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How ADHD Affects Relationships

Nancy DePaul, MSW
July 10, 2006

The timing and rhythm of being a couple is challenging enough when one considers the variables of temperament, style and cultural values, but takes on an added dimension when one of the partners has ADHD. ADHD can affect an entire family system and in some instances can be traced by family members to three generations. Frustrations, caused by interactional patterns that are ineffective, negative or anger-driven can impair and impact parent child interactions, sibling relationships and marital dynamics. Because the etiology of ADHD is based on bioneurological components, each family member is often required to make accommodations around the symptomatic family member’s disorder. Couples often repot certain themes and recurrent stressors that seem to be based on the biological and emotional components of this disorder. Several of the more common themes include: chronic emotional distancing, poor or conflict based communication and loss of trust and friendship with their partner when the condition has not been effectively diagnosed and treated.

Factors that may erode relational health often occur around several main areas: organizational differences, timing and task completion conflict, and impulsive and reactive communication patterns that result in misunderstanding and hurt feelings. Over time these events begin to dismantle hope and assurance that marital health will improve. In fact, it is not uncommon for me to hear from my clients in this predicament, that they feel their marriage is stuck in adolescence, the same drama and chaos day in and day out. Couples therapy can be an effective tool to create change when the clients and therapists agree to some useful guidelines. All parties must reach some level of consensus that ADHD is a physiologically based disorder that affects behavior. This will prevent one partner from feeling they are in the caretaker role and the symptomatic partner feeling hopelessly locked into a one down role.

Disband the myth that ADHD can suddenly develop in adulthood, or that it is the result of poor parenting or a dysfunctional family. Couples counseling that does not begin with a clear conceptualization and understanding of the complexity of ADHD interfacing with social, emotional, educational, physical, sexual and economic areas of life is doomed to failure. I have found that using insight therapy without teaching couples how to accommodate to the neurological components of this disorder will leave couples continuing to feel frustrated and resentful.

When a couple learns that their partner’s behavior can be accounted for by a bioneurological condition there is often a grace period followed by profound grief. Grief can often take the shape of mourning for lost years of intimacy. As one client said poignantly “I became very familiar with his back as he walked away during discussions and arguments. I’m only now becoming familiar with his smile and attentiveness.” During this stage of grieving it can be helpful to explore the meaning of what intimacy can look like in the future and less preoccupied with the accumulation of hurts and misunderstanding. Once the realization settles in that you and your partner have both experienced a tremendous loss with no one at fault, a new marital contract can be developed. The integration of new behavior and communication patterns may be the beginning of a new relationship identity.

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Nancy DePaul, MSW is a Senior Staff Therapist and Assistant Director of CFR’s Paoli, Concordville and Lionville offices. She can be reached at 610-558-4060 ext. 1.

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