“Who’s the Problem Here?” Family Role Scripts in Neurodiverse Households
Thursday, June 12, 2024.
In neurodiverse families, the first person to be diagnosed—whether with ADHD, autism, OCD, or another difference—often becomes the center of a quiet, gravitational pull.
It might be a child with sensory overwhelm. A teen who shuts down when routines are disrupted. A partner who leaves trails of unfinished projects. Or a parent who spent their entire life trying to “just act normal” without realizing why it never worked.
Diagnosis can bring enormous relief.
But too often, it also sets the emotional script in motion: This person is the fragile one. The rest of us organize around that.
Therapy can disrupt that narrative—and offer a more honest, shared human story.
The Neurodivergent as the Designated Symptom-Bearer
In many families, someone becomes the Designated Patient—the person whose struggles make everyone else’s stress make sense.
In neurodiverse families, this dynamic often becomes baked into the emotional economy:
The autistic child becomes the reason everything is so hard.
The ADHD partner becomes the person who can’t be trusted with anything.
The OCD parent becomes the one we tiptoe around.
But as systems thinkers know: when one person holds all the "problems," everyone else avoids their own.
This isn’t just unfair—it’s inaccurate. Neurodivergence doesn’t happen in isolation. It happens within relationships. And sometimes the “problem” is the emotional labor arrangement, not the neurology.
Role Rigidity and the High Cost of Masking
Neurodivergent family members often learn early that their true selves are inconvenient. So they mask—hiding stimming, scripting conversations, suppressing overwhelm.
Over time, this becomes their role:
The ND teen who never protests.
The autistic spouse who hyper-analyzes every social cue.
The ADHD parent who turns into a control freak just to avoid criticism.
But masking is not free. And when the masked finally show need, the system often resists.
“You were always so easy.”
“Why are you making this about you?”
“We’ve done so much to help—what more do you want?”
This is how invisible roles become prison cells.
What About the Quietly Neurodivergent Parent?
Many ND family members remain undiagnosed—especially parents who were just labeled “shy,” “sensitive,” “difficult,” or “scatterbrained.”
In session, they fixate on helping their “difficult” child—meanwhile, they avoid eye contact, struggle with transitions, or chronically forget appointments.
A gentle, reality-altering question:
“Is it possible your child’s diagnosis is a clue to something you’ve lived with, too?”
Sometimes therapy isn’t about helping them manage their child—it’s about helping them reclaim themselves.
What Family Therapists Can Do: 5 Practical Interventions
1. Normalize Role Injustice
Explain how emotional labor is unequally distributed in families—especially when someone is visibly struggling.
Try:
“What if this isn’t one person’s burden, but a system trying to keep balance through unfair means?”
2. Contextualize Behavior, Don’t Pathologize It
Help families ask:
Where does this behavior make sense?
What stressors exacerbate it?
How do we respond—versus react—to it?
Shift from blame to understanding.
3. Invite Conversations About Masking
When clients reveal masking behaviors, validate them. Then ask:
“When did you learn you had to hide?”
“What would feel safer to share now?”
Create experiments in safe unmasking—with scaffolding.
4. Map Emotional Labor
Visually chart who:
Soothes others
Gets comfort
Holds the chaos
Gets to be messy
Gets shamed for it
Then invite the family to co-create a more equitable distribution.
5. Expect System Pushback
When one person changes their role—especially their problematic role—the system destabilizes.
Warn families in advance:
“This might feel uncomfortable. That’s a sign something is shifting—not failing.”
Case Vignette
Ella, 13, has an autism diagnosis and daily post-school meltdowns. Her parents are exhausted. They call her “high-maintenance” and “too much.”
But in session, we see:
Dad flinches at noise, eats the same four foods, and never joins group outings.
Mom was a parentified child and now manages everything with zero help.
Ella’s meltdowns aren't the problem—they’re the signal.
The real work isn’t about fixing Ella. It’s about deconstructing the family’s unspoken rule: Ella will carry the chaos, so we don’t have to.
What If Nobody’s the Problem?
In neurodiverse families, the one who shows symptoms often holds the weight of everyone else’s unmet needs.
Family therapy can offer something radical:
Not just relief.
Not just coping.
But liberation from the roles no one consented to.
Neurodivergence is not a flaw to be managed. It’s a part of the system’s natural diversity—and a cue to rethink how we assign emotional labor, visibility, and worth.
Let’s Rewrite the Contract—Together
If you're a family therapist:
→ Start mapping emotional roles early.
→ Speak to masking with tenderness.
→ Make space for everyone—not just the “easy” or “urgent” ones.
If you're part of a neurodiverse family:
→ Ask: Who holds the mess?
→ Who gets to need help?
→ What would it feel like to be fully seen?
Ready to explore these questions in your own work or home? Reach out and start a conversation with me.
Because no one should have to hold the whole system just to belong.
Be Well, Stay Kind, and Godspeed.
REFERENCES:
Brown, A. E., Bross, L. A., & Rothman, M. (2021). Understanding communication breakdowns in neurodiverse relationships. Journal of Autism and Developmental Disorders, 51(4), 1252–1264. https://doi.org/10.1007/s10803-020-04641-0
Cridland, E. K., Jones, S. C., Caputi, P., & Magee, C. A. (2014). Family-focused autism spectrum disorder research: A review of the utility of family systems approaches. Autism, 18(3), 213–222. https://doi.org/10.1177/1362361312472261
Minuchin, S. (1974). Families and family therapy. Harvard University Press.
Nichols, M. P., & Davis, S. D. (2020). Family therapy: Concepts and methods (12th ed.). Pearson.