I remember the first time I saw Tim Burton’s The Nightmare Before Christmas.
I was 7 years old, sitting criss-cross applesauce in the floor of my parents' bedroom, having just tuned our cheater box to Disney Channel. And there it was—Tim Burton’s creation in all its spooky, scary, skeletal glory. I was immediately enamored by the movie. The dark, lovable characters were brought to life by Danny Elfman’s beautiful score. The set design and claymation like nothing my newly bespectacled eyes had ever seen. I never stopped loving The Nightmare Before Christmas, and my encyclopedic knowledge of the film comforts me to this day. That same knowledge also gave my neuropsychologist pause on a Tuesday afternoon in the early summer of 2022 during our autism assessment.
Fifteen minutes after asking me about my special interests, the doc interrupts me with a “hmm,” jots some notes onto his laptop, and I say out loud, embarrassingly, “I did it again.” You see, the older I get the more likely I am to catch myself running down rabbit holes of my special interests to other people. I’ve learned to recognize the blank stares on their faces, the shift and flattening of their tone of voice, and the minimal encouragers that signal “I’m here, but man I wish I weren’t.” I went much of my life not recognizing those things—to the chagrin of those around me.
Talking about my special interests and relating to people with shared interests has always come easily to me. Other social and parasocial skills have not. At some points in my life, this was one of the only ways I knew how to relate to other people. Many allistic (neurotypical) people are accustomed to reciprocal compassion as a sign of shared understanding and validation. For example, when they say “this bad thing happened to me” they want you to say “that really sucks, I feel your pain, and I’m here for you”—but they don’t tell you that’s what they want to hear. Their expectations for the interaction go completely unspoken, which has created challenges for me (and other autistic folks). In the past, when I've heard "this bad thing happened to me," I've responded by sharing bad things that have happened to me. Relating to others empathically and emotionally is something I’ve had to learn. I learned those skills from my training as a counselor and psychologist.
In 2016, I began my training as a counselor. To not mince words, I had a really fucking hard time. Feedback from my supervisors during my first year of training included: a) my resting face appeared uninterested, sometimes aggressive, b) my tone in sessions appeared flat, and c) I was not "appropriately" empathizing with clients. This feedback was very hard to absorb, because I was just being myself in the room with my clients (who were progressing in therapy well). The feedback was so distressing that I began to see my own therapist to process the feedback I had been receiving. This therapist and I spoke at length about emotions, facial expressions, and practiced different social (and client) scenarios. At one point, my therapist asked what it would be like for me to borrow my supervisors in-session presentations to assist in my own understanding. So that’s what I did.
I started mirroring my supervisors. I began deconstructing their therapeutic nuggets of wisdom, their tonalities and cadences, and their facial expressions. I watched hundreds of hours of videos of myself (as we all do in our therapy training programs), and I began to better understand the purposes of some of the core interpersonal psychotherapeutic change factors. I didn’t realize at the time that my therapist was essentially asking me to engage in my own occupational therapy. As I began to get more comfortable with the skills I was learning, supervisor review of my performance got better. Cynically, I could say that this was because I was reflecting my supervisors back to themselves. More compassionately, though, I think my reviews got better because I was acting more allistically—in a way that my supervisors were more familiar and comfortable assessing positively.
Towards the end of my training as a mental health counselor, I was exhausted—physically, mentally, emotionally. I had entered my clinical training with the intent of becoming an academic and, despite the exhaustion that had seeped into my bones, I decided to continue my academic training towards that end goal. The reality was, though, that clinical work was becoming a drain on my existence. It’s only years later that I now understand why: I had been masking in my role as a training counselor 40+ hours a week for two years.
Masking is a common trait in the autistic community, in which folks on the spectrum mimic neurotypical social interactions to “mask” (read: hide) their autistic traits. This masking can involve forcing eye contact, forcing physical touch (hugs, high fives), suppressing stimming behaviors (soothing touch/movement/sounds), confronting sensory overstimulation, and parroting rehearsed conversational points. Masking is exhausting, but it is also survival. It is one way that autistic folks can be accepted or approved by the larger allistic society. Masking can lead to something called autistic burnout, a condition that can lead to physical distress, anxiety, depression, and suicide. In my case, masking in my role as a clinician helped me pass through my masters in clinical mental health counseling with academic honors while also putting me in a position of being completely and totally drained day-in and day-out.
Moving into my Ph.D. program, my masking became more entrenched and pervasive. I was “on” constantly. In the first year of my Ph.D, one of my advisors was arrested for stalking female-presenting students in my program. After this incident, I remember other students recalling that this faculty member was “weird” and “strange” and “awkward.” It was disquieting to me that I never "picked up" on these components of their shared social uneasiness—I believed their reports, but I was blinded to the qualities they discussed. Maybe it was my relative privilege as a cisgender man; maybe it was my own differences in social understanding. Probably a bit of both. This event shook me to my foundation. These horrific events, and the constant mask-wearing necessity of my program, led to me contemplating leaving my Ph.D. At the end of my first year, I flipped a coin. Heads I would leave, tails I would stay. I flicked the patinated 1974 quarter into the air with my right thumb, snatched it mid-flip with my right hand, and slapped it onto the back of my left. I took a deep breath in through my nose…tails. I’d be staying in my program. That night I had a serious conversation with myself about boundaries, my own needs, and how I could survive the next few years.
As the years wore on in my program, things got easier for me. Less clinical work and fewer classes meant less time wearing my mask. I began to have more supervision, teaching, and research responsibilities and, in these roles, I could make use of the interpersonal skills I had learned in my clinical training but engaging them wasn't the entire sum of my responsibilities. I became more comfortable with being myself, and less concerned with “fitting in”—my performance was now less contingent on meeting allistic expectations for my demeanor. My survival was less contingent on being seen as “normal.” After decades of surviving with a mask on, unmasking can be an extremely difficult process.
In the Summer of 2019, I took my first adult intellectual assessment class. This course was the first time I had critically learned about autism from a psychological perspective. I was floored; we were learning about me. The world changed in Spring of 2020--COVID shut us down. We lost a lot. Ironically, during quarantine, I felt more like myself than I ever had. I lived an introvert's dream. Social pressure was completely eliminated from my daily energy calculations. Everyone was scrambling, so work and social expectations completely changed. This is not to discount the severity of COVID, or my relative privilege during quarantine (I could work from home effectively), but to share that, in my little bubble, I was actually living in a world that catered to my preferences for the first time in my life.
The story until this point has been a backwards reframe of my life through my current understanding of myself. However, in Summer of 2019 I truly began to wonder if there was something...different about my brain. This thought would roll around in my head for three more years before I acted on it. In Fall of 2021, I began my health service psychology internship (our last clinical placement and training before graduating), and I was participating in some intensive assessment training about ADHD, learning disorders, and autism. My placement at a university counseling center meant my training focused on adult diagnostics. Again, learning more about the presentation of autism in adults set off red flags in my mind’s eye. I continued perseverating on the idea that I may have autism for eight more months.
In that eight months, I took just about every publicly available and free autism assessment I could find. Like many folks unable to secure psychological testing, I was hungry for answers. I found an amazing website and organization with free testing resources and self-administered a bevy of assessments. Each came back with score ranges typical of folks on the autism spectrum. After this testing, I decided it was finally time to book my own neuropsychological testing—which I found with a local private practice clinic. I want to take a second to be forward and honest with how privileged I am to have been able to receive autism testing--it was resource-intensive and time-consuming. Many autistic folks cannot (or do not want) to get autism testing for a variety of reasons--cost, danger of being labeled, discrimination--and self-diagnosis is a heated debate in the community.
My test results revealed the writing on the wall: I am autistic. Diagnosed at 29 years of age, after completing a masters degree in counseling and (almost) a Ph.D. in psychology. Technically, I have a diagnosis of Autism Spectrum Disorder, Level 1. Since 2013, the psychiatric diagnostic manual in the U.S. has categorized autism on a spectrum with three different levels indicating support needs: Level 1 = "requiring support"; Level 2 = "requiring substantial support"; Level 3 = "requiring very substantial support." It's bullshit, tbh. The Level system reduces autistic folks to "less autistic or more autistic" which minimizes the extreme range of nuanced support needs that autistic folx have. I write about some of my support needs in the next paragraph, and they look less like "Level 1 autism" and more like a smattering of needs based on how my brain works! If we want to use an autism rating system that makes more conceptual sense, let's hi-jack the X-Men mutant rating scale (personally, I consider myself a delta level mutant).
My testing also revealed something not totally unknown to me: I have a large capacity for masking--suppressing my autistic traits and needs to present more neurotypically. In some ways, I think I've always known that something was different about how I moved through the world, but having new language to discuss it has me reevaluating my life through a novel lens of understanding. Looking back on my childhood, I think obvious signs of autism were present. Socializing one-on-one has often been a struggle for me when it wasn't with those who I was close to--i.e., socializing without masking is easy. As a kid, I would often play with my toys in less typical ways—stacking towers of books, or lining my hot wheels up by length. It was really difficult for me to process certain loud sounds back then—doors slamming, vacuum cleaners starting, and dogs barking always sent me into emotional overwhelm. I love(d) collecting—cards, movie tickets (actually, all tickets), bookmarks. To this day, I have large collections of each (including complete sets of every Nightmare Before Christmas trading and collectible card released). I would borrow CDs from the public library and listen to the same songs hundreds of times in a row (something I still do; including the CDs, which I also collect).
As an adult, I got more skilled in masking my symptoms--I think this can be a helpful skill, but I don't think it is necessarily a "good" thing given that it's often forced onto neurodivergent folx. In a large group, I can be gregarious and conversational. Funny, witty, quick with jokes and words. My brain works overtime, like a tennis player at Wimbledon, to serve back whatever another group member just lobbed across the net. In one-on-one or small group conversations my skills start to waiver. What do we talk about? Am I making too much eye contact, not enough? When I don’t have a group of people handing me the material to weave my social tapestry, I fumble. In these instances, I’ve learned to lean on the skills I’ve learned as a training mental health practitioner to help me get by. I can actively listen all day. Allistics love to have what they say reflected back to them—they’re just talking to themselves at that point. Again, though, this masking takes enormous amounts of energy.
In some ways, I think my autism has been a strength in my training and clinical practice. I utilize a lot of motivational interviewing naturally, because confronting dissonance is something that my brain wants me to do. “Make it make sense to me” is not so much a clinical skill for me, but a necessity. The way I naturally understand people is through interests, values, and lived experiences, because this is how I understand myself—so ACT, existentialism, and multicultural approaches form the basis of my theoretical camp. My brain loves to collect and store information, something I can put to use when working with my clients—remembering small details about someone’s life can really help connection. Last, but not least, my brain loves patterns: I see and hear patterns everywhere I go. This makes me particularly adept at noticing the patterns in my clients’ lives that have been invisible to them. In a lot of ways, my autism is like a therapy superpower.
My clinical journey so far has been a hodgepodge of emotions and experiences. I still sometimes suffer from autistic burnout in my occupational life, which carries into the personal. When I‘m “on”—in the classroom, with clients, out in my community—I feel as though I’m a version of myself operating at 150% capacity. Burning a candle at both ends. It’s bright, but unsustainable. I’ve been privileged enough to have people in my life with whom I can unmask, which is both healing and rejuvenating. I’ve rarely been able to unmask in my training programs, due to neurotypical expectations of my existence.
For neurotypical mental health professional training program faculty reading this: don’t forget about your neurodivergent students who are often left by the wayside. We belong in the mental health fields, but are often "gatekept" because of embedded neurotypical expectations. We can do this work--it may not look like how you do it, but that can be a good thing. For those neurodivergent mental health students reading this: find safe community, embrace your strengths, and be yourself.
Whew, that was a lot. I’m gonna go watch Nightmare Before Christmas now.
Byeeee,
Chris