Show Notes

In this episode, Patrick Casale and Elena Carroll, an Autistic content creator who’s inspiring many others on her journey of late-diagnosed autism, talk about her story of moving from New Zealand to Toronto and finding her voice as a writer and advocate for neurodivergent communities. This conversation highlights some powerful lessons for mental health professionals, neurodivergent individuals, and anyone passionate about inclusion.

Key Takeaways:

1. Unmasking and Self-Discovery is a Lifelong Process: Elena shares her experiences with late autism diagnosis, showing that it’s never too late to understand yourself and make space for authenticity—even if it means returning to and healing parts of your childhood.
2. Accommodations Are Not “Extras”—They’re Essentials: Both Patrick and Elena discuss the importance of embracing sensory tools, routines, and downtime as valid forms of self-care, not signs of weakness or “neediness.”
3. Community & Representation Matter: Finding others who share your experience makes a world of difference. Content creation and open conversation help others feel seen, reduce shame, and normalize diverse neurodivergent journeys.

If you’re looking to deepen your understanding of late-diagnosed autism and want a refreshing, vulnerable perspective on healing and self-acceptance, this episode is for you.

More about Elena:

I'm Elena. I was diagnosed Autistic at 25 after years of struggling with mental health challenges and receiving different diagnoses that didn’t quite fit. I always felt different growing up, but I spent most of my life working hard to appear “normal.” Now, at 29, I’m on a journey to undo more than two decades of masking and finally get to know my true self.

I recently moved from New Zealand to Toronto, Canada, and over the past 18 months, I’ve started creating content focused on neurodivergence and autism. This work has been incredibly healing for me and has helped me connect with others who share similar experiences. I’m also in the process of writing a book about what it’s like to be a late-diagnosed autistic woman, exploring all the complexities and discoveries along the way.

• Instagram: elenacarr0ll 
• TikTok: elena__carroll 
• YouTube: Elena Carroll

🎙️Listen to more episodes of the All Things Private Practice Podcast here
🎙️Spotify
🎙️Apple
🎙️YouTube Music
▶️ YouTube
✈️ Check out available Retreats
🗨️ Join the free Empowered Escape FB Community
🗨️ Join the free All Things Private Practice FB Community

A Thanks to Our Sponsors: The Receptionist for iPad & Alma

✨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.

Transcript

PATRICK CASALE: Hey, everyone. Welcome back to the All Things Private Practice Podcast. I'm joined today by Elena Carroll, who is an autistic content creator and got a really good following on Instagram, and TikTok, and YouTube. And it sounds like autism is a new diagnosis and newly discovered, a couple of years ago, later in life.

You just moved to Toronto from New Zealand, and you've started creating content for neurodivergence and autism, working on writing a book about late-diagnosed autistic women, and also, looking to do a potential TEDx talk.

So, really cool stuff. One, I just want to say, did I miss anything in your bio before we start?

ELENA CARROLL: No, I think you've covered it all, yeah.

PATRICK CASALE: Okay. So, sitting here today, you know, fast forward, a couple of years post-discovery, do you ever like think, man, I would be pursuing some of these things, like writing a book, wanting to do a TEDx, creating content for the autistic and neurodivergent communities?

ELENA CARROLL: Yeah, I definitely don't think I would be interested in doing any of these things. I always knew that I wanted to do something grand with my life.

PATRICK CASALE: Sure.

ELENA CARROLL: But that has gone down so many different avenues, but this one feels so authentic to me and the people that I'm connecting with, it's healing me just as much as other people are getting healed from what I'm saying. And so, the more that I'm doing, I'm just gaining more healing. So yeah, there's a lot going on, for sure, but it's just healing so much of myself and my inner child.

PATRICK CASALE: I love that, yeah, and we talk about that a lot on here, through a lot of different lenses and healing that inner child, right? I talk often about like the grief relief process that I've experienced with an autism discovery later in life into adulthood, and there's almost like this grief of what maybe I could have known as a child, or a teenager, or a young adult.

I know you had mentioned, like, some misdiagnosis along the way, and things that just never really felt accurate or like it wasn't the correct lens. And I think that feels so overwhelming, the misunderstanding of going through that existence, like feeling like I want to figure it out, but everyone keeps giving me the wrong language, or the wrong label, or the wrong information.

ELENA CARROLL: Yeah, yeah, completely. I think it's highlighting for me right now in my life what identity is. And so much has been broken away and fallen apart. And what am I underneath the mask? And what I was told I was as a child is not actually what it was.

And so, I created this video last week, all around how autistic people can often go through, like growing up twice, because you grow up, and oftentimes, you're like the child who's like a mini adult, and then, you're an adult, and you're a mini child. And then, you get these answers, and they suddenly feel correct, but you've just gone so many years, and there is, as you say, like a major grief that comes with it. But, I mean, I'm now onto my fourth year of understanding, okay, this is what was going on. And now I'm in this place of going, okay, who am I? Who do I want to be now? So, it's now in a excitement place.

PATRICK CASALE: Okay, yeah, I like that. It sounds like a big life transition, too, moving from New Zealand to Canada.

ELENA CARROLL: Yes.

PATRICK CASALE: What brought about that change? Like, that seems like a big one.

ELENA CARROLL: It certainly was. I first off want to say that I was someone kind of accepted the fact that I was never going to travel, never wanted to travel, airports, the uncertainty of travel was so big in my mind.

I then had a very good friend of mine move over to Canada from New Zealand. And they, essentially, asked if I wanted to kind of join her over here. And so, there was a safety that came with that. I don't think I would have been the type of person to just, you know, pack some bags and see how it pans out.

And so, yeah, it's been the most challenging thing I've ever done. It's coming up in a few weeks, a year of me being over here, and I would say, only within the last six months has it started to feel familiar. So, it's not been easy at all, but I think my rigid, black and white thinking mind, perhaps needed a bit of a wakeup call, and it's helped me grow in ways that I don't think staying in little old New Zealand would have helped me progress.

PATRICK CASALE: Yeah, it's a huge transition. And for autistic people, you know, having that massive uprooting of familiarity, comfort, routine, predictability, and then, like, uprooting that and really shaking it up a bit. So, yeah, it would come with a lot of dysregulation, and it would take time to really get settled back into, okay, this is starting to feel like home to some degree, and, you know, feeling more and more comfortable.

I just want to say, I love your country, by the way. I was in New Zealand in April. And I was like, "Damn. Is this what it's like to go through life not being anxious every second of every day of my life?" Because that's what it felt like.

ELENA CARROLL: Oh, my gosh, really?

PATRICK CASALE: Mm-hmm (affirmative).

ELENA CARROLL: Is that because of the slower pace, or what did you find was different?

PATRICK CASALE: I think it was a combo, slower pace. I think that, like the kiwi, New Zealand culture, and the Maori culture, was really fascinating to me, and it felt very relaxed, opposed to like being in the United States.

And then, I think the beauty. I was in Queenstown and, like, on the South Island a lot. So, like, it was just so freaking overwhelmingly beautiful. And I think also being 18 hours ahead. Like, by the time I woke up, right, I'm on the next day, for most of my friends and family. They're all, like, halfway through their day. So, by the time I'm eating lunch, they're going to bed. And the demands dropped because I didn't have to check my phone to respond to things on social media, or emails, or messages, because by the time I was like, 1:00, 2:00 PM, everyone was asleep. So, it was really fantastic.

ELENA CARROLL: I know that's super interesting, actually, yeah. I suppose so. So, I currently live downtown Toronto, and it is just chaos. I mean, I worked out that there are more people in just this place than there are in the whole of New Zealand. And so, getting that alone time is pretty much non-existent. And it's been super challenging to find a place of peace and balance.

So, it's definitely strengthening the relationship with myself. Like now, to regulate myself, I'm having to talk with myself, and there'll be people around. And, as you say, I grew up in a place that there's not a lot of people that you're always competing with. There's nature to kind of regulate yourself. So, it's just skill-building right now, but it's a tough one.

PATRICK CASALE: I imagine so. So, you've had a lot of change and transition then over the last couple of years. And you know, for a lot of our listeners who are neurodivergent, especially autistic, a lot of them who have gotten missed or have fallen through the cracks, and a lot of them maybe were AFAB, or assigned female at birth, or trans, or part of the BIPOC community. So, a lot of these people are being misdiagnosed often and early, or scripting, and masking in a way to fit in with like traditional, typical culture.

And then, ultimately, later in life, thinking like, "What the hell is happening? Like something is clearly not fitting for me." So, what kind of leads you to this discovery later on in life? What's happening behind the scenes?

ELENA CARROLL: Do you mean with my sexuality?

PATRICK CASALE: No, well, either way. Specifically, with the autism discovery, but either way, because there is a lot of intersectionality here.

ELENA CARROLL: Yeah, yeah, no, for sure. So, do you mean, like, what brought me to… What was the question, again? I was listening to it in regards to sexuality, so…

PATRICK CASALE: So, basically, what's going on in life that leads you to say, like, I'm pursuing autism discovery. What's happening for you?

ELENA CARROLL: I see, I see what you're saying. Well, I think from the ages of six to 21, there were so many years of mental health diagnoses, and what started as just, you know, anxiety, but can manage suddenly turning to, you know, a teenager, and then, an adult, was becoming depression and burnout. And now life was getting, "Oh, I'm not able to manage this, and I actually don't want to be alive."

And so, I ended up back in therapy just on the brink of despair, had to move home again. I had to quit university, and I just collapsed, just a complete mental breakdown. I kind of felt like a child again.

And I essentially saw at the rate that I'm going and the rate that my life has been going, I'm not going to make it to 30, because it's just not worth it. No one else is having these struggles, clearly. Every single month, I'm breaking down, begging my mom like, "Why is my brain so difficult? It's just not working how others are working."

And so, I was just in a state of despair for my life. So, initially, what brought me to therapy was just complete depression and not wanting to be alive. And so, I saw the same therapist for about three years. So, the diagnosis or the introduction of could this be a possibility didn't come for three years of seeing the same person. So, it's been told to me, like, just how thick the mask is and how ingrained it has been, and that's why it has taken so long. But yeah, essentially, the therapist that I was seeing put me in front of a psychologist.

And at the time, I was like, "There's no way it's this." Because I've been to uni, I've learned psychology, I've learned about autism, and that's not me. And so, yeah, it eventually sunk in, and I thought, okay, how the world viewed autism and how I viewed it is not what it is, but what does this mean? If I'm autistic and no one has seen it and I can barely see it in myself, then there's got to be others like me. So, yeah, essentially, it's just been a long road of questioning myself and identity.

PATRICK CASALE: Well, thank you for sharing that. And I know it's a vulnerable, painful experience in existence when you're constantly questioning what the fuck is wrong? Like, what is not happening?

ELENA CARROLL: Yeah.

PATRICK CASALE: And why can't I figure it out? Or why can't anyone else figure it out? And a lot of people who are in similar boats have definitely been on that brink of, "You know, I can't do this anymore." And it's a lonely, isolated place to be.

ELENA CARROLL: Yeah.

PATRICK CASALE: I'm really glad that you figured it out and were able to start unmasking. It sounds like the unmasking process has definitely been a really, like powerful reclaim as well, in addition to, you know, just all of the confusion and curiosity that comes with it, but it sounds like you're also using it to really heal the inner child parts of yourself and to help other people who might be having similar experiences?

ELENA CARROLL: Yeah, I mean, I feel that I'm kind of regressing a little bit. I'm 29. And I feel 18 years old. And I feel like I'm finally getting to understand a little bit, like I'm kind of going through my partying years right now and doing it in a way that feels intentional for me, even going back to like childhood and wanting stuffed toys around me, and sensory, play, and not feeling embarrassed or ashamed, and having the understanding of why I'm doing these things has just helped so greatly. Because the reason I didn't do any of those things at the age-appropriate times was because I had all these hang ups about myself, and, "I shouldn't be doing this, and I shouldn't be into that." And it's just a constant barrage of, "No, no, no, I shouldn't be this, I shouldn't be that." And now it's like, I don't honestly care anymore. I just have to know who I am.

PATRICK CASALE: Yeah, it's powerful. And I think giving yourself permission, right? To just acknowledge that these accommodations, these support needs, are things that we need on a daily basis to regulate and to be our most authentic self. So, it really becomes this, like, at first, inner conflict and dialog of like, am I going to embrace this, or am I going to continue to push it away?

ELENA CARROLL: Yeah.

PATRICK CASALE: And I think once we embrace it, like I have fidgets all over the damn place, and I'm using one as we're talking about, and it's just like, again, going back to my childhood, I'm like, I never had any of this stuff. I don't remember using anything to regulate. I didn't even know any better. And if I did, I don't even know if I would have done it. Like, I would have felt like embarrassed, or ashamed, or whatever the fact may be.

And now I'm like, I don't give a shit. Like, I [INDISCERNIBLE 00:17:01] with my, like, favorite fidget in my hand, because I wanted to model that we do need these things in order to regulate and that it's okay to have them, because so often as adults, we can feel guilt or like you said, childish or whatever the fact may be. And I just want to really help normalize and affirm that too.

ELENA CARROLL: Yeah, that's a nice thing. I didn't realize that you were holding a fidget toy in your talk. That's amazing. I think as well, just to further your point, I think, for a lot of the time since I've understood the diagnosis and realizing, okay, I do need these accommodations, I kind of felt as though it was a choice. Like, I've gone through so many years of my life without these accommodations. Suddenly, I've become aware of a diagnosis that does make sense. But do I make these accommodations, or am I being needy?

And I'm still trying to find a level of comfort and going, this isn't about a choice. Like, yes, you can manage, and well, yes, you can survive. But when you get home from, you know, a really loud place without putting in noise-canceling earplugs or whatever, you collapse. And that's not normal. So, it's not about whether you can manage or whether you can't. Because a neurotypical person doesn't need to come home and collapse after that. And coming to that realization of, yes, you've done things a certain way and gotten through, but how happy have you been? Like, you need to actually acknowledge these things.

PATRICK CASALE: Yeah, I think we can all remember times where we've, like, pushed through or passed our limitations to just like, mask or adhere to some neurotypical norms, only to come home and, like you said, either collapse or for me, it typically ends up like complete darkness in my house, laying on my couch or my bed, like not able to speak, or function, or socialize or even get through my day. So, I am like, there's a tradeoff to all of this, right?

So, acknowledging like, how can I best support myself and do it consistently so that the collapses get less and less and less intense? Because autistic burnout is pretty hellacious. And I have spent way too much of my fucking life in that space and pushing past my limitations or my capacity just in order to show up to something social, or work-related, or because I think I'm supposed to. And, yeah, the fallout is not worth it to me.

ELENA CARROLL: Yeah. And I think, through finding the neurodivergent community online has helped me to see that there are others making those accommodations for themselves. So, it's starting to normalize it a little bit more in my mind. Like, if every day I'm seeing people talk about the things I'm struggling with and what they're doing to change it for them, then I'm like, "Okay, if they're doing it, I can too." And that's the power, the goodness of social media that I am finding. I'm not sure if you can relate to that.

PATRICK CASALE: 100%. I think, you know, at first, I was so curious, because my reaction was kind of rooted in my own internalized ableism of, "Oh, no, this can't be me." I had a million reasons why it couldn't be.

And now fast forwarding, you know, about four years, I'm like, "Oh, absolutely, all of this stuff is so relatable." Or like the content I put out, I really want to put content out just to help other people feel seen and understood. Because that feeling of misunderstanding or like not being seen, or being too much, or "lazy" or, you know, needy, or whatever the label is, is really painful. And if content can help one more person feel less alone in that, then I think that feels like the end goal for me in all of this. And it's been a journey. And still have a lot of learning and unlearning to do, even four years in as a mental health therapist.

ELENA CARROLL: You're four years in from your diagnosis?

PATRICK CASALE: Mm-hmm (affirmative).

ELENA CARROLL: Must have been the same year.

PATRICK CASALE: Yes.

ELENA CARROLL: For both of us.

PATRICK CASALE: I am almost 39, and I was diagnosed at 35. So, yeah, it's been about four years and [CROSSTALK 00:21:42]-

ELENA CARROLL: Oh, wow.

PATRICK CASALE: …road. That's for sure.

ELENA CARROLL: Wow, that's so interesting. Yeah, I was 25. I can't imagine 10 years on from that, especially, being a male as well, like later on, usually, it's the younger boys that are diagnosed, but yeah, the expectations that come from men at that age. There's different experiences for both male and female.

PATRICK CASALE: Oh, yeah, 100%. And you know, the book that I'm writing is all about late-in-life autism discovery from the male perspective. And I'm interested to see how it plays out, you know? Because a lot of the content that's put out is either by women, or by trans people, or by non-binary people, gender expansive people. I don't see a lot of content from men. So, even though so many men are the ones who all the research was done on as young boys, it's fascinating where this massive gap goes, where it's like research on young, cishet, white boys, then massive gap of like, what happens next? So, it's not often talked about that middle stage or that late in life stage. So, I think it's important to just continuously talk about our experiences.

And I really applaud you for what you're doing. And I know there's a lot of vulnerability in putting yourself out into the world and having thousands and thousands of people who consume your content. But I'm excited to see where that leads you, especially, if you're going to write this book, if you're going to pursue the TED talk or any of the other stuff that comes with it, because I think it really does help people feel less alone, and I think that is invaluable.

ELENA CARROLL: No, thank you. No, it sounds like we're wanting very similar things for our lives and what we're doing with it.

PATRICK CASALE: Yeah.

ELENA CARROLL: But from different ages, genders, experiences. And I think, it's so important to have all those experiences, because if you don't see someone that you relate to when you're growing up, like, you just don't think of those things at all. Like, that's what I was saying earlier. My view of autism was so narrow, stereotypical, you know, as you say, the young white boy. And so, it will be so powerful for so many males, I can imagine, a whole different audience to me, but still very similar in terms of emotions, loneliness. It's these key concepts we're talking about that we can relate to.

PATRICK CASALE: Yeah, 100%. I think it's important to have all of these different perspectives and resources out there, because when I was a kid, teenager, even young adult, they didn't exist.

And the reality is, like, we need more and more people in the spaces talking about their experiences, because it's not a one-size-fits-all experience as it is, right? Like, so it's not binary. But in reality, there are a lot of commonalities and shared experiences, like you said. So, it's a cool space to be a part of right now, and see where it goes, and where it takes us both. And you know, I'm definitely nervous, but excited, and I will say that that's kind of always telling me that I'm on the right track.

And even as, you know, we're wrapping up, a side, to all of you who are listening who are mental health therapists or private practice owners, et cetera, the only time we talked about autism or ADHD in my grad school program was like a very quick Childhood Development course where we talked about ADHD and autism, definitely not from an affirming lens for maybe, like one or two classes. And we only talked about it from, like, a kid's experience, and that was it. And that was like-

ELENA CARROLL: Wow.

PATRICK CASALE: Did I graduate 2015? So, this must have been like 2012 to 15, and that was it. Like there was no other conversation, there was no other learning, there was no other mentioning. And so, you know, for so many people, of course, it's never immediately on your radar if we're not talking about this stuff openly, and sharing experiences, and supporting, and amplifying autistic ADHD and other neurodivergent voices. And I want to just, again, thank you for coming on here and making the time to be vulnerable on here and talk about some of this stuff with our audience.

ELENA CARROLL: Of course. No, it's such a helpful thing to talk to other people who understand without having to over-explain myself. And subsequently, the listeners are like, "Oh yeah, I understand." Without me having to, you know, unpack all the different emotions, and you know, "Oh, but you don't look autistic." Blah, blah, blah. There's a freedom in these conversations. So, thank you so much for wanting to have me on. I really appreciate it.

PATRICK CASALE: You're very welcome. Can you share with the audience where they can find you if they want to follow you? I will also have this in the show notes for everyone who's listening, and so that you have easy access to Elena's information.

ELENA CARROLL: Yeah. So basically, my social medias are just my name, Elena Carroll. I have a YouTube channel that I am uploading every week, talking about different lessons and things I'm learning. And then, yeah, my Instagram is just always trying to connect with as many people as I can. So, yeah.

PATRICK CASALE: Sweet. Thank you so much. And I hope you have a good rest of the day, and best of luck, like, continuing to orient and regulate in Toronto and getting acclimated to your new space and your new home.

ELENA CARROLL: Thank you so much. Yeah, need all the thoughts.

PATRICK CASALE: And to everyone listening to the All Things Private Practice podcast, new episodes are out on Saturdays on all major platforms and YouTube. You can like, download, subscribe, and share. Doubt yourself, do it anyway. I'll see you next week.