A look at “The mask and the self: Phillip Ellington explores ADHD and masking within the therapeutic encounter” by Phillip Ellington (2026)
We tend to hear about masking in the context of autism, but many people with ADHD know it intimately too. There’s the internal mantra of “don’t interrupt, don’t interrupt”, the effort of sitting perfectly still when every nerve wants to fidget, and the constant self-monitoring to seem “together”. This thoughtful piece in Therapy Today, by a London psychotherapist who has ADHD himself, asks what masking means for therapy.
What it argues
The author describes masking as “the effortful performance of a self that is more socially acceptable than your actual experience might allow.” He notes that it echoes ideas across many therapeutic traditions: Winnicott’s “false self”, Rogers’ conditions of worth, schema therapy’s coping modes and psychosynthesis’s “survival personality”.
But there’s a crucial difference. Those ideas usually treat the adapted self as a response to past wounds. Once the wound is healed, the armour can come off. With ADHD masking, the author argues, the wounding environment isn’t in the past. It’s still here, every day, in a world built for a different kind of brain. So the goal of therapy can’t simply be to drop the mask. It’s to expand someone’s freedom to choose when, where and whether to wear it.
He borrows a lovely idea from film theory, the “male gaze”, to describe a “neurotypical gaze”: a watching presence that becomes internalised as a harsh inner auditor. Women with ADHD may face both gazes at once.
He then offers practical suggestions for therapists:
- Understand lateness or struggles with session boundaries as possible “time-blindness” rather than resistance.
- Focus more on vivid present-moment experience than long life narratives.
- See fidgeting as self-regulation, not a symptom to interpret.
- Work with the grain of motivation rather than imposing willpower and routines.
- Accept that progress may not follow a neat, linear path.
A grain of glitter ✨
This is a rich, reflective and genuinely useful piece for therapists, and it’s refreshing to see the limits of traditional models named so honestly. But it’s an opinion piece, not research, and the author is open that some ideas “warrant further empirical investigation.”
Some claims are stated rather broadly. For example, the idea that for ADHD people “the future has no psychological weight at all” comes from one influential theorist. It may not reflect everyone’s experience, and the evidence for some claims, such as poor interoception in ADHD, is thinner than the confident tone suggests. A few references are to self-help books or newspaper articles rather than research. And there’s a risk, when describing “ADHD people” as a group, of swapping one set of generalisations for another.
Why this matters
If you’ve ever left a social situation feeling like you’ve run a marathon while standing still, this piece may feel validating. Masking is exhausting, and it often makes sense as a way of staying safe. Good therapy shouldn’t demand that you tear the mask off. It should offer one place where you don’t need it, and help you decide where else you might be able to set it down.
Every unicorn is entitled to a disguise. But it’s nice to have a stable where you can let your horn show.