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Dropping my mask: Using mindfulness to find my authentic autistic self

Article  in  The Psychologist · March 2021

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Dropping the mask
Eloise Stark experiments with mindfulness
to find her authentic, autistic self
He recognizes that it rests within himself to choose;
that the only question which matters is, ‘Am I living in
a way that is deeply satisfying to me, and which truly
expresses me?’
- Carl Rogers, On Becoming a Person, 1961
Eloise Stark is a DPhil Candidate in Psychiatry, Green Templeton College,
Centre for Eudaimonia and Human Flourishing, Department of Psychiatry,
1 University of Oxford. Twitter: @eloiseastark / @HedoniaResearch
I
n 2017 I received a diagnosis of autism.
During my diagnostic assessment, the
psychiatrist asked me a simple question with
surprising consequences:
‘How do you feel about eye contact?’
‘Well’, I explained, ‘I look at someone for
a few seconds, then take my cue to look away
for a second, then I look back at them. But
sometimes it is painful to make eye contact so I can’t
always do it.’
The psychiatrist explained to me that regulating
eye contact consciously, using rules and algorithms
gleaned from experience, is not the ‘neurotypical’
(non-autistic) way of doing things. Neurotypical
people, she explained, don’t usually think about their
eye contact, it just happens.
Why do I feel the need to regulate my eye contact?
Social camouflaging
The answer is, I am camouflaging. Camouflaging
is a term which means modifying behaviour in an
attempt to conform to conventions of non-autistic
or neurotypical social behaviour (Mandy, 2019). You
may have heard it referred to as ‘social camouflaging’,
‘masking’, ‘compensation’ or even simply ‘pretending to
be normal’.
I have engaged in social camouflaging ever since
I can remember, starting at Junior School aged four.
Filled with a desire to have friends and companionship,
I remember studying intently to understand how other
children my age dressed in cool patchwork jeans at
parties, adorned their hair with colourful hair clips
for school, and greeted each other with a ‘Hi’ rather
than my preferred mode of opening conversation –
with a question about my special interests (‘Did you
see the latest My Little Pony called Firefly?’). Through
carefully observing others, I managed to create a
‘normal’ self that I could present to the world. This
facade only worked temporarily though, melting off
me like an ice cream on a hot summer’s day as the day
the psychologist march 2021 camouflaging
progressed and my energy subsided. and stress following an interaction where they felt a
Of course, everyone, autistic or not, camouflages pressure to camouflage. It is also commonly believed
to a certain extent. In 1956, Erving Goffman penned that camouflaging may prevent timely and accurate
the influential book The Presentation of Self in Everyday diagnoses of autism, thus precluding support and
Life, using a theatrical metaphor to conceptualise perhaps precipitating poor mental health.
human social interaction. Just like performers in a I find camouflaging sometimes helpful, but often
theatrical production, Goffman discussed how during encumbering. On the one hand, I camouflaged for the
social interaction, both individuals will attempt to first 27 years of my life, with a fair amount of success
control or guide the impression that others might make along the way. On the other hand, it has sometimes
of them through their behaviour. been a debilitating strategy. In the first year of my
I had a recent conversation with a non-autistic DPhil I suffered an ‘autistic burnout’, which has been
person about camouflaging. They asked why I would described as ‘having all of your internal resources
want to stop camouflaging and exhausted beyond measure and
come across as my autistic self, and being left with no clean-up crew’
whether appearing neurotypical “I have engaged in social (Raymaker et al., 2020). My
might not be better for my camouflaging ever since well-being was at an all-time low
friendships and career. To this I due to keeping up a facade of
answered an emphatic no, and this I remember, starting at normality for years, while internally
harks back to the opening quote Junior School aged four” struggling with the feeling that
from Carl Rogers: camouflaging is something was ‘different’ about me
not satisfying. Let’s explore why. that I couldn’t name. One potential
Many autistic people report camouflaging as an solution for preventing autistic burnout is ‘an earlier
obligation, rather than a choice (Mandy, 2019). It is diagnosis, which potentially could have meant less
often motivated by the need to avoid standing out, need to camouflage’ (Raymaker et al., 2020).
which may provoke bullying or ostracism, or simply
by a feeling of being different and wanting to belong.
All individuals, neurodiverse or not, face the conflict Exploring authenticity
between authenticity and pragmatism, as Mandy As a contrast to camouflaging (although some
highlights, but for the autistic person, this conflict is individuals report positive consequences) being
often heightened by living in a world as a minority. authentic is viewed as a healthy attribute in both
Indeed, the consequences of camouflaging can be contemporary psychology and society (Smallenbroek,
very negative. In a qualitative study 92 autistic adults Zelenski, & Whelan, 2017). Authenticity is tricky
answered several questions about their camouflaging to define, but has been neatly conceptualised as the
behaviours, and its consequences (Hull et al., 2017). unimpeded operation of one’s true, or core, self in one’s
The most consistent response from participants daily life (Goldman & Kernis, 2002). People with high
was that camouflaging is simply ‘exhausting’. In authenticity are believed to be able to act in accordance
the study, camouflaging was repeatedly depicted as with their specific interests and values. As a result,
being mentally, physically and emotionally tiring; these behaviours enhance their overall subjective well-
requiring intense attentiveness, self-control, and the being. Kernis and Goldman (2006) further separate
continued management of a felt sense of discomfort. authentic functioning into four distinct components:
Some individuals expressed feeling extreme anxiety • Awareness and knowledge of one’s self

• Unbiased processing of evaluative information
• Behaviour that is aligned by one’s true self
• A relational orientation with close others that
fosters openness and connectivity
Carl Rogers, psychologist and one of the founders
of the humanist approach to psychology, described a
similarly authentic state as one of ‘fully functioning’
(Rogers, 1963). Importantly, Rogers defined this
state partly by ‘movement’ or decisive action away
from ‘facades’ and from ‘oughts’, from meeting
expectations and from pleasing others (Joseph, 2017).
In response to moving away from such pressures, the
individual can move towards self-direction, openness
to experience, acceptance and trust, thus following
their own intrinsic motivations rather than acting
for the benefit of others. It struck me that this wish
for authenticity or a ‘fully functioning’ state is pretty
similar to the desire that many autistic people have to
stop camouflaging.
With Professor Francesca Happé, one of the world’s
leading autism experts, I discussed how camouflaging
can prevent an autistic person from feeling that they
have a strong sense of self-identity. She told me that
this is something that she often hears about from
autistic people: if you spend your
whole life pretending to be ‘normal’,
how can you know who you really
Key sources are? Read more from Professor
Happé in the box.
Goldman, B.M. & Kernis, M.H. (2002).
The role of authenticity in healthy
psychological functioning and subjective Using mindfulness to explore my
well-being. Annals of the American
Psychotherapy Association, 5(6), 18-20.
social camouflaging
Hull, L., Petrides, K.V., Allison, C. et al. In the summer of 2017, around the
(2017). “Putting on My Best Normal”: same time as my autism diagnosis,
Social Camouflaging in Adults with I embarked upon an 8-week
Autism Spectrum Conditions. Journal of Mindfulness Based Cognitive
Autism and Developmental Disorders, Therapy course at the University of
47(8), 2519-2534.
Oxford, designed especially for busy
Kernis, M.H. & Goldman, B.M. (2006).
A multicomponent conceptualization students with a to-do list comprising
of authenticity: Theory and research. 101 or more items and a brain full
Advances in Experimental Social of facts and ideas. Mindfulness is
Psychology, 38, 283-357. most commonly defined as ‘paying
Mandy, W. (2019). Social camouflaging attention in a particular way: on
in autism: Is it time to lose the mask?
purpose, in the present moment,
Sage.
Raymaker, D.M., Teo, A.R., Steckler, N.A. and non-judgementally’ (Kabat-
et al. (2020). “Having all of your internal Zinn, 1994). I had heard that
resources exhausted beyond measure mindfulness was the latest panacea
and being left with no clean-up crew”: and I was duly sceptical.
Defining autistic burnout. Autism in One of the first exercises was
Adulthood, 2(2), 132-143.
to eat a single raisin over a period
Zheng, S., Sun, S., Huang, C. & Zou,
Z. (2020). Authenticity and subjective of about 10 minutes. We smelt
well-being: The mediating role of the raisin, felt the raisin, explored
mindfulness. Journal of Research in it with our fingertips, held it in
Personality, 84, 103900. our mouths, and experienced a
greater awareness of the raisin and
its sensorial experience through
Full list available in online/app version.
reflecting on it in this way. Now I
3 am not normally a fan of raisins, but
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I felt that I had been so focused upon the experience
and exploring every facet of knowledge that arose
from the exploration that I had truly ‘lived’ those 10
minutes.
As the course progressed, the number of attendees
reduced, but during the meditations we practiced I was
finding a new awareness. Rather than being consumed
by my thoughts and feelings, I was stepping back and
noticing them. It was certainly not plain sailing – I had
many, many moments of frustration, such as when
we meditated for 10 minutes and I realised that I had
swam off into my own thoughts for the majority of
the session. When completing the ‘body scan’, paying
attention to each body part separately and the aligned
sensations, I was often frustrated that I couldn’t feel
my knees ‘properly’ or that my stomach was grumbling
because it was almost teatime.
However, for me, the pivotal point of learning
was understanding the difference between ‘intrusions’
and ‘appraisals’. Intrusions can be thoughts, images,
worries, or emotions that flood our conscious
experience. But what I had crucially learnt is that
regardless of the content of the intrusion, I could
then choose how I made sense of the information in
my consciousness and how I wished to respond. I
sometimes forget to practice for days at a time when
weeks get busy – I am very much still exploring and
learning.
One of my explorations into mindfulness struck
me as potentially important. As a seasoned professional
at social camouflaging who often questions my
authenticity, I felt strongly that I wanted to learn how
to ‘drop my mask’ and act more in accordance with my
authentic, autistic self. If you are autistic too, you’ll
probably understand this irritation. Camouflaging can
be great, but it’s often burdensome and exhausting,
and if I am honest, I have spent years, a lifetime even,
not knowing how to stop. But the very mechanism that
helps me to camouflage – learning rules, algorithms
and processes to follow – may actually be the key here.
For me, mindfulness offers a one way to reach
Kernis and Goldman’s (2006) four components of
authenticity outlined earlier. If I am able to notice my
instincts to camouflage through mindful awareness
(authenticity component 1), for instance, ‘Jane just
made a joke, you should laugh’, then I can stop, pause,
and evaluate the information with a non-judgemental
eye (authenticity component 2). With the fortune of
appraising my intrusion and instinct, I am then able to
choose my subsequent behaviour to act according to my
true self or true instinct (authenticity component 3), for
instance, I might choose not to laugh because I didn’t
understand the joke or find it funny. I could then ask
Jane what the joke was supposed to convey and how
the punch line operated, thus fostering a more open
and connected relationship (authenticity component 4).
This is nowhere near as easy as it sounds. I do
not habitually go through the motions of adhering to
these four steps, and then flawlessly drop my mask
and proceed authentically. It takes practice, it even
often takes just as much awareness as to camouflage in
the first place. Sometimes, the process of being aware,
appraising and evaluating the information, and then
choosing how to respond, does not tally with the pace
of conversation. Before you know it, the conversation
has moved on and you haven’t had a chance to
contribute or respond. I found this frustrating at first,
but gradually I have learnt that it becomes a faster,
more automatic process over time and with practice.
The scientific literature does seem to support
a relationship between mindfulness, authenticity
and well-being. One study that combined cross-
sectional and time-lagged measurements found that
the association between authenticity and subjective
well-being was in fact mediated by mindfulness skills
(Zheng, Sun, Huang, & Zou, 2020). Two specific facets
of mindfulness were accountable for the majority of
this association, namely, mindfulness-describing (the
use of words to describe inner experience) and acting
with awareness (attending to the present moment).
This finding suggests that mindfulness, and specifically
those two components, may underlie the psychological
mechanism linking authenticity and well-being.
The authors suggest that mindfulness-describing is
linked to authentic self-awareness, while acting with
awareness is more relevant to authentic self-expression
or action. This is an important finding –although there
may be multiple pathways from authenticity to well-
being, mindfulness may offer one mechanism that can
be tested experientially.
Exploring further
The relationship between mindfulness, authenticity
and well-being may be far more complex than a simple
mediation of mindfulness between the other two. Most
research to date in this field has been with neurotypical
participants. In my experience, mindful awareness
and the stepping back that comes with it allows me to
appraise my instinct to camouflage, and to be aware of
my real, often conflicting, instincts. If I have time and
capacity, I then have the choice about my behavioural
response and whether or not it conflicts with the social
norm. I can choose to try to reach a semblance of my
the psychologist march 2021 camouflaging
Eroding the sense of self
– from Professor Francesca Happé
‘I have lovely friends, who are very supportive…but it’s not me they
like, they don’t know me at all – just the mask that I wear.’ These
words, from a 16-year-old girl who received her autism diagnosis a
few years earlier, brought home to me the impact that camouflaging
can have on autistic people. As well as being exhausting – like
speaking a foreign language 24/7 – masking and camouflaging can
erode the sense of self. And if no-one sees who you really are, how
can you develop self-esteem?
In our recent research on compensating and camouflaging,
led by Dr Lucy Livingston (who recently won the BPS Neil O’Connor
Prize), we’ve found that autistic young people who compensate a
lot – i.e. appear more ‘neurotypical’ despite persisting difficulties
understanding others’ minds (failing theory of mind tests) – report
more anxiety than those who compensate less (Livingston, Colvert
et al., 2019). Our qualitative study of compensatory strategies also
highlighted the costs of camouflaging: ‘I feel like I am acting most
of the time and when people say that I have a characteristic, I feel
like a fraud because I’ve made that characteristic appear’, said one
female participant in her 40s (Livingston et al., 2019). ‘Putting on a
performance’, as many participants described compensation, was
linked to ‘a diminished and uncertain sense of self’.
The wider cost to mental health also emerged as a major theme;
autistic people, and particularly women without intellectual disability,
are at greatly elevated risk of suicide (Hirvikoski et al., 2019). Given
that camouflaging is thought to slow recognition and diagnosis of
autism, and therefore provision of support, helping autistic people to
drop the mask – as Eloise discusses – seems important. That’s where
we can all play our part, since camouflaging is often driven by negative
responses, ostracism and bullying by neurotypical people. A greater
understanding and appreciation of autistic differences might mean
that autistic people could take off the mask.
Livingston, L.A., Colvert, E., Social Relationships Study Team et al. (2019). Good
social skills despite poor theory of mind: Exploring compensation in autism spectrum
disorder. Journal of Child Psychology and Psychiatry, 60, 102-110.
Livingston, L.A., Shah, P. & Happé, F. (2019). Compensatory strategies below the
behavioural surface in autism: a qualitative study. The Lancet Psychiatry, 6(9), 766-777.
Hirvikoski, T., Boman, M., Chen, Q. et al. (2019). Individual risk and familial liability
for suicide attempt and suicide in autism: a population-based study. Psychological
Medicine, 1-12.
authentic, autistic self, or choose to blend in and try again
another time.
Of course, we are all individuals, and what works
for some may not work for others. I have learnt to be
accepting of my efforts to socially camouflage – I cannot
break the habit of a lifetime in a couple of years. But I
am also learning to be open to new experiences, to try to
drop the mask when it is safe to do so, and to appreciate
that the consequences of not camouflaging, of being more
authentic, can improve my overall wellbeing. Rogers
asked, ‘am I living in a way that truly expresses me?’ I’m
not sure, but I am excited to explore it further.