 Good day and welcome back to the 40-odd podcast with your host Mr. Thomas Henley, of course, and for any of you who are tuning in on YouTube, you will see that possibly the video might look a bit clearer, might look a bit better. I'm using a new editing recording software, which I'm trialling today, so if it goes well and if it looks good, we're gonna stick with that. But before we sort of get started with the topic of the podcast, which is autism and addiction, which I think is something very important to be talking about, something that I think affects a lot of autistic people. We will obviously get into the details of it. I do want to point out that, you know, just give you a bit of a fill-in on what's happening with me at the moment. You may have heard from even my socials or my podcast stuff that I'm kind of going through a burnout, and it's very much something which is affecting me a lot at the moment. And it's been quite hard, but I'm trying to like find the adjustments to make in my life that will, I guess, make an impact and help me get back on track. As you may know with burnouts, it's not always a clear clear way back to normality. It can take some time. So with that little sort of personal disclaimer out of the way, I want to introduce my guest, Patrick Casal. How are you doing? I'm good, Thomas. I appreciate you having me on and appreciate you sharing how you're doing. I think we too often shy away from being really vulnerable and authentic and real in terms of how our experiences are. So I feel for you for sure. How are you doing at the moment? How am I doing at the moment? I'm okay. I think my default response is always, I'm okay. I don't know. I'm tired. I've been sick getting over a virus and had to go speak at a conference yesterday and these things just take a lot out of me. So got back late last night and haven't done a whole lot today, which has felt really good. Cool. Cool. Having a chill day to relax, refresh your mind. Re-watching the Witcher on Netflix to jog my memory because I don't remember anything that happened in the prior season. Yeah, I need to do that as well. I do want to watch it, but I've seen lots of negative reviews around it. So I'm a bit apprehensive. I actually watched a lot of Game of Thrones when it was coming out. Never watched the last season because everyone said it was so bad. I was just saved myself the pain. Game of Thrones is one of my special interests and I've watched it. If I had to conservatively guess, I would say 30 times in total. Wow. But I never watched it. Not like long series, like long episodes as well. Yeah. My wife kind of knows at this time that if I'm just laying in bed or on the couch watching Game of Thrones that like I'm at my limit, I'm beyond it and I'm just going to sink into that for a while. But I never watched season eight. I just turned it off after season seven and just once was enough for me. It was terrible. Sure. Sure. Well, I'm feeling quite comfortable with we're not watching it. It was good up until that point and it kind of sort of felt like a little bit of an ending. That was cool. That was good. But yeah, so I like this isn't the first time we've done sort of a podcasty situation before. I saw recently that you put out some of the clips that we did on your podcast with Dr. Megan Neth, which was really cool. We got to talk all about Alexa Fimea, which is sort of my focus when it comes to autism related things. Very impactful. But just for anybody who hasn't kind of tuned in from that podcast, would you like to give everybody a little bit of a background to who you are, what you do, a little bit about the podcast as well. Sure. I'm one of those people who absolutely hates bios in general. I always cringe when someone reads mine. My name's Patrick Casal. I'm a licensed clinical mental health counselor and addiction specialist in Asheville, North Carolina in the States. I own a group psychotherapy practice here, which specializes in working with neurodivergent adults and the LGBTQIA communities. We have 15 therapists who work at the practice. And then I also own a separate business called All Things Private Practice, where I help mental health professionals start and grow their businesses. I have a podcast, All Things Private Practice. I host entrepreneurial retreats all throughout the world and have multiple coaching programs where I work with mental health professionals. The podcast Thomas is mentioning is called Divergent Conversations that I co-host with Dr. Megan Neff, all about autistic ADHD adult experiences from both a personal and clinical perspective. So really trying to share our own stories and experiences while also kind of processing the information as we're talking from a clinical lens, which I think is pretty unique to be able to do that. We have 10 episodes out. You are episode number 10, and it's going really well. We're really excited about it. Also the year, the age at which I was diagnosed. So I'm seeing synchronicity and all that. So I appreciate you having me on. And I'm someone who was late diagnosed at, I'm 36 years old now, but I was diagnosed at 35. So it's been an interesting probably 18 months of exploration. Yeah. And I think one of the things that definitely drew me to neurodivergent insights, Megan Neff's work was that I find the autistic community to be very, very useful in terms of experiential knowledge, like knowledge from the experiences of living as an adult. But I also, I think what kind of catches my attention from like Megan and your work is that you do kind of incorporate some of the more sciency kind of psychology based stuff, which I think is really, really important and useful. Because not only because it's good to learn, I suppose, about those different things, but also because I feel like to a certain extent with scientific literature, well, any science in general, it's a very slow process. And sometimes a lot of the really key information and important things, like that we can take away from over over autistic people that they're not necessarily always talked about within the literature. Or at least they're not they don't seem to be within kind of GP practices, healthcare, social care, it all seems to be like lagging behind by like a massive amount. Like, yeah, it's it's like there's such a gap in knowledge and service. I think we're seeing much more of a neurodivergent affirmative movement right now, but I do think that we're still using outdated language, we're still using outdated terminology, we're still talking about autism from a very archaic perspective. And I'll give Megan a big shout out because Megan is a genius when it comes to the clinical side of things. And I'm just like in this podcast feeling like I'm punching above my weight, maybe. But you know, it's it's an she is definitely someone if y'all are listening like her stuff is amazing. And I think it's really important, like you said, Thomas, to have statistics and research and information and and that that sort of guidance as well. In addition, in finding those there's crossovers between I'm actually, I don't tend to kind of, I don't tend to have like a lot of role models, especially like when I was growing up, like, I didn't really have anyone that I saw within the world or media that that I could really kind of model to improve myself from or like strive, try strive towards something. But I am like a massive fanboy of like Megan F like singing of praises all the time, like, absolutely amazing, like Instagram account and person and just like filling like the gap to some degree of psychology and therapy that's just like just often not just so untalered for for autistic people. It's such a like just such an amazing person in my opinion. Megan, if you're listening, we're just going to have a whole episode about you. Yeah. You know, it's interesting because everyone knows Megan and even in my circles in North Carolina in a Facebook thread in therapist communities. Hey, does anyone have any resources for ADHD autism? Resources and everyone's like, Oh, Megan Neff, Megan Neff, Megan Neff. And I'm like, yeah, I'm I do a podcast with Megan like we share space together. I just want everyone to know like I am also the co-host I'm here to like, thank you so much for recognizing it. Megan's amazing. And, you know, we need autistic content creators like yourself out there too, because the more we can speak about our experiences, the more advocacy that can be done. And so the power of social media is is just one that amplifies the message. So it's really awesome to see how much of an audience you've created for yourself and what you're in the work that you've done and that you're doing. So really give you a lot of credit for that. Thank you. It always seems a bit weird because it's it's very hard to, I guess, like, translate in your brain what numbers on the screen mean to you. And like, it's not like the entire like following that you have on social media is like tuning into all of your live streams and commenting on everything and liking everything. So it's very hard sometimes to be like, like, where is my stuff going? Are people seeing it? Absolutely. I mean, think about podcasting, right? Like, I don't know, how long have you been doing this for? Probably, probably over two years, to be honest. I mean, it's kind of been a bit on and off. It's only recently that I started doing like weekly episodes. So it's So I imagine you've, you know, you've had a ripple effect, right? And starting to think about it that way in terms of countries where people are turning tuning into and and where people are listening to your voice. It's it's really a surreal experience. If you ever think about it, like I shared the analytics with Megan about our podcast all the time and I'm like, look at like 1000 people have have listened to us in Australia. And she's like, really? Like people are listening to my voice and like, yeah, like this is pretty freaking cool. So I think you're right. Like numbers don't always tell the story. I think it's more about the quality of the numbers and the engagement that that's received. But I also think there's a trickle down and ripple effect. Like you probably have no idea of how many people have shared your stuff with other people who may not have a direct association to your Instagram account or or following in general. So it is really cool once you start to think about the chain reaction to Definitely. And it's I'm feeling quite like I don't tend to feel like very positive about things. But you know, the past like eight months or so, I've been trying to take it a bit more seriously. And it's starting to kind of pay off a little bit. So feeling good about it. But probably should start talking a little bit about the the topic of the podcast today and that that is autism and addiction. And you know, I think of a better person to talk to about this. I really found a lot of the insights even in our kind of pre podcast chat to be very useful. So I guess a good place to start off with is, you know, what is addiction? What kind of behaviors occur around it? And also, what kind of happens to the brain in addiction? Because we know we show you show well, you're obviously, you know, but it's, although it is a kind of psychological thing, in some cases, there are sometimes those substance sort of interactions and different changes to the brain over time of, you know, being engaged in it and stuff. So it'd be really, really cool to to hear your thoughts on it. Yeah, absolutely. So, you know, if we're going to lay the foundation and the groundwork, we're going to, if we talk about addiction as a, I like to look at it from a biopsychosocial model, you know, some people would say it's behavioral, some people would say and argue like, no, this is genetic. And I think there are components of all of those things. However, I do think there's a lot of outside influences aside from genetics that influence whether or not you're susceptible to addiction and dependency. And if we're going to define addiction, we're talking about not just substances like alcohol, opiates, methamphetamine, marijuana, nicotine, et cetera. We're talking about processes to gambling, sex, shopping, et cetera. And when we start to look at addiction, we're talking about both obsessions and compulsions. So obsessing over something over and over and over. And then the compulsive desire to do something to take action on that obsession. And we're talking about a process that completely changes your brain chemistry, the way that you interact with the world, the way that you take care of yourself and completely shifts the way that you're kind of moving through your existence. And this stuff is really, really damaging. And oftentimes, unfortunately, life-threatening. And we have such a large number of comorbidity, which means that there can be both a mental health diagnosis and an addiction that go hand in hand. And if we're talking about autistic people, then we're talking about a higher prevalence for addiction and comorbidity because of all of the experiences that we have that negatively impact our mental health. And yeah, I can think of many, you know, you only have to give it a quick Google search to see all the horrible stats that are out there. It's unfortunate, but it also makes a lot of sense. Because addiction doesn't, and I always say this, I used to say this to my clients who would come to me for addiction support. You weren't born addicted to heroin. You weren't born addicted to alcohol. Things happen throughout your life where you started to lean on a substance or a process because it was comforting, because it took away the pain, because it masked how you were feeling, because it made you feel more social. That's where addiction starts. And that's where dependency starts. So if we're going to define dependency, it is either the psychological or physiological dependency on a substance or a process, you're relying on something to help you navigate A, B, C, D, E. And then that dependency turns into a tolerance. So you may have used to been able to drink a beer and get intoxicated over the course of continued behavior. Now it takes eight beers to get intoxicated. And that that ceiling keeps raising, that dependency and that tolerance keeps increasing. And then we reach the stage of addiction where it completely consumes and takes over your life. And it's now kind of dictating how you make your own choices and how you plan your day, how you spend your time, you're often spending a majority of your day and time trying to obtain the substance or trying to figure out how to obtain the resource for the process to continue the behavior. And that's when you get into that repetitive, cyclical behavior where it almost feels like you're digging a hole and digging a hole and digging a hole that you cannot get out of. It's really, really interesting. I went through a phase at university where I was introduced to the idea of recreational drugs. Not that I took them, just that it was Manchester, uni life, people are very much engaging in all these things. And I was like, Hey, I actually don't know much about these. And some and even some of the some of the ones that I used to have such a negative regard for are things that now I kind of see in a true light, like I'm talking about things like marijuana and things like sometimes before I would have stopped being friends with someone because they smoke cigarettes or they smoke marijuana or something like that. And I was like, Yeah, it's not good. It's not good. It's going to damage your brain and it's going to do all these horrible things. And so I kind of went down a rabbit hole of just trying to understand what these things were. There was this YouTube channel called CGKid that I used to watch who was a person who had many kind of addictions to a lot of different drugs. His drug of choice was methamphetamine, which kind of destroyed destroyed his life in a lot in lots of different ways. So I kind of looked into the signs of it and also the experiences of people who were experienced in that. And it's tough. And for me, just kind of giving a bit of a background, I mean, I, you know, at the moment for me, like I started vaping like three or four years ago. It's not something that I've talked about on the podcast before. I'm trying at the moment to kind of kick my nicotine dependency, which is obviously like very, very difficult when you have such like an anxiety prone brain, you know, coming off that substance, it's tough. And so I have experience with that side of things, like I've got a very big history of it within my family. And so I'm very, I suppose I'm quite cautious and careful around things, which some degree it's been bad for me socially in terms of making friends, but, you know, to also, you know, quite protective, I think, to come through you know, university with that kind of mindset. Yeah, I think that takes a lot of discipline and self restraint, especially when you're in that influential age. When we're talking about teenage and adolescent years up to young adulthood, where there is a lot of peer pressure when there is a lot of experimentation going on behind the scenes. And for those of us who have had family members who are, who have a history of addiction, we are then predisposed to being, to having increasing likelihood to them become addicted to something as well. So it is important to pay attention to behavior, you know, because oftentimes if we're looking back on a timeline and someone's in active addiction or in recovery, they can point out how when they were adolescents or young adults and they were drinking or smoking, how they were the one in the friend group who always had a problem kind of turning off the switch when certain people could hit a certain threshold and say, okay, I'm at my limit. Oftentimes they're going to be the people who are like, no, I'll do another one. No, I'll have another one. No, I'll have another one. And yeah, it just starts to snowball so quickly when you don't have the coping skills to manage what's going on or even the understanding of the behind the scenes in terms of what's happening to the brain and the body. Sure, sure. It's quite interesting sort of my experience with nicotine because I have come off it once. Very, very tough. I came off cold turkey for like a couple of weeks. It was not very fun. And, you know, at the start, it kind of, it's something that I've seen in a lot of other people who have started to like, or wanted to experiment with, with like nicotine. They kind of had this idea that, you know, they're going to be the different one. They're going to be able to have it and they're just going to be able to kick it. And it's not going to be an issue for them. You know, they say, oh, I'll have some at the end of the day. And then it's going to be a nice treat that I'm just going to have, you know, eventually, after a while, they start like bringing it to work and start having it in the breaks. And then they have it, oh, I'm feeling it sluggish this morning, I'm going to have it in the morning as well. And then they just find that they just can't stop like puffing on this vape device. This is a bit crazy. And it's, it's, it's something that, that not a lot of people I've heard talk about in terms of like the tolerance of it as well, because when you start, it feels really nice and it feels really good. It doesn't take long to get to a point where it's, it's literally just like satisfying this negative edge that's building up in the back of your, back of your head. It's almost like a, like a different form of being thirsty or hungry. You just have this like craving for some, some nicotine. It doesn't necessarily make you feel good. It kind of might give you a buzz like after a, like a tiny bit of a buzz, like after a, you know, you've been to sleep and you've woken up and you, your tolerance has gone down a little bit, but it's very much like not exciting, not fun. It's, it's pretty boring. It's annoying. And you have to pay and it comes out of your bank account. And it's just like another, one of those kind of expenses. And it, it starts off as kind of a fun, curious thing and just turns into like a very sort of negative habit. Like So what you, what you're describing, right? Like it, I mean, one, I want to notate that nicotine and caffeine are two of the hardest things to, to stop once you start because of how addicting both of those substances are. So coffee drinkers, tea drinkers, whether you're smoking a vape, cigarette, you know, cigar, et cetera. These things are very hard and they're designed to be hard. Um, and a lot of people have a lot of shame around saying like, I just can't stop even though I'm not enjoying this anymore. One thing to particularly notate is the fact that you're saying, I don't enjoy this, right? Like it's causing all this negative reaction and I can't stop it. That's what addiction is. Like that is the, the, the textbook definition of addiction. And, and I think that's what's so hard for people who, who have not experienced that to understand, because from the outside looking in, it's like, just stop, like this is, oh, damaging. And you know, I'm happy to dive into this portion of my life. And I don't know if you want to go there, but I talked to you on our, our, um, before the podcast that I had a gambling addiction for a very long time in my life. And that's what everyone would say from the outside looking in family members, friends, et cetera, just stop, like this is destroying you this. Can't you see how damaging this is? And the person who is experiencing active addiction knows how damaging it is. And that is the torturous experience of saying, it is destroying me and I cannot control it. I cannot stop the behavior. Yes. And it's, it's a bit of an, it's an interesting one, isn't it? Because like, I sometimes have this experience, even like when I'm having meltdowns that I feel like I can not do this. I'm not, I'm not, you know, I could just not do it. But like, from my understanding of like motivation, you know, we talk a lot about, you've got to be motivated to do stuff and motivation can be good, but it's, it's a very like fleeting feeling. You know, you could, so there might be some crazy people out there who just feel motivated 24 seven, which is really cool props to you. I don't think everybody kind of experiences life that way, like even with things like going to the gym, it's like, I'm not motivated to go to the gym. I'm just doing it because it's like, I've managed to get it into my routine to some degree. And I feel bad if I don't go. So yeah, go on. Well, I was just saying, yeah, that's your spot on. And we're talking about reinforcement behavior, right? So like, when you first take a, you first smoke your vape or anything in general, it sends that little dopamine hit to your brain. And it's exciting or it feels good temporarily. But then that feeling wears off very quickly. And then you have to try to recapture that and recapture that. And it's almost like playing a slot machine and pulling the lever over and over and over, because you're looking for that positive reinforcement behavior. You're looking and chasing that feeling again and again and again. And then it just becomes insurmountable to obtain and it just gets more and more increasingly difficult. Yeah. And it's a very, it's a very strange experience being like, because I think, am I right in thinking like, because my idea of like dependency and addiction was that like, I am like dependent on my medications that I take, my SSRIs, my anti-anxiety meds. I don't feel necessarily like, like dependency for me feels more of like a state of mind, rather than like a compelling thing. Whereas like, an addiction in my head is like, I, you know, as you were saying, like this kind of cycle, this thing is not actually helping me at all. And I'm just continuing to do it. I don't know. I'm not sure I'm exactly the terminology, like the differences between the two words. Yeah. And I think that's, that's quite common. So, you know, I think when we're talking dependency, tolerance and addiction, those are the words that get thrown around a lot. And we all start somewhere, right? So when I started gambling, it was just like going to the casino, I had, I had $50. Okay. The next time you're figuring out ways to bring more money, it's harder to step away from you lose money, you overdraw your bank account, you ask friends for money. It starts to build. That's where the dependency comes in, where it feels like my body and my brain are telling me, I need to do this. Like I have to do this and I have to incorporate it into my schedule. I have to do it to feel good. Then all of a sudden, once it becomes an addiction, you cross that line, the dependency to addiction line is this very fine line. Once you cross over that dependency threshold and an active addiction takes over, that's where the control goes out the window. And that's where the rational decision making and impulse control goes out the window. And that's when you start to do things that are quite shameful to do. That's where you start to see criminal behavior. That's where you start to see manipulation. That's where you start to see a lot of sense of self completely shift in terms of personality. And it's a very fine line. And once you cross it, at least research would say you can't really go back. You can't go from active gambling addiction to then saying, like you mentioned before in uni, I'll just go once in a while to the casino. And I'll only bring $100 and I won't bring my debit card. And you start setting all these rules for yourself. But in reality, it's like a chain reaction. You go once and you're like, okay, that was really exciting. I might want to do it more and more and more. And then all of a sudden, you're back to where you started. And it's very quick for that to happen. It's in the blink of an eye. And it's just so, so, so damaging. And I think what you said about the shame aspect of it is sometimes the shame can be a really big driver for it. I don't know. There's something about doing something that you feel a lot of shame about and then continuing to do the thing that you feel shame about that kind of has some kind of like disconnect in your brain that you're like, you know, it's almost like you're just you're doing something that's completely the opposite of like how you feel you should be and how you want to be and everything. And you just kind of get into it like a bit of like a pit. You just like, I don't even care about all that stuff. This is like, this is this is all that I need. And if I can just have this, then I'll be good. And I think as well, like the shame around it, it stops you from kind of understanding it for what it is like and because you don't want to really think about it. You know it is and in the back of your head, you're like, this is not good. I don't like that. There's no part of this that is good. Other than satisfying or like removing the negative feelings I have when I'm not having it. But you just don't want to dive in to think about it because you know that it's so like shameful to think about yourself not being able to have control over who you are or what you do or you know, or even talked to other people about it and connect. That's a common part of denial, which is a common part of addiction is we're going to deny, deny, deny. This isn't as problematic as people think this isn't as problematic as sometimes I think it is when I'm thinking clear headed. Minimization is very is a big part of addiction because the shame is so real. The shame is the emotion behind it that leads to the increasing number of suicides that come with addiction. The shame is what leads to people pushing their support systems away. The shame is the stuff that continues to kind of propel and perpetuate the issue. In my opinion, it's one of the most painful emotions that we experience because it comes with self-loathing and it comes with that self-deprecating behavior. That can be so hard to get out of, especially when you're trying to do so on your own. You can spiral with it as well. It's like it's like once you're in that kind of mindset of I don't like myself, I don't like this, I'm still doing this thing. I could just try something else as well. What's the point? Usually for me it has come about due to mental health as you mentioned, like the start. It tends to be when I found nicotine and when I went through a stage at university where I was drinking every night, it was very much, what was I going with that? If I'm reading your mind correctly, it's that when you're in that space mentally it's a lot easier to say. Can I curse on here? No, no. It's a lot easier to say. Screw it. It's a lot easier to make decisions that you would not typically make when you are in a good headspace or when your mental health is at a baseline level of feeling optimal because when you're in that space, when you're in depression, when you're in major anxiety, when you're experiencing major trauma, you're inhibition shut down. Your body and your brain and your nervous system are just saying, help regulate me. Make me feel okay for right now. It is a lot easier to say yes to things or try new things that you would not typically engage in because you're kind of in this ambivalent mindset of like, I just don't care. I just don't care anymore. That decision gets easier and easier to make every time that you reach for that substance or that process. There is something about the impulsive nature of that. It's weird because for me, I don't like being impulsive, I like routine, things like that. But sometimes I think obviously the monotony of life can sometimes be hard and if you're filling up all of your time like myself with work and studying or lots of productive things, it's like, where am I getting any enjoyment from this? It's like, I just have my vape on me while I do editing and I'll just puff on that and I'll get some sort of body feeling that somehow feels slightly nice. So when you're puffing on your vape because it becomes part of routine and it becomes easier to reach for, what's happening in the body is that chemicals and like dopamine and serotonin and adrenaline are being created and these are feel-good chemicals. So those feel-good chemicals though are only taking over very temporarily and that's why you have to hit the vape again. That's why you have to hit the vape again. That's why you have to hit the vape again. And that's the same thing with anything like alcohol. Like, okay, I'll have a drink while I do my studies. Then all of a sudden it's like, I'll have another one. I'll have another one. Oh, I like how this is making me feel in the moment. And then you cross over that threshold once again and it's like, oh, I lost control here. And I feel like that feeling of just saying, screw it, I'm going to do this. I'm just going to do this. I feel like that transfers into a lot of different areas of life once you start to like incorporate that as just something that you do. Like it could be as simple as like, I think I saw some study about like the idea behind like video games that want to get you to make like micro payments and stuff. It's like they make the first payment really worthwhile and really easy and just very cheap. But once you have that kind of feeling of, you know, I don't care, let's just do this. It's very easy to like do that again and again and again. And like that can be with anything. It's just like and then that kind of crosses over into other areas of your life. Like you have that behavior about, oh, should I do this work? Or no, screw it. And, you know, just screw it for now. And then you just like, oh, I haven't done this today. Oh, just, you know, screw it. Like you just sort of get really comfortable with just doing that, even though it's completely like counterproductive to anything in your life. And, you know, when I kind of get myself into those states where I'm like, in that mood, when I actually give myself some distance from those things that I am being so flipping around doing, it becomes a lot easier to like engage my prefrontal cortex and be like, do I want to do that or not? No, I don't. I just want to do it then. Like, I think that there are other aspects, you know, obviously different to behavior, like with things like nicotine for me. The other things like the video games and things like that, it's like, I feel like once I can just get out the habit of doing that behavior, I feel like I kind of return to normality to some degree. But with things like nicotine, like the physical, chemical like withdrawal from it is like the reason why I just don't stop. So I guess like one thing that we tried about before was like, the difference between like substance and process addiction, because that's really interesting for me because, you know, they obviously carry with them different things and different similarities in different ways. So it'd be interesting to know like, what is the kind of like the difference between them? Sure. So when we're talking about substances, I think it's easy to identify, right? Because we're talking about nicotine, caffeine, methamphetamine, opiates, alcohol, marijuana, substances that get ingested by the body. Then the body then processes them into the bloodstream, into the brain, you start to send out different chemicals throughout the body to have different reactions, whether one's going to speed you up, whether one's going to mellow you out and slow you down. So it's quite easy to talk about substance use in that way and that lens. The process addiction piece is difficult for some people to comprehend because gambling, compulsive shopping, sex addiction, we could compulsive eating. There are lots of different processes that we could talk about, but specifically can talk about gambling because I have first-hand experience. It would be good to take care about your experiences with them. So gambling addiction, right? Any process addiction, the act of placing the bet is not the addictive piece of the puzzle. The addictive portion is the process, the lead-up, the build-up and the anticipation to placing the bet. So the addiction comes in when it's talking about making the decision to go drive to the casino at two in the morning during a blizzard in upstate New York, flipping a coin to decide whether or not you should go to the casino at two in the morning. Deciding when you get your test back in college, if you get above 75, if you are going to go to the casino, then it's the drive to the casino. It's the adrenaline that's coursing through the body in that moment. It's the heightened sense of anxiety. It's the anticipation. It's the excitement of placing the bet. It's the excitement of getting there. All of these things are happening simultaneously. You start to think about compulsive behaviors when you're starting to look at your dashboard and say, whichever number is on my odometer is the number that I'm going to play at the roulette table when I walk in the door. Whatever speed limit sign I see is the number of the roulette table that I'm going to play when I walk in the door. Those are the compulsive actions that are behind the behavior. But process addiction is really about the culmination and the build-up of anticipation as we move into the act. Once you place that first bet, it's almost like this calming feeling comes over you where you're like, oh, what am I doing here? It's almost like it's a fugue state in some ways where you don't even really realize the impulsivity and the danger behind some of the decisions that you're making because your whole entire state and mind and brain are taken over by this psychological dependency and need to participate in that action. So once that would happen, that kind of fades away. And that's where the hopelessness, the despair, the despondence takes over. There is a very, very, very high comorbidity with gambling addiction and suicidality because of the financial destruction that is essentially created. And because gambling is legal in most areas of the world, for the most part, and it's not a substance, there's almost an extra additional layer of shamefulness around saying, I can't stop doing this because it's not something that I'm putting into my body. Like it's just an act that I cannot stop. So we see a lot of risk there when we're assessing as mental health professionals because we have to look at bank accounts. We have to get an idea of financial destruction. Most people are lying to their partners or their families about the financial destruction. A lot of people are going to ultimately put second mortgages on their homes, get into deep, deep credit card debt that they cannot get out of, borrow money from dangerous people like bookies, loan sharks, et cetera. And then eventually when the problem gets really, really, really bad, then the criminal behavior takes over for a lot of people where it's robbing, stealing, all sorts of things like that. So it's a very, very destructive process and I've seen some horror stories, unfortunately, and it can be very, very damaging. Like just kind of like, you know, you explained it to me very well. So it was kind of like picturing myself like in the situation that you were talking about. Like I can understand that the fact that it is such an anxiety-provoking experience, like it is kind of like this like it's like the journey rather than the result. Am I right? Like it kind of like, and I imagine that if like the more that you are in debt, the more that is riding on something going well, the more intense that feeling must feel. That like anxiety really increases in that moment. Yeah. And what you were saying about like, you know, the dopamine that you got, like, am I right in thinking that kind of dopamine is like the motivating hormone that kind of the neurotransmitter that like encourages you to do something like. Makes you feel kind of good too. So you want to chase that feeling. There's an adrenaline rush to this. There's an endorphin rush when we're talking about risk taking behavior, coursing through your body. So people are chasing that feeling. So when we say like gambling is strictly psychological, it's not true. You're actually creating this physiological response to the anticipation of the act and then chasing that feeling because it feels good. It might make you feel alive. You might be lying to your partner. You might be sneaking out at night. You might be stealing from your job. Those are things that are very, very common with gambling addiction. And it's unfortunate because there's so much accessibility there. I know when I was struggling, casinos in the United States will actually allow you to withdraw money from your debit card and bank account that you don't actually have. So they have the ability to take out X amount of money more than what's in your account. So there were plenty of nights where I left the casino having overdrawn my bank account by thousands of dollars. And that feeling when you're leaving and you're driving home at six in the morning and you are replaying everything that just happened in your head, that's where the deep, dark, sinister thoughts come in for most people. Yeah. So it's like you experience the high and then you experience like the low of it and you want it. It makes sense why that would be hard to break that kind of cycle because what do you want when you're feeling low? You want to feel good. Or you don't want to feel good anymore. Yeah. And there's never enough money. I'll say that very honestly. There were nights where I won probably 10 to $20,000 in a night and the rush is, I've never experienced a rush like that in my life. There's never enough money. You'll just gamble it away. And you kind of have this internal dialogue where you're like, if I just want X amount and I could just get out of the hole that I've created, I would stop. You kind of plead with yourself that way. But in reality that I don't think that would ever be true. I just don't think there's ever enough because it just consumes everything about what you're doing and what you're thinking and how you're experiencing things. I've kind of thinking about the sort of the other kind of processes. Like I can imagine that, for example, someone who had like a sex addiction or something that perhaps having unprotected sex was the anxiety around it of going and meeting someone that you know may have a disease that you could get. I've watched a couple of documentaries about like people who are like bug chasers and people who do that kind of behavior, which is, you know, I think to a lot of people it just feels like it could be, like it just seems just like such a negative thing that there's no positives to this thing. But like the way that you're explaining it about like the anxiety and like the whole experience about doing something that is inherently damaging to you or could possibly be very damaging to you. Like I can imagine someone getting kind of hooked on that feeling. You know, I've only really experienced like a sense of process addiction with like, as I said, with like video games and stuff. But I think like even when it comes to like things like alcohol, like there is sometimes like a process involved in that because you know, I don't want to be keeping like a crate of alcohol in my house that I can just get upon. And so like there was always kind of a process after university. I was like, oh, this is this is just not feeling good. I didn't have a good day. Go to the shops, you know, that you get the anxiety rush of buying like a four pack of cider every day from the same shop that you've been to multiple times and you kind of it's like a process and then like actually having the alcohol just didn't tend to make me feel good at all. Like it made me feel so much worse. I was like, you know, because it's like an emotional amplifier. And so I didn't actually enjoy it. Like I didn't it didn't feel good to be in that dissociated state. It didn't feel like I was escaping from anything. It just made everything feel worse. But it was kind of like that, that anxiety around that I know that I shouldn't be doing this that was like a little bit attract like attracting in a way. I think that's why a lot of the programs that are implemented into school systems, I don't know if there are any in the UK, but in the States, when we had the dare program, like the just say noted drugs that you get introduced to as a child and a teenager, they don't work because the more you villainize something, the more likely it is that people are going to want to try it. And that's where risk taking behavior comes in. And that's why, you know, teens and adolescents, young adults are so susceptible to becoming addicted to cigarettes and to marijuana and to alcohol, because it's that kind of like, ooh, it's we're not supposed to do this. So that looks fun or that looks dangerous or that looks exciting. And then before you know it, a decade goes by and things are not so fun anymore. And the flip side with the dopamine creation in these in these situations is the dopamine crash. And then your brain is just constantly trying to replenish. And it's constantly trying to pull from these reserves that you do not have. And to create these feelings that you can no longer organically create. And that's a big struggle with opiate addiction as well, because your natural opiate receptors that are impacted by opiate addiction, your muse, your muse and the cappers and the salons. So you know, and I think if we're going to, if we're going to tie in the autistic piece to this, which I am, you know, I think is the important component for this podcast is the is the association and reliance upon something to feel a different way, because so often our autistic people, like ourselves are struggling with our nervous system, or our anxiety, or sensory overload, or being able to feel social, or feeling connected, or feeling too tired, or whatever we are feeling on a magnified level, and reaching for something that can quickly soothe how we're feeling or help us feel social in the moment, or able to unmask in the moment, because you've had a few drinks and now you feel more comfortable. That's why the stuff can get out of hand so quickly and become problematic so quickly. And I'm a firm believer that addiction is the opposite of connection, that the more connection we have, the more security we have, the more healthy relationships that we have, the less susceptible we are to these things. But as we know, autistic folks and social struggles and isolation and bullying and all the things that come with it, the experience, you know, I think it really pushes in the other direction to create a lot of destruction and damaging behavior. You know, I don't think the fact that some substances are promoted socially is obviously like, isn't like a good thing, like there is a big culture. I know that the US does have in the UK, there is like a just a ridiculous lack of awareness about the effects of alcohol. Even in the short term, because people think, oh, just don't have it a lot and you won't get fatty liver disease and you won't get all of these kind of dependencies and you won't have to drink it to feel like to not get ill. But actually with the binge drinking of it, I didn't know that you could die from having too much alcohol. It's served in a pub in a restaurant. I can just have it. I can just get it from Tesco's. I can like, you know. Yeah. And it's what's the latest in the UK 18? Yes, 18, which, you know, you have all those things of, you know, your brain developing and stuff and just kind of magnifies the neural effects that that kind of stuff can have even like things like marijuana is I think can have impacts on your brain's development up to a point on a nicotine, I think as well. Hey, just popping on to say thank you for listening to this podcast this far. If you could do me a real solid, please make sure to rate the podcast if you're in a podcasting streaming service and do all that like, subscribe, comment stuff on YouTube. Damn, even send a heart in the comments if you don't feel like typing. Make sure to check out my link tree, which is always down below in the description or head over to my Instagram page at Thomas Henley UK for daily blogs, podcast updates, and weekly lives. This podcast is sponsored by my favorite noise canceling, noise reducing earbuds that you can adjust the volume on. Really, really great thing. They're called D buds and you can find the affiliate link down in the description of this podcast for 15% off discount. Anyway, I hope you enjoy the rest of the podcast. That's all from me. I think definitely one of the kind of the negative life experiences that I feel very, very strongly about is the social isolation aspect of being autistic. To a certain extent, we struggle with isolation at school, being isolated from groups and people. But in adulthood, especially that transition from school to adulthood or school to university, you will not put in scenarios where you're around people like you used to. It's such a difficult experience. You're like, okay, I need to find people. When you've had all these negative experiences with people in general, when you're younger and even in adulthood, it's very, very difficult to feel like people will like you or you couldn't find a friend or someone. But also that there are those people out there. I remember for the longest time, I didn't think anybody was worth investing in because I just had such a negative bias on my experiences with other humans. I was like, neurotypicals, I can never talk to them. I can never have any kind of trust in them at all. It was only until I kind of started to push myself to kind of get out and in the world that I experienced some like positive experience with it. But I consider myself quite a driven and motivated person, you know, despite my mental health conditions. I just can't fathom just how difficult it could be for a lot of people to find that sense of connection and fun and doing activities with people. It's so easy just to have a dependency on something instead than doing that. Yep. I think that's really the crux of the issue is that it's a lot easier to rely on something that you can easily access to make you to change how you feel. You can't always, even if you organize something, it could be delayed, it could change, it could happen. You just don't want to invest yourself emotionally and stuff. And it's like, or I could just have this thing and then so I don't feel bad about the other things. I can just always have this when I want. It's much easier to slip into that when you are isolated, you don't have friends, you don't really talk to your family much. Absolutely. And I think you're spot on. And I think that if we polled people and looked at research that you would see that the statistics would be alarmingly high for those of us who are neurodivergent or those of us who really struggle socially in relationship and the correlation between substance use. And it's just increasingly high. And because what you're describing, right? And so many of us experience is that loneliness, that constant longing for belonging, but the inability to access it. It's a lot easier to drink a four pack of cider and dissociate from that or disconnect from that or numb that out temporarily. And then not acknowledge the physiological and psychological effects of relying on something to feel differently. Definitely. And I think as you said about the mental health aspects of it, I mean, there's like a ton of crossovers between autism, ADHD, mental health, and also mental health and addiction. And then I suppose you also have the aspect of routine to things that was a big thing for me, like with alcohol. I had a routine that I did each night that even when I wanted to stop doing it, it just felt wrong. And it caused me anxiety to not do the thing like not necessarily just because of like the feeling that it gave me or or anything like that. Just just the fact that I was changing my routine from something that had been a part of me for like months. That was so much harder. And then, you know, obviously going with the withdrawal and stuff from having those things, it's it's like a double whammy. Like you dysregulated and also you don't have your regulating thing. Yep. I think you just explained that pretty perfectly. We all know how important routine and structure and sense of familiarity is for for autistic folks. And it can be a routine that revolves around something that you know is not healthy for you. And that can make it even more complicated to change that behavior, because it's just an extra layer to and challenge to making any sort of adaptation or change to that because of the transition, the structure, the I know at four p.m. I do this thing. I know at four p.m. I go to this place like not for a lot of us is very comforting, even when it's something that isn't useful or healthy. I think that there definitely is another element, which, you know, I think we talked a bit about on a new pod about like a lexifimer and stuff. Like it's very much the case that I feel like a lot of autistic people, we tend to gravitate towards these like blanket regulation methods. Like some of them are good. Some of them are bad. Obviously, like for me, blanket regulation would look like going to the gym, you know, like just regulates me, something that I do and not necessarily bad for me and actually quite good for me. But it's, you know, if I'm feeling something that's negative or experiencing something that's negative, it's not like I'm tackling that, the cause or identifying. How do I feel about that? How do I feel? And what is causing me to feel this way? And being able to make that connection between them to like process things and do things that actively will make my situation or my feelings about it better. Like it just sometimes feels easier just to have all of these different blanket regulation methods that I can use to make myself feel better, you know, it could even be things like stimming or like eating some food that I like or, you know, all of these things that make me feel better, but not necessarily like it's not necessarily like taking time aside to process and get through things. Yeah, I think that's where the really deep challenging work happens, right, is when we're really getting into the what's happening behind the scenes. Why am I feeling this way? How can I change this behavior? That's a lot of mental energy. And I think it's a lot easier to default to just what you're saying blanket behavior to say, I know this works, you know, like I don't have to think much about it. I know it makes me feel better. I know it makes me feel different than I'm feeling right now. And life is so hard that I think it's always a lot easier to reach for the thing that we don't have to exert the extra effort or mental energy into. Yeah, it's like having a button. Like, you can just push this button and feel good. Yeah. Yeah, just keep pushing that button when you feel bad. Like, you know, it might make you feel good and you might have a good like feel like you have a good life. But like you're pressing that button all the time. And it's for everything. And you're not like letting yourself feel bad about things, you're not like, you know, really tackling things at the root. I think as well, like, one of the things that kind of drew me into alcohol, like, I know you're saying that addiction can be like cause like suicidal feelings, especially when it's like impacting your life a lot. And you feel a lot of shame about it. But also, like, I think there was kind of a point in my life where I kind of I was sort of sort of using my ideation for it as like a crutch. It's like, okay, this is going bad, I can always just just not be here if I want to. As soon as I stopped doing that, like, obviously that's great. Like, I'm not complaining about that. But then there's like, okay, there's other options, like, I could drink instead of like, I have this crooks gone now, even though it's a negative crooks, it's like, but now what? Like, now, now what do I do to if I don't have that option? How do I feel good? And it's like, you know, if you're kind of in deep depression, and you don't have the energy to do things, and you don't really feel like you have the support around you, you don't feel positive about things in your life, you don't experience pleasure from things, it's like supplementing with different neurotransmitters via the form of substances or processes, it's just very attractive, like, as something else. Other, you know, obviously mental health, like, you generally just don't care about yourself as much as you should as well. So it makes it quite easy to damage yourself, I guess. Yep. Yeah, that kind of circles back to what you were saying before of when you're in a bad mindset, when it's easier to just say, screw it, I'm going to do this thing. And I think we so often, not just autistic people, just people in general, just want to change how they feel. Yeah. We don't, you kind of just alluded to that, like, a lot of us, myself included, like, we don't want to feel bad, we don't want to feel pain, we don't want to sit with a negative emotion, and we want to change that very quickly. And I know that's a generalizing statement, I think a lot of people would opt to not sit with the discomfort. And sometimes we do just have to sit with how bad and how painful things can be. Because trying to change how you feel, trying to alter how you feel with a substance, it's just a band-aid fix. It's not something that's a long term solution. It is a very temporary short term solution to an experience. And I think we lose sight over that because we just have such a hard time in those spaces. And I suppose that kind of goes around to this idea of like delayed gratification and stuff. Like it's just, you know, pretty much everything in our life is like kind of designed to hook us in and like get us to say, like, screw it and do something. It's like, you have all these adverts that say, oh, be impulsive, do these things and just go on holiday. You might not be so financially sound. Just do this, just do that. You'll feel good from having this and eating this. Like, I don't think it's a sort of illogical assertion to say that, you know, people don't want to feel bad. Like it's, you know, I don't think anybody likes, like the nature of it is that we don't like it. But you know, I think there is a lot of use in having that kind of delayed gratification mindset to things about, you know, life, you know, life is not a movie all the time. You know, you go to the bathroom, you have times where you can't do things. You have to brush your teeth, you have to get up in the morning, you have to go to sleep every night. There's all of these kind of boring monotonous self care things that you do that just don't have any like apparent benefit in the short term. And like, you know, it's difficult. And I think, you know, in a lot of areas of life, people can kind of get fed up with things and not having this kind of glamourized idea of what life should be like. You know, it's, it's, it should be your kind of default mode, your default kind of feeling should be just feeling meh, I guess, just normal, like, and that's not fun. Yeah, it's not good. Like, sometimes you want to feel the high and you feel great and you want to feel lovely. And usually doing that kind of thing, you've even even if it's something like innate, like socializing with people, like you are watching some watching a movie, like, once that goes down, you still you'll always feel worse than you did. Like after so it's, I don't know, I think there's a lot to do with expectations and kind of like the culture that's that's formed at the moment around that kind of mentality of, you know, just screw it and have fun. And, you know, it's, it's, it's fun. It's exciting. And it's nice to think about that. But it's not like, it's not going to like change your life. Like, it kind of has an impact at negatively. Yeah, well, yeah, because the neuro is chasing the next thing, right? Like that vacation is never as good as the next vacation that's coming up. And that meal is never as good as the next meal that you're romanticizing. And I think we want to do that. Like we want to escape. I think that's reality. We're right. I mean, I think, I think a lot of existence is just like, like, existence and yeah. And I think for autistic people who are deep thinkers and like analyze a lot and feel at a very intense level that existence is not always a pleasant place to be. So it's kind of like, how the hell do I change what's happening for me if this is kind of how I feel all the time? It's like, I could get better, but then, you know, why, why would I get better if it's just like this all the time? It's, you know, you see on social media, people posting like all the highlights of their life, you know, you only see the the athletes on the podium. You don't see like the getting up in the morning and going to training and waiting for things like the little and struggling to. Yeah, yeah. Yeah, 90% of the battle. Yeah, to get onto that podium. Yeah. It's an interesting topic, you know, and I don't know. I think that we could explore this in so many different arenas and and vantage points and it's something to just be mindful for to your listeners. Like really pay attention to when you reach for something, why you're doing so, the why behind the action is important, what it's making you feel like during the experience and how you feel after 90% of the time, 99% of the time, the after effect is not good. We're talking about a lot of regret and shame and depression and all sorts of stuff that we're trying to run from or avoid or change that actually get amplified post substance use or post drinking or post gambling and then all of that stuff comes flooding back and that's, that's again why you have to reach for it again because you're like, wow, wow, this is even worse than before. Let me try again. I think not that I don't want to leave on a message of hope, but I do want to just be really honest that, you know, this is very, this is cyclical behavior. It's just it exists in a loop a lot of the time. So it's really about really examining this stuff and stepping back and talking to someone and getting some support around it. If you feel like you are struggling, if you feel like you have behaviors that feel like they're out of your control or you start to notice that they're becoming harder to resist, I think be proactive, you know, like reaching for support before it gets to be too late because once you're in the thick of it, it's very hard to climb out of. Definitely, definitely. I suppose we've talked a lot about I guess the negative effects and, you know, you've mentioned some like a kind of a brief idea of, you know, how you can kind of get past things. We talked about some of like the negative short term, long term consequences of different types of addiction, different possible connectors between being autistic, ADHD and addiction, what it actually is, the dependence substances versus processes. I think we've talked about a lot. I think it would be, I think it would be good to kind of maybe maybe wrap things up. Do you have your song of the day? Oh no, I forgot about that. You forgot your song of the day. Oh man. It's so good. I know. Yeah, I'm so sorry. I don't have a song of the day. I think I've got good one. Good. Maybe. Thank you. Can I just point to something real quick that could be helpful for people? Yeah, yeah, that would be amazing. I come from the background of not really aligning with the 12 step mentality, which is very firmly rooted in religious components for recovery. For those of you out there who are struggling with any process or substance, smart recovery is worldwide. I really think it's a great tool. It is science and evidence based. There are facilitators that actually have to get trained to run the meetings, and it's not a shame based program. And they actually teach you coping skills to deal with triggers and urges and warnings. And I think it's a really, really useful recovery tool to implement. They have both online and in-person meetings. So I think smart recovery stands for self-management and regulation tools and essentially can be really useful for those of you who are listening who are maybe struggling with any of the things we talked about, who just want some support, who want people to talk to, bounce ideas off of, have common experiences with. So I just want to offer that as a resource in addition to the most commonly thought of resources around substance use and addiction. Awesome. I was kind of thinking when you said smart, I was thinking small, measurable, achievable, realistic time-bound goals. We're using sports science to... We're also going to incorporate smart goals here. I mean, smart goals can be useful too for substances and addiction. But yeah, smart recovery, I just, I don't think he gets enough eyes on it because a lot of people don't know it exists. And if you just take a look and there's probably meetings in your area, if not, there are online accessible meetings. And I think just having another resource to just... I really do believe you can get out of this. Like, I'm living proof that recovery is possible. So having gambled since June of 2012, it's almost coming on, I guess this June is, or last June, last month was 11 years. So I know that when I was in the thick of that, there was never a chance or thought in my mind that I thought that was going to be a possibility for me. And so I do want to just really say that therapy works. If therapy isn't affordable, like smart recovery, meetings, having camaraderie, just allowing yourself to ask for help is really more than half the battle. I think it's also good to remember that it's not always a clear path as well. There will be times where you can relapse and you can do all of these things. The times where I put all the most pressure on myself to quit something is the times that it just hasn't really worked for me. I think sometimes just being kind and trying to remove that shame to some degree and just finding different ways to satisfy your needs or redirect your focus is also... It was massive for me with the gym and my binge disorder, whereas sometimes I might... Trying to stop binging was hard, but trying to eat healthy, protein-rich foods constantly throughout the day, not just naturally reduced it, but I wasn't focusing like, I'm not going to binge, I'm not going to binge. It's just kind of having like a different kind of mode of living, which helped me in the most. I like that a lot. Well, it's kind of come to the song of the day segment, which I know that you don't have your song, but we've got a song that I really like. I'm not sure if it's particularly about addiction or not, but I really like the song. It's called Medicine by Daughter, which I think is quite apt, and I'm going to add that to our song of the day playlist. I'm going to find it, here it is. It's going to go in that. And Patrick, where can people find you if they want to look more into your podcasts, the stuff that you do online, the social medias, what places can people find you? Thank you. And thanks for having me on. So if you are interested in the entrepreneurial side of my business, you can find me at allthingspractice.com and listen to the All Things Private Practice podcast and follow me on Instagram at All Things Private Practice. And if you want to listen to the podcast that Dr. Megan Neff and I have, you can follow us on Divergent Conversations on Instagram or go to any major platform that podcasts are on and listen to the Divergent Conversations podcast, which, again, is all about autistic ADHD life experience. And we've had Thomas on as a guest. Yeah. Go watch the episode about Alex Feimer. It's a good one. I haven't really done like multiple people. I haven't done many multiple people podcasts before. It's always been like a one-to-one thing this time. But it was good. It's really nice. And it's nice to talk to you and also talk to Megan again. It's, yeah, definitely encourage you guys to check that out. And I will put, I hope you have a link tree. I will put the link tree down in the description, which you can find pretty much the same place as all episodes and podcasts and videos that I put out. Go check that out. And of course, if you have enjoyed the podcast, make sure to rate it and give it a follow or give it a different terminology. I can't remember what the apple one was like, something like follow, subscribe, something like that to get notified of when new podcasts come out. If you want to go see some of the other stuff that I do, I have a YouTube channel, if you're not listening on there, where I do podcast clips from different episodes as well as reels, TikToks, YouTube shorts of the podcast and also individual kind of original content that I've made. And if you want to stay up to date with my life, whatever you've been doing, Instagram is always the best place to go. That's at Thomas and the UK down in the description. And you'll be able to find lots of different daily blogs and articles and things that that I put up there. So yeah, I hope you have very much enjoyed this. Make sure to rate it if you have. And yeah, I mean, what have you got anything planned for the rest of the day, Patrick? It is 5pm here in the Eastern part of the United States. I have soccer at eight. So now I'm going to go eat something very small so that I am able to run around for an hour and a half at eight o'clock. Awesome. Awesome. Sounds very blanket regulation of you. Yeah, for sure. Absolutely. Soccer is definitely for me. Absolutely. And I hope you have a good weekend as well, Thomas. And it was great to be on here and connect. Thank you, Patrick. And to everyone else, hope you've enjoyed this. Hope you found it useful and I will see you in another episode of the Forty Audie podcast next week. See you later, guys.