Episode 21

Episode 21: Autism Acceptance — Different Is Special

It's Autism Acceptance Month and I wanted to create a really vulnerable episode of the All Things Private Practice Podcast.

I'm an Autistic Entrepreneur and Mental Health Therapist. It's been a pretty painful journey thus far, but learning how to embrace who I am and how I identify has been life-changing and transformative.

When I was formally diagnosed (pathologizing is gross, btw), I had an intense grieving process — mainly because I felt so much sadness for my inner child, the part of me that wishes that I could have known sooner. It certainly made sense in regard to how challenging life has been relationally and in terms of connecting to others.

I also felt tremendous validation and empowerment because now I knew what was going on. I learned that embracing one's own neurodivergence and "differences" can be a superpower. It doesn't take the pain away, the loneliness that exists, or the social awkwardness that I feel, but it certainly makes me feel better to know that my brain just works differently than those who are neurotypical.

Different is beautiful and Different is unique. Different can also be painful. I hope that this episode helps those of you who can relate, and I hope that you know that you are valued, loved, and extraordinary.


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A Thanks to Our Sponsor!

I would also like to thank Spruce Health for sponsoring this episode.

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A Thanks to Our Sponsor, The Receptionist for iPad!

I would also like to thank The Receptionist for iPad for sponsoring this episode. As you prepare for the new year as a private practice owner, one area of your business where you might be able to level up your client experience is from the moment that they enter your office and check in with you. For many private practices, the client check-in process can be a bit awkward and confusing. Clients often enter into an empty waiting room. And chances are you're wrapping up a session with someone else, so there's no way of knowing when they arrive. With a visitor management system like The Receptionist for iPad, you can provide clients with a discreet and secure way to check in for their appointment while instantly being notified of their arrival. What's more, The Receptionist offers an iPad list check-in option where clients can scan a QR code to check in, which negates the need for you to buy an iPad and stand. Go to thereceptionist.com/privatepractice and sign up for a free 14-day trial. When you do, you'll get your first month free. And don't forget to ask about our iPad list check-in option.

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PATRICK CASALE: If you're in private practice like me and you don't know what the hell you're doing when you start out, you probably don't know that you should be having a HIPAA compliant phone system. A lot of us use Google Voice, a lot of us use our regular old phone number, some of us even go and get a second line at our cell phone carrier. None of those are recommended. I learned that the hard way. HIPAA compliant phone systems are really important in private practices. You want to protect your client information, you want to protect yourself.

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Hey, everyone, this is Patrick with the All Things Private Practice Podcast. It is April, so I wanted to talk about Autism Acceptance/Awareness Week and talk about being an autistic entrepreneur. The words didn't really come out there, because I'm still getting used to saying that, and using person-centered language instead of using the term ASD, which is quite pathologizing even though I've been using it in the past.

A lot of people have asked me to do a follow up after my last podcast on being a neurodivergent entrepreneur being diagnosed with ADHD, and the term I no longer want to use, ASD, and talking about how you can really have a successful business and combat the stigma of the shamefulness that can come up around struggling with something and then being told, “Hey, this is what it is. It's lifelong. This is a part of the identity. It's a disability, so to speak.” But it's not being diagnosed with something, right, because it's seriously part of the identity. It's part of the makeup, it's part of the brain structure.

So, I think that following up on the podcast episode that I did about superpowers and kryptonites, just talking about how you can be successful in business ownership, but also having some acceptance around who you are as a human being, and working through maybe the potential shame, or stigma, or whatever emotions are coming up, because when I got diagnosed I definitely had a grief process of, wow, this is unbelievably painful. I grieved for that inner child part of me, and then, there was this acceptance of like, but this is quite validating. And also, there's so much that I can do to show that life doesn't have to go one way and simply having some sort of mental health struggle or any sort of neurodivergence, whether it's, you know, complex PTSD, ADD, ADHD, autism, etc. I know there's more, but focusing on those for today, because that's my experience.

It really is quite empowering once you start to learn how to harness it and learn about the giftedness that comes with a lot of this too, and the way that the brain works very differently, and how you can think outside of the box. You can be really creative, even though you may think that you're not. I assure you that you probably are. When those bursts of creativity come over, it can almost feel like hypomania. And I think there's a lot of misdiagnosis between bipolar disorder, ADHD, autism, etc. Because there's, you know, impulsivity that comes up, changes in mood, fluctuation, there is definitely the creative process where you're like in the zone, tunnel vision, hyper-focused on something. I know when I get those bursts I'm like, I'm riding the fucking wave, because I know how much I can do when that energy comes up, and my brain starts really getting activated and stimulated.

And sometimes that happens at night. So, I'll be working at night, and I think a lot of people can misconstrue that with workaholism or grind culture, or working towards the next accomplishment. And that's really not what it is. And I think that can feel really shaming when friends, family, colleagues tell you that, “Hey, you should stop working so much. You know, you're just feeding into capitalism, and you know, your self-worth is so much more than what you accomplish and what you create.” And it's like, “Yeah, absolutely.”

But I think for a lot of people who are neurodivergent working is really how we feel connected to the world and how we feel inspired and creative, and I think that it discounts that when we simply say you're in workaholism mode, or you're just simply obsessed with achievement, which is certainly not me. If you knew me, I am not a three on the Enneagram provided that some people would imagine that's true. Definitely, a seven that like wander lost thinking about the next thing, getting excited, and then very bored, moving on a lot when something has interested me, and then it no longer holds my attention.

But I love connection too and I think that's a very big misconception about people who are autistic, that we can't connect with other human beings. And although I really struggle to take in connection, to be around people who, “Love and care about me.” What I do like is actually connecting with other humans in different ways. So, it has to be meaningful, it has to be in depth. It cannot be artificial surface level of conversation. I just can't tolerate it. It makes me uncomfortable, it feels disingenuous, it feels like just filling space.

And at times, I remove myself from conversations like that or distance myself from people like that, because for me that just doesn't feel like worthy of the energy that I have, because the energy that comes with absorption for someone who is either autistic or neurodivergent, in general, we're absorbing energy all the time, whether it's by masking who we are, masking to fit in, in a neurotypical world, in social situations, or how we're expected to move through the world, whether it's being around people, because there's this double empathy problem for people who are autistic, where I'm very empathic, and empathetic, and I can pick up on energy very quickly from people, and I can get a sense of how they're experiencing life and if they're struggling.

But the struggle for me is that I can't think about it cognitively. I can't think about the thought process that exists there. It's more about this superpower, right? This intuition of like, “Hey, I know this person’s struggling, hey, I can join with them very easily. There's a lot of attunement that can be done.” But it is so exhausting and depleting. And I think that's why social situations are pretty hard. And it's not that we don't like socializing or connection, we crave connection as everyone does. But it's just really exhausting, and it has to be meaningful.

So, it can't be large crowds of people for me, concerts, it can't be grocery stores, that's sensory overload. My wife will make fun of me, because when I leave a grocery store, like nothing on the list is done, and it's just like, I just throw a bunch of shit in the car and get the fuck out of there as fast as I could. Loud noises are really challenging for me, you know, and I think sensory overload, again, and a lot of neurodivergent people are also HSPs, or highly sensitive people. So, there is so much energy absorption going on all the time from all five senses.

And that's why I think a lot of us struggle with social interactions, because if I'm going to give up my energy it has to be meaningful for me. I can't give up my energy in like small talk or surface level conversation. That's not useful for me. I have no interest in it. But it's also because I'm protecting my energy, the limited capacity that I have.

And I think that so often we also have this misconception that autistic people struggle with being therapists or helpers, and that's really not the case, because there is so much attunement that happens from the way we perceive and pick up on how people are experiencing life. And we can really get in tune with the struggle. I can definitely get in tune with that, whether it's my coaching clients, my therapy clients, my friends, my family.

The struggle I have is receiving it. So, I can be around people who tell me, “Oh, you're doing so many great things. Aren't you proud? Like, we love you, we care about you.” And that doesn't land for me. It just doesn't, and it doesn't mean that I don't know people care about me. It’s just I can't access that, and that has always been a struggle of mine.

And that can create intense loneliness, and disconnection, and sadness, and grief, because it's like, I think about Anthony Bourdain a lot. I'm a huge Anthony Bourdain fan. I have a tattoo, I have a poster on my wall behind me, and he was so inspirational for me, especially, because of travel and the way he connected with people while traveling. And I believe he was probably autistic.

And watching his movie, it was like, it was so hard, and it was so painful, because he was this person who wanted connection so bad, but could never receive it and felt so lonely. And travel was so crucial, because you're in a new environment, and it's like new sensory overload. It's stimulating.

When I travel, I love connecting with people, and I was just in Ireland for a retreat that I was hosting. And everywhere I go, I want to talk to people in pubs, or in, you know, small businesses that they own, learn about them, be curious about their family, and what they do for a living, just who they are as people. And that, for me, is the only way I ever truly feel connected, because, one, I never have to see these people again, two, it's not artificial surface level of conversation. It's really meaningful. There's like these existential questions that go on and conversations. And it's really beautiful to talk to people in that capacity and feel alive as someone who feels flat very often and to feel connected as someone who doesn't feel connected very often.

And for me, that's why I travel. It's not about the next best thing, and sometimes I get caught up in that mindset, but it's more so like, I want to experience new food, I want to experience new scenery, I want to experience new people. And that is really the way that I move through the world.

When I was in Ireland, I found this small coffee cart a couple of miles away from where the retreat venue was, in this really small town, so I didn't expect to find anything like this. But I went over and I met the two owners and they started right before COVID, and they were struggling, you could tell, and we talked and I asked if I could order like 18 coffees a day from them for everyone involved and I wanted to offer like, you know, just cool options for people, because I didn't want to drink shit coffee, and nobody else did either.

And we got to talking for three straight days and I never had an ulterior motive other than to support them, and what came back around is meaningful connection, and one of them was like, “Hey, I started following you on Instagram, and I'm listening to your podcast.” And I'm like, “Holy shit.” Like, that for me is so beautiful. It's a representation of humility and human connectedness, and what the human experience is, is like, I'm invested in you, you're invested in me, I'm interested about you, you're interested about me.

And I think in neurotypical settings that doesn't happen for me very often. I have to safeguard myself, I have to preserve my energy. I probably come across short, or blunt, or too direct, or too concrete, sometimes in those situations. And I've noticed that most of my social circle is made up of people who are neurodivergent, whether they are ADHD, ADD, they have experienced complex PTSD, they are autistic. Those are my people because there's a beautiful weirdness there and a almost unspoken, we know that we don't belong in a lot of places and that we don't feel like we fit in. But at least here, even if we can't access or feel the connection that exists, we know that logically it does, if that makes sense.

So, somatically, in my body, maybe I don't experience that feeling of connection, maybe I feel disconnected. But I know that my friends and my family that go through life these similar ways they do care about me. And I can rationalize that now instead of feeling like no one does. But I still have a hard time taking it in and absorbing it. And that may be the rest of my life.

But I feel like I have acceptance over that now. For those of you who experience similar things, I think it's about finding the little moments in life like the coffee cart situation, or someone I met in a pub who I’ve just started talking to them, and like asking them about why they lived there, what they did, and more real conversation. I just can't stand the fake shit. I'm not someone who wants to have conversations for the sake of having it. And I think that can probably come across as off-putting sometimes to people who don't understand the way my brain works is like, why can't you just engage or ask me like questions about why like… I'm thinking specifically about the psychologist who diagnosed me through testing. And he was like, I knew you were autistic, because I have a guitar in my office, and you didn't ask me if I liked music? And I'm like, why the fuck would I do that? I'm not here for that. That's not the purpose of this interaction.

And then other people would say, well, that's kind of the point, right? Like, you move through life, and you probably don't do that very often. And I don't, and I don't care. Like, I really didn't care about that, and I still don't, to be honest with you. But that's not the point. I think that harnessing our creativity, and our weirdness, and our quirkiness, and the way we are eccentric, and the fact that we are different makes us really special and beautiful.

And I think that if we could talk about this more, and reduce the shame, and the stigma around being autistic, or struggling with neurodivergence, or struggling with anything, for that matter. We're human beings, like the odds that we don't struggle with something is really probably not accurate. You know, I don't think that there's a high percentage of people who had never experienced heart ache, or mental health, or addiction, or anxiety, even. Like, I mean, people are always struggling. It's just the fact that we are still a shame-based culture, where if we talk about this, it's like, why are you disclosing? Why aren’t you keeping that private? And I've been doing this all my life, you know?

I’ve talk about my gambling addiction, I've talked about my depression, I've talked about suicidality, like this is a part of real life. And if that creates a light at the end of the tunnel for someone, or at least the normalization of the human experience, then that's what I'm fucking here for. And that's what I believe my mission in life is, is to make people realize that it's okay to struggle, and it's normal, and we don't need to feel ashamed about it, because the struggle, and the suffering is really a part of the human experience, and without that, how would we ever know when we're feeling joyful, or happy, or satisfied, or pride, or any of the emotions that, you know, offset the, “Negative ones.”

You know, I think that we can do so much in our lives. Like, I want to be an example for people who are autistic and maybe feeling like they can't accomplish because of this label. And I just got back from hosting a very successful entrepreneurial retreat in Ireland, and I already sold it out for next March. And I have this podcast, and this coaching business, and a group private practice. And it's just like, we can do these things, we can do unbelievably powerful things in this world, and we just have to embrace who we are, and know that we're not always going to belong, or fit in, and the puzzle pieces may not align, and that's okay, because there are people out there who feel like you do as well and go through life in the same way, and we have to find those people. We have to create our own inner circle of people who get it and weirdos, and people who are just different, and think differently, because that's when we can feel safe, and sound, and seen, and heard, even if you can't feel it you know that exists.

And I just think that it's so incredibly important to realize that labels don't define you, whether it's depression, bipolar, you know, whether you have diabetes, whether you have cancer, whether you have some chronic condition, like, whether you are autistic, whether you are neurodivergent, whatever. It doesn't fucking matter, like it is an obstacle at times, but you have to learn how to maneuver through those obstacles and not allow for it to be a hindrance, or a crutch, and to tap into the superpowers that exist within being resilient, and persevering, and struggling because you know how it feels to struggle, and you also know what it's like to come out the other side because if you're still here, and you're still listening to this, you haven't given in to the struggle. The struggle hasn't defeated you. And I think it's important to really give yourself some credit and some compassion, even if it feels hard to do.

One thing my new therapist has been talking about a lot is playfulness, and how it's really hard for me to access that part of my being, and brain, and my inner child didn't get a lot of that as a kiddo and went through a really messy divorce growing up, and as an autistic child and not knowing that it was really hard to have friends or connections, and I felt very alone very often. Didn't play a lot, I read a lot. But other than that, playing soccer and reading that was about it. And getting into trouble, did a lot of dumb shit.

But, you know, I think that as an adult, we forget the joyfulness that comes with play, and with just being able to let loose a little bit, or to be okay with who we are, and express ourselves. And I think that is so crucial, and just being able to learn that play doesn't have to look a certain way. And you could be playing games, it could be having silly pictures that you like, or like being creative, and artistic, and having like, I have so many fidget toys on my desk, I'm squeezing one right now, you know? Being able to do those things, and not being embarrassed by the fact that you have to ground yourself in a certain way, maybe you need to rock, maybe you need to move, maybe you need to pace, maybe you need to look at your phone while you're in a meeting, because that's how you actually pay attention, you know?

Don't allow for people to tell you how you should move through the world, and there are going to be those moments when people look at you differently, or ask you why you have to do A, B and C, but that doesn't matter. Those are not your people, and you can explain it, and if they don't hear it, then you really know those are not your people, right? So, surround yourself with people who get it. That doesn't mean it has to be an echo chamber, but people should be able to accept who you are, and those are the people you want around you, and the people who check in on you, and the people who care about you, even though maybe sometimes you can't feel it or access it.

And that can be really painful. That feels really, you know, incongruent, because it's like, “Okay, I know you care about me, but I can't feel it.” What does that mean? What's wrong with me? Am I broken? The answer is absolutely fucking not. It’s just, you know, a part of how the brain is wired, and I think it again comes to protecting oneself, and sometimes it's about masking, and sometimes it's about being depleted, and you may have a social interaction and really enjoy it, and then have to spend three days in bed recovering. Don't let anyone tell you that that's not okay.

And, you know, as we move through this world, just really try hard to work on your stuff, and especially interpersonally, with how you treat yourself and how you see yourself. And, you know, I just hope that we can continue to have conversations like this. And I'm happy to continue to put this out into the world because that's never been a fear of mine. And I hope that it can feel motivating, or inspirational, or at least normalizing, and know that you're not alone.

So, I just want everyone to know that I appreciate you listening and supporting, and I'm going to move into April as Autism Acceptance/Awareness Month, and I don't want to use pathologizing language anymore, or the ASD label, or the diagnosis label. And I think if we can move away from shame and stigma, then we can do great things.

So, thanks for listening to the All Things Private Practice Podcast, new episodes every Monday morning on all major platforms. You can like download, subscribe, share, share with your friends, if this felt meaningful for you. I appreciate the support. And I hope you can get through the month and just continue to work on your stuff and just know that you are special, and that you have a uniqueness to this world, and you matter and you have a lot of resources, so if you're ever struggling, they exist.

And as my new motto says, and the one that I'm embracing this year is doubt yourself and do it anyway. Do the podcast, do the course, start the business, travel more, just do it anyway. Life is way too short, and I will see you next Monday.

About the Podcast

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All Things Private Practice Podcast
Real, authentic conversations about the mental health side of small business ownership and private practice startup.

About your host

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Patrick Casale

Hi, I'm Patrick. I’m a neurodivergent entrepreneur and therapist who truly believes in the power of disclosure, vulnerability, and authenticity. It’s become more and more clear to me that people are either attracted or repelled by what we put out into the world, and we can’t “be everything for everyone.” Through a lot of trial and tribulation, a gambling addiction, and an Autism/ADHD diagnosis, I’ve learned that being your TRUE self is what draws people in and creates connection. I have tattoos related to Lord Of The Rings, Travel, and Anthony Bourdain. And I travel constantly. Becoming an entrepreneur and working through my fears (they still exist) have allowed me to do more of the things I love. That’s my goal for you with this podcast — to use fear as a gas pedal, not a brake, and to learn how to reclaim and own your voice so that you can create your own entrepreneurial journey.