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Building a bridge of understanding and acceptance.

Neurodiverse Couples 

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 is Autistic (formerly called Asperger's Syndrome) 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 stereotypical"male" brains (although the autistic 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. 




It is easy for us to get trapped into the idea that my spouse is not "normal" or at least my marriage is not "normal".  But what is normal anyway?


The illusory nature of normal is captured in the following quote:


“I wonder if we recognize the irony of telling people to act normal, because to act is to perform a role that isn’t real. And I wonder if we truly understand what it does to a human being to tell them to pretend to be someone, or something, they are not, and how this demand requires people to repress, efface, and cover up who they really are.”

― Jonathan Mooney, Normal Sucks: How to Live, Learn, and Thrive, Outside the Lines


With the help of neurodiverse-sensitive therapy, most couples come to the realization that that "abnormality" is not the problem; rather, the difficulty is rooted in trying to fit into their own concept of normal. 


This shift away from "normal" expectations can free a couple trapped in thinking that labels them, shames them, and tell them, even in subtle ways, that they are the problem. If we can reorient the ways in which we view diversity, abilities, and disabilities, a relationship can be completely reinvented.



For better and for worse, the world of psychology used to place the label of "Asperger's Syndrome" (AS) to describe a group of people in the neurodiverse world. AS has since become part of a high-functioning autism (Autism Spectrum Disorder or ASD). Individuals in this grouping often have tremendous strengths while simultaneously experiencing difficulty with social aspects of intelligence. So we can use common language, I use the term Asperger's Syndrome or AS to describe our clients who tend to fit the symptoms formerly listed as part of AS and now ASD.


Although autistic partners feel affection towards others, they may not show it. Relationships may not be a priority for them in the same way as others do; thus causing confusion and disconnect in a relationship. Furthermore, on a day-to-day basis, people considered AS may be more focused on a particular interest, project or task than on the people around them. Yet, I have found that many of our autistic clients are genuine, honest, loyal, funny, make real contributions to the world that we live in, and deeply care about their partner and kids.


Often autistic adults and neurotypicals are attracted to each other and couple up. The neurotypical may be attracted to the autistic partner's stability, focus and intelligence. The autistic partner 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.


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.


Therapists who are not experienced with neurodiversity often tell clients married to autistic 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.


Autistic 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 autistic 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:

  1. the couple work and

  2. 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 during their relationship, accept each other's differences, and follow a clear roadmap to increase closeness:


    • Learning basic communication strategies as a foundation for communicating during counseling sessions;

    • Creating a safe space where the couple can begin to suspend judgment, see each other's unique qualities and strengths, and reset expectations without resentment. This may include a discussion of meltdowns, aggressive pursuit of a withdrawn partner or any other behaviors that may be experienced as reducing emotional or physical safety;


    • Identifying and naming the dysfunctional relational patterns that have build up over years and may be rooted in unaddressed neurological differences;

    • Considering other factors (not related to neurological differences) that may be impacting the relationship;

    • Assessing levels of motivation and making a commitment to the couples work;

    • Self-exploration and self-awareness through sharing personal history (including family of origin), successes and wounds;

    • Exploring how you personal story is impacting the relationship;

    • Identifying deeper unmet needs for each partner;

    • Identifying how each partner may be coping to get needs met or to simply survive (angry or critical pursuit, silent withdrawal,,);

    • Understanding and expressing how each partner's neurological make-up impacts needs and coping strategies;

    • Pursuing a diagnosis (COMPLETELY OPTIONAL) or Identifying the aspects of Autism that apply to you;

    • Accepting the diagnosis OR accepting your unique characteristics (for both partners);


    • Bridging the double empathy problem;

    • Expanding communication skills.

    • Acknowledging past wounds and charting a path forward. In a pre-diagnosis period, a couples history is often marked by misunderstanding, resentment, anger outbursts and withdrawal. This must get addressed in a healing way.

    • Learning different responses to traumatic reactions / triggers (move from defensiveness to providing comfort);

    • Meeting emotional needs through increased clarity and structure (Love List exercise);

    • Learning to play together;

    • Coping with sensory overload and meltdowns; 

    • Shifting from aggression to anger and then to underlying needs;

    • Expanding Theory of Mind for both partners;

    • Managing other possible struggles for both partners (including depression, anxiety, obsessive compulsive disorder and attention deficit hyperactivity disorder);


    • Time Management: Enabling time together (for connection) and apart (for self-care);

    • Parenting: Learn how to leverage your neurodiverse strengths to parent your children (whether or not your children are neurodiverse);

    • Special Parenting: Learn how to parent your neurodiverse children;

    • Sex: Meeting each other's sexual needs through managing different levels of libido, enhancing sexual communication, and addressing sensory issues;

    • Financial: Understanding how each partner feels and thinks about money and building a bridge across the gap.



Although these steps may seem daunting, there is good news. Despite the tendency of the autistic partner to be rigid and focused on himself, most autistic 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.


Autism 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.


Desmond Tutu has been quoted saying: “there is only one way to eat an elephant: a bite at a time.” Everything in life that seems daunting, overwhelming, and even impossible can be accomplished gradually by taking on small manageable steps. 


In fact, many neurodiverse couples that I counsel report that they are satisfied with the marriage and choose to remain in the relationship.


First, I do not like the diagnostic term "Autism Spectrum Disorder" and, instead, much prefer "Autism Spectrum DIFFERENCE". When considering all the strengths and weaknesses, my clients are no more "disordered" than many other people.

Secondly, 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 26 or higher (50 points total) indicates the possibility of Asperger’s

    • 80% of autistic people score 32 or higher

    • Most non-autistic males score 17 on average

    • Most non-autistic females score 15 on average

  • Empathy Quotient (EQ) Test 

    • a result of 30 or below indicates the possible absence of Asperger’s

    • 81% of people previously designated Asperger syndrome score 30 or lower

    • Most non-autistic males score 42 on average

    • Most non-autistic females score 47 on average

  • Ritvo Autism & Asperger Diagnostic Scale- RAADS-14.

    • ​scores of 14 and above out of possible 42 are indicative of possible Asperger's

When a formal diagnosis is requested and we agree that it will be helpful, I use a 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. 

To find out more about a formal diagnosis, please review the material at the Adult Autism Assessment Center.



Where appropriate, I encourage couples to consider if medications can help. There are no medications for Autism 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.





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).


I can highly recommend the following website where you can read about a group of therapists who are deeply understanding of your experience and who would love to help:

Believing Cassandra at




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.


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!


Do you think you might be autistic or ADHD?

If so, consider taking one of our 
Autism & ADHD Screening Tests.


If you are interested in pursuing a formal or informal diagnosis for yourself or your partner, please know that I am also the clinical director of the Adult Autism Assessment.


Many of our couples have daughters on the spectrum who desperately need autistic-aware therapy. If this is you, please consider this unique resource, She Rocks the Spectrum, a therapy center for autistic girls and young women.

Book: Asperger Couple's Workbook
Book: Asperger Syndrome
Book: Thinking in Pictures
Book: 22 Things
Book: Marriage & Lasting Relationships
Book: Journal of Best Practices
Book: Going over the Edge
Book: Asperger Syndrome and Long-Term Relationships
Book: Alone Together
Book: Aspergers in Love
What is Normal?
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