Divergent Conversations – Episode 143: FLASHBACK — Chronic Health: All Brains Belong (feat. Dr. Mel Houser)

Overview

In this insightful episode, hosts Dr. Megan Anna Neff and Patrick Casale revisit one of their favorite discussions from 2025, bringing back Dr. Mel Houser, founder and medical director of All Brains Belong in Vermont. This episode concludes their “chronic health collection” miniseries by exploring the deep interconnectedness of neurodivergence, chronic illness, and the difficulties faced by neurodivergent people navigating a fragmented and often invalidating healthcare system. The trio addresses lived experience, practical advocacy, the reality of post-exertional malaise (PEM), systemic gaslighting, and the power of reframing through community and knowledge. Dr. Houser shares practical tips and robust frameworks for approaching these intertwined challenges, while all three share vulnerable personal stories.

Key Discussion Points & Insights

1. The Biopsychosocial Model for Neurodivergent Health (03:16–06:49)

• Context: The episode builds on previous, vulnerable personal stories from both hosts about their biopsychosocial journeys with chronic health, including sleep issues, Long COVID, workaholism, and depression.
• Integrated Complexity: They highlight the profound complexity of chronic conditions impacting neurodivergent people—how medicine often fails to recognize or address this complexity.
  • Dr. Houser: “It's not part of medical education. It's not well understood. And… the narrative of, you know, you've got 40 things wrong and it's your fault…” (05:07)
• Pattern Recognition: Megan notes that the biopsychosocial model honors this complexity, mapping out how factors interconnect—psychological, social, physiological.

2. The Failures of the Healthcare System & Gaslighting (06:49–11:46)

• Ping-Ponging in the System: Patrick recounts his exhausting journey through the medical system, from primary care to sleep specialists, neurologists, and functional medicine—ultimately feeling dismissed and misunderstood.
  • Patrick: “...you're bouncing from Provider to provider, and they're just kind of like passing the buck or they're just confused.” (07:38)
• Invalidation & Limbic Responses: Dr. Houser describes how neurodivergent people’s repeated invalidation can trigger entrenched limbic (stress) responses, and underscores the importance of community.
  • Dr. Houser: “...your wise limbic system knows and sounds the alarm and that happens to so many people... connection with other people... you trust your own experience and someone else's appraisal... no longer matters because like it's clear that they're wrong.” (10:19)

3. “All the Things” – Interconnected Chronic Health Problems (12:16–16:57)

• Resource Highlight: Dr. Houser details the "All the Things" framework—a free, practical tool from All Brains Belong designed to empower individuals and facilitate communication with uninformed clinicians.
• Holistic Reframing: Chronic issues in neurodivergent people often represent deeply intertwined medical and systemic problems, and typical treatments for one may exacerbate others.

4. Where Do You Start? Mast Cells, Nervous System, and the “Detective” Approach (16:57–24:27)

• Zooming Out Before Zooming In: Dr. Houser recommends first understanding the overarching patterns in the immune and nervous system—namely mast cell activation.
  • Dr. Houser: “...if I'm reacting to the temperature of the room, well, that would have been a lot easier to change the environment rather than change me.” (19:08)
• Detective Mindset: Finding one’s "triggers" or stressors—environmental, immunological, psychological—can help prioritize interventions.

5. Mast Cell Life Cycle & The Timeline of Change (24:27–29:42)

• Longer Than Diet Trends: Mast cells have a 6-month lifecycle—meaning meaningful symptom improvement from intervention (diet, environment change, etc.) often takes far longer than common advice suggests.
  • Dr. Houser: “...you might make a change. And ... you might still feel terrible for a long time. That doesn't mean that I wasn't on the right track.” (27:26)
• Diet & Negotiations: Eliminating triggers like gluten may not yield immediate results; self-compassion is necessary given the realities of executive dysfunction and restricted diets.

6. Post-Exertional Malaise (PEM) & The Boomer-Bust Cycle (29:42–35:23)

• PEM in ND Populations: PEM is not just for ME/CFS but common post-activity in neurodivergent people. Fatigue crashes can be physical, cognitive, or emotional and are often delayed.
  • Dr. Houser: “So, it's not like, yeah, I feel terrible tomorrow. And then I'll be back at baseline the next day. Like, you might be crashed for, like, weeks... Don't do it.” (31:47)
• Boomer/Bust Vulnerability: ADHD and autistic all-or-nothing thinking, monotropism (“deep focus”) and poor interoceptive awareness all exacerbate cycles of overexertion and crash.

7. Pacing, Baseline, and Executing Self-Compassion (35:55–44:53)

• Finding Baseline: Commit to “half of what you think you can sustain” and stop before symptoms arise, not based on internal cues (which are often unreliable).
  • Dr. Houser: “The baseline is half of what you think you can sustain... and you commit to baseline.” (36:44)
• Privilege Matters: The ability to pace or adjust is often a matter of circumstance, work demands, or caregiving responsibilities.
• Cognitive vs. Physical PEM: Cognitive overexertion can trigger delayed PEM, even after beloved, engaging, or “restorative” deep work.
  • Dr. Houser, on monotropism & PEM: “…There are things that feel really good that will still induce PEM, and that sucks.” (42:00)

8. Accepting Finite Capacity, Deconstructing Ableism (44:06–50:27)

• Capacity is Real: The importance of acknowledging real, non-negotiable energy limits, and moving out of internalized ableism and manic defenses against those limits.
  • Dr. Houser: “...every human has a finite capacity. But if that's what it's going to take, that's where I am right now.” (44:06)
• Escaping the “Broken” Narrative: All Brains Belong and ND communities help shift from “I am broken” to “I am integrated, and community is healing.”

9. Collective Healing & Social Baseline Theory (50:27–53:19)

• “Everything’s Interconnected”: The healing potential of supportive community and collective identity.
  • Dr. Houser: “We are intended to be in an interwoven network of other people. And I think… that's the path to health.” (52:29)
• Social Baseline Theory: Megan shares research confirming that humans, by default, conserve energy and perceive less distress when in social connection, affirming what neurodivergent community spaces intuitively provide.

Notable Quotes & Moments

• Neurodivergence & Medical Gaslighting
  Dr. Houser (06:02):
  “...the neuronormative healthcare system that's still telling all the people that it's their fault, when really this is like a constellation of intertwined medical conditions…”

• Functional Medicine Frustration
  Patrick (09:29):
  “…he said, so you're a high functioning autistic? And I said, well, that's not what I would call myself. And he said, oh, on the spectrum. And I said, no, I also wouldn’t say that… and then the $500 appointment just progressively got worse from there…”

• Limbic Alarm in Healthcare
  Dr. Houser (10:19):
  “...your wise limbic system knows and sounds the alarm and that happens to so many people…”

• Pacing & Baseline
  Dr. Houser (36:44):
  “…The baseline is half of what you think you can sustain... and you commit to baseline.”

• On All-or-None & Burnout
  Megan (32:54):
  “…it's hard when we don't trust our minds. And I think that's part of ADHD. Like, I don't trust that I'm going to have motivation to come back to this. So while I have this wave of energy and motivation, I want to keep pushing...”

• Finite Capacity & Acceptance
  Dr. Houser (44:06):
  “...I truly did not know that I had a finite capacity... every human has a finite capacity. But if that's what it's going to take, that's where I am right now.”

• Social Baseline Theory
  Megan (50:32):
  “...[the research] realized that nothing’s turning on, that our brains are default set to be social, to socialize, to draw resources from other people’s systems... in Western life, we are not accessing something that our brains are assuming is there…”

Resource Highlights (53:19–54:02)

• All Brains Belong Resources:
  • Everything’s Connected Project: Free downloadable tools for autistic/ADHD adults and their clinicians.
  • Brain Club: Free virtual community forum (Tuesdays 6pm ET), with archived sessions available.

Timestamps for Key Segments

• Biopsychosocial recap & context: 03:16–06:49
• Medical system & functional medicine ordeal: 06:49–11:46
• “All the Things” and advocacy tools: 12:16–16:57
• Zooming out: immune system & mast cells: 16:57–24:27
• Mast cell lifecycle and dietary interventions: 24:27–29:42
• PEM and the boomer/bust trap: 29:42–35:23
• Pacing and baseline: 35:55–44:53
• Circular thinking & community healing: 44:53–53:19
• Resource links & Brain Club: 53:19–54:02
• Closing affirmations: 54:02–end

Tone and Style

Raw, conversational, deeply validating, and often humorous. The hosts and guest share in a manner that is “affirmative as hell,” vulnerable, occasionally chaotic, and always community-oriented.
Megan and Patrick balance organizing the conversation with candid moments:

• Patrick: “I want to be perceived right now.” (54:14)
• Dr. Houser: “...thanks for doing that,” referencing the insider jokes and affirmations emblematic to the Divergent Conversations audience (54:17).

Conclusion

This episode wraps up the chronic health collection by centering lived experience, systemic complexity, and community wisdom over medical reductionism. Dr. Houser provides practical frameworks for mapping the “all the things” reality of neurodivergent chronic illness, while Megan and Patrick model compassionate, realistic self-advocacy. Their stories, laughter, and honesty offer both a resource-rich toolkit and a sense that no one faces these challenges alone.