Summary and Response to Treating Scrupulosity in Religious Individuals Using Cognitive-Behavioral Therapy

 anxiety, ocd, scrupulosity  1 Response »
May 142013
 

Introduction

This is a summary, select quotations, and responses from myself to Jonathan D. Huppert and Jedidiah Siev’s article “Treating Scrupulosity in Religious Individuals Using Cognitive-Behavioral Therapy” as published in Cognitive and Behavioral Practice 17 (2010) pp. 382-392.

It is perhaps the best article I have read for practitioners or patients on the treatment of scrupulosity.

The Meat

  • “Treating religious patients with scrupulosity raises a number of unique clinical challenges for many clinicians. For example, how does one distinguish normal beliefs from pathological scrupulosity? How does one adapt exposures to a religious patient whose fears are related to sinning? How far should one go in exposures in such cases? How and when does one include clergy in treatment?” – pg. 382.
    • As someone who suffers from scrupulosity this issue of discerning what is normal belief and what is pathological is very difficult, and is (from my perspective) what sets scrupulosity apart from other forms of OCD – in which the individual is generally aware of the unreasonableness of their actions.
  • “…the presence of religious symptoms in OCD predicts poorer treatment outcomes according to some studies (Alonso et al., 2001; Ferrao et al., 2006; Mataix-Cols, Marks, Greist, Kobak, & Baer, 2002; Rufer, Grothusen, Mab, Peter, & Hand, 2005) but not others (Abramowitz, Franklin, Schwartz, & Furr, 2003).” – pg. 382.
    • I’d like to read more on this, as my personal experience is that my more generic OCD symptoms respond well to medication but scrupulous symptoms are much more resilient. I have not experienced ERP, other than self-instituted.
  • “…healthy members of the religious community, including clergy, may inadvertently reinforce rituals by offering reassurance or expressing admiration for the rituals, a process somewhat analogous to the positive reinforcement received by individuals with eating disorders for losing weight.” – pg. 382.
    • This is very true and one of the challenges for all ministers. Interestingly, Dr. Ian Osborn in his book Can Christianity Cure Obsessive-Compulsive Disorder?  suggests the prevalence of OCD in contemporary society may be the result of changes in society, meaning that this problem may not have been as rampant before 1500 or perhaps 1000 AD. I’m unsure that I agree with this hypothesis.
    • It should be noted that clergy have not always been unequipped to deal with scrupulosity. While the techniques may have at times been primitive, soul care in church history has provided for the care of the scrupulous, it is more recently when Christianity cut itself off from much of its history that these methods where lost.[1]
  • “Hence, although the choice of exposure and response prevention (EX/RP), a first-line treatment for OCD, is indicated in the literature for treating OCD…, its implementation for religious patients with scrupulosity necessitates nuanced modifications…” – pg. 382.
  • “The core fear across religions within scrupulosity is related to a fear of sinning. At the same time, the typical manifestation of scrupulosity differs by religion. Whereas displeasing God, going to hell, and devil worship are common obsessional themes among scrupulous devout Christians…, especially born-again, Protestant, or Pentecostal, obsessional themes among scrupulous ultra-Orthodox Jews more closely follow the forms of general OCD themes, such as contamination/washing and doubting/checking… For example, a patient may fear contamination and wash excessively, but in the case of scrupulosity, the feared contamination is religious (e.g., dietary or menstrual impurity, cleanliness before prayer).” – pg. 383.
  • “…how does one distinguish OCD from strict, devout observance?…The most straightforward, obvious answer is by asking the patient whether others in their religious community have the same beliefs and behaviors.” – pg. 384.
    • This is very useful. In general the individual will be practicing beliefs in a way not practiced by others – even if they are in a strict / legalistic religious community[2]. One difficulty though is that some practices are not well-known as to frequency. For example, who prays and how often do they pray and what do their prayers consist of?
  • “Our stance (once OCD is clearly identified as the main presenting problem) is that OCD attaches itself to each individual’s most important or core values, but is not caused by those values (cf. Rachman, 1998). Thus, the fact that they have scrupulosity and not a fear of contamination or of being responsible for something horrible happening like a house burning down is because they view serving God and adhering faithfully to religion as high priorities.” – pg. 385.
    • This is comforting. For the scrupulous our fears oftentimes circle around whether we are doing what is appropriate/necessary/good in our relationship with God (which I usually counter by emphasizing God and His grace/power). Yet, still, it is comforting to think that the reason I struggle with these doubts is b/c OCD centers on what is core to my life.
  • “They include the idea that OCD fears are not latent desires to be an apostate; to the contrary, they are OCD’s method of turning the patient’s own core values against himself or herself (the response to which—as in judo—is to harness the power of the attack against the aggressor; in the case of OCD to accept the thought. That is, to say to oneself, “I accept the risk of this sin,” thus not engaging in a mental battle with the OCD).” – pg. 385.
    • In my case I suppose this might look something like, “I accept the risk that by not entering into single-focused prayer[3] I am disappointing God.” The good news for me is that while I may disappoint God, God is bigger than me and saved me in spite of, not because of who I am.
  • “This distinction between true awe of God accompanied by a desire to serve Him versus obsessional fear of God resonates well with many patients. According to most religious systems, the service of God is not supposed to lead to suffering, but to a sense of peace, connection, and fulfillment. The extent to which a patient’s experience is inconsistent with this can indicate that religious awe—and even fear—has been appropriated by OCD.” – pg. 385.
    • I disagree with the statement that “the service of God is not supposed to lead to suffering” but agree that it should lead to a “sense of peace, connection, and fulfillment” – I do not think these are mutually exclusive. Suffering is a significant part of the Christian’s experience as we resist temptation and experience God’s refining fire at work within us, healing us and making us whole.
    • On the other hand, I do agree that I can see my OCD is self-centered…That is, it focuses on my self and what I need to do to make things better rather than upon who God is and what He is doing in my life. I unthrone God and throne myself in a very subtle way. I also lack the ability to truly demonstrate love and care for those around me…so while I may avoid most sins of commission, I am greatly offending in sins of omission.
  • “…it is best to avoid antagonizing religious individuals with concepts that they may find counter to their belief system, such as the evolutionary function of anxiety. Instead, one can discuss what function anxiety serves, or why God created people to experience anxiety.” – pg. 385.
    • YES! The theory of why we have anxiety from an evolutionary perspective is not necessary to treating anxiety and is a significant stumbling block for many Christians.
  • “…explaining the effects of thought suppression is extremely important, with particular implications for many religious individuals. The patient may resist exposure to thoughts deemed unacceptable on religious grounds; however, by accepting them and allowing them to exist in his or her mind, the patient will actually reduce the long-term frequency and intensity of such thoughts (e.g., blasphemy).” – pg. 385.
    • This is akin to the old joke, “Don’t think about purple elephants….What are you thinking about?” (Purple Elephants). When we focus our attention on not thinking about something, we automatically draw it to mind. I oftentimes occur thought replacement – focusing on something else instead of the negative thought (e.g. moving from contemplation of my sinfulness to God’s glory and grace). I hypothesize that this is not always possible however and sometimes accepting the thought may be the only way forward.
  • “At first, the prospect of accepting sinful thoughts seems at odds with the notion found in many religions that they should be stopped or annulled, and generally we find it unhelpful to attempt to dissuade patients who believe otherwise that thoughts are morally inconsequential. Indeed, there is some evidence that religiously normative beliefs about the moral importance of thoughts are unrelated to OCD (Siev, Chambless, & Huppert, 2010). Rather, we encourage patients to consider the differences between intentional and unintentional thoughts, and between intentional thoughts for the purpose of enjoyment and those for the purpose of treatment (i.e., exposures).” – pg. 385.
    • The problem here, from my perspective, is that we (the scrupulous) underestimate rather than overestimate the sinful nature of our thoughts. Our thoughts are much worse and our minds more depraved than we imagine…while this thrusts us initially into despair, it also free us – b/c we recognize that God is the only means by which we can be freed of them and our own petty attempts to free ourselves are not working and will not work.
  • “Overcorrection is an important EX/RP technique. By tolerating more extreme exposures than are necessary in typical daily living, patients provide themselves with room for backsliding without impact on functioning, and more importantly, conservative tests of the likelihood of their feared consequences coming to fruition.” – pg. 386.
  • “Knowing that a patient washes or checks is insufficient to design effective exposures, for which one must understand the core fears and the function of the rituals at the most basic level possible.” – pg. 386.
    • This is something I have thought of in other words, but which appeared fresh to me as written here.
  • “How does one encourage a religious patient to accept the risk of sin?…we make a clear distinction between risking the possibility of sin with normative behavior and purposefully sinning. The former is a natural part of life—one cannot live life without some level of risk—and in EX/RP we increase the level of risk without going to the point that the level of risk is forbidden by religious law…we do not believe it is of value for a therapist to encourage a religious patient truly to sin or even to say “I am sinning” while taking a risk.” – pg. 386.
  • “Even this approach is not readily accepted by all devout patients. Some argue that living a religious life requires avoiding not only sin, but any behavior that approaches sin. There is Talmudic precedent, for example, to set up boundaries and fence-laws to distance oneself from sin (Mishnah Avot, 1:1).” – pg. 386.
  • “If necessary, the therapist can try to establish that for individuals with OCD, distancing from sin has become a goal in its own right, ironically more than serving God, and therefore tolerating acceptable risk of sin facilitates the service of God.” – pp. 386-7.
    • Very true.
  • “…most religions have a concept of forgiveness for sins, which inherently suggests that one will inadvertently sin.” – 387.
    • Yes, though I am not sure this is particularly helpful to the scrupulous. I know that Scripture indicates that I will sin, that I am not perfect but am being perfected by God, yet the question that always haunts is, “Am I willingly giving in to this sin?” At some level it seems that I must be willingly giving in to the sin…so I am not sure I can see it as an “inadvertent sin.” Again, this is depressing but also freeing – in that I am again pressed back in dependence upon Christ rather than myself for justification and perfection.
  • “…it can be more effective to evaluate the relative value in (a) striving to achieve good acts and a positive relationship with God and to religion by accepting a risk of sin, versus (b) excessive and distressing pursuit of absolute avoidance of one sin at the expense of other sins or opportunities for positive religious experiences (e.g., excessive ritualistic prayer interfering with religious study or at the expense of helping others).” – pg. 387.
    • This echoes my thoughts on the commission of sins versus the omission of sins and that it can be demonstrated to the scrupulous that they are entering into more sins of omission by embracing their scrupulosity than they would otherwise commit actively.
  • “Imaginal exposure is particularly indicated when OCD fears are difficult to confront or disconfirm in vivo, and can be helpful in treating scrupulosity in general, and in leading patients to tolerate acceptable risks. In such cases, the goal of the imaginal exposure is to create scenarios that depict engaging in relatively low-risk behaviors that end up causing extreme consequences. For example, one might create a script in which the patient refrains from cancelling a negative thought with compulsive prayer, opting for the long-term goal of satisfaction with life and religion instead of compulsive behavior to neutralize the risk that the thought was truly sinful. The scenario would continue based on the patient’s idiographic fears—that eventually the community rejects them for being evil, that they die and are judged to damnation for not having repented for that one thought, or that the decision to risk sin initiated a downward spiral into a life of sin. Conducted as such, imaginal exposure is an exposure to the feared consequence, but also a means for experiential cognitive challenging. In the context of imagining the consequences of sin, the patient may recognize their efforts to avoid even the possibility of inadvertent sin as excessive or inconsistent with their religious beliefs.” – pg. 387.
    • I wonder, do those without OCD/scrupulosity feel the same anxiety as I (and I suspect other scrupulous individuals) feel when simply reading this?
  • “…outside the context of treatment, clergy can inadvertently or unknowingly make recommendations that perpetuate a religious OCD patient’s anxiety. Unhelpful responses from clergy include telling a patient that they will burn in hell for evil thoughts that must be purged, suggesting that more meaningful or intensive prayer or study of their religious canon will reduce intrusive thoughts, stating that psychologists have no business dealing with issues related to spirituality, suggesting rituals to cancel intrusive thoughts…, suggesting that the patient is correct in not taking risks of sinning, and encouraging overt avoidance. In other cases, the clergy provides direct reassurance in a way that facilitates the vicious cycle of obsessions and compulsive reassurance seeking.” – pg. 387.
    • It is important for us as ministers to humbly engage those we are ministering to. It is too easy to apply blanket methods of interacting with those struggling spiritually, whereas each individual requires the unique ministry God allows us to provide via the power of His Holy Spirit.
    • If we are good listeners, I think we will hear many of the subtleties in folks problems and more readily address the problems they are actually facing rather than the problems  we project or infer upon them.
  • “To whatever extent possible, we encourage the patient to stop asking any questions related to their OCD concerns and instead to accept the doubt…” – pg. 389.
    • It is important for a minister to refuse to enable the scrupulous. Not only can this consume all the minister’s time, but it will have no beneficial patient (other than some short-lived and ultimately negative relief).
  • “Sara reported that she understood that she needed help, although at many times she wished she just were not Jewish, in which case she would not have such problems.” – pg. 389
    • I can echo that. “If I was not a Christian I would not have to struggle with not…”
  • “The therapist asked the patient whether (a) others agree that such risks are forbidden, and (b) whether there were other things she was not doing that were preferable to continual cleaning and washing rituals.” – pg. 390.
  • On pg. 390 the authors discuss constructing a fear hierarchy in which we rank how severely each potential action or thought causes anxiety and then attempt to battle these thoughts/actions. This seems like a very useful tool in treating OCD generally and scrupulosity specifically.
  • “These instructions shifted the burden of proof from demonstrating that something was permissible (e.g., via consultation with the rabbi) to demonstrating that something was questionable before asking.” – pg. 390.
    • This goes along with the Ten Commandments for the Scrupulous.
  • “It was communicated that she needs to learn to “trust her soul” (i.e., to trust her implicit intuition) and not seek explicit reassurance by asking questions, checking, washing, or mental reviewing.” – pg. 391.
    • I am not sure I would want to use the phrase “trust her soul” but rather “trust God.” The scrupulous attempt to remove all doubt – but their is always doubt and risk. This may in part be a failure to trust oneself (as created in the image of God) but also is a failure to trust in God (who created us and will communicate us in strong enough means to exemplify His message).
  1. [1] I am not suggesting that we should follow all the traditions of the ages, but I do think that it is a mistake to write off what has been learned in prior generations. ↩
  2. [2] Though if the leader(s) of the community are scrupulous, it is possible that they will only be matching the intensity of the religious community. ↩
  3. [3] By this I mean prayer in which my sole attention and energies are focused on prayer, not the “always” praying that many others think of, which to my scrupulous mind oftentimes seems too close to “not praying.” ↩

Another Holiday, Another Heart Attack.

 anxiety, depression, ocd  No Responses »
Mar 292013
 

I’ve been doing really well as far as my anxiety, depression, ADD, stress levels, and so on go since leaving Cairn Univ. at the end of January and launching full-time into the pastorate. There are numerous reasons for this including a significantly reduced workload.

In any case, this last week has been rough. Charity casually remarked, “Makes sense, its another holiday.” It is true, the last time I was panicking this badly was over Christmas. I’m interested to see whether on Monday or Tuesday everything has cleared up.

For the time being not only has the anxiety and depression been back but the chronic pain in my legs has flared up as well – are they related? Not sure…Only time will tell.

What Makes Me Anxious.

 anxiety, depression, ocd  No Responses »
Aug 142012
 

I’m feeling a good bit of anxiety right now. I don’t express it, I kind of stuff it down. Some would tell me that I should express it – and I suppose that is what I am doing right now…but I think sometimes folks don’t understand the nature of this pathological anxiety. Some folks experience a lifting of their anxiety, a relief, a sort of calm when they share what is going on inside of them…me, well, maybe sometimes I feel that but a lot of the time, I just keep feeling the same way even after sharing.

It makes me think of one good friend in particular who struggles with anxiety. This individual will ask for reassurance about the same topic repeatedly – every few minutes, over days, and months…and when the issue finally resolves itself another anxiety pops up to take its place and the cycle repeats itself.

No matter how much reassurance I or anyone else may give this individual it is never enough and can never be enough…sometimes that is how I feel.

My brother, Paul, is getting married soon and asked me to be his best man. I said yes, of course, and am completely honored – but, I feel anxiety pulsing through my veins. Then there is the couple I’ll be marrying soon – now I ask myself where the blood is, as it is evident that only anxiety could be pumping through me.

Don’t get me wrong. There is nothing I want to do more than serve as my brother’s best man and marry this couple. I sometimes don’t want to share these anxieties b/c I know that then sometimes people won’t ask me to do something for them like this – and I don’t want that to happen. For all the pain and anxiety I experience, I still want to live and to give…and I would be deeply saddened if someone didn’t ask me to be their best man or to marry them b/c they were worried about the pain and anxiety it would cause me.

I think I’ve gotten fairly good at saying “no” and “I’m not able to.” I’d much rather folks asked me and I had to say no, than for folks to try and save me from the pain and anxiety by never asking in the first place….and realistically, if I avoided everything that stressed me out and made me anxious, I’d just stay inside all day and do absolutely nothing involving other people…and I don’t think anyone wants that (I don’t).

Tangentially, if folks began doing this (or are doing this), it is unlikely that they are avoiding asking me for stressful things…b/c not even I can predict what will cause me anxiety or grief…and oftentimes what seems minuscule will be a bigger issue than some major stressor.

(big) Stuff that freaks Charity (my wife) out I am able to take in stride, but minor little items sometimes send me into a complete psychological paralysis…

….I think I am about to get my two good hours out of today. It has been rough being physically sick in addition to psychologically ill. Usually I can work for two hours at a time (when I am struggling only psychologically) and then need a break…but now, I find myself with two hours in an entire day. Interestingly, the more ill I feel physically oftentimes the less ill I feel psychologically. I think my bodies’ concern for my immediate physical health overwhelms all senses regarding emotional health.

And now I remember why I began writing this post…after having strayed so far. So I know one of the things that causes me anxiety is when I need to think about something intently (e.g. bachelor party). I want to think about it, but as soon as I begin thinking about it I feel anxiety, depression, and cerebral fog settle in. Then I push it off only to increase the anxiety by lessening the period in which I have to prepare such and such.

David Allen’s book Getting Things Done has been very helpful in this arena as has Asana which has helped me practically implement GTD. I’ve also read several good books on ADD – which appears to be part of my issue in addition to OCD and depression.

So, I continue to read and search…hoping for a cure, or at least a better quality of life…now my research is not only psychological but also physical, as I attempt to get back my health. Today was spent largely in bed with my legs elevated. It feels like there is some sort of waste in them, that is draining out when elevated…but put them back down and they begin to fill again…sit down and its like inserting a dam and I’ll pay for it later.

No real news from the doctors at this juncture. This morning I went in for more bloodwork – this time to test my adrenal functioning. Thursday I have an appointment with an ophthalmologist b/c my eyesight has been deterioriating, and then sometime I have another neurological appointment to get EMGs and etc. Also hoping to get a second opinion from a rheumatologist and would love to get a SPECT scan for the mental health issues, but don’t even know where to begin in looking for that…

So that is where I am at. Yes, I struggle with depression a lot  but in spite of all of the above I’m not feeling particularly depressed right now. I just finished watching a gritty foreign film about the drug trade which reminds me that my suffering is small in comparison to many and how much I desire to relieve suffering, not just my own.

In the Depths of Torment.

 ocd  No Responses »
May 162012
 

Tonight I went back and read through some early journals I had written. In some ways I am a very different person from who I was then, in some ways I am very much the same. I came across this particular entry which I wanted to share…I think it will be comforting to those who are currently struggling with scrupulosity (religious OCD)…I hope also that it will give those who have not suffered from scrupulosity some insight into the suffering which is found in the midst of this disorder…it is important to note that this entry is fairly representative of entries in my journal. This one comes at a “breaking point” – so some are less intense than others, but the overall agony is fairly accurate of the day-by-day state of the scrupulous sufferer.

February 11th, 2002:

Crap! I hate my life. Why must I always be convicted of the smallest nothings? Why cannot I live like any other normal person? Why must I be such an idiot? I hate my life. I wish for the sweet peace of death and eternity with Christ where I will no more sin nor have to worry about sin nor worry about my past deeds. I hate this!

In the past several days I have asked Phil if he was offended by my (jokingly) calling him a heathen b/c he had his ear pierced, told a guy I said things about Dr. —– which I shouldn’t have (don’t even remember his name),[1] and told my mom that I did not watch the Matrix for the reasons I told her I did.[2] Now I am convicted about such things as playing too roughly with my siblings and scaring…Jeremiah’s little brother, I don’t even remember his name.[3]

Ohh God, how much longer must I suffer under this conviction? How much longer before I may have peace? Will you always turn your face from me and give me no wisdom? Must I always be lost in this pit? Why have you forsaken me? I seek your face and yet feel as if it is hid from me. I push on every day behind the mask of peace and serenity and yet within my soul is the utmost turmoil. Can I have no peace? Will you not allow me to move on? What am I to do with these matters? What can I do to rectify them? How can I in any way make better what I have done. I feel like swearing Lord, I want to let loose, I want to die. I do not want life anymore, Father, please will you give me snakes and rocks? Can I have bread and wine? Must I always seek and never find? When I knock on the door will you never answer? Ohh, God, please. Forgive me for my trespasses and show me the way that I am to go. I feel so guilty! And all I want to do is swear. I do not want to speak to you, I do not want to speak to you. I type this now b/c I am afraid as soon as I get on my knees I will lose the desire and stand again. OHHH GOD!!! GOD DO YOU HEAR ME? MUST I EVER STAND THIS WAY? PLEASE HELP ME! GOD!!! PLEASE!!!

Okay, I have to clean my room, but I ask for your help. Am I to press on? God? God? God?

I know you’re out there…I know you hear me….I know you love me….I just don’t feel like it. Ohhh God, please. Please. Please. Please.

Please. Please. Please. Please. Please. Please. Please. Please. Please. Please. Please. Please. Give me peace by life or death, O Lord, I beg of you. Amen. May your will be done on earth as it is in heaven. Forgive me for my anger. Amen.

  1. [1] I was unhappy with the class and did not like the way the teacher taught it. ↩
  2. [2] I have no remembrance of what reasons I gave and whether they were accurate or not… ↩
  3. [3] I don’t think the scaring was intentional, the memory is so faint – I think I walked into a room or something and he just happened to be frightened by the surprise of my presence. ↩

Thoughts on Animal Hoarding.

 animals, crime, hoarding, ocd  No Responses »
Jun 142011
 
Топа 7

Image via Wikipedia

Today I saw a story on Yahoo! about a retired teacher, Stephanie Sinkin, who was hoarding cats. The police and SPCA have found twenty living but extremely malnourished cats and five dead cats – and expect to find more dead cats on a secondary sweep of the house.

I have a tender spot for animals, the older I get the more tender this spot seems to get. I currently have four cats and I love them dearly…even if they do occasionally drive me nuts scratching furniture, knocking down papers, whining, and sometimes defecating in unfortunate locations. It makes me sad and angry to think of animals being abandoned or abused.

Since getting married Charity and I have fostered or adopted seven cats. Of these seven, six came from extremely rough circumstances:

  • Charity found Hermione wandering down a highway as a small kitten. She was extremely malnourished with a rough and sickly brown coat of fur.
  • Barclay was found with some siblings in a dumpster – a few siblings where dead, but she survived.
  • Talbott was found outside, covered in fleas, she would be blind, deaf, and mute for her short life (a little over a year) and remained kitten-sized her entire life.
  • George and his siblings wandered into my dad’s house (through a cat door) after being left by an unknown bypasser along with a bag of food on a stone wall on his property.

I say this to reinforce the compassion I feel for animals and the angst I feel when they are hurt or abused…but I also want to reflect on the angst of an individual like Stephanie Sinkin. While I do not know Ms. Sinkin personally nor am I aware of all the details of this particular case it appears evident from the article mentioned above that Ms. Sinkin is likely suffering from some severe mental distress – possibly a form of obsessive-compulsive disorder focused around hoarding. There is a good article over on Wikipedia on animal hoarding as a mental disorder.

I’m not sure what should be done in a case like this. I’m not sure that mental disorders excuse our actions. On the other hand, I think the primary endeavor should be upon helping Ms. Sinkin to get well…and I think, if she gets well, she will likely care for many more animals well in the future than have been lost to her illness in the past.

I sorrow for the animal lives that have been lost and I sorrow also for Ms. Sinkin, knowing that if she does experience recuperation from her illness she will experience deep remorse and regret over the loss of animal life that occurred under her watch.

Finally, I’d note that the greatest tragedy (in my humble opinion) is neither the loss of animal life nor the remorse Ms. Sinkin will face, but rather the failure of society and the community to intervene in this situation.

I am an amateur student of chaos theory and systems theory – which teach me that everything matters and that “no man is an island” as the saying goes. I take this as a challenge to be more intentional in loving others – especially the difficult ones…and I recognize that I myself need this sort of love from others as well.

Related articles
Enhanced by Zemanta