Shadowing Practice: Masking in ADHD & Autism: The Hidden Cost of Looking “Fine” - Learn English Speaking with Video
Choose a practice mode
Each mode opens a full-screen practice room.
221 sentences
If sentences are too short or too long, click Edit to adjust them.
1
You get through the meeting, you say the right thing, you make eye contact, you keep yourself steady.
2
From the outside, you look composed, capable, socially fine.
3
Then you get back to the car, close the door and your system drops.
4
You feel flat or wired or oddly unreal.
5
And the people around you would never guess how much effort that took.
6
That is part of why masking is so often misunderstood
7
because what looks smooth on the outside may sit on top of a great deal of internal strain.
8
I'm Dr. Sunil Rege, consultant, psychiatrist, educator, and founder of PsychSync.
9
I've trained thousands of health professionals
10
and in this video I want to slow this topic down properly because masking is now discussed widely online, increasingly heard in clinical practice,
11
and often understood through a narrow lens.
12
And in a few minutes I'll explain why the key question isn't whether the mask is real
13
but rather what job is it doing
14
so first let's look at the two issues
15
that keep showing up in the way masking is discussed one is the idea
16
that it is mainly a conscious social performance the other is the idea
17
that because autism is neurodevelopmental masking should be understood only in neurodevelopmental terms
18
and kept separate from personality relationships and the developing self both views miss something important
19
so in this video i want to give you a broader
20
and more clinically useful model one that brings together neurodevelopment arousal regulation interoception behavior relational life and personality organization.
21
The aim is not to overcomplicate the issue, but rather to integrate different concepts to see the person as a whole.
22
Later, I'll also come to why this matters so much in clinical work.
23
Because when masking is misunderstood, the person can be misread and the therapeutic relationship can suffer before we actually begin to treat the person.
24
So let's touch on why the term masking becomes confusing.
25
The first issue is that the term masking now tries to explain too much.
26
It's sort of becoming an all -encompassing term.
27
And once a word becomes popular, it starts absorbing very different experiences.
28
So for one person, masking means copying social behavior.
29
For another, it means suppressing distress.
30
For a third person, it means becoming polished, agreeable, competent, and over -adapted.
31
For a fourth, it means hyper -functioning at work whilst collapsing in private.
32
Now, all of these can overlap, but they're not the same process.
33
So when someone says, I'm asked, the useful response is not to assume we already know what they mean.
34
The useful response is to ask, what kind of adaptation are we talking about?
35
In what setting, under what pressure, to meet what need.
36
Because the same outward presentation can arise from very different internal dynamics.
37
And that's where we need to look underneath the symptom and begin with arousal.
38
I mention arousal because the mask often sits on top of high arousal.
39
One of the most common errors is to assume that the behavior mirrors the internal state.
40
It often does not.
41
For example, a person may look calm while their internal system is running at high level of activation.
42
That activation can then be channeled into monitoring one's own speech, over -preparation, rigid self -monitoring,
43
social scripting, hyper -focus, perfectionism, constant activity, or high output.
44
So the appearance of competence can be misleading.
45
What looks effortless may be the end product of a great deal of effort.
46
And if the system is pushed further, the presentation can change again.
47
The person can become emotionally numb, detached, depersonalized, or simply exhausted.
48
So when we talk about masking, it is often more useful to think of it as a
49
way of managing internal load in contexts where expression feels risky or costly or too hard to express.
50
Think about it this way, the system is doing its best to hold the person together.
51
So to understand that properly, we need to bring in the concept of interoception.
52
Interoception refers to the brain's capacity to detect and interpret signals coming from within the body.
53
Heart rate, breathing, tension, gut sensations, restlessness, fatigue, hunger, heat, the bodily side of emotion.
54
And what's important to recognize is that a lot of this can be happening outside conscious awareness.
55
In plain terms, it's how the brain reads the body from within.
56
the brain's script this matters
57
because emotion does not begin as language it begins as bodily change the body shifts the brain registers
58
that shift it interprets it it assigns meaning to it
59
and from that feeling urge thoughts and action begin to take shape
60
so when intercepted processing is altered when signals are hard to read poorly integrated delayed or mismatched with conscious interpretation,
61
emotional life also becomes harder to organize.
62
I've covered interoception in more detail in this video here.
63
Individuals with interoceptive dysfunction, which is known to be present in ADHD and autism spectrum disorder,
64
can have hypo -awareness of certain signals and hyper -awareness of others.
65
Now, why does this matter for masking?
66
Because sometimes a person is not clearly aware of what is happening internally while still being physiologically under considerable strain.
67
It's a sense of confusion, a sense that something is off, or too much, or hard to settle.
68
But the signal has not yet become a coherent subjective experience that can be named and shared.
69
So the emotion has not converted into a feeling that the individual can symbolize and express, and therefore can stay as internal confusion.
70
So what appears outwardly as composure may coexist with a system that's having to work quite hard just to hold itself together.
71
Because think about it, if there are multiple signals on the inside, the brain's having to make sense of them,
72
whilst at the same time having to work towards external demands.
73
That's a difficult stage or state to be in
74
and once we understand this the relational side becomes easier to understand masking originally began as a relational
75
and behavioral idea masking is originally described in autism was a relational
76
and behavioral construct it referred to the ways in
77
which a person adapted behavior expression and social presentation in order to navigate expectations,
78
maintain belonging, and manage social exposure.
79
So within this context, it is part of neurodevelopment.
80
A neurodevelopmental condition does not exist separately from behavior, relationships, attachment, or adaptation.
81
The process of neurodevelopment has its expression in what we call a personality organization.
82
Themes of navigating uncertainty, building trust, responding to safety needs and much much more
83
and this is often where I think unhelpful splits are often
84
made people speak as though neurodevelopment belongs in one box whilst personality
85
or relational life belongs in another that's an artificial separation
86
because we need to look at the person as a whole
87
an individual with autism spectrum disorder may repeatedly find themselves in situations where spontaneous expression does not quite work
88
or is misread and carries interpersonal cost or creates too much uncertainty.
89
So over time, they develop ways of speaking,
90
behaving, managing expression and organizing themselves socially in order to protect connection and preserve safety.
91
That is the expression of neurodevelopment.
92
That is neurodevelopment moving through lived relational experience.
93
And once we see that,
94
we recognize that personality organization becomes relevant because neurodevelopment and personality development occur as parallel processes.
95
So let's try to understand personality organization and the protective social self.
96
When I use the term personality organization here, I'm not using it loosely or pejoratively.
97
The word personality can often bring up a lot of unpleasant emotions.
98
What I'm talking about here is the ways in which a person comes to organize themselves around closeness,
99
shame, safety, validation, dependence, autonomy, and threat.
100
Questions such as, how do I stay connected?
101
How do I avoid rejection?
102
How do I manage being seen?
103
How do I hold myself together in relationships?
104
These are not separate from development.
105
They're a core part of it.
106
So when an individual with autism repeatedly encounters social situations that require adaptation, and they may have a patent way of responding.
107
They may experience that way of being as effortful, sometimes highly conscious, or sometimes it's so familiar that it's automatic.
108
And we all operate in different modes.
109
For individuals with autism spectrum disorder, there may be a tension within it.
110
On the one side, it's helping the person function, belong, and remain connected.
111
So, it's helping them fulfill their relational needs.
112
On the other hand, it may sit on top of significant stress, arousal, and a sense of distance.
113
That's the conflict.
114
You see, the issue arises when this mode of adaptation, this patterned way of being, turns into the dominant way of relating.
115
In other words, the person does not have any other situational strategy.
116
It starts shaping the person's whole relational style.
117
That's where now the language of self becomes useful.
118
So let's touch on Donald Winnicott's idea of the false self.
119
Once again, this term false self is a psychodynamic term.
120
We're not talking about deception.
121
Winnicott was describing a protective organization of the self that develops
122
when spontaneous experience is repeatedly overridden by the demands of the environment.
123
For example, if a person learns repeatedly again and again that their spontaneous responses are too much, too odd, too risky, too costly,
124
or simply too hard for others to receive, you're too much.
125
Then adaptation may gradually become organized around what is externally acceptable.
126
So the dominant mode of being is, how can I meet others' needs to meet my needs?
127
So when people hear terms like false self, they sometimes assume that what is being described is inauthenticity.
128
That misses the point completely.
129
What is being described here is a form of protection.
130
Think about that mask, which is the false self.
131
And when that mask is removed internally, there is confusion and fragility.
132
So the false self is a social self that develops in order to preserve attachment,
133
reduce danger, feel safe or make life more manageable in environments that have not felt sufficiently safe or accommodating for that individual.
134
Now, this does not mean that every single instance of masking should be interpreted through Winnicott's frame.
135
It does mean that the language helps us highlight something important.
136
Because the question changes, we're no longer asking, is this person being genuine?
137
We rather ask, what has made this form of adaptation so necessary?
138
What is the mask protecting?
139
That's a far better question, because we now move towards understanding the individual behind the mask.
140
You see, the mask is usually doing something important.
141
It may be protecting a vulnerable sensory system.
142
It may contain shame.
143
It may be reducing the risk of rejection.
144
It may be preserving work function.
145
It may be helping the person stay within relationships.
146
And it often works until the cost of maintaining it becomes too high.
147
And I hear this so commonly in clinical practice.
148
It feels like I have to put a mask on.
149
Or what you saw off me in the groups was me putting on a mask.
150
So that takes us to understanding why simply taking off the mask is not straightforward.
151
We can't simply tell the person to stop masking and become more authentic.
152
That assumes, firstly, that they know how to do it.
153
Two, that assumes that the environment they live in is ready to see the person behind the mask.
154
Often, it might not be the case.
155
Asking them to remove the mask also assumes
156
that the person has enough internal stability to function without the adaptation that has been carrying them for years.
157
So the more useful clinical question is this.
158
What conditions would make the mask less necessary?
159
What I do in clinical practice here is I start looking at the needs that the mask is meeting,
160
both internal emotional needs, often safety validation needs, but also the dominant way of being,
161
which may be the individual meeting others needs to meet their needs.
162
And once I understand that, I can now help them build internal ways of meeting their needs.
163
That's when they're able to start gradually, slowly removing the mask at times and bringing the mask back on when it's needed.
164
So the first step is not removing the mask.
165
It is reducing the need for it.
166
And for us to do that, we have to help the individual develop strategies so
167
that they can meet their needs without the need for a mask and that brings us to treatment.
168
Let's start off with medication to understand what medication can and cannot do.
169
Medication does have a place here but it needs to be framed carefully.
170
It does not remove masking.
171
It does not resolve the whole system.
172
It does not act as a substitute.
173
What it may do depending on the formulation is to improve aspects of regulation.
174
For example in an individual with ADHD where there is overcompensation, chronic self -monitoring, exhaustion, effortful task engagement,
175
medication may improve executive functioning, salience allocation, the ability to control impulses and emotions,
176
and thereby may make it easier to have periods without the mask
177
so when medication helps the effect is not necessarily
178
that the person suddenly feels transformed at the level of core identity often it's a lot more practical than
179
that what's happening here is the system is becoming easier to organize
180
but this is where therapists doctors psychiatrists act as important partners in shaping
181
that organization so medication is one part within a larger understanding of the person.
182
Now, let me come to the part that often matters most in clinical practice, a really important point for clinicians.
183
Masking affects not only how the patient is seen, but it also affects what the patient evokes in the clinician, what we call countertransference.
184
So a person who appears polished, articulate, socially skilled, warm, or highly functional can evoke powerful countertransference.
185
This is where the clinician may begin to wonder whether the
186
distress is really as significant as described whether the diagnosis fits
187
whether the person is somehow performing whether they are somehow too
188
aware of what they're doing this is where we can start
189
doubting the individual we need to recognize the countertransference reaction
190
because once the clinician starts confusing this polished presentation with the internal states
191
and not recognize that they may be two separate aspects where this polished presentation may be an adaptation, then we lose something important.
192
We become less curious.
193
Empathy reduces.
194
And the person, of course, will have their transference reactions where they may feel subtly disbelieved, invalidated.
195
And once that enters the doctor -patient relationship, the alliance is disrupted.
196
And this is why we place such an important emphasis on learning psychodynamic psychotherapy
197
and psychodynamic principles in clinical practice on the Academy by PsychSync.
198
So if you're a clinician, check out the courses that we have that cover psychodynamic psychotherapy on the Academy here.
199
Coming back to masking, the task is not to ignore the mask and not to treat it as evidence against the person.
200
The task is to step back and ask, what is the presentation doing?
201
And also at the same time, what am I feeling?
202
What is it stirring in me?
203
So let me bring all of this together.
204
If there's one thing to remember it's this masking is best
205
understood as an adaptive way of managing arousal relational demands
206
and internal strain in order to remain effective in the world it is protective
207
and once we start thinking
208
that way our relationship with patients changes we stop reducing the issue to performance we stop treating neurodevelopment
209
and personality as though they occupy separate worlds we begin to integrate
210
and see the person in front of us as a whole i'm dr sunny reggae
211
and you're watching the dr reggae channel where we use psychiatry neuroscience psychodynamic understanding
212
and careful thinking to make sense of the human experience
213
and for clinicians want you to go deeper into formulation neurobiology psychodynamic aspects
214
and applied psychiatric thinking have a look at the academy by psych scene
215
if you like this video hit the like button
216
and let me know in the comment section how you conceptualize masking
217
or if you've masked for a significant period of your life what does
218
that look like and
219
if there has been a cost associated with it let me
220
know how that's been addressed i look forward to seeing you in the next video.
221
Until then, stay curious.
Download App
Everything you need to speak fluently
AI PronunciationScore every sentence
IPA PracticeMaster every sound
VocabularyBuild your word bank
Vocab GameLearn while playing
Same Channel
FOR YOU
Recommend Video
C12
336 sentences
AuDHD: Why You Can’t Start (or Stop) Anything
Daily ConversationUniversity StudentsWorking Adults
C11
633 sentences
The ‘Self’ You Can’t Find with Sam Harris
Daily ConversationUniversity StudentsWorking Adults
C13
214 sentences
Fawning: The Survival Strategy That Turns Into Self-Abandonment | Fawning #2
Daily ConversationUniversity StudentsWorking Adults
C11
167 sentences
Mental Debugging: How to Build Resilience After Failure
Daily ConversationUniversity StudentsWorking Adults
C1182 sentences
Every Sleep Disorder & Their Effects Explained
Daily ConversationUniversity StudentsWorking Adults
B21,465
20 sentences
Social Media and Your Mental Health
TeensDaily ConversationUniversity Students
C11
251 sentences
Things That Are Not What They Seem and the Truth About Life | Advanced Podcast for Conversations
Daily ConversationUniversity StudentsWorking Adults
C12
82 sentences
The 4 inner voices that we have that sabotage us. @Dr.ShadeZahrai
Daily ConversationUniversity StudentsWorking Adults
C11
75 sentences
The Predictable Shield: Deconstructing Sensory Over-Responsivity
Daily ConversationUniversity StudentsWorking Adults
C16
20 sentences
Are You Shy? Or Is It Social Anxiety?
British AccentBusiness EnglishDaily ConversationUniversity Students
C12
227 sentences
Stop Rehearsing The Life You Don’t Want | Dr Joe Dispenza Motivation
Daily ConversationUniversity StudentsWorking Adults
C12
327 sentences
How to Control Yourself, Read People & Build Discipline | Chase Hughes
Daily ConversationUniversity StudentsWorking Adults
Vocabulary and speaking notes for this lesson
This speaking lesson is built on the video “Masking in ADHD & Autism: The Hidden Cost of Looking “Fine””. The speaker keeps coming back to these words: mask, masking, self, internal, individual. This video has 221 sentences and 2753 words to shadow. The speech runs for 18:35. The speaker talks at a steady 148 words per minute, a comfortable pace for shadowing. Only 80% of the words are among the 3,000 most common in English, so the vocabulary is demanding.
Key vocabulary in this video
15 words from the video worth learning, with pronunciation and meaning:
| Word | Pronunciation | Meaning |
|---|---|---|
| mask noun | /mæsk/ | A cover, or partial cover, for the face, used for disguise or protection. |
| adaptation noun | /ˌæd.æpˈteɪ.ʃən/ | The process of adapting something or becoming adapted to a situation; adjustment, modification. |
| presentation noun | /ˌpɹɛzn̩ˈteɪʃn̩/ | The act of presenting, or something presented. |
| medication noun | /mɛdɪˈkeɪʃən/ | A medicine, or all the medicines regularly taken by a patient. |
| autism noun | /ˈɔːtɪzəm/ | Autism spectrum disorder, a condition characterized by impairment in social communication and interaction, as well as a need or strong preference for… |
| emotion noun | /ɪˈməʊ.ʃən/ | A person's internal state of being and involuntary physiological response to an object or a situation, based on or tied to physical state and sensory data. |
| belong verb | /bɪˈlɒŋ/ | To have its proper place. |
| polish verb | /ˈpɑ.lɪʃ/ | To shine; to make a surface very smooth or shiny by rubbing, cleaning, or grinding. |
| repeatedly adverb | /ɹɪˈpiːtɪdli/ | Done several times or in repetition. |
| conscious adjective | /ˈkɑn.ʃəs/ | Alert, awake; with one's mental faculties active. |
| organize verb | /ˈɔɹɡənaɪz/ | To arrange in working order. |
| awareness noun | /əˈwɛɹ.nəs/ | The state or level of consciousness where sense data can be confirmed by an observer. |
| whilst adverb | /waɪlst/ | Often preceded by the: During the time; meanwhile. |
| monitor noun | /ˈmɑ.nɪ.tɚ/ | Someone who watches over something; a person in charge of something or someone. |
| disorder noun | /dɪsˈɔɹdɚ/ | Absence of order; state of not being arranged in an orderly manner. |
Phrasal verbs you will hear
| Word | Pronunciation | Meaning |
|---|---|---|
| bring together verb | To cause people to do something together; to bring about togetherness. | |
| bring up verb | To mention. | |
| check out verb | To record the departure or withdrawal of someone or something (such as guests, employees, books, etc.). | |
| get back to verb | Return to (an activity) | |
| get through verb | /ɡɛt ˈθɹu/ | To overcome; to endure. |
| look forward to verb | To anticipate, expect, or wait for, especially with a feeling of approval or pleasure; to be excited or eager to. | |
| see off verb | To accompany someone to a point of departure; to ensure someone departs safely. | |
| step back verb | /stɛp ˈbæk/ | To stop what one is doing and evaluate the current situation. |
Sentences worth repeating
Short, complete lines from the video that you can reuse in everyday conversation:
- Questions such as, how do I stay connected?
- How do I avoid rejection?
- How do I manage being seen?
- How do I hold myself together in relationships?
- What is it stirring in me?
Grammar in this video
The structures the speaker uses most, with the exact words from the video:
| Structure | In the video |
|---|---|
| Passive voice be + past participle — the focus is on what happens, not who does it | is now discussed · is discussed · should be understood |
| Present perfect have/has + past participle — a past action that still matters now | I've trained · I've covered · has not converted |
| Relative clauses who / which + clause — extra information about a person or thing | dysfunction, which is · mask, which is · person who appears |
Pronunciation to watch
The speaker uses 21 contractions and reduced forms, such as I'm, they're, you're. Say them the short way, as you hear them.
- The “th” sounds: smooth /smuːð/, breathe /bɹiːð/, underneath /ˌʌndɚˈniθ/, authentic /ɔˈθɛn.tɪk/, thereby /ðɛɹˈbaɪ/
- The “sh” and “zh” sounds: adaptation /ˌæd.æpˈteɪ.ʃən/, presentation /ˌpɹɛzn̩ˈteɪʃn̩/, medication /mɛdɪˈkeɪʃən/, emotion /ɪˈməʊ.ʃən/, polish /ˈpɑ.lɪʃ/
- Long words — get the stress right: adaptation /ˌæd.æpˈteɪ.ʃən/, medication /mɛdɪˈkeɪʃən/, repeatedly /ɹɪˈpiːtɪdli/, spontaneous /spɑnˈteɪ.ni.əs/, regulation /ˌɹɛɡjʊˈleɪʃən/
How to practise with this video
- Listen to the whole video once without speaking and note the words you do not know.
- Shadow it sentence by sentence at normal speed, repeating each one until your rhythm matches the speaker.
- Record yourself and compare with the original, paying attention to words like mask, adaptation, presentation.
What is the Shadowing Technique?
Shadowing is a science-backed language learning technique originally developed for professional interpreter training and popularized by polyglot Dr. Alexander Arguelles. The method is simple but powerful: you listen to native English audio and immediately repeat it out loud — like a shadow following the speaker with just a 1–2 second delay. Unlike passive listening or grammar drills, shadowing forces your brain and mouth muscles to simultaneously process and reproduce real speech patterns. Research shows it significantly improves pronunciation accuracy, intonation, rhythm, connected speech, listening comprehension, and speaking fluency — making it one of the most effective methods for IELTS Speaking preparation and real-world English communication.