So, there’s this really frustrating piece on Spectrum, in which Peter Hess interviews one Eric Fombonne, “director of autism research at the Institute on Development and Disability at Oregon Health and Science University” right here in Portland, about a recent editorial Fombonne wrote questioning that camouflaging by autistics is anything special or unique to autism, and questioning whether or not its even “novel in any conceptually substantive way”.
(Along the way, Fombonne also seems to try to throw into doubt the very idea of an adult autism diagnosis.)
And then, you look at the questions, I quote one in my editorial that says, “I am always concerned when I go in a public place, people are going to look at me and judge me.” This is typical of social anxiety. It has nothing to do with autism. The questionnaire is full of questions like this. Why do they not pick that up? It’s really concerning.
Here’s the thing: Fombonne—who focuses much of his career, in fact, on autism—strangely doesn’t seem to understand: social anxiety is going to hit an autistic brain differently than it will hit a neurotypical brain, which is why it’s often an important component of evaluations for autism. Looking especially through a monotropic lens that feeling that “people are going to look at me and judge me” is a stressor under both “coping with multiple channels is hard” (because that anxiety is a channel) and under “filtering is tricky and error prone”.
Other people might have social anxiety, but not all people with social anxiety are going to be impacted by it the way an autistic brain will. This isn’t something you can just ignore. Fombonne also ignores the idea that an autistic person’s prior experience with how people react to them not camouflaging their autisticness might in fact generate social anxiety in a way that indeed is novel to autism.
But let’s get to Fombonne’s actual thoughts about camouflaging itself, because here’s where it goes off the rails.
I’m a psychiatrist, so I have treated adults and I know a number of adults who have chronic mental health conditions. When they feel better or they want to re-insert themselves into a more normal role when they are doing well, they want to not be seen as having mental health issues. A schizophrenic person who is looking for employment will be aware that when they have a little tremor due to medication, they must hide it. If they have a tendency to have facial expressions which are a bit fixated because it is a secondary effect of the neuroleptic, they will be conscious of that and try to accentuate their facial expressions to cover for that.
I’m short, so if I have the choice between two equivalent shoes, I tend to pick the one that has the highest heel. Likewise, overweight people may prefer black or dark clothing that ‘masks’ their body shape. It’s part of life. When I’m reading these camouflage studies, I think, ‘Well, yes, of course that may happen.’ It’s not specific to autism, I don’t think. I can see that in chronic psychiatric conditions and chronic medical conditions.
These simply aren’t analogues. Fombonne wearing lifts isn’t going to inflict trauma upon his brain the way suppressing one’s autisticness inflicts trauma upon an autistic brain.
The way in which he discusses camouflaging (and dismisses subjective reporting by actually-autistic people themselves) rather makes me suspect that as a psychiatrist Fombonne must be a behaviorist. At the very least, behaviorist thinking seems the only way one can call a short person wearing lifts analogous to an autistic person hiding their autisticness.
It’s important to acknowledge camouflaging as being in autistics distinctly different than similar behaviors through which other populations “accommodate” the world around them. The behaviors are analogous only superficially, such superficialities seeming to be the only thing which with behaviorists (or behaviorist thinking, at least) ever are concerned.
If nothing else, it’s critical to accept autistic camouflaging as its own particular thing if only because the psychic costs of it are consistently reported by autistic people themselves as a major contributor to autistic burnout—but since Fombonne doesn’t much seem to believe in adult diagnosis, I’m skeptical as to whether he believes in autistic burnout, either.