What we mean when we talk about masking

In our work with neurodivergent clients — autistic individuals, people with ADHD, and many who carry both — masking is a word that isn't framed as an initial presenting problem or discussed at the start of treatment. Many clients arrive at their first appointment with little to no knowledge of the term, and in many cases, this is also true for the subject of neurodiversity. But over time, as we work to understand certain experiences, the impact of day-to-day stressors, and how people respond to them, it is a word that eventually takes center stage and becomes useful for making sense of what is or has been happening. It's useful for contextualizing and creating space for how neurodiverse people experience the world differently. Put simply, masking is what happens when someone hides or modifies parts of themselves to get through the day more smoothly. That might look like forcing eye contact that feels unnatural, rehearsing what to say before a conversation has happened, holding still when the body wants to move, or laughing along at moments that do not actually feel funny. Researchers who study this call the fuller pattern "camouflaging," and they discovered it usually involves two things working together: concealing traits that might stand out, and building workarounds for situations the world was not designed to accommodate, and often refuses. Underneath both is the same goal, which is safety from judgement, rejection, or worse.

We can agree that this is a sensible goal. The act of blending in can protect a job, a friendship, or a sense of safety in public. Research indicates that individuals who mask extensively report feeling more interpersonally disconnected, and this overuse has been linked to higher rates of anxiety, depression, and suicidal ideation. Many neurodiverse adults' descriptions echo this observation, and much of it includes discussions of losing sight of who they are outside of masking, and it becomes genuinely difficult to say what they think, feel, or need once the mask is removed. Pressure to overrely on masking can interfere with healthy communication of wants and needs, boundaries, and how we resolve conflicts and ruptures in our relationships.

We're not suggesting that masking should be wholly eliminated, or that using it makes someone fake, inauthentic, or a terrible communicator. Advocates and researchers who write and speak widely on the topic describe masking as a survival skill rather than a flaw. It's something that is neither good nor bad on its own. What seems to matter most is whether it is being used on purpose and in situations that call for it. For some, masking becomes so constant and automatic that a person no longer views it as a choice, and instead feels that pressure to mask consistently rather than as needed. Years of being corrected, teased, or punished for being visibly different can make that second version feel like the only option, even in places where it is not actually needed.

This is where the conversation about therapy and masking becomes interconnected. A goal for therapy won't be to entirely unmask or unmask everywhere, which is unrealistic, but to help clients notice where the mask is functioning healthily and where it has just become a habit that interferes more than it protects. Insight and self-reflection, a natural aim for nearly every therapeutic experience, can be invaluable for those seeking to utilize masking judiciously. A separate but related goal may include finding a few relationships or settings where the mask can come down, even briefly, so a client may experience real relief and connection.