Study links narrow professionalism norms to masking exhaustion

Content note: This article discusses masking exhaustion in training and professional settings.

1. What is happening?

A new open-access qualitative study in Advances in Health Sciences Education looks at how neurodivergent health professionals formed their professional identities during training and early practice.

The study included 12 Australian graduates who were working as health professionals at the time of the research. Participants identified as Autistic, ADHD or both Autistic and ADHD. Their fields included medicine, occupational therapy, physiotherapy, psychology, clinical exercise physiology, medical imaging and nutrition and dietetics.

The authors report that narrow ideas of the “ideal health professional” created pressure to mask traits, uncertainty about disclosure and exhaustion. Participants also described a move toward more sustainable practice when self-recognition, neuroaffirming support and flexible communication accommodations were available.

2. The Somatic & Systemic Context

This was a qualitative study, meaning it explored lived experience through interviews and written responses rather than testing a treatment or measuring a body process directly. Ten participants took part in semi-structured interviews, with options such as camera-off audio and captions. Two participants provided written responses. The authors analysed the material using reflexive thematic analysis, a method for identifying patterns across experience.

The study’s nine themes describe a movement from externally imposed ideas of professionalism toward more authentic professional identities. That movement matters somatically because masking was described as cognitively and emotionally costly, including exhaustion, burnout and stress-related health effects. The study does not measure the nervous system directly, but it does show how social expectations can become a body-level burden.

The National Autistic Society explains masking as conscious or unconscious efforts to appear non-autistic in order to fit in, avoid stigma or meet social expectations. Examples include forced eye contact, altered speech, suppressed stimming and reduced visible reactions to sensory discomfort. In training and practice settings, these are not just “social skills.” They can be ongoing regulation demands.

A related scoping review of 69 papers on neurodivergent students in health professions education found recurring issues around identity, disclosure, accommodations in stigmatising environments and educator perspectives. It concluded that neurodivergent students are still often expected to conform to learning environments that exclude them or fail to support their learning.

The authors of the new study also name limits. The research was retrospective, based on an Australian sample, predominantly female and included only graduates who had remained in professional practice. Intersectional factors were explored only in a limited way to preserve anonymity.

3. The Dual Perspective

What this means for daily life

If you are neurodivergent and often feel exhausted after looking “fine,” this study offers language for a familiar pattern. The strain may not come only from the task itself. It may come from monitoring your face, voice, body movement, sensory reactions and disclosure choices while also trying to learn, work or care for others.

This does not mean every person needs to disclose or unmask everywhere. Safety and context matter. The finding is gentler than that: when an environment only accepts one narrow version of professionalism, people may spend energy hiding the very traits and regulation needs that help them function.

For clients and seekers, the practical question is not “How do I become more professional?” It may be “Which parts of my day require performance, and where do I have enough acceptance to recover, communicate directly or use accommodations?” That question can support self-understanding without turning masking into a personal failure.

What this means for your practice as a coach, facilitator or bodyworker

For somatic coaches, bodyworkers, educators and supervisors, this study is a reminder that “professionalism” can quietly become a compliance test. Eye contact, stillness, polished speech, fast verbal processing or a particular affect may be treated as signs of competence, even when they are simply one cultural style.

In sessions and training spaces, this suggests a need to make regulation and communication options normal rather than exceptional. Camera-off participation, captions, written reflection, direct language, movement breaks or permission not to make eye contact are not signs of lower commitment. They may be the conditions that let a person practise with more steadiness.

Scope also matters. Practitioners should not diagnose clients or trainees, and they should avoid promising that somatic work will remove burnout or masking exhaustion. What they can do is reduce unnecessary performance pressure, ask for access needs without prying into private medical information and build consent-based spaces where authentic practice styles are respected.

For professional training, the business lesson is clear: neuroaffirming design is not only about inclusion statements. It shows up in intake forms, supervision language, cancellation policies, sensory environments, feedback processes and how much difference a training culture can actually tolerate.

4. Key Takeaways

• The study links narrow professionalism norms with masking pressure, disclosure uncertainty and exhaustion among neurodivergent health professionals.
• Flexible communication accommodations and neuroaffirming support helped participants move toward more sustainable professional identities.
• Somatic educators and practitioners can reduce unnecessary performance demands without stepping outside their scope.

Sources & References:

1. Original News – Advances in Health Sciences Education study on neurodivergent professional identity formation
2. Context – National Autistic Society: Masking
3. Reference – Navigating neurodivergence: A scoping review to guide health professions educators

Recommended Video Resource: Kieran Rose: Autistic Masking and Burnout
Why we recommend this: It offers a grounded lived-experience lens on masking and burnout that can support more neuroaffirming practice.

Further Reading on The Conscious Channel: For more on neurodiversity-affirming somatic support, explore our Neurodiversity & Somatics section.

This article summarizes published news and research for educational purposes. It is not medical, psychological or legal advice.

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