Camouflaging in autism and borderline personality disorder: Same or different?

Abstract

In this paper, we tackle the issue of overlapping clinical presentation of autism and borderline personality disorder (BPD). Recently, the phenomenon of camouflaging has been extensively discussed in the context of autism research, whereas it has not been similarly explored in the context of BPD. We aim to show that camouflaging strategies are relevant to the experience of both autistic and BPD individuals, thereby further corroborating the view that the conditions are similar in relevant ways. However, shedding light on distinct forms of camouflaging also reveals important differences between the two conditions, which can be overlooked by focusing on surface similarities. We first propose a broader notion of camouflaging in terms of making unseen, a process through which camouflagers manage to make some aspects of themselves less visible to others. We then interpret different patterns of behavior observed in autism and BPD as different forms of making unseen. Although these forms share the common objectives of fostering a felt connection with others and minimizing experienced divergences, they achieve these objectives in different ways. While individuals with BPD resort to practices such as façading and what we call subversive camouflaging, autistic individuals experience camouflaging as a blend between hiding and imitating. Delving deeper into these forms of making unseen reveals subtle but significant differences between autism and BPD, which can be helpful in clinical settings. We offer an exploratory account of such differences by analyzing three key aspects: sense of self, attitude towards others, and seeking connection.

Keywords

autism borderline personality disorder (BPD)camouflaging connection sense of self

In the past few years, clinical research has emphasized that autism and borderline personality disorder (BPD) may manifest in similar ways, rendering it sometimes difficult for clinicians to reliably distinguish between the two conditions. These discussions mostly occur as a result of increased observed comorbidity between autism and BPD (Cheney et al., 2023; Dell’Osso et al., 2023), as well as of the similar clinical presentation in some populations—notably, teenage and adult women (McQuaid et al., 2022; Pires et al., 2023). In both autism and BPD, individuals often struggle with navigating social situations, desire to feel connected with others, and experience difficulties with identity and sense of self, as well as with stigma and discrimination. In both cases, many of these difficulties relate to how the normatively structured social world enforces or more or less explicitly sanctions certain cognitive, behavioral, and emotional styles.

This paper addresses these surface similarities between autism and BPD from the perspective of camouflaging, a phenomenon so far primarily described in the context of autism.¹

Camouflaging is typically characterized as the enactment of more or less complex strategies to minimize perceived differences and adhere to social standards while modifying one’s appearance and behavior. There is preliminary evidence that experiences akin to camouflaging occur in a variety of psychiatric and neurodevelopmental conditions, including developmental language disorder (Hobson & Lee, 2023), social anxiety (Lei et al., 2023), dyslexia (Alexander-Passe, 2015), and psychopathy (Cleckley, 1941). Yet, a thorough analysis of camouflaging as a trans-diagnostic and multidimensional construct is currently lacking. Several conceptual questions remain open, as the boundaries of the very phenomenon of camouflaging are still unclear and there is significant discussion as to which experiences should qualify as varieties of camouflaging (Ai et al., 2024).

In our view, camouflaging should be interpreted as an attempt undertaken by individuals to make aspects of themselves unseen. Starting from this assumption, we propose to interpret some of the phenomena associated with both autism and BPD as forms of camouflaging. Our exploratory conceptual comparison between camouflaging in autism and BPD represents the first attempt at systematically applying the concept of camouflaging to both conditions. Our aim is to show that once we take a closer look at how camouflaging is enacted in the two conditions, relevant differences can be identified with regard to a triad of relevant aspects.

Our argument proceeds as follows. We start out by briefly summarizing the research on camouflaging in autism, along with its defining features and aims. We then move on to explore whether the notion of camouflaging may capture some of the behaviors and strategies that we observe in BPD. We proceed by offering a preliminary comparison between autism and BPD along the three key aspects of self, attitude towards others, and seeking connection, and we conclude by advocating for an expansive view of camouflaging in different conditions as well as in individuals without a psychiatric diagnosis.

Camouflaging in autism

The phenomenon of camouflaging has attracted increased attention in autism research over the past few years (Hull et al., 2017; Livingston et al., 2019). Difficulties in the domains of social interaction and communication are some of the defining features of autism (American Psychiatric Association [APA], 2022). These difficulties are heterogeneous in nature, ranging from basic issues with initiating or responding to social contact, to linguistic aspects concerning starting and maintaining conversations, to broader aspects such as understanding relationships. Social difficulties have been at the heart of diagnostic descriptions of autism at least since the 1940s: Asperger (1944/1991, p. 79) talked about autistic children as being “often tormented and rejected by their classmates,” and Kanner (1943, p. 242) famously characterized the condition in terms of will to self-isolation present from birth, or “autistic aloneness.” As these excerpts show, some early descriptions ascribe social difficulties in the autistic population to a lack of interest in social contact (see Chevallier et al., 2012 for a more recent defense). Yet, recent research suggests that many autistic people actually display strong social motivation, although they may express such motivation differently with respect to neurotypicals (Jaswal & Akhtar, 2019). The phenomenon of camouflaging represents a powerful example of how many autistic people employ a range of more or less conscious strategies to navigate the neurotypical social world and protect themselves from stigma and discrimination.²

Despite this increased interest in camouflaging, the nature of the phenomenon is still debated and several aspects stand in need of conceptual clarification. Valuable insights may be gleaned from first-person accounts of autistic individuals who have reported on their camouflaging experiences. For instance, in her memoir—aptly titled Pretending to Be Normal—Holliday-Willey (1999) thoroughly describes a wide range of behaviors involving imitation and pretense, which allowed her to approach social settings and interactions that would have otherwise been extremely challenging. She describes herself as an “avid observer” of people and interactions, to the point that she would often “copy accents, vocal inflections, facial expressions, hand movements, gaits, and tiny gestures” (pp. 26–27). Other first-person accounts, such as the one recently published by the stand-up comedian Gadsby (2021), talk about camouflaging in terms of “reverse-engineering normality” (p. 109), whereby the attentive observation of how others behave becomes a collection of clues that informs one’s own actions and speech.

Recent studies based on qualitative interviews have highlighted the complexity of camouflaging experiences in autism. Generally speaking, there seems to be a consensus on the idea that autistic camouflaging involves a mix of two components (Pearson & Rose, 2021; Petrolini et al., 2023). On the one hand, camouflagers hide autistic traits to avoid or minimize exclusion, stigma, and discrimination (this is at times known as “masking”). One prominent form of hiding involves the suppression of traits or behavior that are coded as “autistic”—or simply as “weird” or “atypical”—by others. For example, as one respondent in Hull et al.’s (2017) study reports:

I prevent myself from doing any particularly visible or otherwise noticeable stims [self-stimulating action or gesture] . . . I don’t make any noises people would think are weird, don’t full-body shake (like with the leg but . . . all of me), or do any finger movements or tapping etc. that would annoy people. (p. 2525)

On the other hand, camouflagers mimic or imitate others to assuage anxiety, fit in, and better navigate social circumstances (this is at times known as “assimilation”). Common examples include employing scripts for different contexts or rehearsing conversations in advance. As one participant in Livingston et al.’s (2019) study emphasizes: “It came to me in a flash that if I acted like ‘that person over there’ no one would know that I was struggling inside . . . I made mental lists of the things I had to remember to say/do” (Appendix, p. 6). The interaction between hiding and imitating appears to be quite complex, and most instances of autistic camouflaging are probably a blend of both ingredients. People attempt to conceal specific traits and behaviors to avoid stigma and discrimination, while at the same time enacting strategies to fit into social contexts and appear more similar to others.³

We propose to subsume all these components of camouflaging under the notion of making unseen, which we will employ as an umbrella term to explore similarities and differences between camouflaging experiences in autism and BPD. We expand on this notion later in the paper, but for now it suffices to say that we understand making unseen as a process through which the camouflager makes some aspects of themselves less visible to others. Although the range of what is made unseen is quite broad—for example, behaviors, thoughts, feelings—the intentional object of this process is almost inevitably an aspect of the camouflager. In the case of autism, as it can be gleaned from the reports above, the aspects that are made unseen mostly concern one’s perceived diversity and deviation from expectations within most social contexts that are neurotypically structured.

In the next section, we outline how some behaviors that we observe in BPD may be interpreted as forms of making unseen. Our discussion will be primarily conceptual and exploratory, the main goal being to assess whether the notion of camouflaging may capture the behaviors and strategies that we observe in BPD. We draw on existing research on the nature of BPD, as well as on first-person accounts, to motivate the idea that the strategies employed by individuals with BPD may indeed be rubricated as forms of camouflaging.

Camouflaging in borderline personality disorder

As we mentioned in the first part of this paper, recent research has emphasized that autism and BPD can significantly overlap in their clinical presentation, raising issues with respect to proper identification and misdiagnosis (Cheney et al., 2023). Similarities between the two conditions specifically concern difficulties with social interaction and the perception of one’s own self, including the regulation of affective processes. Indeed, these three aspects are taken to refer to the characteristic features of BPD, which is typically described as being associated with “a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity” (APA, 2013, p. 663).

Difficulties with regulating emotions and hard-to-control impulsivity render social situations especially challenging for individuals with BPD. Research has shown that the lack of adaptive emotion regulation strategies found in individuals with BPD is a complex phenomenon, involving specificities in the experience of one’s own and others’ affect, such as alexithymia, emotional flooding, hypersensitivity, and heightened affective empathy (see Schmidt, 2022). While individuals with BPD tend to be sensitive to their emotional surroundings and seem to be easily aware of shifts in others’ emotional feelings, they struggle with identifying and situating them in the broader context. This evokes primarily insecurity and secondarily maladaptive responses including paranoia, wrong attributions and interpretations of other peoples’ experiences and behaviors, and even rigid beliefs about the situation in question. The way individuals with BPD experience affect has been described as a major impediment for social flourishing, which leads to painful experiences of loneliness (Liebke et al., 2017; Nenov-Matt et al., 2020; Schmidt, 2022, 2023). The desire for connection and the importance that significant others have for BPD individuals form the background against which they are triggered to show intense efforts to prevent real or imagined abandonment (APA, 2013).

Moreover, the instability of emotional experience in BPD is deeply entwined with the sense of self. The sudden ruptures in identity correspond to—and mostly follow—how people with BPD feel about themselves. Given BPD’s dynamics, this may oscillate between the extremes of a lack of self-feeling and emptiness on the one hand, and over-identification with a current emotion on the other hand (Fuchs, 2007; Schmidt, 2021b). Although individuals with BPD can live through phases of relative stability and can be highly functional, even when extreme self-related affect is absent, the general affective setting of BPD individuals is shaped by a chronic “mental pain” (Fertuck et al., 2016) or “desperate vitality” (Stanghellini & Rosfort, 2013a).

We now want to explore in which sense camouflaging might be said to feature in the “stable instability” of BPD (Edwards, 2017). In the literature on BPD, at least so far, the term “camouflaging” has not been used to describe behaviors that have the intended or unintended effect of making unseen features of a person, how a person feels about a situation, or what a person really wants and thus which goals guide their actions. But although the label itself may presently be absent, the phenomenon need not be. We suggest that what has been described as “façading” (Jørgensen & Bøye, 2022) in the context of BPD may be interpreted as a form of camouflaging, although it differs from autistic camouflaging practices. To conceptualize façading as a form of camouflaging is the aim of the next section. The section that follows further expands the notion of camouflaging by introducing another way of making unseen sometimes observed in BPD: subversive camouflaging.

Façading

First-person reports of individuals experiencing BPD contain several descriptions of the need to overspread subjective feelings to function properly without disturbing social settings. These first-person reports seem to imply that, in their self-perception, individuals with BPD are often successful in masking their inner processes to a point that they do not want to further enact a role that they feel is ascribed to them:

I play my part in this masquerade, keeping a smile on my face and the demons down. To be honest, I am growing tired of this masquerade. . . . I go through life doing what needs to be done to fulfill my role in society. (Edwards, 2015, p. 49)

Rather than being cognitively overwhelming, the exhaustion such reports express is primarily affective in nature. As we mention above, many individuals with BPD suffer from a general lack of self-feeling and a weak sense of self. Camouflaging by taking up different social roles can further exacerbate this feeling, by strengthening the impression that it is not really oneself who is interacting with others. This can in turn translate into the impression that one is not partaking in social situations, that one is fundamentally misunderstood, unseen, and ultimately left out, as others respond only to the “false self” (Jørgensen, 2006, p. 635). At the same time, false selves are sometimes the only perceived way to connect with others and develop some self-feeling: “Fundamentally, I am nothing, really, and then with other people, I can be different persons. Then at least I am something” (Jørgensen & Bøye, 2022, p. 51). It is important to note, however, that this may make an individual more vulnerable to becoming dependent on others, as the following report expresses:

Sometimes, now more than ever, I feel like a ghost masquerading as a human being. . . . The ghost knew all along that it was no longer alive. It thought it could play along and that the show would never end. It was wrong. The ghost should have seen that it can only act for so long until people catch on. (Edwards, 2015, p. 45)

By enacting false selves, an individual with BPD requires recognition and confirmation through others to stabilize their sense of identity, given that feelings of inner emptiness in BPD tend to erode any self-feeling that is not supported through interaction with other people. That said, camouflaging by adopting façades can also serve as a protection and distraction, ironically when others undertake the attempt to get in touch with the “real” feelings and self of the person with BPD. Luyten (1985) describes a patient who was stressed out by the recurring questions posed by significant others about her feelings, thoughts, and opinions because this made her realize that she did not know the answers. As the qualitative study by Jørgensen and Bøye (2022) demonstrates, the motives for using façades are various: being socially accepted, hiding inner vulnerabilities, covering emptiness, concealing aspects of the self that are perceived as “bad,” or stabilizing and testing out certain identities.

Subversive camouflaging

We now want to describe another type of behavior observed in persons with BPD that may be interpreted as a form of camouflaging. This behavior occurs especially in situations in which an individual feels that their emotions, intentions, or actions may stand out as ill-matching in a given social situation. One strategy to make unseen related aspects of the camouflager may consist in attempts at changing a situation or how others perceive it. These attempts are typically proactive and may result in a modification of how behaviors in a shared situation are interpreted. By provoking certain behaviors in others, the scene may become a different one to the effect that the camouflager’s affects, intentions, or behaviors are seen in a new light, relativized, normalized, or fully covered. For instance, an individual may camouflage feelings of jealousy by triggering similar feelings in the other person through actions that pose specific challenges to the other. After feeling jealous, a camouflager will perhaps tell their partner that they are going out with an attractive friend, laugh loudly at the jokes of a good-looking party guest, or compliment the achievements or fashion style of their partner’s best friend. By transferring one’s emotional feelings of jealousy to the other, an individual may create an atmosphere of jealousy in which their own jealousy becomes a plausible, normal, and almost expected emotional response. The function of what we dub subversive camouflaging is to make the world fit the camouflager’s situatedness by proactively managing the scene, with the effect that the salience of one’s affect, intentions, and behaviors is mitigated.

Subversive camouflaging may at times take quite complex and subtle forms that can be difficult to detect. This is the case, for instance, when the camouflager engages in making unseen practices geared towards eclipsing the emotional experiences of the other person. Consider the following case: an individual with BPD notices that a significant other displays an emotional reaction. Since the emotions of others may imply changes for the relationship and potentially even destabilize the sense of identity felt by an individual with BPD, taking notice of the other’s emotions can pose a difficult challenge. This is often the case even when the other’s affective states are not negatively valanced, but rather ambiguous (Kleindienst et al., 2019). Arising insecurity can trigger thoughts about loss and abandonment, leading to strong feelings in the individual with BPD that are based more on fantasies and catastrophizing rather than on the reality of the shared situation. Instead of making these feelings explicit as well as the perceived emotional reaction of the other, the individual with BPD may engage in subversive camouflaging, thereby aiming at making both the alleged emotional experience of the other and the camouflager’s felt reaction to it unseen. One commonly observed practice in this respect consists in attempting to recalibrate the attention of those involved in the situation. For instance, an individual with BPD could engage in the emotions of anger and sadness about something that is unrelated to the shared situation, hoping the other may ask about it and develop a concern about the camouflager’s current feeling. By jointly attending to such a mask-emotion, the camouflager achieves a twofold concealment: (a) of one’s own irritation initially triggered by the other’s emotion and (b) of the assumed (though indeterminate) characteristic related to the camouflager—for example, behaviors, individual features, aspects of the relationship.

This complex structure may be illustrated through the following example. A notices a state of impatience and annoyance in B. A does not know what B is emotionally responding to, but fears it may be related to A—for example, to some feature of A, or to something that A has recently said or done. A feels anxious about B’s affective state. To conceal this growing insecurity, as well as the features of the shared situation that A speculates to be at the root of B’s annoyance, A engages in a mask-emotion that recalibrates attention. B’s attention is thereby simultaneously driven away from A’s features that may cause B’s impatience and from A’s insecurity about B’s impatience. In other words, by making unseen another person’s emotions, the camouflager may—by the same token—manage to make the reason(s) to which these feelings are a response unseen. Since the camouflager may fear that these reasons are related to themselves, they are eager to make them unseen, even if they might not be fully clear about what precisely they are.

At times, those interacting with individuals engaging in subversive camouflaging may rubricate such behaviors as “manipulative,” a label that has been frequently associated with BPD and heavily contributed to its stigmatization (Schmidt, 2021a). By contrast, treating these behaviors as camouflaging attempts may provide us with a more nuanced and less stigmatizing interpretation. A similar argument applies to façading. While the label of façading without further specification may suggest inauthenticity, framing it as a camouflaging practice highlights that the behavior is more about fitting in within social contexts, which is less stigmatizing than assuming an intent to deceive.

In the next section, we move to the core of our analysis by proposing a more explicit comparison between autism and BPD along three key aspects.

Camouflaging in autism and borderline personality disorder

The emphasis on surface similarities between autism and BPD has been motivated by existing comorbidities, high rates of misdiagnosis, and empirical findings with regard to instabilities in self-experience, affective processing, and interpersonal relationships. In this section, we address how camouflaging practices feature in—and thus shape—these dimensions in each condition. By doing so, we aim to show that even if some structural behavioral affinities may be manifest in autism and BPD, significant aspects of how individuals experience the world shared with others may diverge. For instance, emotional outbursts and difficulties in regulating emotions may occur in both autism and BPD but likely arise in different situations, such as sensory overload in the context of autism (Rinaldi et al., 2023) and self-related (Koivisto et al., 2022) and other-related frustration (Bertsch et al., 2021) in the context of BPD.

The whole thing is complicated by the fact that similar experiences may manifest differently and/or trigger distinct behavioral responses in the two conditions. For instance, individuals in both autism and BPD struggle with identity confusion, have difficulties with the normative demands formulated by others, and are concerned with seeking connection. However, these struggles are experienced differently, and elucidating these differences may contribute to drawing some conceptual as well as clinical distinctions that risk being obscured by overlapping symptoms or surface similarities. We start by discussing the topic of sense of self (1), where the differences between autism and BPD are arguably more salient. We then compare attitudes towards others (2), and conclude by identifying potential differences in attempts at seeking connection (3).

(1) Sense of self

The first dimension that we discuss concerns how camouflaging practices—qua making unseen strategies—interact with sense of self in autism and BPD. As several first-person accounts show, camouflaging practices may deeply affect one’s sense of self in both instances, especially if they are carried out for long periods of time and become second nature to the person. For instance, some autistic camouflagers report issues with distinguishing between the mask and their true self (Howe et al., 2023), while others cast more substantial doubts about their identity—for example:

But I am such an expert masker, and I have developed my masks to be disguises of such nuanced, subtle, finessed complexity, that I struggle to find myself [emphasis added] . . . And as I contemplated writing this blog, it occurred to me: I don’t know who I am [emphasis added]. (Anonymous, n.d., Para. 5)

Similarly—as we mentioned in the previous section—people with BPD often adopt false selves through the practice of façading, whereby they enact specific personas and may become convinced of their reality for a limited period of time, before a deeper sense of inauthenticity sets in.

We now take a deeper look at how camouflaging practices affect the sense of self in both conditions, with an eye on possible differences. A prima facie difference concerns the fact that, in the case of autism, camouflaging practices seem to be responsible for enhancing confusion with respect to one’s sense of self. In other words, confusion about identity—that is, about who one ultimately is—emerges as a consequence of prolonged camouflaging. As one of the participants in Howe et al.’s (2023) recent study reports:

Because when you mask for a long time, especially you mask almost, you mask on the daily for hours, maybe even days at a time, with no way to recharge, you kind of just don’t really know who you are [emphasis added]. (p. 10)

By contrast, the BPD reports on façading suggest a different picture, one in which camouflaging is employed as a compensatory and protective strategy against a weak sense of self. In other words, preexisting confusion about identity prompts the BPD individual to camouflage. Although in both conditions camouflaging contributes to developing an alternative self built around other people’s perceptions and expectations, such a development follows very different principles. For the autistic individual, the neurotypical other works as some sort of model that allows them to effortfully “reverse-engineer normality” (Gadsby, 2021, p. 109), while at the same time acting as a powerful reminder of their felt difference. Confusion about one’s sense of self thus emerges from the painfully perceived gap between the neurotypical mask that the person has perfected over time and the autistic self that is made unseen.⁴ For the BPD individual, it is the “lack of intimacy with oneself” (Stanghellini & Mancini, 2018) that pushes one to enact different social roles through camouflaging. What façading makes unseen is therefore not necessarily an underlying self that the person with BPD takes to be deviant or unacceptable. What is rather concealed are the emptiness, void, and chaos that lie where individuals feel an identity should be:

I have many different façades . . . . Behind them there is chaos, not knowing who I am or how you’re supposed to act . . . . On the outside, I have no problem appearing calm, in control and completely integrated. But inside, I am going 150 miles per hour, trying to figure out, am I doing the right thing, am I giving the right answers? (Jørgensen & Bøye, 2022, p. 53)

If this is correct, the selves and personas enacted through camouflaging by autistic individuals and those with BPD play a substantially different role. For many autistic individuals, the neurotypical mask(s) are described as a process of “becoming a version of myself [emphasis added] that is more acceptable” (Packham et al., 2023, 00:40) or of playing different roles in different situations while having it somewhat clear that all these personas “are all me at the core” (Hull et al., 2017, p. 2526). In these cases, autistic confusion about one’s sense of self due to camouflaging may take the form of not knowing “who is the real me”—that is, having a hard time prying apart the neurotypical mask(s) and the autistic selves—and may additionally translate into being unable to drop one’s mask at will because camouflaging has become second nature in many social situations.

By contrast, the identity confusion in BPD appears to relate to an inner chaos or self-related uncertainty, wherein individuals with BPD suffer severely from the absence of self-feeling, a gap which they are desperate to fill. It is then unsurprising that the first-person accounts of façading in BPD paint a more elaborate picture, where people report taking up fully fledged roles and committing to them quite deeply for some time. In these cases, façading typically results from the more or less conscious wish to make one’s own inner chaos and uncertainty unseen. While it seems that it is primarily the gaze of other people that is addressed with façading, we speculate that individuals with BPD sometimes start to believe in the reality of the false selves they develop, if only partially and for a period of time. Such belief may be affectively motivated in these cases: its main purpose is to overcome feelings of “not being anchored” (Moltu et al., 2023, p. 6) and to try out and establish a “firm holding” (p. 5). While beliefs are sustained through the recognition of others, in hindsight it also seems that camouflagers are often aware of having used masks (Jørgensen & Bøye, 2022). Typically, façading phases are followed by a peculiar state of exhaustion that individuals with BPD at times describe in terms of “grow[ing] tired of the masquerade” (Edwards, 2015, p. 49). Notably, this sense of exhaustion in BPD is again more affective than cognitive, and is further complicated by recurring depression-related feelings of emptiness, which eventually undermine the commitment to any role previously taken up. But detachment from personas may also occur as a more or less conscious affective response to interpersonal turmoil; for instance, when individuals “pull the plug” (Schmidt, 2021b, p. 214) and try to deny the importance of a relationship and the corresponding roles associated with it. The different tendencies to quickly develop and discard comprehensive façades in individuals with BPD can increase felt distress and chaos. If façading may help individuals with BPD for some time to be “at least . . . something,” to “stabilize the self” (Jørgensen & Bøye, 2022, p. 51), and enable a person to participate in the world of interpersonal relationships, ultimately this camouflaging practice will gravitate towards the fundamental inability to identify who one is underneath the façade(s).

Autistic masking appears to be more situational in comparison, as it often revolves around imitating neurotypical others and mastering scripts and behaviors to navigate social situations. As we mentioned above, in some cases these performances generate confusion because they become second nature and give rise to a bipartite identity. In other cases, even when they are successful, they are still perceived as effortful and ego-dystonic, to the point that they are rarely embraced completely. In support of this point, it is interesting to note that many autistic individuals describe a significant gap between their behavior in public—where the masks are mostly held up—and in private—where the person feels more authentic and free to pursue their real interests (e.g., “I spend hours alone at home rearranging my little piles of bric-a-brac, because it’s really fun” [Gadsby, 2021, p. 273]). Camouflaging thus qualifies as a way to hide one’s differences to avoid negative reactions from others, without implying an underlying confusion about sense of self: “I don’t care about being different, I like my differences (apart from things feeling really stressful and no confidence) but I don’t want to deal with peoples’ negative and sometimes evil reactions” (as reported in Hull et al., 2017, p. 2528).

To further illustrate these different experiences with respect to one’s sense of self, it is illuminating to look at a first-person account of someone who was initially misdiagnosed with BPD and later in life rediagnosed with autism. Gadsby (2021) elaborates on this point in her memoir:

I certainly struggled with self-image, but also not really. I only ever struggled in relation to other people. On my own I always felt as if I had an incredibly strong sense of self, almost rigid [emphasis added]. In many ways the feeling of me has evolved very little since I was five years old. I just had trouble knowing how to be that person when I was around other people . . . . But the one point that never made sense to me at all was the “chronic feelings of emptiness.” While I have felt bereft of hope at times, I don’t think I’ve ever felt empty. I have only ever been very full of stuff. (p. 256)

(2) Attitude towards others

In this subsection, we propose that different camouflaging practices are also shaped by how others and their normative demands are perceived by an agent and which aspects of a social situation are targeted through camouflaging. In both autism and BPD, alexithymia—that is, a difficulty in recognizing emotional states in oneself and others (Kinnaird et al., 2019; New et al., 2012), has been frequently observed. Given such difficulty in identifying and labeling affective experiences, other people’s experiences and behavior may become especially challenging to understand (Di Tella et al., 2020).

However, other people’s experiences and behavior are probably perceived differently in autism and BPD. In the former, the perception of others’ mental states is primarily concerned with finding out and understanding what others are experiencing when they show certain behaviors. This is often accompanied by a deep sense of puzzlement as well as by a cognitive reflection to infer what rationale may be behind other people’s expressions and actions (think about Gadsby’s [2021] excerpt about “reverse-engineering normality,” p. 109). There is evidence suggesting that difficulties in social perception in autism stem from disturbances in affective empathy (Schnitzler & Fuchs, 2024). However, these disturbances are still not fully understood and difficulties surrounding other people’s mental states can hardly be explained by appealing to considerations about varying degrees of affective and cognitive empathy, as if matters were simply quantitative. Independently of the underlying mechanisms, from a phenomenological point of view, what often stands out in autistic individuals is the perplexity and confusion often experienced in interpersonal encounters.

By contrast, a common tendency witnessed in individuals with BPD is the assertiveness with regard to the perception of others’ experiences. Rather than feeling puzzled and engaging in a mode of questioning, individuals seem to tend to overly rely on the impressions they have about what others feel. Often, these impressions can be based on processes of emotional contagion and hypersensitivity to others’ affects. Just like in autism, the empirical evidence with regard to the typical profile in cognitive and affective empathy is mixed and social perception remains a challenging issue in the research on BPD. However, there is a tendency for studies to observe heightened affective empathy in BPD, while there seem to be no studies describing heightened cognitive empathy in BPD (Salgado et al., 2020). Although more research will be needed, we suggest that a stronger inclination towards picking up others’ affects, together with difficulties in recognizing and regulating emotions, may motivate emotional responses in which individuals tend to ascribe, sometimes quite rigidly, certain mental states to others. Such assertiveness often does not leave room for belief revision, which can in turn exacerbate poor understanding of how others truly feel about a situation (Herzog et al., 2022).

However, it is important to stress that difficulties with empathy may not be reducible to an individual’s abilities, but may be better described as a social phenomenon that concerns the interaction between different persons with different styles of experiencing the world. These mismatches of reciprocity may make it appear like some individuals lack relevant capacities of empathy (Ekdahl, 2024; Milton, 2012).⁵ Although it is not fully clear to what extent these difficulties in empathy may arise out of a social mismatch or individual capabilities, we suggest that whereas in autism intersubjective insecurities result in experiences of bafflement, individuals with BPD seem to compensate for their uncertainties by engaging in (overly) self-confident, rigid beliefs about other people’s mental states. Rigid belief may thus be interpreted as a way to rid oneself of the “question” of what others may feel altogether.

This different attitude towards the mental states of others in the two conditions additionally shows up as a different attitude about social norms. As we discussed above, some autistic camouflagers report observing other people attentively to extract information about what is “normal” or “acceptable” in a given situation. Many respondents in qualitative studies report developing more or less complex strategies to foster the impression that they are spontaneously participating in a social encounter. These strategies often concern what is appropriate to do within a conversation—for example:

I’m not good at knowing when it’s my turn and I also tend to just blurt out things or keep talking when I should have stopped, so I prep myself always in social situations to have a reminder or tag or internal buzzer about not speaking too much and trying to do more listening, nodding, agreeing [emphasis added]. (as reported in Hull et al., 2017, p. 2526)

Similarly: “I’ve recently tried to institute a rule about asking more “you” questions [emphasis added]—how did that make you feel, what did you do next, what do you think about a given thing—instead of “me” or “I” statements” (p. 2526). Generally speaking, the autistic attitude towards social norms reveals a gaze “from the outside looking in,” where norms are effortfully internalized to make sense of the inherent confusion and uncertainty represented by the social world—for example, “I have had many years to make rules and discover tricks for myself that make things easier” (Parsons & Jackson, 2023, p. 18).

The attitude towards norms displayed by individuals with BPD appears to be substantially different. Far from being confused about social norms and their meaning, BPD camouflagers often clearly know the rules they are supposed to follow to participate in society, but find it effortful to play along. As several passages discussed in the previous section show, the social world is often perceived by the person with BPD as a masquerade where people generally fail to be authentic, thereby forcing others to repress their spontaneity and take up rigid social roles. The practice of façading—that we have discussed in relation to sense of self—then works as a way to superficially adhere to the rules imposed by society, while at the same time experiencing a pervasive sense of inauthenticity.

(3) Seeking connection

The last dimension we discuss concerns connection. In the case of autism, there has been a long tradition of ascribing to autistic individuals a lack of desire or motivation to feel connected with others (Chevallier et al., 2012). It is a widespread observation that autistic individuals tend to struggle with social situations and find them particularly exhausting, have strong interests that they like to pursue, and show specific patterns of emotional attachment (Finke et al., 2019). Given their discomfort with social situations and the need expressed by many autistic individuals to spend time alone to recharge, the impression may arise that autistic people generally prefer to be on their own and not engage in emotional relationships with others.

However, there is sufficient empirical evidence that loneliness is a major source of suffering in the lives of autistic children and adults (Grace et al., 2022). Moreover, although friendship in autism can look different than friendship within neurotypical bonds, autistic individuals do succeed in developing friendships (Sosnowy et al., 2019). Autistic individuals may not show the “frantic efforts” to avoid rejection and loss that are characteristic of BPD. They may also rarely engage in pro-active attempts of initiating, maintaining, or regaining intimacy with other people in the same way as we observe in individuals with BPD. Moreover, in BPD, an individual’s desires, wishes, and passions typically revolve around interpersonal relationships and felt connection, whereas it is unclear whether this applies to autistic individuals.⁶

Focusing on camouflaging more specifically, we can discern a shared fundamental motivation in both conditions. We propose that seeking connection is what drives camouflaging practices both in autism and BPD, and that—among other factors—the kind of social needs in both conditions determine the type and manner of camouflaging strategies employed. Autistic individuals seem to prefer more structured social encounters where there is acceptance towards any salient neurodivergent behaviors (Sosnowy et al., 2019). Where social contexts are more spontaneous, less planned, and involve unknown people, insecurities are more likely to arise and raise challenges for autistic individuals. Moreover, in these situations, stigmatization may be more likely to occur when the majority of group participants are neurotypical. Although we interpret autistic camouflaging as a blend of hiding and imitating, this does not reduce it to attempts to prevent stigmatization and exclusion through making salient features unseen. Acts of camouflaging in the autistic community can also be considered attempts at actively creating the kind of structured social encounter preferred by autistic individuals, by applying the required and interpersonally accepted rules of conduct in a neurotypical setting.

Rather than being restricted to specific situations, individuals with BPD tend to develop complex façades and roles to which they commit for some time and which go beyond predefined scripts and behaviors. Apart from outward appearance, façading may also involve role-related feelings, emotions, and wishes that camouflagers deem typical or expected for certain roles. This can be explained by looking at the kind of connection that individuals with BPD seek. Unlike autistic individuals, a person with BPD often aims for a form of intimacy of maximum closeness, which can only be achieved if one is involved as a whole person. We suspect that it may sometimes be easier for an individual with BPD to simulate a full persona and to enter a relationship from the perspective of an idealized self fitting its role perfectly, as opposed to integrating potentially contradicting aspects of the self. This might be observed in what clinicians at times call “the honeymoon phase” of relationships with individuals with BPD, where the individual with BPD modulates their behavior, preferences, and mannerisms to closely resemble the personality of their partner (see Lay, 2019 for a clinical case). Pervasive doubts about who one is surely undermine and hamper connection. Façading and fully taking up a role may thus present a means to engage in comprehensive interpersonal relationships that also involve deeper emotional contact. Individuals with BPD, we take it, are therefore eager to hold on to their masks as long as possible, even when they are alone, as the masks allow them to feel connected to the relevant people. The other side of the coin in BPD is the fear of inauthenticity in others, which can be perceived yet again as abandonment: “[Y]ou were covering your arse too. Like every other stupid mortal cunt. To my mind that’s betrayal” (Stanghellini & Rosfort, 2013b, p. 282). In these cases, the desire for intimacy (and perceived authenticity in others) is so strong that it does not allow room for others to engage in camouflaging practices.

Let us now take stock of the main similarities and differences between autistic and BPD experiences of camouflaging. The most significant differences that we uncovered concern sense of self. While in autism, camouflaging practices enhance confusion with respect to a quite determined—and at times rigid—sense of self, individuals with BPD employ camouflaging as a compensatory and protective strategy against a preexisting weak sense of self. Attitude towards others also differs substantially: this may be due to differences in affective empathy, which generate puzzlement and confusion in autism as opposed to a peculiar form of assertiveness in BPD, or to social mismatches. We also emphasize a different attitude towards social norms. In autism, camouflaging works as a coping strategy that allows the person to follow norms and blend in in social situations in a way that would be otherwise difficult to perform spontaneously. In BPD, camouflaging works as a coping strategy that allows the person to “join in” on what is perceived as a masquerade and enact social roles that are cognitively understood but not affectively embraced. Finally, seeking connection with others appears to be a driving motivation to enact camouflaging strategies in both conditions, although some differences may be detected in the strategies themselves. In autism, the focus is primarily on making social encounters smoother and less uncomfortable by applying conversational or behavioral rules that support autistic individuals in “blending in” in the neurotypical world and in masking aspects that are perceived as divergent. People with BPD, by contrast, often seek an intense form of intimacy with others (De Panfilis et al., 2015), which implies connecting with others beyond a present situation and involves the person as a whole. Camouflaging practices in BPD therefore often consist in practices of façading that simulate a whole persona as opposed to more specific traits or aspects.

Conclusion: An expansive view of camouflaging

In this paper, we explored camouflaging practices in autism and BPD to better understand the recently emphasized clinical overlap between the two conditions. Camouflaging has so far predominantly been described in the context of autism. Given the often-stated similarities between autism and BPD, we examined whether similar ways of behaving can be observed in BPD. We generally characterize forms of camouflaging in terms of making unseen. After describing how making unseen shows up in autism, namely in terms of hiding and imitating, we preliminarily applied the notion of camouflaging to phenomena described in the context of BPD. As a result, we identified two general forms of making unseen in BPD: what has been described in the clinical literature as façading and what we introduced as subversive camouflaging.

The various strategies employed for blending in by individuals with autism and BPD unveiled specific patterns of concealing behaviors, which in turn revealed subtle yet significant differences between the two conditions. Specifically, we spelled out variations in an individual’s inclination to establish connections with others and how they perceive and attend to both others and themselves. Considering these distinctions, an examination of camouflaging has brought to light a common experiential foundation, namely seeking connections with others. This foundation does not only contribute to suffering and psychological distress, but also drives the enactment of more or less conscious strategies to conceal subjective aspects of an individual. Both autistic individuals and individuals with BPD aspire to connect with others, thus instigating a yearning for affiliation, intimacy, and social belonging—a yearning that frequently goes unfulfilled due to the unique ways in which they perceive their emotions, themselves, and others.

Our investigation contributes to fleshing out a more expansive view of camouflaging. So far, the literature on camouflaging in autism has mostly focused on the adverse consequences of the phenomenon for mental health. Given that many camouflagers manage to appear neurotypical, this may hinder the diagnostic process and result in misdiagnosis or underdiagnosis. Significant correlations have also been established between autistic camouflaging, anxiety, and poor mental health (Cage & Troxell-Whitman, 2019). Yet, camouflaging may also be understood as a more general skill or coping strategy that autistic individuals develop to overcome social difficulties and to respond to the challenges inherent to human interactions and linguistic communication. In this paper, we offer an account of camouflaging informed by this broader perspective, by showing how these strategies arise as a meaningful response to the worlds experienced by autistic individuals and individuals with BPD.

As a further step for future research, we may want to ask whether camouflaging may be understood as an even broader phenomenon, one that concerns how people adapt their appearance and behavior to conform to social standards. As Pearson and Rose (2021) observe: “Some aspects of masking might be unique to autistic people, but some aspects might be like other kinds of ‘pretending to be normal’ that other people who are socially excluded use to try and fit in” (p. 53). This observation encourages us to consider a continuity perspective and to reframe camouflaging as a set of strategies enacted by people to navigate social situations. Hence, even in neurotypical contexts, specific practices will be employed to make certain subjective aspects unseen. This may take the form of impression management, which has been described as a general human tendency to foster favorable impressions of the self in others (Ai et al., 2022; Goffman, 1959). How this tendency is played out will further depend on the specific social motives—such as intimacy, connection, belonging, or passing—that guide an individual’s attitude and behavior towards others as well as on how individuals perceive others and themselves. Finally, future research may also focus on whether and to what extent camouflaging practices are needed in a given social environment, as they may qualify as a natural and protective response to pressures, inequalities, or stigmatizing practices.

Footnotes

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Valentina Petrolini acknowledges the financial support of the Ministerio de Ciencia e Innovación, projects PID2021-122233OB-I00/MICIU/AEI/10.13039/501100011033, PID2021-128950OB-I00/MICIU/AEI/10.13039/501100011033 and IJC2020-043408-I; by the Basque Government under grant number IT1537-22; Philipp Schmidt-Boddy was funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) – 513696000; 543866258; 446126658.

ORCID iDs

Valentina Petrolini

Philipp Schmidt-Boddy

Notes

Author biographies

Valentina Petrolini is associate professor of philosophy of science at the University of Bologna. Her research focuses on the boundary between health and pathology, affectivity, autism, and camouflaging. She has recently published (with A. Vicente & E. Rodriguez-Armendariz) Autistic Camouflaging Across the Spectrum and (with D. Serpico) Crossing the Threshold: An Epigenetic Alternative to Dimensional Accounts of Mental Disorders.

Philipp Schmidt-Boddy is postdoctoral researcher at Heidelberg University, where he works in a project on familiarity and trust funded by the German Research Foundation (DFG). His research focuses on selfhood and identity, affectivity, agency, and social relationships. Among his recent works on borderline personality disorder (BPD) are (with T. Fuchs) Affective Instability and Emotion Dysregulation as a Social Impairment and The Unbearable Dispersal of Being: Narrativity and Personal Identity in BPD.

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