Masking and camouflaging in autism, or hiding from social threat?

Terminology: Neurotypical, non-autistic and typical refer to individuals who are not autistic. Polytropic means able to have many interests (poly) aroused simultaneously. Single-focussed attention (mono) implies one interest taking over attention at any one time.

Introduction

Certain terminology is often used to describe the actions of autistic individuals who, in trying to 'fit in' with social situations, may be hiding their true selves. This 'fitting in' may occur in any social circumstances, including interactions in places of education or employment. One might argue it is human nature to fit in with social expectation and this argument would be sound. But, if the societal norm you are striving for is not compatible with your biological make-up, cognitive style, cultural expectations, and probable DNA disposition, but, rather someone else's, what is the cost of trying to be 'like them'? Over the generations many have argued that men and women are different and in so many ways this is obvious. Of course, the races and cultures of many humans vary immensely across the globe and we have seen the trauma and devastation caused to whole communities who have been forced into a 'societal fit' that is not theirs (see: Stolen Generations and Cultural Survival).

There is no debate or argument over the outcomes of forced assimilation. But, what if society's 'push' for conformity is isolating a whole population of individuals world-wide and no-one realised the damage this was doing?

Masking and camouflaging, (both words infer an ability to 'pretend', 'deceive' and 'cover up' as a deliberate act) are commonly being used to explain behaviour of many 'autistics'. Of course, this may be a true statement for some. Here, though, it is argued that others on the autistic spectrum experience an overwhelming need to be safe and hidden from harm, which drives a state of 'adaptive morphing'. This emerges not from a desire to deceive or pretend, but from a desire for survival.

For nearly two decades literature [1-5] Hull et al., 2017 and personal blogs [6] have referred to autistic individuals as being able to camouflage, pretend, mask and blend in to fit expectations of others, or to appear 'normal' [5]. The mental health and wellbeing from the effort of such behaviour is only recently being questioned. In their study, Cage and Troxell (2019) [7] demonstrate the negative impact of this on the mental health and well-being of many autistic adults. There is no doubt this is so for many autistics across the globe.

Language

Words are powerful and can lead one's thinking towards certain assumptions, perspectives and concepts. This means that words can, even unintentionally, lead others to certain beliefs which may not be accurate or helpful. In using the powerful tool of language, it is our responsibility to make sure that our words truly represent an individual's reality, are appropriate, and are not simply the language of the majority. For example, as stated above, when words such as pretend, mask, and camouflage are used, they imply intent to deceive; deception implies cheating. Now this may not be the intention of the individual; they are not intending to deceive anyone. Their intention is to escape discomfort, bullying, non-acceptance or other types of strife. So, we can change the words we use to describe this 'phenomenon', but we also need to change perceptions and 'belief' that accompany the terms. When I think of using camouflage two situations come to mind. In one I see a military operation where soldiers are dressed in clothing to help make it harder for the enemy to spot them and in two, I see myself in a bird hide, hidden from view so I can bird watch safely and without frightening off the birds. In social situations where 'masking' is a learnt process to help keep someone safe, which of the two scenarios above is in use? Changing the language and thus the meaning, might be the best way to go.

Autistics Talking

During conversations with many other autistic individuals concerning ways we/they have managed socially; I note the following:

'…as autistic individuals we are all different and neuro-diverse, but many of us are still wired for connection, the need for belonging and the need for a valued positive self-experience. So, as we grow up, we adapt ourselves to our environment and people, to achieve these desired states with as much ease and comfort as possible. We do not mind the effort of doing so, for this is far better than the consequences of not. Yet the effort it takes to constantly be aware and adapt, can come at the cost of learning, earning, connecting and feeling rested and peaceful….' (Hall, 2019, personal communication)

And:
'…yes, from a very young age, when we do act intuitively, (i.e. spontaneously, and as we feel is appropriate in a given circumstance), we are swiftly informed either directly or through others' actions that what we've done is not ok. The human need to survive means that we have to learn to figure out what IS required in order to stay safe and not make ourselves a target. We do this both consciously and unconsciously across a lifetime but underpinning this response is the belief that our intuitive response is the WRONG way to act so we learn to distrust ourselves and our responses and begin to observe and mimic in a bid to blend in and pass unnoticed by those who might do us harm if they knew that we were different from the majority' (Mahony, 2019, personal communication).

And:
'As outsiders we are teased, ridiculed, ignored, turned on. It seems our behaviour triggers others towards predatory actions and this includes exclusion. This feels painful and scary. Loneliness holds as many health risks as poor lifestyle choices'. (Hall, 2019, personal communication)

And:
'Ultimately, masking for me is liberating and debilitating in equal measure. I don't know how to take my masks off. I don't know how to live without masks. And they provide me with opportunities to be what I need to be for the people I love. But living a masked existence has robbed me of me. And I owe it to myself to try and find me. I owe it to the people I love to trust them enough to get to know me too. Even if I don't feel ready to 'Take My Masks Off' completely, yet' [8]

Slocum-Bradley (2010) [9] states, 'if we understand how we construct social reality, we can construct more consciously to sustain norms that promote the ends we profess to desire' (p. 81). Unwittingly, the language we use may be keeping others bound and gagged; they may not even know they are putting their mental health at risk. This has to change!

In 2020, 'person first' language is increasingly being exchanged for identity first language. This has been driven by the autistic majority. Concerned that phrases like 'person with autism' suggest that autism can somehow be separated from them, allowing the person (without autism) to be seen, motivates this change. It can even be argued that saying 'person with autism' somehow suggests (even subconsciously) that autism is 'bad' and must be extinguished so the 'person' can be freed. For example, Applied Behavioural Analysis (ABA) has traditionally been a 'therapy' incorporated into an autist's life to make them 'indistinguishable from their peers' (see: Ari Ne'eman.) Again, the thinking accompanying this 'belief' must change and one way we do this, is to change the language.

Some Autistics may notice another's intention and, therefore, they can predict an outcome. Most of us will have difficulties with this ability due to poor object permanence (e.g. Lawson & Drombroski 2017), poor interoceptive connection (e.g. see Goodall, 2019) and being very much 'one tracked or single focussed' in our processing and experience (e.g. see Lawson, 2011). Therefore, our subsequent culture will likely be less inclusive of small talk and of social 'niceties'. This, however enables us to be direct, focussed and productive (e.g. see Greta Thunberg). Taking this away or aiming to somehow make us more like non-autistics will take away our unique ability to 'focus'. It will dis-empower us and will lead to even more poor mental health outcomes.

Survival

Our human in-built survival mechanisms are prompts that trigger many autistics to notice ways to stay safe socially, when other means are not available (e.g. fight, flight, freeze, flop, drop, fawn & possibly morph). So, although many non-autistics seem better equipped in social situations, their expectation upon autistics to do or be 'like them' is influencing a whole culture of negative expectation from the classroom to the shop floor [10].

In a world in which non-autistics are the majority, it is the non-autistic social interaction style which is considered the acceptable one. This 'norm' is based on the functions of a brain wired to enable social connection in a manner appropriated by the utilisation of polytropic interests [11]. This is only possible because of its communication system which allows for attention to multiple foci at once, leading to behaviours that are valued and rewarded by the neuro-majority such as: good eye contact, 'appropriate' facial expression, 'appropriate' reading of body language and connected interoceptive awareness (e.g. [12]; [13]. People who naturally have these attributes, therefore, have no need to behave in a way contrary to their nature in order to be socially acceptable. Many autistics choose to act in ways contrary to their natural behaviours in order to increase their chances of social inclusion and, thus, decrease their risk of negative consequences from the non-autistic majority.

Is this, however, a deliberate deception or a survival strategy cultivated over many years? Is this a conscious act or a subconscious response to real and/or perceived trauma? Yes, many Autistics cover up aspects of themselves they wish to keep hidden, as a response to trauma, e.g:

'… for me sometimes this is done subconsciously; rarely is it done deliberately. In fact, it's only as we talk together that I realise I have been doing this over many years….'.

And:
'… I don't think my intention is to deceive others into thinking I'm something I'm not it's more about trying to do what I've been told. Or, not do what my family have told me to contain'.

Additionally, many Autistics have poor interoception and this keeps us from recognising many of our inner bodily senses (i.e. hunger, thirst, pain, desire, temperature, heart rate, etc) (see: Education SA).

If you have poor interoception, a cognitive style that is designed for single-focussed attention to one thing at any one time (e.g. [13, 14] (unless a supplementary focus from within your range of interest is involved (e.g. [13]), then you will not naturally develop a global map of neurotypical social appreciation (based around a disposition that naturally multi-tasks, e.g. enables individuals to look, listen, chat and walk all at the same time), nor will you naturally have the necessary neural infrastructure to enable the development of a brain akin to that of a neurotypical person. This means that you are biologically and intuitively drawn to focussing differently from how a non-autistic person might. Autistics are given to focusing upon those things that matter to them above and beyond 'being and doing social'. To respond in a conversation around social demands, or in other settings which pose a challenge to your senses and inherent processing aptitudes, is exhausting. One, therefore, might use other methods to cope. Additionally, it is important to note that the human brain manages best when it can focus upon one thing at any one time, whoever you are (see: [15]).

However, if what we naturally do isn't seen as acceptable (various stimming behaviours) we may observe others to see what it is they use. As we practise these, we note what might work and what does not work. For some autistics, using demand avoidant methods (e.g. refusal to cooperate; pleading inability, and manipulating a situation to enable escape) may work; others use 'fight'; but some prefer to 'morph' and adapt their behaviour to mimic that used by, and shown to succeed in, non-autistic others. The 'morphing' can be compared to tactics used by the majority of chameleons.

Adaptive Morphing

Nature teaches us many things about ways to survive and one lizard particularly, begs our attention. It is the Chameleon. 'Chameleon' is a term used to describe a certain type of highly specialized lizard. It is an Old World clade, meaning from a single source heritage, but with multiple presentations. A Chameleon, being an 'Old World' lizard, has been around a very long time. So has autism (See; The History of Autism).

'The term 'Old World' is used commonly in the West to refer to Africa, Asia and Europe (Afro-Eurasia or the World Island), regarded collectively as the part of the world known to its population before contact with the 'New World' (the Americas and Oceania)' [16].

There are many interesting things about chameleons, one being that many can change their colour to match their surroundings and circumstances. However, this is not a chosen activity so much as a means built into their biology, which is usually triggered by environmental temperature and perceived threat [17].

When we compare the chameleon's response to threat to autistic morphing, we are closer to understanding the strategies some autistics utilise to help them navigate social situations and social expectations. Because of the intrinsically human desire to belong, many autistics are drawn by both biology and necessity to be included with, and accepted by, the non-autistic majority (see: We Belong report). However, without true inclusive adjustments that allow for genuine inclusion and acceptance, this desire will continue to be thwarted by the stigma that is still associated with autism. As long as our society lacks truly inclusive practices, the need for autistics to display chameleon-like responses to threatening social environments will continue.

Female autistics

In recent publications, including Lawson [18]), the words 'masking' and 'camouflaging' are used to explain why females on the spectrum have remained invisible and don't figure in either historical or recent statistics. In fact, the females are there, but they are there, paradoxically, by reason of not being there! This means that their absence in data sets begs explaining. Initially, it was reasoned that they failed to show in the data because autism is predominantly a male condition [19]. In later years it was argued females were more immune to autism because of the properties of oestrogen which gave them a certain 'protection' against becoming autistic [20]. Later again, the debate continued, with females said to use masking and camouflage to hide their difficulties [3].

Biologically, due to inherent attributes on the XX chromosome [21], autistic females and females in general, tend to be more social [22]. Research informs us that females are able to notice and use more acceptable social behaviours because certain behaviours appear to be more available to them than they are to those without the XX chromosome (e.g.[21]). This might imply, for example, in autism, 'noticing' others allows females to learn early on, how to act as if they understood, even when they don't. Therefore, their actions act as a mask that covers their real difficulties. However, in this scenario, 'masking' as camouflage is not so much a chosen state, but, rather the result of enacted behaviour to avoid discomfort (e.g. from not fitting in; from fear of being punished, etc.), and may happen almost automatically, and often subconsciously. One researcher, when asked to comment on this concept, stated:

'…masking ....being learned through trial-and-error rather than intentional thought out deception, seems much more likely as it requires far less executive functioning ability and could be essentially explained by behavioural conditioning.' (Grove, personal communication, 2019)

As well as avoiding discomfort in social situations by adapting behaviour and, therefore, appearing to have social ability, specific passionate interests more commonly accepted as 'typical' in females (e.g. books; animals; people; fashion; Theatre; music; caring profession etc.) are often not recognised as being of a single-focussed or more rigid nature and may pass unnoticed.

Therefore, autistic females may also have more internalizing characteristics, including anxiety, depression and self-directed symptoms such as self-blame and low self-worth, and less externalising behaviours such as aggression or challenging behaviours, compared to males. So, various difficulties may not be noticed by parents or teachers as readily in females as they are in males. Unfortunately though, long-term, these behaviours and strategies which lead to females remaining unidentified as Autistic can often lead to mental health being negatively impacted. As a result, females are more often mis-diagnosed with other issues such as depression, personality disorders, social phobia, eating disorders and anxiety disorders (to name a few) than are males. They are also much more likely to have these as comorbidities (See: [18]).

Due to worrying trends of concern using terms such as 'masking' and 'camouflaging' could be thought of as 'misleading terms'. For example, when it comes to words used as terms for explaining and naming certain individuals' experiences, these should be used to explain the positive unintended outcome of specific learnings not the chosen activity.

In light of the above, in research questionnaires, would an outcome of a question that asks:
'… do you remember when you first began to use camouflage to mask your difficulties?'
… be different to a question that asks:
'do you think you observed ways to respond that kept you safe and socially hidden'?

Camouflage would be the result in both situations, but one demonstrates intention to deceive; the other shows a learnt outcome to maintain safety.

Conclusion

One day, autism will be recognised for the 'norm' that it is, for many individuals. It will be the 'norm' to see individuals wearing sunglasses and/or tinted lenses when inside; the 'norm' to wear a baseball cap, at school and work; the 'norm' to use a weighted garment or soft toy to aid relaxation; the 'norm' for individuals to choose not to be social unless sharing a mutual interest, and the 'norm' to be themselves without the 'need' to camouflage who they truly are. This is very important so our mental health can thrive and we can value who we are without the need to hide.

References

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