How Highly-Masked Autism Mimics OCD Traits
Unpopular therapist opinion with a chart to track my thoughts on this trait mimicking
As a licensed therapist who focuses on the presentation of neurodivergence in highly masked adults, I believe that attempts to compensate for unmet needs in Autistic wiring may resemble, and be misconstrued as, some subtypes of OCD. What I mean by that is a lot of highly masked Autistics, due to social masking and conditioning, are simply not spending time in the repetitive and/or highly focused processing states that their nervous systems need.
Before we go too far into my thoughts, let’s review the basics.
Obsessive-Compulsive Disorder (OCD) and Autism Spectrum Disorder (Autism) are distinct conditions defined separately in the Diagnostic and Statistical Manual (DSM) and diagnosed by licensed professionals. To diagnose OCD or Autism, specific criteria of symptoms (thoughts, sensations and behaviors) that are predefined in the DSM for each disorder must be reported to and/or observed by the licensed professional, and deemed to be causing clinically significant impairment within a defined time frame.
To meet the diagnostic criteria for Autism spectrum disorder, a person must have persistent differences in three specific areas of social communication and interaction plus at least two of four types of repetitive behaviors. Here’s a strength-based overview of the criteria for Autism by Matt Lowry.
Obsessive compulsive disorder (OCD) is characterized in the DSM by persistent distressing thoughts, ideas, or sensations that cause significant fear and anxiety (obsessions), followed by specific behaviors (compulsions) intended to reduce the obsessions. It must impact daily functioning and take up significant portions of a person’s life.1