Expressing physical pain feels to me like just one more communication that has to be managed. As a child if I injured myself I instinctively hid the injury because I could cope with my own sensations or other peoples’ reactions, not both. Then I learned that if you conceal an injury you tend to get found out and then people react even more, putting even more strain on your abilities to meet social norms. So a socially acceptable response to (say) falling over in the playground was the best way to minimise attention – you had to endure a certain amount of people insisting on communicating but that was the least you could get away with. As an adult, if I need medical help, I have to work out a way to express myself that will be heard rather than as feels natural to me, which is a burden I could do without.
“I’d like some help please” – so, why don’t you hear?
I said the words and made my meaning plain.
I logically expressed it, made it clear:
I’m suffering, I’m very much in pain.
But you expected me to be like you –
To use impassioned tone, expression, more.
To you my tone sounds calm and dull; ado
Is signalled by emotions loud and raw.
If I were really suffering I’d scream
You’re sure that’s so, so I must be a fake
My problem isn’t much, it’s not extreme
My agony to you’s a minor ache.
It’s harsh but true that if would be heard
Faking normal’s still the sole password.
Autistic Civil Servant 