Neurodivergent masking

Neurodivergent masking describes how people with developmental disabilities, mental illnesses, and other variations in brain function may hide their differences and seek to "blend in" with others. It can be done on purpose or unconsciously. Masking has been compared to the concept of passing in sociology.Petrolini, Valentina; Rodríguez-Armendariz, Ekaine; Vicente, Agustín (2023). "Autistic camouflaging across the spectrum". New Ideas in Psychology. 68: 100992. doi:10.1016/j.newideapsych.2022.100992. hdl:10810/59712. S2CID 253316582.
Many people engage in some degree of masking. However, neurodivergent people experience more pressure to mask.Pryke-Hobbes A, Davies J, Heasman B, Livesey A, Walker A, Pellicano E, Remington A. The workplace masking experiences of autistic, non-autistic neurodivergent and neurotypical adults in the UK. PLoS One. 2023 Sep 6;18(9):e0290001. doi: 10.1371/journal.pone.0290001. PMID: 37672533; PMCID: PMC10482295.
While autistic masking is the most well-known form of masking, it is being studied in ADHD and other types of neurodivergence.
Masking can be a barrier to accurate diagnosis.Pearson A, Rose K. A Conceptual Analysis of Autistic Masking: Understanding the Narrative of Stigma and the Illusion of Choice. Autism Adulthood. 2021 Mar 1;3(1):52-60. doi: 10.1089/aut.2020.0043. Epub 2021 Mar 18. PMID: 36601266; PMCID: PMC8992880.Young, S., Adamo, N., Ásgeirsdóttir, B.B. et al. Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women. BMC Psychiatry 20, 404 (2020). https://doi.org/10.1186/s12888-020-02707-9 It may also lead to the person not being believed about their condition or being denied supports.Hull, Laura; Petrides, K. V.; Allison, Carrie; Smith, Paula; Baron-Cohen, Simon; Lai, Meng-Chuan; Mandy, William (2017). ""Putting on My Best Normal": Social Camouflaging in Adults with Autism Spectrum Conditions". Journal of Autism and Developmental Disorders. 47 (8): 2519–2534. doi:10.1007/s10803-017-3166-5. PMC 5509825. PMID 28527095.
==Motivations==
People mask to avoid harm."Masking Is Life": Experiences of Masking in Autistic and Nonautistic Adults Specific motivations include social pressure, avoidance of abuse and ostracism, getting and keeping jobs, and making friends.
==Masking in different conditions==
[[File:Neuroclastic Autistic Masking.webp|thumb|300x300px|Autistic masking art by Kate Jones, via NeuroClastic's free infographics page]]
===Autistic masking===
Autistic masking can include behavior like:
*Rehearsing what to say in conversations
*Suppressing stimming
*Faking a smile when uncomfortable
*Forcing eye contact despite discomfort
*Pretending to be fine when experiencing sensory pain
Autistic masking is often described as exhausting.The Consequences of Compensation in Autism Attempts to "fit in" with other people can have profound negative effects.Conceptualising Autistic Masking, Camouflaging, and Neurotypical Privilege: Towards a Minority Group Model of Neurodiversity Autistic masking is associated with:Cassidy S, Bradley L, Shaw R, Baron-Cohen S. Risk markers for suicidality in autistic adults. Mol Autism. 2018 Jul 31;9:42. doi: 10.1186/s13229-018-0226-4. PMID: 30083306; PMCID: PMC6069847.Cassidy, S.A., Gould, K., Townsend, E. et al. Is Camouflaging Autistic Traits Associated with Suicidal Thoughts and Behaviours? Expanding the Interpersonal Psychological Theory of Suicide in an Undergraduate Student Sample. J Autism Dev Disord 50, 3638–3648 (2020). https://doi.org/10.1007/s10803-019-04323-3 Download citation
*Exhaustion
*Autistic burnout
*Loss of identity
*Feeling like a burden
*Anxiety
*Depression
*Suicidality
Therapies like applied behavior analysis have undergone criticism for training autistic people to mask.Schuck, Rachel K.; Tagavi, Daina M.; Baiden, Kaitlynn M. P.; Dwyer, Patrick; Williams, Zachary J.; Osuna, Anthony; Ferguson, Emily F.; Jimenez Muñoz, Maria; Poyser, Samantha K.; Johnson, Joy F.; Vernon, Ty W. (2022). "Neurodiversity and Autism Intervention: Reconciling Perspectives Through a Naturalistic Developmental Behavioral Intervention Framework". Journal of Autism and Developmental Disorders. 52 (10): 4625–4645. doi:10.1007/s10803-021-05316-x. PMC 9508016. PMID 34643863.Dawson, Geraldine; Franz, Lauren; Brandsen, S. (2022). "At a Crossroads—Reconsidering the Goals of Autism Early Behavioral Intervention From a Neurodiversity Perspective". JAMA Pediatrics. 176 (9): 839–840. doi:10.1001/jamapediatrics.2022.2299. PMC 10069446. PMID 35816341. These therapies may cause long-term harm.“Recalling hidden harms”: autistic experiences of childhood applied behavioural analysis (ABA)Davis R, den Houting J, Nordahl-Hansen A, Fletcher-Watson S (March 2022). "Helping autistic children". The Wiley-Blackwell Handbook of Childhood Social Development: 729–746. doi:10.1002/9781119679028.ch39. ISBN 9781119678984.
Compared to neurotypical and non-autistic neurodivergent people, only autistic people mentioned masking sensory sensitivities (e.g. hiding pain caused by loud noises) and feeling suicidal due to masking.
===Masking in ADHD===
Some people with ADHD feel pressure to mask.The experiences of adults with ADHD in interpersonal relationships and online communities: A qualitative study
Masking in ADHD can be similar to autistic masking. People with ADHD may also obsessively check belongings and spend extra time cleaning and organizing to make up for their executive function difficulties.What Is ADHD Masking?, Verywell Health The heavy mental effort can be distracting.What Is ADHD Masking? Signs You Are Masking & How To Deal With It, Simply Psychology
==Management==
Supportive, compassionate environments can help people feel more comfortable being themselves.Cook, J. M., Crane, L., & Mandy, W. (2024). Dropping the mask: It takes two. Autism, 28(4), 831-842. https://doi.org/10.1177/13623613231183059Why ADHD Masking Is a Form of Self-Sabotage, ADDitude Magazine In autism, experiencing autism acceptance can improve mental health.Cage E, Di Monaco J, Newell V. Experiences of Autism Acceptance and Mental Health in Autistic Adults. J Autism Dev Disord. 2018 Feb;48(2):473-484. doi: 10.1007/s10803-017-3342-7. PMID: 29071566; PMCID: PMC5807490.Chapman, Louise; Rose, Kieran; Hull, Laura; Mandy, William (2022-11-01). ""I want to fit in… but I don't want to change myself fundamentally": A qualitative exploration of the relationship between masking and mental health for autistic teenagers". Research in Autism Spectrum Disorders. 99: 102069. doi:10.1016/j.rasd.2022.102069. ISSN 1750-9467. S2CID 253495529. Having a safe place to "unmask" without criticism can be a relief.
Some psychologists recommend identifying strengths and sorting out which behaviors are helpful vs. harmful for the person.Masking in ADHD: The “Why” Matters, Psych Central For example, taking extra time to get organized may help a person with ADHD, while stifling the need to stim might impede focus and relaxation.
Self-compassion may also help people who struggle with "beating themselves up" for behaving differently.
On a societal level, social acceptance of neurodivergence and appropriate supports can reduce the need for masking.
== See also ==
* Autism
* Stimming
* Applied behavior analysis and autism controversy
== References ==
Category:Neurodivergence
Category:Autism