The Self-Harm Bogeyman in ABA

CW: The following article may be triggering to people that struggle with self-harm and contain descriptions that may not be appropriate for everyone.

“ABA has helped this autistic child so much. They’ve stopped self-harming!”

The phrase is beaten like a drum by pro-ABA advocates. It’s an anthem that proclaims, “ABA isn’t bad because it stops harm!” The problem is it doesn’t address what lengths ABA is going to stop that harm. And does harm need to be stopped behaviorally in the first place?

Autistic people are three times more likely to self-harm in both children and adults than the general population. An estimated 42% of autistic people engage in self-injury. It’s clearly behavior that requires attention.

I think most neurotypicals (in the broad sense, not mentally ill) view self-harm as an irredeemable behavior that needs to be stopped at all costs. It’s a visual representation of how abnormal someone is acting. It’s unfathomable; why on Earth would you ever want to hurt yourself? Isn’t that against the integral drive of self-preservation?

Let me be clear, I do not advocate for self-harm, nor do I think that it’s bad to stop it. Certain self-harm behaviors pose a threat to safety and long-term well-being. Some people struggle with head-banging so severe they cause concussions or worse. There are interventions that help with this that are more humane than ABA, but I will get into that in a minute.

In my own experience, I have self-harmed both for sensory seeking reasons and for “mental health” reasons. There are many reasons people self-harm, and most people don’t really think about why someone might use it as a coping mechanism.

For me, my self-harm during meltdowns comes in the form of hitting my head or hitting my head against things. I’m old enough now to regulate my environment, so I can choose soft things to headbang against. I also used to self-harm as a teenager during acute panic attacks. So, why would I self-harm?

It Starts with Understanding What a Meltdown is Like

Think of the most unpleasant busy place you go. Maybe it’s a post office full of people. Maybe it’s the department store the weekend before Christmas. Or maybe it’s a kid’s party where every child is screaming and running around. Now imagine your least favorite song. It can be anything, just that song that when you hear it, you feel angry. Maybe it’s Baby Shark or Let it Go for the 100th time. Got it? Now imagine you’re hungry and tired on top of all of that.

So, putting that all together, you’re at another child’s birthday party, and someone just brought out the cake, and so everyone is screaming. In the background, Cocomelon is blasting at an unholy volume. You skipped breakfast because you were running late trying to take your kid to this f*$&!^@ party, and you worked late, so you got 6 hrs of sleep. Spend a moment here. Hear the screaming, feel the full-body ache of hunger and tiredness, feel the bristling of hearing that song.

It’s horrible, isn’t it? Makes you want to “bang your head against the wall”? That’s it. Now you understand why an autistic child in similar circumstances may actually bang their head against the wall.

For me, it feels like a million sirens are going off in my head all at once, which is physically painful. All I want to do is stop the noise. What stops the noise? Hitting my head. That hard sensation quiets things, even if only for a moment.

Other forms of self-harm do the same thing. They create a sensation so extreme that it can take away the pain for a minute. Like the tongue-in-cheek adage of “Your finger hurts? I’ll hit your leg with a hammer and I promise your finger won’t hurt anymore.”

I’ve also heard from others that sometimes they physically can’t feel the self-harm during a meltdown. If everything is cranked up to a 10, what normally would register as a 10 with banging your head isn’t going to register.

And then there’s the aspect of anxiety. Going back to the kid-birthday-party-hell scenario created earlier, imagine how you would feel. It’s such an overwhelming situation you’d likely feel incredibly anxious. Particularly if you were a child and couldn’t control the situation or remove yourself when the anxiety started to build. Or, maybe you don’t know what “anxiety” feels like, so you’re not sure why you suddenly feel bad all at once and don’t know what to do with it. On top of that, adults around you are freaking out and telling you to stop and wanting you to fulfill all sorts of demands.

What do you do with that anxiety when you don’t know how to cope with it? I’m sure you’re starting to see how self-harm might make sense to cope with anxiety. The body doesn’t process how harm is caused differently when you’re the one causing the harm. It just registers it as harm. And what happens when harm is caused? Endorphins are released.

Self-Harm and Self-regulation

One study examined people’s endorphin levels before and after self-harming (Störkel et al., 2021). They found that people before self-harm had significantly lower endorphin levels. Endorphins after self-harming weren’t significantly higher than daily life. This suggests that self-harm may be an attempt to get back to homeostasis, the baseline endorphin level that we experience daily.

Another interesting finding was that the severity of the injury was tied to the level of endorphins released, which has implications for more severe levels of self-harm in autistic people.

Self-harm serves a purpose. So, when ABA “trains” self-harm behaviors out of a person, it doesn’t address the purpose. There is no physiological intervention done. There is no cognitive intervention done. It only removes the behavior. So, where does that anxiety or sensory overload go?

The truth is, we don’t know. It’s not something that ABA research has studied. ABA research has been so focused on behavioral outcomes that we don’t know the effect of ABA on anxiety. We know that CBT (cognitive behavioral therapy) and ACT (acceptance and commitment therapy) effectively reduce anxiety in autism. But these differ from ABA in that they are cognitively based.

We have no evidence to support that the anxiety and sensory overload experienced during meltdowns goes away when self-harm is trained out of someone. What kind of harm is caused if we’re not teaching cognitive coping skills to deal with these feelings?

This is the last time I’ll bring you back to the kids-birthday-party scenario, but bear with me. Imagine that state of overwhelm happens frequently, and you don’t have any means of coping with it other than self-harm.

Then, imagine someone comes along and takes away your phone until you stop self-harming. You learn over time that you can get your phone back if you don’t self-harm (or not get it taken in the first place), so you learn not to self-harm. Does having your phone stop you from feeling overwhelmed at the party?

No, having your phone doesn’t stop anything from happening around you. It just gives you access to something that you are really reinforced by. But it was successful because you stopped self-harming, right?

Outside the Scope of ABA

Woman with glasses and a labcoat looking through a microscope with a large plant and test tubes next to her.

Many clinics don’t train staff at all to deal with sensory meltdowns. As an RBT (registered behavior technician), I asked my BCBA (board-certified behavior analyst) to train us on sensory meltdowns. I noticed staff were often making meltdowns worse. She said, “no, that’s outside our scope.”

If a fundamental symptom of autism is outside the scope of an ABA therapist, and kids are spending 20-50 hrs a week with these therapists, how do we expect them to handle meltdowns? Many behaviorists believe that ABA can fix meltdowns through behavioral mechanisms. I saw this with my coworkers.

We were trained to assume the meltdown was caused by the function of access, escape, or attention.

When they thought it was access, they wouldn’t give the child access to regulating items (stim toys, etc.) until the child performed another task so it “wasn’t contingent on the self-harm.” When it was escape, they’d force the child to do whatever task they were doing before the self-harm, so “we didn’t reinforce them to self-harm.” And when it was attention, they would take the kid to a padded room and then ignore them until they stopped.

I watched the staff do this, and the kids get increasingly agitated, if not immediately meltdown. They would often start with smaller behaviors like crying, which escalated to self-harm when they weren’t given the tools to regulate. The staff was causing meltdowns by not knowing how to handle them.

The level of education ABA therapists have (or don’t) causes real-life consequences. Since I have personal experience dealing with meltdowns, I knew how to help the kids cope.

One kid was violently self-harming and aggressing against others. I dimmed all the lights, helped him get to a safe space and started giving him sensory items I knew he liked. This was the opposite of how I was “supposed” to help him because I was reinforcing his self-harm by giving him coping items. All the other staff was panicking, trying to figure out what to do, and there were about seven adults in the room trying to calm this one kid.

I showed him a sand video and he calmed down almost instantly. I reversed the meltdown because I showed him how to sensory cope. Because we had a good relationship, he wasn’t agitated by me being close to him like some other staff. He stopped self-harming and stopped being aggressive towards others.

Alternative ways of coping

There are ways to deal with self-harm that are humane. And not every self-harm behavior needs to have an intervention. I don’t stop myself from self-harming anymore unless there’s a real risk of harm. I’ve learned sensory coping. I taught myself ways to “harm” that won’t leave lasting marks, like headbanging on soft items, holding ice cubes, flicking myself with a hair tie, or hitting myself in ways that won’t bruise.

Occupational therapy, non-ABA TEACCH, art therapies, and cognitive therapies (like TF-CBT, ACT, and DBT) are all options for reducing harm ethically. These are humane, opposed to ABA because they help address the cause of the behavior. An OT might help you find a space at the party that’s quiet. A non-ABA TEACCH interventionist may teach your family how to help you regulate in the overwhelming environment. An art therapist may have you draw, listen to music, or create something to help you regulate your feelings. And a cognitive therapist may teach you the mental techniques you can use to help bring you back to a state of homeostasis without self-harm.

So, when you hear, “this child is so much better off because ABA fixed their self-harm behavior!” you should be asking, “what skills did they learn to regulate the cause of the behavior?”. For self-harm to be truly addressed, we cannot solve it through further harm.

Masking 101: What I Wish My Parents Knew Pt. 2

Here is Pt. 1.

When I was young, I was labeled “gifted.” The Gifted Kid ideology promotes the idea of these young prodigies – talented in academics, social issues, leadership, technology, art, physical skills, or proficient in any other area. There’s supposedly a symptom list associated with gifted children; having a hard time connecting with peers, boredom at school, hyperlexia, having strong feelings compared to other children, and hiding their “giftedness” to fit in.

Sound familiar?

I wasn’t gifted, I was an autistic girl (read AFAB) with ADHD.

The gifted movement has been critiqued for lumping in neurodivergent traits as “symptoms of giftedness” and leading to “gifted kid burnout.” In recent years, the gifted kid movement has tried to pass itself off as a form of neurodivergence in itself, without any professional classification of this so-called “giftedness.”

As is typical of gifted children, I worked hard to hide my “giftedness.” I suppressed my extreme emotions, didn’t discuss my special interests, dumbed down my vocabulary, and tried to remove every autistic trait I could in an attempt to make friends and not be bullied.

I learned masking.

Cutting Away the Parts of Myself That Weren’t Normal

I experience emotions intensely, to the point the smallest injustices feel like a personal calling. Some professionals would likely pathologize it as “moral black and white thinking.” I just call it empathy.

When I was 10, I had a pet ladybug I found outside that I would gaze at for hours. I asked my mom to Google what ladybugs ate and tried to find small bugs in the garden to feed it. I took it out of the little plastic enclosure and let it climb across my arm, engrossed with the little creature.

Unsurprisingly, I lost it somewhere in the kitchen and never found the ladybug again. I cried and cried for days about it. I searched frantically for it. Eventually, I moved on after mourning the loss of my new friend.

When I heard good news, I would jump up and down and flap my hands. I would scream and run around the house and be elated for days.

My emotions were too much for most people in my life to handle. I would get scolded by my parents, teachers, and other adults. I would be ridiculed for crying in school or expressing strong emotions.

I stopped bouncing and flapping my hands when I was happy. I stopped repeatedly asking questions when excited. I didn’t express what I wanted and learned to take whatever was given to me.

I think many adults that punished my emotions wanted me to “be prepared for the real world.” Instead, they left me vulnerable as an adult, struggling to hold boundaries, regulate emotions, and voice what I want.

Like a sculptor, I carefully carved away at my core, creating a socially acceptable version of myself. I chopped off my sensory needs in exchange for dissociation, pushed myself to interact despite my anxiety, forced myself to subdue emotions to meltdown later, and pretended like I had it all together instead of asking for accommodation.

The fear of being mistreated for expressing myself is ingrained so deep, it’s hard to distinguish myself from this mask.

What are the effects of masking?

Research has demonstrated that everyone, regardless of neurotype, engages in some form of masking, like changing your appearance, voice, and mannerisms to fit in. Something unique to autistic individuals though, is that they mask so significantly that it has a severe impact on their sense of self and is detrimental to autistic wellbeing. Masking for autistic people is directly related to suicidality, which is not the same for non-autistic individuals.

Not all autistic individuals mask, but it is often necessary in our present society to succeed. This is especially true for intersectional autistic people that may face discrimination, maltreatment, withheld support, and systemic abuse if they don’t mask. A black autistic person, when confronted by police, is literally faced with life or death depending on their ability to mask.

It’s easy to sit back and say, “well, then stop masking!” when considering the fix to preventing long-term health problems. To be able to unmask is an incredible privilege. On the other hand, the ability to mask can in itself be a privilege because it provides the safety that many autistic people aren’t afforded.

There is no correct answer for what to do about masking, but we know there are adverse long-term effects. Ideally, societal change would be so fundamental that no one would need to mask regardless of identity. But, that’s not currently realistic.

As a late-diagnosed, white, hyperlexic autistic person, I can only provide a privileged experience. For me, I am incredibly grateful I learned how to mask, but I also can unmask now that I’m in a safe place. That’s not going to be true for everyone. It would be inappropriate for me to give a blanket suggestion of what should be done about masking.

The one thing I do wish my parents had known though, is what masking was and passing that knowledge on to me. At the very least, knowing that this “mask” was a separate part of myself would have helped my feelings of inadequacy about my authentic self. It may have aided my ability to cope appropriately because I’d be able to recognize that I don’t have to mask when I’m alone.

Knowing what masking was would have likely helped me avoid mental health crisis because I’d have developed healthier coping mechanisms like I’m doing now as an adult.

And if my parents had known, maybe they’d have understood a little better why I’d lie about how I was feeling and smile when things were terrible. Perhaps they would have tried harder to encourage autistic expression.

I’m not lazy, I’m burned out

Masking is exhausting. If you wear a false version of yourself all of the time, you don’t have the energy to do necessary things. Different autistic people are hit with burnout at different times with different severities, but autistic burnout in children can look a lot like laziness to parents.

Why does my kid want to watch TV and do nothing else when they get home? Why aren’t they doing their homework? Why do they never take any initiative around the house?

The unseen portion of these types of questions are, what emotional and cognitive labor have they been doing all day that you can’t see?

Couple this with ADHD executive dysfunction, depression, or any other comorbidity, and you have a recipe for contention. Nothing is more overstimulating than having someone pester you to do something repeatedly when you’re tired from the day. It explains why meltdowns are so common after kids get home from school.

If I had a time machine, I would have wished my parents had known what masking was so they could have avoided some of the power struggles we had. I couldn’t explain to them that I didn’t have the cognitive/emotional resources to fulfill demands.

This is why environmental support is essential. Having environments to escape through the day can make a big difference for sensory overload. Not being pressured to “act allistic” is incredibly relieving. And being given a clear schedule that can be flexible to my needs can make the difference in whether I hit burnout.

Masking may be unavoidable and necessary for many people, but there are ways we can support autistic individuals in their lives to minimize the damage of long-term masking. Through education, support, and compassion, we can help prevent autistic burnout in ourselves and the people we care for.

For more information on specific sensory supports that can be used to prevent burnout check out Pt. 1.

The Great Big List of Sensory Coping – What I Wish My Parent Knew Pt. 1

This post contains affiliate marketing links.

Pt. 2

When I was 8, my parents took my family to Disneyland. I remember meeting Disney princesses in my Snow White princess dress, being invited on stage to fight Darth Vader, and swallowing about a gallon of seawater trying to learn how to boogie board. It truly was the trip of a lifetime.

My mom is a very go-go-go type of person, so she pushed us from activity to activity, wanting to experience Disneyland to the fullest. My dad was the type of person who liked to stage large family photos (his special interest at the time was photography). Family photos often included me holding a screaming child, standing in the same place for an hour, and squint-smiling as the sun shone directly in my eyes.

Together they were an unstoppable duo of go-wait-go-wait, trying to get the most out of the money they spent during the 2008 recession. It’s easy to feel pressured to have the maximum amount of fun when you’re trying desperately to create a memory-forming experience.

At one point, my mom dragged me into the bathroom, begging me to use the toilets, but I sat down on the floor and cried. “It’s not scary,” she reassured me, but the looming monster of automatic toilets begged to differ. I had a meltdown on the bathroom floor, my mom frantically trying to calm me down while equally stressed parents passing by watched the unfolding “tantrum” with a judgemental look.

To me, it felt like the world was ending. I was hungry, tired, needed to pee, and my mom was trying to get me to use automatic toilets (how dare she?!). I was terrified of the noise and the abruptness. It had been a long-waged war between us to get me to use automatic toilets in public.

She flipped open her guidebook and tried to find toilets at Disneyland that weren’t automatic. She found one bathroom in all of Disneyland that didn’t have automatic toilets installed.

Our family ran down Main Street, rushing to get to the bathroom. I went in and did my business, relieved.

For the rest of the trip, we walked over to that bathroom regardless of where we were.

It’s funny looking back now because I was so obviously autistic. But back then, as recent as it is, girls (read AFAB) weren’t diagnosed with autism. I was just “quirky.”

My parents handled some of my autistic behaviors well, and others… not so much. If I could go back and give them a guide on what to do differently, here’s what I wish they would have known.


Sensory Coping

Learning sensory coping as an adult solved my “panic attacks” overnight.

What is sensory coping? Sensory coping is any sensory intervention that helps the person regulate sensory stimuli. This can be both the addition or removal of sensory experience.

One of the biggest “a-ha!” moments with sensory coping was realizing how vital oral stimulation is to help me regulate. It is one of the less acceptable ways of seeking sensation because of the association with childishness.

I sucked my thumb until I was 5. I would have done it longer, but my mom trained me out of it using aversives. “You’re too old to be sucking your thumb!”

When thinking about it critically though, what is the actual harm in children or adults using safe objects in their mouths to cope? Nothing really, it’s just not socially acceptable.

An autistic teenager I mentor chews on the rubber tires on his toys. His mom came to me in exasperation and said, “Why is he doing that?! How do I get him to stop?! He’s too old for that.”

I smiled and said, “If you want him to stop, give him something to chew on.” I helped her find a chew necklace on Amazon.


When considering sensory coping, you need to understand the person’s unique triggers, sensations they enjoy, and the type of sensation they naturally seek. Never force a sensation someone is expressing discomfort towards.

Auditory Coping:

  • Music. Everyone I’ve ever encountered has a type of music they like. Try cycling through different genres (even ones you don’t listen to)
  • Ear plugs. Noise-cancelling headphones can be great during a meltdown or rising sensory-overstimulation. High fidelity ear plugs are great if you can’t stand bulky noise-cancelling headphones.
  • ASMR can be enjoyable to some people
  • White-noise or other non-content noise. One kid I knew liked standing next to the outdoor A/C units because he found the noise calming.
  • Stop talking. Try communicating without speaking for a bit. I’ve heard this can be especially helpful for people who have selective mutism.

Oral Coping:

  • SAFETY: Make sure to regularly sanitize chew toys/etc., especially during the pandemic. Keep them in a designated place when not in use and don’t let others touch them. Watch for items that can become choking hazards or that someone could injure themselves on if a part breaks off.
  • Chewies – chew jewelry/chew toys. There are chew toys that exist that are meant to be subtle and ones that are different textures and materials. You can find them on Amazon or from autistic creators. One of my favorite autistic creators of subtle chew/fidget jewelry is The Divergent Minds Club.
  • Safe objects – straws, pencils, clothing, toys, etc. I know it seems frustrating when you see your child chewing on objects, but it is serving a purpose. Give them designated items based on what they normally chew on if they don’t like chew toys. A friend of mine likes chewing on plastic straws because they’re a different texture than the silicone toys and keeps a few in their office.
  • Ice – one warning is don’t chew ice (it’s bad for teeth) but sucking can provide a lot of sensory stimulation
  • Baby Ice Teethers – if you like chewing ice, this is a great substitute
  • Gum – have them choose the flavor. I really like the dessert flavors the Extra brand makes.
  • Food that imitates inedible items – edible playdough, chocolate “dirt”, candy rocks

Visual Coping:

  • Youtube videos – the videos marketed for “baby sensory”, “sand sensory”, “visually pleasing”, “surprisingly satisfying” can all be great places to look
  • Hourglass, color, or “visual toys” – lava lamps, bubble hourglass, sand toys, kaleidoscopes, Jacob’s ladder, I Spy book, light toys, and color changing optic lights
  • Projectors – there are fairly inexpensive light show projectors or you can easily make your own
  • “Beer goggles” – the type of goggles used in high school classrooms to warn students against drinking and driving, or any glasses that distort the world
  • Eye masks
  • Simulating an odd perspective – fish eye lense, going somewhere high up, spinning, tutting
  • Smart devices – you can get smart lights that are able to dim or change color and connect to smart home devices like Alexa

Tactile Coping:

  • Water, sand, and sensory tables
  • Dancing, exercise/movement, trampolines
  • Fidgets – I’m a big fan of this fidget toy set online or you can make your own.
  • Squeezing – autism “steam-rollers” (though these are pricey), full body hugs, hand or foot massages, head squeezes (can be good in place of headbanging), using objects around like pushing your body against a wall
  • Things to throw your body against – mats, beds, wearing a helmet, wrestling, punching bags, foam pits, diving
  • Sensory swings – in my living room this looks like a hammock chair and stand (no screwing into the wall needed)
  • Body suits
  • Bodies of water – swimming, bathtub, etc.
  • Weird/Pleasant textures – soft rugs/blankets, lotion, walking through the fabric aisle at Walmart, items that vibrate, smooth/bumpy items, temperatures (hand warmers or ice packs)
  • Activities that keep your hands busy – knitting, baking, puzzles, video games, drawing, rubix cube
  • “Safe space” – a small area that there’s a lack of stimulation or only pleasant tactile stimulation available
  • “Medicinal Herb” – if legal and of age

Olfactory (Smell) Coping:

  • Candles, incense
  • Scratch and sniff stickers/markers
  • Nose plugs – ones that you can still breathe through are usually less irritating
  • Perfumes/lotions of a preferred scent
  • Cooking fragrant foods – cookies, spicy foods, anything with cinnamon
  • Scented toys – stuffed animals, bubbles, play dough,
  • Essential oils – these can be put on diffuser necklaces to be worn around
  • Scent diffusers

Hopefully, you find some of these suggestions for sensory coping helpful. Consider putting these things in a “coping kit”.

If my parents had been equipped with how to help me sensory cope, I likely wouldn’t have developed as severe of anxiety pre-diagnosis. Sensory coping is an essential part of understanding autism and should be a staple for every autistic kid. These are all things you can try at home, but if you are looking for professional help, Occupational Therapy can be a great way of learning how to cope with sensory issues. Some areas offer OT services to children and adults, so check your local resources.

Let me know which ideas you found most helpful! For more information on why sensory coping is important check out pt. 2.

Can You Tell Who’s Faking Dissociative Identity Disorder (DID)?

When I discovered I was a system, it hit me like a truck. I was destabilized by several traumatic events, thrown into extreme states of dissociation interfering with daily functioning, having the overt experience of alters switching for the first time, blacking out, and losing necessary skills. My head was a cacophony of a bunch of people that suddenly wanted a say in my* life.

(*our primary experience of the world is through the host, so this is written from the host’s perspective)

Like autistic burnout, DID seems to be caught most often when the system is so destabilized that it suddenly becomes visible. The diagnostic criteria focus on what a system that’s destabilized looks like, similar to how a lot of late-diagnosed autistic folks say their autistic traits only became visible after they hit a certain level of stress.

Add to this the view of the media, where you have systems that are dangerous, overt, and extreme, like in the movie Split.

The public and clinical view of DID is a limited one. Systems are supposed to be simultaneously overt and unaware of their alters, rare and impossible to exist, prove they’re not faking and not share their diagnosis.

The expectations of systems are ridiculous and paradoxical. It leads to underdiagnosis, underrepresentation, and wild misinformation.

I don’t experience total blackouts anymore. I don’t lose time, and the only amnesic parts are retrograde (past memories). I still have alters, but we don’t present significantly differently or switch in at random, unpredictable times. This is how I’ve experienced DID for most of my life.

So, do I still have DID then? According to the DSM-V criteria, yes.

A recent internet movement (fake-claiming) has been going after systems trying to “spot the fake system.” It’s a witch hunt that believes that if we can find just one fake system, it’s worth all the real systems that get accused.

A poll in one of my DID groups yielded interesting results. Of the 135 systems that participated, 58% had been fake-claimed and felt hurt/angry/ashamed/doubted themselves/or some combination.

Do you believe that all 78 systems that were fake-claimed were faking?

So, why do people fake-claim? There are a few justifications that are common.

1. There’s all of these teens on Tik Tok sensationalizing DID

Tik Tok is villainized by the broader internet world and disregarded as a platform for silly teens to do their silly dances. This villainization has taken on a much more sinister form regarding all mental health Tik Tokers, especially for rare disorders.

The world loves a good “switching caught on camera” video. It’s seen as a novelty, similar to a circus act, amazed that someone is suddenly a different person. Making content that appeals to a broader audience requires that you sell yourself as a novelty.

I want to emphasize that I have a covert form of DID, and presenting overtly in itself isn’t necessarily sensationalized. Many creators are forced to show the parts people want to see, which tends to be overt characteristics.

This incentivizes the sensationalization of DID. People don’t want to hear what it’s like to be dissociated, how deeply trauma affects daily functioning or the severe co-occurring symptoms like psychosis and catatonia. Most of the content I made on Tik Tok about my DID was about the less savory parts of my disorder. I only received attention from other systems, not from the general population. My videos on DID didn’t go viral because they didn’t appeal to sensational DID.

Add to that the self-curated feed. You can easily see how someone who interacts with sensational content is likely to see primarily teenagers (Tik Tok’s largest audience is 10-19, followed by 20-29) showing performative parts of their disorder to get recognized by a broader audience.

The issue is not faking DID but sensationalization. It’s further incentivized by fake-claimers interacting with this content.

I believe every system has a right to present how they want on social media. As long as misinformation isn’t being spread, it’s not hurting anyone. It’s interesting that sensationalized DID has received so much negative attention, considering that it’s just following what people on Tik Tok want to see. It’s catering to your audience, similar to how lifestyle vloggers post the happy parts of their families, exercise routines, parties, and lives. I’ve never seen anyone fake-claim a family vlogger saying, “that’s not even your family!”

Sensationalization ≠ faking. If you don’t like it, don’t interact with sensationalized content.

2. Fake systems hurt the community and need to be deplatformed

In my opinion, this is one of the most valid reasons why people fake-claim, and the one I’ve seen most often used by systems that fake-claim other systems. There’s a rational fear that sensational influencers that might be faking the disorder are harming the community image and therefore harming systems as a whole.

I always compare this to my experience in the trans community. People like Caitlyn Jenner sensationalize being trans, spread misinformation, and contribute to a negative stereotype of trans people. It’s easy to see this harms the community. But I wouldn’t say Caitlyn Jenner is faking being trans. I fully believe she is trans, despite her harmful actions. The trans community has a similar tendency to be hypervigilant against potentially “fake trans people” due to the mistreatment from the broader population. The thing is, the number of people who are in a fragile state of questioning their gender are the ones that get hurt when the community seeks out “the fakers.” It villainizes specific presentations and is usually targeted at people that are trans but present in unconventional ways.

We need to re-frame this argument. The main issue is not people faking DID, though it’s easy to feel that way when public systems spread harmful misinformation. But by pointing fingers ourselves, we are inviting non-systems to do the same to us.

The problem is misinformation, not being honest about the difficult parts of the disorder, the lack of support available for systems, and the lack of good public/medical representation.

We can call out misinformation, educate others, and advocate for support/representation without fake-claiming.

3. Look at how obvious they’re faking! They have alters from anime and talk like a baby

Cringe. It’s the fuel of internet hatred and a re-packaged form of hate for mentally ill behaviors.

Someone being cringey does not indicate they’re faking.

An unusual alter presentation doesn’t exclude someone from having DID. In the DSM-V, there are no specifications on what an alter can be other than “discontinuities of experience that can affect any aspect of an individual’s functioning.” It at no point specifies if they have to be real people (even including “ghost” as a potential personality), the demographics of the alter, or the number of alters required to be a system (beyond two).

Age regression (the experience of taking on a mental/emotional state of someone younger) is common in childhood trauma disorders. And child alters are very common.

Going back to a previous comparison, Caitlyn Jenner is cringey. That doesn’t make her not trans.

DID has a broad presentation of what it can look like. Policing cringey behavior hurts all systems, as it discourages natural expression. And there’s no evidence that someone is faking just because you don’t like how their system presents.

4. DID is rare, there’s got to be people out there faking

This one is easily disproven with a bit of math. There is controversy about the prevalence of DID due to underdiagnosis and myths. There’s also OSDD which can have alters without amnesia, making the prevalence of systems higher than estimates for DID.

But, if we’re going off what’s stated in the DSM-V (based on this study) , the prevalence is placed at 1.5%.

1.5% of the U.S. population is approx. 5 Million people. Tik Tok has roughly a billion people on the platform. Assuming Tik Tok is representative of the general population, that means approx. 15 million people on the platform have DID. Again, this doesn’t include other systems that have OSDD or are unrecognized by the medical community (due to accessibility).

That’s the number of people in Costa Rica, Ireland, and New Zealand combined.

It’s rare, but it’s not as rare as people think when talking about statistical prevalence.

Consequences of Fake Claiming

Content Warning: This section mentions suicidality and self-injury. Reader discretion is advised.

Why does stopping fake-claiming even matter?

Systems are an incredibly vulnerable part of the population that has been through severe/repeated forms of trauma. This makes fake-claiming not only problematic but dangerous.

Studies have found the prevalence of self-mutilation in diagnosed DID between 34-48%. Rates of attempted suicide are 61-72%, with a 1-2.1% completion rate. This is likely underestimating the actual completion rate due to the number of undiagnosed DID systems.

People with DID are finally starting to have a public image that doesn’t center around being homicidal monsters or only presenting in one overt way. And the backlash is astronomical. People create forums to laugh and point at DID symptoms under the guise that the person is “faking.” They’ve swarmed social media channels with hundreds to thousands of comments arguing that creators are faking, and they’ve doxxed and harassed systems with large followings.

They don’t hate fakers; they really hate people with DID. It’s bullying. An internet mob quickly becomes an abuser, and in this case, it’s abusing a population that already has significant trauma.

Fake-claiming may increase the likelihood of self-injury or suicidality, but it also instills a sense of self-doubt.

Especially for newly recognized systems, this can be a devastating blow, leading to many self-destructive behaviors in an attempt to “prove” you’re not a system. Newly recognized systems or people questioning if they have the disorder may try to ignore signs of breakdown because they believe it’s all in their head. The negative self-stigma seems incredibly prevalent in the DID community and is made worse by the recent fake-claiming trend.

You may think you’re not hurting anyone when you “expose” someone that is “obviously faking,” but you’re hurting DID systems as a whole. You’re contributing to an internet mob deadset on proving every DID system is faking. And you may be contributing to self-doubt and self-injurious actions in response to bullying.

No, you can’t tell if someone’s faking DID unless they come out and say they’re faking. And the minuscule number of malingering systems are not worth the damage caused to the millions of real systems by fake-claiming.

Let’s call out harmful community behavior without bullying someone for their existence.

I Was Part of the “Good ABA”

I became an RBT because I saw a real opportunity to help people.

A coworker mentioned that she had been looking into the voices of the autistic community. She said that there was a big push away from ABA. In training, they presented all the research that supports how much better autistic lives are because of ABA; reduced self-harm, aggression, greater adaptive functioning, and less family stress. With that kind of evidence, who could possibly be against ABA?

Our clinic was a part of the new “good ABA.” It checked off all the boxes of what to look for in ABA clinics; “child-led,” “natural environment teaching,” “reinforcement, not punishment focused,” “communication driven,” and “not discrete trial training (DTT).” I was part of a force for good, part of the cutting edge of the field where ABA was seeing true reform.

Content Warning: this article contains descriptions of abusive therapy. Reader discretion advised.

It still haunts me hearing that electronic voice say “granola bar.”

The longer I worked there, the more I started seeing the red flags that weren’t visible when I initially wore those rose-colored glasses. It started with one of my favorite students, a nonspeaking child who was incredibly intelligent and very funny.

I could tell that he was bored with his programming. 90% of it was maintenance. He already knew how to perform the desired behaviors. They were still there because the BCBA and others couldn’t reliably get him to produce the behaviors.

We were encouraged to run DTT-style trials with him, where he would get frustrated easily to the point of self-harming. He was doing this with every tech three times a day, 40 hrs a week.

I started seeing other coworkers gossip about him, discussing how he was “manipulative” because he would seek reinforcement without performing “desired behaviors he knew how to do.” I couldn’t help but laugh at the idea of a 7-yr-old being “manipulative” of adults around them.

That kind of thinking was what led to my first instance of seeing something so morally abhorrent that it was impossible not to speak up. I shadowed another RBT and watched the student request food on his AAC device. Previously, the supervisor had set up an eating schedule for the kids to eat their lunches during the school day, and he was out because of training.

The RBT gently told him no, that he would have to wait for lunch, and he went and played. He continued returning to his AAC, asking for food, and the RBT continued to deny him. I watched this slowly escalate over 30 minutes until I saw the student start breaking down crying. He brought her to his snacks and pointed at them, and the RBT continued to say no.

I urged her to let him, but she brushed me off, saying that it would be “reinforcing maladaptive behaviors.” He went to other staff and brought them to his snacks, and everyone ignored him because he was exhibiting “attention-seeking” behavior. He manded over and over again, and it still haunts me hearing that electronic voice from his AAC device say “granola bar.”

I had enough and sat him at the table and gave him food. He continued to cry softly as he ate his snacks, so emotionally overwhelmed he couldn’t stop. I told my supervisor about the incident, and she wrote up a “training protocol” that was posted on the door of how lunchtimes were flexible.

I asked if she was planning on telling his parents, and she said, “What is there to tell? A kid having a problem behavior for food? That’s nothing new. We don’t report that kind of thing in our clinic, and if we did, there’d be way too many things to write reports on!”

 “It’s like he had PTSD or something!”

That’s not where it stopped. Shortly after, another supervisor bragged in a staff meeting about their research on the IISCA and a functional analysis they ran on a nonspeaking child.

The child had a history of self-harm and aggression, so they were trying to target the behavior so they could “turn it on and off at will.” They first gave the child homework and a bunch of puzzles all mixed together, so there was no solution.

In response, he didn’t have a “maladaptive behavior,” so they were forced to escalate. They started yelling at each other from across the room (knowing this kid had extreme hypersensitivity to noise) and banging items around the room. They brought in a speaker to blast music that the kid hated. The music was so loud it could be heard in other rooms.

He continued to self-regulate and didn’t have a maladaptive behavior. They started forcing him to watch clips of TV shows he hated and did all of these aversives combined, trying desperately to produce a behavior.

Finally, what broke him after 20 mins of what I can only describe as torture, they let him get up as if to let him leave and then forced him to sit down when he had reached the door. The kid started crying, and they considered the functional analysis a success.

I was horrified as my supervisor enthusiastically told me how much better he was making this child’s life. All I could feel was the deepest pit in my stomach, knowing how horrible my own sensory problems were and imagining that on a child who could not stop it.

In a staff meeting, the BCBA joked that “it’s like he has PTSD or something” when discussing him avoiding the room they were in, both supervisors and the RBT who were present at the time. She discussed how frantically he would act when she would even start to blast music to “turn on the behavior” and how quickly he would scream “my way, my way, my way!”

She said all of this laughing and boasting about it, and I looked around and saw my coworkers laughing with her. They didn’t understand how cruel it was. They had no training on dealing with sensory regulation in autistic children.

Every clinic considers itself to be the “good ABA.”

This clinic considered itself part of the “good ABA” and still does. I had no idea how to report it and was traumatized by my experience. I had heard about how stringent the BACB was with documenting events to take a case seriously.

At the end of this, I didn’t have enough documentation to feel like they would genuinely do much, especially hearing their inaction at even more significant ethical violations like JRC’s use of GED shock devices. I could already envision the slap on the wrist or, worse, complete dismissal “proving” my supervisor in the right.

I went public with the information, knowing I would be terminated.

Statistically and anecdotally, not every clinic can be the “good ABA.” It’s so easy to lose sight of what’s happening when you’re hearing things described in more appealing language. When valid criticisms are raised, ABA therapy has historically been morally disengaged.

I urge practitioners to watch the reaction of refusing to acknowledge harm when presented by autistic people, by coworkers, by supervisees, and by that feeling in the gut that something isn’t quite right.

It’s time the field listened to autistic people, especially when it’s difficult.

Why I’m Moving Platforms – A Confession of A Burned Out Advocate

I never intended my Tik Tok to be a route for advocacy. It was a place where people related to my darkest parts for the first time. A place to share trauma that most people don’t want to hear.


I don’t regret that it launched my advocacy platform. I couldn’t have predicted a job I had taken to help other people, autistic children, would turn into such a traumatic and life-changing experience. My job as an ABA therapist was a relatively short blip in my life, and yet it made such a significant impact on who I discovered myself to be.

I suppose finding out you’re autistic from ABA, an industry that views your existence as inherently wrong is just about the worst way you can find out. The guilt I felt at leaving helpless children at the hands of people who saw them as manipulative, dysfunctional, and in need of saving was nearly unbearable. I started posting on Tik Tok about it as a means of gaining sanity. A touch of reality when I was being gaslit by my coworkers and boss. Being fired was just about the best thing the clinic could have done for me.


Motivated By Spite

My goal was to reach 10K. That was the number my father had at the height of his relative “fame,” which he weaponized against me growing up. It was a spite-motivated goal and one I craved desperately to reach. But when I achieved it with a controversial video, I was wracked with anxiety I hadn’t felt since starting the account.

I had thousands of people telling me I was wrong, spewing the worst kind of hate towards me, and arguing with each other. I became obsessed with managing the comment section, refreshing the page repeatedly to see dozens of comments pouring in.

My victory was hollow. I had reached my goal, but what was the point? It marked a year-long project that devolved the second half a million people saw my video. I started noticing other activists’ efforts, posts of friends and mutuals that went viral. The comments were filled with all sorts of projections, removing nuance and accusing creators despite their content being less than a minute long.

While it isn’t just Tik Tok, it seems especially bad because of the level of audience that you can reach and the length of videos. Being seen by more people isn’t necessarily a good thing. I grew bitter as I got comments on my videos critiquing minutiae, putting words in my mouth, and insulting me. It made me realize my efforts required a much more nuanced approach than Tik Tok.


Welcome to Life of Lieu

Advocacy is exhausting, even if it’s behind a keyboard. It’s a ton of emotional labor to explain the same things over and over to the same questions/arguments. I don’t pretend to have it harder than most activists. I haven’t reached a platform where I’ve experienced a fraction of some of the abuse I’ve seen. I am also not out in the field advocating in harsh conditions against cruel people. But, I’m still tired.

I created this blog because I need a place to flesh out my ideas. I can’t articulate what I need in only 150 characters. I hate talking on video. And writing has always been the way I communicate best.

This blog will be a mix of my thoughts/feelings/experiences on mental health topics I feel are essential to address. Like Tik Tok, I imagine it will take on a life of its own. Welcome to Life of Lieu.

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