Episode 110 (Season 2): Neurodivergent Wellness Tips That Backfire and How to Adapt Them

Show Notes

Typical wellness advice is often made to sound simple on the surface, but it can feel alienating, frustrating, or downright unhelpful in real life for many neurodivergent people. For many Autistic and ADHD adults, tips like “just relax,” “try meditation,” or “write in a gratitude journal” can miss the mark, complicating our efforts to find meaningful self-care and regulation.

In this episode, Patrick Casale and Dr. Megan Anna Neff, two AuDHD mental health professionals, ask their audience to join in on the worn-down and worthy #NotYourNeurotypicalWellness conversation, exploring why so much mainstream wellness advice doesn’t work for many neurodivergent folks. They invite their community’s feedback, break down common “wellness” suggestions that actually cause stress or shame, and offer authentic, adapted strategies that respect neurodivergent needs and differences. You’ll hear personal stories, practical alternatives for things like mindfulness and “positive thinking,” and relatable honesty about everything from sensory baths to the pitfalls of forced gratitude practice.

Top 3 reasons to listen to the entire episode:

1. Discover why classic self-care advice—like meditation, yoga, or gratitude journals—so often backfires for Autistic and ADHD adults, and get expert-backed adaptations that actually make sense for neurodivergent bodies and minds.
2. Learn how to reframe “don’t worry,” “just relax,” and other well-meaning but minimizing messages, with concrete scripts and possibility-focused responses that parents, clinicians, and peers can use right away.
3. Connect with candid, compassionate stories from Patrick and Megan Anna as they share their lived experiences with sensory overload, masking, and shifting toward wellness practices rooted in real agency, accessibility, and joy.

If you’re tired of being told to “just be positive” or have struggled to find self-care practices that truly fit, this episode offers honest validation, community-sourced wisdom, and neurodivergent-friendly alternatives you can try today, as well as a refreshing take on what real, sustainable wellness can look like—on your own terms.

 

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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.

Hey, everyone. Welcome back to Divergent Conversations. We're continuing on with our collection on Worn Down and Worthy, #NotYourTypicalWellness. And today is a fun episode because we asked the audience, especially, in our Substack groups about wellness tips that you've been given that typically don't work. And we want to talk about, not just kind of pick them apart a bit in a fun way, but also, offer some adaptation because we don't want to just completely shit talk a bunch of wellness tips because that just doesn't feel useful despite that being my immediate instinct.

MEGAN NEFF: We can't deconstruct without reconstructing or offering reconstruction. And you know how I learned this was growing up evangelical, because I was like, running around deconstructing everything. Like, "Well, that theology is shit because this…"

And from feedback from people was like, "You know, it's a lot more hopeful to cast a vision of what you're moving toward, not just what you're tearing down." And that's always stuck with me, of it is really easy just to tear stuff down, but that's not very agency-giving or hope-filled. So, like, yeah, can we have fun with some deconstruction of wellness that's perhaps not been easy for us or perhaps caused shame? And can we, like, build up a thing, too?

PATRICK CASALE: Yes, exactly. I agree. And I'm going to shift more into that mode. Tearing stuff down feels good in the moment, but it never lasts very long. It's a very, like, quick dopamine hit, and then, it's kind of like, and now what? So, yeah, we are going to offer adaptation and just perspective on some of the stuff that you gave us, and we appreciate those of you who contributed. And we hope that this is helpful.

MEGAN NEFF: Yeah. Awesome. So, yeah, let's just dive through themes that we found in the comments people shared. So, first up, basically, oversimplified advice. Things like, just rest, just relax, or don't worry. Oh my gosh, don't worry, that's a hard one for me.

PATRICK CASALE: Yeah, exactly, because it feels really not just simplistic, but it kind of feels like placated, as if you're just saying it just to say it.

MEGAN NEFF: Yeah, yeah.

PATRICK CASALE: And how is that statement supposed to help me in the moment, especially like you've mentioned, if they ignore the complexity of trauma, sensory issues, and nervous system dysregulation?

MEGAN NEFF: Yeah, it brings to mind two things. One, something we mentioned on the grief episode, which is how the tendency is to pull away from uncomfortable feelings or emotions. So, when someone offers a placated response sometimes they're actually soothing themselves of like, your stress or the fact you aren't well is hard for me, so I'm going to say something that makes me feel better like just relax, just don't worry. So, that's one thought.

The second thought I had is, you know, in its most maybe neutral form it can be like, well, that's kind of annoying feedback, but it can often trend into invalidation, of like invalidating a very real experience around sensory limits or burnout. And those are the things that are kind of like splinters over time that can stack up in ways that make it hard for us to trust ourselves if we're expressing very real needs, and if we do get a lot of those invalidating responses, especially, from like parental figures over time. That's one of the things that can impact that self-trust.

PATRICK CASALE: Yeah, and it really feels like minimalization in a lot of ways, so when you are vulnerable or you're struggling and it's met with either feeling dismissed, or minimized, or just completely missed and overlooked, it can really feel confusing. And I think so often for me, one thing that I always feel like is feeling like the miscommunication or just missing the mark, and feeling that is really a shame response in a lot of ways, when I'm trying to communicate something and it just gets completely missed. So, it can really be painful experience.

MEGAN NEFF: Absolutely, absolutely. And partly, because, for many of us, that's often part of our baseline experience, is feeling misunderstood. So, I think, I for anyone those comments can be hard, right? Like, if you're neurotype, but I think if your baseline experience is feeling misunderstood, then that's just going to land a bit more sharply when we do get those placated responses. Yeah, yeah.

PATRICK CASALE: 100%.

MEGAN NEFF: So, this came from a parent in The Nook who is, like, really interested in kind of linguistics and like language justice. And I've learned a lot from her. But on one of the parent calls, so she shared some of the scripts she uses. And one was that makes so much sense, like that makes so much sense you feel that way. And I love that. And I've started using that more with my kids and with even with myself, of like, "Yeah, that makes sense you feel that way." 

And it's so simple in phrase, but like, I just kind of melt into the into the experience of like, oh yeah, it does make sense I feel that way. Like, it's so comforting.

PATRICK CASALE: Yeah, it's really affirming. And it's like, I see you. You know, like, that makes total sense. And I think that's sometimes all we want is just to feel understood, or heard, or affirmed. And that's a really nice statement.

MEGAN NEFF: Yeah, yeah. I love that as an alternative to some of that, especially, if for parents out there, like our kids' anxiety can activate our anxiety. And it can be tempting to want to, like, squash it with, like, you know, just do this. But like to be able to step into that differently and say, "It makes sense you feel that way."

PATRICK CASALE: Yeah, that's a great statement to start to incorporate and implement. You have a couple of statements written down here that are kind of some helpful reframes for this one [CROSSTALK 00:09:25]-

MEGAN NEFF: Yeah. I think the one I'll talk about is the like 5% or sometimes I even make it 2%. So, instead of just relax, kind of, can we notice, like, where we feel tension? If it feels comfortable to do, like, bodywork? Like, where in your body do you feel tension?

And then, one question that I'll often ask myself is, how do I make this moment 2% better or 5% better? Because that feels enough of like, "Oh, I can do that. I can go get, like, a weighted blanket. I can go get my [PH 00:09:55] sensei and put it on while I'm doing email. I could get on the walking treadmill. I could go in the sunshine." That'll make it 5% better. But if I'm like, "How do I get out of my anxiety or how do I relax?" That's too big. So, I really like the how do I make this moment 5%, or 2% better, or more relaxed?

PATRICK CASALE: Yeah. I like that too.

MEGAN NEFF: Yeah, yeah.

PATRICK CASALE: I also like the one that you have that says, replace think positive with plan for what might go wrong, so you can actually feel safer when it goes right. For people like me, who often think worst case scenario in almost every situation, that would be a very helpful reframe opposed to just like, "Oh, don't worry about that thing." Or like, "That's not that big of a deal." Or like, "Why do you feel so overwhelmed by that?" Like, being able to plan for the worst-case scenario, so that if it does go better than expected, then that's a really nice reframe for me.

MEGAN NEFF: Yeah, and I also like it because it gives… Like, a lot of autistic and ADHD folks, to some degree, I think we spend a lot of time planning out potential scenarios. And that can look a lot like anxiety and it can be combined with anxiety. But I think what people maybe don't always realize is we do that so that when we're in the moment we can be less anxious. 

And part of that has to do with, you know, and there's perhaps some controversy over how this will sound, but there's some research that suggests we're not as good at predicting what's going to happen next in the moment. Like, our prediction maps are not as, like, instantaneous or the ability to predict what's going to happen. So, we rely more on prediction maps that we make.

So, if I'm going into a scenario, I'm going to probably plan out, "Well, here's five different ways this might go." I'm going to create prediction maps for myself. It's like an accommodation I'm making. But it will look like I'm anxiously ruminating like, "Oh, well, maybe I'm going to hop on and Patrick's going to do this. Maybe he's going to do that." But it's like, no, I'm creating prediction maps.

PATRICK CASALE: Sure. Yeah, no, that's helpful, for sure. Some other stuff that we got, which is, this is one I struggle with so much, and I've made fun of it publicly often, but meditation yoga and mindfulness practices that backfire. Like meditation, watch your thoughts, visual meditation, yoga. I see the often-frustrating piece or overwhelming. That for me is very real. I've tried to go into, like, yoga classes before, beginner's yoga, but I can't follow what the instructor is doing. And then, I get really frustrated. And then, my body is already in a lot of pain, and I'm just like, you know, I'm giving up on this.

MEGAN NEFF: Yeah, yeah. And this can be kind of the classic go-to wellness. And so, I think, again, this is an area that could fuel a lot of shame for us of like, "Well, I tried that. It didn't work for me." And then, that collapse into helplessness as well. Yeah, yeah, yeah. 

Yeah, yoga, I've only done it through YouTube. I would never go to a class that, like, being perceived I'm very inflexible, actually. So, like-

PATRICK CASALE: Me too. [CROSSTALK 00:13:24]-

MEGAN NEFF: Yeah. Being perceived and-

PATRICK CASALE: [INDISCERNIBLE 00:13:24] like a two-by-four. Like, I can't bend and touch my toes. Like, I can't-

MEGAN NEFF: Me neither.

PATRICK CASALE: Yeah, it's painful, and I'm very, like, rigid in those movements. So, it's really tough for me.

MEGAN NEFF: Yeah, yeah. So, the only time I've ever tried it was YouTube. Who was it? There's some Adrian, Yoga with Adrian, or someone. There's someone who's huge on YouTube. This was like years ago, Pop Pilates before, or Blogilates before she became really, really big. So, she was combining Pilates with hip-hop music. And actually, I've never thought about this. So, I got really into it, kind of in my pregnancy, postpartum years, and it totally… Because she was using hip-hop music and pop music, she was using pop music. It, like, was stimulating enough. Otherwise, Pilates and yoga, it's not stimulating enough to capture my attention.

PATRICK CASALE: Yeah, yeah, no, that makes total sense. Total sense. Another thing that we had written down, gratitude journals, hard to maintain, feels like a chore, and triggers demand avoidance, yeah.

MEGAN NEFF: [CROSSTALK 00:14:38] isn't going to work at all. Like, we know from this research on gratitude journals. So, the gratitude research is really interesting. The very first study they ever did, no one knew what to expect. So, there was no sense of I am doing this for this outcome. And then, after that study, they have replicated it. But it can at times be hard to replicate. Because if you're doing gratitude as a demand, if you're doing it as, "I'm doing this, because I hear it's going to help my sleep, I hear it's going to help my mood." That actually changes the experience of it. So, gratitude is tricky.

I actually love gratitude research and positive psychology. I find it really fascinating. And there's ways I've adapted it to work for my brain, but so much of it, yeah, if some therapist is like, "Do a gratitude journal." And we're coming at it as, like, this is a to-do, this is a task, this is a demand. Yeah, it's probably going to backfire, for sure.

PATRICK CASALE: Yeah, there might be an odds there for me if that was my therapist. I wouldn't go back. I would just be like, "Yeah, so I just can't take this type of advice, and I probably won't come back." So, that's definitely led to that in the past.

MEGAN NEFF: Well, because it can feel invalidating, right? If it's in minimizing, if it's, "I'm really depressed…" And we'll have you try gratitude journaling.

PATRICK CASALE: Exactly. That's exactly how it would feel for me. And I would just look at them, probably like, "Okay." And then, how much time is left in this session, and how do I get the hell out of here?

MEGAN NEFF: Yeah. So, can I now give my alternative to gratitude?

PATRICK CASALE: Of course, yeah.

MEGAN NEFF: Okay, so I actually have a workbook on gratitude. I haven't marketed it much because, I think, because I'm like "ooh" for all the reasons of like, this can feel really invalidating to be like, “You're depressed, try gratitude.”

So, when I, like, understood the science behind it, that's when I was like, okay, I can get on board with this. And part of this goes back to, like, the mood congruence effect. So, when we're depressed, or, well, whatever state we're in, and I think I've mentioned this on the podcast before, but we will be more likely to pull out memories that match our current mood. We will also forecast that into the future. 

So, if we're depressed, all of the memories that are going to come to me are ones around, like, where I'm not worthy, all of the really negative, negative, negative stuff. Also, my forecasting of the future.

So, if we know that we're working with a cognitive bias if we're, like, depressed or anxious, then can I, from a place of agency be like, you know, I know my mind is doing this, so I'm going to actually remind myself. It's kind of like the timeline exercise you mentioned on the first episode. Like, I'm going to actually remind myself that this is not all there is. And so, I'm going to create an experience where I'm tapping into a different emotional experience. I'm reminding my mind this is not all there is.

PATRICK CASALE: Right, yeah, yeah. That's helpful for me too, to just be able to, like, zoom out a little bit, because otherwise you get so kind of consumed by the moment. It's hard to see the forest for the trees, so to speak. And I like that approach for sure. Let's see, you've got some-

MEGAN NEFF: Okay

PATRICK CASALE: Yep, go ahead.

MEGAN NEFF: I guess gratitude is like, I wouldn't say it's a special interest. I would say positive psychology, like, gets into that. So, I'm just going to go on gratitude for a little bit more.

So, this is my favorite gratitude exercise. And there's a lot of different gratitude exercises out there. And I think, like, yeah, the journal doesn't really work for me either, because it would feel like a demand. But as I go to sleep, like thinking through, okay, what are three moments today that felt good? And if good is not accessible, then that felt neutral.

But my favorite practice, and I do this with one of my kids, and it's actually really sweet. And it's called the orange moment. And we maybe want to rename it, because I'm going to explain it, and then I think we're going to both be like this maybe doesn't work for autistic people. But if you think about an orange, like when you peel it, you know, the whole room will smell of orange. It's a very rich sensory experience. And like the juice gets on your hand, that's the part that autistic people probably don't appreciate. So, it's a very, like, immersive experience.

So, an orange moment is when you're having just like such a delightful moment, and you want to linger there, and you want to take it in, and you want to smell it, you want to taste it, you want to have that experience of opening an orange. So, like, my kid and I, when we're having a sweet moment, maybe we'll be cuddling, maybe we'll be in the sun, maybe we'll be like watching Greys, which is a special interest show, and like assigning neurotypes to all the characters, and we'll kind of look at each other and be like, "This is an orange moment."

And it's an invitation. We'll just kind of sink into it and, like, taste it, like be in it. And so, that's my favorite gratitude practice is catching orange moments where I'm just like, "This is it." And I'm going to sink into it in all of my sensory systems and experience it, and feel it, and be in it.

PATRICK CASALE: Yeah, [INDISCERNIBLE 00:20:01] yourself, into it and really absorb it.

MEGAN NEFF: Yeah. So, orange moment.

PATRICK CASALE: Let me just add a side note to that. It sounds really lovely. I despise oranges so much, the smell, the taste, the texture.

MEGAN NEFF: The juice on your hands.

PATRICK CASALE: Yes, it's one of my least favorite fruits by far. I just want to name that. Anyway, continue-

MEGAN NEFF: So, I sometimes call it the mocha moment, because like Mochas are the most comforting beverage to me.

PATRICK CASALE: I love mochas, for sure.

MEGAN NEFF: So, I will sometimes call it a mocha moment and like the smell of it that-

PATRICK CASALE: [CROSSTALK 00:20:34].

MEGAN NEFF: Okay, yeah. Yeah, I don't think orange moment works great for us.

PATRICK CASALE: As soon as you started describing like an orange moment and opening an orange I got like, a visceral reaction where I was like, "Oh God, I hate oranges so much."

MEGAN NEFF: Okay, so this would be a great example. That's out there in positive psychology. I'm not sure who coined it, but maybe that works for other people. So, to adapt it for autistic ADHDers, maybe it's a mocha moment, although, some people will have sensitivities to coffee. So, whatever, like item brings just so much sensory delight, it's X moment.

PATRICK CASALE: Yeah, and just really allowing yourself to absorb it, and sit in it, and immerse yourself into it on like a cellular level, in a lot of ways.

MEGAN NEFF: Yeah, yeah.

PATRICK CASALE: Yeah, I like that for sure. Cool.

MEGAN NEFF: Okay, so we can move on from gratitude now. Thanks for letting me linger.

PATRICK CASALE: It sounds like we can continue on that for a long time. But yeah, so other strategies that you wrote down, try embodied focus, surfing, climbing, walking, and work instead of seated meditation. That sounds pretty good to me, because seated meditation for me is really hard. I'm usually really uncomfortable. I'm usually really, like, I'm fidgeting around a lot. I'm like, sitting on my knees a lot. I'm like, trying to move around my lower back pain starts up. But getting into that movement, or climbing, or walking, or anything like that, that's much more accessible for me.

MEGAN NEFF: Well, and for ADHDers, it's stimulating enough, because, like, if we don't have enough stimulus, you know, our mind will create it through distraction. So, if we're trying to do a sitting meditation, there's not much stimulus there. Like, that's going to be really hard for our mind to slow down. Yeah.

So, I've been slowly reclaiming my relationship to meditation. We actually had someone, a new member in The Nook, Florah Chambers, is her name. She's from Australia. And she spent like, 15 years in the meditation space, and then is kind of newly considering things through a neurodivergent lens, so thinking through how to adapt it.

And she did a session in The Nook that was so good, broke down like all of the myths around meditation, all the different kinds of meditation. And one of the things she identified is that so often this is what comes to mind is seated meditation, but that's just really one kind, and it's often the kind that's recommended to folks, and then it's like, well, that doesn't work for me, which I left that session, she led us through meditation, and I felt so, like, deeply connected to myself, to others. Like, it was restorative. I was like, "Oh my gosh. I think I like meditation. What is happening?"

PATRICK CASALE: I love that, and it's a great perspective check. Because I think when you hear seated meditation and your mind instantaneously says, "I can't do that or I don't enjoy that." You shut everything else down in terms of possibility. So, really allowing to know that there is more than one way to do a lot of these things that are often offered to us in terms of wellness activities, and I think that's a really important adaptation.

MEGAN NEFF: And maybe that goes to, like, learning from neurodivergent people, right? Because if these things are going to work for us we often have to adapt them. So, finding teachers who are experts in these things, and neurodivergent, and can, like, translate it.

PATRICK CASALE: Right, exactly, yeah, because it's certainly not a one-size-fits-all all approach in any sense of the word.

The next one you have I really like, using neutral grounding statements instead of emptying the mind. And like, for example, I'm in my room, my feet are on the floor. You've even done this on the podcast before, where you've grabbed a cold drink and said like, "I'm grabbing this cold drink and I'm acknowledging how cold it is on my hand, and the sensation." And that for me would be much more accessible than when I have been told in the past, “Just allow whatever thoughts are there to come in and, you know, just really empty your mind.” And again, it's one of those moments where you almost instantaneously get frustrated. And it's like, again, I can't do this.

MEGAN NEFF: Yeah, those moments, like I just had a body memory of you describing that, because those moments have always felt so… I'm going to say the word that I can't say, claustrophobic.

PATRICK CASALE: Claustrophobic, yep. Remember when someone asked us, like early on in the podcast, and are like, "What word is Megan Anna trying to say in this episode?" And I swear to you I was convinced it was like a word. And I was like, "She's saying claustrophobic." And like I said it was such confidence to like, yeah.

MEGAN NEFF: I know. I definitely got some emails of like, "Is this a word that [CROSSTALK 00:25:37]."

PATRICK CASALE: Yeah.

MEGAN NEFF: Claustro… claw, like a claw.

PATRICK CASALE: [CROSSTALK 00:25:45]. 

MEGAN NEFF: So, like claustrophobic?

PATRICK CASALE: Yeah.

MEGAN NEFF: Okay. So, it makes me feel claustrophobic to think about it, because I can't empty my mind, and then, I'm thinking about how I can't empty my mind. And then, also, going back to something we shared a couple weeks ago, the idea of how painful it is to be alone with my thoughts. So, then I've got a lot of systems to not… And I realize that's emotional avoidance, and it's something I'm working on, y'all. But it's that sort of emptying mind can feel very painful, partly, because I can't do it, and then I'm thinking about how I can't do it, and I'm judging myself. But also, just because there are a lot of, like, hard things that can come up around that.

PATRICK CASALE: For sure.

MEGAN NEFF: And also, the demand avoidance. Like, so I went to a lot of youth retreats growing up where the speaker was definitely trying to get an emotional experience out of you. And I remember always being like, “I'm not feeling the thing that everyone else seems to be feeling, what's wrong with me?”

And so, like, whenever someone is leading me through something where they're trying to get an experience out of me, I don't respond great to that.

PATRICK CASALE: Same. And I can, like, remember this in certain clinical trainings that I've done. So, I did brain spotting training with a couple of my staff a few years ago, and they put us in, like, these practicum rooms, and I couldn't access whatever they needed me to access. 

But you've got an observer, and you're trying to, like, react for your partner. So, instead of just sitting there for 15 minutes saying, like, "I am not accessing anything." I just made shit up because I was like, I feel bad for my partner. But I felt so embarrassed for myself that, like, how is everyone else having these experiences? I'm not accessing anything.

MEGAN NEFF: Yeah, yeah, no, absolutely. And I love you brought the clinical space up because I think that's really common for neurodivergent people or autistic people, specifically, going through clinical training, there's a lot of role-playing. There's a lot of, like, on-demand experiencing. Like, on-demand experiencing, on-demand emotions. And maybe that's it with meditation too, guided meditation, is it can feel like you're supposed to have on-demand experience or on-demand emotion, which, for those partly autonomy stuff around demands, but also, I could imagine, just because I think many of us do process our emotions a bit more slowly or more privately, that that's really uncomfortable for a lot of us.

PATRICK CASALE: Yeah, absolutely. Those are some of the most uncomfortable moments, actually, going through practicum, and internship, and the clinical side of like my grad school program. Go ahead.

MEGAN NEFF: Did you have to do role plays? Role-plays were so awkward for me.

PATRICK CASALE: Well, yeah, and, you know, I was just so bad at them. And I always felt so bad for my partners, because I was like, I don't know how to be in this space. And this was pre-discovery, so I'm sure I don't know what they left those rooms thinking, but it certainly was not like I want to be partners with Patrick again. It probably was awful.

MEGAN NEFF: Yeah, totally. It would make me so anxious the classes we had to do role plays in. And, yeah, my mind couldn't do it. Like, I'd have to either be real like me, or channel a client that I had had historically. Like, I just couldn't. It's that whole imagination.

Well, it is interesting. I have a vivid imagination, but the whole like, tell me a story right now. Like, my brain… In the same way that if my kids are like, tell me a story, like, I really struggle with that. And it's the same thing with role play, of like, I don't know how to do that unless it's real.

PATRICK CASALE: Right. Yeah, it was very tough for me. And this is a good reminder. I actually gave my professor feedback in that class that I could not do it because it felt disingenuous.

MEGAN NEFF: Yes, yes, yes.

PATRICK CASALE: Because they were like, "We've been watching your tapes and listening, and we can tell you're struggling in this." And I said, "I can't do this, because this isn't real." And they were like, "What?"

MEGAN NEFF: Yeah, yeah. So, there is an assessment that is done around autism, and one of the activities is kind of looking at scenes, and then you're supposed to say what you'd feel like if you were the person. And you're supposed to react like them. Like, so you might see a scene, or a picture, or a photo of like two people chatting, and one person's maybe looking disgusted. So, it's like, okay, what are you thinking?

And for so many of us, and this was my natural inclination is to be like, "Well, I would be thinking…" Like, we start describing it, versus like, "Oh, that's so disgusting." Like, that's what you're supposed to do. Just like be in it. And this is what will sometimes get called theory of mind. Like, "Oh, well, you don't have theory of mind, like, oh, well, you don't have theory of mind so that you're struggling to do that." 

And like, maybe there's something in perspective taking. I mean, theory of mind, theory, you know, that's problematic for many reasons. But maybe there is something to perspective taking. But for me, what's most accessible is just that feels so disingenuous and awkward to speak from the first person of someone that I'm not. So, I can say, like, well, if I was in that situation I'd be thinking.

PATRICK CASALE: Right. And then, the person assessing you is like, checking that box very clearly. Yeah, very much, a struggle, for sure. Skipping through some [CROSSTALK 00:31:42]-

MEGAN NEFF: Okay.

PATRICK CASALE: …I'm going to go into sensory wellness that misses the mark.

MEGAN NEFF: Or is there any other adaptations around meditation or mindfulness?

PATRICK CASALE: Sure, yeah there's… go ahead.

MEGAN NEFF: Sorry, I keep slowing us down.

PATRICK CASALE: I'm just leading you through your doc. So, I'm just going through what-

MEGAN NEFF: Oh, these are just like, yeah. So, for mindfulness, actually, I do love mindfulness. But mindfulness is not an activity. It is a way of being. It is a way of being with ourselves. And so, I do a lot of, like, mindfulness on the go. And so, like, tagging of scripts. I'm like, "Oh, that story is going right there." And it's non-judgmental, observing, like, naming that, or it's kind of clunky, but I'm noticing, I'm having the thought. So, like, let's see what would be an example. Like, if I have the thought like, “I'm a terrible mom.” Right? Then to create a little bit of distance from that I might be like, "Okay, I'm noticing I'm having the thought I'm a terrible mom." And then, what it's doing is, instead of being totally hooked and fused on that thought, it's, yep, that's what my mind is doing right now, it's like giving me a thought that's painful, and I'm going to notice it. And so, that sort of mindfulness on the go has been so helpful for my mental health, so helpful.

Sitting down and doing a 10-minute mindfulness, I'm not going to be the person that does that, but I do a ton of mindfulness on the go.

PATRICK CASALE: Yeah, I like that. And you've mentioned that before, and that's definitely more my speed, for sure. And [CROSSTALK 00:33:21]-

MEGAN NEFF: [CROSSTALK 00:33:21].

PATRICK CASALE: Yeah, sensory wellness that misses the mark. This is probably a big one for those of you listening. Like, and here are some examples, candlelight and bubble baths. And the quote is, I don't know if this is your quote or someone else's.

MEGAN NEFF: This was from a Substack person is I find it boring and uncomfortable.

PATRICK CASALE: Yep, can relate, "Drawing a bath that takes longer than the time spent in it. I get bored and damp." Okay, yes, that sounds right. Oh, my God. This is one of my worst ones, massages requiring such unpredictability, social interaction, and these "soothing activities" that often misfire, are sensory-sensitive or touch averse folks.

Massages for me are hell. I am definitely touch-averse, and it just makes me so unbelievably uncomfortable. And the only thing I think about when getting a massage is about the person who's giving the massage, how much time they have left until they get to be done with the experience. And that's like, in my mind the whole time like

MEGAN NEFF: Oh, my goodness.

PATRICK CASALE: [CROSSTALK 00:34:30] five minutes left or 10 minutes left until they can be done with this.

MEGAN NEFF: Yeah, yeah. People recommend massages to me all the time, and I like, just kind of like, "Excuse me?"

PATRICK CASALE: Pass.

MEGAN NEFF: Yeah. So, I had an interesting experience, but I still don't go to massages even after this. So, a few years ago, I was very lucky that it wasn't worse, but I was in a highway

accident where, like, a car spun into my lane, and then I was able to get out, but I hit a tree, and I was okay. But I had a lot of neck and back pain from it. So, I was going to the chiropractor regularly. And he was like, "If you do a massage before our work, that's really going to be helpful." 

And just because it was medical I just, like, forced it. So, for six weeks, I would go every week, and I would do a massage, and then a chiropractor. And it really was helpful for the pain. And I think maybe because it was like, this is medical, I got into a rhythm of it where I was like, "Okay, like, I can see the benefit of it."

But even knowing that, and being someone that has a bit of neck and back pain, I still don't, like, actively, like, "I'm going to go get a massage." Because unless it's very medically necessary, I'm going to avoid it. But I do see the physical benefits of it after I've done it, which is annoying.

PATRICK CASALE: I go to the chiropractor pretty regularly for my, like, lower back pain, and I think it's fine. Like, it has some usefulness, but there's this one process, because it's always the same positioning. Like, "Lay on your back first, and then lay on your left side." And then, she'll be like, "Now lay on your back so I can crack your neck." But it's a really, like, intimate experience where she [CROSSTALK 00:36:17]-

MEGAN NEFF: Yeah.

PATRICK CASALE: …my back, holding my head up, like looking into my face, cracking my neck. So, I have to, like, associate majorly where I'm like-

MEGAN NEFF: Oh yeah.

PATRICK CASALE: I can't look at you right now. And this is so uncomfortable for me.

MEGAN NEFF: So, this would be another example of like, well, it's hard to do, but when we can find neurodivergent-aware providers. So, actually, I have a chiropractor I adore. And I, actually, need to go back because my hip-pelvic stuff is flaring again.

But she, like, first of all, legit, like, cured me of my 10-year chronic pain. I had, like, hip pelvic pain that the doctors were like, "Let's do hip MRIs." And then, I go to a chiropractor, and it was just amazing.

But I told her I was autistic ADHD, and she was aware. And so, she does a drop table, and she was so good. She like, before we did the first drop, she's like, "I'm just going to let you know what it sounds like, so you know what to expect." But for the next stuff, it's face down, and she does it through the drop table instead of what you're describing. And so, again, that's where, if we've got providers who can adapt some of these things, it makes it so much more accessible to us.

PATRICK CASALE: Yeah, huge difference for sure, huge.

MEGAN NEFF: Yeah, yeah. Any other like sensory, so you don't like baths [INDISCERNIBLE 00:37:45]-

PATRICK CASALE: No, I don't [INDISCERNIBLE 00:37:46]. I don't know if you want my real thoughts on them. I just think they're disgusting. Like, I think that-

MEGAN NEFF: Oh, yeah. Like, from an OCD lens?

PATRICK CASALE: Yeah, the idea of, like, going into a bath and just sitting there, it just…

MEGAN NEFF: Sitting there in a mix of like your filth.

PATRICK CASALE: Yeah, it just feels disgusting.

MEGAN NEFF: Do you feel that way about hot tubs?

PATRICK CASALE: Yeah, oh yeah. I don't like hot tubs either. Yeah. So, those are out for me.

MEGAN NEFF: Okay, I do like-

PATRICK CASALE: [CROSSTALK 00:38:14] like, "Take Epsom salt bath." And I can kind of get behind that mentality when you're in, like, significant pain. And I'm like, is this going to help me play more or, like, you know, and be able to walk down the stairs? If so, okay, I can get behind that. But I don't want to just sit in a bath for like pleasure purposes or relaxation.

MEGAN NEFF: I will occasionally. Like, if I'm really in a state where, like, my body just needs to be immersed in warmth and a shower won't cut it, that's when I'll do a bath. But it's rare, because it feels like a lot of prep and like the transition in and out. And I have to have a really good audiobook or podcast, otherwise, it's too boring.

But I do like the immersion and warm water is one of the most soothing experiences for me, but the transitions around it are hard. So, I'd actually probably benefit from doing it pretty regularly, except the transitions is what makes it so I don't do it very often.

PATRICK CASALE: My height makes baths-

MEGAN NEFF: Oh, yeah.

PATRICK CASALE: …like, uncomfortable, because I'll be like, sitting in a bathtub at 6’ 2” and then, like, your legs are just kind of, like, rolled over, you're like, tucked into your chest. Like, it's not [CROSSTALK 00:39:30]-

MEGAN NEFF: That doesn't sound enjoyable, yeah.

PATRICK CASALE: …for me.

MEGAN NEFF: This is like a rare situation where my height would be an advantage. Like, being 5' 2", a bath is a very different experience than being 6'2".

PATRICK CASALE: Yeah, yeah. You know, I will say being tall is not anything that it's cracked up to be. I can reach things for people. It's so painful, especially, with all the, like, chronic pain, stiffness, rigidity. Like, it's so painful.

MEGAN NEFF: I think you should start a new account about, like, what would be the word for ableist, but for like the tallest, and like, the struggles of tall people?

PATRICK CASALE: Yes.

MEGAN NEFF: The oppression of tall people.

PATRICK CASALE: Oh, God, yeah.

MEGAN NEFF: I'm joking there, but I actually agree with you. And I learned this through clients that I worked with. I worked with some clients who were very introverted and very tall. And it was so interesting, and you know, we're working kind of psycho-dynamically around just what their experience of being a human was.

And at some point, I realized this person doesn't have the option of blending in. I can walk into a room as a 5' 2" person, and I can blend in. But what would it be like when you walk in and everyone's like, "Oh, you're tall." And like you are the tallest person, and you stand out, and you don't have the option to blend in. And then, psychologically about how you would carry yourself when that's your experience. I actually think height is really interesting psychologically.

PATRICK CASALE: Yeah, I'm very aware of like, being taller than most people I'm around, and how you get, like, looks when you walk past certain people. It's interesting. But I also was told by [CROSSTALK 00:41:11]-

MEGAN NEFF: And people comment on it because they don't see it as a bad thing. So, they can be like, "Oh, you're so tall."

PATRICK CASALE: Yeah. And you're like, "Oh, yes, that is true." I had a coworker tell me back in the day that I didn't swing my arms when I walked, and that I walked like a serial killer, is what she used to say. So, now I'm very aware that I, like, swing my arms when I walk, but now, in my head all the time of like, am I swinging my arms because I'm supposed to be swinging my arms, or is this actually how I walk now? And I don't know the difference. I don't know.

MEGAN NEFF: Well, and this reminds me of, I heard you say this, I think it was at your TEDx talk, how you used to never smile, but Arielle taught you how to smile with your teeth.

PATRICK CASALE: Yeah.

MEGAN NEFF: But like, I've always thought, tell me how this lands? When I see your photo, it doesn't feel like you. And I'm like, it feels like the smile that you do, the classic, like, Patrick, like, hand on hip smile. It's like, where is Patrick? Like, I don't see you in it. And it makes me think of the hand swinging. And like, how many things do you do, because it's like you've been taught, well, you're taking a picture and not smiling, you look like a serial killer, and [INDISCERNIBLE 00:42:20] without moving my hands, I look like a serial killer. So…

PATRICK CASALE: Then there were like three people who joined in on that conversation, too. They're like, "You don't swing your hands when you walk." They're like, "Maybe you are a serial killer." And I was like, "What is happening right now?" And now I swing my arms when I walk. So, there's that, and you know, just masking the fit in, and then your body is just like, "This is what we do now." And, yeah.

MEGAN NEFF: Don't be a serial killer. That's like, we just learned [CROSSTALK 00:42:51]-

PATRICK CASALE: Yeah, that is a part of this. So, anyway, sensory wellness that misses the mark and adaptations. So, you say trade bubble baths for pressure, blankets warm socks, or wrapping in a hoodie burrito.

MEGAN NEFF: And obviously, again, that's not going to work for everyone. Everyone has different sensory systems. But like, yeah, pressure, warmth, I know those are things that feel good for me and can give a similar sensation, but with less transitions.

PATRICK CASALE: Yeah, swap candles for your preferred scent, stim, essential oil, roller, favorite lotion, even clean laundry. Yeah, smells for me, my olfactory sense is off the charts, and like, I really have to, wait, is olfactory smell?

MEGAN NEFF: Yeah, yeah.

PATRICK CASALE: Okay. I was, like, thinking I said that incorrectly.

MEGAN NEFF: Got it.

PATRICK CASALE: I really need, like, neutral soothing smells. And it's amazing the difference in terms of sensory experience for me based on that. So [CROSSTALKS 00:43:56]-

MEGAN NEFF: Smells are huge for me. Yeah, like, Luke and I were on a walk last night, and we walked by a house that obviously was doing laundry. And I was like, "I bet you like that smell." He's like, "Yeah, I love it." He's like, "Yeah, I can tell like that's a nice smell. But it's so overwhelming to my system and gives me a headache. Maybe if it was like 1/100 of that bad, then I could enjoy it, but just the intensity alone."

So, here's a question. For me, it's like a chemical thing. Like, I just can't do artificial smells, but I actually really do like essential oils, because they are a strong, intense sensory experience, and they don't give me headaches because they're natural. For you, is it all intense smell stuff? Or is it… Like, for me, it's very much like chemical or natural is the big thing?

PATRICK CASALE: No, it's just like intensity. Yeah, it's everything. And it's really bothersome because it can really disrupt your day big time and, like, even disrupt my sleep. Like, if our dog needs a bath, and like, just smells like outside, like too much, right? Or sweat, or whatever, and I will smell [CROSSTALK 00:45:10]-

MEGAN NEFF: Yeah, that's hard.

PATRICK CASALE: …and I'm like, "Oh my God, he just, like, snorted while he's laying on the floor next to me like a pig." But yeah, so I'll smell that really intensely, or like food that's been cooking, or like anything. And, yeah, it's just so hard for me. Smells are really, really, really challenging.

MEGAN NEFF: Yeah, and this can have a big social impact, because, like, there's people in my life I can be text friends with, but not embodied, because maybe they enjoy wearing perfume or cologne, and, like, it's too much of a deterrent to want to be with them.

PATRICK CASALE: Yeah, no, I get that. I mean, certain restaurants in town, if my friends ask me to go, I'm like, "Aah." I really have to be in, like, peak sensory stabilization regulation mode to be able to say yes to certain things, if I know how impactful they're going to be. Like, if I was at like a phone charge battery or a video game life battery, I would really need to be at 100% in order to say yes to certain things.

MEGAN NEFF: Are there any smells that, like, that delight you, that you really like? That you could be like, "I want more of this in my life."

PATRICK CASALE: Yeah, I really like, like, mint-smelling things. I really like eucalyptus, spearmint, any sort of mint, refreshing type of smell. I really despise, like, citrusy, florally, yeah, anything that's perfumey. Yeah, it's really, it's tough. But yeah, mint, eucalyptus, anything that would feel like typically refreshing in that way, or like cooling, is what I would say.

MEGAN NEFF: Yeah, no, I like that stuff too, yeah. Do you use scented deodorant or unscented?

PATRICK CASALE: Unscented.

MEGAN NEFF: Yeah, yeah, yeah. Because so much of like, body care is scented, and that's then so intimate, yeah.

PATRICK CASALE: Yeah, yeah. It's probably hence, like three showers a day type of thing too. Two to three showers a day. There are certain coffee shops in town that my friends really like and I think they smell awful. And I really like these coffee shops, but I have to go knowing that I will immediately take a shower after and wash my clothes immediately because the smell is so overpowering for me that it's like hard to be in.

MEGAN NEFF: Yeah, I worked at a coffee shop for several years, and I would just come home and like, I would just be smelling of coffee. So, yeah, I was like, clothes in the wash, shower. And I actually really liked the smell of coffee, but when you work at a coffee shop it's too much.

PATRICK CASALE: One of my first jobs was at a subway. And subway smells so bad. And it's the bread that is constantly, like, being baked in the ovens there. And it gets in, like, your clothes, your hair, your skin, and it's really hard to get off. And it was really hard to be in all the time.

MEGAN NEFF: So, now I'm thinking about because sensory wellness, I'm thinking about for folks for whom, you and I both like showers as a sensory experience, for whom have these experiences, maybe they work somewhere where there's a lot of sensory stuff, and then they come home, and showers are actually a undesired sensory experience, like that's pretty brutal if I'm absorbing sensory smells throughout the day. I really want it to off my body, and to do that, I have to do an unpleasant activity.

PATRICK CASALE: Right.

MEGAN NEFF: That's brutal.

PATRICK CASALE: Have any strategies for those people?

MEGAN NEFF: I mean, like, so adjustments for that would be like wipes, like using hand wipes and like dry shampoo. Like, there's a lot of work arounds. You don't have to shower every day, or you don't have to shower to get that off, so probably changing clothes. But I mean, there's still, like, some sensory transition around using the wipes, but probably better than shower.

I think someone mentioned this. I think they learned it from TikTok, but I think it's brilliant. It's a temperature change thing, especially, in, like, colder climates, setting up a little space heater before you hop into the shower, so that when you're coming out, you're not getting that because you know that, like, hot to cold, like, that's a terrible sensory experience. So, if you have a little space heater in your bathroom so that the air temperature is a little bit warmer when you're coming out of the shower. That's when I heard that sounds brilliant to me. I haven't tried it yet, but that sounds like that would be helpful.

PATRICK CASALE: Yeah. Thinking of sensory stuff, temperature for me is also another one that's really hard… Like, my temperature regulation/like interceptive senses, I know when it's above 67 degrees at all times. Like, I am so uncomfortable once it hits 68, 69, 70 and above. And like, I can sense it. And like, go look at my thermostat, and I'll be like, yep, it's that one degree difference too, where it's like, how did it just go from just right to, like, unbelievably uncomfortable in that slight variation? So hard.

MEGAN NEFF: So, that would probably be an adaptation for sensory wellness is as much as possible controlling the temperature environment, and obviously, that's going to, for some… And that's what's really hard, especially, with climate collapse, right? We're seeing more fluctuations, and not everyone has access to air conditioning or consistent heating, in the sense where you do have that tight control over your environment, or there might be people in the house. Like, so for me, I run really cold, and then I've got a kid with POTS and who runs really hot. So, it's also like, there's going to be different temperature needs in the same household sometimes as well.

PATRICK CASALE: Yeah, totally. I've had to default to like those little, like portable pocket fans at times, or like, old packs, and things like that, and like, accommodation. That's why I also will no longer stay at my dad's house in Florida, because he keeps the thermostat at 77 degrees, which is outrageous, but like-

MEGAN NEFF: Like, that's too hot for me. And that's saying something. Yeah, I start feeling kind of like, almost like, feverish when it's at 70 and it's like, I don't feel good in my body, yeah.

PATRICK CASALE: No, it's not fun for me, so…

MEGAN NEFF: Okay, other like things on here is replacing massages for things like, again, weighted pressure, self-massage tools, because then we have more autonomy over it. This is where I feel like I talk about all the time, but I love TENS units, which is that, like, electrical pulse experience. I love that sensation so much, and I use that a lot for my lower back stuff, yeah.

PATRICK CASALE: Yeah, those are really helpful. Yeah, having that chronic lower back pain, it's super helpful, and you can just pop it on for 15, 20 minutes, and it can really help quite a bit.

MEGAN NEFF: Yeah, yeah, yeah. Well, so we've gone through some of the anti-wellness tips and adaptations. Do we want to wrap here and continue this conversation next week?

PATRICK CASALE: Yeah, I think this is a good place, for sure.

MEGAN NEFF: Okay, do you want to do the, like, mindless ending where you tell people to go like our stuff? Or should we go for a more awkward, authentic invitation into interdependence?

PATRICK CASALE: Wow, what a choice?

MEGAN NEFF: When I put it that way [CROSSTALK 00:53:00]-

PATRICK CASALE: Yeah, when you put it that way. Where's your mind going right now?

MEGAN NEFF: I want us to have a script, but I want it to be a script that we do at the end that's feels more connected to what we're actually saying and asking of people, but where it's not me awkwardly going off on a rabbit trail like this every time.

PATRICK CASALE: Yeah. So, if you do like Divergent Conversations, new episodes are out on Fridays on all major platforms and YouTube. We have our transcripts up on our website, divergentpod.com. You'll always have access to those. Our YouTube channel has all of our full-length video recordings. We also just started a Substack.

MEGAN NEFF: And so, if you want to continue the conversation, that's where you can go.

PATRICK CASALE: That's right. If you want to continue the conversation come on to our Substack. What else? What else?

MEGAN NEFF: And then, if you're looking for other ways just to support our work, and if any of the sponsorships that we put in front of you sounds like they would be supportive and aligned, that is something that helps us to secure sponsorships, which helps us keep doing the work.

PATRICK CASALE: Yeah. And right now our sponsor is Jane app, which is for mental health professionals in private practice, and you can use code DCPOD for two free months. And they actually have a really good platform for autism assessments, and their data privacy policies are really secure in comparison to some other platforms. So, I think there's a lot of reasons to like them right now. And the code goes into a very weird place where you probably would overlook it, where it says, like, Corporate Codes, Educational Codes, and something else that I can't-

MEGAN NEFF: And something code, yeah, yeah.

PATRICK CASALE: Yeah, something code. But make sure you don't overlook that if you are going to use the platform. And we have links to all of that stuff in our show notes as well. And we will see you next week for our finale.

MEGAN NEFF: Goodbye.