Neurodivergence and Relationships

The concept of neurodivergence rests on another concept - that of diagnosis. To be able to discuss neurodivergence and relationships, we first need to quickly overview the idea behind diagnosis.

We humans love to categorise things. It helps us deal with our world. We separate animals from humans, plants from animals, good people from bad people, lazy people from ambitious ones, and so on.

Experts in any field will do the same. A builder will tell you if the problem is repairable or if you need to replace that area of your house. A dentist will tell you if the tooth is dead or if it is still alive, or identify if you have a cavity from the normal functioning of a tooth.

Psychiatrists are no different. They study the brain and will then put people who come to see them into categories. This has some benefits and some shortcomings. On the positive side, it can:

• Be helpful as a way to improve understanding more quickly. With that understanding we can explain to the client how the pattern functions and what are the best ways to address it. For example, we know the things that people who are depressed tend to struggle with in life and how to help them and so we don’t need to start from scratch with each person who comes in describing a problem that fits with depression.

• Creates a word to refer to the pattern and tendency in question. For example, if we are referring to someone’s tendency towards impulsivity, it’s helpful to have a word to refer to that.

On the negative side, it can:

• Lead people to not look further at what is behind the label. For example, once the label of depression is applied, there is a risk that the person diagnosing does not look at the cause. Depression can be caused by many things such as dissatisfaction at work, relational problems, and high anxiety. It is important to look at what is driving the problem rather than just diagnosing depression.

• Lead to misdiagnosis. For example, someone may be bipolar but diagnosed as simple depression. Or someone is diagnosed with ADHD when in fact they have Autism.

• Negate the positive side of the tendency in question. This is a downside that comes from the fact that diagnosis is based on the medical model. The problem with this is that essentially all diseases are negative (no one wants cancer, an infection, or high blood pressure). But when this is applied to people who have a unique brain that works differently, it negates the positive side of that tendency and sees it solely as a negative. For example, people who have a tendency towards depression are often very empathetic people while ADHD people can be highly successful in fast-past situations such as entrepreneurship, business, finance, or other such occupations.

• Create a passive approach to the tendency. Another consequence of the medical model is that for most medical problems, the person just needs to seek the right treatment, take it, and wait for the disease to cure. That is not the same with brains that work in unique ways, we often need to work hard at managing our tendencies so that they are not so impactful to those around

• Lead people to use the label as an excuse for their behaviour

The reality is that when working with someone, a word for a pattern is helpful to have so long as we are careful to not fall into the trap of the shortcomings of using such a label. One option is to talk about a tendency towards a certain problem (e.g. a tendency towards depression or ADHD) rather than seeking a formal diagnosis. This allows the tendency to still be managed without needing to even decide if it reaches the official threshold for a disorder.

When it comes to relationships, if someone’s brain works in a way that is very different to most people in a few key areas, it is likely to create challenges for the partner. Let’s take the example of someone who’s brain works in a way that is consistent with what we call ADHD (this often involves a busy mind and a tendency towards impulsivity, boredom, and addiction). This unique way of the brain working is going to create difficulties for the partner because connection requires consistency, safety, and presence but it can be hard for a partner with ADHD to provide this due to how their brain works. A person with ADHD will react quickly to things and that can then trigger a reaction in the partner, setting off a cycle of conflict. The partner of the person with ADHD may fight to get their attention or may suffer when an addiction emerges that has been hidden.

Another example is that of Autism (previously separated into two categories - Asperger’s Syndrome and Autism). With Autism, the brain processes stimuli and emotions differently to most people. It’s almost like the person does not have access in real time to their own emotions. Our emotions are a compass we use to guide us in social situations (such as knowing that if we say x, it will make the other person feel bad). But if that emotional information is not available to a person in the moment, they will often create inappropriate contact with others or not pick up on their partner’s emotions.

The same will happen with other types of neurodivergence. Being with someone who goes through the highs and lows of bipolar is incredibly hard, as is living with someone who seems to not feel emotions. Or feels them all very strongly. Or a partner who has high anxiety, or constant depression.

Having a different type of brain can still lead to a long-lasting and fulfilling relationship but sometimes it can mean that some management and understanding is required. The couple need to be able to discuss how the unique brain operates, how it impacts the partner, and to come up with a way of managing that impact. There may be things that the individual will also need to do to manage their own unique brain.

The first thing the therapist will need to do is untangle whether the relationship problems are due to a partner having a unique brain or if they are just typical relationship problems like any couple will experience. And it can be both. From there, the therapist can propose the best way to work with the two partners to get their relationship functioning well.