I am an 18-year-old autistic person with complex mental health issues, including addiction, which I am seeking treatment for.

I’ve been forced to do a lot of introspection as part of trying to get sober, and something that has come up for me is the pressure I’ve felt of being the “good girl” when I was a child.

I was very book-smart and well-behaved; I feared getting in trouble. As such, teachers fawned over me as the “perfect student”, even as it became obvious that I was massively struggling socially and was deeply depressed. It was only in my early teens when my mental health issues started affecting my attendance and grades, that any adults in my life really acknowledged that I was struggling. Even then, this came across as disappointment that I wasn’t “living up to my potential”, rather than genuine concern for my wellbeing.

I feel deeply resentful of the “good girl” label being used to dismiss all my problems, and I think that this has contributed to some unwise decision-making in more recent years (abusive relationship, drink, drugs) in part to prove that I was not going to take the path in life that they imagined for me.

I don’t know how to break free of this cycle. I don’t want to be the good girl. But I also don’t want to destroy myself with bad decisions in an attempt to prove them wrong. I don’t know how to find balance.

I’m so sorry for everything that’s happened. Your letter was full of such insight but I was astonished that there was just one mention, in passing, of your parents. Where are they in all this? You are technically an adult, and maybe to them you became one a long time ago. But it’s clear you needed, and need, emotional support.

I went to Association of Child Psychotherapists-registered child and adolescent psychotherapist Graham Music, who is very knowledgable and experienced in matters of child mental health.

Is it possible you could go back to whomever diagnosed you with autism spectrum condition (ASC) to ask if there is some specialised support for you? And who is helping you with your addictions? I have put some links below for you in case they are useful.

Music explained that with ASC “you can get more overwhelmed by sensations than neurotypical people, there can be less processing capacity so it’s harder to ‘make sense’ of things.”

Someone shouting at you becomes terrifying noise (rather than, actually the other person unable to control their temper, say.) “The tendency then,” says Music “is to withdraw.”

None of this in anyway excuses what the adults around you were doing and none of this excuses the neglect.

“My heart really goes out to you,” said Music, “you’ve been suffering silently for such a long time, it seems that the child you were was ignored in order that they – teachers and parents – could have a precocious, brilliant student. That’s a high price you paid”.

Big feelings, if you are not allowed to really know and feel them, and feel OK about having them, well they don’t go away. They go inwards and can be turned towards ourselves, especially anger. Music thought it seemed in the absence of anyone to see through the carapace of “good girl” to how you really felt, you learned that you could only really rely on yourself. We should learn how to make ourselves feel safe via the people around us, and they should help us regulate and process our feelings. Music wondered if anyone has ever had your back – someone who understands neurodiversity, but also someone you can be vulnerable with.

You ask a very good question, how to find balance. It seems you’ve learned that you’re either the good girl, or your rebellion takes on an extreme, self-damaging form. There’s the middle ground where you get to define yourself, not let others do it for you.

“You need to find a context, which could be therapy, where your feelings – including those of anger and despair – are taken really seriously in a way that you can own them and feel OK about being that person,” said Music.

You have a lot to be angry about. Just not at yourself.

Music felt your defiance was a really positive sign. You’re rebelling. That’s good. You just need to learn, with some help, that doing the opposite of what those around you want, “proving them wrong”, isn’t the way forward if the way you do this is self-harming, as that repeats the neglect of your real needs that you experience earlier. Doing this, is not only harmful to you, but it’s still, in a way, letting others dictate how you behave.

Further advice about autism, substance misuse and young people’s mental health can be found at autism.org.uk, youngminds.org.uk, psychotherapy.org.uk and childpsychotherapy.org.uk

Every week, Annalisa Barbieri addresses a personal problem sent in by a reader. If you would like advice from Annalisa, please send your problem to [email protected]. Annalisa regrets she cannot enter into personal correspondence. Submissions are subject to our terms and conditions.

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