On Autistic Masking & Dental Visits

A reflection

I have been on the fence about autistic masking since I heard of it.

It’s not that I didn’t believe it for other people, I struggled to understand it for myself.

The examples I found from clinical lectures to personal podcasts didn’t strike a chord. It never was a stake in my heart or guided my personality to the point of changing who I was. I had been told I was too much, too blunt, so stubborn, tactless—features diametrically opposed to masking.

One night in therapy after work, I had mentioned how much strength and energy goes into monitoring my voice and tone daily. Since I work part time in a person forward job, I’m in constant moderation. Sometimes I slip, or perceive I slip, and this can cause me to spiral afterward.

Not because I control the spiral until I leave the environment that created it, but something about not being able to be perfect and even all the time starts to gnaw at me in time. Hours later I am flailing (physically and emotionally) unable to track the source of my freak out.

My therapist told me this was masking. I was surprised. I suppose the bubbles of criticism have pooled over the years to form this huge glob that’s pasted itself over my natural way of talking or being, in many circumstances.

Self Portrait, around 2014, literally drawing myself in masks. “BuT wHaT dOeS yOur ArT meaN?”

Not believing in masking, for me, is multi-factoral. There is a significant chunk related to my internalized ableism. I think I also conflated autistic masking with masking in the general populous.

We all have different personas with friends, family—the customer service voice is well known. This is a relatable and superficial way to get someone familiar to the idea of autistic masking. However, it doesn’t do it justice and obfuscates the nature of it.

In time, I came to consider that my masking was so embedded I could not recognize it. And if the latter was true, I thought once conscious of it, it cannot be buried forever and wondered how long until it was going to make itself known to me. No matter how much control I wanted over the matter I had to wait.

It finally did and I never saw it coming.

---

I wrote before about some dental experiences. With that check up my dentist told me there was decay on my fourth and final wisdom tooth. It was time for extraction.

This time, I had coverage from the provincial ministry to help with the expense. I booked the removal for the following month. 4 weeks is abstract time. It was easy to forget until the day crept upon me.

The morning of I woke with intrusive thoughts. What if I go blind? What if they crack my jaw? What if I have to go to the hospital after?

I have been working diligently on my ERP and did my best to reduce the amount of Googling (compulsion) to reassure myself (attempt to neutralize thoughts). I did about ten minutes and then stopped. That is improvement from what used to be 2-5 hours.

Everything was ok until I was in the chair, having my blood pressure taken. What is something shows up? Why are they taking it? I don’t remember this from last time.

“What a perfect, healthy pressure,” the attendant noted out loud.

This time I brought a special item with me to squeeze my stress into. Something to try to distract me as I sat through this.

The surgeon is a tall, handsome man with a deep voice that almost sounds like he’s singing when he talks. His joviality feels like a mark of competence that comforts me, if only momentarily.

They started in with local anesthesia and told me to wait til it crawled into my lip. I squeaked a bit from the needle poke.

“Wiggle your toes remember, wiggle your toes, wiggle your toes,” he soothed.

I sat looking out over the city from the high rise office. It was a Vancouver day that other people like. Clear, sunny, dry. I watched the little lines of traffic over all the bridges thinking of what other people are doing in this moment.

They took the foreceps and began shifting my tooth side to side, I thought I felt a different sensation within the middle of the tooth. It felt pain-adjacent. It is a big tooth with some decay held on by deep roots and nerves.

They continued and I felt a pull too much. The freezing wasn’t enough. I said ‘Ow’ as my eyes watered behind the sunglasses. I think it’s the wrong sensation.

They administered more numbing. I felt it crawl its way along my lip far faster this time. They continued. “Don’t worry, you will hear it” I must have been grimacing as the curling and ripping of the roots in my head became louder .

No-I felt-something wrong. This is taking a lot of pressure and too long.

“We may have to cut into this tooth”

My stomach dropped. I cant have this extend. I wasn’t prepared for this possibility. It cant change like this all of a sudden. I got really hot and my brain shrivelled. I shake my head and start to cry. Not a little watery corner eye tear. I start to bawl.

Everyone in the room took a pause and immediately started to comfort me. I was holding my elephant and their stress tennis ball and it wasn’t enough to brace the torrent of anxiety running through my body.

“You were ok the last time…but it was the upper tooth. The bottom’s roots are very settled.”

His tone was not criticizing or shaming—it sounded more perplexed and concerned.

Nothing had changed, actually, he just hadn’t seen me freak out with the other teeth he extracted. I white knuckled it like I had haircuts. I had taught myself to swallow my thoughts, feelings and physical discomfort until I got home and to fall apart later. I cried the entire day and onto the next. Healing was slow. If I show how I really am reacting (which I used to) I’m perceived as a baby, overly sensitive and am subject to criticism. Lately though, I have wondered if no one hated me so much for it as I hated myself.

My voice stretched thin, I begged him not to cut. I cant control this panic. Who is this shrieking vulnerable person with tears streaming down my face.

I didn’t even know I lived so repressed. Who am I really? The question: Where am I safe to be myself. They kept asking if I was in pain and I would shake my head no. The attendings started to affirm me, words of encouragement and care. Where is this deep pain coming from, these tears are not from me. I feel scared, my face is dripping.

They went back in. It was such a horrific feeling. My vivid imagination runs off the rails—I can SEE the tooth in my head being extracted and it makes me want to vomit. I try to focus on clutching my stress items and stop the movie playing in my head. Being in the middle of something is truly the worst part.

“I think we can get it,” he said. My body reacting to his confidence that I can make it and it’s almost over. The rocking sensation of the pliers started to change. It has loosened without cracking. Having this bundle of nerves and calcified tissue coaxed out of my jaw bone was over. I was bleeding. A lot.

“Next one is general anesthetic?” As they wrap up I feel comfort in the knowledge that to them I was just a 10:15 appointment and they stop work at 5. Many patients through the doors today.

His voice was warbled. “It’s out. Good job. Thumbs up. Thumbs up? Can you give me a thumbs up?”

Oh. I point it to the sky.

“Good. We are all done, you did great and it will never happen again.”

He went on to describe the small waiver of a fee he was going to provide me—I interrupted that this time I had differing payment.

“Oh, ok. You didn’t have ministry coverage the last time.” The statement floated in the air for a second before it stabbed me in the heart. I shook my head silently. 2021. The year I cant remember. So much had changed in those years it sometimes doesn’t feel attached to me.

I took extra time, shaking, to get to the front. I just stood at reception.

“That’s all, its all taken care of.”

The surgeon waved and thumbs upped again. I responded the same. The elevator took forever to come.

What do you do with yourself when you drop the act, but didn’t even know you were performing?

If you can extrapolate the decades of this repression, occurring over major and minor life instances, how reasonably could someone traverse their mind rationally while being cracked open to their true self.

I hate it. It’s all very personally harrowing. Everything has always been as bad—or beautiful—as I experience it. Camouflaged or not.