As an autistic I resolve this in my head by reminding myself that words can have different meanings.

For example
(“How are you?” -> “I’m fine how are you?” -> “Doing well, thanks”)
actually means
(“hello” -> “hello”)

It’s code. The meaning is precise, and it’s not a false question. It’s a symbolic question.

It’s an equivalent meaning in the same way that:
(“hola” -> “hola”)
means the same thing as
(“hello” -> “hello”)

English is, therefore, not just one language. English is many languages using the same set of words.