Internalised autism, what’s that?
Autism is widely recognised as being a spectrum, with no two autistic people being the same. Thanks to ongoing psychological research and disability advocacy work, there is now a better understanding about the autistic experience for different people. We are now more aware that people can be autistic and not “look” autistic!
However, some autistic people’s experience still happens more on the inside than it does on the outside. We call these profiles internalised, or non-stereotypical autism. Sometimes this is known as “female autism” due to the high frequency of girls, women and people assigned female at birth (AFAB) who share these features of autism.
Because the autistic characteristics in internalised presentations tend to be more internal experiences, people with this profile can often receive a diagnosis later in life or be missed altogether. It is therefore important that more awareness is raised around these autism profiles, to enable people with knowledge of their identity and access to the supports they need.
Here are 6 key (and possibly surprising!) ways that autism can present in internalised presentations:
1. Hyper-empathy and hyper-sensitivity
Many autistic people often describe struggling with their emotions, particularly with recognising these in themselves and others. However, for some autistic people the opposite is true: they feel too much! This can often show up as hyper-empathy (experiencing other people’s emotions as their own) or hyper-sensitivity (feeling emotions quickly and strongly).
2. Internal repetitive behaviours
Repetitive behaviours are a key characteristic and diagnostic feature of autism, but did you know that this can show up differently in different autistic profiles? Often we think of repetitive behaviour as an external action – like spinning a toy, saying a phrase over and over again, picking at a part of your body. However, these actions can also appear as internal experiences. These can be things like constant rumination or worry about one thought or topic, playing a scene in your head over and over, or even doing something repeatedly to feel the same positive feeling again multiple times over.
One of the core criteria for diagnosing autism is “restricted, repetitive patterns of behaviour” that can appear as a need for sameness, consistency and predictability. Though we can often see these characteristics show up in a child’s play, social interactions and routines, perfectionism is a little known feature that also relates back to this. Where uncertainty and unpredictability can create anxiety for an autistic person, perfectionism can show up as a coping strategy to control for some of these unknowns.
It is often thought that autistic people have difficulty with the neurotypical social experience. However, many autistic people are socially motivated and even have social success in these spaces due to a process called camouflaging. Many autistic people don’t “look” autistic for this reason – they are highly adept at camouflaging their autistic ways of socialising. Camouflaging refers to changing, altering or hiding one’s true self in an effort to “fit in” and appear neurotypical. Camouflaging can involve one or more of the following methods:
- Compensation (strategies to actively compensate for social difficulty, like scripting what to say in a social situation).
- Masking (strategies to hide autistic features or mannerisms, like being very conscious of your facial expressions and body language).
- Assimilation (strategies to try and fit in with others in neurotypical crowds, like hiding stims and downplaying special interests).
5. Special interests that blend in culturally or developmentally
Special interests are strong, highly focused areas of interest that bring an autistic person joy. In stereotypical presentations these tend to be recognised as being more intense (such as repeated conversation in an area of interest) or uncommon (such as in the periodic table or the Titanic). Some special interests, particularly in internalised presentations, can seem more “typical” or age-expected for a person (such as K-pop bands or animals). For adults, special interests may blend in by appearing relevant to a person’s work or social circles (such as a specialise PhD topic or avidly collecting figurines).
6. Autistic shutdowns
Meltdowns are a common experience with autism and can occur for a variety of reasons – anxiety related to a transition, emotional overwhelm, or sensory overstimulation. However, many autistic people with internalised presentations may be misperceived due to having meltdowns on the inside, also known as shutdowns. Shutdowns can present in multiple ways but typically appear as the person being withdrawn, crying, retreating to a quiet and/or dark space, unresponsiveness or even a loss of certain skills (the person may become nonverbal or have difficulty performing usual tasks).
Where can I find out more?
If you would like to learn more about internalised autism, check out some of these great resources:
- Yellow Ladybugs (https://www.yellowladybugs.com.au/)
- Reframing Autism (https://reframingautism.org.au/)
- AUsome training (https://ausometraining.com/)
Written by Alyssa Cvetkovski
Alyssa is a registered psychologist with experience working alongside children, adolescents, young adults and families. She has worked extensively in multidisciplinary settings and has a professional background in disability advocacy and behavioural support.
Alyssa is passionate about supporting individuals through a compassionate, client-centred and neuroaffirmative lens. She strives to create an environment that is emotionally safe and respectful of people’s needs, using a warm, playful and empathetic approach when working with individuals and the important people in their life. Alyssa draws on evidence-based approaches including Acceptance and Commitment Therapy (ACT), Cognitive Behavioural Therapy (CBT) and Dialectical Behaviour Therapy (DBT) to create supports that fit the needs, strengths and goals of each client.
In her spare time Alyssa enjoys cooking up a storm, watching documentaries and spending time with her two cats, Percy and Olive.