“Is everything okay?”
“Yes.”
“Are you comfortable?”
“Yes.”
“Do you understand?”
“Yes.”
Perfect.
Except sometimes… it isn’t.
People don’t always tell us when they’re uncomfortable, confused, overwhelmed or struggling.
And for some neurodivergent people, appearing to be absolutely fine when they’re actually working incredibly hard to cope can be something they’ve practised for years.
This is often described as masking.
What is masking?
Masking generally describes hiding, suppressing or compensating for behaviours or responses in order to fit social expectations.
It is particularly discussed in relation to autistic people, although people with ADHD and other neurodivergent experiences may also describe forms of masking or camouflaging.
It can look very different from person to person.
Someone might force themselves to make eye contact because they’ve learned that it’s expected.
They may copy how other people behave in social situations.
They might suppress movements that help them regulate themselves.
They may laugh when everyone else laughs even though they’re not quite sure what was funny.
Or they may simply become very good at saying:
“I’m fine.”
Why does this matter to therapists?
Because we rely heavily on communication.
Is the pressure okay?
Is the temperature comfortable?
Do you want music?
Does that position feel alright?
A client may answer yes because it feels easier than asking you to change something.
They may worry about seeming difficult.
They may have spent years learning that their preferences are “fussy”.
Or they might not recognise that they’re becoming overwhelmed until they’re already very uncomfortable.
So while we should absolutely listen to what clients tell us, good communication sometimes means making it genuinely easy for them to say no too.
“Tell me if you need anything” can be surprisingly difficult
Therapists say this all the time.
“Just let me know if you need anything.”
It’s well intentioned.
But think about what the client has to do.
They have to notice they’re uncomfortable.
Decide whether it’s uncomfortable enough to mention.
Interrupt the treatment.
Work out what they need.
Ask for it.
And possibly worry that they’re inconveniencing you.
For some people, that’s a lot.
Specific questions can be easier.
“Would you like the pressure lighter, firmer or is this about right?”
“Would you prefer the music quieter or switched off?”
“Are you comfortable with me working on your feet?”
Now the client has clear options.
The same thing happens in training
A tutor explains a task.
“Everybody happy with that?”
Four students nod.
So the class moves on.
Twenty minutes later, one student is completely lost.
Why didn’t they say something?
Perhaps they didn’t realise they’d misunderstood until they tried to do it.
Perhaps everybody else seemed to understand and they didn’t want to hold the group up.
Maybe they’ve spent years hiding difficulties because they don’t want to look less capable.
Or perhaps being asked:
“Do you understand?”
is simply too broad a question.
Instead, try:
“Talk me through what you’re going to do first.”
or:
“Which part would you like me to demonstrate again?”
That checks understanding without requiring the student to announce to the whole room:
“No. I haven’t got a clue.”
Masking can be exhausting
Imagine consciously managing things that other people do automatically.
Am I making enough eye contact?
Am I talking too much?
Not enough?
Should I be smiling?
Everyone else seems comfortable with this music, so don’t mention it.
Don’t fidget.
Remember what she just said.
Don’t interrupt.
Act normal.
That’s a lot of mental effort.
Some people describe coping perfectly well in a situation and then feeling completely exhausted afterwards.
For tutors, that might mean a student seems engaged throughout the training day but struggles considerably once they get home.
For therapists, a client may appear relaxed during a treatment while actually spending much of it managing sensory discomfort or uncertainty.
We can’t always see effort from the outside.
Don’t become an amateur diagnostician
This is important.
A quiet student isn’t necessarily masking.
A client who doesn’t like eye contact isn’t necessarily autistic.
Someone who fidgets doesn’t automatically have ADHD.
Our role isn’t to watch people for clues and diagnose them.
We simply need to recognise that outward behaviour doesn’t always tell us exactly what’s happening internally.
That principle applies to everybody.
Make saying no normal
One of the easiest things we can do is remove the feeling that there is a “correct” answer.
Instead of:
“You’re okay with music, aren’t you?”
try:
“Some clients like music and some prefer silence. Which do you prefer?”
Instead of:
“Pressure okay?”
try:
“How does that pressure feel — would you like it lighter, firmer or about the same?”
Instead of:
“Everyone understands?”
try:
“Before we move on, let’s quickly recap the three things we’re going to do next.”
Now nobody has to identify themselves as the person who needs something different.
Choice is simply part of the process.
Watch your reaction when somebody does speak up
This matters more than we sometimes realise.
A client finally says:
“Actually, could you turn the music off?”
And the therapist replies:
“Oh! You don’t like it? Everyone loves this playlist!”
It sounds harmless.
But we’ve just told the client their preference is unusual.
Or a student asks for something to be demonstrated again and hears:
“We’ve already been through this twice.”
They may be much less likely to ask the next time.
If we tell people they can speak up, our response needs to show that we genuinely mean it.
“Of course.”
“No problem.”
“Let’s go through it again.”
Simple.
Create environments where people don’t have to pretend
We will never know exactly what every client or student is experiencing internally.
Nor do we need to.
We don’t need to identify who is masking.
We don’t need everyone to disclose a diagnosis.
And we certainly don’t need to analyse every behaviour.
We can simply create environments where people have choices, questions are welcome and asking for something different isn’t treated as inconvenient.
Because sometimes someone really is fine.
And sometimes they’re doing an excellent job of looking fine.
Our job isn’t to work out which one they are.
It’s to make sure they know they don’t have to pretend.
