Camouflaging Autism in Pursuit of Friendship and Intimate Relationships: A Systematic Review

Difficulties in making and maintaining social relationships is common among autistic people. These difficulties are thought to be due to differences in autistic social interaction and social communication that have been theorized to be the result of reduced social motivation. We argue that this theory does not account for camouflaging, a combination of strategies that are employed frequently by many autistic individuals in pursuit of obtaining social relationships; however, its utility in achieving satisfactory friendship and intimate relationships for the individual is not clear.

This review synthesizes empirical evidence of camouflaging as a strategy for achieving friendships and/or intimate relationships among autistic adolescents and adults. A systematic search yielded 1421 records. Forty-nine full texts were screened, and eight qualitative studies were retained.

Results reveal that camouflaging was a main strategy in pursuit of friendship, with little evidence for intimate relationships, in this sample of autistic adolescents and adults. For most, camouflaging is exhausting, often ineffective and inefficient, and ultimately a challenge to one's social authenticity.

Research suggests that many autistic individuals rely on camouflaging in pursuit of friendship and intimate relationships, although this is often a nonpreferred strategy. Some autistic individuals seek to replace camouflage with alternative strategies to obtain social relationships, yet outcomes typically remain dissatisfying. This demonstrates that we need to reconsider the social motivation theory, and to better understand alternative strategies that can help autistic individuals to obtain authentic, satisfactory social relationships, and to support opportunities to achieve these desired outcomes.

Why is this topic important?: Many autistic individuals feel dissatisfied with the quality and quantity of their social relationships and are, therefore, more vulnerable to loneliness and reduced well-being. This may be because autistic people communicate and interact differently to non-autistic individuals. These differences can, at times, be misinterpreted as a lack of motivation to socialize and connect with other people. But many autistic individuals are motivated to build meaningful friendships and intimate relationships and often rely on camouflaging to achieve these outcomes. Regardless of their efforts, many autistic people continue to struggle to make the social connections they desire. Therefore, the effectiveness of camouflaging on building friendships and intimate relationships needs to be better understood.What was the purpose of this review?: We set out to understand the impact that camouflaging has the friendships and intimate relationships of autistic individuals by examining the existing research.What are the results of this review?: We found that camouflaging is a common strategy used by many autistic individuals to connect with others in aim to build and maintain friendships, especially with non-autistic people. Pressure to camouflage began early in life, for many autistic participants, and continued to increase in both complexity and use across the lifespan. However, many autistic individuals remained dissatisfied with the friendships and intimate relationships gained through its use. For many, camouflaging prevented genuine social interactions, and the friendships that resulted from its use were often lacking in closeness and authenticity for the autistic individual. To reduce the reliance on camouflaging, some autistic individuals socially withdrew, or attempted to find friendship within the autistic community or in social contexts where camouflaging felt less necessary. Yet, many autistic participants remained feeling lonely, frustrated, and dissatisfied with their social relationships.What were the weaknesses of this review?: Only half of the eight studies involved an autistic researcher and author, while most studies incorporated community participation in the design of the study. We found that participants were mostly female, from countries such as the United Kingdom and United States of America, and most participants were above18 years of age. Results may be impacted by a lack of researcher and sample diversity, and minimal autistic input in study design and interpretation; thus, generalization of these findings may be limited. Camouflaging is an evolving area of research, and we recognize that there may be terminology or perspectives that were not captured by our review.What do the authors recommend and how will this help autistic adults in the future?: More research is needed to better understand autistic social interactions and to support alternative strategies to camouflaging, including environmental modifications and changes in the way non-autistic people understand and interact with autistic people. We recommend that autistic individuals' strengths and needs drive this area of research, and that supports address ways that all people can help to enhance autistic social outcomes. We anticipate that these strategies will promote more authentic social relationships, reduce reliance on camouflage, help to decrease loneliness, and improve well-being among autistic individuals.