The wrong advice
The advice people who mask hear most is to be themselves. If you knew how, you would have done it by now.
A 2021 analysis by two autistic researchers explains why that advice misses. Masking is learned in response to stigma. Dropping it is not a decision, and it is not safe in every room.
A professional who understands masking will not start there.
Source: Pearson & Rose 2021
What to look for
Autistic adults who described masking to researchers were clear about what reduced it. Being accepted for who they were. So the first test is whether the professional works that way.
- They know the word, and they do not need it explained
- They treat a calm exterior as information, not as evidence that you are fine
- They can say what they do not know about autism or ADHD
- They do not push a diagnosis on you, and they do not refuse to discuss one either
- They know that autistic burnout is different from depression
- They ask how sessions could cost you less, before you have to ask
That last point matters most. Therapy is another room, and it is possible to perform your way through it. A good professional makes it a room where you do not have to.
Sources: Bradley et al. 2021, Higgins et al. 2021
What NICE expects
The national guidance for autistic adults asks professionals to adapt how they work. Concrete structure, with written and visual material. Plain English, with less metaphor and ambiguity.
You can ask for those adjustments whether or not you have a diagnosis. A professional who understands masking will usually offer them first.
Source: NICE CG142
Questions to ask before you book
You are allowed to ask before you commit to anything. A short message is enough.
I mask a lot, and it is exhausting. I do not have a diagnosis and I am not looking for one right now.
Do you work with masking as a thing in itself? And can we agree a signal for when I need a break?
If the reply answers the question you asked, that is a good sign. If it steers straight to assessment, you have learned something early.
Another place to look
We are not the only route, and we would rather you found the right person than used us.
The National Autistic Society's directory of services and professionals across the UK.
Listings are held by the charity, not checked by us.
How our conversation names it
We are a connecting service, not a clinical one. We do not assess anyone and we do not diagnose anyone. What we do is listen to how you describe the day.
Masking is one of the things our conversation is built to recognise. If you describe rehearsing, copying or the exhaustion of performing, we treat that as the theme itself. It is separate from autism and ADHD, and you do not need to choose either one.
Our conversation recognises masking most reliably when you describe what you do, such as rehearsing or copying. Saying only that you are worn out can read as tiredness. If the mask is the point, name what it takes.
If you are past tired
Autistic adults who defined burnout described suicidal behaviour among its impacts. If tonight is that kind of night, please do not wait for an introduction.
Our crisis page lists free confidential helplines you can contact now. You do not need to be in danger to use them.
Source: Raymaker et al. 2020
Thanks for your interest. We're not taking on new clients at the moment.
Ready to say it once?
We ask what matters to you, then find professionals who fit.
- I do not want to be told to just be myself
- I want a professional who will not push a diagnosis on me
- I need to know they understand masking
- I have tried therapy before and I performed through it
References
- Bradley, L., Shaw, R., Baron-Cohen, S. & Cassidy, S. (2021). Autistic adults' experiences of camouflaging and its perceived impact on mental health. Autism in Adulthood. doi:10.1089/aut.2020.0071
- Raymaker, D. M., Teo, A. R., Steckler, N. A., Lentz, B., Scharer, M., Delos Santos, A., Kapp, S. K., Hunter, M., Joyce, A. & Nicolaidis, C. (2020). "Having all of your internal resources exhausted beyond measure and being left with no clean-up crew": defining autistic burnout. Autism in Adulthood. doi:10.1089/aut.2019.0079
- Higgins, J. M., Arnold, S. R. C., Weise, J., Pellicano, E. & Trollor, J. N. (2021). Defining autistic burnout through experts by lived experience: grounded Delphi method investigating #AutisticBurnout. Autism. doi:10.1177/13623613211019858
- NICE (2021). Autism spectrum disorder in adults: diagnosis and management (CG142), recommendations 1.6.2 and 1.6.3. Link
- Pearson, A. & Rose, K. (2021). A conceptual analysis of autistic masking: understanding the narrative of stigma and the illusion of choice. Autism in Adulthood. doi:10.1089/aut.2020.0043
