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Module 11 — The Family You Grew Up In Was Neurodiverse Too
The Neurodiversity Supplement session, step by step: who in your family was wired this way, what it was like to be you, and what your therapist does with those pages.
The family-of-origin worksheets have a second part, the Neurodiversity Supplement. It asks about a childhood nobody was measuring: who in your family was wired the way you are, who understood you, and what you hid to belong. This module walks through the session where those pages come back, in the order your therapist takes them.
The Supplement, in the order we take it
Summary: what happens in the session
1 Written alone, opened together. Nothing you wrote is read aloud unless you choose it.
2 The family table. Who was wired this way, and what you actually saw them do.
3 The early years. What was true before you can remember, and who might know.
4 Your inner life, joy first. How your thoughts and feelings were different from everyone else’s.
5 Your social life, and who understood you. What being different cost, and the one person who got it.
6 Diagnosis. Any word you were given, and what you made of it.
7 Masking at home. What you hid to belong, and whether there was anywhere you did not have to.
8 Your lineage, both halves. Your own traits, found in the family table, and what that changes.
Not a form to work down. Your therapist chooses the questions that matter most for you, and over a few sessions that can be most of them.
Step 1. Written alone, opened together
The Supplement is optional. Your therapist suggests it when neurodivergence is already part of your story, and warns you first that writing it can open memories not yet named. You fill it in on your own.
How your therapist opens. You did this by yourself, and I have read all of it. I will not read any of it out loud. Your partner hears what you choose to say.
Why we do this together, not alone. Most therapy about childhood happens one to one. We do it with your partner in the room, on purpose. Your partner gets to understand the wounds you carried into the relationship, and to see, often for the first time, how those wounds shape what happens between the two of you. Then the two of you have a chance to find a healing path together, rather than one of you doing it alone.
That only works if it is safe for your partner to hear it. Making sure that safety is in place is your therapist’s job, not yours. If it does not feel safe yet, say so, and we will work on that first.
The gauge is what people expect. The ledger is what the pages actually produce.
Step 2. The family table
Neurodivergent traits run in families. A parent or grandparent was probably wired this way too, and nobody said so. That person still shaped the house you grew up in.
The first page is a table: who in your biological family, what kind, whether it was diagnosed, self-identified or suspected, and what you actually saw. Your therapist works from that last column.
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.
If the top of the table is blank. Most people draw a blank on anyone over fifty. That is a hole in the record, not in your memory. In England, about two in three autistic people have no diagnosis at all,1 a group two researchers named the lost generation.2
The family table. Your grandmother, the one everybody called highly strung. Whatever she was called, what did she actually do?
The tall bar is children. The one you can barely see is their grandparents.
Step 3. The early years
Six short questions about the time before you can remember: the birth, when you talked and walked, whether things ever went backwards. These come back mostly blank, and that is not avoidance.
I don’t know is a complete answer, and better than a guess.
The early years. Most of this page is empty, which is honest. Who might know? A parent, an older sibling, a baby book?
The way this goes wrong. The parent phone call goes wrong in a predictable way: the parent hears an accusation. So try saying why first: I am filling in some things I was too young to remember. Nothing is wrong. Stop when it turns, and bring what happened back to the room.
Step 4. Your inner life, joy first
Three questions: how you were different, when you first noticed, and which differences felt like strengths or were treated as weaknesses. Your therapist takes the strengths first, every time.
Why joy comes first. It is the question people skip, at the kitchen table and in most therapy rooms. The answer is often the first good thing a person has said out loud about how they are wired.
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?
Step 5. Your social life, and who understood you
Nine questions about your social life as a child who was different: shamed or bullied, what it did at home and at school, how you coped, whether it still hurts. Most of them ask what went wrong.
Where the sentence was written. Thousands of neurodiverse couples have told us that something is wrong with me was written in childhood, and often not by a parent. Close to half of autistic children are bullied at school.3 Passing as typical is its own route to the same belief, with nobody saying anything unkind.4
One question asks who made you feel understood, and how. That one gets protected time: feeling accepted by the people around you goes with doing well now.5 The answer is usually small and specific, and often something your partner could do.
Who understood. You named somebody who made you feel understood. What did they actually do? Not who they were. What they did.
You can always say it. If any of this starts to feel like too much, you can say I am uncomfortable. That is a complete sentence. Nobody has to explain it or defend it. We stop, we look together at what is happening, and we decide as a group whether to stay with it or to understand first what is getting in the way.
Some of these answers have not been said to anyone before. If one of them is too much today, the words move it to another day. Nothing is lost by waiting.
Step 6. Diagnosis
A short table for anything you were diagnosed with, identified in yourself, or suspect: the age, who said so, what you thought at the time. A nine-year-old given a word and not what it meant often concluded something was wrong with them. That conclusion is usually still running.
Diagnosis. When they gave you the word, what did you think it meant?
Step 7. Masking at home
The last page asks what unspoken rules you followed to be accepted in your own family, and what you hid or performed in order to belong.
The page assumes home was where the mask came off, and often it was. When it was not, that is the answer that matters most. It usually has a person attached: the parent whose mood the household ran on, often the one nobody named.
The off-switch. Was there anywhere you did not have to do it? Anywhere you got to just be however you were?
A person who has had no off-switch anywhere will not have one in this marriage without something changing on purpose.
Five rooms with the mask on and one with it off is, by the standards of the people we work with, a good childhood.
Step 8. Your lineage, both halves
The final question asks you to find your own traits in the family table. When a person finds one of theirs in two more relatives, something in their posture changes.
Something is wrong with me.
This is what my family is.
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: it is still your relationship to run.
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. Your therapist closes before capacity runs out; whatever is left on the pages keeps.
After the session
The grief lands late. Putting together a childhood nobody witnessed produces a specific grief, for a child nobody understood. It arrives days or weeks later, as 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: the questions that mattered most, as you would answer them now, and how it has landed. If you were the partner listening and thought, this is me too, say so. It gets its own session, not twenty minutes of somebody else’s.
Before you go on. The next module, Competing Sensory Needs, Then and Now, has its own optional worksheet. If sensory issues were significant in your family, we strongly recommend 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. 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 questions that mattered, 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, we start with joy and who understood you, 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