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Module 11 — The Family You Grew Up In Was Neurodiverse Too
The session where the second part of the family-of-origin worksheets comes back, worked as four questions instead of nine pages.
The family-of-origin worksheets have a second part. It asks about a childhood nobody was measuring: what you were like before anyone was looking, who understood you, and what you hid in order to belong. This module is about the session where those pages come back.
What this is about
The title of this module is a claim, and for most couples we work with it is true. Traits like these run in families. If one of you is autistic or ADHD, a parent or a grandparent probably was too, and nobody ever said so.
That person still shaped the house you grew up in.
The rules, what was tolerated, whose mood everyone watched: some of that was a nervous system nobody had a name for.
The supplement. The second part of the family-of-origin worksheets is about that house. It comes after the family drawing and the wound session, and it is optional. It goes out when neurodivergence is already part of your story, when one of you is heading toward an assessment, or when one of you has always felt different and never had words for it.
The pages ask about your family and where the differences show up in it. About your earliest years, your inner life and social life as a child who was different, and what you hid, shrank or performed in order to fit in. You write it alone.
It can open memories that have never been named. You are told that before it is sent.
What happens in the session
Your therapist has read your pages before you arrive, so you are not watching a face while it reads about your childhood. In the room we do not work down the pages. We start with four questions, in this order.
The four questions. 1. Joy. Which of the ways you were different felt like strengths?
2. Who understood. Who made you feel understood, and what did they actually do?
3. The off-switch. Was there anywhere you did not have to perform?
4. Your choice. Which of the hard things on the pages do you want to talk about today?
With the answers, your therapist says the lineage out loud: where your own traits show up in the family you listed. Over time the two of you will go through all of the questions in the supplement, or at least a lot of them. These four are where it starts.
The other pages are not thrown away; they are held for a session that has room for them.
The Supplement Session
1 We start with the fact that you wrote it alone. Your therapist says it out loud: you wrote this by yourself, and some of it looks hard to write. We are not going through all of it today. Nothing is read aloud in front of your partner unless you choose it.
2 Questions one and two: joy, then who understood. Which of your differences felt like strengths? Many people have never been asked. Then: who made you feel understood, and what did they do?
3 Questions three and four: the off-switch, then your choice. Anywhere you could just be however you were? Then the page you choose, which can be any page.
4 What your therapist does with the answers. Says the lineage out loud, with a second half attached so the family pattern does not become an excuse. Then we close before you run out of capacity.
If you are the partner listening, this session is not about you. Around page four you may think, wait, this is me too. Say so. It gets its own session, not twenty minutes of somebody else’s.
Joy. Before we go anywhere near what was hard: which of the ways you were different felt like strengths? Which of them brought you joy?
Who understood. You named somebody who made you feel understood. What did they actually do? Not who they were. What they did.
The lineage, both halves. This clearly runs in your family. You were not the first one. You were the first one to have a name for it. And the other half, so it does not get misused: this is what you inherited, and it is still your relationship to run.
The off-switch question
The worksheet assumes home was where the mask came off. For many people it was. The answer that matters most is the one where it was not. It usually comes with a person attached: the parent whose mood the household ran on, the sibling who mocked. Often that parent was the one nobody identified.
A person who has never had an off-switch anywhere will not have one in this marriage without something changing on purpose.
So if the answer is nowhere, your therapist will say so. If the answer is somewhere, that place is the model: what made it safe, and can any of that be built here?
By the standards of the people we work with, one room where the mask came off counts as a good childhood, and no room at all is more common than the page expects.
Some pages come back mostly blank, especially the questions about your earliest years: late to talk, late to walk, a stretch when things went backwards. That is not avoidance. I don’t know is a complete answer, and better than a guess. Your therapist will ask who might know instead: a parent, an older sibling, a baby book, a school report.
The way this goes wrong. The parent phone call goes wrong in a predictable way: the parent hears an accusation, because for that generation a question about early development is one. So say why before you ask: I am trying to fill in some things I was too young to remember. Nothing is wrong. I just realized I don’t know. Get what you can, stop when it turns, and bring what happened back to the room.
Why we do it this way
The first page asks who in your family was neurodivergent, and most people cannot answer it about anyone over fifty. That is not a hole in your memory. It is a hole in the record. In England, researchers estimate that about two in three autistic people have no diagnosis at all.1 Two researchers named the whole group in a title: the lost generation.2
In family language, those relatives survive as character, not condition. So the family page asks what a child could have seen.
What they were called: difficult, highly strung, the one with nerves.
What a child saw: what she could not stand, what he did at the same time every day.
Children today get a name for it and their grandparents almost never did, so the blank next to your grandmother is a fact about the record, not about her.
The frame we are building is lineage, not flaw.
Thousands of neurodiverse couples have told us that the sentence something is wrong with me was written in childhood, and often not by a parent. Being bullied at school is close to routine for autistic children.3 Passing as typical is its own route to that belief, and it never needed anyone to say anything unkind.4
Why joy comes first. In the research, feeling accepted by the people around you goes most with doing well now.5 That is why the joy question opens the session and the who-understood question gets protected time. What that person did is usually small and specific, and something your partner could do now.
When a person finds one of their own traits in two more relatives on the family page, something in their posture changes.
Something is wrong with me.
This is what my family is.
We are careful how much we expect of that moment. Knowing sooner has not been shown to fix anything by itself. What the research points at is whether the people around you accepted it, and this room can change that.
Why there is a second half. It runs in the family says where a trait came from, and nothing about what happens next. A partner who turns it into a reason nothing can change has taken the wrong thing from the session. So your therapist says the second half in the same breath as the first.
After the session
The grief lands late. Putting together a childhood nobody witnessed produces a specific grief: for a child nobody understood, and often for the adult life that would have been different. It arrives days or weeks after the session, and it does not look like sadness. It looks like flatness, irritability, or a sudden conviction that the therapy is not working.
Now you both have a word for it, and your partner will not read it as a relapse.
The workbook below is for the week after, not the session: the four answers as you would give them now, one question for the partner who found themselves on the pages, and how it has landed a few days on. If either of you ever pursues an assessment, these pages are the history an assessor needs, already gathered. That is never the reason for the session.
Before you go on. The next module, Competing Sensory Needs, Then and Now, has its own worksheet. It is optional, like all of these. But if sensory issues were significant in the family you grew up in, we strongly recommend doing it.
The one thing, if that is all you have. If the pages are more than you have this month, answer the joy question and the who-understood question and send those. Two answers is a complete return.
Your workbook
Your answers save to this device only - we cannot see a word of what you write. This one is for the week after the session, not the session itself.
The four questions, as you would answer them now
A week later the answers are often different from the ones in the room. Nobody sees these unless you bring them.
Which of the ways you were different felt like strengths, or brought you joy?
Who made you feel understood, and what did they actually do?
Was there anywhere you did not have to perform, anywhere you could just be however you were? — Yes, and I can name where, Somewhere, sort of, Nowhere, I have never thought about it before
If yes: where, and what made it safe
Seeing your traits as part of a family pattern rather than a personal flaw: — Changed how I see myself, Changed it a little, Did not change anything, I do not see the pattern, Too early to say
If you were the partner listening
One question, and it is the one people do not say out loud.
Somewhere on those pages, did you find yourself? — Yes, Maybe, No, I would rather not say yet
A few days on
Fill this in a few days after the session, not the same evening.
A few days on, how has it landed? — Fine, Flat, Short-tempered, Sad, Relieved, Convinced this is not working
Whatever it is, one line about it for the next session
Where this comes from
Every source below was checked against the published record. They are grouped by the kind of evidence they are, so the numbers may not run straight down the page — a number points back to where the source is used in the lesson.
Research discussion
Nothing on the nine pages is a validated instrument. It is a structured way of putting together an account of a childhood, kept in three kinds of ink: what you remember, what someone can confirm, and what nobody knows. The studies behind this module support the reasons for the questions, not the questions themselves.
The undiagnosed figure comes from prospectively collected English primary-care records for one year, which is about as clean as this kind of count gets.1 The caution is geographic: it describes one country’s record-keeping. The lost-generation framing is a review, cited for the idea.2 That undiagnosed relatives survive in family language as character rather than condition is our observation, with no study behind the vocabulary.
The bullying figure is pooled across seventeen studies, and the path from being bullied to a core belief is plausible rather than demonstrated.3 The camouflaging study is ninety-two people describing their own experience; it says what passing can cost, not how common the cost is.4 The acceptance study is one survey of 111 adults at a single point in time, so the direction is not established; it is quoted for the size of the association.5
The study
Autism diagnoses in England, by age, in one year1
Who this research was done with. The couples studies behind most of this module drew heavily on white, comparatively well-off, English-speaking participants. If your household carries pressures those samples did not — money, immigration, racism, disability, unsafe housing — the practice still applies, but the room you are practicing in is harder. That is the room, not you.
Peer-reviewed research
1. O'Nions E, Petersen I, Buckman JEJ, Charlton R, Cooper C, Corbett A, Happe F, Manthorpe J, Richards M, Saunders R, Zanker C, Mandy W, Stott J (2023) Autism in England: Assessing underdiagnosis in a population-based cohort study of prospectively collected primary care data. The Lancet Regional Health - Europe, 29, 100626. https://doi.org/10.1016/j.lanepe.2023.100626 Population-based cohort using prospectively collected English primary-care records. Diagnosed autism prevalence in 2018 was 2.94 per cent among 10-14-year-olds and 0.02 per cent among those aged 70 and over. The authors estimated that between 435,700 and 1,197,300 autistic people in England were undiagnosed, 59 to 72 per cent of the autistic population. Limitation: one country's record-keeping in one year; the undiagnosed estimate depends on assumptions about true prevalence, which is why it is a range.
2. Lai MC, Baron-Cohen S (2015) Identifying the lost generation of adults with autism spectrum conditions. The Lancet Psychiatry, 2(11), 1013-1027. https://doi.org/10.1016/S2215-0366(15)00277-1 Review article naming and characterizing the cohort of adults who reached adulthood before autism was widely recognized and who remain undiagnosed or misdiagnosed. Limitation: a review, not a study, and cited here for the framing rather than for any figure.
3. Maiano C, Normand CL, Salvas MC, Moullec G, Aime A (2016) Prevalence of school bullying among youth with autism spectrum disorders: A systematic review and meta-analysis. Autism Research, 9(6), 601-615. https://doi.org/10.1002/aur.1568 Systematic review and meta-analysis of 17 studies of school bullying among autistic children and adolescents. Pooled prevalence of general victimization was about 44 per cent, and of verbal victimization about 50 per cent. Limitation: prevalence figures pooled across studies with different measures and settings, and the path from victimization to a later core belief is plausible rather than demonstrated by this study.
4. Hull L, Petrides KV, Allison C, Smith P, Baron-Cohen S, Lai MC, Mandy W (2017) 'Putting on my best normal': Social camouflaging in adults with autism spectrum conditions. Journal of Autism and Developmental Disorders, 47(8), 2519-2534. https://doi.org/10.1007/s10803-017-3166-5 92 autistic adults described in their own words why they camouflaged, what it consisted of, and its consequences, analyzed thematically into a three-stage model: motivations (fitting in, connecting with others), techniques (masking and compensation), and consequences (exhaustion, challenging stereotypes, and threats to self-perception and identity, including feeling fake or losing a sense of self). Limitation: a qualitative study, so it describes what camouflaging can involve and cost; it cannot say how common any of it is.
5. Cage E, Di Monaco J, Newell V (2018) Experiences of autism acceptance and mental health in autistic adults. Journal of Autism and Developmental Disorders, 48(2), 473-484. https://doi.org/10.1007/s10803-017-3342-7 Survey of 111 autistic adults measuring perceived acceptance from others, personal acceptance of their autism, and depression, anxiety and stress. In the regression model, external acceptance and personal acceptance together predicted 52.1 per cent of the variance in depression scores. Limitation: cross-sectional, so the direction of the relationship is not established, and a single self-report sample.
A childhood nobody was measuring, taken seriously
The Neurodiverse Couples Counseling Center works with couples where one or both partners are autistic, ADHD or AuDHD. The neurodiversity supplement is read before you arrive and worked as four questions, and nothing you wrote is read aloud unless you choose it. Therapy for clients in California, coaching worldwide, all by telehealth. A first conversation costs nothing.
Up next
Module 12 — Competing Sensory Needs, Then and Now