Building a bridge of understanding and acceptance.
Because of the location of my practice in Silicon Valley, I have had the privilege of supporting many Neurodiverse couples, where one partner has Asperger's Syndrome (AS) and the other is Neurotypical (NT; referred to elsewhere as Non-Asperger's, or Non-Spectrum).
In fact, a UC Davis study has identified the Sunnyvale/Santa Clara area as an autism "cluster". Said another way, there are a lot of really smart engineers with extreme "male" brains (although the AS partner may be female!) in Silicon Valley that need a tailored approach to relationship support. In order to serve the neurodiverse community around me, I partnered with other like-minded professionals to form the Neurodiverse Couples Counseling Center (NCCC). You can read more about our work at the NCCC website.
Having worked with many neurodiverse couples, I have discovered some encouraging news; that, with the right help and a willingness to examine themselves in a new way, neurodiverse couples can have relationships that are tremendously rewarding and fulfilling.
WHAT IS ASPERGER'S SYNDROME?
Asperger's Syndrome (AS) is a neurological condition that is considered as high-functioning autism (Autism Spectrum Disorder). Individuals with this syndrome have difficulty with social aspects of intelligence. Although people with AS do feel affection towards others, relationships are not a priority for them in the same way that it is for people who do not have AS.
On a day-to-day basis, people with AS generally seem to be more focused on a particular interest, project or task than on the people around them. Yet, I have found that many of my clients with Asperger's are genuine, honest, funny and certainly make real contributions to the world that we live in.
Often Asperger adults and neurotypicals are attracted to each other and couple up. The neurotypical may be attracted to the Aspie's stability, focus and intelligence. The Aspie may appreciate the neurotypical helping him or her navigate social situations. They may feel like they are complementary, a perfect fit - hence it may feel like a "magnet" pulled them together.
DIFFERENCES TURN INTO DYSFUNCTIONAL PATTERNS
Once the couple is married, they discover that they speak different languages and have a disparity in how they think and experience emotions. Without the tools to understand and constructively deal with neurodiversity, these differences are often interpreted negatively which, over time, become cemented into dysfunctional painful patterns which gradually destroy the relationship.
THERAPY FOR COUPLES WITH ASPERGER’S
Therapists who are not experienced with neurodiversity often tell clients married to Asperger adults that their partner cannot feel empathy and cannot truly love.
This is dangerous feedback because it is simply not true. All of my clients feel empathy and are capable of love.
Asperger adults are often shocked to find that their partner’s faith in their love and loyalty could be compromised by a forgotten good-bye or missed eye-contact. I believe that most of my typical AS client feels empathy but often needs a lot of help to understand his partner and when he does understand, has difficulty expressing empathy.
In session, our work often takes two paths:
the couple work and
the support work for the neurotypical spouse (see below).
For the couple work, I help you create as much emotional intimacy as possible. Often, emotional intimacy has been blocked during the years the couple was not aware of AS. This pre-diagnosis period is often marked by misunderstanding, resentment, anger outbursts and withdrawal.
First, I am very aware that many of my clients have been hurt by therapists that tried to make them "less autistic." I will try hard NOT to do that.
Instead, we work together to eliminate the counter-productive patterns (mostly based on misunderstanding) that have developed over years, accept each other's differences, and begin extremely explicit behavioral steps to increase closeness.
Pursuing a diagnosis (OPTIONAL) or Identifying the aspects of Asperger's that apply to you;
Accepting the diagnosis OR accepting your unique characteristics;
Understanding how AS impacts the individual;
Managing depression, anxiety, obsessive compulsive disorder and attention deficit hyperactivity disorder;
Self-exploration and self-awareness;
Creating a Relationship Schedule;
Meeting each other's sexual needs;
Bridging parallel play;
Coping with sensory overload and meltdowns;
Expanding Theory of Mind;
Improving communication (learning to interpret gestures, facial expression and tone of voice of others so that intentions and the meaning of communication is clearer);
Managing expectations and suspending judgment (developing a realistic understanding of who one is, greater appreciation of one’s unique qualities and strengths).
Although these steps may seem daunting, there is good news. Despite the tendency of the AS partner to be rigid and focused on himself, most AS clients that I work with will put in tremendous efforts to change in the context of my therapy and the support from the NT spouse.
Asperger’s is NOT a fixed condition that locks someone into the same behaviors throughout life. It is subject to the same forces of change that occur in anyone’s life. Understanding this provides the ray of hope to break painful entrenched patterns of interaction.
Please know that the change is usually gradual but, over time, both partners usually experience progress and your relationship can finally become more relaxed and rewarding. In fact, many neurodiverse couples that I counsel report that they are satisfied with the marriage and choose to remain in the relationship.
Most of my clients do NOT seek to receive a diagnosis from me, nor do I find much benefit in providing one. It is much more effective to treat whatever unique characteristics which present themselves and avoid the negative effects of labeling and having a fixed mindset.
On the other hand, it can be INCREDIBLY helpful to receive a diagnosis if it can help a couple reinterpret behaviors as a way of experiencing the world as opposed to a sign of bad intent.
In such cases, clients start by taking the following on-line assessments (not definitive tests):
Autism Spectrum Quotient (AQ) Test (a result of 33-50 indicates the possibility of Asperger’s)
Empathy Quotient (EQ) Test (a result of 30 or above indicates the possible absence of Asperger’s)
Ritvo Autism & Asperger Diagnostic Scale- RAADS-14. (scores of 14 and above are indicative of possible Asperger's).
When a formal diagnosis is requested and we agree that it will be helpful, I use collaborative process and involve the neurotypical partner in the process as long as this can be handled in an emotionally-safe way. This often helps build an understanding of what the diagnosis actually means.
The following steps are usually involved in the diagnostic process:
Discuss your developmental history
Discuss your development of peer relationships and friendships and the quality of attachment to family members
Make behavioral observations including your social and emotional presentation
Interviewing your partner regarding the nature of interactions and the quality of attachment
Observe your self-awareness, perspective-taking and level of insight into social and behavioral issues
Discuss your ability to understand another person’s feelings, intentions and beliefs
Ask for your self-report of certain symptoms
Possibly meet with other friends or family members who can provide additional perspective
Assess for related issues such as obsessive-compulsive tendencies, general anxiety and depression.
Please note that neurological testing is not required to get a “formal” diagnosis.
Where appropriate, I encourage couples to consider if medications can help. There are no medications for Aspergers but there are meds for anxiety, depression, OCD and ADHD which often are experienced in these situations. I always provide a referral to a qualified psychiatrist for all discussions on medications.
Overall, I recommend in-person therapy for Neurodiverse couples. Nonetheless, because there are so few therapists who specialize in Neurodiversity, I also offer video counseling or coaching. This approach often works well and may be more comfortable for the AS partner.
FOR THE NEUROTYPICAL SPOUSE
RELATIONSHIP OF CONVENIENCE?
Because the person with AS does not have the same relational needs as the non-Asperger partner, he or she is often unable to instinctively recognize the emotional needs of his or her partner and may feel ill-equipped to meet them. Relationships can thus form seriously dysfunctional patterns.
People who do not have AS enter a relationship with the normal expectation that the priority of a relationship will be about togetherness, mutual terms and meeting of needs, but in reality the relationship ends up feeling like one of practicality and convenience for the person with AS.
For those who had typical expectations of the mutuality of marriage, there will be a sense of betrayal and a feeling of being used and trapped. Instinctively they know that their partner needs them, but feelings develop that the relationship is about the needs and interests of the person with AS and that there is not room for their own voice.
Many partners feel that they are daily sacrificing their own sense of self to help fulfill the priorities of the partner who has AS. They begin to feel that they are entirely defined by the role they fill for their Asperger partner. There often is a felt loss of mutuality. The set of symptoms has been described as Ongoing Traumatic Relationship Syndrome/Cassandra Phenomenon (OTRS/CP).
SPECIFIC STEPS FOR THE NEUROTYPICAL
With this dynamic in mind, a large portion of my work is to help the NT partner in some of the ways listed below. Usually, about half of them work. My job is to help you explore and find the ways that fit you best.
1. Focus on the Positives
Appreciate the strengths of the AS partner (which often included loyalty, stability, intelligence and independence),
2. Be Concrete with your Requests
Learn how to communicate your needs in a constructive manner that can be received by your AS partner
3. Focus on small, positive changes
Don't expect big changes overnight or you will be disappointed and it will make it hard to stay on track. Imagine the smallest change possible that would signal a shift in how things have been going. Then focus on that.
4. Promise yourself that you will have a great future, no matter what.
You can not control what your spouse does, but you can control what you decide to do with yourself and your children, if you have them. Take a deep breath and envision how you are going to create a great future, regardless of your spouse's choices.
5. Exercise your worry away.
Take a walk, get some exercise to become more fit. Exercise can be a lifesaver. It helps to assuage worries, feel good about yourself and increase feel-good hormones like endorphins.
6. Do one new thing you enjoy.
Don't become stale just because you are having a shaky time in your marriage. Novelty will stimulate your brain and maybe even your heart and help you have a more positive outlook about the future.
7. Prioritize quality time with your children or other loved ones.
Be present. You will never be able to do your children's childhood again, so do your best to be with them mentally when you're with them.
8. If you get off track, get back on quickly without self-blame.
What separates the winners from the losers is not whether or how many times you get off track, it's how rapidly you get back on track.
9. Do activities that help you rediscover serenity.
Meditate, pray, hike in the mountains or watch a sky full of shooting stars.
10. Be kind, even if you think your spouse doesn't deserve it. You may be angry, disappointed, or even devastated by your spouse's choices and actions. However, rather than react to unsettling behavior, assume your spouse is lost and confused. Be patient, kind and steady.
FOR THE AS PARTNER
By turning your analytical powers onto the problems in your relationship, you can make tremendous strides to a better life. The pathway forward is laid out in a special section in the Neurodiverse Couples Counseling Center website. This work can be closely integrated with your couples therapy efforts.
The healing journey for a Neurodiverse couple is a long one. Like any other adversity, this can end up making you both better human beings with a deep appreciation of each other. I understand your struggle and would be honored to support you!