19/04/2026
*Content warning: mental health crisis, masking, ableism*
I’m sharing this personal piece as part of my own story, because my lived experience is always shaping and informing my work.
I was going through my university notes yesterday and came across a “reflection form” I wrote during my Speech and Language Therapy degree. Reading it now feels uncomfortable...but also important.
After a placement (clinical work experience) in 2016, I was told in a meeting with my tutor that I’d received negative feedback about my “professionalism” and “interpersonal skills.” One example has always stayed with me:
As students, we were told we couldn’t wear jeans on placement. Then one day, my placement educator came in wearing jeans. It was confusing but also not surprising, given the mixed social messages we receive about what is acceptable. So the next day, I wore jeans too, thinking I’d understood a different version of the rule.
..that turned out to be a big mistake.
I was pulled up on it, and it became another moment of feeling like I’d got something wrong.
As an autistic person (which I didn’t know at the time), I’ve always put a huge amount of effort into presenting a socially acceptable version of myself - understanding the rules, reading between the lines, and getting it right. I’ve learned to mask, to mirror, and to contain.
And for the most part I can do that well. But when something doesn’t make sense and doesn’t feel fair, that tension doesn’t always stay internal.
I didn’t have a large window of tolerance back then, so I was often in a state of nervous system dysregulation - moving between overwhelm and shutdown. In those moments, confusion isn’t just cognitive (“I don’t understand this rule”). It becomes SOMATIC; felt through the body before it can be fully processed into words or meaning.
So when I’m faced with something that feels unjust, I’ll do my best to contain it, but it may show in small ways:
- going quiet
- looking away to create psychological distance
- fiddling with a pen
- a more audible exhale
- sitting further back in my chair
- my responses might become more minimal or literal
..And sometimes I just call it out.
Following that meeting with my tutor, I was asked to write a reflection and a plan of action. I wrote things like:
• “I have a lot of compassion and empathy, but I don’t think I transmit [it] as well as I could”
• “I want to manage my anxiety so that it does not interfere with my professional relationships”
• “I want to work on what my body language is saying”
• “Presenting a calm exterior will help my working relationships”
I can see now how much of that reflection was shaped by trying to fit into a VERY SPECIFIC idea of what a “good professional” looks like. I can see how I internalised the belief that there was something wrong with me.
And to be fair, being aware of how I communicate and interact in my work DOES matter. It can have a real impact, especially when topics are sensitive and potentially triggering. A low-arousal, calm presence can help provide a sense of relational safety. I can do all these things with authenticity, and I value them.
But what I didn’t have at the time of writing that reflection was clarity.
I wasn't seen, heard, or understood.
Because alongside that, there was constant pressure to monitor everything - my tone, posture, facial expressions, and to get it “right” in social spaces where expectations weren’t explicit or consistent.
And that comes at a cost.
You see, what nobody knew at that time, and what wasn’t seen - was the pain I was masking and holding beneath the surface just to get through.
Because 6 months after writing that reflection, I experienced a mental health crisis and was hospitalised.
It didn’t come out of nowhere – it was the culmination of years of being corrected, reshaped, and repeatedly (overtly and covertly) told that I needed to change. Years of being misunderstood, dismissed, and told I was "too sensitive". I just needed to be more resilient...
I now understand how exhausting it is to constantly self-monitor, and how sustained masking, combined with anxiety about how you’re perceived, erodes well-being.
Today, as a Speech and Language Therapist working with autistic young people, my perspective has shifted.
I think differently now about what “professionalism” really means, and how often “improving communication” can quietly mean “appearing more neurotypical.” What I once framed as deficits to fix I now see as part of a wider system that often asks autistic people to override THEMSELVES to belong. Performing traditional conversation skills feels draining - it does not lead to fulfilling relationships.
Today I have those fulfilling relationships. True connections that were formed from genuine intimacy, mutual understanding, and let's face it.. with other autistic people.
My practice isn’t about performing; it’s about creating safety and meeting people where they are - including myself.
I’m still learning and reflecting. I have to manage the transference / countertransference that shows up when I sit with autistic young people (and their parents, who are often autistic themselves).
At times, it feels like sitting across from a younger version of myself - and managing that requires care, reflection, and grounding in what is mine and what is theirs.
I want young people and their families to know that I listen deeply, I feel deeply, and I see you.
