Chapter 4 discusses the various coping strategies and detrimental behaviors that masked Autistic individuals often adopt to conform to neurotypical standards and manage sensory overwhelm or social pressures.

Price explains that Autistic people often experience sensory overload due to their distinct neurological processing, which makes them more susceptible to being overwhelmed by sensory stimuli over time. This can lead to states of sensory overload, manifesting as meltdowns, shutdowns, or irrational responses. To cope with this sensory overwhelm and the demands of social regulation, many Autistic adults turn to problematic drinking habits or substance use. Price notes that traditional cognitive behavioral therapy (CBT) approaches may not be as effective for Autistic individuals, suggesting the need for modified treatments that consider the unique communication and sensory processing needs of Autistic people.

There is a noted correlation between Autism and eating disorders, particularly among women, transgender individuals, and those diagnosed later in life. Price observes that masked Autistics may be drawn to eating disorders due to their structured nature and the control they offer. He emphasizes the importance of Autism-friendly eating disorder treatments and finding non-performative, authentic ways to seek belonging and social structure.

To cope with the pressures of

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