The Fat Doctor Podcast

Unmasking My Autistic Self

• Dr Asher Larmie • Season 5 • Episode 13

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 We’re doing things slightly different this week (it is episode 13, after all). As a 44-year-old doctor who recently discovered I'm autistic, I'm sharing my personal journey of self-discovery for Autism Awareness Day. In yet another deeply personal episode, I walk through the signs I missed in myself while recognizing them in my kids, how I've been masking my whole life, and why I'm now embracing a more authentic way of living and working. 

I also explain why I'm done trying to build a business the neurotypical way and how I'm restructuring my work to avoid burnout while still continuing to create content I love. If you've ever wondered about late-diagnosed autism or are feeling burnt out trying to follow other people's rules, this one's for you! 

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Hi, there it is Wednesday, the second of April. It happens to be world autism Awareness day. I'm your host, Dr. Asher Larmie. This is episode 13, lucky for some, including myself. Episode 13 of season 5 of the Fat Doctor podcast and in case the title of this podcast didn't give it away, I'm going to be talking about autism today. In particular, I thought I would share some personal revelations, maybe, and my story, my own story. Every so often I'm like, "Oh, I know what I'm gonna do. I'm just gonna bear my soul in front of a camera." Hopefully, it's recording today, you never know with zoom. Sometimes it records me, sometimes it doesn't, but fingers crossed. Because I'm going to get really real with you today and tell you about my own path towards a late autism self-diagnosis. Yes, I'm self diagnosed. I'm a doctor, Oops. I've just realized that I hadn't turned my phone off like a professional. I should edit that out, but I'm not going to so I'm really sorry if I blew anyone's eardrums out. Maybe I will edit that. We'll see, we'll see how this goes, shall we? Anyway? It's world autism awareness day. And I am a 44 year old person who has perhaps over the last 2 to 3 years, 2 years probably, come to terms with the fact that I am, in fact, autistic. And the reason that I realized, or one of the first reasons that I realized this is that I recognized that my children were autistic. So actually, my diagnosis, my experience of autism, started off with my children. I can remember with my oldest child, I think I shared this last week. Did I share this last week on the podcast? I can't remember, but my oldest child was in a nursery, and he was very young, and somebody said, "Do you think he might be autistic?" And I got very offended at the time. I was like absolutely not. I'm his mother and a doctor. I think I'd know by now if he was, and I ignored that. And a decade later it was my middle child actually, whom we first recognized was autistic because he was so very classically autistic, like he had all the features. It was a bit textbook. It was boring to be honest, and so we went through the process of getting him diagnosed, and for those of you who have been through that process with your children. It takes forever. And we have to fill out all these forms. And they ask all these questions and many of the questions I was looking at. And I was like, "Well, that's not just common in this child, but it's common in all of the children and actually wait. Hang on a second. I just assumed they inherited all of these sort of quirks from me, because you're just describing me here." All sorts of things, sensory processing, for example, and my kids have always found certain sounds to be very loud, annoying, like they would hear the car alarms and like go absolutely like mental. "Can't you hear it? It's so loud! It's so loud!" I'm like, "Is it? Is it that loud?" And they would find certain textures were a problem. Certain foods were a problem, labels in clothes. My God! One time I accidentally bought my daughter's socks and they looked really lovely, but they were like spotty. They were polka dot socks, and what I hadn't realized was on the inside of the polka dot socks was like the thread, I guess. And no, no, it was terrible. She spent like 2 years of her life with the socks turned inside out, refused to put them away. She liked them, but they had to be turned inside out because she couldn't have like the rough part on her skin. Wool. Oh, gosh! Like, don't put wool anywhere near her. And I used to think, "Oh, yeah, that's just that's just how we are." The same. Put a wool sweater on me, and I'll lose my mind. Oh, my God! Oh, my God! On my neck! No, no, absolutely not! No! And I don't wear coats. I don't like to wear coats. My children don't wear coats, it's freezing cold. They're in shorts. That's just how my kids are, and just thought that was normal, and it is normal. Let's not use the word normal. But it was just common for me, and I didn't think much of it. And I'm like looking through. And I'm thinking, Yeah, no. I remember my mum used to tell stories about how, when an ambulance or a police car would pass by. How I would like as a really young child would lose my mind, and she said, I used to put my hands by my ears and like bend over like I was almost like I was being sick and like I couldn't, even if it was quite far away. I couldn't handle a siren, and she used to think I was a bit weird. She also said I would never socialize with any of the other children. She'd take me to my NCT friends, for those who don't live in the UK. NCT stands for National Childbirth Trust. And so basically, what happened was all these expecting parents would go to these groups like in their local community, all about childbirth, and being parents and stuff, and then they would befriend all of the other parents in the room, and they'd form a little group, and then they'd hang out for like years later, and those people would become your friends and their children become their children's friends, and it was a bit shitty, anyway, so my mum would like take me to these kind of get togethers, and apparently I didn't play nicely with the children. Apparently biting other children was acceptable behavior. I don't know why. And I was the odd one out. I didn't play with kids. My mom thought I was a bit weird, didn't like that didn't like the fact that I showed her up much. But so when my kids didn't play nicely with the other children, I was like, Well, I'm not going to put that on them. I'm not going to make them feel bad about it, so I didn't. I just didn't take them to. I didn't join the NCT. And I didn't take them to these events, and if I did, you know, I would just keep them on my lap, or whatever, because they didn't like to play with other children. They like to play on their own. They're quite happy playing with other toys, but just not with other children. I remember also my whole life being told that I stare a lot. "Gosh! You're always staring. You're so rude. Why are you staring at those people?" But it's because I realize now I'd get very distracted by things. Shiny object! Oh, hello! And so if I was in a crowded place, and people were moving around like a waiter was in a restaurant and moving like I couldn't keep looking at someone. I had to follow the waiter. I had to watch the waiter walk past, and like bright lights. Anything like that. I had to follow them like a magpie following shiny things. And if people were talking, they're so loud. It's like they were talking right next to me. How could I not get invested in their conversation, even if I didn't care about that conversation. Of course I wanted to listen. They were so loud, except for I don't think they were so loud now that I look back, I'm like they probably were talking at a normal volume, and I was just hearing it very loud, and so I'd get super distracted. And I'd always like listening to other people's conversation, and I remember my husband, who is very understanding and very kind, like even he would be like "dude, you know, you're staring right," and I'm like, "Oh, am I? Sorry?" So, yes, I was very rude. I stared a lot. I didn't make any friends. Shiny things, loud noises, visual stuff, often like just completely confused me. I found I had to really put my head down. If I wanted to study, I had to like, just have no distractions whatsoever. And also, when I was at home, I did all these weird, quirky things which I never admitted to anyone else like. I have to bounce my legs all the time like, bounce them, bounce them, bounce them, bounce them, bounce them as quickly as possible, and I like scratch my skin. I like pick at my skin. I've been a nail biter all of my life. I also have to touch soft things. If there's like something fleecy or something soft. My poor dogs! Oh, gosh! There is! There is, though I can't not. They're so soft, and I just have to keep stroking them, and they let me, because they're lovely like that. But yeah, soft things. I have to touch them. So I have, like I usually do these weird things, but only at home, and even at home. My mother did not like them, so I'd get told off for them quite a bit, so I tried not to do it in front of her, and not in front of other people, because they thought it was weird. But when I'm on my own just shaking out my leg makes me feel so much better. So yeah, when I like, when I'm filling this form for my children and like, "Do they do this? Do they do that?" I was like, yes, but so do I. What are you trying to say, sir? And I thought to myself, maybe maybe maybe I'm autistic, but my kids. But then I got to the next part of the form, and then I was like, no, I can't possibly be autistic, because I'm a great communicator. I'm very social. I enjoy social interactions. In fact, at the time when I was filling in these forms, I was like, I'm an extrovert. I love being around other people. I like conversations. I have really good social skills and communication skills. In fact, whenever I was assessed from like the moment I entered medical school. Whenever I had an assessment. I always scored super super high when it came to communication skills like that was always my strongest suit. It's not something I've ever worried about. So I can't be autistic because autistic people have communication sort of issues, issues with social interactions and communication. I got some notes here. So I'm turning over so yeah. I was like, yeah, maybe. And then no. And then I learned about masking and I didn't know what masking was. Masking is sometimes called camouflaging. And it's basically a way that neurodivergent people for those who don't know, it's a way that neurodivergent people can camouflage amongst the neurotypicals and not expose themselves. Oh, gosh! I didn't mean it like that, you know that I don't mean actually exposing that. Not their privates; I'm talking about not exposing themselves. No, that's not the word. I'm not like well, like in Scooby-Doo, when they like unmask themselves. It's actually masking. I can't think of another word. Never mind, it doesn't matter. I'm going to push forward, push forward, Asher. Don't worry about it. You've accidentally told people that you expose yourself. But that's fine. And so I learned about masking. And so I learned that masking can include forcing eye contact. So I've never had, I didn't think I had an issue with eye contact, except for I remember my mum saying, like you never made eye contact, and I used to hate photographs. I don't have any photographs taken of me when I was a young child, because I hate people taking my picture, not because I was like embarrassed. I was too young. It was like there was something about the picture taken that was problematic. I never looked people in the eye, and, like, you know it was a bit weird like that again. But I learned to do eye contact. Eye contact comes quite easy for me now, and it got easier, I think, as I got older, because I think when I was younger, eye contact with older people is always harder, right? But once I became a doctor, and then I was older. I could look people in the eye and not have any issues. I learned how to copy neurotypical social cues. I just, I learned it like I learned it like a script, you know, when someone does that, that means that when someone says it like this, that means sarcasm. In fact, I learned sarcasm so well that I got to perform sarcasm and do sarcasm, and then I became quite sarcastic. I have quite a sarcastic sense of humor now, but it's something I guess I learned how to do. I certainly learned to suppress my stimming. I knew that I couldn't stim outside of the house, so there's certain things that I couldn't do, so bouncing my legs. People wouldn't tolerate that, and picking at my skin, biting my nails. I do do in public sometimes, and people always call me on it as well. "Oh, you're biting your nails. Oh, haven't you outgrown that?" No, I haven't, because it's very comforting for me. But yeah, biting my nails. What else? Oh, the Echolalia! Oh, the Echolalia! Have you ever heard of Echolalia? It's basically when sounds kind of repeat over and over and over and over again in your head. So they become unbearable, like they just go over and over and over. Sometimes it's a word, and the words suddenly, like you ever have a moment where you're saying a word, and then you're like that word sounds funny, and then you have to say it over and over and over again, but that happens quite a bit for me, and also songs. I sing things all the time. I hum things all the time. But I've learned not to do that in public, because it's apparently when you're in the middle of a conversation with someone, and you start humming, that's very rude. Apparently it's considered unacceptable social behavior. So I learned to stop doing that. I am humming. By the way, when we're talking, chances are I am probably humming, but I'm humming in my head because it's rude to hum out loud, apparently. Yeah, I mean, if I'm really interested in what you're saying, then I stop humming, but when it comes to social chit chat, you know the social discourse the whole like "Oh, let's talk about the weather" kind of thing. I'm humming, and especially if it's someone I don't want to talk to like my neighbors. I don't want to talk to my neighbors ever. I don't like them. I have nothing to say to them. They do not share the same values as me, and so when they're chattering away, I assure you. I wonder if they listen to this? Podcast well, never mind, they should know. I'm humming in my head, because I've got better things to do with my time. Yes, that was rude. I am rude, everyone tells me so. I've learned not to be so blunt, because, being blunt again, something that's not considered socially acceptable, but when I was younger I would just say the first thing that came to my mouth often. It was the truth. I'm not particularly invested in lying. I'm not very good at being manipulative, like. I have learned some forms of manipulation, especially with my children. Manipulation, bribery, whatever you want to call it like, you know, basically getting them to do what I want them to do when I want them to do it. I have learned how to do that. I'm not so good at doing it with other people, but I'm not bad at doing it with my children. Anyway, I've gone on for the tangent, haven't I? I knew this was going to be an interesting one. Anyway. Masking, let's get back to masking. Masking is more common in women and people assigned female at birth. So anyone that was conditioned as women. That would be me. People who are black and other people of color, not me. LGBTQ+ people, that'd be me, people who are late diagnosed. That would also be me. And people who have strong verbal and communication skills again, me. I've never had any issues with talking with communication. And what's interesting now? Actually, because, of course, the ICD 11 has come out. Now, the International Classification of Diseases version 11. That's the international classification of diseases in case it wasn't clear in the title. So the whole world uses this. There's the DSM 5, which is which is used predominantly in the US. And that's a psychiatric manual, whereas the ICD is, for every, any condition, any medical condition talking about whether or not Autism is a medical condition, separate conversation, because I don't believe that it is. But anyway. So the ICD 11 now thankfully says that. Yes, absolutely. You can have autism with or without intellectual impairment, and with or without functional language impairment. So you don't have to have an intellectual impairment and or a functional language impairment in order to be autistic. And of course we once upon a time we believed all of these things happened at the same time. So. Yes, you can be autistic and have a language delay. But you don't have to have a language delay in order to be autistic, if that makes sense. So yeah, people who have strong communication and verbal skills less likely to be diagnosed as autistic because more likely to mask. And so that would explain a lot right? So I was like, "Oh, hang on! Hang on! Maybe I'm autistic, and I'm masking. What happens if I drop the masking for a bit?" So I start doing that. I started allowing my legs to bounce again in private. I didn't do it in public. Yet I allowed my echolalia to come out of my head, and, like I sing a lot and hum a lot, and I stopped forcing myself to make eye contact with people, and that was very pleasant. I stopped forcing myself to have conversations with people, and that was also very pleasant. I was like. Hmm! There's something to this unmasking stuff. And I read, of course, that masking is mentally and physically exhausting. And I was like, that I can relate to, because, even though I'm a fantastic communicator, I find it to be so exhausting. I used to call myself an extrovert, and now I know I'm not because I don't get any energy from communicating with people. I get my energy from being on my own and fixating on something, because that's the other thing. I'm really good at focusing on stuff and getting stuff done. If I am interested in the subject, if it's something I want to do, my, I can focus with a level of intensity that most of my peers, most people I knew were not capable of doing. If I wanted to do it, I could just focus to the detriment of everything else which is not necessarily healthy. By the way, it's not something to show off about. But that was definitely something that I've always been able to do. If I'm interested, I'm focusing and fixating on it. In fact, to the point of obsession. If I'm not interested, I'm not. Anyway, it's exhausting, masking, really exhausting. And so I started to read that. Did you know that people who mask all the time, especially those who aren't diagnosed with autism often suffer from autistic burnout. I was like, I've had a lot of burnout in my life, could have been the autistic kind, because I used to think it was a work thing, you know, I burnt out at work, but actually, well, looking back, it was before work, looking back. Actually like it was happening to me in childhood. It was definitely happening in my teenage years, definitely happened in medical school. I pushed through because I tend to do that. But yeah, I burnt out a lot because I felt exhausted. I'd shut down. I would lose my ability to cope with the little things in life, and as a result I got very anxious. I developed bouts of depression. I was diagnosed with anxiety and depression. I had a lot of suicidal ideation. I made several attempts, several. I made 2 attempts on my life. I tried to unalive myself twice. You know I was quote unquote chronically stressed, chronic stress just never went away. It's not like I had moments of like being stressed because stuff happened. And then other periods of time it was fine. I was just always worn out, always tired, and I just thought that was normal. I thought being burnt out was just a normal thing. So then I was like, well, hang on! Hang on! This is all sounding very familiar. Folks, are you with me so far like I'm ticking a lot of boxes? My kids are ticking, I'm ticking the boxes. Hmm! And then I read that, I think an autistic child, I think it's 50% chance of having an autistic parent something like that I don't know. Maybe it's higher. Who knows? But anyway, hmm! My kids, also, my kids, they aren't, they don't be disingenuous, they're truth tellers, right? So where we were going through the diagnostic process, we talked a lot. We were very open with each other. I talked to them a lot. They were very keen on a diagnosis. Actually, my kids are well, one of them is a teenager. One of them is not quite a teenager yet, but you know they're older. They're not very young. So they we talked a lot about it, and we'd often talk about like this is what is common in autism. This might be why you're feeling that way, you know. We talk about it, and then they'd like, stand their nose up at me and be like "You would know, I got that from you. You're patient 0." And so I'm starting to think, okay, all right, maybe, and then I read something else. And this is really important, because it says, according to the ICD 10, right? Not only should these symptoms have been present from childhood, although they accept that it might not have been detected until later, they should have been present to some degree from childhood, which is fine, because, as I've explained, they were, and they also should have a significant impact on your personal, social, academic, occupational functioning. So once again, I was like, well, then I can't be autistic. I'm a doctor. I'm raising 3 children, you know. I have a roof over my head. I'm able to hold down a steady job. I have friends like it's not affecting me personally, it's not affecting me socially. It's not clearly not affecting me academically or occupationally. Everything's fine, so I can't be autistic, except did I mention anxiety and the depression and the suicidal ideation? Did I mention the constant burnout? I think I did. I've always struggled with meltdowns from when I was really young I'd melt down. I have a history of self-harming, and I think when I was a young person, and I was having meltdowns, I was self-harming at a time where that wasn't very common. By the way, it wasn't something that I had ever read about. Not that we had the Internet, but you know it wasn't something that I knew. I didn't know anyone else that did it. It wasn't a common thing. It was something I learned to do as a means of coping when I was having what I now realize were meltdowns. But even as an adult, when I stopped self-harming I would have these intense meltdowns, and I'll give you an example right? I'm cooking something, and it doesn't quite work out. I followed all the steps. I'm a good cook in case you can't tell. I cook well, and I follow all the steps. For whatever reason I mess up. I burn something, and something doesn't quite turn out how I want it to be, or I've decided I'm going to try something new, and it doesn't turn out how I want it to be, and then like it would just all go on top of me, and then I just can't cope. I can't cope. So then I would like, throw the food on the floor, break a pot, throw things in the bin like, lose it, throw an absolute freaking tantrum over nothing. And Junior, my partner always laughs at me and says it's always about food. When in doubt, it's about food. There's this really funny story in my family. It's not very funny for him. He loves rice pudding absolutely loves it. When I want to do something nice for him, I just make him a big bowl of rice pudding like that is like his dream come true, and he is absolutely can't tolerate dairy properly, allergic to dairy. So I have to make like dairy free rice pudding, and I make it real good, and he really loves it, and we'll never forget, like one time I had a meltdown, and I got so upset that I went to the bin, and like like really angry, like just throwing it in the bin, and it was all falling out, and it was like "no!" in slow motion, like trying to reach out like "not my rice pudding," and he's had to clean mashed potato off the walls as well. Suffice it to say I have meltdowns, especially when it comes to food. I once had a meltdown when it came to killing a moth, it was a real to do. Pete killed a moth, and I once threw my wedding ring over a fence because I was having a meltdown. Then he had to go and fetch it. Do you know, as I'm telling all of these stories, I'm realizing poor Junior, he really does go through a lot. I'm not that upset about it. If I'm honest, I keep him on his toes. He's lucky to have me to be honest. Anyway. So yes, suffice to say, I did have meltdowns, and I did struggle, and it did affect me personally and socially and academically and occupationally, because I was burning out all the time. Don't tell my kids this, but I did fall pregnant; each time I got pregnant was because I knew I was burning out, and I was like, I don't think I can work for much longer. Oh, I know I'll have a baby and go on maternity leave. In the UK, you can get up to a year of maternity leave, folks, and turns out having children is not the answer to burnout. By the way, just in case anyone's thinking about it. But I have burnt out many times at work is what I'm trying to say, and my children were absolutely planned. It wasn't the only reason I did it, but it was one of the main reasons. I hope they never listen to this. So, as I began to realize that maybe I might be autistic, and maybe I might be doing a lot of masking. And maybe that's not ideal for me and my mental health, I started to unmask. As I said, I start to like, let the humming and the Echolalia out. I start to stim. And I stopped, I stopped socially interacting; now once a month, once a month, leave the house, go out, meet other people. There's plenty, not even that. I probably do it once a quarter. I do like being in community with people. I really do. But there is like kind of rules around that. There's a structure. There are boundaries when it comes to being in community with people rather than just going out and socializing. First of all, I can do it thankfully. Thank you very much technology, I can do it from the comfort of my own home. It's not particularly loud. I can control a lot of my environment. So that's quite nice. And also when it comes to community, there doesn't tend to be too much chit chat. It tends to be like, let's just dive into the things that are important, and that matter which is great, because I'm not really good at chit chat anymore. It's not. It's not for me. As I was telling a friend of mine. You know there is a big part of me now that I'm unmasking that just wants to be like "this is really boring. I don't want to talk about it anymore." Thankfully, most of my friends are autistic now. So I can actually say to them, "Yo, this is really boring. Can we stop talking about it," and they won't get offended. But that did not work out when I was younger. So yes. And I don't like socializing. I don't like going out for meals. I don't like, I used to like really want to travel. And now, when I think about travel, I think about all of the all of the kind of like sensory processing stuff that you have to go through to travel. It's not to say I never want to travel. It's just that I'm much more mindful about how this will impact me now. If I'm going to get on a plane, if I'm going to an airport or getting on a train, or even getting on a bus like the smells and the sounds, and the kind of like the commotion and the visual. And so it's actually a lot. And in a way, this has been really amazing. It's been really amazing to understand these things about myself, to be like, "Oh, that's why I do what I do, and that's why I feel the way I feel, and what a relief not to have to do that anymore!" What a relief not to like, have to constantly perform in a way that just doesn't work for me. It's really hard. And also I'm 44 years old, mate. I've been doing this since I was a kid. It's been really exhausting, and it's taken its toll on me. I tried to imagine what it would be like to go back to medicine now, you know I took a long enough gap for me just to think now I just couldn't do it. I don't have it in me. I'm too happy not socializing to be able to have these kind of really important conversations with people. That's not to say I don't like, because I do have clients right? And I look forward to them. I love working with clients. I really do. But again, not 30 plus a day, one or 2 a day, Max, because that's much easier for me. Oh, I think I've lost my train of thought. But yeah, I hope. But I was thinking to myself, "Why are you doing this, Asher? Why are you sharing all of this stuff?" But because it's literally this is Wednesday, the second is autism awareness day 2025. And that's the day that this podcast is coming out. I really felt like, I wanted to talk about it also, because if you're listening to me, there's a chance you might be relating to some of this. If you're listening to me, there's a chance that you might be a Fab. Maybe you're non-binary. Maybe you're transgender. But you were conditioned as woman. If you're statistically speaking, that is the case. By the way, because you know, there are these things that measure metrics and stuff and give you like feedback, and I know most of you were conditioned as women. Many of you are queer or LGBTQIA+ plus. You may even be black or a person of color. Hello, welcome. As you know again, I don't know this from personal experience, but I am raising black children, and I know that when I have conversations with them they'll often say "We mask more because we are already so different. And we're already being treated like the freak show. And so, or we're being discriminated against just because people have seen our hair and our skin tone. And that's enough. And our noses and our lips and they've made, they've made assumptions about us based on that. So the last thing we want to do is be even more weird." So when we talk about masking, they've told me this. It's not something I could personally speak about, but certainly I've heard it from other people. The people even that I'm closest to. What else might you be? Well, you might be my age like speaking again like you. You may be in the middle age, as it were. You may be, and you probably are, and you may well be a bit neurodivergent, because one thing that. And we talked about this last time, didn't we? If you haven't listened to Molly's podcast, yet, please go back and listen to episode 12 and listen to Molly Moffat, who is an expert in this. But you know we find each other because we understand each other a bit better, because we don't have to mask as much around each other. So it's but you know, if you're listening, and if you're a fan of the podcast there might be a chance that you might be autistic, too. And so I wanted you to hear my story in case you can listen to parts of that story and go. "Oh, hang on! Hang on! Hang on! That's ringing a few bells for me!" I believe that I have AUDHD. I believe I have ADHD and autism. It's very, very common. The overlap is very common, even more common than we think. It is. Our ability to diagnose and make the official diagnosis is not keeping up with the demand. So a lot of people will have an autism or an ADHD diagnosis. But actually they have both. I'm not as knowledgeable about my ADHD as I am about my autism, and I definitely think autism is like for me. Not that I should have to pick between a diagnosis. But like autism is the one like, I know, I'm autistic. And so yeah, you may have autism. You may have ADHD, you may have both. You may have post-traumatic stress disorder. CPTSD oftentimes manifest in another way. You may have a history of childhood trauma. And you might be saying, "Yeah, you know a lot of the things you're describing that could just be childhood trauma." And you're right. It could. I don't want to play the game of, is it my childhood trauma, or is it my autism? It's not a fun game. I don't want to play that game anymore. It could. Yes, you're right. It could. I don't think that it is. In certain respects I don't know that, like the sensory issues that I've been having could really be linked to my own personal childhood trauma. But it could well be, and it certainly could for you. But does it matter? Okay, I'm not sure. I don't understand why it's important to be able to pick it apart. Is it trauma? Or is it AUDHD? Well, it could be either or both. Both will cause neurophysiological, neurochemical changes in the brain. Right? That we know. So yeah, I'll leave it at that. I've been going to therapy for many years. I have a therapist. Her name is Amy. I don't think she listens, but just in case, Amy, I love you. Amy is a very, very slim woman. Cisgender woman, who I don't know that it's particularly, I wouldn't say doesn't know about fat activism, but certainly I didn't meet her through fat activism in any way. I wasn't involved in fat activism when I first met Amy. It was long before that and she is the person who helped me really learn to accept my body, and helped me to wade through so many of the kind of thoughts and beliefs and assumptions that I had about my body. She's so good at it, and she still is, even though, like she knows what I do now, and like, we don't necessarily have conversations about weight stigma so much, because I think we've kind of moved beyond that. She really did help me, and so I see her. I see her every 2 weeks at the moment, probably see her for as long as she practices. Don't imagine ever going to a different therapist. I just lucked out; she was my first and only, but she's brilliant. I don't think that therapy is the only solution, and I don't think therapy is necessary. I also think therapy is very much kind of been kind of in now. The way that we describe therapy in the mainstream, there's there are certain boundaries and rules and like expectations, and it's been commodified a little bit, and like I, you know I have, I have a lot of opinions about therapy, and yet I am in therapy, and very much love the time. The time I spend with Amy once every 2 weeks is really quite fantastic, and we met on Tuesday, and it was one of those days where I just said, "I've had enough. I've had enough. I can't keep doing this anymore." And Amy said, "Oh, I love those days. Those are the best days, because those are often the days when you're finally ready to shine a light on something that you have been keeping in the dark for a long time," and we've shone a light. And one of the things that I realized is that I have for a very long time, I've just been faking it. I've been like, I said, masking. I've been trying to be a neurotypical person, and I'm not one. And there have been things I've been able to let go like, for example, I don't feel like I need to be a social butterfly anymore. I really don't. It's great. I am very content to be ensconced in my home and not going out. I wouldn't have been able to handle that a few years ago, but now it's cool. I've worked on all of the kind of like, "What does that say about me? How does that impact my identity? How does it impact the way that I relate with other people." I work through my fear of rejection and abandonment, and all of this stuff like I've worked through it. It's been great. It's taken years. Probably, what I hadn't realized for the longest time was how autism was impacting me in the workplace for want of a better word. So I graduated medical school in 2003, and I put in 20 years of service. I did a challenging job, not the hardest job in the world. I was fairly compensated for it, remunerated for it, not complaining. But it was stressful. And it required me to interact with people a lot. Right? It was, I mean, talk about a person facing kind of like job, like it was my job to have 10 minute conversations with people that if I messed them up could potentially end a life so high stakes job and of course I burnt out. As I said, I've already said I burnt out quite a few times, and most recently burnt out after, it was would have been at 2021, 2022 towards, it was about 20 years or so. That was when I had a biggest burnout. I was burning out prior to the pandemic. I knew that I was burning out. I was going to see a doctor and was like "Dude. I'm burning out. I need some help. Can you help me?" And they put me on SSRIs? I'd been rejecting SSRIs for the longest time, but I started SSRIs just prior to the pandemic, and then the pandemic hit, and then for about a year a year and a half. We're like we were just, it was on in terms of medicine. We've never seen anything like it. This was a one in a lifetime thing that galvanized us all, and all of a sudden you forget, burnout, we were dealing with life and death here, and so that got put on hold for a bit. But then 2 of my children became really unwell. I just wasn't coping, so I took some time off, and as I took some time off I began to slow down a little bit like I wasn't seeing 30 plus patients a day, and because I wasn't seeing having those that many kind of interactions with people, plus dealing with all of my colleagues as well, plus dealing with all the paperwork. I began to sort of... it's like taking a comfy a pair of shoes off right like you've been on a really long walk, and then you take off a pair of shoes, your feet just kind of like. They relax, putting them back on again much harder, and I was struggling to do that. So then we moved to Scotland, and that was a decision that we all took, and it was a great decision. It was the best decision I've ever, we've ever made in terms of where we live. And we moved here, and a lot of stuff was going on, and many of you have been following me since then, because that was 2022. And then there was the GMC. The General Medical Council, the equivalent of the Medical Board for those of you who don't know what the GMC is. Then there was the Medical Board who thought they could mess with me, who thought that they could tell me that I wasn't allowed to speak about white cisgender, heterosexual people online, that I wasn't allowed to talk about it because that was prejudice, and that was bringing the profession into disrepute, and they commanded that I heel, beg for forgiveness. Otherwise they were going to censure me and put a note in my file, you know, put a record like a warning caution in my file. They expected me to apologize and say I won't do it again, and I told them to go suck my dick, and I didn't say it quite like that, although well, no, I didn't. I told them to fuck off, though literally in those words. I wasn't having any of it. I was like, "You're a bunch of racist, homophobic transphobic people. And we know this because we have evidence of it. So no, I'm not here. No, I'm not stopping. I'm not going to back down. I'm not going to apologize. I don't have anything to apologize for. You're the ones that have something to apologize for. If you can't tell the difference, you can't accuse me of racism towards white people. It shows that you don't know anything about racism." And so we went this back and forth, and that took 2 years, and that was not pleasant, and during that time I was very much like, well, I'm not, I'm not doing this. I don't enjoy it. I'm burnt out, and now you know, I have to heal, and I'm not going to heal. I'm done doing that. I'm done. I'm done hiding who I am. I'm speaking my truth. I'm being the authentic version of me. Yada Yada, Yada go therapy, and then they did it again. Then, to make matters worse, halfway through the first investigation, they did another investigation, this time, because apparently I'm anti-semitic because of my pro-palestinian stance. So then we had 2 investigations going on at the same time, and I was just like, fuck this lot, fuck this. I don't want to do it.

And so, you know, I was like, I'm gonna see whether it's possible to build a business for want of a better word. I'm going to turn my advocacy into a business because I want to do the advocacy thing full time. And so I did, and I didn't know anything about running a business, because, you know, I've never done that before. So I went and learned how to run a business, and I listened to all these people talking about. This is what you have to do. This is how you have to do it. And you got to do this, and you got to do that and emails here, and social content here. And this is how I made a million dollars in one month. That kind of nonsense right? I didn't fall for that, because I'm not stupid. But you know I was listening. I was listening to people. I was listening to people who talked about business and money and stuff that I didn't know anything about, and being the good autistic that I am, someone says to me "What you really need to do Asher is," I'm like, "Oh, okay, fine. Yes, I can do that." And so I do it. I'm very good at following the rules. So I did a lot of stuff. And you know, emails every day, podcast a week, blog post a week, 2 websites, not one, but 2, that I maintain on my own, editing, podcast on my own. I mean, I don't edit. But you all know, I don't edit, my podcast, right? You can tell, but it's all done on my own, everything on my own, like I said, I'm very good at hyper focusing on stuff and fixating on stuff when I need to creating lots of free resources for people, making courses sure. Check out my Thinkific, check out, learn.fatdoctor.co.uk, there's loads of courses on there. Oh, yeah, create a course. No problems. I'll do it. I'll do this. I'll do that. I'll do this because that's what I was told I needed to do. That's how you do business folks, except I don't want to do that anymore, because I'm tired. I'm tired of it, and that's what I said to Amy. I'm tired. I'm tired of doing it. I'm not tired of doing the things that I enjoy doing. I love creating a course or writing a leaflet. I love doing the podcast I really do. I like, I like creating stuff. I like talking to people, I like forming communities with people. I like a lot of the stuff. I really do. So I don't want you to think this is the end of the Fat Doctor. It's really not, I promise. That's not what I'm about to say, but I'm sick and tired of trying to build a business. I really don't want to do it. I was not even build a business. I'm sick of trying to build a business, the neurotypical way. How about that? I don't want to do an email a day. I don't want to keep trying to sell you stuff. You don't want to buy the stuff, and I don't want to sell the stuff. It's like it's exhausting, you know. I just, I'm tired. I'm really, really tired. So I have come to a place where I'm just going to let go of a few things, not everything. So I'm still going to do this podcast, every week. So I freaking love doing this podcast for as long as I can. I will do this podcast. And and I like writing blog posts. So I'll do that. And I'm writing a chapter of my book every month as those of you who are paying attention know my book is called No Way. Everything you know about, everything you've been told about weight loss is a lie, and I am on Chapter 5, I think, and there are 12 chapters in total. There were more, but I think I've dropped it down to 12 or 13 I can't remember. But I'm on Chapter 5, finished Chapter 5. So moving on to Chapter 6, and for those of you who want to support me, and they're like "Asher, I really care about you, and I want you to be able to keep your electricity on every month, and I'd really like to support you. How can I do that?" Well, you could join No Way. You could join No Way, and so you wouldn't just be supporting me for free, you'd be getting something out of it by joining No Way. You get first access to the book. You get a presentation from me once a month with loads of information, and you also get to ask me anything, and we have weight inclusive Wednesdays once a month, where we all get together and talk about all of these issues. So yeah, like, you get something out of it. But that's something that I'm doing. So I'm writing my book. I'm not going to stop doing that. I'm writing a masterclass once a month. I used to do them live. I don't do them live anymore, just because of timings. I've realized that for a lot of people coming live is really difficult, and there wasn't much benefit to joining something live when it was basically me teaching something, anyway. So you get a masterclass a month. But now it's pre-recorded which makes life a bit easier for me, so I'm still doing that. I'm still doing No Way. I'm still doing my masterclasses. I'm still consulting. If anyone wants to consult with me, I've got quite a few spaces taken up at the moment, I have to say, but I could probably probably fit in one or 2 more, no more than that. But yeah, I'm consulting with people still, that's not stopping. As I said, the podcast isn't stopping. I will write a blog post a week. I think I'm going to write a newsletter a week because I've been doing a No Way Newsletter, and I've really enjoyed doing that. So I think I'm going to do one of those a week. But I'm done with the constant emails and the constant social media content folks. I just can't keep up. I can't keep up. I can't have a social media strategy. I can't have a strategy, I think if it has the word strategy in front of it, I just have to be like. No, no, that doesn't work for me because it's not creating. It's not fun creating for me. I know a lot of people love creating social media content. I am not one of those people, so you'll be seeing a lot of less of that, not saying I'll stop. But you'll be seeing a lot less of that. And if you're like, "Oh, but, Asher, I need your Instagram content." Cool. Pay me. If you pay me money, I will find someone to help me with my Instagram content, and then I'll make more Instagram content. But since you're all getting it for free, that's tough. I'm putting my own needs first. So you'll find me here on podcast, you'll find me once a week in your inbox. If you want a newsletter, I do the No Way Newsletter, and I think it's useful. I don't know. A lot of people have said nice things about it, so you'll get a newsletter once a week like I said, you get a blog, a podcast and a blog a week usually. And you can get a masterclass. If you think, "Oh, masterclasses, I really want to join your masterclasses. I really want to do that." You can join the masterclass membership. And then you have access to the masterclasses. Every, all the masterclasses, every single one of them. Or you could just be like, "I just want a specific masterclass on intracranial, idiopathic, intracranial hypertension or osteoarthritis of the knee, or whatever." And then you can just purchase that masterclass. Otherwise, come, join me in the community, because that's like one of my favorite places to be. We had seeds of joy the other week, and it was so much fun I had such a blast getting to know some of you. Some of you joined the community afterwards and are in the Discord group now, and we're chatting away and making each other laugh and sharing stories and supporting one another. And it was a really beautiful moment where someone just like had to sort of like, you know, had to share something, get something off their chest. And then someone else just came along and the comments was like, "I'm really sorry this is happening. What do you need from us? Do you just need to vent? Do you want support? Do you want some ideas? What do you need?" It was just so beautiful. I was like, this is lovely I really enjoy. I didn't get involved. I was like, "Oh, carry on people. You're so amazing, such incredible community." It's really hard to find a community that is as accepting, I'd like to say, put it out there, as accepting as the Waiting Room. So yeah, why not join that? But yeah, I hope you've enjoyed this episode all about Asher's autism, and then Asher's therapy sessions. And why Asher no longer has a strategy. As long as I can, I will keep doing this because I can't think of what else I want to do. I'm not going anywhere. A friend of mine the other day asked, "Are you stopping? I keep getting the feeling that you're going to stop." I'm not stopping. I'm not stopping. I'm not leaving people. I'm not abandoning people, but I am going to be a little bit more careful about what I invest my energy into, because the last thing I want to do is burn out again like that would be my worst, not worst nightmare. That would be such a shame if I burnt out again. So I'm not going to do that. Thanks for listening next week. I have no idea what we're doing. What we doing next week. Oh, I think we're talking about how weight loss doesn't prevent you from getting sick and extend your life expectancy in any way. Something like that. And I don't have any other plans. I'm not planning ahead because I no longer have a strategy, but I look forward to seeing you next week. Take care, bye.