Masking

The information provided herein does not constitute medical advice or are not provided by medical doctors and should not be relied upon as such. 

If you're interested in neurodiversity (an approach that views diversity in human cognition and behavior as a natural part of human biology), you've likely come across the term "masking." In this article, we'll explore what it is, how it can affect neurodivergent people, and how it relates to breathwork.

In the neurodivergent community, the terms "masking" and "camouflage" are often confused or used interchangeably. Recent clinical research considers camouflage to be an umbrella term encompassing three strategies: masking, compensation, and assimilation. Camouflage is the phenomenon where a person tries to minimize visible neurodivergent traits in social interactions, whether consciously or unconsciously. It is important to realize that, to some extent, everyone uses camouflage, because from an evolutionary perspective, blending in means survival. But for neurodivergent people, camouflage strategies are far more pronounced and alter a person's identity to a much greater depth than they do for neurotypical people. A typical example is eye contact, where you calculate how long to maintain eye contact or look at the tip of the nose or between the eyes. Another example is a memorized list of proverbs, their meanings, and when to use them, or a list of appropriate "small talk" topics. Camouflage stems primarily from the need to "fit in," that is, to be accepted by the group. Research from recent years points to a visible difference between the sexes (men and women). Women hide their differences far more than men, especially in active interaction with others. This can lead to poorer mental health and delayed diagnosis. Let's take a look at individual strategies.

Masking manifests as concealing and suppressing natural traits of neurodiversity. An example might be refraining from asking follow-up questions about an assigned task, even though you have no idea what is actually expected of you.

Compensation is a set of artificially created strategies ("guidelines") for overcoming various social barriers or other deficits. If you struggle with time management, you have an insurmountable series of alarms, reminders, and notes. Even so, you arrive at important meetings two hours early.

Assimilation is a conscious effort and action to blend in with your surroundings or a chosen group. Wearing clothes that are so uncomfortable you'd rather set them on fire, but your peers wear them.

All three strategies overlap and complement each other in real life. They can reach a point where a person no longer even realizes they're actually using them. In other words, it becomes that person's identity. We'll discuss what happens when this false identity, built up over the years, falls apart in another article.

And how does this relate to the world of breathwork? Let's first look at the perspective of a neurodiverse participant in a group workshop (it's important to remember that neurodiversity is a spectrum and every individual has a unique experience).

Imagine this. You sign up for an afternoon breathwork workshop. Just to be safe, you arrive an hour early and spend that time sitting in your car. Even though participants have already started arriving, you wait a little longer, because nobody likes the ones who are always first. You make your way to the studio door and start wondering why there's a line. After a moment, you realize the reason is a hug with the facilitator. That's good; there are two people in front of you. This gives you time to mentally prepare for the intrusion of a stranger into your personal space, and at the same time, you quickly gauge the length and style of the hug. You've navigated the first hurdle and are already mapping out the space. Everyone is chatting with each other, and you ask yourself another question: "Do they all know each other?" At that moment, you start systematically observing behavioral patterns. After a while, you'd be pretty good at guessing who knows each other and who doesn't. At the same time, you feel your own social deficit as you start running through conversation scenarios in your head. You're snapped out of your thoughts by someone getting a little too close to you, so you tactically disappear (at lightning speed, of course) to the bathroom. There, you realize three things: 1) you're still wearing all your stuff and have no idea where to put them, 2) the bathroom is really small with all those things in it, and 3) how utterly blissful it is because it's quiet in there. For the next 10 minutes, you sit on the toilet and ponder your decision to attend a social event.

Although we haven't even gotten to the breathing itself in this story, you can already see all three camouflage strategies at work. What does this mean for me as a facilitator? For example, that an event of this type can be exhausting for a neurodivergent participant, unnatural in many ways, and stressful. It may happen that an activation technique such as CCB (Conscious Connected Breathwork) disrupts that "mask." For example, eye contact may change, the participant may suddenly leave, or conversely, remain seated even as others gradually leave. If something like this happens to you, I would personally recommend not jumping to conclusions about the participant's state; don't be afraid to ask and give them space and time, especially if they ask for it. I'd like to invite you to think about how you could create a more inclusive space and if you would like to know more about this topic, you can explore references below.

In the next article, we'll look at camouflage from the perspective of a neurodivergent facilitator.

References:

Cook, J., Crane, L., Hull, L., Bourne, L., & Mandy, W. (2021). Self-reported camouflaging behaviours used by autistic adults during everyday social interactions. Autism, 26(2), 406-421. https://doi.org/10.1177/13623613211026754

Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M. C., & Mandy, W. (2017). "Putting on My Best Normal": Social Camouflaging in Adults with Autism Spectrum Conditions. Journal of Autism and Developmental Disorders, 47(8), 2519-2534. https://doi.org/10.1007/s10803-017-3166-5

Khudiakova, V., Alexandrovsky, M., Ai, W., & Lai, M. (2024). What We Know and Do Not Know About Camouflaging, Impression Management, and Mental Health and Wellbeing in Autistic People. Autism Research, 18(2), 273-280. https://doi.org/10.1002/aur.3299

Klein, J., Krahn, R., Howe, S., Lewis, J., McMorris, C., & Macoun, S. (2024). A systematic review of social camouflaging in autistic adults and youth: Implications and theory. Development and Psychopathology, 1-15. https://doi.org/10.1017/s0954579424001159

Perry, E., Hull, L., Mandy, W., & Cage, E. (2020). Understanding camouflaging as a response to autism-related stigma: A Social Identity Theory approach. Center for Open Science. https://doi.org/10.31234/osf.io/7w2pe

Radulski, E. M. (2022). Conceptualising Autistic Masking, Camouflaging, and Neurotypical Privilege: Towards a Minority Group Model of Neurodiversity. Human Development, 66(2), 113-127. https://doi.org/10.1159/000524122

Bargiela, S., Steward, R., & Mandy, W. (2016). The experiences of late-diagnosed women with autism spectrum conditions: An investigation of the female autism phenotype. Journal of Autism and Developmental Disorders, 46(10), 3281–3294. https://doi.org/10.1007/s10803-016-2872-8.

Begeer, S., Mandell, D., Wijnker-Holmes, B., Venderbosch, S., Rem, D., Stekelenburg, F., & Koot, H. M. (2013). Sex differences in the timing of identification among children and adults with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43, 1151–1156.

Cage, E., Di Monaco, J., & Newell, V. (2017). Experiences of autism acceptance and mental health in autistic adults. Journal of Autism and Developmental Disorders, 48, 473–484.

Radulski, B. (2023, March 31). What are "masking" and "camouflaging" in the context of autism and ADHD? The Conversation. https://theconversation.com/what-are-masking-and-camouflaging-in-the-context-of-autism-and-adhd-193446

van der Putten, W. J., van Hooff, J. C., Begeer, S., & Geurts, H. M. (2024). Is camouflaging unique for autism? A comparison of camouflaging between adults with autism and ADHD. Autism Research, 17(4), 785–794. https://doi.org/10.1002/aur.3099

Webb, M. (2022, April 20). What is ADHD masking? Verywell Mind. https://www.verywellmind.com/what-is-adhd-masking-5200863

The Empirical Data on ADHD vs. Autistic Camouflaging: van der Putten, W. J., et al. (2024). Is camouflaging unique for autism? A comparison of camouflaging between adults with autism and ADHD. Autism Research.

Kartar, A. A., Horinouchi, T., Örzsik, B., et al. (2025). Neurobiological substrates of altered states of consciousness induced by high ventilation breathwork accompanied by music. PLOS ONE, 20(8), e0329411. https://doi.org/10.1371/journal.pone.0329411