The Cost of Camouflage: Understanding Masking in Neurodivergent Clients

The Cost of Camouflage: Understanding Masking in Neurodivergent Clients

/ ADHD, Autism, Personal Growth, Therapists & Coaches / By

The Cost of Camouflage: Understanding Masking in Neurodivergent Clients

Why Therapists, Educators, and Healthcare Professionals Need to Recognise the Hidden Labour of Fitting In

Introduction: What Is Masking?

Masking—also referred to as camouflage—is a coping strategy used by many neurodivergent individuals, especially those with Autism, ADHD, and Dyslexia, to conform to neurotypical norms in social, academic, or professional settings. This often unconscious process involves suppressing or disguising natural behaviours and compensating for difficulties in communication, attention, or executive function.

While masking may lead to apparent “success” in fitting in, it often comes at a significant psychological cost. For professionals in mental health, education, and healthcare, understanding masking is crucial to providing informed, compassionate, and effective support.

 

What Does Masking Look Like?

Masking manifests differently across individuals and conditions, but common examples include:

  • Autistic masking: Forcing eye contact, mimicking social cues, scripting conversations, suppressing stimming behaviours, or faking facial expressions.
  • ADHD masking: Over-preparing, hyper-focusing to compensate for attention challenges, avoiding situations that expose forgetfulness or impulsivity, or over-apologizing.
  • Dyslexia masking: Memorizing spelling and word patterns instead of decoding them, avoiding reading aloud, or developing anxiety around writing tasks.

These behaviours may be praised as signs of “resilience” or “good coping,” especially in high-functioning or academically successful individuals. But they are often signs of chronic stress rather than success.

 

The Hidden Costs of Masking

Masking is not benign. Research and lived experience both suggest that long-term masking can lead to:

  • Burnout: Persistent exhaustion from sustained effort to appear “normal.”
  • Anxiety and depression: Internalizing the belief that one’s natural way of being is unacceptable.
  • Identity confusion: Losing connection to one’s authentic self due to chronic performativity.
  • Delayed diagnosis: Especially for women, girls, and people of colour, whose neurodivergence may be obscured by effective masking.
  • Suicidality: Multiple studies show a higher risk of suicidal ideation among masked or “high-functioning” neurodivergent individuals.

 

Masking and Misdiagnosis

Because masking mimics neurotypical behaviour, many individuals are misdiagnosed or undiagnosed for years. For example, an autistic child who imitates peers well might be seen as merely “shy” or “quirky,” while an adult with ADHD who’s developed rigid organisational systems may be perceived as “high-achieving.”

Common misdiagnoses linked to masking include:

  • Anxiety disorders (instead of understanding anxiety as a result of masking)
  • Borderline Personality Disorder (particularly in autistic women)
  • Depression (when emotional blunting is actually exhaustion from masking)
  • OCD or social phobia (when repetitive behaviours or avoidance are compensatory strategies)

 

Why This Matters in Your Practice

For Therapists:
  • Clients may appear “fine” but are in a state of hypervigilance, afraid to show their authentic selves.
  • Masking may cause emotional disconnection, making therapeutic rapport difficult unless recognized.
  • Standard therapeutic techniques (e.g., CBT or behavioural interventions) may inadvertently encourage more masking if not adapted.
For Teachers:
  • High-achieving students may be struggling silently. Masking can lead to meltdowns at home, chronic stress, or school avoidance.
  • Interventions focusing only on behaviour (e.g., compliance, quietness) may reinforce masking and increase long-term harm.
  • Classroom flexibility and strengths-based learning can reduce the need to mask.
For Medical Professionals:
  • Masked presentations can lead to inaccurate clinical impressions and missed diagnoses.
  • Medical environments often exacerbate sensory overwhelm, yet masked patients may not voice discomfort.
  • Creating low-stimulation environments and asking open-ended, sensory-inclusive questions can help.

 

Supporting the Unmasking Process

For many neurodivergent individuals, the path to health includes learning to unmask safely—but this requires a supportive environment and professional validation.

Ways professionals can help include:

  • Affirming identity: Frame neurodivergence as a valid identity, not a problem to fix.
  • Psychoeducation: Teach about masking to empower self-awareness and reduce shame.
  • Creating safety: In therapy, education, or medical care, build relationships where the individual feels accepted in their full authenticity.
  • Normalizing stimming, silence, and different communication styles.
  • Advocating systemically: Push back against rigid norms in schools, workplaces, and institutions that demand conformity at the expense of wellbeing.

 

A Word on Intersectionality

Masking intersects with race, gender, class, and culture. For instance:

  • BIPOC individuals often experience pressure to conform to both neurotypical and white-dominant norms.
  • Women and girls may be more adept at social masking, contributing to later or missed diagnoses.
  • Trans and non-binary individuals may mask gender and neurodivergence simultaneously, compounding identity stress.

Recognising these layered identities is crucial for holistic, inclusive care.

 

Conclusion: Toward Compassionate Recognition

To truly support neurodivergent individuals, professionals must learn to see beyond polished surfaces. Masking is not a strength—it is a survival strategy born of a world that too often misunderstands and devalues difference.

Whether you are a therapist in private practice, a teacher in the classroom, or a physician in a busy clinic, your ability to recognize and validate masked experiences may be the first step in helping someone finally feel seen.

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