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[Music] Hi everyone, it's Iain. Welcome to Happy Healthy Autistic, where I share my dual perspective as an Autistic Psychologist. Today is the second episode of a mini-series called Now What, where we explore ideas following, finding out that you're Autistic later in life. Today I'm going to discuss self-identifying, why I get assessed at all, talking about masking and unmasking, parsing what is and is not autism, talking about disclosure and accommodation. In the previous episode I talked a lot about internalized ableism, the emotional labor of re-examining past experiences after finding out that you're Autistic, and

how deeper self-understanding can set us up for increased self-acceptance and then meaningful change in our lives. Just as a quick recap on why I'm doing this mini-series, I saw a forum post titled, "I'm X years old and I just got diagnosed." This is a very common kind of thread for me to see. And nothing in this thread stood out to me as particularly unique, and it was interesting and sort of heart-wrenching in the way that they often are. So the person who originally posted is saying things like how confused they are and my world is

spinning and the things that I thought I knew about myself seemed like they were all a lie. My entire life feels turned upside down, and I don't know which parts of me are real. And so some of the responses were saying things like, "It's been a year since I found out and I'm still grieving, and I don't know how to pick up the motivation to keep going with my life, and it's made me lose hope that things could get better." And so seeing this kind of response, I find that really affecting and just really sad,

I guess. I don't want to shortcut anybody's emotional experiences. I just feel strongly for people who find out later in life that they're autistic, having had that experience myself and not really getting the support I needed and the information I needed at the time. And, you know, this was years ago, so it was less available. It's great that it's all more available now, but I guess it can just feel really isolating and we can feel lost. So it's nice that these communities exist, that these conversations happen, and that people who are, whatever they're feeling about

it, can reach out and connect and feel less alone. So I just wanted to highlight it, that these discussions do happen very regularly, and if this is part of what you're going through, I definitely encourage you to just Google autistic adult forums or subreddits or these kinds of things. There's lots of great ones out there. Other people talked about, you know, "I went through and I'm still going through a major identity crisis. It made me feel hyper-aware of all the social masking I was doing and how I felt like a fake, but therapy's been really

helping and my therapist tells me how common this kind of thing is, sort of the self-doubt and whatnot for late-diagnosed people." Not that it makes it any easier, but I really find it helpful to engage with my special interests and go to therapy. And then somebody else said, "You know, I never let it bother me. I always knew I was weird and quirky and just not normal, but I love myself and, you know, I encourage you to love yourself and these kinds of things." So the people who engage in these conversations will be at all

different parts in their own journey and how long they've known and how much self-acceptance they do or don't have or are feeling in those moments. So it's often a rich and helpful, hopeful kind of discussion. So again, I encourage you to check them out if this is of any interest to you. And as I said, fortunately, there are lots of these kinds of communities online, but there's also lots of resources, books, and so on. And I mention these throughout all my episodes here and there when relevant, and I often include them in the show notes,

of which there will be quite a number of today as well. And I hope my work adds one more option to the mix. When I was talking about self-acceptance in a previous episode, I should have talked a little bit about this idea of, you know, why get assessed at all. And I fairly frequently hear from clients that somebody, like their family doctor or a therapist or someone like that will say, you know, often these people are fairly dismissive of the possibility of the person being autistic. I don't know why they do it. Maybe it's an

attempt to be diplomatic or something, but they'll say, "Why would you even seek a diagnosis at all?" Like, even if you are autistic, which I don't really think you are, but even if you were, why would you get assessed? What would that do for you? That wouldn't do anything for you. You're an adult now. I can see how maybe as a kid that could be of some practical value, but why do that as an adult? So my sort of professional opinion is don't bother. So I think that that's a very uninformed opinion, very unhelpful opinion.

Some people choose to never seek a formal assessment, and that's completely fine. Some people just want to go through the formal assessment process for all kinds of reasons. And some people, I think, especially depending on the complexity of their case, I think some people should get assessed formally. So a couple of reasons why a formal assessment could be worth doing, again, is back to that idea of how complicated the clinical picture could be, and part of that is relating to how many co-occurring conditions there often are. So the chances of a lot of different conditions

go up. Like, if you're autistic, the chances that you're going to have ADHD are higher, or a history of trauma, or OCD, anxiety, bipolar disorder, and on and on and on. So a thorough assessment can be really important, especially in cases where those things are present, and sometimes it's like most of those things are present at the same time as the autism, and sometimes many of those things are present and the person's not autistic. But they may look at some of their experiences and think, "I mean, this looks a lot like autism," which can be

true. A lot of those conditions have a lot of overlap with autism and can sort of obscure and mimic the traits in different directions. So depending on that clinical complexity, that can be a really strong reason to seek an assessment, because we don't want to end up with a misdiagnosis. If you are formally diagnosed, then medical staff will usually be quite a bit more likely to believe that you're autistic, thus take you more seriously when talking about your other healthcare concerns or when you're asking for accommodations or these kinds of things. Obviously, it allows possibility

for access to accommodations at work, at school, to help with our sensory differences and executive functioning differences and so on. A formal diagnosis will help some people with feeling more confident in understanding their own experiences and their identity, and it can really help to cut down on feeling so much imposter syndrome. I talked about this a lot in previous episodes, but knowing you're autistic really can allow for a lot more focusing your efforts on self-acceptance and any changes that may be necessary for you or possible. I talk about not only knowing what those things would

be for you, but also believing you deserve them is really important. Again, being diagnosed can allow a person to get a lot more specific about what supports or information they want to seek. They can get really specific about social differences, sensory differences, co-occurring conditions, their "strengths and weaknesses" and whatnot. It allows us to modify our home and work and relationship environments to be a better and better fit for us. Lastly, it can help the people close to us better understand our differences and needs. Just a quick point on language between self-identifying and getting diagnosed. Oftentimes,

I'll hear people use the term "self-diagnose." I don't want to be pedantic, but it's important to recognize that diagnosis is in a lot of places, technically, it's like a protected medical-legal process in the same way that I am not allowed to say that I'm a lawyer or a physician or something like that. People who aren't psychologists can't say they are or certainly shouldn't and there would be repercussions if they did. There are certain professional clinical activities that as a psychologist I'm allowed to do if I'm experienced in those things. This would be like practicing as

a therapist generally or providing clinical supervision or in this case providing assessments and diagnosis. To say you can self-diagnose is kind of like-- I don't want to say it's quite an oxymoron, but it's just not a process a person can do to themselves. I think self-identification with autism is wonderful and is something that lots of people do. Not only do I have no problem with it, I think it's great and I encourage it when it is a good fit for people. I think it's something you want to do carefully and thoughtfully and take your time

with. Again, it can be inappropriate in some cases. Just when it's clinically very complicated, it would be better to try to seek a diagnosis if you can. It can be impossible or very difficult in some scenarios. That's another part of the question. You can self-identify in a partial way or an experimental manner. Learn lots about autism. Try it out. See what it's like to think about yourself a little bit differently, to try these accommodations and so on. It's sort of a diagnosis by treatment. Self-identification is definitely valid in terms of personal understanding and community belonging.

Again, I'm a big supporter of that kind of thing. A formal assessment follows a much more structured and rigorous process generally speaking. Again, obviously there's only certain regulated professionals that are allowed to do this. It involves taking developmental history, probably some standardized tests, mental statuses, exam observations, clinical interviews, reviewing relevant collateral information. And then of course all of that being done by hopefully somebody who has assessed many, many people and has lots of relevant clinical supervision and experience in these kinds of things. Even so, back to the self-identification, there's a self-screening process you could think

of as a starter's guide for this whole thing. So I provide some guidance and resources and thoughts about how a person might get started with their self-identification process. Now I'm going to talk about masking and unmasking for a little while. I defined this in the first episode, but I will define it a little more thoroughly now. To start with, I'm going to read a little bit from my book where I talk about this. Masking, also known as social camouflaging, refers to the strategies an autistic person uses to try to hide or minimize their autistic traits.

These behaviors are developed to navigate social expectations and are deployed for reasons of physical and emotional safety, professional survival, and the basic human need to belong. For many, masking is a learned survival strategy developed in response to the repeated social trauma of being misunderstood, criticized, or ostracized. When a person repeatedly learns that their authentic self invites negative consequences, their social world can become a source of persistent threat. In this context, masking functions as a chronic, low-grade, adaptive trauma response. So it's the social equivalent of fawning, a constant performance of agreeableness designed to appease a perceived

danger to ensure safety and maintain connection. The capacity for social adaptation presupposes a degree of social awareness. Masking develops from the ability to determine, at least some of the time, when a social exchange has gone awry. This recognition might surface in moments or it might lie dormant for months or years. Regardless, when it's paired with a subsequent negative feeling, it can register as a threat to one's safety or a sense of belonging within a group. A high masking presentation is often marked by a tendency to internalize distress, an extensive use of varied social strategies like

compensation and assimilation, and a socialization process that emphasizes agreeableness and refined social skills to avoid punishment. So to circle back to a couple of those terms, internalizing is when you suppress your own feelings and boundaries, and in particular to sort of make room for other people's feelings and boundaries. It's a lot of blaming oneself when something goes wrong and thinking if I had just tried harder, if I just did more, if I wasn't so lazy, then things probably would have worked out for me. Internalizing is involved in a lot of mental health concerns like depression

and anxiety, and it's certainly quite common for autistic people with higher masking presentations. I also mentioned assimilation, which involves attempts to blend into social situations in which the individual is uncomfortable without letting others see this discomfort. It can feel a lot like a performance. I also mentioned compensation, which includes more cognitively demanding masking strategies. People talk about two types of compensation. There's shallow and deep compensation. So shallow compensation is using pretty basic learned scripts and mimicry, often not necessarily understanding exactly if or why a behavior is appropriate in the given context. So this might be

a moment where you're like meeting somebody or greeting someone and thinking, "Oh, is this a moment for a handshake or a hug or neither? Should I just wave?" And then you take a guess and they don't seem to respond negatively. So you think, "I guess I probably did that right." Deep compensation is the development of an alternative cognitive pathway to understand other people's mental states, using mostly logic, pattern recognition analysis, and so on, often being consciously built over the decades on a catalog of past experiences. You could think of this as the work of building

an analytical theory of mind. In any case, autistic people who use high masking behaviors often have interests that align more closely with peers of a similar age and gender, which can further obscure social differences. And beyond that, superior language skills and/or above-average intelligence can provide the cognitive architecture necessary to analyze social patterns and attempt to construct elaborate coping mechanisms. So the more of either one of those things, higher verbal fluency, above-average intelligence, and so on, the more of either one or both that are present, that tends to lead to more social masking, particularly when somebody's

autistic but doesn't yet know that about themselves. Something like the attractiveness halo effect, more often casually called "pretty privilege," can have an effect here as well. While some autistic people may use masking selectively with limited ill effects on themselves, its consistent use is widely understood within the autistic community and increasingly in research as a major contributor to poor mental health. Chronic masking often leads to autistic burnout and can erode a person's sense of self. Each of us gets to decide for ourselves if we mask, how often we mask, why we do it. You could decide

that in a particular moment, like maybe you're at the bank or something, that masking might help you get through a situation for 10 seconds or a few minutes more easily than taking a very principled stance and refusing to mask. Some people choose to never mask, and I think that that's excellent. I certainly aspire to that as well, and I feel healthier or more calm when I don't mask. I do think there's an important difference here to consider between masking actively versus learning more about social experience in a way that helps you understand what's going on

around you and why it's happening. I think that can have a lot of utility in relationships, at work, at school, in any kind of situation where understanding what's going on around you socially matters, but it's quite separate from how you decide to respond to those moments. Just because you understand what's going on doesn't mean you have to mask in your response. In fact, I would encourage you not to whenever it's reasonable or safe for you to do so. This can also have really important implications for safety, as in being able to notice when a situation

you're in is getting increasingly unsafe. So if we're not picking up on what certain things might mean, we can find ourselves in fairly dangerous situations, and I think a lot of autistic people can probably relate to that over the years or decades of their life. I certainly can as well. So in practice, I mask very rarely, as far as I can tell. I do find it can be fairly sneaky, as in it can happen, and I won't notice until later. If we were to ask in a practical sense, how do I stop masking, which is

a common question that I get asked, also a common question you would see online and so on, there are, I think, a lot of ways to tackle that. I don't need to reinvent the wheel here. I think it's been very well covered by an increasing number of high-quality resources. So, of course, the classic unmasking autism book by Devin Price, who's a psychologist who's autistic, that's a great resource that I would check out. Another great book on this subject is called Taking Off the Mask, practical exercises to help understand and minimize the effects of autistic camouflaging.

That's by Hannah Belcher, I think it's pronounced. They are an autistic researcher, speaker, and author. They have a PhD. I'm not sure if they're a clinician. As far as I can tell, they might not be, but still seems to be a very well-received resource. Beyond that, there's lots of great content online on YouTube or wherever you want to find content like this. For example, from Paul, who's got a channel Autism from the Inside, Yo Samity Sam, these kinds of people. Probably for me, what made the biggest difference is first, learning as much as possible about

my experience of being autistic, and second, focusing on the emotional processing related to all of that, and then most importantly, focusing on the work of accepting those things about myself. The more I felt at peace with those aspects of myself, it just sort of organically happened that I was like, why would I hide these? There's nothing here that I feel like I need to hide. There was nothing left for me to feel scared of or embarrassed about, and so on. This is definitely an ongoing process for me, even still many years after finding out that

I'm autistic, as I discover more and more about myself. So this remains aspirational work. Certainly the job that I have allows me more latitude to not mask, which I recognize as a privilege to have. I still would encourage anyone, regardless of what your life looks like if you're working or in school or you want to be working or whatever it is you're doing, I would hope you can, over the sort of medium and long term, aim towards and experience a situation, an environment that's more accepting of your autistic differences. I get that for safety and

stability and these kinds of things, sometimes to just flip a switch and stop masking at work could be pretty problematic in some contexts, and some people certainly feel they can't do that. So again, it's a personal choice, and I think that safety is the top priority. Do note that other mental health conditions can have an effect on masking. I think you could probably imagine how depression or anxiety could alter a person's social behavior, and so if you're masking on top of that, it can get pretty complicated pretty quickly. So for example, if you have a

history of complex trauma, addressing that may have some effect on masking behaviors generally, which addressing complex trauma, processing it, healing, growing, and so on, I mean, that can change a person's life anyway, so as much as is reasonable for you, if that's the case, I would hope you can do more and more of that work over time. Beyond that, the more resolved a person's trauma is, the easier it becomes to identify autism. Whether you're self-identifying or undergoing a formal assessment, it can be quite challenging to determine what of our experience is autistic masking and what

of it is self-protection based on old trauma, and then those things can get pretty complicated and mixed together because for a lot of people, we're very socially sensitive, so we can experience what you might call social trauma, which can be partially or deeply related to being autistic. It can become a pretty interesting lens to view most or all autistic masking as being the result of social trauma or trauma more generally, or at least having a trauma-informed perspective, but I won't distract as here with those thoughts. So overall, unmasking, I think, is a very personal thing

for each of us. It's often a fairly long-term process or even a lifelong process. For me, I would say so far it feels like a lifelong process, but who knows? I really don't think there are any easy answers here, though it does help to hear about other people's experiences, such as in online forums or some of the books I mentioned. I think it can be really helpful to discuss it in therapy or with people you feel safe with. And to some degree, perhaps the most useful thing we can do is spend time with other neurodivergent

people in person or maybe in a video call if that's as close as you can get for now, because getting a sense of a person's way of being, especially somebody who's known they're autistic much longer than you, getting more and more diverse exposure to more and more of these people can really help us get a sense of, like, wow, what else might this be like for people? How else might this be for me? So it can, I think, catalyze some of our growth and healing. Now I'm going to talk for a few minutes about differentiating

between what is and is not autism. I think this is a really important subject at many points in a person's journey of self-discovery around this, like, "Wow, I'm autistic. Now what do I do?" Whether it's at the very beginning or during a formal assessment if you choose to do one, or in the months and years following that time. Here we're talking about the after period, but it's, I think, always a very important subject. To start with, this is a very complicated and very individualized subject. I don't say that to skirt responsibility and not have to

talk about this in detail. It's just the truth. A good assessment will help you with this kind of differentiation, but even if you do do that, at the end of the day, in a really detailed manner, you're going to have to do a lot of this work yourself because of how individual it is and, like, just how rich a person's life is as far as the amount of experience we've been through. You can't sit and tell an assessor about 35 years of your life experience that's going to take you hundreds of hours or something. So

this is work to be done in part, or at perhaps a higher level of resolution. A lot of that's going to happen either individually or with close friends or family you feel safe with or with a therapist or these kinds of things. It just takes time. So there's lots of great books and videos and articles about this. I think journaling is a really great way to approach this kind of work. If you wanted to, it's not hard to find articles, whether they're casually written or more clinically written or even research articles, differentiating autism and other

conditions, like specific conditions if you looked at autism versus social anxiety or these kinds of things. As always, I would encourage you, if you're going to look at these kinds of resources, and ones written by clinicians, physicians, researchers, and so on. That specific focus, I think, is a good way to often go if you're aware of some other salient condition that you have or may have. Anxiety is a great example, but trauma is another great example, particularly complex trauma, but OCD, ADHD, depression, burnout, and so on. These are all common and excellent examples for what

I'm talking about. Basically, I would try to get very familiar with what overlaps between those two conditions and the traits that do not overlap between those two. I'd reflect on those things personally. I would write about it, make notes, and journal, and so on. It would be a way for me to process, but you do whatever works for you. Megan Anna Neff is a psychologist who is autistic. She has great resources on her website. I believe Neurodivergent Insights, which I'll put in these show notes. Some of her articles and resources look at autism versus XY

and Z, other conditions. It's really, really helpful for thinking about differentiating between what of my experience is and is not autism. The key to differentiating between these kinds of conditions, it's really important to be thinking beyond simply looking at someone's behavior or at a glance, "Is this thing present for this person?" For example, do they sometimes seem to fail to account for a social cue that happened during a conversation they were in? Because they might have seen that social cue and not known what it meant. They might have observed that social cue within their visual

field and not even registered it as something to interpret or try to interpret. Or if it's an attentional concern, such as someone with ADHD might have, that social cue may happen, but the person is not even listening. They don't even notice. They're either not looking at the person they're talking to or they're looking at them, but they're just lost in their own mind thinking about something else. That's a very simple example of, "Is this social cue being missed due to an attentional concern, or is it being missed because I'm having trouble interpreting it?" So ADHD

versus autism in that case. So we can't just look at, "They missed a social cue." We have to ask, "Why? Why is this thing happening for this person? What's their motivation? What kind of emotions of theirs seem to relate to it? Are there particular experiences in their past that seem to be related to it or causing it?" Trauma is a great example there. But the kinds of questions you, I think, need to be asking to dig into that, what's behind this very endlessly based on the person in front of you. I can't give you an

exhaustive list. And it's perhaps, "I'm not trying to sell my services or convince anyone to get assessed." But that's a good example of where a experienced assessor can be very useful. And consider, too, when you're trying to read through this stuff by yourself, I mean, you can read articles written by experienced people. That can be great. But for example, if you're meeting with someone who's assessed like 4,000 autistic adults, all of who have average or above average intelligence, that level of experience gives them a massive advantage in trying to help you figure this out, plus

all their clinical background and everything like that as well. Back to this question, particularly around trauma and sort of how this might relate to parsing autism and not autism, I think that level of self-reflection can be pretty difficult for a lot of people, in particular when the things causing the behavior in question is unprocessed or if it's still kind of in the middle of being processed. And some of this stuff takes years or decades for people. Some things remain unresolved for people's entire lives. And so if the behavior in question is related to that, my

experience has been a lot of people struggle to reflect accurately about that kind of thing, even if they think they are understanding it fully, but they're not. Like, if they're not, that can really get in the way of figuring this kind of thing out. So I just really caution people to be very careful with this kind of thing. I guess what I would say is I meet a lot more people who struggle with this but do think they've figured it out than people I meet who have actually figured this out. And these people are highly

motivated, highly informed, given that they are not clinicians. They're really doing their best. And I respect that. I just think these are very challenging questions for everybody, and in particular when it's not a person's specialization professionally. I don't say that to discourage anyone. I just say it to encourage you to be responsible and thorough and seek high-quality resources and therapy and so on as needed. One resource that's available from me, which has no cost, is on my website ndpsych.com, is a self-screening. That's a way to start thinking about this question of, "Wow, might I be

autistic?" But one of the resources listed in there is a version of what's called the Coventry Grid for adults that other clinicians created, and it helps differentiate between experiences or traits of trauma, in particular complex trauma and that of high-masking autistic experiences. But the original version for adults was written for clinicians, and it's also written in a pretty opaque and confusing way, and it's definitely not trauma-informed or neurodiversity-affirming. So I rewrote it to be a self-reflection tool that any autistic adult can try to use to further differentiate between what perhaps is high-masking autistic experience as

well as complex trauma. Though, unfortunately for many autistic people, they're experiencing both of those things. So you sometimes see that online. People are like, "I can't tell if I'm autistic or if it's all just trauma." And of course for some people it, quote, "is all just trauma." But what I'm saying is that for a lot of autistic people, unfortunately we have experienced quite a bit of trauma, so it gets complicated. The point is the self-reflection tool that I created is available for free in my self-screening, and that's on my site. In any case, the aspects

of our experience that relate to autism, I think deserve to be deeply understood, accepted, accommodated, and the parts of our experience that don't relate to autism, they also deserve to be investigated, healed, for us to experience growth related to those things in whatever way is most appropriate. It gets kind of complicated because we could be talking about anything at that point. But I do think that there can be a risk of over-identifying some, many, all, within themselves of their troubling behaviors and experiences as all being related to autism and then using that as a rationale

for some, in some way, to avoid taking responsibility for their behavior at times or other areas of growth. It's pretty rare that I see this, but being used in some kind of like get-out-of-jail-free type way socially, more likely though is we make an innocent mistake of misidentifying one of our experiences or traits as, I guess that's an autism thing, so I'll just leave it be, which is, you know, in a way very compassionate, and I'll try to understand it and be self-accepting, but it's like what if actually that piece was a trauma piece and you

could be working on it, healing, growing, and putting that piece to rest and like moving on with your life, wouldn't that be lovely? So I think this is a good example of why accurately differentiating between what is and is not autism in ourselves is very important. As a final note on the differentiation, I'll just share anecdotally, I sometimes hear from my autistic clients who experience a lot of burnout that, I mean, when I give them my opinion that they are autistic during an assessment, sometimes they get very upset because they'll think, "Oh, wow, I guess

this is what autism feels like, and this feels terrible," which is their burnout experience, and so you're now, you're telling me I'm always going to feel this way, that sounds terrible, I don't want to put up with this, I wish I wasn't autistic, and so they're conflating their burnout experience with their autistic experience, and I wouldn't want to feel burned out for my entire life either, that sounds terrible, but autism does not guarantee that a person is going to be burned out. Admittedly, autistic people are more vulnerable to becoming burned out, and those same vulnerabilities

can make it more challenging for us to recover from it. Most people have heard of the term autistic burnout, which is trying to further specify these kinds of things. So anyway, the point is that's another good example, almost from a moral or hope point of view, to understand what is autism for that person, and then what is autistic burnout, because they're not the same thing, and making that mistake in this case made that person very, very upset, and I'm not saying I'm amazing, it's just that, like, had they not had someone to help clarify that,

I think that that could have been pretty depressing, or sort of led to a fair amount of hopelessness for a while. Next I'm going to discuss disclosure. Disclosure here refers to the decision of whether or not to tell somebody that you are autistic. Disclosure is a really common thing for people to think about when they have recently found out that they're autistic, and some of the questions they might ask themselves include, "Who should I tell that I'm autistic?" "Why or would I not tell a particular person?" "How might I approach telling someone if I wanted

to tell them?" "Is it safe or advisable to tell my coworkers?" "My boss?" "What about human resources?" and so on. Something to keep in mind is that you can't tell somebody once you disclose, so if you're not doing very well emotionally, if you're feeling kind of fragile about finding out that you're autistic, and you're, you know, I think it makes sense to be looking for some support in those moments, but if you choose a person who then reacts poorly, that, you know, never really feels good, of course. If we're feeling pretty sensitive or fragile, that

can feel much worse. So as best as possible, I would encourage you to be thoughtful about picking people who are very, very safe, especially if it's the beginning and you're thinking like, "Oh, I just need to tell somebody." Ideally, you'd have someone in your life that's safe for that. If not, consider a therapist who's quite explicitly neurodivergent affirming. Keep in mind too that you don't have to always fully disclose to somebody. Sometimes it's just not required, and sometimes, especially earlier in this journey of finding out they were autistic, we're not maybe ready to be telling

a ton of people the full thing, so you can disclose in a partial way or sort of a minimal way. So an example might be if somebody says, "Hey, like, why don't we go to this restaurant?" and I've been to that restaurant before and I know that it's pretty noisy, I might just tell them, "Hey, you know what? I have really sensitive hearing. Would it be okay if we met at this other place or at that same restaurant but at a different time, a time that I would suspect would be quieter? Also, I would probably

bring my earplugs and so on." So I could use this partial disclosure to get the accommodation that I need and just go from there if I wasn't ready to fully disclose in that context. So that can work well in employment situations sometimes as well. There are a lot of pretty good resources on this subject, so I'm not going to go over everything in an exhaustive way, but you can see the show notes for links to those kinds of things, especially the article from the National Autistic Society out of the UK. When thinking about why or

why not to disclose, some of the pros of disclosing in general would be increased understanding and empathy from other people. It allows us to unmask more and be more authentic. It can give us greater access, hopefully, to accommodations, and it can also reduce shame because we're no longer hiding our identity. A non-exhaustive list of the cons of disclosing, and these are potential cons, but there's a risk of dismissal, disbelief, discrimination. But I think a really key question to ask ourselves is, "What change am I hoping for by sharing this?" Or, "What am I hoping to

gain?" And if you don't have a great answer to that question in the particular case when you're deciding whether or not to tell a specific person, consider not telling them or waiting to tell them. This is personal, right? Sometimes the answer is just, "I want to feel more understood. I don't think being autistic is a shameful thing and I want to be quite open about it, and so I'm going to tell this person." That's a good answer for some people in some situations. I'm saying, like, that's "good enough." It doesn't have to be some huge

specific answer beyond that. I think that's a good answer for sure. And I disclose to people for many reasons, including that one. And basically, I just really think it's okay to take your time. You can wait weeks or months before deciding who to tell. There were definitely times early on for me where I disclosed to some friends and later realized, you know, "I wish I had waited another couple of weeks or a couple of months to tell that person or this other person." I think that the way we understand autism at the time, like our

own experience of being autistic, has a pretty substantial effect on how we disclose and why we disclose. And in those early months for me, my understanding of that stuff and the way I felt about all of it was changing pretty rapidly. I mean, it continues to evolve, but early on it was evolving a lot. And so realizing, had I waited another month to tell this friend or that friend, I would have done it probably pretty differently. And so if I could give you some advice maybe, it would be certainly that it's okay to wait if

you're not sure, take another week or two. And in most cases, there's not going to be any difference. So I just think that it's okay to take your time with this one. As far as how to disclose, again, there are good resources, but generally you want to choose a calm moment. I really think this is best done one-on-one. You could start by saying, "Well, you know, you want to ask them, 'Hey, do you have five or ten minutes to chat?' There was something I wanted to talk to you about." I found something pretty important about

myself recently. You can do it however you want. I find it like not too too much explanation. It's a good place to start. And then asking the people if they have any questions about autism or your experience of finding out. You can encourage them to, like, if they don't have questions now, questions tomorrow or in the future are totally okay as well. I think being honest, straightforward, offering resources, if they want to learn more, can be a nice way to go. Don't feel obligated to explain or justify everything, especially in that very first conversation. I

would just start with sharing what feels right to you at the time. I also think it's totally okay to show up to a situation like that with notes. And I just tell people, I'm like, "Hey, this is kind of complicated for me. I have point-form notes. I'm going to probably reference them at times to make sure I don't forget anything." There's a couple specific groups that I'm going to chat about disclosure with, starting with parents. Oftentimes this is the most emotionally charged group to disclose to. There can be a lot of reasons for that, but

certainly, like, generational stigma would be a big one. So if I'm mid-30s or so, my parents are in their 60s or 70s right now, autism was seen very differently for them as they grew up or when they were young adults versus how it is seen today by people who are 20, for example. So generationally, there can be quite a bit more stigma. Beyond that, parents can feel, I mean, a lot of complicated things related to this, but it's not unusual for them to be quite defensive or even dismissive. They might feel very guilty. They might

feel ashamed. It's, you know, because of that stigma and so on, they might think, "Well, this couldn't possibly be true. That would be so terrible." And I wouldn't want that to be true. I wouldn't want other people to find out that this horrible thing is true about someone in my family or you. So, no, it couldn't be true. And you seem, quote, "fine." Or if they sort of believe you, even partially or hypothetically, if they entertain the possibility, they might think, "Yeah, but if you're autistic, that means I didn't notice that when you were a

kid, which means, or might that mean, I failed you in a pretty substantial way." So I could feel a lot of guilt about that as a parent or even shame, worrying that I did a bad job and failed you. So that could feel overwhelming. And so to say, "Well, that would be really uncomfortable if that was true. So I'm going to sort of avoid that possibility again by being defensive, dismissive, and so on." It's just a big one, I think, for a lot of people to hear, especially if they don't know much about autism, which

most people don't, especially older people at present. Some people try to sort of warm up their parents. Sometimes they call this breadcrumbing. In the sort of weeks and months prior to disclosing, share articles they see about autism or videos or start kind of mild conversations about it, just talking about autism in general, or sharing the article or video saying, "Hey, I saw this and I thought it was really interesting," or, I don't know, the context of your life and relationship with these people, but finding ways to just share information, because then when you finally disclose,

they're going to read those articles and hopefully some detail will stand out to them and they're going to think, "Wow, that really reminds me of you or of myself." That's a big part of this, is that because autism is so highly genetic, many autistic people's parents will have at least some autistic traits or just be autistic themselves, so that can add a whole other layer on top of the complexity I just talked about for them hearing that their child is autistic, but on top of that, wrestling with their own recognition, perhaps for the first time,

"Wow, might I be autistic too?" Given that generational difference in stigma and understanding, it's often a more challenging thing for them to contemplate. I want to believe that most parents will eventually, over time, respond with curiosity and support, and I think for a lot of people that is true, for a lot of other people that absolutely is not true, and that is really unfortunate. When considering disclosing to healthcare providers, like doctors or therapists, in general, I would always encourage people to disclose that they are autistic to these people. However, I understand that it can feel

and be unsafe to do so in some circumstances, which is incredibly unfortunate. Typically, when we go to see these people, it's because we actually need help and we're probably feeling quite vulnerable, so to have them be dismissive towards us can be particularly painful and reminds me of the term "medical trauma." The more times this happens, and in particular, during a very sensitive period, the more difficult it will often be in the future to disclose or ask for help. I mean, with the same person, of course, but even with totally new healthcare providers. I've definitely had

this experience myself when I was younger, suggesting to my family doctor that I was autistic, and he was pretty dismissive towards me, and that made it very difficult to share again in the future. Certainly, there are lots of well-informed, caring, neuro-defergent, affirming healthcare practitioners out there. Unfortunately, there are also many who are uninformed, or all they know about autism is based on old stereotypes and outdated media and things like that, which seems unusual but is surprisingly true, because autism has a pretty high prevalence rate in the general population. It doesn't mean that people actually learn

anything about it or learn anything in depth about it during their healthcare training. It just depends on when you were in school, what school you went to, what classes you happened to take, who happened to teach them, and so on. It's surprisingly arbitrary, at least currently. I hope that that will continue to improve. So again, unfortunately, there are quite a few therapists and physicians out there who can be pretty skeptical or dismissive of the possibility, even when somebody, if they're suspecting that they're autistic or that they've self-identified, or even people who have been formally diagnosed,

they can still have their diagnosis questioned, which can be quite frustrating. I wrote an article about this explaining high-masking autistic presentations to healthcare professionals, which I'll leave a link to in the show notes. When practitioners are dismissive, I like to remind them that the level of intelligence a person has is not part of the autism criteria, though it is one of the qualifiers to indicate with or without intellectual impairment. Beyond that, the article I mentioned does include research on autistic physicians as well as international organizations of physicians who are autistic, and there are many of

these people. The research I've seen seems to indicate that at least the same prevalence rate of autistic people in the general population is present in the population of doctors, I guess. I don't know how else to put that. If there was 2% of the general population was autistic, at least 2% of doctors are also autistic, so you can check out the links in that article. The reason I think this is relevant in this kind of discussion with healthcare providers is that in a lot of societies, particularly North American society, doctors are strangely revered. If "even

they" can be autistic, then perhaps "I could be too" or "you could be too." Anyway, I think these are some of the first couple of things I like to mention to these people when they're feeling skeptical, and typically they are surprised by this information. It's going to depend. Some people will get defensive. Some people will be open-minded and surprise you. Certainly with my clients, I encourage them to have their healthcare practitioners contact me directly if they want, but the article I wrote, which is also the basis for the book I wrote, are available to anyone

to share with their providers. As far as why I think it's important to have your healthcare providers understand that you're autistic and recognize why that matters, I'm going to read a little bit from a chapter in my book again on co-occurring conditions. "Autistic individuals experience higher rates of a wide range of chronic, physical and mental health conditions, yet their symptoms are often misattributed to autism itself rather than being investigated as distinct medical conditions. This misattribution, which is a form of diagnostic overshadowing, occurs when a clinician attributes new symptoms to a client's existing diagnosis, thereby potentially

missing a co-occurring condition like generalized anxiety disorder or some kind of chronic illness. Certainly the reverse can also happen, when an existing diagnosis like trauma or social anxiety prevents a clinician from recognizing that that client is also autistic. For a lot of people, this is actually more common that the other condition is treated as like, that's what you have, that's what's important, and this suggestion you're making that you're autistic is ridiculous, it's just trauma or it's just anxiety or what have you. In either case, treatable conditions can go unrecognized, leaving autistic clients without the care

they need due to communication differences, social masking, variations in how they express distress, differences in sensory processing, and theory of mind, lexithymia, and so on. From a clinical perspective, an autism diagnosis is a critical piece of data that should recalibrate a clinician's reasoning. This adjustment represents evidence-based practice rather than a diagnostic bias. When any member of the general population seeks care for an undiagnosed concern, a clinician's list of possible diagnoses is partially based on general prevalence rates, but for an autistic client, that statistical baseline needs to shift. The likelihood of numerous conditions, from anxiety and

ADHD to hypermobility, increases to such a degree that our diagnostic approach requires adjustment. Symptoms that might seem vague or suggest a rare "zebra diagnosis," which is an uncommon or unlikely explanation in normal circumstances, in a non-autistic client may need to be given greater weight and considered earlier in the process for an autistic individual. The "zebra point" is quoting sort of an old point in diagnostic wisdom in general, which is saying, "When you hear hoofbeats, think horses, not zebras." In a landmark study of over 1,500 autistic adults, they found that autistic people tended to have dramatically

increased rates of nearly all psychiatric and medical conditions, compared to a control group of about 15,000 individuals. And I'll link this paper in the show notes, as from 2015. The risk for co-occurring psychiatric conditions was elevated across the board in their sample, and the prevalence of suicide attempts was five times higher. The same study found that a multitude of major chronic physical conditions were also more common for autistic people, including immune disorders, gastrointestinal and sleep issues, seizure disorders, hypertension, hypermobility, spectrum disorders, and Ehlers-Danlos syndrome, postural orthostatic tachycardic syndrome, more often known as POTS. POTS is

very common. I think I have POTS. It sucks. A lot. Diabetes also more common. Other large-scale research confirms these findings, emphasizing the need for clinicians to maintain a high awareness of co-occurrences with autism to improve detection and provide suitable care, especially given the added complexity of assessment with this population. So I wrote that for clinicians. So the language there is a little more clinical, and you can sort of hear me talking to clinicians, and sort of from my point of view as a clinician, which is a little different usually than how I talk in this

podcast. So forgive me there. Anyway, it's always a personal choice whether or not you share that you're autistic with your healthcare providers. Again, my general advice is that it's probably useful to do, but I understand that it's not always going to feel safe to do that. When considering disclosing that you're autistic in your place of work, I would encourage you to be extremely careful and take your time and be thoughtful in making this decision. I don't want to implicitly stigmatize autism here by saying, "Oh, you should be very careful about disclosing it," because I don't

think that being autistic is something to be embarrassed or ashamed of. However, a lot of people do think that. There's a lot of stigma around autism still, unfortunately, and you don't really get to decide what other people think about it. You can try to educate them and show them by being yourself and maybe representing different things than those stereotypes. And if you're in a position to do that, that's great. But again, a lot of people unfortunately aren't. And so I'm just saying I would be very cautious deciding whether or not to disclose at work. I

think there can be a lot to be gained from the work we do on ourselves relating to understanding ourselves better and the self-acceptance that can come along with that, as well as the accommodations we can make for ourselves at home and the minor accommodations we can make at work without asking anyone hopefully, as well as the effect of partial disclosures at work, which for some people I've seen can get them some or even a lot of the accommodations that they would otherwise hope for. If I could just tell them I'm autistic, then I could ask

for X, Y, and Z. But a lot of the time, you can still ask for at least some of those things without disclosing almost anything. You could talk about I get headaches or I just have really sensitive hearing and within reason that's true. And a lot of people I think are fine with that and they would let you change something, especially something minor. Some workplaces of course would not let you regardless. So this could lead to great outcomes and accommodations or it could lead to you being isolated or somebody at work trying to make you

so unhappy that you quit or they might try to find any other reason to fire you now. I've definitely seen lots of people have a positive time after disclosing and I've seen lots of people have a very negative time after disclosing at work. So again, I think that work is often the place to be most careful or thoughtful with disclosure. So definitely see the resources in the show notes and I would strongly encourage you to talk to trusted friends, family or a therapist before making that decision. As far as disclosure in dating or sort of

romantic settings, not to talk about my personal life much, but I've been doing a lot of dating in the last year or year and a half. So I have a lot of thoughts about this right now. Fortunately stigma relating to autism is reducing over time, which is great, but there's still definitely some stigma. I'm not saying that I think autism is some awful or embarrassing thing, but there is a lot of prejudice against it. A lot of old stereotypes out there. I do think this can be a good temperature check actually for internalized ableism. If

you're feeling hesitant or uncomfortable in general with dating sharing that you're autistic, I would encourage you to explore why you're feeling that way because it probably does indicate some internalized ableism and that there's more room for self-understanding, self-acceptance in these kinds of things. With a particular person, you might feel uncomfortable disclosing, but that person may have given you reason to feel sort of emotionally unsafe around them or that they're just not that compassionate or something. And so then it's like, oh, telling this person this sensitive thing about myself or this thing I feel sensitive about,

then it could be more difficult. But at that point, that's probably a pretty good indication for you to not be dating that person anyways. So in brief, I lived with a partner for about 10 years. So that was through all of my 20s, and that relationship started before Tinder existed. And then after that ended, after a while, I dated somebody that I knew already, and that lasted about a year. And there was a time off between all of those things for healing and growth and so on. So the experience of meeting a total stranger for

the explicit purpose of determining or trying to determine if we'd enjoy each other's company, you know, and over time to figure out if we're a good fit romantically. So that was new to me as an adult, knowing that I was autistic. I had done these things, but not knowing I was autistic. So not having to think about how do I tell these people? Do I tell them? When do I tell them? And so on. You can look this up online. There's lots of opinions about when to share that you're autistic in the dating world and

in using dating apps and things like that, if you're using dating apps or not. Some people feel like they don't need to tell anybody, or they'll just tell them at some point in the same way that they would say anything about themselves. They would just share it at some point because to them it's like not a big deal. So why would I rush to tell you in a way I can understand that? I've tried a lot of different things. And I do think that disclosing upfront or like very early sometimes can have people who don't

understand very much about autism kind of withdraw. They just don't know what it means and they have these strange outdated ideas. And so they're like, "Oh, well, this person I don't even know." Now they're indicating to me that they've got some problem. And so with the throwaway culture of online dating, that's just one more reason for them to not worry about it and move on. Personally, where I landed over time was to simply include it in my profile in some way and then to confirm it in like very early messages with people. I wouldn't meet

with somebody in person if we hadn't already discussed me being autistic. It's a great kind of litmus test for people to see what they're like, to see how they handle it, if they're informed or compassionate and curious and so on. And if they're not, I don't want to meet with them anyway. I was interested to notice in myself that this disclosure was pretty hard for me early on, even given who I am, what I do, how publicly I'm autistic, that I told thousands of people that I'm autistic. It was still difficult and felt new to

tell people in this dating context. So like with anything emotional processing related, I sat with this experience, tried to just be curious about it. I used a feelings wheel, which some people hate, but I find very useful. I journaled, chatted with my friends and so on about it. And then just continue to engage with that kind of process each new time that I disclosed about being autistic in this dating setting. It certainly got easier over time. I got more familiar with my feelings about it over time. And I think also too, it's normal and it's

okay to have complicated feelings about things, even if those feelings can seem unusual. I think this is very cheesy, but I think that all of our feelings deserve to be heard and considered, which reminds me of a really great book called No Bad Parts by Richard Schwartz, which is looking at internal family systems, IFS therapy. But if you haven't heard of it, I think it's a really nice fit for a lot of autistic people. Anyway, I like discovering things about myself like this. They help me understand who I am better. They help me heal parts

of myself that I hadn't noticed before. And like I feel in pretty much any context, rather than trying to be perfect, I think what matters a lot more than that is how we treat ourselves when these kinds of things come up. And another context that that I think applies really well in is in communication with romantic partners or people that we're close with, right? It's not that we're never going to make mistakes. The question becomes, how do we act? How do we treat each other when these mistakes are made? Are we curious, compassionate, supportive, or

are we withdrawing and defensive and what have you? So anyway, dating is complicated and difficult enough. And so anyone who's engaging in that right now, I hope you're able to enjoy yourself and have fun and be safe and just be compassionate with yourself as you're going through this interesting and difficult thing. So some quick takeaways about disclosures to remember that there's no right or wrong timeline for disclosure. There are some people in my life I waited about a year and a half to tell. By that time, I had told pretty much everybody in my personal

life. I think I took a little longer than that to disclose professionally in an increasingly specific way, first just saying that I'm neurodivergent and then over time more specifically that I'm autistic. But there was some people in particular in my family that I waited, I think, six or seven years to share this with. These are not people I saw too often, but I noticed myself having some complicated feelings about it for reasons that are personal, it doesn't matter. But they were important enough to me that I would be around these people and notice myself not

bringing it up in a way that I don't talk about autism all the time, like it's my personality or something. But I did notice in some of those situations in the past, purposely not bringing it up and then feeling weird about that later. So at this point now, I've told everybody and it does feel good. But again, there was no right or wrong timeline for me on that one. And I just sort of got there when I got there. I do think it's okay and it can help to start small and gradually build confidence over

time with disclosure and feeling secure and self-accepting before disclosing more broadly tends to make the process much smoother. And I've said this before, but you can always tell somebody you're autistic, but you can't untell them. So waiting until you're ready, I think, is the right move here. Regarding accommodations, these are the changes we might make in our life. So it's a better fit for us. So we feel more comfortable moment to moment, day to day. A lot of these involve small changes that we don't have to ask anybody about. Like if I'm just going to

wear earplugs while I'm at home or during specific activities at home, I don't have to ask anybody. If I wanted to wear earplugs while I'm rock climbing, for example, because the gym I go to plays music that's a little loud for me, I don't have to ask anybody, but that does make a big difference. I need to feel socially comfortable wearing them. At some point, people sometimes ask me, "Oh, what music are you listening to?" And then I'll say, "These are just earplugs." And they say, "Why are you wearing earplugs?" Some people do. They're very

nosy. I don't know. So I have to feel comfortable doing that personally, but I didn't have to ask someone's permission to do it. So these kinds of changes are very accessible. And I think there's a lot of them. And fortunately, depending on what your life is like, this could be the majority of the accommodations that are going to help you. The majority of the time are ones you don't have to ask anybody about. You just have to feel like you deserve it and just make that change yourself. Often the thing that is difficult for people

beyond the feeling they deserve it, include accommodations that involve asking somebody else to change their behavior or if you're at work, maybe needing permission to make one of these changes. And that makes me really annoyed that you have to ask permission in these ways. I think that having been self-employed for so long, I would struggle very greatly working for somebody else. I know it's not simple, but on the medium and long term, finding a job that allows you to accommodate in the ways you need is probably a good choice. I know financial realities and so

on are not always that simple, but I would hope for people over time that they can make these kinds of changes so they're in an environment that is well suited for them. As far as what accommodations you might ask for, a lot of them involve sensory adjustments, but they can also involve different approaches to socializing and then all kinds of things related to executive functioning, organization, motivation, and so on. These can apply to pretty much any context you find yourself in regularly, but the most common ones would be accommodations at home, relationship accommodations, a big

one would be work accommodations, which I've been talking about, and then also academic accommodations. Fortunately, academic accommodations tend to be pretty available because schools have systems set up for this kind of thing, so you'll need a letter often to kind of justify that this accommodation is required, but once you can get that, then they'll just typically just give you the accommodation, whereas in workplaces it can be quite a bit more complicated than that. Common accommodations to ask for at school could be getting extra time to write tests or getting a room alone to write the

test in or to be able to wear earplugs during a test or use a stim toy or things like that. Some of the resources I listed in the show notes talk about the different accommodations you might ask for in different environments. I think Googling about this can also be very helpful as well to read forum discussions about the kind of accommodations people find most helpful. Sometimes the change we would want is very obvious to us, like, "Wow, I wish I could close my office door," or "I wish I could turn these lights down," or something

like that, but I do find reading what helps other people can be quite helpful as well, for me at least, because they'll mention things I wouldn't have thought of, which can provide pretty useful guidance as well. So I'm not going to try to list those in any kind of exhaustive way, just see the resources in the show notes. They also cover how to ask for accommodations and speak up for ourselves in this way, that kind of self-advocacy and boundary setting as well, which can be really helpful. I would think of accommodations as a form of

self-compassion and taking care of ourselves can be part of sort of unlearning that any critical ableist inner voice is that may be present for us, again, that internalized ableism. So accommodations is a very big topic. It's been pretty thoroughly covered elsewhere, so I linked those resources and won't try to recreate them here. As a final point, at the bottom of the podcast page at ndsyke.com, there's a form to submit questions to go over in the podcast. So we have a listener question here, which is great. So the question was, "I was wondering if you could

talk about the difficulty for autistic people in comprehending certain concepts. For example, my boyfriend gets annoyed when I do not answer his question where the answer is obvious to him what I should say in my response. It makes me feel like I need to read mine sometimes. Also, people at work get into correcting me when I'm not answering their question. Do you have any thoughts about this?" To start with, if one partner in a relationship refuses to try to bridge a gap in communication, that often takes us from a sort of like communication mismatch into

a question of equality in a relationship. And often that burden of adaptation can fall on the neurodivergent person as far as like trying to do the social translation. I think it's really important for both people to try to bridge the communication. And if only one person is trying, then usually that connection is just not going to work out. The person who submitted this question mentioned their partner being annoyed with them. I think it's important for them to differentiate between, you know, "Is this person annoyed or frustrated with me, or is there some contempt here?" You

know, "Are they momentarily confused, or are they habitually annoyed?" So if they're feeling like, you know, "I'm struggling to get my point across, I feel a little stuck in this conversation, can you help me understand? Can you try to explain this again?" "You're important to me and I want to understand what's going on." That's very workable. Versus contempt would be, you know, "Why don't you just get this? It's obvious. What's wrong with you?" I would say that seems like a pretty big red flag. The Ottmans talk about contempt as the number one predictor of relationship

failure. Treating a partner's neurodivergent traits as annoying or stupid certainly seems like a form of contempt. Another really useful thing here, which I did talk about earlier with dating, is this kind of litmus test around how willing is somebody to learn more about autism, how curious and compassionate are they when these kinds of things come up, versus judgmental, annoyed, impatient, and so on. So a classic thing to do here is to ask this person to read an article or listen to a podcast on a particular aspect of autism that you find very relevant to yourself.

I think we can do our part by locating that article to specific things or they're checking out the thing we want them to, rather than just saying, "Why don't you read a book about this or something?" And so here we can see, you know, does this person happily engage with that material? Are they curious? And do they want to discuss it with us? Does it change anything in their behavior? And so on. Or do they not read the article, not listen to the podcast, not watch the video? Do they dismiss the information? You might hear

something like, "I shouldn't have to read a book or listen to a podcast just to talk to my partner," and then continues on with their criticism. Like many autistic people, this person who submitted the question has probably spent many years being "corrected" by parents, teachers, peers, and so on. That can leave us feeling like we're the one who needs to change, to change to be okay, to change to be deserving of love. So no matter how nicely a person phrases it, if they're annoyed by a core aspect of your autistic experience of the way your

brain processes information, that to me sounds like they're just annoyed by you. And so it to me seems like a form of self-respect to at least have a boundary about this and tell people, "It makes me feel X when you criticize me in this way." I think we deserve to feel safe, respected, cared for, valued by the people close to us in our life, whether those are friends, family, romantic partners. I definitely think a person's home, this is the way I feel about my home, it should be kind of a sanctuary, whether it's for sensory

concerns or socializing. It should be a place, I think, where we don't have to mask, not just another place where we have to perform for people and where we're constantly being corrected. To be honest, reading this person's question, I've been in relationships like this, I've had friends like this, and I ended all of those connections for this specific reason. I just, I think life is too short to be around people, to be in spaces that are not accepting of who I am. So I'm not telling this person explicitly they should end their relationship. It's a

"but I am saying I have ended every single one of mine that included this dynamic." As for why this happens, I mean, autistic people, we tend to have pretty different approaches to theory of mind. An autistic person who writes about this kind of thing, who's using the term "context of blindness" is Peter Vermeulian, I think it's pronounced. But this is getting at all the unspoken social rules that everyone is assumed to know. Autistic people often have that feeling of like everyone else got a manual to social experience and we just don't have it. And so

a lot of non-autistic people, when they communicate, use subtle hints. When they want something, they'll be hinting about it in a subtle way, and then they of course don't receive it, so then they can feel upset, hurt, rejected, unsupported, and then they can become distant and withdrawn, they can take that very personally, they can become passive-aggressive and eventually become quite aggressive in their communication. Of course, I think the solution here is to simply be upfront, clear, direct, assertive, kind in our communication when we have something on our mind or we need something. It might be

helpful to look into the difference between bottom-up and top-down processing, which autistic people tend to do a lot of bottom-up processing, thinking about every detail of a question before trying to come to a conclusion, literal thinking can be relevant here as well. The mind-reading piece that this person suggested, I think that can be very fatiguing and a lot of autistic people over time just realize it's better for them to just tell people, "Hey, I don't really do well with social hints. If there's something going on, I would hope you could just tell me directly whether

this is at work or with personal relationships, just tell me directly. I'm probably not going to pick up on it if you don't." A pretty gracious thing to say to the partner in this case would be something like, "When you say something is obvious, it feels like there was a test that I didn't know I was taking. If you need a specific response, please ask me for it directly. I don't mean to ignore you. I'm just waiting for an explicit version of the message you're trying to get across." And at a workplace, you might say,

"Hey, I process information very literally. If I'm not answering the question in the way you expected, it can definitely help me if you rephrase it or just give me specific, clear detail about what you're looking for." So I know it can be hard to contemplate that people close to us don't actually respect us very much or aren't very patient with us. I don't think the answer to all situations like this is to just cut and run to leave the relationship. But I do think it sounds like there's a larger concern here around being respected and

having boundaries. My point is it sounds like there's the need for a larger conversation. I'm just speculating, but that is my guess. So I hope that this leads you to constructive, compassionate conversation with your partner. And I'm glad you wrote in. And anyone else is certainly welcome to write in as well. So that's it for today's episode. As a reminder, this podcast is for education and entertainment. It is not clinical advice. I do AMA episodes and I just answer questions like I just did a minute ago. So if you have general questions about the autistic

experience, please feel free to submit them at ndsyke.com/podcast, where there's a form for that and I may answer them in an upcoming episode. Though this can't replace professional advice suited to your personal situation. Anyway, whether you're autistic or not, I hope you're feeling happy and healthy these days. [Music]

This podcast episode serves as the second installment in a mini-series exploring the practical and emotional landscape of adult diagnosis, covering themes of assessment, masking, differential understanding, disclosure, and necessary accommodations. The tone balances clinical insight with validating empathy for the confusion and identity crises that often accompany realizing one is autistic later in life.

Iain begins by addressing the common skepticism regarding the value of formal assessment for adults. While validating self-identification as a meaningful path for personal understanding and community connection, he argues that formal diagnosis retains significant utility in some cases. This is particularly true for complex clinical presentations marked by a high probability of co-occurring conditions such as ADHD, OCD, anxiety, or a history of trauma. A rigorous assessment helps differentiate overlapping symptoms, reducing the risk of misdiagnosis. Furthermore, formal documentation can increase credibility with medical professionals, facilitate access to workplace or academic accommodations, and help alleviate the persistent imposter syndrome that many late-identified individuals experience.

The episode transitions to a detailed examination of masking, defined as the conscious or unconscious strategies used to suppress autistic traits to meet social expectations. Iain frames masking as an adaptive survival response to the repetitive social trauma of being misunderstood, criticized, or rejected. This process often involves internalizing distress, where individuals suppress their own boundaries to accommodate others, leading to self-blame. Iain describes cognitive masking mechanisms, distinguishing between shallow mimicry of social scripts and deep compensation, which involves constructing analytical theories of mind based on pattern recognition. While acknowledging that masking can sometimes be necessary for safety, Iain notes its strong association with poor mental health, burnout, and an erosion of the authentic self. Unmasking is presented as a gradual, personal process of building self-acceptance and seeking safer environments where authenticity is possible.

A significant portion of the discussion focuses on the challenging work of differentiating what aspects of a person’s experience are autistic and what may be attributed to other factors. Iain emphasizes that this is highly individualized work that often requires time, journaling, and potentially therapy. The key is looking beyond observable behaviors to understand underlying motivations; for example, distinguishing whether missed social cues stem from autistic interpretation differences or attentional lapses related to ADHD. This differentiation is frequently complicated by the presence of complex trauma, which can mimic or obscure autistic traits in high-masking presentations. Accurate parsing is necessary to avoid diagnostic overshadowing, ensuring that co-occurring issues like depression or trauma are identified and treated appropriately rather than being solely attributed to autism.

The episode then addresses the complex decision of disclosure. Iain advises caution and patience, suggesting individuals carefully consider their goals and safety before sharing their autistic identity. Disclosing to parents can be emotionally charged due to generational differences in understanding stigma or their own defensiveness and guilt. However, Iain encourages disclosing to healthcare providers. He cites research indicating that autistic individuals experience significantly higher rates of various chronic physical health conditions, such as gastrointestinal issues, hypermobility syndromes like Ehlers-Danlos, and autonomic dysfunction like POTS. Clinicians need to be aware of a patient's autism to adjust their diagnostic baselines and provide appropriate care. In professional settings, caution is advised due to ongoing stigma; sometimes, requesting specific functional environmental changes without explicitly labeling them as autism-related may be a safer route. In dating contexts, timing of disclosure is considered.

Finally, the discussion moves to accommodations, framed as acts of self-care. Many necessary adjustments are small, self-directed changes made at home to manage sensory input. Others involve advocating for specific needs in work or academic settings, such as extra time for tasks or sensory-friendly environments. The episode concludes by addressing a listener's question regarding communication difficulties with a partner who expects them to understand "obvious" social hints. Iain asserts that effective communication requires effort from both parties to bridge gaps. He explains autistic differences in information processing, often characterized by a need for directness over implicit social cueing. He suggests that consistent annoyance or criticism from a partner regarding these fundamental differences is a red flag for the relationship's health. Autistic individuals deserve respectful environments where their communication styles are understood rather than constantly corrected.