Masking and camouflaging – terms used to describe neurodiverse individuals who seek to hide or minimise their autism traits to fit in with the neurotypical world – are an uncomfortable and exhausting experience, often linked to mental health issues ranging from stress and anxiety to depression, burnout and an increased risk of suicidal thoughts.
It might seem counterintuitive to neurotypical people that neurodiverse people who find social interaction complex should choose a career with empathy and connection at its heart. But, says Jones, it makes perfect sense. “Around 1% to 2% of the UK population is autistic, but in my postgraduate year of around 80 students at least five were neurodiverse: over 6%. We’ve spent a lifetime trying to figure ourselves out, often misdiagnosed with mental health issues and desperate for answers. We’ve become accidental experts in that respect.”
Maria, a mental health nurse in her mid-50s, agrees that a career in mental health might seem a curious choice to those who know her. She once found talking to people so difficult it was hard for her to speak at all. “It may seem very strange that someone like me, who had so little confidence, was so very shy to the point of mutism, and who had such difficulties with people, interaction and social functioning, was drawn to a career that requires all of those skills, but I was filled with compassion, empathy and a desperate desire to help people, especially those that were also misunderstood,” she says.
“I don’t think I actually realised that everyone else didn’t have this extreme anxiety, constant nervousness and incredibly strong sense of justice and fairness,” she adds. “I think what was really driving me was to stop anyone else having to feel the way I always had, to help people where I had been left to my own devices.”
Nadia also became interested in psychology after struggling with her own undiagnosed autism. “I often felt that I didn’t understand myself or others,” she says. “I’ve spent most of my life trying to be ‘normal’ and fit in, which has involved huge amounts of time trying to understand people, and I wonder whether this process of understanding others is continued in my work.”
Like Jones, Nadia feels her autism has meant she is better at her job. “Despite the common myth that autistic individuals don’t have empathy, I find the opposite, in that I can really connect with the people I work with, and can feel what they feel,” she says. “My brain is quite analytical and notices patterns, which can be helpful in various phases of therapy (assessment, formulation, treatment). I also find clinical conversations a lot easier to have compared with generic, informal small talk.”
But Nadia is also worried that divulging her neurodiversity to colleagues could wreck her career. “There can be a lot of misconceptions about autism, and I worry others will assume I am not competent or capable, that I cannot communicate with others,” she says.
Abdullah Shahjan, an autistic therapist who works with the National Autistic Society, agrees that disclosing can be dangerous. “Autistic mental health practitioners who want to be open about their condition are all too likely to experience intolerance and negativity, which could seriously damage their careers. The risk is far greater than in other professions.
“Neurotypical mental health practitioners aren’t any different from the general public when it comes to understanding autism: that is, they have a negative perception,” he says. “This is exacerbated by the fact that as mental health specialists, the only openly autistic people they are likely to see are patients in crisis. This will inevitably lead them to link autism with an inability to function.
“An added problem is that mental health services are still in their infancy,” he adds. “As a specialism, it’s still struggling to be taken seriously as a science and to define best practice. That means that when an autistic practitioner comes along who doesn’t conform, there’s a risk-adverse defensiveness that kicks in.”
Jess Hendrickx is director of Hendrickx Associates, a UK-based specialist in autism spectrum conditions, which provides training sessions to employers within the mental health sector. “We need to get rid of the stigma of being autistic in general but especially in the mental health sector,” she says. “One way to do this is for there to be a wider understanding that autistic people are not flawed or broken, but instead process environments and information differently from non-autistic people. These differences can provide clients with a diverse but equally effective approach.
“Giving the wider public more positive information on autism should help to challenge any biases people may have about being treated by an autistic mental health professional,” she says. “This, in line with education and training for all staff and managers in mental health settings, will hopefully encourage more autistic people in the field to speak up, and more people to consider this as a career path.”
‘A lot fell into place’: the adults who discovered they were autistic – after their child was diagnosed
Of course, not all autistic people experience disadvantage in their workplace, but the fear among autistic people working in mental health about “being out” is widely felt.
Oxana is an assistant psychologist. “Being autistic for me means that I am on high alert most of the time,” she says. “I tend to overthink social interactions, notice patterns of behaviour, have an excessive urge to understand systems and organisations. This makes me a good therapist because I ask a lot of questions and facilitate patients to find their own truth. I do not have any preconceived notions of one ‘right’ way to solve their problems.”
But she wouldn’t dream of disclosing her autism. “I have witnessed how professionals would discuss someone autistic and doubt their abilities,” she says. “I feel that instead of gaining credibility for going through any mental health or neurodiverse difference, I might actually lose some.”
Among autistic professionals who have disclosed their autism to colleagues and employers, however, there have been positive outcomes. Karen is a PhD student studying the support of marginalised groups. “My autism helps me in my work because I am a very empathetic and at times an emotionally sensitive person,” she says. “I’ve been told that makes me very relatable and approachable.
“I opened up to my employers about my autism recently because in a meeting I couldn’t string a sentence together and was so ashamed. I blurted it out in tears but it was such a relief. Now I know that they have an understanding of why I am the way I am at times. It helps tremendously.”
Jones, who has decided to start being more open about her autism, is hoping for a similarly positive experience. “I recently told a long-term client of mine. It was the first time I’d ever disclosed in a professional sphere and I was understandably worried what she might say. But her response was brilliant: surprised, kind of excited and definitely curious.”
Jones is now determined to be completely open about her neurodiversity. “I work with hundreds of autistic professionals who are afraid to disclose in work for fear of judgment, so they mask all day, go home and have meltdowns, and it’s the same again the next day,” she says. “I’m taking a huge risk in putting myself out there but I hope that in the long run it will be worth it, not just for me, but for others like me, so they feel brave in owning who they are too.”