Especially If You Were Diagnosed In Midlife
I’M NOT SUICIDAL (I have my days where if the world ended I might not do more than shrug, but I’ve no interest in hastening the event), but buried in the Discussion section of a new study on suicide among autistic adults is a look at camouflaging that concerns me.
Camouflaging significantly predicted suicidality in the ASC group, after controlling for age, sex, presence of at least one developmental condition, depression, anxiety, employment, and satisfaction with living arrangements. Camouflaging and age of ASC diagnosis, and suicidality and age of ASC diagnosis were not significantly correlated. This suggests that camouflaging is directly associated with suicidality rather than in combination with delay in ASC diagnosis. Camouflaging also explained significant additional variance in suicidality above depression or anxiety, suggesting that the association with suicidality is, at least in part, independent of mental health. This is the first evidence of camouflaging being a unique independent risk factor for suicidality in ASC.
In order to engage in camouflaging, one must have insight into one’s own difficulties, how these may be negatively perceived by others, and have a strong motivation to adapt one’s social behaviour to be accepted. Understanding associations between these factors with camouflaging, and the consequent impact on mental health would be valuable. For example, autistic people who have greater insight into their own difficulties are more likely to be depressed than those with less insight, and autistic people are able to accurately predict how family members perceive them, despite being different to their own view. It would be interesting to explore whether perspective taking ability and insight into one’s own difficulties increase likelihood of engaging in camouflaging behaviour with consequent negative impact on mental health and suicidality.
Emphasis added because I quarrel with that particular statement and the particular view of camouflaging that it espouses.
When you are not diagnosed until, say, midlife, you in fact likely spent decades without much in the way of “insight in one’s own difficulties”, yet you likely spent much, of not most (or, for some, all) of those decades camouflaging just due to society’s background radiation of conformity.
One thing I’ve been pondering lately is the idea that society has a sort of background radiation of conformity. So, even if you don’t know you’re autistic, you conform unconsciously because you’ve been “irradiated”, unless you have the sheer self-awareness and strength of will to resist. That’s how you go four decades camouflaging, masking, passing without knowing — and then hit midlife and wonder why the hell all of these routine things about the world suddenly hurt so much.
It’s problematic, then, if not potentially dangerous, for researchers or practitioners to think of camouflaging purely or solely as a conscious and deliberate act. We need research and practice to consider the implications and impact both of intentional masking on the part of autistic people with a diagnosis and unintentional conformity on the part of autistic people who didn’t yet know they in fact are autistic.
The latter, by its nature, mostly comes into play only once you receive a diagnosis. It’s then a matter of retroactively and retrospectively looking back at your pre-diagnosis life to try to see where you might have lucked out in being a part of environments where your differences happenstantially were accepted and where instead you might have been subject to that background radiation of conformity.
“It would be interesting,” say the study’s authors, “to explore whether perspective taking ability and insight into one’s own difficulties increase likelihood of engaging in camouflaging behaviour with consequent negative impact on mental health and suicidality.”
How many people does this leave out of the equation?
Everyone, autistic or not, is subject to that conformist background radiation to one extent or another, but it’s going to have a greater deleterious effect upon autistic people. Camouflaging comes with risks, and both short-term and long-term harms, regardless of whether you knew at the time that it was happening. Surely if camouflaging brings “negative impact on mental health”, it’s worth also specifically looking into what effects unknowingly camouflaginghad on late-diagnosed autistics?
If researchers and practitioners define camouflaging as something that only results from “perspective taking ability and insight into one’s own difficulties”, they are leaving behind all of us who spent decades not knowing we were autistic.
It’s already tough enough, being diagnosed in midlife. Researchers and practitioners shouldn’t make it worse by leaving us out.