“How Are You?” Is No Longer a Neutral Question

“‘How are you?’ is no longer a neutral question, and ‘I’m okay’ is no longer a simple answer.” - Mary Coughlin

Lately, when people ask me how I am, I find myself answering, “I’m okay.” And then sometimes softly, sometimes silently adding: Given everything.

What’s interesting is how often people now nod. They don’t rush to fix it. They don’t push for more.
They just… understand.

Historically, “How are you?” functioned as a social placeholder. A greeting, not a question. We weren’t meant to answer honestly. We were meant to say fine and keep moving.

But something has changed.

Now, when someone asks how you are, it can feel like opening a door you didn’t intend to walk through. Because answering honestly means acknowledging the moment we are living in, a moment marked by instability, moral injury, grief, anger, vigilance, and an undercurrent of fear about where things are headed.

To say “I’m okay” no longer means all is well. It means I’m surviving. It means I’m staying engaged.
It means I’m paying attention. And maybe that’s the shift.

We are living in a time when neutrality itself feels like a stance. When silence can feel like consent. When being “fine” feels dissonant with what our nervous systems and our values are registering.

So when I say I’m okay — but not much more — I’m naming a boundary. I’m acknowledging that I am carrying the weight of this era while still choosing to show up. I’m protesting in the ways I can. I’m practicing civic engagement when opportunities arise. I’m staying awake rather than numbing out.

And when others say, “Yeah… I get it,” I feel something quietly human happen between us. Not consensus. Not performative outrage. Just recognition.

Perhaps “How are you?” is no longer a throwaway line but an invitation to honesty, to restraint, to shared witnessing. And perhaps answering “I’m okay” is not a failure of optimism, but an act of integrity in a time that demands we stay awake, responsive, and connected even when the answers are complicated.

Why This Moment Is Inherently Trauma-Informed

What I’m noticing in these exchanges, these pauses after “How are you?” is something deeply familiar from my work in trauma-informed care.

When the world becomes unpredictable, when systems feel unsafe or unrecognizable, our nervous systems don’t distinguish between “personal” and “societal” threat. We carry it all into our bodies, our relationships, our work, our language.

That’s why small relational moments matter so much right now.

Trauma-informed care has never been only about crisis response. At its core, it’s about how we show up for one another when the ground beneath us feels unstable. It asks us to slow down, to listen for what isn’t being said, to respect boundaries, and to understand that “I’m okay” might be the most honest answer someone can give on a given day.

In neonatal care, in healthcare more broadly, and in civic life, this same principle holds: we don’t heal by pretending things are fine. We heal by creating conditions where honesty, dignity, and regulation are possible even when the answers are incomplete.

So when I say “I’m okay” in this moment, I’m not disengaging. I’m practicing discernment. I’m staying connected without becoming consumed. I’m choosing to remain responsive rather than reactive, protesting when I can, advocating where it matters, and protecting my capacity to keep showing up for the long haul.

This is the work. Not just in hospitals or classrooms but in conversations, pauses, and the courage to remain human in times that make that feel harder than it should.

Perhaps the most trauma-informed thing we can do right now is allow “How are you?” to be a real question and allow “I’m okay” to be a complete, honest, and dignified answer.

Take care and care well,

Mary