Wednesday Dec 28, 2022

Episode 1: I’ll Bring The Chaos & You Help Organize It

Have you ever felt like there was some big mystery that you could never solve as to why you acted and thought the way you did?

Maybe you were told that you are neurodivergent but struggle to understand what that means for you.

Do you feel tired of masking and don't know where to find a voice that will speak out, be supportive, and educate about neurodivergence?

This episode is for you.

Top 3 reasons to listen to the entire episode:

  1. Understand what it means to be autistic and how it can be easily misdiagnosed and misunderstood.
  2. Identify the many ways in which autism shows up in a person and its diversity.
  3. Understand what it means to mask and how this reflects in and shifts the dynamics of relationships.

In this episode, you'll hear from Dr. Megan Anna Neff, Psychologist, and Patrick Casale, MA, LCMHC, LCAS, 2 Autistic-ADHDer Therapists, and see what this podcast has in store for you.



MEGAN NEFF: Hey, I'm Dr. Neff, I'm an autistic, ADHD psychologist.

PATRICK CASALE: And I'm Patrick Casale, I'm an autistic, ADHD psychotherapist. And this is Divergent Conversations. And we are really happy to start this podcast together. So, Megan, episode one, we've been talking about this on Instagram and are making this a reality. So, do you want to take over and just kind of tell everyone what we're doing here?

MEGAN NEFF: Yeah, so we have gotten to know each other through, we recorded two podcasts together on your podcast. And then through messages, realized that it felt like we had a lot to talk about, specifically, around autism and ADHD. And we wanted to create a space where we could have more of those conversations.

PATRICK CASALE: Yeah, and I think that's the really important part for our audience is to have those conversations. Megan is going to talk a little bit about all the content that she creates and puts out on her Instagram, and all the resources, and the things that she does. 

And it's really important to also be able to have authentic, real conversations that our audience can listen to and participate in. And we want you all to be listening and just feeling like there's a place for you and there's a safe space for you because we realize so often that we get so much feedback about the work that we put out and it's just really important for us. 

So, Megan, did you want to talk a little bit about what you're doing behind the scenes, outside of this podcast?

MEGAN NEFF: Sure. I think my mic, okay. Okay, yes, I do. But so, a little bit of context for my life. Do you like how I need to nail down the prompt there a little bit more? Like Patrick, that's too broad of a question. What am I doing here? 

PATRICK CASALE: Yeah, a little-

MEGAN NEFF: I think it'd be context for my life. Actually, I had that thought as we were, like, starting this episode, and even as you were like, Megan Anna, do you want to tell our audience what we're here about. I had that like moment of freeze, of like, "Oh, shit. Like, this is the kind of thing I haven't pre-scripted it, this is a summary statement, how am I going to summarize, like how this came to be?" 

So, it's interesting to be in this moment with you. We're creating a frame, but it's not yet established. And I'm noticing that autistic part of me is craving like, okay, what's the frames? What's the rules? What are we talking about here? So, that's my interpersonal in the moment divergent thought. 

Back to your question, what's my context? So, my context, I live in the Northwest in the United States, in Oregon. I have a small private practice where I work primarily with neurodivergent adults and I do some autism and ADHD assessments. I think I'm one of a small handful of neurodivergent-affirming assessors in the States. It's a slightly different assessment process. 

And then I create content on Instagram, mostly educational content. Neurodivergent Insights is my handle over there. 

Part of what I've been noticing I'm longing for and one of the reasons I'm really excited for this project to get started, is that a lot of what I do is education. And the things that really get me excited is where I'm talking more vulnerably about the experience of being an autistic ADHD human. And I think that's what I noted in the conversations we've had in the past is, it felt like we could go there pretty easily. And so that's what I'm hoping for this project is that we're able to grapple with both the joy, and the grief, and the complexity of what it means to be a neurodivergent human on this earth.

PATRICK CASALE: Yeah, I love that. And I appreciate you also naming your vulnerability in the moment because I think that's going to be an important part of this process of like, yeah, I need the prompt and I need it to be concrete right now. 

And it's so interesting how we are processing this experience very differently in the moment because as someone who… let me circle back and backtrack, I will give some context now. I am in the southeast in Asheville, North Carolina, originally from upstate New York. I own a group practice here, Resilient Mind Counseling, made up predominantly of neurodivergent therapists, and prescribers, and entrepreneurs. We specialize in ADHD, and autism, as well as the LGBTQ community. 

And then I also own All Things Private Practice, which is a private practice coaching business where I help therapists start and grow their businesses throughout the country and have a podcast, the All Things Private Practice Podcast, and host domestic and entrepreneurial international retreats. 

I notice as I'm talking right now, I'm like, "Ooh, do I even know my context or my bio?" I hate bios. So anyway, I think that, you know, the two episodes that you've come on my podcast and we've talked about our own experiences for me have been really freeing because it's really enjoyable to talk with someone who gets it. And we can almost, like, read and pick up off of each other's energy and experience. 

And I remember the last episode you were on with me where you looked at me and you stopped talking, and you were like, "Wow, this is really fucking dark right now." And I think what happened in the moment because I've been getting feedback about that episode recently of like, "Oh, my God, it wasn't dark at all, it was so validating, it was so helpful." 

I think what was happening is we were picking up on each other's vulnerabilities. And we were really absorbing the pain, and the grief, and the struggle that we both experience on a daily basis. And even though we were putting the information out there very succinctly, and very real, and authentically, like, I think it was the energy that was being transferred back and forth is what we were experiencing that day, perhaps, and I'm excited to see where this goes. 

And you mentioned to me on Instagram, like, this has to be real, like this cannot be cookie cutter. Like, I want deep conversation, I want real, authentic relationship. And I look into our lives and other neurodivergent folks who come on the podcast as guests really being able to be vulnerable and share their stories, too.

MEGAN NEFF: Yeah, yeah, absolutely. I think that's something you and I have talked about in our conversations is, we crave place for complexity, place for nuance. And I hear a lot of people talking about that these days, that with so much communication kind of gravitating towards social media and these online spaces, I think we are losing the ability for some of those more complex, nuanced conversations. 

And when it comes to neurodivergence, it is a really complex experience. And so, we have to have space for this complicated, like, what is the word I'm looking for? Paradoxical. Like, when you're trying to hold to things intention, we need space for this sort of paradoxical conversations. They're hard to have, you know, in a 90-second reel, or a single post, or even a blog post, it can be a bit complicated to try and host that sort of nuance.

PATRICK CASALE: Yeah, absolutely. And I think it's so hard to capture in those moments because things can be misinterpreted if you're [INDISCERNIBLE 00:07:32] a 90-second reel. You can only put so much information into that. And it's so easy to pick something like that apart, and to really have longer conversations, and really get into some things that are really deep. And like you said, paradoxical. There's a lot of, all things can be true in a lot of these conversations and I think that that can be really challenging too, to try to make sense of. 

And I want to give some background on both of our, you know, stories as autistic, ADHD people before even delving into the mental health component, and the entrepreneurial component. Like, life has been pretty hard in a lot of ways for both of us. And, you know, like Megan just said, there's challenges moment by moment, and a lot of these days, and just trying to figure out how you're feeling, and what you're experiencing, what's coming up and reacting appropriately in those moments is quite challenging. 

So, you know, I am a late-diagnosed autistic adult who was diagnosed last year after kind of having plenty of suspicion most of my life. And after telling most of my close friends and family, they were not surprised. But I certainly was. 

And Megan and I have talked about grief before in terms of diagnosis, and it was challenging. And I think it was also liberating and that feels paradoxical in a lot of ways.

MEGAN NEFF: That's so well said. I had such a similar experience around… Well, I think at first came to liberation for me. And for me, this is a very familiar story, especially, for autistic adults. And I see this a lot, particularly, among autistic moms, is that it's after a child's diagnosis that we discover ourselves. And that was very much my story. 

And at first, it was so liberating because I'd been in-depth therapy for about four years and I had probably 100 questions or mysteries, that frankly, I was working to come to acceptance of, I will never know why I'm the way that I am. So, I was working to accept that my existence was a mystery. And then what fell into my lap was this one thing that explained all the mysteries and that is such an empowering, freeing, liberating experience. And then came the grief. Like, so the law aberration, and then the like, oh, wait, these are permanent limits, this fatigue it's probably not going to go anywhere anytime soon. 

And holding the both of that has been so important for my journey. And I think you and I are both staunchly in the neurodivergent affirming world. I think it can be a little bit harder to talk about the grief, and still sound affirming or be affirming. But I think it's deeply affirming to honor both experiences.

PATRICK CASALE: I completely agree. And I think that is one of those things that feels really, really challenging to make sense of and to discuss openly and freely. And, you know, to honor other experiences, too. 

And I just know that my diagnosis came with grief immediately where I was just like, "Oh, well, this could have explained a lot when I was growing up had I known and had my parents ever decided to pursue any sort of support." Which they did not. 

And then it came with a lot of questioning and then a lot of putting things together like, "Oh, that makes sense. Ooh, my Thai Beanie Baby and Garfield collection at an early age makes a lot of sense now." 

And, you know, I think I see myself like really struggling in the social aspect of all of this in terms of where things ended up landing for me and just realizing like, that's why it's been so hard to make so many friendships and so hard to feel connected. And like you were saying, like searching for your arrival point.

I often thought that like, "What the hell is wrong with me? Why can't I connect with people? Like, I know, people care about me, and they love me, and they tell me this, and I can make sense of that rationally. But I can't feel it, I can't absorb it." And I often don't feel that that feeling in a way that is also shared. 

And, you know, I always made sense of the ADHD part. And I think that society does a good job of kind of helping cishet white men come to terms with being ADHD. Like, it's like almost expected in a way at times, of like, yeah, you're a young white man. Like, you have all this energy and like, this is just who you are. And it's so much more complex than that. And also true to some degree, like majority of our research is done on white men and boys in particular. 

And, you know, I think that this last year has been really freeing because now I can say to myself, like, I understand my energy limits, I understand what I do, and don't want to socialize and who I want to socialize with. I understand that I'm going be using sensory or soothing tools most of the time when I'm socializing. And I just have to really be aware of where my energy goes. And I also know, like, you said, like, oh, this is lifelong. Like, okay, this is something that I'm going to be managing and struggling with throughout the duration of my life. And I think that's hard to still come to terms with at times.

MEGAN NEFF: Yeah, yeah. This is kind of a random association to something you said. But you mentioned kind of the cultural script about being a white cishet, ADHD male. And also, thinking about the fact that you are a late-in-life diagnosed white cishet, autistic man. Some of the people I work with that struggle the most with diagnosis and with imposter syndrome are late in life diagnosed white cishet men because like, for me, I feel like, well, of course, I wasn't identified. I'm a woman, I present in these other like, non-stereotypical ways. So, when you can have something to point to of like, it makes sense I'm late identified, I think in some ways, I mean, there's other challenges that come with that for sure. But it makes sense of the later diagnosis. 

I also feel like sometimes I have to catch myself of, it's like there's a split that happens of like, genderqueer, BIPOC women autism, like, and then those white cis men who get the diagnosis early. And so, then it's like, I don't know. I don't know if you've felt tension around that. But it's something I've been thinking about lately of partly the split, and I don't even like how I always talk about it because I realize I talk about it as if white cishet men with autism, wow, that was a word slip, autistic men have some kind of privilege as if they aren't also experiencing a lot of complexity around this.

PATRICK CASALE: Yeah, and this is why we started this podcast because this… my thought process right now around my response is complicated. And it's so interesting because as someone who was late diagnosed, not knowing this throughout most of my life, you know, I don't think I would have ever, you know, had any thought or knowledge that I could fall into, you know, the neurodiversity, you know, marginalized community. I don't think even, you know, I pass, obviously, very well, in most instances, and I didn't have to think about it, you know? I don't think I had to feel forced into thinking about identity because I have so much privilege. And it's so complicated because I also struggled so fucking much growing up. And childhood was hard. Adolescence was hard. And adulthood was hard. 

But I know that it's harder for a lot of people. And I think that makes it challenging to carry both and to really conceptualize both are true. And again, lots of paradoxes here and just, yeah, I don't know. I feel like it's challenging. And it's heavy. It's just heavy. 


PATRICK CASALE: And, yeah, go ahead, I'm sorry. 

MEGAN NEFF: Well, I was just going to jump in, like, this is part of the complexity of identity, right? Like, both you and we're part of a neuro minority and a lot of our pain is associated with that. We are also very, very privileged within our neuro-minority group, right? We're both entrepreneurs, we're both white. Like, I identify as genderqueer, it's… that could be a whole other podcast. I'm attached to the idea of being an autistic woman and I identify more as agender. 

But I have like, het or I'm in a cishet partnership. And I'm in a cishet partnership and I am cis passing and cis presenting. So, I've got a ton of privilege around, like, I've got cishet privilege, white privilege, economic privilege. 

So, we're in this space where we're very privileged within our neuro-minority group. And then within society, we also have this marginalized experience, and to be able to speak to both of those experiences, honor both of those, I think, I know that my privilege identities provide so much buffer from my more marginalized identities. And I think it's really important to talk about that, so much of autistic advocacy space is dominated by white privileged people who aren't considering the complexity around that. So, yeah, here we are episode one. And we've kind of tripped into this huge conversation,

PATRICK CASALE: Which is exactly, again, I want to just say this is what we want because staying above the surface doesn't work for either of us, and artificiality doesn't work. And it's so challenging to just not have real-depth conversation too. And we can also say that if we were recording prior to recording, you would have seen that Megan and I were using artificial intelligence to talk about a weird children's book that I had it write today and all sorts of other shit. So, like, you know, rabbit holes galore. 

But nevertheless, you know, I think it's important to just really name what you just named, and we'll continue to advocate and we'll continue to show up in honor and listen to people whose voices really matter. And we want to have a lot of those folks on this podcast, too. 

When you messaged me, originally, we were talking about this idea. And I think you said something that really stood out to me, which was something like, "I'll bring the chaos and you'll help organize it." And I feel like that could definitely be the tagline here. But it's so interesting how, you know, sometimes my autistic self like really is dominant. And other times ADHD is like, nope, I'm here like, this is my show. So, can you talk a little bit about that?

MEGAN NEFF: First of all, it's so funny. Okay, so I like Carl Jung, who's a psycho-analytic person, and he talks about the collective energy or the collective unconscious. And right before you said the thing about the chaos in the order, I was having the thought, because you were like, pulling us back out of this kind of complex puddle that I'd let us do. And you're giving like bird eye view, and I was like, "Oh, this is the chaos order thing." And then you mentioned it, so…

PATRICK CASALE: I just bought one of my staff who is a bit young and therapist and psychoanalyst union tarot cards and union socks for our holiday party that we just had, just wanted to name that. 


PATRICK CASALE: So, Zach if you ever listen to this, you're welcome.

MEGAN NEFF: That's a good gift.

PATRICK CASALE: So, anyway, the chaos and order piece and the organization of the chaos because I think that can flip flop all the time, right? Like, because there are definitely things that I really struggled with structure and orderliness around. And there are lots of people in my life who are like, they have spreadsheets for their spreadsheets and they're very happy about this. And I cannot make sense of that. Like, my brain doesn't work that way. Spreadsheets freak me out. But I know how helpful they can be. And I'm just curious about your processes in terms of when you've said that to me and just in general.

MEGAN NEFF: Yeah, well, I mean, you were even surprised. I think, partly, I took a screenshot of my computer and I had, you know, like, 15 browsers open reaction. 

PATRICK CASALE: Visceral reaction.

MEGAN NEFF: uh-huh (affirmative), uh-huh (affirmative). It's interesting, I think I present to the world more organized and perhaps more autistic than I am… like, my work process is very ADHD, which I'm sure is part of my stress. Like, if you opened up my Canva, which is where I make all my infographics, like, it is just a mess, there's no order to it, which makes it really hard to find like templates or whatnot. 

So, my process is pretty disorganized. I tend to somehow be able to wrap it up into a way that I think, like, when I present a infographic or a blog post, I think it has some order to it. But the behind the scenes is just like a messy closet of like whirlwind, which I'm sure contributes to my stress. And I wish I had the executive functioning to know how to create those systems, but that is not my strength.

PATRICK CASALE: Yeah, I appreciate you naming that. And those are the things that I feel like are my strengths. And then I have this system where internal chaos, it's more like my ideas are all in my head, but I never map them out. And I lose things or lose track of things so often. And it's so challenging. And I'm so thankful for the folks in my life who are either admin assistants, or virtual assistants, or the people who help me with those processes. And I just really struggle with it. 

But everything in my office right now has its place and is very orderly and is very clean. And if I walk into my wife's craft room right now, I would have almost a mini panic attack. So, I struggle with just stuff being everywhere, visually. And that is really overwhelming to me. 

But other than that, like, everything is very rigid in my thinking. And it's just interesting to see. You know, I think the ADHD parts of myself for entrepreneurial success a lot because I think that's when my creativity really starts to take over is when that part of my brain is really stimulated, and that part of me is just like. But then I also struggle with the fact that I will definitely hyper-fixate, and lose track of time, and lose track of things. And then all of a sudden, I don't even know what the fuck I was doing for the last hour.

MEGAN NEFF: Yeah, which that experience, right, can either feel so good or so terrible, probably depending on what's grabbed our attention for the hour. Like, I hate the feeling of wasting time. I think it's one of the worst feelings in the world. So, if it's been something like bad it feels terrible. And it's almost like I want to figure out how do I get that time back? I think it's just part of being really existential. And I see this a lot in autistic ADHD people of, I'm very aware I'm going to die, and so, I'm very aware, like, if I just wasted an hour scrolling, that's an hour of my life I'm not getting back.

PATRICK CASALE: Megan, I almost messaged you about this the other night. Like, it was like 3:00 am. And I was thinking to myself, but like, if I go to sleep now, that's an hour lost, right? Like, what if this is really important? What if this show that I really want to watch is really important, and very aware of like, okay, I have less time going forward. I have less time going forward. And I'm thinking about that all the fucking time.

MEGAN NEFF: Yeah, yeah. I'm curious what it is about autistic ADHD mindset. I notice we tend to do that more. Like, I know, for me, I definitely have a scarcity mindset when it comes to time and I imagine partly it's because my resources, my energy resources, my executive functioning resources feel scarce. I also imagine it's more than that, but it's certainly something I've noticed being more common among this group.

PATRICK CASALE: Yeah, it's like a video, game, lifeforce in a way, you know, while it gets depleted, you realize like, I have less and less ability, I have less and less capability right now. And I think that, if you're hyper-focusing or just very aware of how depleted you get, and how often you get depleted, and just know how valuable it is when you're feeling okay, or you're feeling good, or you're feeling just able to complete the task on your to do list like, I don't want to waste that. And those moments can be fleeting and it can be really challenging to kind of regenerate that energy again.

MEGAN NEFF: Yeah, yeah, yeah.

PATRICK CASALE: I think that before we started you were talking about my throat and my surgery and saying, like, "I don't want to waste this resource that we have right now." And you know, it's just that feeling of like, there's this urgency in a way. And I agree with you about the timeliness thing, that's really a struggle for me. 

Just thinking out loud, you know, about what we want to offer people who are going to be listening going forward. I mean, what are your thoughts on kind of what you want to offer this community, and who's going to be listening to this podcast?

MEGAN NEFF: Yeah, I hope that we can offer a space where there's some recognition. I think, even thinking back to the two podcasts we recorded on your podcast and the comments that I've gotten on Instagram, and that you've gotten a lot of those comments, the ones that felt really meaningful were around like, "Oh, either I feel really recognized in this or this helps to give me language around this experience I'm having." 

I think, there are so many experiences around the autistic ADHD experience that can feel really isolating, that can induce a lot of shame. So, I think giving it space, like breathing space, to talk about some of these things so that people feel less alone can be more gentle with themselves, is my hope. I think part of that will involve public learning, which terrifies me like, I'm already catching my brain ruminating on the conversation we just had around identity and privilege because it's such a sensitive topic. And I'm like, oh, shoot, like, what did I say? How are the ways that this… or maybe I wasn't as careful in my speech as I could have been, or this could be experienced by a listener?

But I think, for us to do the kind of podcast we're wanting to do, being okay with public learning and with diving into that complexity, which sounds, frankly, kind of terrifying and enlivening at the same time. But I think that will be an element of what we're doing here.

PATRICK CASALE: Yeah, I couldn't agree with everything you just said more than that. And there's going to be a lot of moments where there's going to be public learning. And I think whenever you're talking about just people, and struggle, and the complexity behind multiply marginalized identity, there's always room to grow and learn. And I just hope that we will continue to do that, and amplify voices of people who also are parts of community that we do not exist in, and just really making sure that we are trying to the best that we can to just show up and to honor space. 

And I don't think that people will agree with everything that we have to say about our experiences, either, you know? And I think that's a part of identity. And I hope that we're able to, like you said, just referencing people reaching out to us privately about either your work that you're doing on your Instagram, or our podcast episodes, or just whatever we've got going on to help people validate and affirm because so many people just either don't have language or experience, or just don't feel supported, or safe enough to talk about experience. And I think that's why we ultimately decided we wanted to do this. 

And I hope that, you know, it allows people to feel like even if they can unmask by themselves while listening, or it gives a little bit of liberation in a way, or it leads to late adult diagnosis, if that's something you're interested in, whatever it feels like that allows you to really align with who you are, and your identity, I think is really important here.

MEGAN NEFF: I like how you said that, yeah.

PATRICK CASALE: And I think going forward, you know, just trying to talk about how we're doing too while we're going through this process, you know, it's interesting to co-host something you're going to learn a lot about each other along the way and it's just an interesting back and forth process. And I love having conversation like this. And I also overthink conversation afterwards where I'm like, "How did I come across? Like, was I a douchebag that entire time? Did I overthink this or say too much?"

MEGAN NEFF: Yeah. I mean, and like, that's that classic masking self, right? I always must say this, someday I'm going to learn how to actually say it. But that experience of like going over past conversations with a fine, okay, a fine comb tooth? What am I trying to say? 

PATRICK CASALE: A fine tooth comb.

MEGAN NEFF: A fine tooth comb. I can never say that. Like, when you go over that past conversation with a fine tooth comb of like, okay, what did I say? How could it have been interpreted? I'm that anxious ruminating. That is so pervasive among high maskers. I mean, that, until I understood what was happening, I spent so many hours of my life doing that, I still do that. And I'm sure I'll do that with this podcast. But I do notice I do a lot less of it now that I feel like I'm living a less masked version of myself.

PATRICK CASALE: Yeah, I definitely agree. And I like that you name that for sure. I just want to thank everyone for listening to episode number one. And we are going to continue this process and just learn and grow as we go. And I think that this is going to be a really exciting journey to go on together.

MEGAN NEFF: I agree. You're looking at me like I should chime in here.

PATRICK CASALE: This is what I was talking about. It was like how do we close episode one? And that's what I'm thinking about right now as I'm talking, so like my words are coming out faster than my thoughts.

MEGAN NEFF: Have you always been bad at goodbyes. This is like an autistic thing. I really [INDISCERNIBLE 00:31:55] goodbyes. 

PATRICK CASALE: Yeah. I'm [CROSSTALK 00:31:57]. 

MEGAN NEFF: We just like end and have it be like a really autistic goodbye, where we don't have a greeting, we don't have an ending, it's just bye.

PATRICK CASALE: I kind of like that because, my God every social situation I've ever been in has ended like that. And it's always like, how the fuck do I get out of here before I can [INDISCERNIBLE 00:32:18] people can make eye contact with me or before like I have to say goodbye.

MEGAN NEFF: Or they ask for a hug. 

PATRICK CASALE: Yeah, they want… 

MEGAN NEFF: Yeah, yeah. 

PATRICK CASALE: Then I have to read, do I handshake, do I hug? [CROSSTALK 00:32:28] Do we just look at each other and nod? I mean, it's…

MEGAN NEFF: Yeah. I just always awkwardly leave and avoid the goodbye.

PATRICK CASALE: Yeah, I mean, I do that now. And I think I used to like linger in the space of like, "Oh my God, I feel like I need to say goodbye. I don't want to say it. I want to leave. I feel bad leaving." So much internal dialogue, for sure. So…

MEGAN NEFF: Maybe our sign-off can be something like a place where we don't do awkward goodbyes or a place where we do, do awkward goodbyes, goodbye.

PATRICK CASALE: So yeah, I like that a lot. So, a place where we do awkward goodbyes, goodbye. And then that could just be it.

MEGAN NEFF: I like it. Let's do it.

PATRICK CASALE: All right, well, a place where neurodivergent and I just said the name of the podcast wrong. This is a good glimpse into the creation world. But Divergent Conversations podcast, a place where we do awkward goodbyes, goodbye!

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