anxious when we are away, we want them to learn better cope with our absences-even if very brief. We do this mainly through behavior modification using desensitization and counterconditioning. These terms just mean that we take baby steps to desensitize them (make less sensitive) and carefully gauge for signs of going over threshold (panting, whining, pacing, drooling, eliminating) suggesting we have pushed them too far. If we go too fast and expose dogs to situations they're not ready for, we risk sensitizing them (make more sensitive) because we are just convincing them that they are right to be anxious as we are exposing them to the absences they so deeply fear. The whole process obviously takes time and setbacks can occur, especially in those cases when we have no way to prevent them from being left alone for longer than what they are comfortable with (which is why it's best leaving them with a family member or other care taker initially for longer absences). On top of baby steps, we want to also insert counterconditioning which aims to change the dog's emotional response. From being overly concerned and anxious we want the dog to learn to relax, or at least better cope/tolerate when we are away. There are certain emotions and things dogs do that are on the oppositive spectrum of feeling anxious. For instance, dogs are unlikely to eat/play/sleep when they are nervous. So if we can expose them to very small absences and get them to eat or play with a toy that dispenses food, that's a little step in the right direction to help change over time their emotional responses. In a dog capable to hold a sit/stay and fluent with the "leave it"cue, I personally like to build anticipation so I would toss several treats on the ground while the dog holds the sit/stay and say "leave it" and release him to "go eat!" as I go out of sight for the duration of the dog eating the treats and then would come right back. The aim of this is getting the dog thinking "when my owner leaves, wonderful things happen." It also helps to gauge how the dog is doing. Is the dog eating the treats eagerly? Is the dog eating only the easiest treats to consume leaving behind those that take more time to consume? Is the dog eating quickly but nervously? Does he eat and then go straight to looking for me? Or does he sniff around in search of some crumbs or a stray kibble? I like to record the dog's behavior during my absence and his eating style from which I can deduce some info on his emotional well being. In a dog in the beginning stages of training (with not a great sit/stay and "leave it") I would prepare a muffin tin filling the holes with some smelly treats or some other irresistible foods and let the dog watch me prepare it. I would then place it on a tall table (if the dog is small), extending a bit towards the edge. The dog would normally stick around the table and perhaps start whining or even try to stand up to look at it or catch a whiff with his nose.That's fine: I'll take a dog who is a little impatient over suffering from the stress of full blown separation anxiety any day (we can always work on better impulse control and a good "leave it" later, which is much easier to work on). Once enough anticipation has built up, I would lower the muffin tin and let the dog enjoy the goodies within as I step quickly away. If the dog starts eating, fine, but if he starts eating but then tries to follow me as soon as he notices me leaving, I will remove the muffin tin and try again (and I may try to increase the value of the treats further or make them easier to access, maybe smear something to lick on the tin such as a bit of cream cheese (if the dog tolerates it) or peanut butter (careful with the sugarless types which contain xylitol, very toxic to dogs). After another trial or two, most dogs will start eating as they'll learn that access to the goodies happens only when I leave. Another version of this is for dogs who don't mind crates. I will place a bowl with some lip-smacking goodies inside the crate with the door locked and the dog outside. I will allow some anticipation to build up (even a bit frustration with the dog possibly pawing at the crate/ whining) and then I will approach the crate and open it and then leave briefly and wait till the dog is expected to finish and return. I can do this by using remote monitoring, watching from a distant window or placing a mirror that allows me to see the dog without him seeing me. If the dog struggles with this, off course, will re-evaluate what can be done next, such as split these exercises into smaller steps, increase the value of the food, and sometimes consider whether a calming aid (or prescription meds from a vet) may be needed for lowering that anxiety just enough for the dogs cognitive functions to open up and learning to be able to sink in. Moral of the story? Lots of baby steps and make great things happen contingent on your departures. Back to your case, if she slept in another room, I take that as a positive sign that she's likely starting to learn to relax despite you not being there or she can be tired from all the extra training and brain games or likely a combo of the two. Keep up the great work! As absences progress gradually(always mixing in briefer ones) there may come a point where the use of technology may come handy. Remote monitoring with a nanny cam or a Furbo camera (which offers the advantage of tossing treats) can help monitor the dog to gauge comfort levels and make adjustments to the plan as needed.
hill.ellen Posted December 29, 2019 Author Posted December 29, 2019 Hi I can’t believe a month has passed since I started the exercises and unfortunately I have to admit with so much going on I have made little progress since November. However I am determined to get back in the saddle. However I discovered a new problem over the Christmas period which may or may not be related to her inability to relax. This came to light when we had friends visit with their older labrador. Belle, my dog, was not happy with the situation having the other dog in her space for three days. Her routine was thrown completely and possibly due to inconsistency and confusion over rules regarding food as the other dog was allowed to beg at the table whereas we have never allowed Belle to do this and it caused great problems between them. So much so that Belle started to growl and block when the other dog approached. It was difficult to know how to handle this situation as the other dog was larger but also more dominant but not aggressive so it was Belle who was marked as to blame and troublesome.Do you have any suggestions as to what action I should have taken to defuse the situation.
Adrienne Farricelli Posted December 30, 2019 Posted December 30, 2019 (edited) Hello, In such a case where the guest dog is staying only for a few days and the problem happens only in a specific circumstance (in your case, contingent upon food being on the table) , management may be best way to tackle the issue. In other words, we would keep the dogs away from the table area since it evokes unruly begging behavior in the guest dog and growling along with body blocking in your dog. A good set up may be therefore to erect a barrier by the dinner table (or dining area altogether) such as a baby gate or pet gate (if both dogs don't mind being together) or having dogs down/stay on their own mats (if they are trained to do so) or just keeping the dogs in different areas (so nobody gets upset). When new dogs visit the home it can be a highly stressful event for some dogs. You can try to keep your dog's routine the same if time allows and reassure her every now and then that she is always your favorite despite this other dog visiting and acting as if he owns the place. It therefore helps to not give any attention to the guest dog (no talking, feeding this dog, petting in her presence) and preventing putting Belle into situations that cause her to negatively react emotionally. I am glad you are determined to keep training Belle. The festivities surely can put a dent in many things (like diets and exercise programs!) on top of dog training goals. May the New Year bring more progress! Wishing you the best, Adrienne Edited December 30, 2019 by Adrienne Farricelli
hill.ellen Posted December 30, 2019 Author Posted December 30, 2019 Thank you so much for your response and reassurance. I have to admit that the situation worried me and I feel happier with your answer. The feeding at the table was embarrassing as it is difficult to suggest to another dog owner that they should change a routine but I did suggest that the owners sit at the opposite side of the table so both dogs were by their owners and neither able to see that the feeding from the table while the other slept. Unfortunately the problem worsened when the grandchild arrived and usually both dog and children are very close but once they gave attention to the guest dog Belle reacted badly and I had to put her out of the room for everyone’s safety. Once again I didn’t know whether she was protecting them, was jealous or trying to send a message to the guest dog who seemed oblivious to her signals. Once the guests left she reverted back to her routine and slept for most of the day as if mentally challenged by the whole situation. Do you think after a little while we should invite other dogs to the house to ascertain whether it is all dogs or this one in particular that causes the problem? I feel it is all to do with her inability to stay under her threshold and remain balanced and calm.
Adrienne Farricelli Posted December 31, 2019 Posted December 31, 2019 "Do you think after a little while we should invite other dogs to the house to ascertain whether it is all dogs or this one in particular that causes the problem? I feel it is all to do with her inability to stay under her threshold and remain balanced and calm." Here's the thing: dogs who live as the "only dog" may find it stressful to have other dogs abruptly land into their household. Of course, this doesn't apply to all dogs, some dogs are impacted more than others. It's somewhat a similar experience to the "only child" who must suddenly learn to live with a new sister who will get lots of attention and with whom she may need to share toys and living spaces. From a dog's perspective, this change in their environment is not easy, and it takes a period of adjustment. Some dogs may hide from the other dog, some others may get upset by this new "intrusion." For this reason, when a new dog is brought into the household of an "only dog" a variety of steps are taken in hopes for a smooth transition. The two dogs are introduced on neutral grounds, then they are walked together, and once home, introductions are done very gradually, over the course of several days. The new dog during this transitional time is ideally kept in a neutral area along with toys, blanket and other necessities considering that placing the new dog in an area that the resident dog considers highly valuable can trigger conflict. Areas of high value include bedrooms, areas where owners spend a lot of time and favorite resting areas. If the new pet is allowed access to a highly valued area and the resident dog feels excluded, this can trigger anxiety and possible conflicting situations. Of course, at some point the new dog will need to be introduced to new areas of the home, but once again, this is done very gradually, as the resident dog gets used to the new dog's sight, smell and vocalizations and is in a more relaxed state. Now, this is just an insight into what happens when a new dog must be introduced into the household and is expected to become a permanent member of the household. With visiting dogs, things get tricky. There is not enough time to acclimatize the two dogs, and the resident dog may get upset by this intrusion. For this reason, since guest dogs are only occasional, the best thing to do would be to just manage and keep the two in separate areas so that there are no hard feelings, preferably keeping the guest dog away from highly valuable areas or valuable people. There is really no way to predict if your dog would act the same way with other dogs visiting the house as this depends on many variable. Perhaps, things may go well if the other dog acts less intrusive, is more shy and respectful of your dog's body signals, but it might not be worth trying just to keep things safe and prevent unnecessary stress. Of course, for longer stays, it may be worthwhile doing the whole gradual introduction and see how things go proceeding gradually paying attention to your dog's comfort levels. If your dog is prone to resource guarding though, behavior modification with the help of a professional may be needed.
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