by Momo

It was the first and only time that I saw a psychiatrist. On a sunny afternoon in December 2023, I entered the psychiatric hospital and joined the queue with several indifferent adolescents and their anxious mothers. There was no window in the corridor. Everyone was scrolling their phones under the pale artificial light. I was glad that no one was paying attention to me. I was too old for this department for developmental disorder, yet I had no children to take here. “No, she can’t go to school yet,” a mother spoke on the phone with a low voice. I guessed I looked like a tourist who was looking for a toilet but wandered in here by mistake.

And then it was my turn. I entered the room. It was nice to see that there was a large window. The sun was shining through the crowns of trees, lighting up the room with a warm tone. Yet the psychiatrist behind the desk looked so tired. I was only the second patient in the afternoon.

"I wonder if I have ASD." I said.

She seemed surprised. She briefly verified my request – no, I was seeing her for myself, not for my non-existent children - and she let me tell her my story. I started my monologue that had been rehearsed countless times in my mind:

My mother kept telling me that I was different since I was a toddler. I started to talk too early and learnt to walk too late. Rode skipping and radio exercises at school were very difficult for me. I was always the last one to know about the gossip in my class. Holidays drove me mad, because I couldn't hold on to my daily routine and had to meet my family. I didn’t know how to get along with them, because we had no common interests. Nor did they enjoy talking to me. I saw the same weirdness in my father. I thought I probably had depression when I was in college, but at that time I had no idea who to turn to. I could speak four languages and a dialect, even though I had no experience of living abroad. I always thought about what to say in detail beforehand, like that day. And so on.

The psychiatrist patiently let me finish my talk show, then she asked me a few questions. Finally, she said: "You seem to have some autistic traits, but you are doing well, right? I won't give you a diagnosis, but remember, I’m not denying your self-diagnosis either. I'm just not drawing a conclusion."

“In addition,” she added, “if you want to have children – I mean it’s okay if you don’t – no worries, okay? The children of ASD parents are not bound to have ASD traits. And if they do, you already know how to deal with that.”

I thanked her and left the room. Before the visit, I have read numerous stories about how people feel after getting a diagnosis, and another one about being excluded from the diagnosis. I had thought that as opening the box of Schr?dinger's cat: the psychiatrist would tell me if I had autism spectrum disorder (ASD) or not. Yet inside the box was just another box.

If I insisted, the psychiatrist said, she could prescribe a diagnostic test. She told me the price, and I gave up. “The test won’t guarantee you a diagnosis,” she nodded in agreement, “and even if you do get one, there is no treatment for ASD itself. I think you might already know that.”

She was right. I did a lot of research before meeting her. According to a friend who is a counselor, I won't get a diagnosis unless I also have depression or anxiety and must be treated with medicine. And in that case, the psychiatrist will have to inform the community where I live, so that I can be placed under constant surveillance, along with those "retards and maniacs", another friend warned me.

They wondered why I wanted a diagnosis. The short answer was that I wanted the magic spell “it’s not your fault”.I had gone through sessions of psychological counseling to figure out whether I was as terrible as my mother described. And I had done every online test I could find, just to make sure that if I seemed indifferent, that was because of my genes or neural pathways. Finally, I needed someone professional to check the results.

I wanted a permit, so that I could talk about my feelings without feeling guilty for being different. But it’s not easy to find a proper term to talk about the condition. Asperger's syndrome is a popular tag on social media, referring to geniuses with a weird temper. However, it is no longer a valid diagnostic term and has been reclassified within ASD, while some psychiatrists are still making the diagnosis, including the one I met. The term "high-functioning" autism is also controversial and discriminatory, suggesting that those with severe learning disabilities are “l(fā)ow-functioning”. In fact, it looks like something written on the label of some electric device.

ASD is the mainstream diagnosis, yet it might cause confusion between those with minor social problems with those who need much support in their everyday life. Although the diagnosis is classified into 3 levels based on the severity of the symptoms and the support needed, those terms are little-known. Personally, I prefer “people with autistic traits”. Everyone without the diagnosis of ASD shares some of those traits, the psychiatrist told me.

And one doesn’t have to gather every trait to be “qualified” as a patient. In other words, there is significant individual variation in symptoms and severity among ASD patients, and that’s why it is called a spectrum. The question is: where is the boundary between neurotypical and ASD? And which side do I belong to?

“You’re learning fast. Faster than most of my students,” my mother said with a large smile. She taught math at a primary school. I was five and a half years old, and she was ready to send me to school for the second grade. At that time, stories of educational experiments and genius Chinese students entering Ivy league school were circulating on newspapers and magazines. As the new century came, the book Havard Girl was published and became a bestseller. Although it did not appear on the shelves of the small bookstores in our small town, my mother read the story in a magazine: by rigorous education and detailed planning, the authors successfully raised their daughter to be accepted to Harvard University.

My mother had thought about homeschooling, only to find that she couldn’t teach me English. And I couldn’t learn from radio tapes alone either. But her efforts were not entirely in vain. As I could read the headlines of newspapers and do some math, she decided that I could skip kindergarten and the first grade. Unfortunately, I failed badly in Chinese class. It turned out that I was just remembering the pronunciation of Hanzi without understanding what they meant. And I developed myopia. I had to take a year off before entering third grade.

That was fine, I was still a year younger than my classmates. Do the right thing at the right age, says Chinese wisdom. And according to my mother, it would be even better to get there earlier.

“You’ll be able to enter university at 17 and get a bachelor’s degree at 21. Or a master’s degree at 23. But no doctor’s degree, no. There’s a good chance you’ll meet someone in college and get married at 25, so that you can have kids before 30. Then I’ll take care of them, and you’ll focus on your work. Perfect.”

I still remember the day she said all that to me. I was in high school, the best one in our small town. She was chopping up chicken in the kitchen, and I was eating an apple by the door to the balcony. She told me how to tell if the chicken was free-range and then let me get back to my homework. She just wanted to make sure that I knew how to be a good wife and mother in the future, but I didn’t have to help out for the moment. I had a more important task, which was to study. “That’s all she could do. She’s such a nerd.” she always said when people praised me for getting good grades in school.

And I hated being young. I was not allowed to hang out with my friends. “You look like a child. You can’t walk down the street alone.” I could easily be kidnapped, or I would have to pay extra money to buy the same thingbecause I didn’t understand the world, she warned me. Before family gatherings, she would always tell me what to say, like a rehearsal before a performance: don’t forget to say hello as soon as you see your aunt; tell them your latest success; if you don’t want any snacks, don’t be rude, just say that you are full. She wanted to make sure that I could be polite and sweet.

I didn’t want a rehearsal. I hoped to have the same privilege as my father: to be the last to arrive and the first to leave. No small talk.

My father was an outpatient doctor. As far back as I can remember, he worked Monday through Sunday, hardly taking a day off until he retired. He worked so hard to get the overtime pay, my mother said. Besides, he had no hobbies and no friends to meet with. Occasionally, he played cards on an online platform.

Now that I’ve got a career of my own, I realize that working seven days a week does not necessarily mean working hard. Sticking to a routine makes me feel at ease. In fact, the insistence on routine is listed as an autistic trait. It has some inherent relation with repetitive and compulsive behavior. And working is much easier than meeting my family. I could never hold on to those conservations about who had a dispute with whom, and how another person thought about them. I try to play the role of an anthropologist, but I keep drifting away. Gossip seems like a foreign language that I could never understand. Even worse, they might turn to me at any time.

“Do you want some peanuts?” No. Usually I have no appetite on such occasions. I have a sensitive taste and prefer familiar food. “Be good. Just eat something.” My mother said when I was a child, “I’ve never seen anyone like you. Normal children crave snacks. When I was your age, I was always hungry. I never missed anything people offered to me.”

Sensitive taste (or other senses) is another common trait among people with ASD. When I eat a croissant, I can tell whether it contains shortening or is made with pure butter. If the fruit is bruised or the peanuts are stale, I would notice immediately. But as a child, I couldn’t explain why I didn’t want any snacks. My mother found another plausible explanation: “You are as picky as your dad.”

Indeed, I have much in common with my father. But we get very different comments from her for the same traits. My father hates eating out. “He is so faithful to my cooking.” He is ineloquent and sometimes seems rude. “He is an honest man who never uses fancy language.” He looks ten years younger than his real age. “That’s because he has nothing to worry about. I’m taking good care of him.”

When I first realized those double standards, I was confused. I had been trying so hard to hide those peculiarities. When I visited someone for dinner, I always paid compliments while eating little. Although my mother stopped telling me what to say (well, not entirely), I prepared myself for family gatherings by thinking out certain topics and phrases beforehand, such as answers to questions like “Why are you leaving so early?”. For once, I had my hair permed to look more mature. It felt like I had stepped on a stage by mistake and there was no exit, so I had to perform in a play without a script in my hand while everyone else had one was having it. Then I saw my father improvising at ease. There is no one in the audience, because we are all on stage.

Now looking back, I see a desperate wife trying to prove that she was doing a good job, and an anxious mother preparing her daughter for the same role in the future.

Women with autistic traits are better at masking behaviors, because we have to conform to societal expectations of what someone’s daughter, wife, and mother should look like. Most women would recognize their own condition only after having children. I’m lucky enough to get to this point earlier, so that I can choose not to become a mother. If there is a Peter Pan living inside my heart, I will never be ready to rear another child.

And I wonder why Peter Pan is a boy. I want a Petra Pan.

Autism is perceived as a very masculine condition. Autistic traits include strong interest in STEM fields, difficulties in reading and responding to the emotions of others, and so on. When a man fails to show interest or empathy at the right time, “boys will be boys”, people say. Stories about nerds often depict a male scientist or engineer who is respected for his genius, and his social awkwardness makes him even more adorable. I wonder how much talent is needed to make people tolerant of me. My father spent his career as a dedicated physician, and his free medical care for the family offset his estrangement. I used to be a good student who made my mother proud, until I started to deviate from the path she had planned for me in my sophomore year.

“You should be an engineer. You’ll get a stable job right after graduation,” my mother said. I was doing well in English, that would provide me a better chance to study abroad. Liberal arts majors were for those who couldn’t do well in math, she said. When I told her that I had started to translate and write some articles for a popular science magazine, and that I wanted to be a journalist in the future, she yelled at me: “Stop being childish! You can’t just do whatever you want! You’re spoiled!”

She kept telling me how disappointed she was. Things began spiraling out of control. When I saw her number or dozens of unread messages on the phone, I couldn’t breathe. I started to have trouble concentrating in class and dropped from the top 10 in my grade to the bottom. Even daily tasks like eating on time started to become challenging. My teachers wondered why. I couldn’t remember what I told them. Memories of the last two years in university faded like a fuzzy dream. Those days were so disturbing that my brain just sealed them somewhere in the unconscious mind, the iceberg underwater.

But there is a vivid scene remaining in my mind. One afternoon during the summer vacation, most students had gone home, but I wanted to stay. It was so quiet on the campus. I was walking up the stairs to my dormitory on the 6th floor, with an iced latte in my hand. Then the disposable cup slipped and dropped to the ground. Splash. The creamy brown latte gently spread on the ground and dribbled over the edge of step. Ice cubes stood among the liquid like mini glaciers, making tiny squeaking noises as they melted and cracked. As I stood there alone and felt all this, I gradually woke up from my sleepwalking and returned to the present. I heard my inner voice saying: “You can’t go on like this.”

I decided to take a year off for an internship in the media. Then I dropped out. I knew it was not a good choice, but that was the only way to save myself. I’m still not sure whether that was depression. There was a counseling office at school, but I had no idea what it was for. A friend I met online kindly suggested that I see a psychiatrist, but I didn’t get the point. I started counseling only after landing a job in another city, far away from the university and my hometown. In the next few years, I kept asking myself: was that because of me or my mother? Or some elusive neurotransmitters, pathways, and genes?

People with ASD are more likely to have depression, anxiety, and attention deficit hyperactivity disorder (ADHD). All those conditions can be treated with medication, except ASD itself. Autistic children can be treated with behavioral training, though. However, if there was a magic bullet that could make me outgoing and cheerful, would I choose to take it? What could it do for me?

Perhaps I would get better grades in oral exams for not talking like a robot. I could add more variations to my voice as every language teacher I’ve met has instructed. And that’s all I can think of. It is hard, if not impossible, to imagine what it would be like to be someone else. Besides, some autistic traits are not without merit. I read faster than most people. I can easily concentrate on a task that I’m interested in. And when I eat something good, I can fully appreciate its complex aromas and flavors.

If I don’t want to change those traits I embrace, and I can’t get a cure for the monotone voice or for being introverted either, then what is the diagnosis for? I once imagined that when I wanted to leave the conservation, I would pull out a paper and announce: “Sorry, but I have to go. My doctor prescribed solitude.”

According to stories shared online, the diagnosis of ASD often brings a sense of relief. Many people share the experience of frequently being accused of being rude or indifferent, even though they were trying their best to be friendly. After getting the diagnosis, they could finally announce that their problems can be attributed to some neurochemical process that can’t be controlled at will.

Talking about ASD without a formal diagnosis is risky. Most stories about ASD involve severe mental problems or traumatic experiences of being bullied. I feel the survivor’s guilt for leading a happier life. And the destigmatization of mental disease has gone so far that Asperger has become a fashion item on social media. I don’t want to be perceived as a self-labeling snob. Sharing the same condition with people like Elon Musk may sound cool, though personally I don’t want to be put into the same category with him in any sense.

But I’ve decided to write down the story anyway. I might not be “typical” enough to be diagnosed by a psychiatrist, but I think articulation is a right, a power that should be used. Those “typical” patients may not be able to speak out their own stories, because ASD is related to learning disability and language impairment. Some may not want to disclose their own condition for fear of discrimination. And a lot more people may struggle to find a psychiatrist and get a diagnosis or any other kind of professional support. Access to mental health services is still a privilege in most parts of China. According to qingshanasd.cn, a nonprofit neurodiversity community, there are fewer than 10 psychiatrists who can diagnose ASD in adults in Guangzhou, a large city with a population of nearly 19 million.

Despite the scarcity of psychiatric services, a lot of my friends have been diagnosed with depression, anxiety,ADHD, or other conditions, not to mention those who have self-diagnosed. With or without a diagnosis, all the frustrations and struggles were real.

Neurodivergent people are drawn to each other like magnets, a friend once said. However, it still baffles me that there are so many people who struggle with mental health issues. People like me: young, highly educated, and seemingly carefree. We are Petra Pan and Peter Pan trapped at the age of the first traumatic event: a major failure at school, a toxic relationship or a stressful job.

I’m not denying the existence of ASD, depression, or anything else, but I still wonder where lies the boundary between normal responses to stress and abnormal symptoms, and who has the authority to define them. For example, why is it considered normal for a man to work seven days a week to avoid family life, but not for a woman? Why is it much easier to take some anti-depressants and go to work under some bastards than to get them out of their positions? Why do people expect young children to sit still for 40 minutes and prescribe Adderall to those who can’t make it?

I wish doctors could prescribe treatments like punishing the bad managers or outdoor activities. Personally, I find distancing myself from my mother is the most effective cure.

Another winter came. One afternoon, I walked through the drizzle to meet a friend who was setting up a booth for environmental education in a park. It was the coldest day last December. There were not many children coming. To help us pass the time, my friend started to read everyone’s palms.“You are in good health in general, except some minor problems with your guts.” he said to the lady who was setting the booth nearby, “You are talented, but you don’t want to work hard. You will meet three people who mean a lot to you…”I sat on a camping chair behind them and watched the scene, with my hands hiding in the pockets of my coat. Shall I have my palms read? What if he told me that I was not very talented?

Just before he had the chance to turn to me, several children came to the booth. He stood up to greet them.

Several days later, as I recalled the event to some other friends in a group chat, someone replied: “Then the palmist must not be very talented.”

Tutor Maya's Comment

Momo, your writing is clear, articulate, vivid, lucid, and flowing. I’m really glad that writing about this in English has been a helpful and freeing experience for you. It can make such a difference to find the words to articulate mixed emotions that exist in our lives with intensity, but for which language always feels inadequate. Articulation might not provide a direct answer, but it can make the feelings legible. I think you can help a lot of people with your work.

Afterwards

I had been thinking about writing the story for a year without any progress. The topic was sensitive and wrapped in complexities. Writing in English helps me to step back from those disturbing feelings and organize the materials from an observer’s perspective. But still, as I mentioned in the story, who or what is responsible for my uncomfortable feelings and emotional breakdown?

In real life, I find distancing myself from my mother is the most effective “cure”. But I don’t want the story to be another Tiger Mom or refrigerator mother narrative. I’m still wondering why so many people are struggling with some kind of mental condition, and why society is failing to meet our needs.

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