and record. Recording in progress. Thank you. Well, hello, everybody. It is great to see all of you and or feel your energy. And I am Mel Hauser. I use she, they pronouns and I'm executive director here at Albrains Belong, Vermont. And welcome to Brain Club. Share screen and we'll orient everyone. All right. Tonight we're gonna be talking about reimagining healthcare. This is the fifth week of the month and all month we've been talking about life reimagined in all the various domains. So it's only fitting that we cap up with what we do for a living. So by way of introduction, all forms of participation are okay here. Looks like many of you have figured out that you can have your video on or off. And even if it's on, we don't expect anything of you.  And everybody's welcome. And because everyone's welcome, including people of all ages, we are very big about safety and about consent. And so we, you'll see me in a second, we have a content warning for some kind of shocking healthcare statistics that I'll include at the beginning of this presentation. And we just ask that you use content or you're welcome to talk about, you know, a variety of topics. We just ask that you give content warning so people can listen with informed consent. But I would say that even though we're talking about healthcare today is for education purposes only, not medical advice. And just because we really wanna be respectful of people coming from a variety of perspectives and some of them, it's really hard to hear about traumatic experiences. We just, just individual traumatic experiences are best processed in a therapeutic setting because we're not in a place to be providing medical support in the context of Brain Club. Last bit of access, just word about language. You'll hear me and maybe other participants tonight use identity-first language. I am autistic, that's in contrast to quote a person with autism. And people are welcome to use whatever language you use for your own self. But just if you're new to Brain Club and you haven't heard language like that, I wanted to set the stage that that's where that comes from because for many neurodivergent people, neurotype is not needing to be separate from identity. And so that's why I use that word. And we welcome people to use whatever language for themselves that they use to describe their own identity. Okay, all right, one more thing about access. If you'd like to use closed captioning, they are turned on already. You just have to toggle them on at your end to use them. So depending on your version of Zoom, you may see either live transcript CC or if not, try the more dot, dot, dot and choose show subtitles. And you can choose hide subtitles if you'd like to turn them off. Okay, now I'm ready. So some Brain Club regulars have likely seen this slide like a million times, but hold on a second. While I'm, I just wanna make sure, I'm gonna make a couple of members of our team here, co-hosts to let people in from the waiting room because I'm no longer gonna be paying attention. There we go. Sierra, Sarah, and Lizzie can I make a co-host too? Just in case we have some backups. Sure. Great, all right, awesome, okay. So I, as many of you know, I did not know really anything about brains until I became a parent. Despite having a whole lot of medical education, and there I am as a picture of me on the left, a pregnant a week before I gave birth, a to Luna. And here I was, a doctor takes care of babies and knows all the things about child development, quote, all the things about child development. Yeah, no, I did not know all the things about child development. And I thought I had it covered, but Luna felt otherwise. Luna made it clear in no uncertain terms that my medical education like was profoundly inadequate for her needs. And it was my environment that was a problem. My environment was a mismatch for her needs. And she let us know in no uncertain terms that the world was too bright, too loud. And so much of the defaults of like being a baby, like the defaults that were imposed on her and what that's supposed to look like, that did not work for Luna. And she let us know by screaming for two years. And healthcare, healthcare was a place that Luna, so as Luna's six now, and Luna continues to make it known when she does not feel safe. And healthcare environments were a place that Luna has never felt safe.  There was never anything wrong with Luna and there's never anything wrong with someone who feels uncomfortable in healthcare environments. But that's not the message that people receive. And so tonight we're gonna be talking about part of reimagining healthcare is shifting that narrative from the healthcare system as expert to putting power back in the hands of patients who almost always know what we need as human beings and are the experts in our bodies and know when an environment is not meeting one's needs. So before we get into that, I wanna share some background information that I think is pretty important. It's in fact why I quit my job to start this organization. So I'm gonna give a, actually I tried to do a little animation and forgot that I did it. All right, so we're talking about empowering patients as I said and we're also referring to the double empathy problem. So the double empathy problem is a term that we refer to a lot during brain club. It's a term coined by autistic social scientist, Damien Milton in the UK, referring to rather than like one normal set of social communication skills and like everyone else, it's about a mismatch of worldview and a mismatch of communication styles that is responsible for misunderstandings. And there are so many misunderstandings in the healthcare system. And what we've come to learn in the past year that is involved in building a connected healthy community. So now my content warning before I get into some background information. So I'm gonna show you some pretty terrifying health data, particularly in reference to autistic people's health. And in so doing their mention of healthcare trauma, mention of premature death, suicide and a reference to ableism. So for the next, I would say for the next three minutes if you would like to shut your sound off or leave the room, I will be done with that in three minutes, I promise. And Sierra, can you tell me when three minutes is up so that I can be true to my word? Excellent, okay. So, Darity et al in 2020 did a study of autistic adults looking at the barriers to accessing healthcare. And in fact, in this particular study, these were all autistic people, autistic adults who had established primary care relationships like they were an established patient. And yet of that group, almost 80% had difficulty accessing healthcare. It's not like they couldn't access healthcare because they couldn't get an appointment like they couldn't get a practice to accept them. They had that and they still couldn't access healthcare. And the themes of that study are about the barriers of why they could not access healthcare related to three main buckets. The environment, including like interactions with the environment, including with the people in the environment. So that included sensory processing, communication challenges with staff and interdisciplinary staff. Barriers with the provider, it was perceived by the autistic people in the study that their healthcare providers had insufficient knowledge and skills to take care of them and that they had unhelpful stigmatized attitudes. And back in the same study, about only a third of autistic adults sampled, even told their primary care physician that they were autistic, specifically because of fear of judgment. Whoa. And problems with the system. There are so many defaults in the healthcare system. Now you must fill out a 20-page packet to become a new patient. You must pick up the phone every time you want an appointment. Yeah, I guess who rarely gets healthcare because the phone and the culture of the healthcare system and I get to say this because I was trained in it. Like, you know, there's a hidden curriculum for trainees that there's a correct way to be a person. I remember as a medical student, you know, hearing doctors talk about, oh, there's the patient with the list as though there was something wrong about like organizing your thoughts and writing or, oh, there's a positive cell phone sign meaning if someone were using a cell phone that means they can't be in pain. So many people have kind of a pain on their arm and you can't do the thing. So there's just this, these myths that are harmful, harmful for health. I mean about this because autistic patients are dying. The average life expectancy for an autistic adult is 36 to 54 years and I didn't know that. When I first learned that, I flipped my lid. I was 37 and I had just received my autism diagnosis. The leading causes are cardiovascular disease and suicide. We're gonna talk a little bit about what we've learned here in the past year about the cardiovascular system and in neurodivergent people, not specific to autism and suicide as a leading cause. Autistic adults have a four to nine times increased risk of suicide and that risk is higher in those with lower support needs. And it's been shown in the literature that pressure to camouflage or mask one's autistic traits is independently increased with risk of completed suicide. And so there are so many messages that actively encourage camouflaging and masking. This is not only bad for health. We talk about that at brain club every week but it increases the risk of death. Consent minutes now. Thank you. Right in track, I'm losing. It's for someone who doesn't feel time. Now it's pretty good. So when we launched all brains belong and many of you have seen this graphic many times, we set out to improve the health of the neurodivergent community. And yeah, it would have been really easy to just open a medical practice and say, okay, we're doing healthcare now. But I don't think that would help many people's health because to do anything for the neurodivergent community, we have to do everything. It's not just medical care. It's, I mean, medical care is like a huge unmet need but it's social connection. It's accessing education, it's employment. It's all part of health.  So when I was in medical school and residency, I got taught that there were co-occurring conditions more common for autistic people. But it was never really told to me or it didn't seem like anybody was wondering why. There were like some, you know, some assumptions made but what we learned here in our first year at Albrightons Belong and, you know, we don't have all neurodivergent patients but we have mostly neurodivergent patients. We were forced to zoom out and recognize some patterns because we're pattern matching systems thinking people that our patients had a lot more in common than being neurodivergent. What they had in common was different connective tissue. The nervous system, the musculoskeletal system, the blood vessels, the gastrointestinal tract, even the shape and presentation of the face were different and turns out connected tissue holds the whole body together. And so a lot of the common medical conditions that neurodivergent people more commonly experience has to do with connective tissue. And because everything is connected to everything, one of our patients came up with that. I thought a pretty profound quote. They said, hey, the way you explain that to me kind of reminds me of a ball of yarn where if you pull the wrong string you make the knot tighter. Sounds like you have to find the right string to pull. Yup, but the problem is that so many of the, so much of the healthcare system is so fragmented, right? So like the body parts are fragmented and like, well, we're gonna, we gotta take care of this one part. And you know, in the 15 minute appointment we can't take care of the rest of the body. You can take care, it doesn't work. And in fact, some of the standard management from some parts of this big picture that we call all the things cause it doesn't have a big picture name yet. It's cause mostly all the people here have all the things. So part of the standard management of some parts of all the things make some of the other parts of all the things worse. So for example, there is a condition called pots or a postural orthostatic tachycardia syndrome has to do with when you stand up, heart rate gets really, really fast and people get really bad symptoms related to this. And I wonder how many people in the audience you can have that without maybe even having a name for it. Anyway, but the point is one of the standard management for pots is compression.  Well, it turns out that's not good for health. And that's just one of the many examples where some of the standard managers from some parts make the other parts worse. I made this slide and called it the many names of suffering and invalidation. This is, there are so many medical conditions that have a lot of stigma associated with it. And patients who have these conditions, they often don't get their needs met. And the healthcare system doesn't frequently do a good job at meeting their needs. And the last item on this list, long COVID. So in April of 2022, we did some internal quality improvement looks at our practice. And we found that 70% of our practice had long COVID or long COVID-like conditions. And we're like, what? So we started learning about long COVID. And here's how we did it. We established a task force, not just of interdisciplinary clinicians, but of patients. We invited our patients and other members of the community with all the things and we got together. We prioritized the value of lived experience. And we started the process of building a community village, a community village of learning and healing together. We didn't know how to manage long COVID. We didn't know a whole lot about all the things despite me having all the things. I still didn't know the best way of managing all the things. So we brought people together and we learned. And since we've began that process, we haven't had a single new case of long COVID in this practice despite starting out with almost like the majority of the practice having long COVID because neurodivergent people, for those who don't know, neurodivergent people have higher rates of long COVID. That's a known thing in research related to the immune system, just higher risk of complications of COVID including long COVID. So it wasn't like, I mean, it was 70% was really surprising to me, but we has having more neurodivergent people in a concentrated area. We were gonna see more long COVID than other primary care practices. But to turn that around to say, by shifting the script and empowering patients to be part of learning and healing together, that's how we've been reimagining healthcare. So because instead of zooming in to the different body parts, it's zooming out and seeing the big picture. And like all of the many, we say this like probably in every brain club in one context or another, that safety and regulation and co-regulation between people, that's the path to health. And so bringing people together, many of our patients come here because they're looking for connection. They're looking to meet other people, navigating similar health challenges. They're looking to engage in the broader community. And that has been that peace alone is such a, when I tell people we do that, like healthcare people, when I tell healthcare people we do that, they're like, but HIPAA, like, uh-huh. We in fact can not violate HIPAA and help the people get their health needs met, turns out. There's so many myths about what healthcare has to look like. And as I showed you, it doesn't work. So I had a couple of ideas of things I was wondering from you, but we can talk about, we can take this in any direction folks wanna know. Maybe we can talk about what you wish, what you wish healthcare looked like.  Or we can, you know, I just want to hear your comments about some of what you've seen so far. Hi, I think with healthcare, what we need is we need, like there needs to be sort of, the social model needs to come into play and we need to get rid of the medical model, but medicalizes people and people's differences and then neurodiversity. And we just need to, and it needs to be more person centered. It's like, who often there's like, okay, this is how we're going to do it rather than like, this is what we'll want to do. And like, yeah. I mean, in an emergency it might be harder, but that's not to say that it would be impossible and that what the patients feel is taken into account and they're not just seen as being difficult. Yes, thank you, thank you for saying that. You know, I did a training earlier today for nursing students. And what came up was exactly what you said that the healthcare system often talks about patient centered care, but it's not the fault, it's not of the individuals in this, it's the system. The system is developing like the opposite of customized individualized care a lot of the time. Becca. Well, I kind of have two things, but one, I feel like even just getting access to health insurance is a hard thing. I recently moved to Vermont and so I had to switch my insurance and had to do it in this very stressful type window of open enrollment and had the experience of like the way that the information was presented when it was like being sold to me was different than the information packet I got in the mail after signing up and basically misunderstood what would be covered and what wouldn't be covered. And so I think, yeah, some sort of assistance to even just navigating how to get health insurance so that you can get healthcare would be helpful. And then also along those lines, just like, I feel like mental healthcare is kind of this like cherry on top, like it's like this special extra thing that you get if you pay more or whatever. So it would be nice, especially like after you shared the like statistics of how helpful it would be to have easier access to mental health that I think could make a really big difference in the whole picture of a human. Absolutely. Thank you for sharing that, Becca. I'm so sorry that you've had to go through this as so many people have health insurance makes no sense. I don't understand health insurance. I ask like, we have a resource coordinator here at all brains belong works with our patients to understand so many of the and overcome so many of the barriers to like things outside of our organization, like Amy tells me everything about health insurance because I don't understand it and I'm a doctor. It's so hard and it's so unfair and it's so, it's so awful. And yes, the other thing is that, I think the healthcare system really unhelpfully makes a distinction between physical and mental healthcare. Like this is one thing and it's health and it's treated by separate systems. And that's not helpful. And so often people tell us the stories of, the initial explanations for their symptoms of all the things. Oh, well, you must be anxious. Yeah, I would be anxious if my heart rate were 150 also. Like, yeah, that feels really awful. But like just the idea that they're mutually exclusive and that's so not just unhelpful, but it's harmful. Like it's harmful. It's harmful to tell people that anything is in your head. Yeah, it's in your nervous system. The one that goes through your whole body. Emily has a hand up, Mel. Oh, sorry, it's, Emily, you have to be, and you're also in my periphery or you're in my upper left corner. I'm so sorry for not seeing you in my peripheral vision. Yeah, no problem. So you updated to, it's normally yellow and now it's like skin tone, which like I don't think I actively chose. Very strange. Anyway, I was gonna say that the thing that I find most frustrating is that it feels, and I don't know if it's just a, you know, where I live, but the primary care system doesn't seem to function as I think that it should. So my primary care doctor will see me and refer me to all these specialists. And then the specialists will give contradictory advice. So like one will say, hey, take this NSAID for all your inflammation. And then the allergist will say, stop taking the NSAID because of your gut biome. And I'll be like, oh, but these two doctors told me to do these two different things. And I understand that I might need one. And then I'll want to ask somebody who knows more about medicine than I do. Okay, so there's risks and benefits to each of these. And please tell me all of the information so that I can make, you know, what are the potential harms and helps that are gonna be caused by taking this medicine or not taking it so that I can then make an informed decision. And nobody has the time to do that. And they don't know each other's specialties.  But, and so that's where I'm like, I wish that there was just somebody who could actually, that they would, the specialist would tell the advice to the PCP who then would go through my options with me because like, I don't doubt that it's a real thing that I should both take NSAIDs and not take them, but that is actually not possible. And I'm gonna have to pick one. And I would like to make an informed decision with somebody who knows more about medicine than I do. Health care, yes, I'm, yes, yes. Like, so I, that story just encapsulates so much of the problem. And we hear versions of that story all day because that's what goes on. You know, the, you know, the piece of education or the strategy I might, I might offer is that since you do have a good relationship with your PCP to be, to be something you feel comfortable going in with a clear agenda. I am here to talk about the conflicting advice between these two specialists so that you can actually have someone who, quote, knows more about medicine than you do thinking through that with you because other ones it's how could you not feel overwhelmed and confused and super stressed out. I'm reading in the chat, sunrise shares. I wish I had a doctor who understood autism. I'm fairly newly diagnosed. So I'm talking about past experiences. When I would give my true symptoms I was treated as if I were lying and not believe that is so common. We hear that all too often. When I put those past experiences together they point to typical symptoms that those on the autism spectrum have. Yup. Probably, or sorry, my dyslexia gets in the way of reading often. Possibly neurotypical people lie but as is typical of a neurodivergent person I do not lie. Wish I had been believed and might have been diagnosed earlier. My diagnosis came at age 72. And some of my confusing life experiences would have had clarity and some of the losses I agree would not have been losses. Amen to that, sunrise. Thank you for sharing that. And I think that, and this is what I shared with the nursing students that I presented to you earlier today. The system, like the medical education system contributes so much to the experiences that you had. In medical school I was taught that people who have this particular symptom they present this way. And as though there were one way to present it makes no sense. And when you're thinking about the natural diversity of human beings, people are gonna experience things in all different ways. And I think that, especially in the case with, with all the things, this, these multi-system immune neurologic hormonal differences that most autistic people have, there's no training about that at all in medical school. Reading in the chat, CB says, I wish I could text back and forth in medical appointments, but it's not an option. Access to mouth words and processing others responses in 10 to 15 minutes is inaccessible. Absolutely. So one thing, and again, this is part of the ableism of the healthcare system is that the onus is on the person with the disability to come up with their own accommodations that is ableist. And I can share with you that in our healthcare practice we text back and forth with our patients all the time. I wonder if you tried asking for, whether it's using your phone, using, if you bring your laptop and you type something, whether, anyway, just bringing that up and asking for it, you shouldn't have to ask for it. I'm upset, I'm upset as an understatement. I'm really pissed off that you have to ask for it. And most people don't even know they can ask for it. We think that inclusive design offering flexible, multimodal ways of engagement to all people, not waiting for someone to disclose a disability, but to all people, we think that's better. And short of that, you can ask for things. And it is really hard to come up with your own ideas, but you have the idea already. And it's really hard to advocate for yourself in an imbalanced power dynamic. So maybe that suggestion is useless, but I just wanted to put it out there that you are allowed to ask for things. And maybe the thing is to think about what might make it safer to ask for things, whether that's bringing someone with you, making your request ahead of time, reading in the chat. I think like most autistic people, I have a long list of ICD codes, diagnosis codes. And they see this and automatically think that I'm exaggerating my symptoms or something, or maybe I am deemed way too complicated, even before I open my mouth. Yup, yup. I'm reading from Cat. And I think probably Cat, maybe you typed this when Emily was sharing their story. Yeah, okay, all right, yeah. Yeah, that is what a PCP is for. Yes, absolutely. And Christina adds, even when attached to a giant document that was categorized in specific symptoms listed and even links sometimes, they don't read it and they want me to go over all of it right there in the visit in a short time. Yeah, and that may be conflicting access needs, but that's not what's presented to you. So in our practice, we try to have just open conversation about conflicting access needs. So if someone prepares a really thoughtful document, it's my access need, because of my dyslexia, like I can't just like read a bunch of emails, I gotta print it out and I gotta highlight it and I'm gonna do that with you during your appointment. I'm gonna read what you wrote and you're not gonna have to rehash the whole thing, but we're gonna do it in an appointment, because it's laborious and I'm gonna do it because you put in the labor of preparing the thing, but that's not what's communicated. It's just like, oh yeah, tell me what you're here for. When this is all about access needs, I think conflicting access needs is the key to the universe. Sarah and then Mia. Yeah, I was gonna say about access needs. I was talking to a friend recently who was asking for support around going to a doctor and what might make it easier and the conversation centered around things like, well, bringing a legal pad with you to write notes down or having notes, taking notes while you're at the appointment, just all kinds of different things that might be helpful. And I wound up reflecting on my experience giving birth and realizing that I have two children and the first birth, I didn't really know that I had rights. I didn't know how to advocate for myself in the system and consequently, I didn't have a lot of ownership over the experience. And in between my two children, I saw the documentary business of being born and it was a completely different experience the second time around. And what I was reflecting on recently in my second birth was that I had a birth plan, a document that was at the door and anybody who walked through that door needed to read the birth plan. And what I was reflecting on is that really my birth plan was me stating my access needs. So it was like I wanted low level lighting or I didn't want a thousand med students coming in and out of my room while I was giving birth, like all of those things and recognizing now through the lens of access needs that that's really what that document was about. Yes, yes, oh, that's so, that's so, yes. Thank you for sharing that. Nia and then Becca. Yeah, I think what was said about people not always knowing they have certain rights. I mean, I don't know a lot of my rights and I do feel because of having an abusive past I do feel quite intimidated asking for them because I wanted people might think I'm, yeah, I mean, I haven't had any particularly bad experiences in like physical health but with mental health services. A lot of people have made me out to be the problem and I think also I was talking with someone today and they were saying about how when it comes to mental health a lot of us, a lot of these things are created to sort of because they don't want us to be in a state where we can question the status quo and how so much so many natural human reactions to things that sort of made out to be sort of disorders just because like I think when we're sort of in a good when we're in the place to, when we're off, when we're in a good place, we can mentally, we can sort of stop and just question the whole system and that isn't, a lot of people don't want, a lot of people in the system, they don't want us to. Or they may not be able to because they may not have access to their cortex either. Even, you know, and I'm gonna write this down so I don't forget because it's not my turn yet. Becca, go for it. Yeah, just thinking about access also I, so I was diagnosed like a little over a year ago at age 35 and in my health insurance experience also learned that certain ASD services are covered and it seemed and I could be wrong because again, I don't fully understand health insurance but the way that the information was presented led me to believe that the sessions with my mental health provider would have been covered if I were under age 22. Like for some reason there's this like age cutoff for any sort of services related to autism, which I don't know if that is all insurance or just mine. I have Blue Cross Blue Shield, which seems like a relatively universal health insurance. So anyways, that was also a strange thing to learn because obviously like autism doesn't go away when you turn 22. Yes. And we are diagnosed later in life. So it's like, well, then can I get the 22 years of care that I didn't get back then now? Yeah, no, you're absolutely right. There are these like, these boxes, these like really arbitrary. Anyway, I mean like services, you know, it, anyway, things are not created equal and insurance makes distinctions between, you know, mental health support and occupational therapy. And like just as, and both are very much supporting, I mean, one of the most common supports for mental health that I refer my patients is to occupational therapy. And anyway, yes, so confusing. What I also wanted to add about Mia's point about difficulty with like asserting rights and feeling like those in power don't want you to, I think it's even, it's even more basic from that, I think in a lot of instances, which is that the system dysregulates patients and healthcare providers. The system dysregulates everybody, it's the system. And so dysregulated people don't have full access to their cortex. And so so often, you know, and I don't remember what month it was, it might have been like June or July, one of our healthcare related brain clubs, we had a nurse on a panel who was talking about how, you know, she was, you know, made to work like a 17 hour shift and like taking care of all these patients and feeling so awful that she couldn't do the right thing. And like that this was typical, like the inhumane working conditions is really common. And the, there's so many people who don't have their access needs and might who don't even know that they have access needs, including unrecognized neurodivergent people. So it's such a messed up system. I'm just catching up in the chat, sorry for missing all this. So sometimes insurance can deny things because the person in medical billing made a typo and wrote the wrong medical code for something, which results in hours in multiple phone calls and autistic nightmare and CVS adding. Yes, it's so frustrating. I tried to reach up to disability services to advocate for the millions of time in a medical assist facility and you could only call them. No messaging or email to access. Yep. Kelly says, it seems that even our health is being viewed from what will keep the status quo lens rather than what do we need, right? Systems perpetuate systems. And this is a very big system that is designed to perpetuate the system. I, yes, Luna is singing in the hallway. I wonder, has anyone had any good healthcare experiences? Are there any strategies that they've personally found helpful that others might be able to learn from about like things that they've done or things that kind of worked out? Cat sharing, one of my favorite specialists when I first met him gave me the option to choose between a short visit where he basically told me what he thought I needed to do or a two hour visit where he taught me about my condition and gave me suggestions to consider. I chose the long visit and took pages and pages of notes and even though he saw that I wrote it all down, he printed out his notes for me too. I got a whole file. That's pretty interesting, that's a story. I think that story is gonna be hard to beat for sure, but anybody else have any stories of things that have gone well? Linda? I have had enough experiences where I went in and I said, this is happening and I was told I was wrong. And we go through this dance five or six visits and then I ended up being right. And between that and now being technically old, I finally just started to tell people, no, I am right. And go ahead and do the test and then we'll meet back to discuss what we need to do next. And they say, well, it won't be covered. And I said, well, once you find that it was needed, we can go back and recode it. And that has worked a couple of times. So I guess part of our system to remake the old system is to reinforce each other that we actually do know what our body is doing. And we know our kids and we know our families and we're right. Amen, that's right. Because how could it not be true that an individual is the expert in their own bodies? How could that not be true? It's obviously true. Yes. Emily's adding, my PCP is only allowed to spend so many minutes with each patient. So in the time's up, she asked me to message her through the system. She spends an hour after work each day responding to everyone's messages off the clock. I love that she does this but wish she didn't have to. Yeah, so it's a conflicting access need thing. And I think that, if you work for a system that violates your own autonomy as a professional as far as how much time you spend with people, but maybe that doesn't have to limit how often you can see them. So if you run out of time, you're running out of time and then, but again, the system also is a barrier to that work around. Because then there's maybe not any room in the schedule for another three months because the system is set up to incentivize the system to over admit patients, despite the lack of capacity to fit them into the schedule. The system perpetuates the system. Christina's adding, Linda, that's so hard to hear that you had so many appointments for them to agree with you. Every appointment's a challenge for most of us and I give up a lot of the time before I get what I need. Yeah, and that's all too common, all too common. I presented a couple of weeks ago for Academy, which is a really cool autistic led organization in the UK. I presented on all the things. And we covered and Lizzie, can you link to that in the chat, Sierra and I prepared some like strategies for how to talk with your healthcare provider. And anyway, so there's some like practical tips in that recording that we'll get in the chat. But in summary, I think like two of the strategies that I talked a lot about on that recording were the idea of like scripting what you're gonna say ahead of time because if you're in dysregulating environments with the overhead lights and the clicking ticking clock, yeah, right, it's hard. And then you have the pressure of the 15 minute visit and it's just that. So being really, really being specific to about what you wanna make sure you get across that and bringing someone with you, not just to like take notes for you, but to like co-regulate you. If you're used to being othered and invalidated by the system, you go in there and even before anybody walks in the room, you're dysregulated a lot of the time. So co-regulation is really important. Reading in the chat center says, for six years I was seen in a community health clinic. I had no insurance and paid a percent of my salary for visits. A physician assistant was the best provider I ever had. I am a question box and of course I've been shunned for this by some, but this provider would find on her computer screen a website with the answer to my question and she in effect over a period of time taught me medical websites that I could find answers. She never questioned my symptoms. She accurately diagnosed my benign positional paroxysmal vertigo and she provided care for my broken wrist which mended with absolutely no residual effects. And she taught me to exercise the wrist daily to keep it from losing its, yeah, I think range of motion. I think that's a turn I'm used to. I felt so safe and well cared for by her. She has gone on to be in some type of rescue medical person for those needing medical attention on wilderness trips. And I bet she's happy in her work, at least I hope so.  Thank you so much for being here. And Kelly says, because my husband isn't facially expressive, they don't believe his pain, right? So yeah, he isn't formally diagnosed, can't afford it, but he presents textbook autistic. Yeah, so he can't get his arm fixed. Oh man, right, because the one right way to present in pain thing, like that makes, that's how could that possibly be true? It's obviously not true. So sorry. Healthcare, the opioid crisis has made this harder. I think, yeah, I think that there are, talk about conflicting access needs. I think many healthcare providers have been taught certain things. There's regulatory requirements, there's like threats of like losing your license and like these threats are real, they're really there. And I think like we say in so many instances that transparency is the way out of chaos. And I think that naming that, naming, like if people could just, people within the healthcare system name the stresses and pressures, I think that's the first step, right, of transparency so that your patients don't think you're judging them. Because it's interesting when Summary's gave the examples of what her provider did that was so helpful, some of it was so basic. And it sounds like just the never questioned my symptoms, told me she believed me. Sometimes that is the most therapeutic thing that someone can do. And I think that, you know, yeah, most healthcare providers are not gonna know anything about autism, they're gonna know anything about all the things. It's about being able to say, I don't know, but I believe you. I don't know, I believe you and I'm gonna work with you to figure out this together. And that's a paradigm shift. And that is, I think, another really important part of reimagining healthcare. So I appreciate all of you being here today and joining in this important conversation. And we hope you'll join us back next week to, hold on, I'm just reading the chat. Becca says, someone has recently moved, I don't have anyone come to appointment, but I love that idea and it'd be awesome to have a volunteer group. Yeah, we talk about that in our medical practice a lot. And I think that's kind of one of the things about building community. And I think that this is a place that you can meet friends at. And there's so many people that don't have that connection. And that's one of the things. And that's an important part of health is having those community connections or social connections. So please, please, please keep on coming here. And next week we're gonna kick off our theme urgency urgency culture, the impact of urgency culture on our health preview. There's bad impact on health for urgency culture. So next week is urgency culture and internalized ableism. So we look forward to seeing you next Tuesday. Have a good week, everybody.


Hi friends, welcome back to my channel and a special welcome if you're new here. My name is Jen, I'm a certified weight loss and nutrition coach and I'm on WW personal point. Today I am sharing with you an instant pot recipe that is so good. It is healthy, it is filling, it is comfort food, it is full of vegetables and both my husband and myself absolutely loved it. Now if you don't have an instant pot, you can make this recipe either on the stove top or in a slow cooker. So I'm really excited to share this with you. I am planning on bringing out more recipe videos for you guys in 2022. In addition to my meal prep and the recipe that I share in my what I eat in a day, I really wanna focus on more dedicated recipe videos. So today we are making instant pot chili. So if you are excited for instant pot chili, give this video a huge thumbs up. And if you're new or you haven't yet subscribed, I'd love to have you here. Hit the subscribe button and click the bell right next to it so you never miss a single video. I do upload five days a week so make sure you hit the bell next to it so you're notified whenever I post. Check out the description box for nutrition coaching. I offer personalized macros and calories and one-on-one coaching if you wanna chat with me directly. Links and discounts to my favorite things and my instant pot that I love is down in the description box. And don't forget to come on over, join us on Facebook, we'd love to have you. So let's make instant pot chili. For today's instant pot recipe, I am making instant pot chili. Now you can also make this in your crock pot or on this stove top. This is loaded with vegetables, loaded with protein and fiber, just a really well-rounded lunch or dinner, especially for the colder months. So let me show you what's in our recipe. First, you're going to need some beef broth, salt and pepper, one large can or two small cans of tomato sauce, a can of green chili, fire roasted diced tomatoes, and any type of bean of your choice. I'm going with red kidney beans and then you'll need a bell pepper. Any color will do. A couple of small zucchinis or one large zucchini, an onion, extra lean ground beef, a eight ounce package of mushrooms, minced garlic and lots of seasoning. Chili powder, cumin, bay leaves and garlic powder.  The first thing we're going to do is brown the ground beef. So I'm going to set my instant pot to saute. Once it's hot, we'll add in the ground beef. Now we're going to add in the pound of ground beef and we're going to let that mostly brown before we add in the garlic and our veggies. Now we're going to add in our minced garlic. I'm going to give quite a big squeeze of minced garlic and then we're adding in all our veggies, mushrooms, onions, bell pepper and zucchini. We're going to allow the veggies to saute down as well as the garlic to add some yummy flavor to the veggies and the meat. My mushrooms are kind of large, the pieces, so I'm going to break those up a little bit while I stir. Now we're going to add all the remaining ingredients. It is still on saute mode. I'm letting those veggies just soften even more, but I'm going to add two cups of beef broth, one can of drained and rinsed kidney beans or whatever bean you chew, two cans of tomato sauce or one large can, one can of fire roasted diced tomatoes and one can of mild green chilies. We're going to add in a couple of bay leaves. Next up is chili powder. It says either a quarter cup to a third of a cup depending on how much chili and spice you want. So I'm going to add about a third of a cup of chili powder, a tablespoon of garlic powder, two tablespoons or so of cumin, and some salt and pepper. We're going to stir this all together really, really well before getting the Instant Pot ready to start cooking. We're going to put our lid on, set it to pressure cook or high for 20 minutes. All right, it is done. We are going to allow it to naturally release for about 10 minutes and then we'll manually release any additional steam, but it smells absolutely delicious. Oh my goodness, look at this yum. This looks so delicious. You can see the ground beef, all the veggies. I am going to remove all of the bay leaves and then I will plate this up. We are going to top our chili with some cheese and sour cream. You could add crackers. I am pretty excited for this. So let me get this plated up and then I'll be back to share points and calories. So here is my Instant Pot chili. This looks so delicious. I wish you could smell how good this smells, but I did add two tablespoons of light sour cream and one quarter cup of the light shredded cheese on top. That way it adds that little bit of cheesiness and I love the creaminess that the sour cream gives it. You could also use non-fat Greek yogurt if you would rather, but the entire Instant Pot makes only six servings. I will go ahead and put the points and calories here on the screen for you. I cannot wait to dig into this true comfort food and so easy in the Instant Pot. Thank you for joining me for tonight's Instant Pot recipe. I hope you enjoyed seeing this amazing chili recipe packed with protein, packed with vegetables, fiber. It was really, really good. That sour cream and the cheese game changers on that chili. I will make sure this recipe is on my website. The link will be down in the description box along with nutrition coaching, links and discounts to my favorite things in my Facebook group. Come on over, join us there. Thank you so much for watching and I'll see you next time. Bye.


Hello there, everyone, and welcome. This is Melissa Arma with the Stock Swoosh and I wanted to review the year-to-date results for the Stock Swoosh Show Live Trading Room. This is advanced trader tracking. We'll go over what that risk is a little bit here. This is from January, beginning in January, through today for year-to-date results, 368,522, so it's been a good year. It's been a solid, solid year and I've been extremely focused this year and I think that it's showed. It's definitely showed in the results for the room and for myself. So if you'd like more information, you can reach out and email me at melissathestockswoosh.com or call me at 929-3200-GAP, following on Twitter, Facebook, YouTube, or Skype. So there've been 142 winners, 70 losers, six break-even trades, and 218 trades called so far year-to-date. So win ratio's 68%. Yeah, and any given week or any given month, depending on how busy we are, that's pretty much the average will to be between I'd say 65% and 80%, depending on how many trades we're getting on any given day. And right now we're getting into the beginning of the fall trading season and it's gonna start to get busy. So we're gonna have more gaps and when it is a busy season, it is definitely a fun time to trade. Yesterday was FTX, it was an amazing call and a good example really of why it is so fun to trade gaps. So earnings season again, like I said, is a great time to trade. Fall earnings season starts in a few weeks. The class is this weekend. If you wanna learn before the earnings season period, it's one of those times where I say, you know what, if you wanna make money before the holidays, now is the time to do it because the market does tend to get slow around the holiday period. When there's Christmas and different holidays, people tend to take off. But right now everybody's working, everybody's trying to make money before the holidays, stocks are gonna report their quarterly earnings coming up in October and November and it is definitely a busy time. So going back to the beginning of the year, again, there were days where we don't have any trade. So I'm always looking to qualify the gap based on the gap itself. And again, a gap is a difference between the close and the open. I'll discuss that in another video, but when you're looking to trade, you have to find specific things to do and so I focus each day on one or two picks. So going back to the beginning of the year, we started the year off, SPI required two trades, one trade loss, one worked in here that was a retake. And then you see many of the days here where I have one ticker symbol, that's a solid good fast quick trade we're in and out quickly. You see this here with the Lulu and the Netflix. And again, I tend to stick on one single symbol, which you can see here with the SIG. XP didn't work here in the 18th, the Qs was a winner, market closed the 21st, SWK was a winner, COF. Again, you see here how I'm focused on one or two picks a day. I'll tell you, the biggest days I've ever had trading is typically when I've had one good solid trade, like I said with the FDX yesterday. And typically if you see multiple symbols, I'm having a difficult morning. So it is really important to be focused. You only need one quality gap to make money in the market. And again, also, this is not like your regular job where you get paid if you show up. If you don't have any good gaps at rate per the system, then you don't trade. So there were days in here earlier in the year we didn't have any trades, Twitter was a good gap. And again, quarterly earning seasons were the best time to trade. We did a lot of trades in the market this year looking back here at the results from the beginning of the year. There was a lot of longs in the market, a lot of bullish gaps in the market. I tend to focus on shorts, but we will go long in the room. I will call longs if I see a good bullish gap. DPZ was a nice gap there in February. WTW has just been flying this year. HPQ was a good one. And again, the busiest times are earning season. And that's because you get volume, you get momentum and all of the people that are active traders, professional traders, institutions are watching the stocks when it happens to be that particular time when they report. Whether the earnings are good or bad, I don't follow fundamentals, I rank the gap, okay? Nike actually is out next week. I'm seeing the Nike here, Nike reports next week. I'll be watching that. Here was FDX from earlier in the year. That was back in March. Len was a good gap, Lulu was a nice gap, Lulu's had good moves. Here again was a market. A lot of market trades beginning this year. Again, look at that, WTW. And Disney was one of those ones we've done a lot this year as well. And those were bullish gaps in Disney, most of the gaps that we've done. And some of the options were in Disney, they were calls. Twitter was a nice gap. Apple was a small one there. Apple's had a rough year though, I will say, overall. But in April, we did do the Apple. That was a nice move in there. Big move in the Apple and XLNX. Many of the stock symbols that we trade are companies, companies you've heard of or you know. There was Apple, again, that was in the first. That was before the market fell off. That was that last day of that move up before it dropped off. But we trade stocks that have volume, so you would know of them. MGM's another recognizable name. DDD, again, you've heard of these companies, you know most of these companies. Teva's another one. No trades in the 14th. Again, sometimes I'll look for follow-through gaps. Teva's twice in here. I watched FDX this morning, didn't see anything in it. But again, there will be days where we do things a couple of days in a row. Baidu was the 17th and Baidu was again on the 20th. So if I see something's good, we may do it a few days in a row or even like the low. There was two trades in this on that day. That was a really nice day. That was getting into the end of May. Again, earning season and JWN too. Took a couple of days off on Memorial Day. It's a nice thing about working for yourself too. You can take time off. If you're an active trader, this is what you do. When the market's slow, you take off. And again, you get weekends off too. AEO was a good one. DOMA was a good one. LLY, CRM. Again, we did LLY two days in a row. Twitter, AVGO just did not work. That was back in June. Disney didn't work that day on the 18th. Adobe worked on the 19th. There's a lot of really nice moves though in some of these, none of them remembering back. Mew's coming up next week. This was Mew on the 26th. Kaig was a good one on the 27th. Again, we did the market. BBBY was nice in July. DPZ, that was a really, really good gap. First trade loss, second trade one, but that was a nice move. CSX. And again, all these trades have a risk of about $2,000. So the advanced trader risk is around two grand per trade. Your risk should be the same or close to the same in every trade that you take. And so you're looking usually for one turnover, but many of these days were more than a turnover of one. Many of the days were two turnovers or three. Again, I'm looking for the moves quick in the morning. So I'll hold something a little bit in the morning, but most of the move of 80% of the moves, the stocks make the gap happen in the morning by 10 o'clock, 10, 15. In the morning, T2 was a good gap as well. August was a very solid month, no losing days. BYND was a trade. Square didn't work. NTAP worked queues was a good one. Two days for the queues, Kate. She worked. Spy was a winner. No trades on the 9th and the 13th. Was very focused during the month of August. Macy's, I'm sure we're gonna be looking at the next quarter too. HD was a winner. Lowdent Workout, but Target did that day in the 21st. LB was a winner. Footluck are a really nice gap. V&W another one. Again, if I see two really good things, we might do two things at once. And ALTA was definitely the gap of the month for August, as far as all around. And September started out. It took some time off. AAL didn't work. Queues were break even. GLW break even, KHC was a small winner on the 17th. FDX was a really nice gap yesterday and X today. And again, being very focused, being very focused this month in September, waiting for the big moves. So as I was saying, an advanced trader risk is about $2,000 per trade. I mean, even I would consider $1,500 an advanced trader risk. So when you're starting to trade, you have to look at the size of your account, your experience level, and definitely people cannot join my live trading room where I called all these trades unless you take the golden gap course. I think it's important to learn the method, to understand why you're doing the trades, why you're trading. The nice thing about day trading though is you can work for yourself when the moves happen quick. In these gaps, you could be out and done within the first hour of the day. If you're interested in more information and you wanna sign up for my class and learn and join and be a member of the trading room, you have to take the golden gap course first. Once you do, then you are eligible to join the stocks-wush group. The class tuition is $64.99. Class dates for this period for September, September 21st and 22nd. Class is nine to five Eastern time. Cost of the class is 64.99 US dollars. You pay with a credit card and you must email me for the forms to do that. The class is online. You can be anywhere in the world and take it. Email me for the forms if you wanna sign up. The trends course is Tuesday, September 24th from 11 to three. This is a combo. You would do the golden gap and the trends three days of classes in the next week. You save money by signing up for both at the same time. The trends class is about long-term trends in stocks. If you'd like more information and you wanna sign up, email me at alissa at the stockswush.com. It has been a fantastic year. I'm looking forward to closing out the year very strong. Thanks everyone, have a great day.


Hi there, lovers! This is Hannah Witton. If you guys do not know, go and watch our other collab video which I'm going to link in the iBots above that we did hair a year ago. And also on my Instagram, I talked about her book and I spoke about it to you because I just absolutely loved it because you know, girl! Quick pause.  Now, many people are skeptical about calling these addictions because there is no substance attached, but they are known as behavioral or process addictions. So here is the big question. How do you know when you're addicted to sex or pornography? The answer, yes, can be complicated and to get a real assessment, you need to see a licensed psychologist or therapist. But in short, it's when engaging in sex no longer feels like a choice. You find yourself ritualistically doing it without concern for your own well-being or the well-being and comfort of others. And after the act, oftentimes you feel regret and self-loathing. Sex is a drive much like food, social contact and power. Now, drive exists in the risk and reward center of the brain, a place that encourages us to do just that. Most addictions can be linked to the risk and reward neurochemical chain.  Number one, engage. Followed by guilt, promise to never do this again. Unwelcome stress in their life, then an obsessive urge to soothe by engaging again. Then a sense of desperation and finally a need to release and then repeat. The inability to control one's behavior is not an explanation, it's a cry for help. If someone could break the cycle without help, they would have done it already.  Now, many people do prolong getting help for this addiction, but you have to ask yourself or the addict, what kind of bottom are you waiting to hit? A loss of self-respect, loss of relationships, criminal charges or loss of good health. Now below, I listed some links that I think are really helpful and are a great first step for anybody who wants to learn more.   Sure. So this was actually something that was new to me when I was researching the book and I got someone who has arousal addiction to write a bit for the book about it. And say even that. What? Yeah, that was new to me.  You wake up in the morning and it works the same way as any other addiction like it chemically gets into your brain. And arousal addiction is the need to be aroused all the time. So in the case of the example in my book, it was someone who has a penis who was writing about it. So the way that he said it was the need to be hard all the time. This is the age old question for any sexual educator. They constantly, I'm sure you get asked this all the time, especially by like an older reporter. They're like, well, kids today are just watching so much porn. So what have you noticed and what have you noticed about when it comes to youth and porn consumption? Part of me is really freaked out and then part of me is like not because I think adolescents like have always like will always kind of go through some of these cycles. But the thing that is different is the technology and the access to it because like my mom would say to me and like my dad would be like, oh yeah, like, you know, we were always trying to like reach for the playboys on the top shelf or like, you know, your friend would like have a Playboy magazine and you'd like go around and be like, oh my God, oh my God. But like now it's like it's on your phone like, you know, a lot of teenagers like it's just that. And the statistics are quite scary as well in terms of like how many young people will see porn by the time they're 16. But there's a lot of the like research that I've seen. It doesn't really differentiate between young people who have seen porn, which might be like not their choosing. Like it might have just been sent to them or shown to them and young people seeking out porn. Like I think there's definitely a difference there. But I haven't really seen much research about that. So do you think it's time to be afraid or is it time to be like, okay, well sex is becoming a more normal part of our lives. We're more exposed to it and there's actually something positive about that. I think it's a time to educate. And I think a lot of people are scared about how much like porn is accessible to young people.  How do we then best educate them and give them the tools in order to see those things and be critical about them, enjoy them if that's like what they're there for.  And how much dopamine is a release while you're actually having the act because of the fact that you're desensitized in many ways. Exactly. The desensitization to things. It's like you with a lot of most cases of porn addiction.    So, yeah, so basically I try and avoid watching any mainstream free porn, anything that is exploitative. So do you have a subscription service? Yes, so I pay for my porn. Oh wow, okay. School me on the ways. Well, so Erica, like I watch a lot of her films so she has a site called X Confessions and one of the beautiful things about it that I love is the fact that people submit their confessions that are either like things that have happened or fantasies that they have and then she'll pick them and make a film based off of it. So when I'm watching these films I'm like this wasn't some random porn producer-director's creepy fantasy.  Can I ask you a question? I'll give mine actually to you. What is one of your fantasies during sex? Yeah. What's one of your like fantasies that you're like? Because I read this. Have you read What Women Want by Daniel Berger? Yeah, okay, yeah. So yeah, good. But what is one of your fantasies? I'll start with mine. I might edit this out. I have a fantasy. I love hearing about people's specific fantasies because they're so interesting. Fantasy, I found really interesting because I feel that there's a taboo around like, oh wait, you're not like fully in the moment when you're having sex that you think about other things. It's like, yeah. And I also enjoy like watching porn together as well. That's like a big thing for me too. And then when it comes to watching porn together, if your partner picks something that you find offensive, is that the right, when do you bring that up? I'm the one that picks what we watch. Okay. He doesn't care. I'm like, it's like movie night. It's like, let's watch this short film.  How do you suggest somebody broach that conversation in a way that doesn't shame? I think it's about, you've got to recognize where both people come from. Like neither person is wrong. First of all, like if you feel isolated and if you feel unwanted because your partner watches porn, then that's valid. But also the fact that your partner's feelings towards you don't change because they're watching porn. That's also valid. So it's about really trying to see it from the other person's perspective and maybe compromising on it or maybe changing your view or the other person changing their view.   Yes.  I'm not good enough.  I think that that is definitely something that you might feel. But that's not the case. Like, talk to your partner about their fantasies and like what kind of porn do they watch. You might be surprised. Maybe you can watch it with them. I will say like as an ode to Lindsey who's not here, Dr. Lindsey Doe of Staying Curious, I do feel like a common theme throughout your book was that was like you never attempted to tell someone else's story. Hannah's book is called Doing It and it is specifically that it is an all-inclusive guide.  And it's available right now. Yes, you can get it in the UK in shops but if you are anywhere else then the book depository do free worldwide shipping.


Now we're going to move on and look at how to get the answers to problems four through seven, the next section of this assessment. So here I've got to make some new changes. I'm going to cut down the conservation of energy, turn that to one, and the growth rate stays at point one. The blue sliders are going to change so that the renewable upper limit is 20 all the way down here and the growth rate is point one. I'm going to turn the DCR, direct carbon removal switch on, set the start time to 2030. The target atmospheric concentration, I'm going to set this to 470. The cost decline rate, I'm going to make point zero two. So 2% per year decline in the cost of this process. The growth rate in terms of our capacity is going to be 2% per year and the initial amount that we can withdraw from the atmosphere is 5 gigatons of carbon. So that's all set. According to the instructions, now I'm going to run it and see what the ending temperature is in this case. And here, by the end, we see we're down to just below 2.1.97. So that's answer C. Then five is what is lowest pH in this case. So I'm going to flip to page number two. Looks like the lowest pH is back in here. That's about 8.06. So that's answer A. Then the next one is what is the total cost per person? So that's page 14 of the graph pad. I'm going to get there this way. There's 14. We see that's up considerably higher now. It's $9.00 per person at the end of time. So that's answer B. Now the last question, seven is, why do the human fossil fuel emissions drop to zero around the year 2095? So if we went back to, let's say, graph pad number two, you can see the human fossil fuel burning emissions. This is gigatons of carbons rising, flattening off, and then it just crashes. Boom, to zero here. And so why is that? Well, it turns out that if we cycle through here to page 11 on the graph pad, we see the fossil fuels. So this is in gigatons of carbon. And by the time we get to about 2095 or so, we've essentially gone to zero. So we've run out of fossil fuels. And so that's why the emissions dropped to zero, because we've got nothing left to burn. So that's answer C on the assessment.


Guitar and Excel, open chords, C major scale, A minor, 6 chord intervals. Get ready and don't fret. Remember the board's been fretted, so you don't have to be. Here we are in Excel. If you don't have access to this workbook, that's okay because we basically built this from a blank worksheet, but we did so in a prior section. So if you want to build this from a blank worksheet, you may want to begin back there. However, you don't necessarily need access to this workbook. If looking at this from a music theory standpoint, because we'll simply use it as a tool to map out the fretboard, give us the scale and chords that we're focused in on. If you do have access to this workbook though, there's currently like eight tabs down below. We've got the six green example tabs, one OG orange tab and the practice tab. The OG orange tab represent in the original worksheet we put together in a prior section. It now acting as the starting point going forward, mapping out the entire fretboard, giving us our entire musical alphabet and letters, numbers and combining them together and providing a key that can be adjusted with this green cell, helping us to then create the scale that we want to be focused on, in this case the C major scale, providing us the notes in the scale and the chord constructions from the notes in that scale. We then wanted to look at each of the chords constructed from the C major scale in open position starting with the one chord, C major chord, which we did on this first tab, mapping it out on the first three frets of the fretboard, looking at the fingering, showing the one three five, and then discussing in detail. We then went to the F, which is the four chord, skipping the two and the three because the one four five will be the major chord constructions. We talked about it in detail. Then we went to the five, similar kind of process, this being a major chord mapped it out on the fretboard, discussed it in detail. Back to the minors, we went to the two chord, which was the D minor chord, and we mapped it out on the fretboard, discussed it in detail. Then the E minor, the three chord, mapping it out on the fretboard, discussing it in detail. Then of course, we went to the A minor, our point of focus this time, which is the six chord, minor chord construction. We talked about mapping it out on the fretboard in prior presentations. We looked at the fingering of it, and we looked at it in relation to its pentatonic and major scale, which we can think of as either being in the key of C, or you can think of it as the A minor pentatonic and scales as well. Remember that when we're looking at the A minor, so this time what we're going to do is we're going to be talking about the intervals more. This is something that I recommend doing in the morning when your mind is still working, possibly if you have 15 minutes to a half hour to take something that's pretty easy to do, fingering the A minor chord on the fretboard, and then really analyze the notes within it in some detail. We'll do that here first. Let's think about the numbering systems that we want to keep straight in our mind as we do this, because there's a lot of different numbering systems, and if we don't get them straight in our mind, if we muddle them all together, we're going to get confused. For example, we need to name the actual notes in in the musical alphabet. We can do that, of course, with letters, but we can also do that with numbers. So we'll talk about that. We have a numbering system typically used to number the relative positions of notes in the scale that we are in, and then we could alter that numbering system. It's still providing the relative note position in the scale that we're in, but also because now we have upper and lower case, it allows us to indicate what the chord construction will be uppercase, giving us the major chord, lower case, lower chord, that little dot represents the diminished. Then we have the construction or the numbering system in terms of the intervals of the notes in a chord. So when we talk about a particular chord, such as the A minor chord, we think about it in relation to the first note in the chord, not the first note from the scale that we're basically built it from necessarily. So we'll talk about that. And then we can think about the absolute intervals, in essence, in terms of the intervals in our chord in relation to the one chord. So a lot of different numbering systems here, but none of them are difficult in and of themselves. I'm going to go back to the OG tab. They're difficult because people, they get all mixed up, right? So on the OG tab, just remember, I'm still going to argue here for a numbering system to actually number the notes in the musical alphabet. These are not relative numbers, they're absolute numbers. Why do I do that? Why do I argue for that? Well, because if you just say the musical alphabet, it's kind of confusing to be able to just say it forwards and backwards, if you're not, say, in the key of C, right? Because you've got the sharps and flats. So you've got AA sharp or B flat, BC, C sharp, D, D sharp, E, F, F sharp, G, and then G sharp and back to the A. Saying that backwards, just to say the musical alphabet backwards, is difficult. And then you have to worry about going backwards, you should be using the flats, basically. So there's good stuff to that. It works well when you're trying to voice out certain chords and stuff, but it's cleaner in some ways and easier if you just number them. So if I just number the notes and you're going to memorize a bunch of stuff anyways, might as well memorize this, right? So the one is an A, two is an A sharp or a B flat, I'm not going to distinguish between a sharp and a flat when I'm numbering them, because the point of the number is for it to be as simple as possible and also allow me to do simple math to look at intervals. The three is going to be a B, or C is four, C sharp or D flat is five, D is a six, D sharp or E flat is seven, and E is eight, F is nine, F sharp or G flat is 10, G is 11, and G sharp or A flat is 12, and then it starts all over. Obviously, I can count one, two, three, four, five, back down five, four, three, two, one very easily. And I can look at intervals if I'm trying to think about the distance and you can think of notes as distances in essence. If I went from an A to a D, what's the distance? What's the interval? It's going from a seven to a six, right? I can use my math and do some subtraction there and find the interval a lot more easily. So that's the first numbering system I'll argue for. That's why in our fretboard over here, I put both the letters and the numbers so we can see them in both ways, and those numbers are going to help in particular with our intervals. So if we just finger the chord and name the numbers, it'll be pretty easy after a while to see these as both letters and be able to switch in our mind from letters to numbers. Okay, and then we've got this numbering system, which is the relative number of the notes in the chord. There's only seven of them. How did we get those seven? Well, we went over here and we made our key go to a four, which is a C, and then we did our musical intervals for a major scale, whole, whole, half, whole, whole, half, or you can call it two notes, two notes, one note, two note, two note, two note, one note, right. And so if you start with a four, notice the intervals are a lot easier. You can see it just as a formula four plus two is six. If you know that six is a D, then that's easy to do right six plus two is eight. And if you know that eight is an E, that's an E eight plus one is nine. The half step that gets you to F nine plus two is 11, which is a G 11 plus two is back to one because there's only 12 notes in the musical alphabet. So you have to be able to account for the fact that you're going over around 12 back to one. And then one plus two is three gets you to a B three plus one is four gets you back to the C. So these seven notes are what we're using to construct the major scale over here. So that's going to be these notes. And then we construct the chords from those notes. How do we construct the chords? We just start on whatever note is in the scale and take every other chord. In this case, we're starting on the six. So six, skipping the B to here, skipping the D to here, we get to the A C E. When we number them, though, even though I created it from the C major scale starting on the six note, I'm not going to call it the six one three, you could as long as you define it as the six one three of the C major scale. But instead, I'm going to look at its relative scale. In this case, the relative minor scale, which is a very, you know, popular scale that people you would like to be able to re visualize in your mind making it the one. And so so now we can say if I look at the relative minor scale, then now we do have the one three, we just skip every other note from the one one three five. That's why we call it a one three five, even though here I'm looking at it from the six note that we constructed from the C major scale, we're naming it from the one note. Now you don't want to have to visualize every other scale. When you're trying to when you're trying to look at how to construct a chord, if you're working in the key of C, therefore, instead of doing that, you think about the intervals, right? What's the interval from each of these notes to the one chord. And so the three is going to be the distinguishing interval in our case, when we're looking at minor compared to the major. Now also remember that this one three five is here one three five of its relative minor. You might say, well, where's this nine coming from the 11 and the 13. There's only seven notes in the relative minor. And that's because we're basically just going around the horn. And you can look at it at its relative mode, which is the minor as though we started here on the a and we went boom, boom, boom. And then and then if we did it again, we would get to here. And then if we did it again, we'd get back to the B the one we skipped and then we get here and we get back to the D that's that's we're not going to go back and count like the two. Instead, we're going to keep going up to the top. So if it was here, this was the one. Here's the three. Here's the five and then the seven. And then it goes back to the two, which is now going to be called a nine, right? We're not going to call it we're not going to call it the two, we're going to call it the nine because we're going to keep our numbering system going up as we skip every other note. But we're still just picking up all the notes that are in the relative scale over here. Okay, so that's going to be that that concept of it. Alright, so now and now, I think it's useful, like if you just had a little bit of time to put the to just finger this on the guitar, and then and then just try to analyze, given your worksheet here, what we're actually holding down. And then to the point where you don't need the worksheet anymore, and you can just kind of say it in your mind, although I think it's actually better to say out loud. So what I'm going to do is say first, I'll just name the the intervals, am I holding down a one three or a five? So where are the 135? Well, if I'm holding this position down, the first string right here, the open string, let's do it like this, that's going to be the one. So that's going to be the one. And then I'm going to say, okay, and then this string right here, that's going to be the five. And I can also put maybe I should put this over here. That's going to be the five. And maybe I'll do this. And then this string, when I'm just looking at it, I'm going to say, okay, that string is going to be another one. So now I've got two ones and you can start to think about the pattern here. Okay, so this was a one. And this is a five. So if I just look at those two strings that relationship, you've got this relationship here between these two, I'm trying to look at I went back to here again, the one and the five. And that's like your power chord relationship. So if you've played the power chord like this, you're always going to have the five there. It's going to be the same interval, whether it be a major or minor. And then down here, I grabbed the wrong one. And then down here, you have your a. So now I've got another a here. So this was an a when it was open. And then this is an a. So that's a relationship that you'll see as well. If I if I see my a up here, for example, down two strings and over two frets, you'll find another a right another a different, different octave, but another a. And then here, we're going to say this note is going to be the three. So now we're on the three. And so notice that the three is down one and back one. But it's of interesting relationship because of the different interval between these two strings. So that relationship will basically be kind of unique to these two strings because of that different interval between these two. And then we've got the open e down here, and that's going to be my five. So that's the first thing to kind of be able to map out because because then you'll be able to see the relationship between the the ones the three and the five. Then I and notice this is also a bar chord, by the way. So if you looked at it like this, you could say, okay, that's a bar, you know, that's the your bar chord. So if you move that like up to here and you moved it in position, this would be a D minor bar chord that I'm moving up, then you can analyze your bar chord, which will always be the same if you're playing a D minor bar chord. And that's your that's your root. You can say, okay, in terms, this is not an a, but I know that it's going to be my one, right, it's going to be my one, which happens to be a D. And I know I might not even know the note that I'm playing down here. But if that's the one, I know this is the relative five to it. And I know that this is going to be another one. And I know that this is my third. Notice there's only one third, and this bar chord construction. So you have to make sure that you get that third in there. Otherwise, you're just basically playing a power chord, which is cool. You could do that too. But if you want a full thing, you got to get that in there. And then here's another fifth. So notice, as long as you know that one note, you can move this bar chord up and you could just say, Well, I'm playing whatever note that is on. And you know what the interval notes are, even if you don't even know the notes in the chords you're playing, right, that's the power of knowing the shape, and then knowing just the intervals that you're in. So now let's go let's go back in and say, Okay, well, now let's analyze it a little bit more in depth thinking about the intervals up top. Now notice that these intervals that I put up top are related to the one chord. So what I'm looking for then is when are these chord constructions intervals different than those on the one chord. And when I'm looking at a major or minor, it's going to be the third. So this is the major interval to note to our whole step. And then the minor is going to be different. Okay, so knowing that I'm going to go back up here and I'm just going to try to say this in my mind, I'm going to say, Okay, that that one is the relative position. I'm saying it's relative because it's going to be relative to the chord that we're playing, not even the scale that we're in. So I'm going to try to define that in my head. That is a relative number relative position one of note a or note one, which is an a relative position one of note one, which is an a and which is of course, a one or an a right, I'm just going to list that in my mind and then I'm going to go over here and say, Okay, this one is going to be and I'm going to call this and notice I didn't really have to say because it's the one I didn't have to say if it's a major or minor, I can say, Well, that's if that's my one note, whether it's major or minor, it's still the one of whatever chord construction I'm making, whether it be major or minor, then this one is going to I'm going to call this a relative position that note. What is that? Well, that's a relative position. I'm going to say it's a seven note away fifth. What does that mean seven note away fifth? Remember the fifth is the interval you might say, Well, the end we made it from the C major. So is that it's a G the fifth is a G no, the fifth in relation to its related scale, which is the is the minor scale, if I had an a minor scale, the fifth would be the E. So that's what it is. But I'm not going to I'm not going to have to think about the scale, the related scale that's kind of tedious to do what I'm going to do instead is say is know it by the interval, right? I'm going to say, Well, the fifth, the fifth related to the one chord is seven absolute notes away. So I can look at it by position and I can know it by interval seven notes away. So if I pull up the trusty calculator, and say, Okay, we don't really need the calculator, we can do it in our head, but calculators easier. And I could just say, All right, well, if I started on a one, and if I and if I name my notes as a one plus seven, that gets me to eight, and eight is an E. So you can see how just analyzing these simple chord positions this way will help you to memorize the intervals. It'll help you to memorize the relative positions help you to get the numbering system straight in your head, and help you to then put a numbering system in place for the actual numbers, absolute numbers of the notes, which I which I find to be useful. So then, okay, so then what I'm going to go then here, let's go to the C. Well, that's the wrong one. Wait, I want to go to the a. So then here's another a so I'm going to call that relative position one of note one, a, which is no one or a. And then this one, I'm going to say boom is here. And I'm going to say that that one is a C. So that's going to be here. And I'm going to say, Okay, that's a relative position, not four notes away. It says for why does it say for because that's what it is for the one chord. And I made it yellow, because it's different here, that's the differing factor between a major and a minor. And that's going to be that it's not four notes away, it's three notes away. So this is a relative position, three note away, minor third. I'm also going to define that it's a that it's a three notes away instead of four, and that it's a minor third as opposed to a major third, because this is the differentiating fact differentiating factor. The third is the differentiating factor between the major and the minor, the minor being that's you can call it the interval, you can name the interval as a minor third, which is basically three notes away.  However, you want to measure that interval. But I think the easiest unit to measure them in is notes and three notes, it's three notes away instead of four notes away. So then I could say, Okay, well, then I if I started on a one or an A plus three, that gets me to four, which is a C.  If we go to this E again. And we say that this one is seven notes away. What does that mean? Well, if I start on an A, like here's an A, the open note is an A right here, and I go seven notes, that's seven intervals, one, two, three, four, five, six, seven or seven frets. So then I get up here to an E. So this is an E right there. But it doesn't really help me because I'm trying to play an open position. So it's cool for me to go up to that. And that'll that'll work. It might fit that in there. But but you can also see that this E and that year both ease and look at the relationship between that. Well, that is one, two, three, four, five frets up the fretboard and one fret up towards the ceiling on the fretboard. When I look at the third, I'm saying it's three notes away from the root. The root once again is a so it's an open a. So 123 frets up gets you to your C. So there's your C right there. Now that's pretty much in open position. But I don't normally want to hold it down because I want to play the open a right. So that's why the C down here is useful. And you can look at that relationship and say, Oh, those are both C's. And that'll start you to kind of see the pattern within the fretboard as well. If you want to count them up, you know, on one string. But so there's the C and then we're going to go to the E again. So the E is down here. And I'm going to say this is a once again, seven or the ease down here, boom, that's going to be a seven note away. I don't have to say minor or major because it's seven notes away, whether it be major or minor, seven note away, fifth of note one, which is an A. So I'm just going to say, Okay, one plus seven is going to be eight, eight is an E. Let me do that faster this time. I'm going to say, Okay, and then I and then I would do this without the without the key here. So okay, this one right here, boom, that's, that's going to be this note. The open a is relative position one of note one, a which is of course note one, a and then I'm going to go Okay, and then this one is going to be here, dude, dude, dude, dude, dude, dude, that's going to be relative position seven note away, fifth of note one, a which is seven plus one, or eight, eight is an E. And then I'm going to go over here and say, Okay, this one, no, okay, that's going to be relative position one of note one, a which is note one, a and then I'm going to go here and say, Okay, this one is going to be relative position three note away, not four note three note away, minor third defining that it's a minor of note one, a which is one plus three, or four note four is a C. And then I'm going to go here and say, Okay, and then this down here is going to be relative position, relative position, seven note away, fifth of note one, a which is one plus seven, or eight, note eight is an E. Right. So you see how just by, if you say that in your mind, you're solidifying the shape, you're solidifying the the positions in the shape one three five, where they are located.  Now then you could, you could experiment beyond that you could say, Well, if I put this on top of the minor scale, I can look at the minor scale in relation. And remember, the minor scale is just these these five notes out of the seven. And because this a minor is special, meaning, you know, it's the relative minor and in Western music, we focus on the major and the minor, this pentatonic scale fits beautifully. And you can think of it as either the C major pentatonic or the a minor, you can't think of it so much as the the Dorian pentatonic right or the Phrygian pentatonic or anything right. So but let's go down to this scale down here. And this is going to be our our the whole major scale, or you can think about it as the whole relative minor scale here. And I'm going to build my my fingering again. And then we can think about picking up other notes in this right so you could say, Well, what if I played what if I play just like these notes, that would be like a movable shape that you can do. So that would be like this. And then I could say, Okay, well, if I did that, let's make this yellow again. And I'm going to go go here and say, then I would start analyzing that with my, with my root, which is now on the bottom. So usually, I would I would look at it from the root and say, Okay, well, that bottom note then is my a that's relative position one of note one, a, which is an a, and then above it, look at the construction here above it all the time. And unless you're looking at the relation between these two strings, you will have a fifth, whether that fifth, whether you're doing a major or minor, you're always going to have a fifth above it, right? So now you're going to say, Okay, well, if that's the one, then this one above it is my relative position seven note away fifth of note one, a, which is the one plus seven or eight note eight is an a, and then I can go Okay, and then up and over one, you get the the third, which is the minor third. And that's where the position is going to be a little bit different because that's the different chain factor. So if this was the fifth, then up one and over one, you find the minor third, which will be different than if you find the major third, or if you're looking at it from the first, from relative position one, you go up two strings, and over one string, you're going to find, you know, the minor third that pattern will repeat. So if you move this up the fret board, it would be remaining the same. As long as you know where your root note is, which is down here in this case, because it's inverted, we were inverted. Well, if you were directly above him, how could you see him? Because I was inverted. So there you have that. So we're going to say that that's going to be the three note away minor third of note one, a, which is one plus three or four, four is a C. So there's that construction. You can of course look at it when you move this shape up this way. You might just look at these three notes, right? And this is a very common weight way to see it as well. It's just part of this same structure. But now you can imagine that if I move this, this up, it would look like this, right? And so now you've got relative position one. And then the third is down one and back one. But that's because of the relationship between these two strings being a little bit different than all the rest of the strings. So you're going to find a different relationship between those two. And then down one and back one, here you would find then the fifth that's useful because then again, if you move this up to here, for example, then, you know, you could see the same relationship here would be like, like the C minor, right? You could see a relationship that would be the same as long as you know what the root is, then you can kind of move that shape up and you can see the relative strings around it. Now, then you might think, Well, what happens when I start blending stuff around? Because last time we talked about picking up fingers and doing crazy stuff. And we basically were thinking of it in that sense as I'm just going to do whatever I want to do to blend things together as long as I'm within this structure, all the all the colored notes, and it should be okay, right? But if you want to analyze that more technically now, which we'll do more later, but you could go beyond and do that now, you could you could say, Okay, well, if I picked up this finger, then I'd be going from an E to a D. What does that mean? Well, I can go Okay, what if I picked up E to a D? I still have all that all I need for a minor chord construction. But I have another note, which is a D. And that note is over here. So you could say, Okay, well, it's a D right there. And if you do that, as long as you're picking up a note that is in the scale, either you can think of it as the C major scale or the relative minor, you'd probably be thinking about it as the relative minor, but it's all the same notes as the major here. You would you would say, Okay, I can I can say it's going to be the the 11th. Now, remember, when you look, I won't get into the detail on the intervals out here, because it's going to be a whole nother, you know, can of worms, as they say. But if you want to get into that, just remember that the intervals here that we created up top are the intervals that are related to the one chord. And and so we decided we then we're going to say any other chord down here, we want to see is it different than the one chord? If you're looking at the majors and minors chords, the three is going to be the one that's different. When you look at these other, these other ones up above that, you can't just say, Well, this is a minor and this is a major, and therefore the intervals will be the same. That's what gets confusing about them, because you could have a situation where you have to know it's the four chord will have a different interval, for example, and the one the easiest one that that or the next common one that you'll generally learn would be the seven, right, which can starts to confuse people because it's like, Okay, the seven, if you if you're looking at the major sevens, then you have a different interval between the one and the four, and then you have a different interval for the five. So you can't just say, Well, all the majors are going to be positioned in the same shape on the fretboard, or have the same interval, it won't be the same shape because it doesn't have the same interval. And therefore you have to start thinking, Okay, this is the interval when I'm playing a certain chord. So then you can start to to figure out which of the intervals are the same, which are different, but it's not going to be as easy as just saying, all the majors are the same, and all the minors are the same. But if you're playing in the key of C, you can just grab whatever is in this position, and then you can analyze it more in depth, if you so choose. So obviously any, anything is like that, not just the open chords, like I could pick my finger up here, and then put it down here, for example.  Well, then what happened? Well, now I've got this is now here. And, and I've added this, right? So that's so so now I've got something like that, which sounds a little bit more kind of dissonancy. What so what did I do? Well, I added a B there. So we added a B. And we added a an F. And that 13 is the one that usually makes it sound a little bit more a dissonancy type of thing, a little bit more attention in there. So so so that's what that's basically what's going on there. So you can kind of analyze what you're doing there. So I would practice like in the evenings or something not analyzing it, just trying to say, Well, that's in, you know, that's in, I know that's illegal. So I'm just going to blend stuff together and see like, what if I grab like some stuff and work with your fingers and then when you want to get into why does that sound good or why does that not sound as good? Then you could start saying, Well, what am I actually picking up over here? And then the next step would be to like kind of look at the intervals, what are the intervals of what I'm picking up. And if I was to change keys, which we'll talk about later, what kind of things can I pull with me as I changed the keys? Because it'll be different in the relative position. In other words, if this minor chord was constructed as a two chord, instead of a six chord, what kind of things can I still pull with me? Well, the 135 construction would be the same, because it would still be the 135 is going to be the same if it's a minor construction. But then the seven through the 13 might be more dependent upon the position, right, whether it be the two chord or the six chord, that kind of thing. So any case, we'll talk possibly more about that later, but I just want to touch on it now. So if you wanted to dive into that, you can analyze it that way. And analyzing that kind of stuff, by the way, which is really interesting, is way easier to do way easier, in my opinion. I mean, I'm not like if you have your number, if you number the notes, because then you can look at the you can actually look at these intervals and say, Well, why is this different? Why is this shape different? Instead of having to count up the scale, you just count the actual intervals, you know, Oh, yeah, well, has a different interval. That's, that's why that's easy to know if you can do a little subtraction, which would be nice to be able to do, which you can do if you had numbered. Anyway,


How are you? How are you doing tonight? Welcome to downtown crossing. We're having a great time tonight. This is the Illuminous Festival and We've got lots of artists doing lots of lighting projects. This is the light rover next to me here You can see all the blinking lights people love to sit on it and get their pictures taken But we've got all local artists doing arts projects all night long right here in a downtown Boston Business Improvement District So come on down and enjoy it Well, as I said, it's local artists that all auditioned and and gave proposals and they took almost 250 proposals for different projects and They were curated and this is what we have These are the best of the projects that were submitted you know within reason people do get grandiose so all the artists Proposals were curated and choices were made and they're here for two nights showing off what they can do with light And there's some pretty phenomenal things so you start here and you walk up Washington Street and while you go up the street You see a different exhibit almost every step of the way Well, this is a second year here and last year we had over 30,000 people in two nights So we're hoping to do better than that hopefully the weather helps us out a little bit, but It's great. It's a great great time to come into downtown crossing Stand out here at 10 o'clock at night and enjoy yourself