Episode 200: Permission to Pivot: Grieving What Was and Embracing What’s Next

Show Notes

Throughout your entrepreneurial journey, it's important to take moments to reflect on what you’ve built, where you’re heading, and what truly brings you energy. In this solo episode, I opened up about the messy magic of pivoting, evolving passions, and the vital importance of giving yourself permission to grow in new directions.

After years of building communities, running retreats around the globe, and coaching clinicians to “Doubt Yourself, Do It Anyway,” it’s clear that our journeys rarely go as planned. And that’s okay.

3 key takeaways:

1. It’s Normal for Passions to Evolve: If the spark fades or your interests shift, that’s not failure. Growth isn’t linear.
2. Zoom Out and Acknowledge Your Journey: Take time to recognize how far you’ve come, even if it feels like you’re standing still. Every pivot is part of your story.
3. Give Yourself Permission to Pause: It’s courageous to rest, reflect, and admit something no longer serves you. Grief and relief can coexist in letting go.

You’re not alone if you’re navigating uncertainty or sitting with grief about retiring some hard-won entrepreneurial roles. I’m right there with you—learning to honor my energy, trust intuition, and celebrate each imperfect step forward.

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A Thanks to Our Sponsors: The Receptionist for iPad, Alma, & All Things Private Practice — 2025 & 2026 Retreats!

✨The Receptionist for iPad

I want to thank The Receptionist for iPad for sponsoring this episode.

This podcast is sponsored by The Receptionist for iPad, a digital check-in system that eliminates the need to walk back and forth from your office to the waiting room to see if your next appointment has arrived. Clients can securely check-in for their appointments and you'll be immediately notified by text, email, or your preferred channel. Break free from interruptions and make the most of your time. I've been using them for almost three years now and it saves me hours in my week.

Start a 14-day free trial of The Receptionist for iPad by going to thereceptionist.com/privatepractice. Make sure to start your trial with that link. And you'll also get your first month free if you decide to sign up.

✨Alma

I want to thank Alma for sponsoring this episode.

Building and managing the practice you want can be challenging. That’s why Alma offers tools and resources to help you build not just any practice, but your private practice. They’ll help you navigate insurance, access referrals who are the right fit for you, and efficiently manage administrative tasks — so you can spend less time on the details and more time delivering great care. You support your clients. Alma supports you.

Visit helloalma.com/ATPP to learn more.

✨ All Things Private Practice — 2025 & 2026 Retreats

All Things Private Practice has some amazing retreat experiences coming up in 2025 and 2026.

If you're a leader or aspiring to start a group practice, join our Leadership Retreat in Chania, Crete, from September 6th to 11th. In 2026, we have two retreats in Queenstown, New Zealand. The first is for Neurodivergent Entrepreneurs from March 1st to 8th, and the second retreat, Beyond Private Practice, focuses on moving beyond one-on-one therapy and creating alternative income streams from March 15th to 22nd.

Spaces are limited, so check the links to sign up today. Doubt yourself, do it anyway!

• Leadership Retreat in Chania, Crete: empoweredescapes.com/greece-retreat-2025
• Neurodivergent Entrepreneurs in Queenstown, New Zealand: allthingspractice.com/new-zealand-neurodivergent
• Beyond Private Practice in Queenstown, New Zealand: allthingspractice.com/new-zealand-income-streams

Transcript

PATRICK CASALE: Hey, everyone. Welcome back to the All Things Private Practice podcast. I don't do a lot of solo episodes on here, but I just feel like I want to in terms of an announcement that I made on my newsletter and my social media the other day. And it was just really about pivoting and adapting. And I know how hard that is for a lot of us, including myself.

And the post that I made on social media and to my newsletter was, basically, like, what to do when the spark leaves you or when the passion is gone? And a lot of you know that I haven't had my Facebook group open for almost over a year. It hasn't been open since March of 2024, paused indefinitely. And every time I go back to, like, resume date time, I'm ambivalent about it, I push it out again as far as I can go.

And I realized, you know, over the last couple of years, especially, post-autism discovery, honestly, that a lot of my passions and ideas are shifting and changing. And I'm trying really hard to figure out what to do next. And I know so often in my life, and maybe some of you can relate that, like what comes next is constantly on our minds, whether it's because of financial insecurity, or stress, or trauma. Thinking about where's the next paycheck going to come from. Maybe it's just from, you know, changing interests. I know for my ADHD side, like, I used to shame myself for interests changing and evolving or not following through with everything that I started, or every idea that I had.

I noticed over the last couple of years, with all the retreats that I've done, which is now upwards of 20, since March of 2022, when I did my first Ireland retreat, being on a plane, traveling to a different country every other month, or potentially, you know, sometimes in the same month, dealing with jet lag, dealing with how hard it is for my system to transition, and sleep, and change into new environments, and the hosting, and the events in general, it's been a lot. It's been a lot. And how tired I am all the time, like in between these events, because they take so much out of me. I'm exhausted, depleted, running on fumes, you know? I've been pushing myself well beyond autistic burnout for a long time.

And I loved the events, that's the grief side. You know, I think grief and joy are two sides of the same coin. There's so much beauty that has come out of some of these things, like the connections, the relationships, the friendships, the experiences. Like, it's been so freaking cool. And if you've come to any of them or have watched from afar, it's been an amazing journey.

And I had to do like a timeline exercise, and I encourage you all to kind of do the same, where I zoom out, and I have to remind myself of the things that I've done over the last few years, because I can get into the mentality of I'm not doing enough, or I haven't done anything. And that's just simply untrue. And, you know, that inner critic needs to take a nap.

But in reality, when I was like, okay, I graduated with my masters in 2015, I always thought like, I'll go into community mental health, that'll be it. I mean, obviously, if you've been following my journey or this podcast, you know that it was not the final destination, and it wasn't for a lot of you. And then, it was private practice, and how that was going to be the final destination.

And for me, just doing the same thing every day, over and over and over again, I just can't do it. It pushes me into like depression, and under stimulation, and monotony. And, you know, now that I understand my neurotypes and my neurology, I understand why I struggle so much to do that. Some of you might be saying, "I love the fact that this is what I do every day." And that's okay. There's no shame or shade there at all.

And then, after that, it was I want to start helping therapists start and grow a private practice. And I started All Things Private Practice back in 2020. Started off as Casale Coaching and Consulting, and I was doing six-week, six-person programs, helping people work through, in my mind, the most important modules of small business ownership that we don't learn in grad school.

And then, that turned into starting the All Things Private Practice Facebook group, which now has upwards of 15,000 members. And then, I simultaneously started the All Things Private Practice podcast in like, November of 2020. I used to think like, "Who the hell would want to listen to what I have to say? There's not a single person who would do that."

Now, almost four years in, and 200 plus episodes, and a lot of amazing guests, and interviews, and conversations, and sponsorships, and monetization along the way, getting paid to podcast from my home office, it's wild to me, still to this day, to starting a group practice in January of 2021, Resilient Mind Counseling here in Asheville, which still exists today, employed over 25 people at this point in time, mostly neurodivergent, LGBTQ, and BIPOC clinicians.

And then, starting Take the Leap coaching programs for like four-month increments where we really deep-dived the psychological and emotional side of being a small business owner, especially, a private practice therapist.

Keynote talks on autism discovery and self-doubt, and my motto of doubt yourself, do it anyway, to hosting retreats, starting with Ireland in March of 2022, fast forwarding to present day, which is June of 2025. I'm about to host my second annual Doubt Yourself, Do it Anyway summit in Edinburgh, Scotland, and I have two retreats in New Zealand next March. It's just like to a TEDx on autism discovery and a book deal on autism discovery, I just never thought my career would take me to these places.

And I used to live in insecurity/comparison all the time, of, "I'm still not doing enough, look what everyone else is doing." Even after listing all that stuff, I don't feel it anymore energetically. Like, I used to viscerally feel it, that insecurity, that self-doubt, the feelings of impostor syndrome that would come over me.

And social media doesn't help, right? Like, it's constantly telling us we're not doing enough or comparing ourselves to people's like count, and engagement, and followers, and successes that are posted online.

I've always tried to stay away from that because, like, I've always tried to do things differently, where I talk about more of, like, the challenging parts of being a human, a neurodivergent one, but also, a small business owner, because I think we don't normalize fear and failure enough. We don't talk about the hard times, the rocky times, the speed bumps, the ebb and flows, the roller coaster ride of small business ownership, of being a leader, of employing other humans. Like, we need to normalize the stuff, because it is a normal part of the process. And it's certainly not like always great. It's not always like sunshine and rainbows. It's really hard. And I think so many of us doubt ourselves, and we keep ourselves small, and we struggle to put our ideas out into the world, because maybe we have RSD, rejection sensitive dysphoria, maybe we really struggle with self-doubt and criticism.

There's vulnerability in creating, and launching, and having a presence, and having a following, or trying to sell something or create something that you think is valuable. And I used to really enjoy private practice startup. I used to really enjoy working with therapists, getting them to take that risk, take that leap, and that shifted, you know, like a couple of years ago, where I started to really enjoy the retreat component and the podcasting I've always enjoyed.

And then, helping therapists move beyond private practice. I always wanted to start the Beyond Private Practice, extension of All Things Private Practice, but unfortunately, someone else had secured that name already, because I really enjoyed, like, helping people move into the things that I have done over the last couple of years, because so much of it is like how to get started, but more so importantly, like beyond that, how to get started, maintain momentum, channel the chaos that's happening in our brains, especially, for neurodivergent entrepreneurs, and harnessing the creativity, how to move past our self-doubts, and our fears, and our insecurities, and our perfectionism, to take up more space, to be more authentic, to be more real, raw, vulnerable, to show up the way that we want to show up, to pursue some of the things that we want to pursue you. And that stuff has really lit me up for a long time.

You know, over the last couple of years as an autistic ADHD human who has unmasked drastically, I have noticed that I am impacted significantly when I host retreats, when I market, when I have to respond to the demands of a growing audience and the responses, the messages, the emails, everything has made me feel like I need to almost shrink back and disappear. The TEDx didn't help. The book deal didn't help. Like, these are accomplishments that I'm very proud of, but they also impact me psychologically and emotionally significantly.

And I spend a lot of time in my home. Like a lot of you see, me traveling the world, and hosting these events, and doing these things, but when I'm not doing that, I'm really in my home, typically, in the darkness, if I'm not podcasting, laying on my couch, laying on my bed, exhausted, burnt out, really unable to be a part of the world that I've created, and it's been hard.

I had two throat surgeries over the last four or five years, and as you can all tell, who've been following my journey my podcast for a while, I do think my voice is improving from where it was like October of 2023 after my second throat surgery, because one of my vocal cords got paralyzed. But it still is impactful.

And I think like with the state of the world, there's that stress of what people are experiencing on a daily basis. It's all combined. It feels very heavy. And I noticed, like, that spark was leaving me where I was, like, not feeling creative about anything. I was not feeling energized by anything. It's taking a lot more effort to get started. And I was looking for that flow state, that like monotropic focus of dropping into creativity, and I just couldn't access it.

And I think when I realized, like, I don't know what I want to do in 2026, because I've had the last couple of years planned, you know, where retreat this month, speaking engagement, retreat, retreat, retreat, summit, etc., was just a lot. And I've had like, feelings like the walls are closing in a bit, and it feels like claustrophobia-inducing, in a way, mentally. nd it makes me like uncomfortable viscerally and physically. And just the realization that I think this chapter of my life is, if not over, pivoting, and changing, and adapting, is for sure, and evolving, allowing to have a season in my life where there's quiet, and less response, and less demand, less expectation. I mean, I have to write this book, so that feels like a big, daunting task.

I co-host the Divergent Conversations podcast with Dr. Megan Neff, and that is a very enjoyable project, but this stuff, like, it all takes energy. And then, I get into this mindset, right? Like a lot of you can probably relate to, if I'm not doing enough, but if I'm not going to do all these things anymore, what am I doing? It's wild. The tricks that our own minds can have on us sometimes, because when I zoom out and I think about all the things that I have done, and created, and accomplished successfully for the most part, not without struggle or self-doubt, which is always with me, but they have been done and giving myself some credit, you know, some props in that way, trying really hard to be like a role model in this field, and an example, and someone who inspires and helps you all feel like you can accomplish anything. And that you know it's going to be hard and it's going to be rocky, but that doesn't mean you shouldn't do it and to really embrace the doubt yourself do it anyway mentality of yeah, this scares the ever-loving shit out of me, and I'm going to try it. I'm going to swing for the fences. I live one life, right? Like, I'd rather take the risk than convince myself that this idea is better suited for someone else, or that I'm not the one who can bring this to reality or to life.

So, I want to encourage all of you to zoom out and think about your accomplishments. Think about the things that you've done since graduation, the places that you thought you would never be. Some of you might thought, "I could never start a private practice, I don't even know how." And then, you did it. It was scary, it was risky. And then you were like, "I think I want to start a group practice, but I don't know how to be a boss. I think I want to host a retreat. I think I want to have a podcast. I think I want to write a book. I think I want to do a coaching program." Like, whatever has come to your mind.

And these don't all have to be professional accomplishments, but write them down. Visualize that. Really look at that, the accomplishments, me getting my voice back to some degree, major accomplishment, because I never thought I would.

And I think there's grief in pivoting and adapting, and admitting publicly and openly, not only to yourself, which is most important, but to any sort of audience, or your friend group, or your colleagues, that your career is shifting and changing, and it's not going to look the same anymore, and that the things that you might have worked so hard to do and create, and have become a part of your identity are also shifting as well, because there's massive grief for me when I admit it publicly that I'm really not interested in doing private practice coaching and consulting anymore. I am interested in working with neurodivergent entrepreneurs and mental health professionals, and helping them really, like I said before, kind of channel the chaos and harness the creativity, strategize, implement, get things going, work through the psychological and emotional side of small business ownership. That stuff lights me up.

I don't know if New Zealand in 2026 will be my last retreat, but for now, it feels like it will be for a while. I don't want 2026 to look the way 2022 through present day have looked, leaving the country every other month or every month hosting events, non-stop, the marketing that comes with it. It's been a lot. And there's grief in that, and publicly admitting, like, I think things are changing. And there's also relief.

So, I think it's about looking at your journey and giving yourself permission to pivot, adapt, evolve, pause, reflect, grow. You don't have to know what comes next all the time. I'm leaning more into intuition, and energy, and following my gut instead of feeling like the ceiling is going to fall out or the floor is going to fall, I think the term is the floor is going to fall out from under me all the time, zooming out and looking at the list of the things I've done over the last couple of years, acknowledging I did not know how to do any of them.

So, giving myself permission to rest, take a break, reflect, and see what comes up next, opposed to forcing it and giving yourselves permission. If you've worked really hard to get somewhere or create something, it's no longer inspiring, you're feeling unfulfilled. It's okay to pause and reflect and say, I don't know if this is what I want more of anymore. I don't know if I want to continue down this path. And acknowledge that it's going to be a path that has a lot of grief, honoring exactly what you need energetically in this season of your life.

So, I am going to continue the podcasts for as long as I can. I don't foresee that stopping. I am going to continue to do speaking engagements, and I am going to eventually get a neurodivergent AuDHD, entrepreneurial like membership community coaching program off the ground when I have the energy. But I'm going to put a pin in it for now. I'm going to get my Beyond Private Practice program for mental health therapists who want to move beyond private practice off the ground, but again, putting a pin in that.

And that doesn't mean it will never happen. It just means that right now is not the right time. And I think sometimes we need to be honest with ourselves and acknowledge that too.

Thank you to all of you who have been a part of my journey for the last four and a half years and continue to be. Couldn't have done it without your support. This podcast will continue coming out on Saturdays, and it's going to continue to evolve into really what it has been for the last couple of years, focusing on the emotional and psychological sides of being a small business owner, talking about the struggles, making it really raw, authentic, relatable. And I hope to see you at one of my upcoming events before New Zealand 2026 and to continue to support one another online and in community spaces.

So, new episodes of this podcast come out on Saturdays on all major platforms and YouTube. Doubt yourself, do it anyway. And thank you so much for the last couple of years. It's been a fun journey and a fun ride.