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Therapy For Couples With Autism Spectrum Disorder: What I Do And Why

“…when you find yourself staring defeatedly at your spouse over breakfast or watching them hunt through the dryer for a pair of socks, and you wonder, Who in the hell did I marry?-and you will-I can now say with absolute certainty: there is hope. You can turn things around.”

The Journal of Best Practices: A Memoir of Marriage, Asperger’s Syndrome, and One Man’s Quest to be a Better Husband

As a clinical psychologist who specializes in adult Autism Spectrum Disorder, I’m often asked whether it’s possible for neurodiverse couples to have a relationship as satisfying and fulfilling as normal couples. The answer is, yes, of course. Autism Spectrum Disorder doesn’t prevent two people from loving each other any more than any other mental, emotional or physical difference. It’s not the condition that keeps two people apart, it’s what they do with it.

That said, a couple where one person has Autism Spectrum Disorder and the other doesn’t is bound to have challenges. How then do they overcome those challenges and achieve the well-being and satisfaction necessary for a successful relationship?

Here are the steps I use in neurodiverse couples therapy to achieve relationship success.

The Assessment

My initial goal in working with couples is to determine whether the identified Autism Spectrum Disorder partner has, in fact, a correct diagnosis. This may require a preliminary assessment, if one has not yet happened, or a review of an existing assessment.

Assuming the diagnosis of Autism Spectrum Disorder is accurate, my next step is to evaluate the couples’ communicative style, that is, how the partners shares information with each other. Are they competitive vs. affiliative? Direct vs indirect? How do they communicate about differences? What emphasis is there on understanding each other and their individual needs, worries, goals, plans, preferences, etc.? What flexibility exists in how they communicate?

I also want to find out what each person’s goals are for the relationship and how different or similar the goals are for both partners. Different goals are not necessarily bad. What is important is whether the couple is aware of the differences and whether they can agree to work within those differences, recognizing that meeting each person’s need is not only possible but vital for the relationship to improve.

Finally, my task as a couples therapist is to determine the degree and extent to which each partner is willing to work for change. If the motivation to change is absent or diminished beyond repair, couples therapy will not succeed.

The Work of Neurodiverse Couples Therapy

Helping couples change is generally complex. Dysfunctional communication patterns, disparate relationship goals, frayed trust in the other, lingering feelings of betrayal and disappointment, resistance to change, competing outside interests—these and other challenges within a relationship must be uncovered and addressed in a lasting way for progress to occur.

Lack of reciprocal communication is a frequent problem with neurodiverse couples. Sharing conversations, activities, and resources is either minimal or non-existent. While the non-Autism Spectrum Disorder partner typically seeks emotionally intimate interactions as a way of feeling understood, validated and cared for within the relationship, the Autism Spectrum Disorder partner often is fearful of being entangled in the complexities of interrelating, sharing and forming intimacy. This must be understood and worked through for the relationship to grow and succeed. A frequent focus of the couples work is conflict management, that is, replacing negative conflict patterns with positive interactions.

Essential to bringing neurodiverse couple together is a thorough understanding of Autism Spectrum Disorder, for both partners. Each must learn the problems or challenges that are central to Autism Spectrum Disorder, what they mean and how they shape a person’s life. Without that understanding, and an appreciation of the challenges and strengths of someone with Autism Spectrum Disorder, it’s hardly realistic to assume change will happen.

Improving a neurodiverse relationship can be compared to learning a new language. Both partners are well advised to imagine the other as resident of a different country, and to recognize that succeeding together depends upon understanding the language, customs and etiquette of that country.

Learn more about what I do and why in neurodiverse couples therapy.

The Couples Therapy Contract

While recognizing that each couples’ needs and circumstances differ, and that it’s important to be flexible in how we work together, I do have several basic requests of each couple I see.

I suggest that we agree to work together for at least six months. In my years of experience, I’ve found that lasting change for couples is not usually achievable in less time.

Also, I often meet individually with each partner, from time to time, in addition to meeting as a couple, in order to help with challenges that are better suited to one-on-one work.

Using this framework for the therapy along with an understanding of what neurodiverse couples work requires, satisfying and lasting change is a very much a realistic, achievable goal.

In Conclusion

Neurodiverse couples therapy offers a promising path for partners where one individual has Autism Spectrum Disorder. These couples can experience a relationship that is as rewarding and fulfilling as any other. The key lies in understanding the unique challenges presented by ASD and actively working through them with informed strategies and empathetic communication.

The process begins with an accurate assessment of ASD, followed by an evaluation of communicative styles and relationship goals within the partnership. Therapy For Couples With Autism Spectrum Disorder involves addressing issues such as dysfunctional communication patterns, differing relationship aspirations, and the need for reciprocal emotional exchange.

A crucial element in this therapeutic journey is gaining a comprehensive understanding of Autism Spectrum Disorder’s impact on both partners. This knowledge fosters empathy and paves the way for positive change. By approaching their differences as if learning a new language—complete with its own set of customs and etiquette—neurodiverse couples can bridge gaps in their interaction.

With a commitment to at least six months of therapy for adults with Autism Spectrum Disorder, which may include both joint sessions and individual support when needed, lasting improvement is not just hopeful but expected. Through dedicated work within this framework, neurodiverse couples can achieve satisfying relationships that thrive on mutual respect, understanding, and love.

Dr. Kenneth Roberson is an Autism Spectrum Disorder psychologist offering Neurodiverse couples therapy in San Francisco, California for over 30 years.


Dr. Kenneth Roberson

Dr. Kenneth Roberson is an Adult Autism Psychologist in San Francisco with over 30 years of experience. Click below to ask a question or schedule an appointment.

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