Stop saying “how are you?” as a greeting unless you want an honest response

There are three acceptable answers to the question, “How are you?”

These are “fine, good, and great.”

That’s it. That’s all you’re allowed to say. Say anything else and you’re met with glazed eyes or mild confusion. Answering with a detailed explanation about how you’re having car problems and some sort of rash will get you a look of abject horror.

“How are you?” has become a meaningless pleasantry in many English-speaking cultures. It’s more a verbal handshake than an actual question expecting an honest response. These types of phrases evolved into what linguists call “phatic expressions”; forms of communication primarily used to build or maintain social connections rather than convey factual information.

“How are you?” creates a social contract where dishonesty is not only acceptable but expected. Saying “fine” when you’re not is considered appropriate social lubrication rather than deception. Linguists have found that people respond to “how are you?” faster than to almost any other question, suggesting it’s processed as a formula rather than inquiry. I wonder if this struggle is a common issue among the neurodiverse… those who generally thrive on clear and direct conversation?

The last couple of years have been pretty spicy for me; there’s been more doctors and counselors and specialists than I’d like to admit. Walking into their offices to be greeted with, “how are you” has just felt… wrong. This is because after being met with this greeting, I’m immediately sat down to be asked the exact same question. This time however they’re expecting an honest and detailed response about the many reasons I’m here… which are generally because I am not, in fact, ok.

The “How are you” dilemma had been gnawing at me for a while now. My counselor would come out into the waiting room, “Hi James, how are you?” I would want to answer honestly. I would get this feeling I needed to start spilling my guts right there all over the reception floor. At work, I would see coworkers greet employment service clients like this, only to witness the clients visibly shrink or cringe. “Great!” They’d say, followed by, “Well… maybe not great. In fact things are pretty hard right now,” as they are ushered past my door on the way to the privacy of an office.

I brought up the topic of “how are you” with my Mom recently and she had literally experienced the same thing. True to her form, however, she simply slam dunked the response:
DOCTOR: “How are you?”
VMOM: “Fine, that’s why I’m here.”

So it’s not just me. It seems a lot of people can’t stand this greeting, especially if it’s coming from someone who exists in their lives to share the hard stuff to. Someone that they are supposed to speak honestly to about what’s bothering them. It seems so obvious now that it hits different coming from your doctor than from the corner store clerk.

Here’s what I’ve been trying:
“Hi John, it’s nice to meet you!” (First meeting)
“Hi John, nice to see you again.” (Subsequent meetings)
“Hey Sarah, glad you made it.” (Honest enthusiasm that they exist!)
“Hey Mark, love the shirt” (A compliment about a choice they made!)

These alternatives acknowledge the person in front of me instead of defaulting to a script. They’re also flexible! They work whether it’s a good day or a terrible one, because they’re not asking anyone to perform.

The irony is that by abandoning “How are you?”, I’ve found myself actually connecting with people instead of just exchanging pleasantries.

What if you’re asked? You can try hitting the default response button and then internally thank them for the verbal handshake. You could try going over the top and say “Never been better!” before launching into a detailed explanation about the rash on your butt.

You could try not answering. Let it slide because. It’s. Not. A. Question!

SERVICE PROVIDER: “How are you?”
YOU: “Hey, thanks for seeing me.” / “Hi John, nice to see you” / “How are YOU?”

“How are you?” isn’t inherently bad, the purpose is still one of connection. It works fine at the grocery store, at parties, in passing. But when someone’s job is to help you untangle your life, leading with a question that’s explicitly not meant to be answered honestly creates friction.

We should choose to be more intentional with our greetings, especially in rooms where vulnerability is supposed to happen. Maybe we should choose something real and personalized instead.