Episode 105 (Season 2): Autistic Grief and Wellness: Holding Space for Hard Emotions

Show Notes

Grieving the loss of a beloved pet or navigating collective trauma can feel overwhelming, especially for neurodivergent individuals who experience heightened attachment and sensitivity. This episode highlights the raw realities of grief, loss, and emotional processing, and explores the complexities unique to neurodivergent wellness journeys.

In this episode, Patrick Casale and Dr. Megan Anna Neff, two AuDHD mental health professionals, discuss the challenges of navigating grief—particularly pet loss—while managing the heightened sensitivities and emotional intensity common among Autistic and ADHD adults. They talk about how grief impacts daily life, the importance of ritual, attunement in relationships, the role of animal companionship, and how the neurodivergent experience can complicate or intensify the grieving process.

Top 3 reasons to listen to the entire episode:

1. Understand the unique ways neurodivergent grief manifests, including sensory and attachment factors, and gather validation for experiences that may not be widely recognized or understood by neurotypical circles.
2. Learn pragmatic strategies for processing grief—including rituals, attunement with supportive friends, setting boundaries, and balancing self-compassion with the demands of social expectations.
3. Explore the intersection of collective trauma, emotional wellness, and coping in a world full of ongoing stressors, with candid advice on when to lean into hard feelings and when to step back for necessary self-preservation.

For individuals navigating loss, especially through a neurodivergent lens, this episode offers insight, solidarity, and practical support. Remember that honoring your unique grief journey is vital—and that connection, self-compassion, and community are essential parts of healing.

 

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Transcript

PATRICK CASALE: Hey, everyone. You are listening to the Divergent Conversations podcast. We are two neurodivergent mental health professionals in a neurotypical world. I'm Patrick Casale.

MEGAN NEFF: And I'm Dr. Neff.

PATRICK CASALE: And during these episodes, we do talk about sensitive subjects, mental health, and there are some conversations that can certainly feel a bit overwhelming. So, we do just want to use that disclosure and disclaimer before jumping in. And thanks for listening.

MEGAN NEFF: Hello, everyone. So, we know that we have a generic disclosure on all of our episodes, but I actually just wanted to pop out and give an extra disclosure on this one, because it did get pretty heavy, and especially, because a series on neurodivergent wellness that might not be the headspace that you're entering with.

So, we start by talking about pet loss and grief, and we also talk about suicidality, and reference collective trauma, and school violence. So, it's a heavy one, so just take care of yourselves and be sure you're in the right head space as we grapple with questions around how we navigate grief and heart emotions in complex times.

PATRICK CASALE: Hey, everyone. Welcome back to episode two of our Neurodivergent Wellness series. And today we are going to spend-

MEGAN NEFF: Okay, Patrick, I'm cutting you off. Let me try this. You just sound so depressed.

PATRICK CASALE: Listen, I wanted to read our ad like that. I wanted to read it really morose and depressed as fuck. And be like-

MEGAN NEFF: [CROSSTALK 00:04:09] people.

PATRICK CASALE: "Hi, everyone." [CROSSTALK 00:04:13]-

MEGAN NEFF: If you want to support us with-

PATRICK CASALE: Jane app, it sounds great. And we just put our dog to sleep on Sunday, and I feel dead inside.

MEGAN NEFF: I was wondering if you wanted to talk about that. Like, I didn't ask on air because I wasn't sure if you… Yeah, do you want to talk on that or?

PATRICK CASALE: Sure, yeah.

MEGAN NEFF: Like, I mean, yeah, that's part of your… Because we referenced you being low energy last episode, which is, probably, we're literally recording these back to back same day.

PATRICK CASALE: As you could tell from my Hobbit shirt that I'm still wearing. Yeah, I can talk about it. I know we were going to talk about like community, finding community, what it meant in terms of wellness. And I think it's appropriately like linked for me, at least, because connection, community, wellness, like animals. Like, I would rather spend time with animals than people nine days out of 10.

So, yes, my wife and I did put our 11-year-old basset hound, Hazel, to sleep on Sunday, which was two days ago. It's been hard. I have had to do this before with our other basset hound, Herman, about five years ago, but it doesn't feel the same. And I think there's so many reasons for that, but there's just a lot of grief in this experience. And it's hard.

And I mentioned to you like, I think some of this challenge or struggle is the last 11 years with her has been nothing but reliability, consistency, knowing exactly what to expect out of her every single day of her life. And I cannot understate how valuable that has been for my own mental health, like and how sweet she was, and how loving she was, and how happy she was.

And now we have another dog that I've mentioned on here many times, who I also love, and it's just not the same, because he is so neurotic, and so clingy, and so needy, and so loud, and can really be a struggle sensory wise, comparatively. So…

MEGAN NEFF: I mean, he's always so like, the way you describe it, so baked into your life, in like, such an attuned way of just doing your breakfast together or, yeah.

PATRICK CASALE: Yeah, Hazel and I like to eat peanut butter honey toast most mornings. So, she would just come over and sit near my feet. And she would never, like, make a noise. She would just sit there, and she just knew that she was going to get some. And then, I would like to throw it in the air, because she always caught it in the air like a seal. And I never knew how, because she didn't ever learn any other tricks. And I was like, "How do you have such good eye coordination, Hazel?" Like, it's amazing. But yeah, just so many great memories.

And I think with any experience like this, you always second guess yourself in the build-up. And we try to do things in a really intentionally, like, well-thought out way to really honor her life. And had friends come over throughout the weekend, and they brought her like snacks and stuff, and our dog sitter, and our dog walker, and we did an at home euthanasia that we had done previously, and it really creates a lot of honor and respect for that animal as well. But she was just in a lot of pain, and it was really hard to watch every day. And it's just really sad, too.

MEGAN NEFF: Yeah, yeah. You were very intentional. Like, you built a lot of rituals around the experience for yourself, for Hazel, for your family, for community.

PATRICK CASALE: Yeah, you know, it's sad because, like, my other dog, I don't know if he really understands who knows, maybe he does, maybe I don't give him enough credit, but, you know, he kept getting up last night, out of bed, and, like, going into the kitchen, where she was, like, sleeping most nights, and like crying, and then, I have to bring him back into the bed, and, like, comfort him. And I'm like, "I am not built for this man." Like-

MEGAN NEFF: You're comforting his grief.

PATRICK CASALE: Yeah. So, it's a messy process, for sure. And I know for so many of you out there listening like animals are so important in so many ways. You talk about sensory soothing strategies, and, you know, hugging your animal or being with your animal if they bring you comfort, not if they're your menace, poltergeist Shih Tzu. And I mean, I really can't even, like, quantify it, you know?

MEGAN NEFF: Yeah, yeah, Patrick.

PATRICK CASALE: Doing the thing where you repress tears, push them away, which I do all the time in therapy.

MEGAN NEFF: What if, and no pressure, and we can cut this. What if you didn't?

PATRICK CASALE: Yeah, we don't have to cut it. You know, as long as our listeners want to watch and listen to this. You know, it's not even like I'm aware of it, and sometimes it just happens like that. And it's so baked into who I am, where that emotional process is, like, constantly stuffed down. But I'm realizing how emotional I am, like all the time. And I think that's one thing I was talking about earlier with a friend. This is going to be a weird divergent thought right now, but she was asking me yesterday, we went and got coffee, which was super helpful.

And she was like, you know we're talking about, she brought up post discovery for a lot of adults who discover that they're autistic later in life, how come it's so much harder you would think like, you unmask, you learn, you're autistic all of a sudden. Like, I don't know if she thought like the birds are chirping and singing or, I don't know. But I'm like, yeah, I feel everything so intensely post discovery, you know? And that was four years or five years ago now. So, yeah.

MEGAN NEFF: I'm curious, so I hear that a lot. I feel that. So, for me, there was something about I adapted to the too muchness of the world myself by just dissociating, numbing out. And then I, like, reconnected with my body. And it's like, "Oh shit, this is a chaotic place to live."

PATRICK CASALE: Autistic body, zero out of 10, we would not recommend.

MEGAN NEFF: Is there something similar for you around reconnecting?

PATRICK CASALE: 100%. I spent so much of my life, you know, dissociating, numbing, whatever. And then, it's just like, poof, everything feels magnified and intensified for me.

And I imagine for a lot of you listening, it feels like times a million. You know, I'm like, every little thing is so intense sometimes. So, yeah. This is actually tied into wellness, for those of you listening, and you're like, "What is happening right now?"

MEGAN NEFF: I actually think… Like, and we talked about talking about community, but like, we're talking about grief, and emotions and, like, perhaps, okay, I am trying to, like, censor myself. I was about to be like, abso-fucking-lutely, that ties into wellness. Like, the ability to move through the hard stuff, and to do it in a way that honors, and that we can metabolize.

PATRICK CASALE: Yeah, absolutely. Yep. We will talk about relationship and community tomorrow, because we are meeting again tomorrow to do more recordings.

MEGAN NEFF: Yeah, so let's lean into this, because this feels important. It feels alive.

PATRICK CASALE: Well, one thing I want to mention too is, like, you know, meeting with my friend, it was really a weird, full circle moment, because she was the first person who, like, looked at me a couple years ago. I've shared this story on here before, we're eating lunch, and she was just like, "I think you need to go get tested to figure out if you're autistic or not." Because I was having such a hard time.

And we talked about that yesterday, and you know, I got emotional while talking about that. But really appreciated that she saw me in that moment, and was able to, like, offer that feedback to me in that moment.

But prior to getting out of my car yesterday, she texted me and was like, "Shade or sun." And I was like, "Always shade." So, I saw her, like, in the courtyard of the coffee shop get up from this very sunny spot and, like, walk over to, like, the very gloomy, dark alleyway next to the coffee shop. And I was like, "This is really wonderful." Like, that for me is a part of wellness too, is boundary setting, and asking for what you need with people that you feel safe enough to do so. So, I just want to name that as well.

MEGAN NEFF: I also love that she knew to ask you like sun or shade. [CROSSTALK 00:13:43]-

PATRICK CASALE: She jokes with me all the time. She's like, "I know if I ask you where we're going to eat, like, you're going to tell me three places. I'm never going to suggest a place to you." And I just appreciate friendship like that. You know, we talked about that too, you know, yesterday, just having those types of people in your life is really liberating.

MEGAN NEFF: Yeah. And like, I would use the word attunement there, someone who's attuned to you and to your needs, and is, like, also thinking about it proactively, not waiting for you to ask, yeah, yeah.

PATRICK CASALE: Yeah, yeah. For sure. So, yeah. So, I'm all over the place right now. So, where do you want to go?

MEGAN NEFF: Yeah, and we can move if it feels too hot. As you were talking, I think back to… This is actually a thread that's come up several times in The Nook where people have lost pets and they say, "Hey, does anyone have resources on autistic grief?"

And we had Kylie Hanish on, like, long, long time ago, talking about pregnancy loss, and infant loss, and grief. And I do think this can be a complex experience for us. And there's not like a one size. Like, I think there's not like a one way, it'll show up for autistic people. But I do think it can be a complex experience for us, grief, but then also, what you're saying around attachment to pets, particularly, in a ways that people around us might not fully understand.

PATRICK CASALE: You know, one thing, like, if I zoomed out on my life and I looked at experiences, and I had more understanding of, you know, assessing for autism as a child and a teenager, I can think back to so many moments when I was at, like, a nature-based place with animals, and how like, excited I got, and how excited I was to, like, go see the red pandas at the western North Carolina Nature Center. Or how excited I am to, like, see the highland cattle in Scotland, or how excited I am to always find these, like, special interest animals of mine, and like be in existence with them. And how regulating I have always found it to be.

And, you know, I think about how healing animals are for us, and it's through, you know, both verbal and non-verbal cues. And just presence alone can be so unbelievably co-regulating, even for both parties. And I've been like, I don't know if I'm trying to do this to myself as like a grief strategy, but I've been trying to replay like visual images of like Hazel as a puppy to like, earlier years, and all the experiences that we had together till now. And like, those visuals keep, like, flashing through my brain.

MEGAN NEFF: Like, that's beautiful. I mean, that's attachment, right? Is like you're holding on to the attachment, holding on to those memories.

PATRICK CASALE: Yeah.

MEGAN NEFF: Yeah, yeah.

PATRICK CASALE: So, I get these, like, romanticized ideas, as we talk about a lot on here. And during, like, the onset of COVID I was like, "Okay, I got to get out of Asheville. I got to get away from people. Like, I feel unsafe with what's happening in the world. I need to be by myself. I'm going to take Hazel with me."

So, I found this farm in the middle of Tennessee, and it was like this working farm, and you could be around all the animals all day, every day. I was like, "I'm just going to bring Hazel. It's going to be great. It's going to be so relaxing."

Go out into the middle of Tennessee, and let's just say the politics swing drastically. So, like, when I get there, they're like, "We haven't been masking for years here, and we're not going to, and fuck what's happening."

And I'm like, "Oh God, this is a nightmare." So, it was just Hazel and I on this big ass farm, and we're walking around, like, every day. And like, she was so overstimulated by all the animals, and smells, and noises. So, she would not settle. She would just walk this farmland all day for like two days in a row. And like, the first thing she does as soon as we get there is immediately, like, rolls around in some sort of animal poop, immediately, just a white basset hound. I'm just like, "This is everything in an experience that I do not need this to be. Like, you are supposed to be my one consistent presence." And it was just that memory really stands out to me because she's just like, happy, and smiling, and like, does not care. And I'm like, spraying her with a hose. And I'm like…

MEGAN NEFF: This is like such a sensory nightmare having a dog rolling all day.

PATRICK CASALE: And it was like that. It was like the moment we walked out of our like, it was like an Airstream that I had rented on this property the first five minutes. And I'm like, "Oh my God." But yeah, I took her everywhere, and she was my buddy. And just sad.

Yeah, it's also sad to have to make those decisions. Like everyone tells you you're doing the right thing. You're doing this like, and you're helping maintain the animal's dignity. And they're not going to tell you when they're ready to go. And for me, I felt so guilt ridden and so ashamed of the build-up of making that decision, calling the person who was going to come over, setting a date, and Hazel is living her life like all week and weekend, I felt like… And I kept thinking, this dog has no idea that, like, Sunday morning is going to be her last day on earth. That was really hard too.

MEGAN NEFF: Yeah, that would be a torture point for me too of like, we know this is coming, but you don't. There's not a way to communicate to you and for you to get to know this.

PATRICK CASALE: Right. And I try to, like, look for signs, you know, all weekend and week, of like, making the right decision, like looking for validation in a way. And there was a lot of just like chronic pain, movement, mobility, not going on walks and not eating, like all the telltale sucks.

But like every time someone came to the door, she certainly, like used every ounce of energy to get up and wag her tail and greet them, and like, say hi to them. And I was like, "I don't know if I'm doing the right thing." You know? Yeah, stuff is just really, really tough.

And it's amazing, you know, I've been working from home for last five years. I think that's played a role too here is like, working from home, spending a lot of time with both of them. And I think that's probably increased attachment as well, because, like, we've just been through a lot between COVID, and Hurricane Helene, and a lot of like survival situations, really. And just always at the forefront of my mind, you know, to make sure that we had what we needed for her, and her comfort, and stuff like that.

MEGAN NEFF: How are you doing, like, in this moment, not like as we're talking about this?

PATRICK CASALE: I'm good, I'm good. Like, I actually appreciate this outlet. I don't want to use it as like a therapy session, though. So, I'm trying to be mindful of that as well.

MEGAN NEFF: I mean, like, I don't even think I could feel like a therapist toward you. So, I don't think that's what this is.

PATRICK CASALE: Yeah, I think, you know, I just noticed the more I've understood my own neurology, the more I've understood how important some sort of animal companionship has been. So, I think that's really what's been on my mind too, is just the realization of like, I really do need to have some sort of animal companionship. And, yeah, I think that has been coming up a lot for me.

MEGAN NEFF: Yeah, yeah, yeah. It is such a stabilizing, grounding, gathering force.

PATRICK CASALE: Yeah, yeah. And, you know, grief is such a complex, like, beast of an emotional experience, because, you know, I think it comes in waves a lot of the time, or whether you're in, like, I don't know, I don't prescribe to the five stages of grief, but, like, I definitely have been experiencing them.

MEGAN NEFF: Yeah, I mean, there's a reason that's out there. Yeah, and I would think, especially, with when an animal is so baked into our life, like all those little routines of like, those are all those splinters of grief, like making toast, and like remembering, "Oh, wait, shit, Hazel's not here.

PATRICK CASALE: Yeah, yeah. Those little like reminders, you know? So, I think that's something for sure. And to those of you listening, if you're like, you know, you've experienced something similar. It's something that you've been wondering about. I think it is about the both and, the duality of life and death. And when I think of it, I'm like, also thinking about all the beautiful moments too that existed, and all of the reasons that I am sad because of those moments.

MEGAN NEFF: Yeah. Like, flipping the grief to like, this grief hurts because on the flip side of that is, like, so much love, and care, and being able to anchor into that. Absolutely.

PATRICK CASALE: Like, I'm not a monster, but if she was a difficult animal, this experience may be different. Like-

MEGAN NEFF: Yeah, I mean.

PATRICK CASALE: [INDISCERNIBLE 00:23:29] sad.

MEGAN NEFF: And then you'd have complex grief. Like, I mean, this is talked about in literature with, like, if a parent dies and there's a complex relationship there, that can lead to complex grief, which could actually, in some ways, be, I don't want to be, like, hard or easier, but well, it can be more complicated to navigate, because then you're grieving like the loss, but then you're also grieving like the mom, or the dad, or the parent you never got. And so, like, it would just be a different grief experience. It'd be a complex grief.

PATRICK CASALE: Yeah. Might be grieving like the emotional experience around the grief, around the loss, like, in some of those situations. I know for myself that there will be some grief potentially about like, relief.

MEGAN NEFF: Yeah, yeah.

PATRICK CASALE: Yeah, so that's the complex grief. Anticipatory grief is also one of those, you know?

MEGAN NEFF: Participatory grief.

PATRICK CASALE: Oh, Megan-

MEGAN NEFF: [CROSSTALK 00:24:45] yeah, which you had.

PATRICK CASALE: Yeah, I think about that a lot for, we've talked about addiction on here. I think anticipatory grief so often. I see parents in anticipatory grief with children who are in active addiction.

MEGAN NEFF: Yeah, yeah.

PATRICK CASALE: Which is a complex, complicated place to be mentally as well.

MEGAN NEFF: Yeah, because it's like, I don't know what we're setting up here for, and so I don't know how to, like, emotionally pivot toward you when there's anticipatory grief. Yeah, yeah.

PATRICK CASALE: So, what's coming up for you around grief and wellness in general?

MEGAN NEFF: One thought I had as you're talking about grief was this idea I heard years ago about how, like when we're in grief, like it opens up the doors to all past griefs too, which is part of why it's so painful. And definitely, when I think about losses I've had, it's obviously the loss, but then, it's like, this is also opening up all of the losses, all of the grief, and it's such a such a tender moment when that's all just open and on the outside of our skin.

PATRICK CASALE: Yeah, this is going to sound perhaps off putting, but for me, and I imagine for a lot of people who don't enjoy being perceived when you experience grief like this, it's a bit messy socially, because everyone is like, reaching out to you. And I almost feel like pressure to respond. And then, I probably experience some demand avoidance, where I'm like, and then I know it's like, well-intentioned, and all of that, you know? But it's like stuff situations like these are hard for me. And I imagine for a lot of us where it's like, I don't know how I'm supposed to react or not react in social environments, or situations, or responses.

MEGAN NEFF: I'm so glad you brought that up, and I don't feel like that's off putting at all. Like, there is a social dynamic to grief, and many of us have complex social experiences. And I could guess that you and I might be kind of similar here, but like in grief, I go inward, and I would, yeah, I guess I appreciate the reach outs, but like, mostly I just go inward, and that's what I need.

PATRICK CASALE: Found myself like yesterday getting a lot of like, messages and requests, not from you, but from people who were asking me, like, to commit to doing things with them, and they were doing it out of their like, feeling like this is an offering, and like a best interest, and help you, like, navigate this time. And I found myself getting frustrated, but in reality, really, what I was responding with was like, "I just don't think I'm up for it."

And I was trying to, like, pick that apart in the moment. I was like, "You know, where's this frustration coming from?" Almost going back to our last episode of, like, zooming out and not focusing on the content, and really just trying to pay attention to that in my responses.

So, I think copy and paste can be your best friend sometimes. And also like, so I leaned into that because I am someone who really struggles with not responding to things. And I've tried so hard to get better at it, and it's still so hard. So, copy and paste is a good friend, leaving my phone, or your phone, or devices if you're listening at home, like somewhere for a little bit of time, so that you just aren't checking them routinely. I was really just trying to honor that yesterday and like just exist in it, you know?

MEGAN NEFF: Yeah, yeah, absolutely. And I love that as a like to pull out some pragmatic things for folks, like, scripts, yeah, grief scripts, of like, thank you so much for your care and like. And that's not even just an autistic thing. Like, anyone in grief, it is so hard to respond. And it is that complex thing, of like, I'm glad people know and care, and also like, gosh, I don't have a capacity to engage. Or like, even thinking about you, Patrick, you I feel like are quick to reassure people. So, I imagine there's even a poll to like, I want to reassure people that I'm okay, but like, I'm not okay, so then I don't want to reassure people I'm okay if I'm not.

PATRICK CASALE: Right, yeah, that's exactly it. It's really complicated. And for me, personally, where I go, when I feel that way, like, that push/pull of I need to reassure but I'm not. And then it feels disingenuous or not authentic. And then, I feel like… Then everything becomes almost like unraveled. I really like go into almost a shame spiral type of experience of like, "You should feel more grateful. You should be more appreciative. You should not be frustrated." Things like that. So, I have to really [INDISCERNIBLE 00:30:24]-

MEGAN NEFF: Your mind is just like a little bitch, my gosh. It's like, let's just not be in our grief, right? Like, also, let's be really judgmental about the fact I don't have capacity to respond to people and talk about how I'm such an ungrateful, little [CROSSTALK 00:30:40]-

PATRICK CASALE: Little bitch.

MEGAN NEFF: Yep, a little bitch.

PATRICK CASALE: My mind is a little bitch about this stuff. Yeah, I'm glad you said that, because that was actually really funny. I was going to say that while also trying really hard to exhibit some self-compassion, like in these moments, really just trying to offer some grace and self-compassion, like words that I absolutely despise and things that I'm like, you know, you really, it's almost like this… I'm having, like, very differing conversations, angel/devil style, almost of like, "You should have self-compassion, you should let yourself cry, you should let yourself feel this experience. You just had a major loss. You should be grateful. You should be appreciative. You should not be frustrated."

But I will say, I think yesterday the self-compassion piece won out, you know, because I was able to set some boundaries with certain people including my mother. And I was also able to say yes to some things that although I did not want to say yes to them, going back to our other episode of knowing that they would be nourishing despite my affect and my mood. Because when I went and got coffee with my friend, I did say, you know, this is what just happened, and also, like, I don't know what kind of mood I'm going to be in. Like, I don't know if I'm going to be talkative, I don't know if I'm going to be sad. I don't want to come… We haven't seen each other in two months, like, be completely just emotional and not regulated. But she was like, "I don't give a shit. You should be all of those things. If you don't show up that way, I'm going to be really upset with you." And I was like, "Cool, I'll see you at 2:30, fine."

MEGAN NEFF: That's such a beautiful response. It's like, "Come as you are." And those are the people for whom, like, I think we need to be around in our grief, is the people for whom, "Come as you are." And then, we're not going to get like an overly worried energy. Like, I know for me, it's really hard for me when people worry on me, because then it'd be like, "Oh, well, I've got to reassure them that I'm okay." But I'm, again, aren't. Someone who can just be like, "Yeah, show up as you are." It makes sense.

PATRICK CASALE: Yeah, exactly.

MEGAN NEFF: And we can hold that.

PATRICK CASALE: Yeah, for sure. I was actually texting someone else yesterday while I was texting you and similar conversation where I was like, I ordered lunch, but it's sitting on the porch and I really can't even get off the couch to go get it. And she was like, "Well, when I had an experience like this a couple years ago, my food sat out on the porch for four hours, and then I ate really soggy, disgusting wet noodles for lunch." And she texted me this morning. She was like, "I hope you got your own wet noodle experience yesterday to some capacity."

And I was like, "Thank you for checking out me. Okay, also goodbye for now." Like, so I appreciate those types of connections and those types of interactions. I think I struggle so much with, like, the generic cookie cutter I don't know what to say to you, and I don't know how to receive that and respond back to it. And it's just my perspective, and it's not even in this situation, but grief, in general. I think so many people are often saying things then they're trying to, I wouldn't say placate, that would be not the right word, but saying things out of their own discomfort or I don't handle those types of, like, comments and responses well, is where I struggle the most, I think.

MEGAN NEFF: Yeah. And I think that is a really human experience, especially, in the, I would say, kind of white culture, in the states, Europe, like, we don't do the full spectrum of emotions very well. Like that was something that was so wild to me when I first lived in Malawi, like grief and funerals. And it's like a full body experience. It's like people feel their grief and they feel their aliveness and joy. Like just the spectrum of emotions is so different in other cultures, I would say.

So, like, huge blanket statement here, but like, white people kind of suck at grief. And so, part of that then happens is when we encounter other people's pain or grief, like, there's that tendency to pull away from it, and it can sometimes come out as either like making placated statements, like everything happens for a reason, like, that stuff, or the stuff that's like kind of what you're describing of, they're obviously trying to… Maybe there's some discomfort there, and they're trying to soothe that. But grief makes people uncomfortable. And then, when you're in grief and you're around people who are uncomfortable to be around you like you feel that.

PATRICK CASALE: That's where I really struggle. You had mentioned that Malawi experience before, and I think that's really beautiful, culturally, you know, to have like embodiment of the duality, which is life, because life is not without death and loss. And I really appreciate that.

Yeah, I think what you're saying makes so much sense. And this is something, and I've said this on air, so if you listen to it, whatever, that I struggle with my mom. Like, even with my throat just disorder, right? Like, there's grief around having a chronic medical condition that is going to impact you for the rest of your life. There's grief when my vocal cord got paralyzed and my throat surgery. Like, there's grief of my voice being lost for a while and changing pretty drastically.

But the comments of like, "I hope that you have the best outcome that you can want or imagine tomorrow during surgery." And I'm like, "This is why we don't talk." But like the reality is what I would have much rather heard, right? In that moment, which is again, going back to your point of it being uncomfortable, is acknowledging and just naming the discomfort, the pain, the grief. "This fucking sucks. I'm really sorry that you have to experience this." I would have much rather heard something like that, you know, instead of, like, "Oh, I will send you thoughts and prayers over your throat condition." Okay, it's not going to change, still a chronic throat condition, you know? Like, yeah.

MEGAN NEFF: And this is something where I think autistic people can sometimes, like, a way, we can show allistic people another way of being. I think, in general, we sometimes have a little bit easier of a job naming the thing. And that gives people around us permission to do that. And I think when we're in pain like that is sometimes the most containing, grounding thing is to name it of like, I'm scared, or this is painful, or it hurts.

We've both, like, talked about how self-compassion is a hard word for us, even though I use it all the time. But my favorite self-compassion statement is like, I'll put my hand on my chest, and it's like, this is a hard moment. And like that to me is self-compassion is like, naming what is.

PATRICK CASALE: I love that, yeah. Because I can get down on that, you know, like, that can resonate and land for me.

MEGAN NEFF: Yeah, if it's a-

PATRICK CASALE: [CROSSTALK 00:37:54].

MEGAN NEFF: If it's like a flowery, like, I don't even know. Like, what's it like cringy, self-compassion sentence that comes to your head?

PATRICK CASALE: [CROSSTALK 00:38:02]-

MEGAN NEFF: I deserve.

PATRICK CASALE: I deserve… What is the worst that could happen? Something like that. Or…

MEGAN NEFF: I actually love compassion. That's just, yeah like…

PATRICK CASALE: This [INDISCERNIBLE 00:38:11]. 

MEGAN NEFF: Yeah, what is cheesy self-compassion statement?

PATRICK CASALE: You're going to make me cringe. It's probably those tarot cards that Jess and Cherish were pulling for me in Belize, where it was like amused tarot card deck, right? And then, I think Jess put like a bro dude voice to all the cards, because I was like, "I'm going to try to help you drop into this." But those types of things like that makes me cringe.

But, yeah, you're right, flowery, whatever. My last therapist was like, "Let's stop using self-compassion. Maybe we'll say like feeling seen, or like, seeing yourself in a certain way, or like…" And that was helpful for me to reframe. But I want to just name something real quick, and maybe I'm wrong. As I was going to definitely go on a tangent about my relationship with my mom, which I don't need to do on this podcast, I saw your face, and I saw you make like an expression upwards, where you did the reframe of like, I think this is a moment where we could do this thing, where we could really teach people, and I really appreciated that. And maybe that was subconscious, or maybe I caught it incorrectly, but you reframed that really well, of this is a moment just where [CROSSTALK 00:39:22]-

MEGAN NEFF: Like just now?

PATRICK CASALE: …could frame.

MEGAN NEFF: Yeah, yeah.

PATRICK CASALE: …allistic people in a way where, like, you know, maybe it's not as easy for them to name the thing. So, I just wanted to name that I appreciated you did that. Whether you did that consciously, subconsciously, intentionally, unintentionally, I don't know.

MEGAN NEFF: You're giving me way too much strategic credit. It was not that intentional, but I love that you think it might have been, and I would like want to take credit for that-

PATRICK CASALE: [CROSSTALK 00:39:48]-

MEGAN NEFF: Because that would have been really, yeah, this kind of brilliant strategy of, like, okay-

PATRICK CASALE: Well, I saw your eye go up into the right. So, that was telling me you had a thought of, like, "I need to. Catch this." Or, "I need to say this." And I think that-

MEGAN NEFF: I think, yeah, the thought was around, like, naming the pain, how important that is, because that is something I think about a lot. I talk about a lot. And how, like, that was supposed to be really pragmatic people can do is, like, name the pain.

PATRICK CASALE: Yeah. And I think that's such-

MEGAN NEFF: And people are afraid to, but it's like, actually name it, it's the same thing, okay, this is just going to be a dark episode. It's the same thing with suicidal ideation. People are afraid to talk about it. Research is clear around this, like, even therapists can be nervous about talking about it. That is not what increases the risk. It is the not talking about it?

PATRICK CASALE: Exactly. Yes, yes.

MEGAN NEFF: Yeah. And again, it's back to this white culture thing of like, we have a really hard time talking about hard stuff, yeah? I mean, so go back to wellness. Get comfortable talking about hard stuff.

PATRICK CASALE: Yeah, absolutely yes. Preach this is exactly it, because I think about that, suicidality therapist/client relationship all the time of how often we were taught, like, "Better get your safety plan. Better get your crisis plan [INDISCERNIBLE 00:41:14] someone mentions suicidality.

MEGAN NEFF: And that's moving away from the pain. And okay, and I'm not to say, like, sometimes we absolutely need to do a safety plan. And like, we should actually maybe talk about this sometimes [CROSSTALK 00:41:24]-

PATRICK CASALE: [CROSSTALK 00:41:24]-

MEGAN NEFF: So, I'm not saying don't do that, but if it is, my client has just told me something that is really painful and I want to move away from that pain. Like, and I'm going to pull up an intervention in the plan, and it's going to distance from that pain. First of all, that's going to feel so alienating to the client. It's going to say, like, "I can't hold your pain. We've got to make a plan around it." And so that can also be a way of moving away from the pain.

Now, I think, ideally, it's let's move toward the pain, let's understand it. And then, I will say this, because we're talking about it. The reason safety planning is so important is that for most deaths that happen by suicide, it's in an impulsive moment. And if you don't have a plan around that, then the risk is so high. So, for most people it's like a 15 minutes of like in my impulsivity. And this is not a baseline decision I would make. So, you absolutely want to build a safety net around that to reduce that risk. And it does save lives. But it can't be done in a like, "Your pain's making me uncomfortable. Let's put a safety plan around right this [CROSSTALK 00:42:33].

PATRICK CASALE: Exactly. It can't be a knee jerk reaction, because what I have… And I just want to quantify, why am I using that word? It's not even the right word. It's also not applicable. Asterisk around all of that. Like, we are not saying safety planning and aftercare planning, and crisis planning is not crucial and important. What I really struggle with is in therapeutic settings, right? You name the pain. Therapist gets immediately uncomfortable. Therapist then immediately reaches for clinical intervention. It creates a wedge or separation in the humanness and the relationship, and it creates such significant rupture. Like, I think I've mentioned-

MEGAN NEFF: Yeah, shame, your pain scares me.

PATRICK CASALE: Yeah, your pain is making me uncomfortable. We need to immediately plan for your pain. Yeah, they're in your office.

MEGAN NEFF: Yeah, and to be fair, like, when I was starting out as a therapist and I was in a behavioral health setting, I was, like, 30 minutes, like, I did this stuff. So, I had to learn. Like, I was like, what am I doing? Okay, so when pain enters, there's a tendency to want to pull away and then, like, offer fix it. So, then I did a lot of work around, like, what's my relationship to pain. And it's hard, like, even for seasoned therapists, to, like, see the pain, and to move toward it. And there can still be the fear of, like, if I move toward this pain, am I actually going to make it bigger.

PATRICK CASALE: Right. Yeah, absolutely, 100%, yeah. I was going to tell a story, but I think it's going to diverge us too much. So, yes, all of that. And again, going back to wellness, like you said, sitting with that pain, sitting with that discomfort, and using that strategy for self-compassion if you need to, of like, yeah, this is really hard, and it's allowed to be hard. Like, having that permission so important to just say like you are allowed to feel this way, like you are allowed to experience this this way.

MEGAN NEFF: And then, you're allowed to distract from it too, if you need to. So, you're allowed to feel this. And then, there's also like containment, in the sense of sometimes if the pain is like, too dysregulating. And it's like, you know, DBT does a lot with, like, distress tolerance skills and talks about this. But if it's now I'm feeling, I'm contacting my pain, and it's just regulating, then it's too much. It's like, it's too hot, then it's okay, we want to, like, take it back a bit so we can get to a place where we can metabolize and move through that with a bit more agency. So, that point it might be like, I'm going to distract with, like, silly YouTube memes, or Lord of the Rings. And like, that's not a bad thing. Sometimes we need that distraction when the pain is that intense, and that's what, like, grounds us and regroups us. And that's not us abandoning ourselves or, like, being emotional avoiders. That's us caretaking.

PATRICK CASALE: Absolutely, yeah, really well said.

MEGAN NEFF: I can see your brain's pivoting.

PATRICK CASALE: No, I'm just like tracking, like, time stuff [INDISCERNIBLE 00:45:35]-

MEGAN NEFF: Sure.

PATRICK CASALE: So, we're kind of at that place. So, well, here's what a real, like, glimpse into my brain is like, okay, timing is what we talked about. Boom, Megan Anna just left some like great takeaways. Like, if we diverge from takeaways on wellness, does that like, you know, derail us too much, in a sense?

PATRICK CASALE: Like you had a place to go conversationally, and you were like, is there space for that? Or, like, yeah, yeah. I don't even know if I have a great place conversationally. It's just what was happening in my brain. But yeah, I think that is a great strategy. And I think we do need distraction, and sometimes we are going to need to dissociate, and sometimes we are going to need to avoid. Like, sometimes the pain is too much. And I think that is applicable with everything we're talking about in all of these scenarios and contexts. And it's applicable sometimes with what's happening in our [CROSSTALK 00:46:41]-

MEGAN NEFF: I was literally just going there, yep.

PATRICK CASALE: …in our freaking world, in our country. Like, it is okay for you to name that for yourself and go whichever direction you need to go, because the pain of watching never-ending, unrelenting suffering is a lot.

MEGAN NEFF: Well, and our like bodies, our brains, our nervous systems were not designed for that. Like, I've had this thought for years of like, in our pockets we have access to so much pain and suffering that we, like-

PATRICK CASALE: [CROSSTALK 00:47:13]-

MEGAN NEFF: …at the blink of an eye. And like, the first time I had that thought I was sitting with my two-year-old at the time. Oh gosh, this is a really heavy episode. We need to put a, like, thick disclaimer. I was pregnant, and it was after two pregnancy losses. I was pregnant with my second, and I was with my then two-and-a-half-year-old on the floor in our, like, 100-year-old wooden home, and I saw the news about Sandy Hook. And, like, it just cut through that moment. And I was like, "What the hell am I doing bringing a kid into this world, another one."

And like, there's so much pain in the world and like. And not that we should numb from it, but also like our brains and our systems were not meant to, like, any moment of our day be intruded with the horrors of humanity, and the suffering. And then, for people who are hyper empathetic, trying to hold that and make sense of that, and like it's this isn't what our bodies were built for.

PATRICK CASALE: No, no. Yeah, I can't imagine experiencing that in that moment. And yeah, it's not what our bodies are built for. Let's throw into the mix like some justice sensitivity, some RSD.

MEGAN NEFF: But then, are you also having to, like the moment I said that I'm like, but I'm not the person suffering, so how dare I complain about being exposed to it? Are you also having that narrative?

PATRICK CASALE: For sure, yeah.

MEGAN NEFF: Yeah, yeah.

PATRICK CASALE: And it is easy to fall into that narrative too. And it's so easy to get completely absorbed into this stuff. 24/7, non-stop. It's just not sustainable.

MEGAN NEFF: Yeah. And then, I think it goes back to like agency community. So, if we get pulled into it, and we are so frozen by it, like, I think a few things can happen. I think we can be desensitized. I think we can lose a sense of agency. And it's like, I feel like those are the questions I keep coming back to this year is like, how do we get back to connection? How do we get back to community? How do we get back to agency? How do we keep showing up?

And I know for me, and you and I have had different process around how we consume news. I know for me, it's I am limiting my news conception to, like, a few things that keep me plugged in, and it'll look different for everyone. But that question of, like, what is going to help me show up in the way I want to show up.

PATRICK CASALE: Yeah, exactly, exactly. And guess what? Megan Anna, we were looking for episode ideas of what we're going to record on tomorrow. And it sounds like community, connection, and agency all make a lot of sense when it comes to wellness.

MEGAN NEFF: Yeah.

PATRICK CASALE: Social ligamenting right now.

MEGAN NEFF: Yeah, I was just admiring that, yeah.

PATRICK CASALE: But no, in all seriousness, I think they're such important topics, because I don't know how you can have wellness without those things.

MEGAN NEFF: Yeah, I mean, and maybe that's even my like, I could even tell some resistance when I was like, let's talk about neurodivergent wellness. I've, like, picked up some resistance a little bit, I think. And I get it. Like, I actually, it's funny, I just gave this talk. I gave an anti-self-care self-care talk. And I make fun of myself, of like, I literally wrote a book on self-care. And like, the concept is one that I like cringe at. And so, like self-care, wellness, I think, it can often be talked about in this kind of, like, toxic, positive, let's bypass negative emotions, and just like do these things. And that's shit advice. Like, robust wellness self-care, it's communal, it's interconnected. It's like, let me figure out how to move through the hard stuff. Like, yeah, robust wellness has to also talk about the hard stuff.

PATRICK CASALE: 100%. I agree, and I think that, yeah, that's probably my first reaction when I just hear the word wellness I'm like, "Woo." Because it's like very whitewashed, white, centered, like self-care, bubble baths, like spa days, all the things. I'm like, but I know that's not us. So, also [INDISCERNIBLE 00:51:49] and maybe-

PATRICK CASALE: [CROSSTALK 00:51:50] wellness.

MEGAN NEFF: Maybe we change the title of season two, which we don't have much time to play with, but maybe it's like Anti-Wellness Wellness, Anti Self-Care Self-Care-

PATRICK CASALE: I was just thinking of that.

MEGAN NEFF: Radical Wellness, yeah.

PATRICK CASALE: Okay, yeah.

MEGAN NEFF: That's like neuro queer a little bit. Like, let's play with the concept of self-care and wellness. So, recently, I gave the Anti-Self Care Self-Care talk I just made. Talked about at this symposium for the AANE, Association for Autism and Neurodiversity. And it was so interesting. There were three of us that did like TED Talk style talks, not as cool as you, Patrick, not an actual TEDx talk, but Ted style talks. And it was so like, we didn't know what the other people were talking about, but it was all on this theme of like community care, kind of rethinking self-care.

And actually, it was funny at the end. I was like, this would have been really awkward if I'd done like a classic self-care talk, because the last speaker was, like, I had some like mic drop quote about how like self-care is what people tell you to do when like the systems drop you, or something like that. And it was really cool to see, like, the autistic mindset around it. It all felt very connected, and how we were thinking about it quite differently than it's often talked about.

PATRICK CASALE: Nice. I love that. And I love, like, rearranging how we phrase the titling of this series. So, really love that, too.

MEGAN NEFF: Yeah, we can play with it. It's good because, like, we came into today, like, let's just start talking and see where it goes. And we're going to record a whole season in, like a week and a half. We didn't have episode ideas, and now we have plenty. So, it's exactly what we were hoping for.

MEGAN NEFF: Yeah, and I think that goes back to connection. Like, I think that comes from generativity, which arises when we're connected. Yeah, yeah. Okay, so we should close this episode out is the feeling I'm getting. So, if people are liking this, you all should go find our YouTube, or our Instagram, or our Substack that we're starting.

PATRICK CASALE: Or, even better, if you look over Megan Anna's right shoulder, there's the, what is it? The Self-Care Book for Autistic People.

MEGAN NEFF: Self-Care for autistic people. Yeah, go find the right one, because there's a rip off that is really annoying. Yeah, like it looks like an AI rip off, and that it's like Self-Care for Autistic Adults. So, find the blue one, Self-Care for Autistic People. Don't buy their like rip off. Apparently, this is like a whole thing that happens now. It's really common for people to take well doing books and make it like an AI rip off version and post it on Amazon.

PATRICK CASALE: Congrats on having a well doing book. [CROSSTALK 00:54:47]-

MEGAN NEFF: Yeah, I guess you're right. It should be like I am successful enough to have an AI rip off of my book that is actually doing really well. Like, the rip off is doing well on Amazon, which is really annoying. But anyways-

PATRICK CASALE: [CROSSTALK 00:54:57]-

MEGAN NEFF: Yes, [CROSSTALK 00:54:59]-

PATRICK CASALE: …like us, find us on all those things. And we'll continue more of these conversations episodes out on Fridays. Goodbye.