I know I'm not the only one who had a crappy childhood so in this video I want to share with you my journey of trying to forgive my alcoholic mom. What is up everybody this is Chris from the Rewired Soul where we talk about the problem but focus on the solution and if you're new to my channel my channel is all about mental health and I do my best to try to help you to improve your mental health so if you're into that kind of stuff make sure you subscribe and ring that notification bell. So I have a ton of new subscribers there have been a lot of topics that have come up lately and I think this video will summarize a lot of what people have been asking what people need help with and all of that and a lot of you are going to get to know me a little bit better but there's a lot going on so I've made some videos about how your childhood can affect who you become as an adult using that as a reason but not as an excuse. Two of the big things that are important to me and my mental health are forgiveness and empathy and these are things that took me a very long time to figure out and it's really hard to tell people who are just meeting me that I used to be the angriest person that you would ever meet. I was just constantly and perpetually angry and a lot of that had to do with my depression my anxiety my childhood and everything but anyways let me let me share with you this story it's going to be kind of long but if you are somebody who had a bad childhood a rough childhood I hope this video gives you some hope I hope it helps you heal I hope it gives you some suggestions so anyways I'm the child of an alcoholic mom alright spoiler alert for those of you who don't know my mom was just in a video I did yesterday I think she's coming up on 13 years sober alright so I just want to get that out of the way but anyways growing up my parents divorced when I was about four years old we lived in Fresno California they got divorced not long after I moved in with my dad and he was my primary parent and I would go visit my mom on the holidays something that just came to mind is that for many many many years and even to this day I'm not sure but for many years the way I had that story in my head was I was living with my mom she sent me to go visit my dad and then she just didn't want me back and I just stayed with my dad so if you if you imagine that as a five-year-old child like that's something that gets printed in your brain and something that's come up in my videos recently is trust issues so like it's important to go through this process and realize like where these things are coming from so anyways it wasn't long after that when my mom started drinking heavily so I would go and visit her during the holidays so we're talking about Thanksgiving and Christmas and she met my stepdad not too long after they're no longer together that's a whole different story but yeah I just remember going down there and every time I would go to visit she was just insanely drunk and my mom was the type of drunk where she was homicidal or suicidal like she was threatening to stab or kill somebody else she's this feisty little Sicilian woman or there were times when I was like seven eight years old and I remember my mom like locking herself in the bathroom threatening to kill herself and like that's rough that's rough as a child I remember you know Thanksgiving's or Christmas Eve I just remember my mom getting blackout drunk like these are supposed to be this family time of the year and my stepdad having to carry my mom's unconscious drunk self to the car as we drive home and I remember just sitting in the back of the car just thinking about how much I just hated my life and I hated everything I always was just like why can't I just have a normal childhood and there were periods of my life like as I got older when I became like I don't know middle school high school age there were times where I just I just didn't want to visit my mom anymore I just didn't want to go out there I just didn't understand why she couldn't love me or why she couldn't stop drinking because of me like doesn't she care about me enough to just quit and I got I would get fed up with it and I just wouldn't go visit her I remember somewhere around high school there was like a year or two where I just went without even talking to her like I just had so much anger and resentment towards her like I did not understand why this woman could not quit for me you know and I got I got older and because my mom was an alcoholic I swore that I was never gonna drink or use drugs and at the end of my senior year that's when I got drunk for the first time because of a breakup and you know I thought I was gonna marry this girl and all sorts of stuff and I just didn't want to feel anything I I never knew how to handle my emotions I was always anxious or depressed or angry and the first time I drank I was like oh okay like this gets rid of everything and that's what started my addiction so I have a ton of other videos like I just want to kind of give you like a a brief little history of what my life was like before I started drinking and real quick I'm gonna pause right there I think it's important to understand two things statistically children of alcoholics or addicts well let me put it this way people who have addicts or alcoholics as their caregiver they have an 80 chance of becoming an alcoholic or an addict because of their environment there's also a 50 genetic factor in there so like I often I do a course like at the treatment centers I work at and like I go through the risk factors and like you can add all these things up and like I was screwed from the get go of becoming an alcoholic or an addict but I do want you to have a little empathy for those of you who don't struggle with addiction or anything like I just want you to know again it's a reason but not an excuse a lot of the people who have addictions had some kind of really bad childhood so there's a story that I don't tell often and those of you who understand or know about 12 step programs it'll make sense to you but when I was in like in deep into my alcoholism was when my mom got sober and she she wanted to come visit me in Las Vegas and I lived in a little two bedroom apartment with my roommate and my mom wanted to come visit me which I thought was weird I'm like okay and her being sober just didn't really click for me right so she came and visited me and like I remember she said at a hotel here in Vegas not far from our apartment and she came by the apartment and like she came in and there was just alcohol bottles everywhere and beer cans everywhere and her heart must have been breaking you know seeing where I was at and the morning that she was leaving to go back to California she asked if we can have breakfast so of course I'm like okay let's go to this uh this bar across the street from my house because here in Las Vegas they're 24 hours and they have cooks 24 hours so we went like six or seven in the morning and we go there you know because of the omelets are really good and like I was I was drunk I was already drunk and my mom sat down and she apologized to me she apologized to me for everything she's done and you know my childhood and her being an alcoholic and everything and I'm just like whatever because to me that's something that she always said she always said that like she would be drunk when I was a kid and apologized to me so I'm just like whatever um later on I found out she was doing her ninth step with me all right she was making an amends with me and that's really interesting you know someone making their ninth step to their son who is getting drunk at like seven in the morning at a bar really weird stuff so when my son was born a few years later my mom was still sober and she came out to visit and like I don't know I just remember there was this change in her right she had this kind of glow she kind of had this happiness and peace and serenity it was like it was like this mom that I hadn't met before um but I still had all of my issues with her like you don't just let go of 20 years of your life and pretty much hating your mom right so years after that after my life spiraled out of control my mom's actually the person who saved my life I'm gonna be linking a bunch of videos in the info card where I've talked a little bit more in depth about certain sections of my story I also wrote a book like shameless plug but I wrote a book it's like five dollars on amazon I'll link it in the description it it's pretty much my story of addiction and recovery so if you want all the deeds like go ahead and check out the book or go to my website and you can get a free copy anyways back to the story so my mom ended up um saving my life and I got sober and I was so mad at her um I remember when they had an intervention I was just screaming and cussing at her just this is your fault it's your fault I'm the way I am and I called her all sorts of names that you should never call anybody you know especially your own mother right and all this and you know she helped me get sober and I went into sober living for a few months and then I ended up moving with my mom and I was just so angry I was constantly fighting with her constantly I just had so much anger and I remember calling people and calling my sponsor and just being like I don't know why I'm so angry right like all the time so now we're gonna get to this kind of healing process so one of the things that I learned is just to let go all right and forgiveness is a huge part of that something I always teach my clients and it's because it was a huge lesson to me like forgiveness I think I think in our brains and part of it's our ego we feel that forgiveness is letting the person off the hook for every terrible thing they've done I don't think of that about it like that forgiveness is letting me off the hook it's letting me and myself the sooner I can forgive somebody whether it's my mother or the person who cut me off on the freeway the sooner I forgive them and let go I can move on with the rest of my day or the rest of my life even so that's something that I learned now one thing that broke my heart so my son was three years old when I got sober and this is where empathy comes in and I saw I saw people in my mom's life that were just treating her like garbage right like you know we all get so wrapped up in our own stuff and I had so much anger towards my mom but I remember just seeing people talk smack to my mom and my mom was seven years sober at this time and people were still people were still giving her crap about what she did in her addition I'm sitting there like wow like I want people to forgive me for all the terrible stuff I did in my addiction why why can't I do that for my own mom so that kind of helped me like I empathize with her maybe I sympathize with her you know but like I knew that I didn't want to be treated like that so that was part of it which really kind of like I was like you know what maybe I need to start calming down a little bit now here's the most transformative part I I learned through the program that I work to get sober to to write things down break things down look at my fears and everything and basically what I what I found was like okay so look at me I mean I was an alcoholic a drug addict and stuff why did that happen because of my childhood right and I blame my mom well I had to look at my mom's past okay and this is this is something I would ask all of you if you have problems with your parents like look at their past look at their childhood can you empathize so I already asked my mom like a couple weeks ago when I was starting to plan to make this video I was like do you care do you care if I'm completely open and honest she's like I don't give a crap right so my mom's awesome but so let me put myself in my mom's shoes real quick so my mom grew up in a time where there was still a lot of racism okay the 50s the 60s and all that and those of you who don't know surprise I am half African American yep that's right my father is black so my mom she as long as I can remember my mom is just attracted to African American men you know and yes I know all of the jokes that come along with that but my mom is attracted to African American men but anyways back to the serious note imagine a young white woman growing up in an area where this stuff isn't really accepted and my mom is only dating black men my mom got bullied picked on beat up my mom has two fake front teeth right and just so you know like my mom ain't no punk like my mom wasn't just getting whooped out like my mom was a scrapper so she fought she beat some butt too but like my mom was beaten for who she was attracted to like that stuff is insane to me right my mom was beaten by people at her school they called her an inward lover and all this like this is what my mom dealt with in her childhood then going home my mom is Sicilian my grandpa is Sicilian my grandpa is way more accepting now but back then you know it wasn't okay for my mom to date African American men my my mom was beat by my by my grandpa like I remember my mom telling me stories they were like beat with a hose my mom would like step up to my grandpa when like he was gonna hit her twin sister or her other siblings like my mom was getting in between that so like I'm sitting there and I have to look at this like look at the childhood my mom had right then later on I mentioned this a long time ago in a video but I'm actually supposed to have a brother who's a year older than me okay but my mom um her and my father's first child he died just a few days after he was born all right so like after that my mom had a lot of trauma and panic attacks and so much stuff going on so like when you start to compound all of this stuff that happened through my mom's life like I look at I'm like no wonder why she turned to alcohol like no wonder you know what I mean and again it's a reason but it's not an excuse but my mom did what so many people can't do which is get sober and then she helped save my life so like this is what helped me heal and process this stuff is that I realized like you know not everything is about me like yes I can sit there and think about my rough childhood this and this and this but when I can step back and say okay well her childhood was rough and maybe that's what turned her into the person that she became that helped me forgive her and today and you know I'm not even gonna jump to today I will say this I lived with my mom for a while before I moved back to Las Vegas and I remember this and I just think this is an important part of the story I remember everything was going great for me I moved back to Las Vegas I got a job I got a beautiful um girlfriend who I felt was way out of my league I had money in my pocket I was seeing my son again just all sorts of stuff and my days were going great but then my mom would call and my day would go to crap and I started to notice this pattern right like my day's going great anytime my mom calls me it goes to crap right and I was like over a year sober my mom was sober eight years at this time and I ended up telling my mom I said mom listen I love you okay but right now I need to work on some things before me and you can talk I said I need to take a break so I didn't talk to my mom for a few months why while I worked on myself all right now me and my mom have an amazing relationship so the reason I share that as part of this story is sometimes you have to take a break and heal like sometimes like I don't think I ever had the proper distance from her to fully heal like it was a struggle to forgive like all the stuff I was talking about with her childhood like it made sense but it was hard because she was constantly in my face but when I was able to just cut her out and just have my own kind of like space to process and deal with this then it got better today my mom and I are like best friends um she calls me for advice I call her for advice she's a psychologist she has a phd in psychology um she specializes in addiction I mentioned this the other day our dream is to someday open a treatment center together and help people like my mom and I just our relationship is amazing today and that's why I want to give you some hope but like that hope is like we a lot of times we expect the other person to do all the all the work we want the other person to grovel and apologize and forgive like it's my mom's coming up on 13 years sober I'm six years sober there are still people who hold my mom's addiction over her head right like I had to step back and realize like I have to put some work into this I have to put some effort into this like they cannot do all the work there's only so many times a person can say sorry you know what I mean but I actually get to go and uh visit my mom this weekend as well as my father and a bunch of other friends and everything like that but I really hope this video helped any of you out who had a rough childhood if you have anybody in your life that you're struggling with forgiving again I will repeat this one last time forgiveness is not letting the other person off the hook for what they did forgiveness is letting yourself off the hook so you can go to sleep at night so you can move on with your day all right but anyways this video is way longer than I expected if any of you have any experiences that you want to share or maybe if you want to leave comments about how you're struggling to forgive people maybe I can do a follow-up video about this make sure you leave comments down below all right but that's all I got for you if you like this video please give it a thumbs up and if you're new I'm always making videos to try to help you out with your mental health make sure you subscribe and ring that notification bell and a huge thank you to everybody supporting the channel over on patreon you help me do something I love which is help others with their mental and emotional well-being and look there's some new names on the patreon list if you would like to become a patreon supporter just click 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We should not be complacent by the fact that there have been no scandals, and there are no revelations in the media, that actually everything is fine in Scotland, Having said that I think actually it's a really good time to consider these proposals. I think you know in terms of good governance and kind of an even look at these things best to do it, not in a crisis moment when you're reacting to something but to actually look across the field and think what can we do here to improve the transparency and accountability of this Parliament, I think there are various sound principles and I think proposals ar how lobbying transparency are completely aligned to the founding principles that institution, I think it would make a real concrete contribution to actually advancing that. The CIPR approach over the last decade or more has been to pursue a joint approach of transparency and of signing up to the UqPAC register, which all CIPR members are required to do, and also a voluntary code of conduct, which we think sets a very high bar in terms of professional standards of CIPR members. In addition to that, there is a swit o'r traenig ac edrych yn gyfrifio ar EICIPR a cyfwrapeth i gfynodol a oeddiad aeth yma sy'n strategiaeth ar y Loiwg Llywodraeth ac yn gyfer yr YUK, mae'n bobl sy'n cyhoeddwyr yn meddwl. Mae'n gwybod dda i ddweïddio yn ei dweud o ddod o gydag o ddod. Mae hyn yn myth i gydag o ddod is demonstrating that that approach is working in the fact that there hasn't really been any issues in Scotland over the course of the last 14, 15 years. It captures the lobbying activity. The one that's proposed in Westminster at the moment is a list. It's a list of names and clients. It doesn't show any information about their interaction with government bodies, so it needs to have what people are lobbying on and whom in government they are lobbying. Otherwise, you just have a list of names. If you're going to have transparency in lobbying, it needs to capture the lobbying activity, not just who. The democratic access and tradition in the Parliament is one of its, the processes are one of its strengths. As I said earlier, we do have a problem with democracy in Scotland because we've got a million people nearly disengaged from politics, actually mostly in our poorest communities. That's where people are not voting at a local government election or a national government election, and that's where the disengagement is. Now, I don't think a lobbying register is going to make any difference to that. We need to be careful about just being realistic about the difference between an organisation whose prime purpose is to lobby. It's well resourced. It's very able to comply with a regime because it is someone whose job it is to do so and a very small charity or community group or grassroots group that might forget or that might not get the paperwork because they don't have an office, or that might be acting in the very best of faith but actually not keep up to date with the register. We maybe have to have some way of trying to distinguish whether there's been administrative oversight or change of staff, that kind of thing, or whether there's some kind of deliberate evasion going on. I think that's important. Sanctions, I would really ask you to think long and hard about that because I come back to the principle lobbying is a legitimate democratic pursuit. The fact that scandal only becomes scandalous when one is given access to secret information doesn't mean that there aren't things that might be exposed going on. I think for the Electoral Form Society all the research that we've done through focus groups and our Democracy Max Inquiry shows us that the general public feel that there is an opaqueness and a secrecy going on behind politics and they would like more transparency which would improve their confidence in the process and therefore potentially increase their involvement in the political sphere, which is something that we are very worried about. I suppose from the society's point of view certainly we've detected no particular problem with what lobbying is carried out in the Scottish Parliament or with the Scottish Government. I think, though echoing what Juliet has said, in terms of maintaining public trust and confidence in the system, the system has to display that it is free from any suggestion that there might be a lack of transparency. Therefore, I think that we're in a position where we agree that theoretically, although there might not be a problem, that doesn't mean to say that additional transparency wouldn't help to prevent that from being a problem emerging in the future. Lobbying I think is one of the most contested definitions of any concept in political science. Rarely get two scholars that are going to agree with what is meant by it or what's meant by the term lobby group. Now, generally I think an accepted definition would be to the effect of a lobby group as an individual or organisation which would have shared or vested specific interests that tries to seek to influence political decisions. That's a very important distinction to make between influencing and seeking to influence. A lobbyist isn't necessarily successful but they seek to influence. My starting point is that I don't think that a register or legislation is the right way to go. I think that it would be a real displacement of energy and activity and, frankly, taxpayers' money to spend a lot of time doing that. I think that there's a number of other things that you could be doing to address the fundamental issue, which is about confidence and trust in politics and good decision making. The aim and aspiration of this Parliament is to encourage openness and access and a free flow of information and to build understanding. The last thing that you want is people worrying away about how they're labelled and whether they've complied with the rules before they come and speak to politicians. Obviously, it's important for decision makers to be transparent about who they are meeting with and I absolutely agree that MSP diaries should be made public. Equally, those who are seeking to influence need to bear in mind their responsibilities to be as transparent as they can be also. I would certainly say that I think a lobbying transparency register would make MSPs' needs to apply to the code of conduct a lot easier because you would have a basic piece of paper that told you who people were and who they were lobbying on behalf of.


Yeah, you're trying to get rid of me. I tried my best, Mark. We were the second smallest group. I have had plenty of things to say, but there's never any shortage. We actually shared the room here with Murray, and it was quite interesting because I noticed that Murray was unable to come to consensus with himself over several points, which, you know, just as a comment. So our group was Betty Graham, Pearl O'Rourke, Laura Rodriguez and myself, and we ended up talking about, I think, some overarching issues that have come up across many of these projects, and I'll just go through these very briefly. One that came up quite a bit yesterday was IRB-related issues and the fact that there's a high amount of variability between how our institutional IRBs approach these types of projects. And so the idea is, would there be the potential to develop some general guidelines to review, perhaps a point to consider, or FAQ, best practices that could be disseminated? There was a fair amount of pessimism that we can engage with OHRP to actually have them issue a guidance about some of these issues that we're coming up with. But there's also perhaps the opportunity to do some discovery, and so we were thinking about the idea of taking information that had been collected from a survey that Wiley Burke had done and had been recently published, and to use this as a basis of a tool that could be distributed to members of the Genomic Medicine Group, to investigators and also to the group's institutional IRBs to try and answer some questions, which is, can we understand why IRBs are giving different answers for the same project? And if we can identify some of those areas, is there a way that NHGRI or other entities could provide some guidance or fill that gap? Now this is something that turns out has been sort of on Laura's to-do list for a while, and so she volunteered to take leadership of this, and so there will be more to come. The second issue that came up frequently was the idea of the clinical research interface. You know, what is clinical care? What is discovery research? There are blurring of these issues, and there were several sort of case studies or examples that we came up. Some of it related to logistics and electronic medical records that in some places research results are contained within the same data warehouse. As clinical results and while there's attempts to firewall research results, in some cases when you have a clinical investigator they have actually access to some of these research results, which can lead to mixing of research and clinical data, probably not the best way to do that. This is not new with electronic health records, if that can certainly and has happened with paper. It's just probably the energy barriers are lower. So this was the example that was given was an oncology clinical trial where genetic testing was done as part of a trial for discovery and that somehow those test results were then available in the electronic health record even though we'd had no idea what to do with them. HIPAA treats family information differently than OHRP. There was an example given from the Virginia Twin Study where OHRP issued a guidance or said, if you have an identified subject and then you identify a relative of that identified subject, so the mother of an identified subject that that subject is by definition identified and is a potential research subject that may be, or is a research subject that may be subject to consent. And while we've talked about it to some degree in a hypothetical situation, the reality is our clinical laboratory colleagues deal with this daily trying to make an assignment of whether something is pathologic or benign or uncertain. And there have been, this came up more at our previous meeting last week, that there are issues relating to when does that cross the line into research and at least one clinical laboratory has an IRB approved protocol that allows them to do family contact to look at whether variance or de novo or familial and to get additional phenotypic information. The return of research results that are actionable that we discussed today and the blurring of the term consent. So we give consent to receive clinical care, but in some cases the consent to receive clinical care also indicates information provided to say we're going to be using residual specimens for research or other purposes, and so there is some blurring in that area as well. There is the potential to do discovery around these questions of blurring. There may also be the opportunity to do evaluation or inventorying of different approaches, what are we all doing to deal with these issues, and also to study consequences of this blurring. And this just by chance happens to be the subject of the panel that I'm going to follow my talk, so we'll have plenty of opportunity to discuss that. Variants for clinical use. Different groups are making recommendations about what's ready for primetime. We've heard about those. For the most part, with a few notable exceptions, these decisions are being made on a siloed basis or they're institution-specific. Would it be possible to develop criteria that we could agree on that would allow us to evaluate the clinical implementation of variants? And if so, how could we facilitate the consensus building around this? Is that a role that this group could fulfill? This was also an issue that came up in the previous meeting and so one of the proposals that we would have would be to create a work group that would be a subset of members from this group and membership, from the previous meeting to address these issues since they're relevant to both. We've heard about implementation science and while we have a lot of varying expertise in the room, we don't have a lot of expertise related to people that are actually the implementation scientists that are studying implementation. So the idea could we create a group of consultants for systems, members of this group that are looking to implement something. So this would be implementation scientists, quality experts, to help with some of the issues that need to be considered in terms of how do we actually successfully implement something. I mentioned yesterday the liaison with the dissemination implementation group through NIH of which we have some representatives here, David Chambers, who we'll be hearing from shortly. So that may be a possible opportunity to enhance our knowledge around those areas. Developing a suite of validated methodologies to collect data out of the clinical setting, to answer clinical and research questions, to complete that dynamic loop so that when we put something out into clinical practice, we can actually collect the data to show that this really is having an impact. An example being what we talked about earlier with Murray's project that if we can show that we're canceling fewer surgeries, that that could be a signal to administrators that would say, hey, there's something important about this genomic medicine and maybe we should be looking for more opportunities to take advantage of it. We also probably need to understand more from our colleagues that we're going to be imposing this on about what their experience has been with the genomics. This was a very enriching for us when we were looking at family history implementation to actually find out what it is they were doing, how they were experiencing. We just don't often ask them, what are you actually doing with this and what do you think about it? We learned some things that we really didn't suspect going in and had we gone forward on our preconceived notions that we would have not had a successful implementation in a couple of different areas. Those are ideas that we kicked around that were there to be the possibility for collaboration or perhaps more importantly incorporation of these concepts into some of the other projects that are more specific to some of the content areas that went previously. I'll take questions. I have a question, no. But will you be able to come to consensus with yourself? I'm of two minds at that. Mark, I think the idea of aligning the rules for sharing family information, both family history and genetic information is critical right now because of the state of Massachusetts law, the lawyers and partners have actually discussed not allowing some of the practitioners who care for a patient to see the genetic results on the patient they're caring for. So it's a long step to when I'm going to be saying that I want to know what the mother and father's genetic results are to care for the patient. But that may be a local issue in part, the broader issue of really defining when you can share medical records amongst family members is really going to be important. And I know Jeff's laundry list is pretty long for the family history group but maybe this is something that could be potentially incorporated in that as well. When you had the issue of making group decisions about variants and we heard about that with BRCA 1, BRCA 2, it's recently as yesterday to my left as someone who leading the CPIC activity has brought a peer group together and they are, for all the pharmacogenes, are one by one going through them. And there are some things that are obvious slam dunks but there are other things that are not such slam dunks and I think this is an example, the BRCA 1 example is one, this is another one and Mary you're too modest to say something but how is that gone because those are models that I think you're implying we should be applying. Well and I would nuance that just slightly in the sense that it's perhaps less so, I think the decisions about implementation are always going to be local decisions and because it's always going to be the local people who are going to decide is this for our system ready for primetime or for not? I think what we were talking more about was a consensus around the necessary information or criteria to at least make the decision and CPIC is one of the examples of a consortium that's coming together although I think it's a consortium of like-minded folk and in some sense advocates and so that could be at least subject to someone saying well these are all people that just want to do this and so are they really being objective in terms of their criteria but it's at least a model of people that are trying to move this forward. Yeah I agree and we have as a goal to and we always did after we do the first few examples what were those things that made us consider this a slam dunk. Right. And we haven't had to delve down into the examples of gene-drug pairs yet where there's a lot of disagreement and a perfect example of that is CYP-2D6 and Tamoxifen so there are some very strong advocates and there are some people that are really against that when we come to those controversial issues then we're going to have our hands forced to really say what are the criteria to advocate for implementation of this, this and that variant. Yeah. So we haven't really been pressed to make those difficult decisions yet but I guess our feeling was you start with the things that are non-controversial then you figure out why you thought they were non-controversial. Right and I think that's exactly what we want to do and if we take the process of CIPIC is using plus the process that many of us are using when we're making these decisions and we gather the information together about okay, how did we come to the idea that this was controversial and non-controversial. We should be able to identify some common themes which I think could lead to some standardization around a methodology. The other thing I would point out is that controversy in this context is a really good thing because that's going to set out your discovery projects which is to say okay, half of you think the tamoxifen thing is good, half of you don't. Let's develop a research agenda to answer the specific questions that we have concerns about because a lot of times what we find is the studies that are being done aren't answering the questions and I think if there's one thing that I can point to for EGAP that has been very useful is that even though the majority of the recommendations have said not enough evidence what they've done in their recommendation statements is to say this is precisely the kind of evidence that we need to actually answer the clinical question and we'll have to take that into account you know how much of it is actually pragmatic enough to be able to be captured but at least you have a chance then to direct people to try and answer the question that is important as opposed to answering other questions that might otherwise not be useful. So Mark, the five clinical action five clinical sequencing UO1s that were just funded all have the aims to return either exomic or genomic results to their subjects and so they would be good partners in a clinical action group think. Good, and eMERGE obviously also has a subgroup that's working on you know how do we make decisions about this so there are a number of groups in the space but as usual you know they're all sort of the cross talk is not necessarily being facilitated and I think that that's something that this group could potentially do. So again, I mean I don't want to belabor the point but I want to go back to really having this done in a very systematic way. So when we do this for rear say one and two it's really based on prior probabilities so that you have something that's deleterious or the prior probability of 99 to one something that's suspected has a prior probability of 95 to 99 to one and that there are different levels of evidence and it's been determined how you weight those levels of evidence and so I really think that this is an area and Karis can also chime in where we really thought about this a lot I think that I was talking to Mary about what the levels of what the types of evidence that you have to use we've seen functional studies be wrong they aren't weighted that strongly conservation is weighted depending on how far it goes in the species you weight co-segregation you weight things in trans you weight LOH there are lots of levels of evidence that are used to move these together you do modeling of people who have deleterious mutations and large sample sets versus people who have an UCV or depends on VUS and you look at it there's lots of ways to approach this and certainly in the rear say one and two field there are a lot of people who thought a lot very hard about how to do this and to really be very rigorous about how you move things between different categories and I get a little nervous about this conversation when it's sort of we think it's good or we think it's bad it really has to be done in a very rigorous thoughtful fashion yeah I don't disagree with that although I think we're talking about two different things there are things that I think we clearly have have rigorous evidence about where we can look at implementation where it's really a very different question than arguing about the level of evidence or the binning there are discovery things that are going to be much farther down the pipeline we need to account for both of those ends of things but I think we also have to be pragmatic which is you know the current output of EGAP to just pick on one systematic synthesis of evidence is one variant a year that's not going to cut it and so we have to figure out ways to do this in a systematic way and do it rapidly and then be willing to learn quickly whether this is having an impact or not and this is an issue that we deal with in medical practice all the time there's almost never certainty about what we do in medical practice but we have to be able to put it into an environment where we can actually define and capture outcomes to say do we make the right choice or do we not make the right choice so there's compromises in terms of how we're going to do it and we need approaches that are not only systematic but are also scalable so I'm going to follow Mark's admonition to be practical and suggest that we break now lunch is ready if everybody will just grab their lunch in the next 15 minutes or so and then we'll start Pearl's session at 12.30


the reason why the narcissist has to keep you around, the narcissist will often attach themselves to you and they will always have a reason or excuse for being around you even though they claim that you are not right or no good for them they will still cling to you and it will get very angry if you try to walk away there could be several reasons for this maybe they don't have it anywhere else to go or maybe they need you for financial support but the main reason that I would like to discuss is that they are overly dependent on you emotionally they need you for emotional support, they need you to be their emotional punching bag they take out all of their emotional distress, anger, anxiety and suffering out on you maybe they had a long day and someone upset them but they couldn't react in the way that they would like to because they know that's not an appropriate way to behave in a public setting they know that it would tarnish their false image so they hold in that anger until they get home or until they see you and that is when they release it you are the one who has to deal with that anger and frustration and that is why they have to keep you around because they need someone to regulate their emotions they need someone who will put up with their BS without questioning or confronting them someone who will accept them regardless of what they do to you regardless of how they treat you and you don't get anything in return you give up everything to be their nothing you give up your passions joy and happiness to be their pet their slave, their punching bag you go through all of this abuse you are treated with cruelty and violence you experience constant confusion and uncertainty and in return you get nothing you stay with them because you hope that maybe they will see what they're doing wrong maybe then they will change but the narcissist believes that they deserve this privilege and special treatment they believe that they deserve someone who loves and accepts them regardless of what they do to you but it never works out that way the reason why the narcissist has to keep you around is because they need someone who they can control someone who they can have influence and authority over it provides them with a false sense of stability and security it makes them feel secure it makes them feel as though they are in control and they just expect you to accept it they expect you to not complain about it that is what they want from you that is why they have to keep you around because they have so much anger and frustration inside of them and they don't know how to release it they don't know how to deal with it on their own so they project it onto the person who is closest to them even though it has nothing to do with you when you are the closest person to them they will project everything from their past onto you they expect you to absorb all of their pain and distress and they see nothing wrong with it they think that it's okay and they expect you to be comfortable with it they have unrealistic expectations they expect you to be okay with this and even see it as a privilege because in their minds they are so great you should feel honored to kiss their feet no matter how degrading and humiliating it may feel for you they see it as though you should feel privileged to do that so whatever they do to you however they treat you you should just accept it once you begin to solve and explain the manipulation and the games that they are playing with you they have no choice but to leave you they are never going to put themselves in a position to be beneath something that they believe that they are greater than and once you are no longer willing to cooperate with them you become a risk to their safety because they can no longer control you they are expecting you to retaliate they are expecting you to take revenge on them after everything they have done to you so now you become a serious risk to their safety and they know that the only reason you are with them is because they successfully manipulated you and disdain with them they know that you don't love them because they know they haven't given you anything that would make you love them they know that they are not being real or genuine with you so there was never anything for you to love or appreciate because they were never considerate or compassionate towards you it's just a game and they are fully aware of this you have to figure out what this game is and once you do that it's game over they know that you will not have any consideration or consume for them after that they know that you will not have any compassion or forgiveness for them they know there's no going back after how they have treated you they know that you're never going to see them the same way ever again and they are just waiting and expecting for you to retaliate they are expecting you to take revenge they have to keep you around but it's not because they love you it's not because they care about you it's just a game and although they managed to trick themselves into thinking that you want them around or you love them deep down they know it's not love they know that you would be better off without them they know that it's just the illusion that you have fallen for the fantasy and that's what makes you think you love them as the victim you don't understand that it's not love because you're in the game they have trapped you in their maze where you're just trying to figure things out and once you do figure it out the fall clears you realize that it was never love you would just be manipulated you were being controlled once you leave the game it should then make sense why it was so easy for them to leave you as though you never even existed because it was never real they can't experience love or intimacy they only experience anger, fear and shame and that is why they do what they do that is why they could never treat you with the love and respect that you deserved but once you figure out the game they already know what they've got to do they've already planned their exit because they knew that one day you were going to figure them out and they know that there is no future in something that started out as a game everything you saw everything they displayed to you wasn't even real you thought you were getting to know someone but it was all an act they were just telling you what they thought you wanted to hear showing you what they thought you wanted to see in the hopes that it would keep you around but you never really knew them because there is nothing to know it's just a bunch of coping and defense mechanisms games and manipulation with no real human or heart in sight thank you for watching I hope this video resonates with you please like, comment, share and subscribe click the bell icon to receive notifications for my future videos if you would like to donate my paypal link is in the video description coaching enquiries you can email me at nartisweavercoachin at gmail.com thank you for watching and I'll talk to you soon