Neurodiversity-Affirming Care in Couples Therapy

The Importance of Neurodiversity-Affirming Care in Couples Counseling

Kristina Damiano, MHC-LP October 9, 2024

Explore the unique challenges faced by neurodiverse couples and how neurodiverse couples counseling can support addressing such challenges.

While all relationships experience challenges and no relationship is perfect, neurodiverse couples are often faced with unique challenges that traditional couples counseling isn’t set up to properly address. A neurodiverse relationship is a relationship in which at least one partner is neurodivergent. In our population, neurodivergent individuals make up 15-20% ranging from individuals with ASD, ADHD, Dyslexia, Sensory Processing Difficulties, Dyspraxia, Dyscalculia, Synesthesia, OCD, and other common brain variations that impact how the individual processes information differently than neurotypical individuals. In this article, we’ll explore the unique challenges faced by neurodiverse couples and how neurodiverse couples counseling can support addressing such challenges and foster greater understanding of the neurological differences between individuals and their impact on relationship dynamics. 

While Autism and ADHD are the most common forms of neurodiversity spoken about today, it is important to remember that neurodiversity represents a variety of differences in brain structure resulting in a different way of interacting and experiencing the world. No two humans are the same, whether Neurodivergent or Neurotypical, and so no two people experience the world around them in the same way. That being said, there are some common differences between Neurotypical and Neurdivergent people that can be found. Some of these common differences in Neurodivergent individuals include difficulty managing impulsivity, sensory and emotional overwhelm, low frustration tolerance, difficulty reading non-verbal cues, executive functioning difficulties, rejection sensitivity dysphoria, and hyper-fixation in special interests. On top of the typical issues faced in relationships, Neurodiverse relationships tend to experience conflict due to a build up of resentment over time and feelings of being misunderstood. 

Interestingly enough it is often these same differences that draw these partners to each other. The Neurodiversity magnet is a term which represents the initial strong pull and attraction the neurotypical and neurodivergent individual feel towards each other. This magnet specifically speaks to some of the dynamics seen between a neurotypical person and a partner with Autism. For example, the neurotypical partner  may be attracted to the autistic partner's stability, focus and intelligence while the autistic partner may appreciate the neurotypical facilitating or helping them navigate social situations. Also sometimes seen within this dynamic, the neurotypical partner may be the autistic partner's special interest, especially during the dating period. The neurotypical partner tends to enjoy the intense attention given to them during this initial stage, further intensifying the pull between them. 

While all relationships face challenges and each presents with their own unique issues, the challenges faced by a neurodiverse couple are unique because they stem from structural differences in the brain. Some common sentiments found between neurodiverse couples include feeling disconnected from their partner, feeling as though they speak two different languages, or feeling like their partner cannot provide empathy or patience. Neurodivergent couples often encounter a unique set of challenges that can impact the dynamics of their relationship. These challenges can include communication difficulties, sensory sensitivities, social interaction challenges, emotional regulation, and issues with intimacy and connection. 

Communication difficulties in a neurodiverse couple stem from a difficulty interpreting non-verbal cues, difficulty understanding non directive language, or difficulty with expressing feelings effectively. This will typically lead to frustration and misunderstandings within the relationship. Daily routines or activities can also be difficult between partners due to discomfort or distress from environmental stimuli, sometimes making partners feel as though certain situations need to be avoided to minimize sensory overload. Social interactions can also be more complex due to difficulties with social conventions, such as maintaining eye contact or small talk. This can sometimes lead a neurotypical partner to feel as though they must carry the social load, sometimes creating a difficult dynamic or leading to feelings of resentment over time. Another common challenge seen between neurodiverse couples is a shift in emotional climate due to difficulties with emotional regulation. This is because neurodivergent individuals may struggle to regulate their emotions, leading to emotional outbursts or shutdowns which can cause the neurotypical partner to often feel emotionally isolated. Oftentimes differences in communication styles, emotional expression and regulation, and sensory needs can also cause challenges with physical and emotional intimacy. 

While most neurotypical couples can also experience similar difficulties with communication, intimacy, parenting, and daily routine, differences in brain structure and processing over time can lead to diminished trust within a neurodiverse relationship. This dynamic can often result in feelings of blame, shame, isolation, confusion, loneliness, or hopelessness and can sometimes cause one or more partners to pursue, withdraw and/or explode. This can also lead to diminished sex life and make shared responsibilities, like parenting or chores, more difficult to manage. This can especially be frustrating for individuals who may be undiagnosed or diagnosed later in adulthood.

Oftentimes a lack of understanding or awareness about how different these individuals process and experience the world can cause partners to feel completely alone and misunderstood. This is also why traditional couple counseling does not work, as it typically assumes both partners are equally adept at focusing on emotions and sharing insights. Since most counseling modalities are developed by clinicians who are neurotypical, and for neurotypical clients, it makes sense that traditional counseling may be ineffective and sometimes cause more damage between the couple. A neurodiverse relationship consists of two or more partners whose way of perceiving the world and responding to it are fundamentally different and so couples therapy for neurodiverse couples should be tailored to better understand and embrace these differences.

So you may wonder what makes Neurodiverse couples counseling different from traditional couples counseling. One of the biggest differences between Neurodiverse couples counseling and traditional couples counseling is therapist training. Therapists are specifically trained to understand Neurodiversity and do not expect both partners to operate from the same perspective. Therapists who specialize in Neurodiverse couples counseling do not strive to change anything about the Neurodiverse partner but rather focus on equality and understanding versus trying to mainstream the dynamic within the couple. Another difference is that neurodiverse couples counseling allows for the decoding of neurodiversity and provides guidance and support in creating a ‘user manual’ to better understand the interactions between neurodivergent and neurotypical brains. Therapy is then tailored to understand how differences in brain structure influence the specific relationship dynamic which allows for a unique treatment plan. There is no one size fits all approach as different individuals and relationships will have different needs.

In addition, another key factor for successful Neurodiverse couples counseling is acknowledging sensory sensitivities and ensuring a comfortable space for Neurodivergent individuals. The most effective therapists and treatments customize strategies to the unique needs of each partner. Specific modalities often used in Neurodiverse couples counseling includes cognitive-behavioral therapy (CBT), social skills training, and relationship-focused interventions. Since communication is often one of the biggest challenges in neurodivergent couples, therapists introduce specific communication techniques that focus on clear and direct language, visual aids, or social stories to reduce misunderstandings. Therapists who provide neurodiverse couples counseling will also put an equal importance on emotions and logic by helping to connect both together, whereas most traditional couples therapy tends to focus most on emotions and feelings.

One thing you will continually hear in Neurodiverse couples counseling is ‘changing the narrative.’ This sentiment highlights the goal of neurodiverse counseling which is to change the narrative versus changing the behavior of the neurodivergent partner. By changing the narrative, therapists are focusing on understanding and embracing the differences between the couple so they can set more realistic expectations within the relationship. An example of this is often seen when the neurotypical partner recognizes the impact sensory sensitivities may have on their neurodivergent partner’s nervous system and ability to manage their emotions. Honoring this difference would allow for the neurotypical partner to meet the basic needs of their partner, allowing for nervous system regulation or coregulation to take place. This form of understanding often allows for a deeper level of intimacy within the couple. Self-care also plays a pivotal role in Neurodiverse couples counseling. In a neurodivergent relationship, self-care refers to partners respecting boundaries and building resilience. It provides an opportunity for space to help empower each person to manage challenges and better contribute to the relationships well-being. Self-care also allows space for the forming of empathy, understanding, and partnership which helps to view differences as a strength within the relationship.

There are also some common forms of conflict that are addressed in neurodiverse couples counseling. One source of conflict addressed is feeling misunderstood by your partner. When in a neurodiverse relationship feelings of being misunderstood can lead one partner to feel as though the other partner does not care or try hard enough to change. At the same time, the other partner can often feel like there is a lack of patience and an inability to please the other person. Another source of conflict commonly seen is misreading situations and jumping to conclusions. In any relationship it is easy for people to misread situations between them; however, in neurodiverse relationships the differences in how each partner processes information and the tendency to jump to conclusions or misread a situation can often be magnified. 

Another common conflict addressed within neurodiverse couples counseling is overlooking differences between the neurotypical and neurodiverse brain. Oftentimes a neurotypical partner may overlook the degree to which their partner processes the world around them differently. This can often cause the neurotypical partner to maintain expectations that their partner ‘should’ think or react the same way as themselves. Setting clear expectations within the relationship by acknowledging and embracing those differences is a major component of neurodiverse couples counseling. Lastly, while all humans have the tendency to feel defensive, often the quickness to defensiveness is amplified due to rejection sensitive dysphoria (RSD). Rejection sensitive dysphoria is a condition which often occurs in people who have ADHD and Autism. Due to differences in brain structure, people with RSD have more intense emotional reactions to rejection or perceived rejection or failure. Difficulties with emotional regulation and RSD make certain interpersonal experiences feel more intense for the neurodivergent brain especially when receiving feedback from their partner. This creates conflict to often escalate as it creates an impasse in communication and feelings of hypervigilance to develop between partners. While one partner’s brain may register a situation as acceptable, the other’s may not, which may create further distance within the relationship. 

It is safe to say that all relationships require a level of dedication, empathy, and understanding to create a safe atmosphere for both partners. Neurodivergent couples face challenges in their relationships which can often make them feel as though they are worlds apart. Neurodivergent couples counseling strives to connect both worlds to create a more resilient and supportive relationship. Driven by the values of empathy, self-care, equality, and inclusion, Neurodiverse couples counseling focuses on problem solving through a neurological lens to bridge connections and bring partners closer together. Couples will walk away with the confidence and tools knowing that they now have a better understanding and more empathy for the way they process the world and situations differently.

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