Good communication involves careful listening, being able to empathize with the person you are listening to, and then responding in a constructive, non-defensive fashion. It also involves communicating your own thoughts and feelings in a way that is not critical or accusatory, so that your partner can truly hear and understand what you are saying instead of becoming angry or defensive. This may sound simple and straightforward — stay calm, listen, empathize, respond, problem-solve — but when feelings overcome us, good communication skills are often thrown to the wayside as couples start to engage in denials, accusations, refusal to continue talking, interruptions, and countless other reactions that get in the way of positive communication.

Adults with ADHD often experience even greater communication challenges because ADHD impulsivity may lead to interruptions, even when emotions are not high; and ADHD distractibility may lead your thoughts to wander just as your partner is telling you something very important to him or her. Someone with ADHD may overlook non-verbal cues that their partner is becoming distressed because they are so caught up in the thoughts they are trying to communicate. And many with ADHD struggle with poor emotional self-regulation causing them to be hyper-sensitive and over-reactive to even mildly negative comments. Sometimes, those with ADHD are so caught up in the challenges of their own daily life that they can seem insensitive to the needs of their partner.

Relationship problems also occur when a non-ADHD partner misunderstands ADHD patterns and interprets their partner’s behavior as intentionally uncaring. For example, if an ADHD individual is often late, their partner may feel that this is due to lack of consideration. A greater awareness of how ADHD affects people could help them understand that lateness results frompoor time management rather than lack of caring. When an ADHD partner repeatedly works late or comes to bed late, their partner may misinterpret this as a sign of emotional distance or lack of caring. Messiness can be misinterpreted as lack of consideration instead of understanding that poor planning and organizational skills are the root cause.

Good communication and constructive problem-solving require a combination of both good communication skills and learning about ADHD so that behaviors are not misinterpreted and constructive problem-solving can take place.

At the Chesapeake Center we find that Imago Relationship Therapy offers a communication model that provides clarity and structure that is very helpful for those with ADHD. Although Imago communication patterns can feel awkward and unnatural at first, when it is learned with a skillful therapist, and practiced regularly at home, it can become a very natural, comfortable way of problem-solving that helps couples navigate around communication obstacles such as defensiveness, interrupting, and distracted listening. Imago Relationship Therapy (IRT), a couple’s treatment, was originally developed by Harville Hendrix, Ph.D., and described in his book Getting the Love You Want: A Guide for Couples (1990).

The Couple’s Dialogue is a structured communication process that is designed to help couples communicate about difficult or emotionally sensitive issues by creating a safe environment for both partners — an environment in which each partner listens carefully to the other and responds empathetically. This safe environment helps each partner relax their defensiveness so that they can once again feel connected and close to their partner.

The dialogue is ADHD-friendly because it provides a clear structure that helps those with ADHD to slow down, to avoid impulsive reacting or interrupting, and to carefully listen rather than listen distractedly. Instead of defensively preparing a response, the couples dialogue teaches each partner to carefully listen and respond to their partner before speaking of their own feelings or dissatisfactions. Knowing that “your turn will come” helps you to truly listen and hear your partner.

The Couples Dialogue consists of taking turns:

• • • • Mirroring — repeating your partner’s communication in your own words, to be sure that you have heard and understood your partner

      • Validating — communicating to your partner that what he or she has said makes sense from their point of view

      • Empathizing — expressing to your partner that you truly understand how the situation he or she has described feels

Each partner learns to talk in “I” terms, such as “I feel frustrated when you come home late for dinner so often.” Instead of accusing their partner by saying, “You are so inconsiderate when you come home late for dinner over and over again.” Speaking in “I” terms helps your partner listen and empathize rather than becoming immediately defensive.

Once this communication pattern has been practiced enough to become more natural, problem-solving is only a short step away. When neither partner has argued, interrupted, or become defensive — when feelings have been heard and understood — then problem-solving becomes much easier.

At the problem-solving stage, our Imago Therapists take advantage of their expertise in managing ADHD challenges, guiding couples to find more ADHD-friendly solutions to their dilemmas. For example, coming home late for dinner may be related to a long chain of events related to ADHD such as a night-owl tendency that leads to sleep deprivation or a late start to the work day; which, in turn may lead to lower productivity; which then results in a need to stay late to accomplish the day’s tasks. So the “solution” to coming home late from work may actually begin the night before, combating night owl tendencies and teaching the adult with ADHD strategies to go to sleep on time to get a full night’s sleep.

Relationships that are suffering from issues related to ADHD can often be repaired and helped to become more satisfying through:

• • • • Working hard to learn the structured, brain-based communication approach used in Imago Relationship Therapy (IRT). It reduces emotional reactivity, impulsive interrupting, and distracted listening patterns that so often get in the way of good communication I couples where one or both partners have ADHD.

      • Once problem patterns have been clearly communicated and understood, ADHD-problem solving can take place. The focus is on helping both partners understand the ADHD basis of many of their struggles so that behaviors are not misinterpreted and solutions can be found.

For ADHD couples therapy to be effective, it is essential for ADHD partners to take responsibility for management their ADHD — through exercise, sleep, medication, ADD-friendly lifestyle, and, when appropriate, individual solution-focused ADHD therapy such as the therapy we offer at the Chesapeake Center. It is equally important that a non-ADHD partner dedicate themselves to learning as much as possible about how their partner is affected by ADHD through reading books, attending support groups and actively participating in ADHD-focused couples therapy. Their partner cannot be “fixed” without their active participation in the process. ADHD affects both partners in a relationship and both need to work to find solutions and create an ADHD-friendly living environment at home.

Select References and Recommended Readings

• • Hallowell, E. and Hallowell S. Married to Distraction: How to Restore Intimacy and Strengthen your Partnership in an Age of Interruption. New York: Ballantine Books, 2010.

  • Hendrix, H. Getting the Love you Want: A guide for couples. New York: Harper Row, 1990.

  • Pera, G. Is it You, Me or Adult A.D.D.? Stopping the Roller Coaster when Someone You Love has Attention Deficit Disorder. San Francisco: Alarm Press, 2008.

  • Orlov, M. The ADHD Effect on Marriage: Understand and Rebuild your Relationship in Six Steps. Plantation, FL: Specialty Press, 2010.