Episode 70: Chronic Health (Part 1): Biopsychosocial Approach to Chronic Health Issues
Sep 05, 2024
Show Notes
Dealing with chronic health issues can often feel like a neverending battle, especially when it seems like there’s no clear path to improvement.
In this episode, Patrick Casale and Dr. Megan Anna Neff, two AuDHD mental health professionals, discuss their personal battles with chronic health conditions. They provide an insightful analysis using the biopsychosocial model, share their experiences, and introduce this new series on chronic health issues for neurodivergent individuals.
Top 3 reasons to listen to the entire episode:
- Gain practical insights into managing chronic health struggles through the biopsychosocial model, which considers the interconnected biological, psychological, and social factors affecting well-being.
- Discover the power of setting concrete, manageable goals to tackle issues such as sleep, depression, and chronic pain, and learn strategies to cultivate self-efficacy and align your actions with your values.
- Learn how diet, exercise, and behavioral health perspectives play crucial roles in managing complex medical conditions, and hear about the hosts' personal plans to focus on movement and diet for improved health.
As you embark on your own journey to better health, remember that you don’t have to do it alone. Identify one tangible goal you can work on today, and consider the broader biopsychosocial factors influencing your well-being. Reflect on how you can take actionable steps, no matter how small, towards living a more value-aligned life.
🎙️Listen to more episodes of the Divergent Conversations Podcast here
🎙️Spotify
🎙️Apple
🎙️YouTube Music
▶️ YouTube
A Thanks to Our Sponsors: Resilient Mind Counseling & Learning Nook
Resilient Mind Counseling is a neurodivergent-affirming therapy and medication management practice operated in North Carolina. We specialize in supporting neurodivergent individuals, especially Autistic ADHDers, the LGBTQ community, and the BIPOC community. For mental health therapy, we accept Blue Cross Blue Shield, UnitedHealthcare, MedCost, Aetna, and self-pay. For medication management, we accept Blue Cross Blue Shield and self-pay. We can see clients all throughout North Carolina. If you are looking for medication management services, you need to be within a 60-mile driving distance to the office in case you need to come in. All of our clinicians identify as either Autistic, ADHD, or Autistic-ADHD, or have some form of neurodivergence or are neurodivergent-affirming. We strive to create a neuro-inclusive healthcare community. You can text or call our main line to get started at 828-515-1246 or visit our website at resilientmindcounseling.com. We look forward to helping you along your healing journey.
Explore the power of the neurodivergent community with the Neurodivergent Insights Learning Nook—a neurodiverse space that welcomes all neurotypes. Our community fosters personal growth with access to workbooks, eBooks, workshops, and more. We also host body double sessions, parent gatherings, and monthly live events. Clinicians can join our special tier for exclusive resources and networking. Limited to 20 new members monthly. Enroll at neurodivergentinsights.com/membership. Scholarships available.
Transcript
PATRICK CASALE: Hey, everyone. You are listening to the Divergent Conversations podcast. We are two neurodivergent mental health professionals in a neurotypical world. I'm Patrick Casale.
MEGAN NEFF: And I'm Dr. Neff.
PATRICK CASALE: And during these episodes, we do talk about sensitive subjects, mental health, and there are some conversations that can certainly feel a bit overwhelming. So, we do just want to use that disclosure and disclaimer before jumping in. And thanks for listening.
Welcome back to Divergent Conversations. Megan and I have been talking a lot off-screen about some of the chronic health struggles that we both experienced, that we're both experiencing, some of the frustrations, and just the kind of unrelenting things that seem to pop up [INDISCERNIBLE 00:02:33].
And we're going to do something kind of unique today. Megan pitched the idea of kind of looking at this from like a biopsychosocial model, and creating some Venn diagrams, and then holding ourselves accountable to the suggestions that we throw out to each other. And hopefully, that also means that it doesn't make this episode doom, and gloom, and depressing the entire time.
MEGAN NEFF: And I totally realized this after we were texting about this morning of like, what should we talk about today? And then, we decided to do this mini-series. And what I realized is like, oh my gosh, we're like ADHD interest nervous systeming it. Like, and part of the motivation for this, my spouse actually mentioned in our romantification episode on ADHD how, like, we both said something like, you know, I know if I did this for a month I'd feel so much better. But I didn't do it. Like for me, it was movement, I know if I walk. I'm realizing that to get myself to do some of these things I have to, like, turn it into a thing.
So, I think I love journalists, and writers, and documentary people who make themselves the experiment. And are like, "I'm going to do this experiment, and I'm going to document it, and I'm going to reflect on it, and I'm going to then, like, circle back."
So, I realized, I think what we're doing is we're just turning things that we want to do into something challenging and fun and interesting by making a podcast series out of it.
PATRICK CASALE: Yeah, I think that feels on brand because if we don't do that, what are the odds that we're going to follow through with these recommendations or suggestions?
MEGAN NEFF: Zero. Like, I know all of the things I should be doing. I could, like, conceptualize my biopsychosocial. I think I will in a future episode. I could say these are all the things that would help you if you start doing them. I know all of the things, but doing them, like, that's where the challenge is, is in doing them. So, I like the idea of making ourselves public guinea pigs to get ourselves to actually do the things.
PATRICK CASALE: I agree because if I just say it out loud that's not enough. And you're right. Like, rationally, I know what I'm supposed to be doing for the most part. You know, there's some things that feel out of control, but I know what I should be doing to get some of this stuff more manageable. And sometimes it's just so freaking hard.
If we're going to talk about my situation, my sleep, especially, today, the lack of sleep then plays a role in the ability to do any of the things that are actually going to support you to sleep better. So, it's like this unrelenting self-fulfilling prophecy situation.
MEGAN NEFF: Absolutely. And that's what we would see and what… So, I worked in behavioral health for a while. Most of my training and my doctoral program was doing internships in hospitals. And most of the complex… So, behavioral health providers get a lot of the complex medical patients. And usually, it is exactly this. It's a spiral, and it's like, well, there's pain, and then, I can't sleep, and then, on top of that, like, behavioral and cognitive factors layer on top of like biological, physiological factors.
And I kind of think of, the metaphor that popped in my head this morning is the cognitive and the behavioral stuff, it's like wet cement, and it almost, like, locks you in then into like this trap of whether it's sleep issues, or fatigue, or all these other things. So, then you get trapped in a spirally cycle that's both, it's got biological components, for sure, but then it also has cognitive and behavioral elements to it. And then, it typically pulls in social factors. And this becomes a cycle that can feel really helpless. It can feel really hard to get out of.
I know, especially, when my chronic pain was at its peak, I was like, "I can map out my cycle of like, pain, substance use, sleep." But it was so hard to break out of it, even though I can map it out.
PATRICK CASALE: Yeah-
MEGAN NEFF: [CROSSTALK 00:06:42] cement.
PATRICK CASALE: Yeah, it feels like that's good imagery because I think that's exactly what it feels like. And you're right, there's this helplessness that comes up where it's like, I've tried all the things, but everything's compounding, everything's layered, everything's building on itself. In order to get to this outcome, I have to, like, swim or wade through all of this stuff that feels really murky. And how can I do that if I can only get through like, one of those things in a day let alone six or seven?
MEGAN NEFF: Yeah, yeah. You know, it's interesting. We recorded an episode recently on values and ADHD business. And I think we both said autonomy was your number one value. After we recorded that episode, I was thinking more on it. And I was like, "You know, I think the value, my number one value is actually agency." And I think that's something that I've really struggled to have. And I think for many reasons I'm a lot more impulsive than I think I lead with. I actually think I try to hide that quite a bit. But I'm often, like, at the mercy of my impulses. I have a lot of executive functioning challenges.
So, agency, my whole life has been incredibly hard. And I've been holding that as a mantra of like, like thinking about that, like, are you moving away or toward this core value? Like, I'm thinking about that every day of like, does this decision move me toward having more agency in my life or toward helplessness? Because I think helplessness is the opposite of agency. So, it's something I'm really working with a lot of intention to cultivate.
PATRICK CASALE: That makes a lot of sense, I think. I like the way you just kind of portrayed that because I experience a lot of that too. And I think this values-aligned perspective that we've been introducing, and obviously, are well aware that this is a big part of our lives plays a lot of roles in our decisions. The more I stray from my values, the more I feel pulled away from them, especially, when it comes from, like, a medical standpoint, and it impacts my ability to be values-aligned because I'm having to make decisions based on constantly treading water, so to speak, it's really challenging.
MEGAN NEFF: Yeah. I mean, I think that's part of what makes things like depression and fatigue so depressing or pain, is it makes it harder to be value-aligned in how we live, and our quality of life tends to go way down when we're not value-aligned. So, like, living a value-aligned life, you know, there's lots of research about how that's protective for our mental health, and our wellness, and our quality of life. So, when we are struggling to do that because of some of these situational factors, again, that often activates that downward spiral.
PATRICK CASALE: So, what do we do? That's the big question.
MEGAN NEFF: Yeah, so, and I think that was part of it because we were talking today of like, do we do another episode on health because we're both really, like, in it with our health stuff? And that's where I was like, "Well, if we do that, let's, like, do something about it not just complain about it."
And so, the framework we're going to use that we talked about is kind of the biopsychosocial model. And we're going to, like, behavioral health ourselves.
So, the biopsychosocial framework, it's a framework that's used in a lot of, kind of, holistic programs, or like, specifically, behavioral health. Behavioral health is often, it can be a social worker or a psychologist… Typically, either a psychologist or a social worker in a health care setting who is helping people to kind of work with all of the factors of their complex medical condition.
So, the framework is that whenever we have a complex illness there are biological factors, right? So, those innate physiological factors. There's psychological factors. So, that can be kind of a lot of the, you know, if there's a co-occurring mental health condition, that, for sure, but also just how we're talking to ourselves, mindset, that sort of stuff. And then, social factors as well.
So, I like to map out, and this is something I used to do with my patients, or I would at least do in my own conceptualization, map out what are the biological, psychological, and social factors that are contributing to this person's problem. You also want to look at what are the factors that could help this person to kind of reverse the spiral.
And I like it because it's really holistic and it makes it concrete. So, part of the helpless cycle I know that I experience is it feels so big, it feels so overwhelming, you don't know where to start. And so, by breaking it down, it gives you anchor points of like, okay, well, here's one thing you could do within this one domain to push the needle more toward wellness than illness.
PATRICK CASALE: Yeah, I love that. And I love looking at it holistically so it doesn't just feel like it's just this medical, like, big thing that I don't have any power or control over. Like, there are things that I actually can influence here, and at least manage, and make symptom alleviation a little bit easier.
MEGAN NEFF: Yeah, yeah. Exactly, exactly. And the other thing about this framework, you know, sometimes when someone's experiencing a medical condition it'll be common for a provider to say, "Well, have you talked to a therapist?" Or, "Have you, like, considered mental health?"
And it's sad because often the way it's communicated, and sometimes what the provider does mean is like, "We can't find anything biological here, so we should start considering kind of psychological components." What's unfortunate the message the patient often feels, I felt this myself as a patient is, "It's in your head, go fix your head."
And the reality is that medical conditions are complex. Like I said at the beginning of the talk, there's often biological factors that start but then behavioral, like, so our behavior, and then our cognitive factors, how we think about it layers on top of that. And that's part of what gets us stuck in cycles.
So, anyone with a complex medical condition, I think, would benefit from working from a really holistic framework. But we often feel like I don't want that because that's the dismissive route. That's when the doctors have given up on me, is when I go to the behavioral health provider. And that's not what we're talking about here. We're talking about there's a lot outside of our control. We both have bodies that just suck, that's out of our control. But like, instead of just having more and more episodes where we complain about it, like, let's focus on the parts that are in our control, and then treat ourselves as guinea pigs.
PATRICK CASALE: Exactly. And I think, like, the psychosomatic component, right? If we can take these little steps and incorporate little pieces of skill, strategy, education, etc., maybe it doesn't fix the problem. Maybe it doesn't completely absolve us from the problem or the issue. However, maybe it makes our mindset feel a little bit better about approaching it and managing it, opposed to just feeling like bleak and utter hopelessness.
MEGAN NEFF: Yeah, absolutely. And again, I think that, like, agency, self-efficacy, that's another study that they've looked at with folks with, like, chronic pain, chronic medical conditions, is self-efficacy. Like, there's skills for how much self-efficacy does the person have, which is really the sense of like, the belief I have the power to do things that have an impact in my life. And that, consistently, is such a strong measure of, like, patient outcome and overall well-being.
And so, maybe we can implement a behavioral change, and maybe it pushes the needle a little bit in our symptoms. But if it pushes the needle in our self-efficacy, then that, in and of itself, is a significant outcome.
PATRICK CASALE: 100%, absolutely.
MEGAN NEFF: Okay, so let's cultivate self-efficacy for you and me or at least try.
PATRICK CASALE: Yeah, we're going to try. And that's all we want you to do at home too. We just want you to try.
MEGAN NEFF: Okay, I feel like I just talked a lot about like, framework, the model. Like, do you have any questions about, like, health psychology, or biopsychosocial stuff, or this framework?
PATRICK CASALE: No, I'm a firm believer in looking at the holistic picture instead of just medical model versus behavioral health model. I think, you know, we still see a lot of that in the medical community, where it's like one or the other, when, obviously, we know medical or physical health impacts mental health, vice versa. And there's other factors at play. So, I think it's just acknowledging, like, this is a holistic viewpoint that's really an ideal perspective when we're looking at any sort of complex situation, whether it be a mental health condition or symptoms, physical health or symptoms, sometimes it's societal, sometimes it's, like, just a part of our daily living experience.
So, everything plays a role. Everything plays into it. And picking that apart is really important. And I think it gives you a little bit more optimism as well instead of saying this is the only thing you can try or you're basically screwed.
MEGAN NEFF: Yeah, I also, of course, love it because it's visual, because it's a diagram. And you…
PATRICK CASALE: You love Venn diagrams.
MEGAN NEFF: I love Venn diagrams. I do. Yeah-
PATRICK CASALE: [CROSSTALK 00:16:37]
MEGAN NEFF: And I love conceptualization.
PATRICK CASALE: Yeah. And you're very good at it. And I bet, from it, I know you don't want to be perceived if someone was like, "Was this Megan Neff? Like, Dr Neff did really well." I bet Venn diagram would be in the top three that would come up as, like, a random family feud-esque type poll of like, how many of the audience members said Venn diagrams? Like, 60 out of 100 because they're so helpful. So…
MEGAN NEFF: Okay, enough of me being perceived.
PATRICK CASALE: Enough of Megan, okay.
MEGAN NEFF: Topic change.
PATRICK CASALE: So, which of our many complex chronic health conditions do we want to talk about? For me, it's this [CROSSTALK 00:17:17]-
MEGAN NEFF: So, and that's actually a really good point, Patrick, is that often it is helpful to, like, zoom in on one tangible goal. So, like sleep. I think that's a really good one because, again, it could be overwhelming if it's like sleep and this and this and this and this.
For me, it's going to be fatigue/depression. And I say slash depression because I think with fatigue, it really is tricky to know because when you're depressed, it's kind of like it shuts down the system, and you have more fatigue.
And then, as we've talked about, like, I know when I'm fatigued or sick it makes it hard to do the things that give my life meaning or to be productive, or even find my interests interesting, and that's depressing. So, it's like a chicken or egg scenario, but I think the fatigue definitely has some physiological basis. But I'm going to clump those together and that'll be my target.
PATRICK CASALE: Okay, that sounds good. And you're right. I think zooming in when we're talking about people who have a lot of different things going on, as so many of us do, it feels a little bit more manageable instead of like listing and this and this and this and this. Because even when I'm at the doctor and they're like, "So, tell me what's going on with you." I don't know where to start. Like, "What do you want me to tell you?" So, it does break it down into smaller, more digestible chunks, too.
MEGAN NEFF: There's a metaphor from Dr. Jonathan Dalton I really like. It's when he was doing the anxiety masterclass with me. And he's a specialist in anxiety, but he also talks a lot about autism.
And he uses this metaphor of the school of fish. So, one of the reasons the school of fish will swim together is it's a lot harder for like a shark or a predator to bite into a school of fish than an individual fish because it like, doesn't know where, essentially, to like bite into. I realize this is a cruel metaphor.
But that's, for a lot of autistic people are processing with our bottom-up processing. And I think ADHDers because of executive functioning, probably, also, experience this. It's like a lot of decisions feel like that pool of fish, or that school of fish. And we don't know where to bite into it. And so, we don't know where to start. And that's, again, something that impacts self-efficacy. And I think the combination of our processing style plus our health conditions, it often feels like I'm just trying to bite into a school of fish. I don't eat fish, but metaphorically.
PATRICK CASALE: No, that makes a lot of sense because it feels so big and so hard to conceptualize, or even explain, or where to start, or how to approach. What do you start with first? And it just becomes so complex and overwhelming. But I think my instinct, at least, is to just shut down and be like, "I'm just not going to pursue treatment because this feels hopeless."
MEGAN NEFF: And like, I'm so embarrassed to admit this with the knowledge I have, but that's been my approach. Like, I'm really medically avoidant. Like, I should be working with a medical team, given everything I'm dealing with. But partly, it's the hopelessness that they'll understand me, and then, partly it's the, I'm so overwhelmed by all the things I wouldn't even know where to start.
PATRICK CASALE: Yeah.
MEGAN NEFF: Yeah.
PATRICK CASALE: I told you, like, offline about my experience with that sleep doctor last week. And those are the types of experiences that do make you just want to be like, wave the white flag. Like, give up. Like, what is the point? So…
MEGAN NEFF: Yeah. Unless you can find a Mel Houser, it's like, what's the point?
PATRICK CASALE: Yeah, yeah. Dr Houser, like, if you could become available in all 50 states that would be really fantastic-
MEGAN NEFF: All the humans.
PATRICK CASALE: Yeah. All of our neurodivergent humans that need neuro-inclusive health care and really great understanding and affirming quality health education. So, please get licensed outside of Vermont if you're listening to this. Thank you so much.
MEGAN NEFF: Oh, my goodness. How much would you pay to have Mel Houser be your provider? Okay, that's a bad question.
PATRICK CASALE: Whatever it takes. Whatever it takes.
MEGAN NEFF: Like, yeah, no, I was saying that to my spouse the other day. It was a really low-energy day. And I was like, "If they made energy in a bottle, like real energy, not like caffeine…" I was like, "I would pay an ungodly amount for that."
PATRICK CASALE: Yep, I guess I relate to that, yep. And going back to what you were saying about, like, chronic fatigue/depression. Like, it's one in the same, right? That's the same for me with like chronic insomnia/fatigue/depression. Because, like, they all are in the same, like, bicycle spoke, so to speak. They're all playing a role into each other. Don't sleep for whatever reason, or wake up and not be able to fall back asleep. Next day, you're going to be fatigued. All of a sudden, you're depressed. Now, the littler tasks in life become so much more unmanageable. Now, instead of being "productive" you lay on the couch all day and watch TV because that's all you can do. That is so much of my day-to-day and my reality.
MEGAN NEFF: Yeah, absolutely. I mean, these all spiral into each other, which I think when we do our conceptualizations we'll flush out a bit because, yeah, absolutely. And then, it's just a matter of finding, like, okay, where's the place where I reach in and I switch the cycle around. Like, what are the anchor points? I like to think about what are the anchor points where, like, that's something concrete I can grab, I can do it differently, and it can shift the cycle.
PATRICK CASALE: So, for you, chronic fatigue/depression. What are the anchor points for that, for you?
MEGAN NEFF: The ones I think I will be focusing on are movement and diet because I think I have a lot of inflammation. It's been interesting, part of my unmasking was, I think, like, having less food roles, which, on one hand, I think was really good for me, but then on the other hand I think has contributed to some health things. And I have so many complex feelings around this because, like, food is such a complex topic. And like, especially, when you throw in neurodivergence, and like safe foods, and eating disorders. Like, it's complex. And a part of masking for me was having a tighter brain. Well, I don't know if it's masking, but I there was a really, like, harsh, fierce kind of driver in me that had a lot of rules. And when I started unmasking, the rules started going away.
And part of that for me was my rules around health started going away. So, like, for a long time, I didn't do sugar and gluten. And then, I like… So, things like that, where it's like, now I want to come out at a place not from, like, this harsh rule maker, but a place of agency, of I want to do things that are good for my body because I can tell my body is impacted by, like, I probably have a sugar addiction and I know how terrible sugar is on the body, and inflammation, and adrenals.
So, things like that. I want to focus on diet changes, nutrition changes, and incorporating movement would be my two anchors.
PATRICK CASALE: Okay, I think mine for my sleep would be movement/exercise or activity. I noticed I live a very sedentary lifestyle, whether it's sitting here, whether it's sitting on my couch, and having all these soccer injuries pile up. I can't be as active as I would like to be. But I've also realized if I'm just sitting around the house all day, whether it's working or leisurely, I'm not discharging the energy that I have, which is probably going to impact me later at night when I feel more restless or I feel more unable to fall asleep. So, that would be one of my anchors, for sure.
My other would probably be diet as well. I don't eat unhealthy food, but I do eat, like, a lot of hot food, a lot of spicy food, a lot of carbonated like drinks, especially, for like, my throat. But I also understand how that impacts sleep, impacts, like, how often you have to get up to pee at night, like things like that. So, really, being a lot more conscientious about things that I have control over on my day-to-day.
MEGAN NEFF: Yeah, yeah. I think we've both picked good anchors because we've both picked anchors that we have some control and agency around.
So, structure of what we're going to do, I think we're going to do an episode where we do the biopsychosocial conceptualization for each of us. I'll probably make notes while we do it, so those might be good episodes for people to do on YouTube if they want the visual aid.
I don't know, how do you feel about making the visual aid available as a download? I don't know, that's a ton of personal information.
PATRICK CASALE: [INDISCERNIBLE 00:27:10] I mean, I don't have a preference whatsoever. I would defer to you.
MEGAN NEFF: Maybe after we do it, we can also take our names off of it. But I think the visual would be helpful for listeners. But yeah, we can decide after we do it. And then, we'll create really concrete goals. And then, record a follow-up episode in like a month, maybe make…
PATRICK CASALE: Yeah.
MEGAN NEFF: So, the way behavioral health works, like when you're working with a behavioral health patient, you often will make goals and then see them two to four weeks later, check in on those, and make new goals. I don't know if we want this to be like an ongoing series where we do that. We could kind of play it by ear.
PATRICK CASALE: I think that knowing both of us and how much we do in our lives and how distracted we get the more accountability measures the better. Yeah, so we can play it by ear, but I think that's a good idea to just reassess, yeah. And I think [CROSSTALK 00:28:14]-
MEGAN NEFF: Like people could follow along. Like, if we have goals that are similar people will like, "Okay, I'm going to do this goal for a month."
PATRICK CASALE: Yeah. I imagine a lot of you listening have similar struggles, whether it's with sleep and fatigue, fatigue, and depression. I cannot imagine that you are in the minority at all.
MEGAN NEFF: Yeah. Probably 80% of our listeners can relate to these struggles. That said, this isn't health advice. Just, like, check with your doctors, do all the things. Like, feel free to experiment on yourself but this isn't medical advice.
PATRICK CASALE: No, we're two people talking about this nice asterisk.
MEGAN NEFF: That was like the most clunky medical disclaimer ever.
PATRICK CASALE: By the way… this podcast is not medical advice, it's not mental health advice. We're not responsible for whatever decisions you make. Thanks so much.
MEGAN NEFF: There you go. Thanks for turning my clunky medical disclosure into a actual one.
PATRICK CASALE: So, I do think this is a great idea, and we can create some, like, offline accountability, text each other whatever we need to do to hold each other accountable and support one another. I think, like, accountability is a big piece that goes unmissed and unchecked in this because, say, you go to your medical provider, your mental health provider, you set these goals, and then, you can go home to yourself. It's like, "How do I keep myself engaged and accountable, right? If I know the only measure is going back in two to four weeks to talk to this person?" If we can create even more layers of accountability in place, I think it's more realistic that we actually follow through with that.
MEGAN NEFF: Okay, this is the first time… I know we've talked about, like, do we set up a Patreon for our podcast? This is the first time I actually think it could be kind of cool too because we could, like, record images or videos of each day, and, like, upload that to a Patreon or whatever membership site we did. This is the first time I'm like, okay, maybe it actually would be worth it to do the legwork to set up a Patreon.
PATRICK CASALE: Okay, I mean, totally open to that too. So, what we're going to do next episode is the biopsychosocial and follow along, play at home, play along at home, create your own. Check out Megan's Venn diagrams for a good visual aid because I think those are super helpful to help you, like, compartmentalize all of this and conceptualize it. And we will make sure that we find some creative way to figure out how to include these graphics and these downloads, whether it's on our newsletters, or the show notes, or something like that, or the YouTube channel.
So, yeah, I know this episode is just kind of talking through this process, but I think that's what we're going to do. And we would love for you to all start this process with us starting next week, in next week's episode, and set these goals for yourselves as well.
MEGAN NEFF: Okay.
PATRICK CASALE: Okay, so to everyone listening to the Divergent Conversations podcast, new episodes are out on Fridays on all major platforms and YouTube. Like, download, subscribe, and share. And we will talk about all this stuff next week.
