Of the 157 conditions listed in the Diagnostic and Statistical Manual (DMS-5), the authoritative handbook of mental disorders, Autism Spectrum Disorder (ASD) is one of the most difficult to diagnosis.
The reasons for this are many, beginning with ambiguity in the diagnostic criteria. What exactly are deficits in “social-emotional reciprocity,” or “nonverbal communicative behavior,” or “restricted, repetitive, patterns of behavior, interests, or activities” the three characteristics required for a diagnosis? I consider myself an expert in Autism Spectrum Disorder in adults yet I have trouble figuring out whether someone’s behavior represents problematic social-emotional reciprocity, for example. Matching abstractions with real-life behavior is challenging, to say the least.
Yet, it is not this imprecision alone that makes diagnosing Autism Spectrum Disorder difficult. The real problem lies in the fact that, for many people, the evidence of ASD lies buried beneath layers of normal appearing behavior, leading even experienced professionals such as myself to believe ASD isn’t present when it actually is.
This problem is referred to in the literature as camouflaging. It is a coping strategy, sometimes conscious, often unconscious, designed to create the appearance that the person functions quite normally, without obvious problems and need for special attention or help. Those who are good at camouflaging end up avoiding the help they need to address their actual problems, in turn leading to complications with others and unhappiness within themselves.
Why Do People Hide Their Autism Spectrum Disorder?
Simply put, people pretend they don’t have Autism Spectrum Disorder because they want to appear normal. They want to be accepted, to increase connections and relationships with others, to socialize more easily and feel safer in social settings, to avoid drawing attention to themselves, and in some cases to ease the difficulties of work or managing their day-to-day lives.
How Do People Disguise Their Autism Spectrum Disorder?
The main vehicles for camouflaging are suppressing, hiding, minimizing and controlling Autism Spectrum Disorder behavior. One person I saw for an evaluation described an elaborate system of observing others, breaking their behavior down into component parts, analyzing the antecedent and subsequent reactions of that behavior and then constructing a conditional, if-then, system of responding with selected behavior to specific situations, all in an effort to mimic normal social behavior.
Asking questions of other people is a common method of disguising social difficulties, as is controlling self-focused talk. Some people will prepare topics of conversation ahead of time along with reactions to possible responses from those they are speaking with, much as an actor memorizes the script for a movie or play.
All of these strategies are designed to reduce the anxiety of social interactions and create an impression of normalcy, leading to the intended goal of disguising one’s Autism Spectrum Disorder.
Consequences of Camouflaging
Constant monitoring of social interactions and the ensuing efforts to hide the symptoms of Autism Spectrum Disorder is draining, increasing one’s existing chronic anxiety and stress. Many people report being on edge by the fear that people will find out they are concealing their social difficulties. Hiding their challenges, in turn, leads to the recognition of inauthenticity and further damage to one’s sense of self.
Increased feelings of loneliness and isolation are prevalent risks of hiding one’s Autism Spectrum Disorder. The effort to deceive, along with the recognition of a fundamental dishonesty towards others, is debilitating for many adults with Autism. Often, a self-perpetuating cycle of concealing one’s true self out of fear, leading to greater isolation and additional worry of being inadequate, all increasing one’s need to hide, is the outcome of camouflaging.
The many disguises of Autism Spectrum Disorder are both a common companion of this condition and damaging consequence of it, the least of which is the difficulty it adds to diagnosing Autism. For those adults who live with the need to hide who they really are, the many disguises of ASD are an unfortunate fact, and way, of life.