Autism spectrum condition (ASC) encompasses a wide range of neurological differences that affect the way people communicate, learn, and interact with others. People with ASD need a lot of assistance in their daily lives, others can work and live with little to no support. Some are not diagnosed until they are much older and can be deprived of the early intervention and diagnosis they highly need.
Autism spectrum disorder does come with masking; it is a life skill developed to blend in with other people. It is their way to ensure their autistic characteristics go unnoticed. Some are so good at masking that no one can tell that they’re pretending or performing. Not all of them are experts at it, some are less effective at masking.
Constant camouflaging or compensating blocks their need to perform neurotypical behaviours at the cost of avoiding being outed or harassed at school or at the workplace. It helps them feel comfortable in social and professional settings in the short run, but it does harm their mental health and sense of self-worth in the long run. People who mask do report feeling drained and exhausted because of putting too much effort into trying to conform to neurotypical standards of behavior. Autistic burnout can result as a result of masking, and it can lead to decreased mental health; making one probe to experiencing high levels depression, sleep problems and anxiety.
Here are some signs of masking behavior;
- Forcing and faking eye contact during conversations.
- Imitating smiles and facial expressions of others.
- Mimicking other peoples gestures.
- Feeling the need to hide personal interests.
- Feel discomfort when their routine changes.
- Developing strategies and rehearsing responses to feel ready to respond to everyday conversations.
- Scripting complex conversations and rehearsing ways to disguise stimming behaviours such as jiggling foot.
- Experiencing intense sensory discomfort ( eg; loud noises, chewing sounds).
- Practicing appearing interested or relaxed in social settings.
- Adjust their tone of voice to match other people’s vocal patterns.
Constant efforts used to copy and learn neurotypical interactions can quickly lead to social overload. Stress and anxiety are much higher in autistic individuals who routinely mask their autistic traits, compared to those who mask less often. Woman and girls are more likely to mask than people who identify as men. Research suggests that autistic girls and women are more inclined to developing friendships than autistic boys and men.
Mastering skills of masking can lead to delayed identification of autism. Success at this skill can hide the apparent signs of autism, delaying identification until they are much older. The delay can lead to mental health issues because people don’t get the support or understanding they need at the right time. It can also lead to loss of identity. Some mask for so long that they don’t know who they really are anymore. Some reported that masking feels like a self-betrayal; others have said masking makes them feel they’re deceiving other people.
Prolonged masking is also linked to increased risk of suicidal thoughts and suicidality. Loneliness, having difficulty recognizing or talking about emotions, not being able to pick up social cues, lack of social connections and not being able to experience romantic relationships does trigger suicidal thoughts among neurodiverse individuals.
There is no cure for autism yet community members are support the notion that neurodiverse people don’t need to be cured. Advocates propose that best solution to prevent negative effects of masking is to make the world an accepting and safe space for neurodivergent individuals, this in turn will automatically reduce the need to mask. One important thing to do could be early intervention and identification; it can give families a chance to learn about child’s needs and provide a healthy, supportive environment in which the child can feel safe and accepted.
Tips and tricks for helping autistic individuals from home or in a clinical setting
If you are a therapist, learning how to adapt to each patient is important at getting healthy outcomes. Be aware that ASD patients may seem as if they do not hear what you say to them, they may not be able to respond to their name, or they may appear uninterested to any attempts you make at communicating with them. Take your patient to a quiet safe room, where they feel safe. Please make sure the environment is relaxed and peaceful, free of patients and staff. This can help calm the patient down , as it will help to decrease the amount of sensory overload that is affecting the patient.
Explore how the patient communicates, this will give you an overview on how the patient will react with you.
- Use simple words and try talking slowly
- Do not feel frustrated over having to repeat and stress over same issues
- Be patient and allow them to process the things you are saying.
- ASD individuals have difficulties when they are out of their routine and comfort zone, your patience will help reduce their anxiety and help the session go smoother.
- Do not use figurative language such as dark humour, sarcasm, idiomatic expressions, or read-between-the-lines sentences. ASD people take things very literally.
- Please be respectful towards the individual. Individuals can distaste themselves from healthcare providers who start out talking to them as if they are severely mentally challenged.
Overall, showing your familiarity, respect, patience and knowledge of autism will result in a very positive experience for the ASD patient.
References:
1. https://scholar.google.com.tr/scholar_url?url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8992921/&hl=en&sa=X&ei=9pTcZObXDZGJy9YPweieYA&scisig=AFWwaeaE0RtihoRu_EKcfNGlhwEC&oi=scholarr
2. https://scholar.google.com.tr/scholar?q=autism+masking+research&hl=en&as_sdt=0&as_vis=1&oi=scholart#d=gs_qabs&t=1692177676415&u=%23p%3DupTh1R5Uo-QJ
3. https://autismawarenesscentre.com/what-is-autistic-masking/
4. https://www.healthline.com/health/autism/autism-masking
5. https://www.accessibility.com/blog/examples-of-autism-masking?hs_amp=true
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8992921/
Header Image Credit: Lesley Oldaker
Silan Eser
Silan Eser is a clinical psychologist originally from Turkey, Istanbul. She has a bachelor of science in psychology from the University of London, Goldsmiths and Master of Science Degree in Clinical Psychology and Health Services from Goldmiths College.
After starting university, she found her passion in research in psychology, focusing on conspiracy theories and personality differences. She then established her own company, PsychCentre, a private mental health practice located in London. She diagnoses and treats mental, emotional and behavioral disorders. She currently resides in Istanbul, Turkey, where she is running her new company BetterMentalLife.
