When Love Gets Lost in Translation

by Anita Robertson, LCSW

 Attention Magazine February 2024

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Love is always in the air, isn’t iT? Supportive relationships are key to positive health outcomes throughout one’s life. However, most of what we see in the media does not reflect what healthy relationships look like. Turn on the TV, watch YouTube, go to social media, or listen to some music and you find yourself constantly bombarded with messages about what love “should” look like. We hear and see these messages so often that we don’t even realize we’ve internalized unreasonable and even absurd myths about love including, “relationships should always be easy,” “we should give each other butterflies all the time,” or—my personal favorite—“true love can magically change a person.”

ADHD and RelationshipsWhen reality strikes—and it always does if you stay in a relationship for any length of time—these myths-turned-beliefs foster conflict or silent disillusionment, especially when one or more partners have ADHD.

Most partners in ADHD relationships work super hard at trying to support each other, yet when they don’t have success (because they don’t have the right tools and don’t understand executive functioning challenges), it can get quite messy, figuratively and literally.

Here is the issue: There is a lot of advice out there on how to build healthy relationships, but very little specifically for and about what ADHD adults and the people who love them require to thrive in love. This is because things get lost in translation in neurodiverse relationships. While there are great couples counseling interventions that help many partners go from fighting to flourishing, some of my favorite couples therapies include features that can be harmful if not adapted for ADHD and executive functioning challenges.

Positive, supportive relationships make a huge difference in whether adults with ADHD thrive. When adults learn ADHD-affirming tools, they see a difference quickly because they are able to understand one another’s “language.”

Thriving in some environments, struggling in others

Approximately six million, or 9.8 percent of children in the United States, have an ADHD diagnosis according to the CDC. While our school systems are making great strides in understanding the ADHD brain and how to create a more productive learning environment for ADHD children, most adults with ADHD did not grow up with these advantages in school. They endured a learning environment that was challenging (if not toxic) for their brains, frequently receiving negative messages that they were bad, lazy, or a problem (to name a few). No one knew how to give them skills to help develop their executive function, much less the appropriate support for sensory processing differences. Creative and resourceful, ADHD kids back in the day were left to find their own workarounds in this non-ADHD-dominated world.

As adults, many found work environments in which they could excel. These professions usually come with a lot of stimulation, crisis, and action—entrepreneurs, emergency service professionals (police, firefighters, ER doctors/staff), or creative/artistic roles. It can be mind-boggling for partners (and sometimes the ADHD individual him/herself) to see a person be so successful out in the world yet struggle with simple tasks at home.

I like to divide the differences in the ADHD brain and body into four categories that explain why ADHD adults thrive in certain environments and can struggle with the same task in a different environment. When ADHD clients and their partners grasp these differences, they typically say, “Wow, this explains A LOT.”

Default Mode Network (DMN). The DMN is an essential brain network associated with daydreaming, self-reflection, and interpreting the actions and intent of others, among other important functions. In non-ADHD individuals, the DMN shuts down when they focus on completing any kind of task. But the DMN does not turn off in the partner with ADHD. Even when they’re engaged in a task, the DMN continues to run in the background and create distractions. However, when treated with methylphenidate or when they stand to gain a high-value reward, the DMN has been shown to turn off according to research studies. This explains why high reward (which includes something they are interested in, including your recognition and praise) and/or medication makes a big difference in the ADHD partner’s ability to focus on and complete tasks.

Neurotransmitters. Dopamine and norepinephrine, the neurotransmitters that “reward” the brain and assist focus, work differently in the ADHD brain. The ADHD brain has less dopamine, for example, so it requires external rewards, like praise, to focus on a task they are not interested in. Relationship confusion ensues as people watch their ADHD partners focus on big projects at work that generate a high reward, but struggle to accomplish the little things at home (that tend to have very little external rewards). This also increases their risk of engaging in short-term dopamine boosts that can have negative consequences, like shopping, binge eating, and consuming alcohol. Knowing one’s praise and dopamine needs and how to get a healthy dose of them are key for success.

Sensory processing differences. Several studies show that kids with ADHD have one or more sensory processing differences that correlate with ADHD traits like hyperactivity. This is why using sensory techniques in relationships can go a long way. For example, a partner with ADHD can focus better seated on a swing, hammock, or yoga ball when they are having a conversation or doing work.

Supportive relationships. There are many studies that show positive support from a parent/teacher actually changes adaptive brain development. Recall that most ADHD adults had little to no positive reinforcement during their school years. Negative (critical) support impacts the parasympathetic nervous system for ADHD, blunting its response which is key for emotional self-regulation. This is why positive support from one’s partner is so important.

The Five ADHD Relationship Pillars

In the beginning of a relationship, there is a lot of reward, novelty, and interest that makes it easy for the ADHD adult to go above and beyond. As the relationship incurs more executive functioning demands like buying a house or having kids, executive functioning challenges often cause frustration that leads to criticism. This can escalate into a negative cycle if ADHD-affirming support is not present.

The Five ADHD Relationship Pillars below serve as a compass for relationships and make a huge difference because they are working with the unique features of the ADHD brain and body.

1. Growth Mindset
Focus on the process over the outcome. This means working hard, embracing failure (because you have to fail in order to learn), and accepting that you will continue to grow throughout life. Celebrate what is working first, praise effort, and THEN give constructive feedback.

2. Praise
Praise is fuel for the ADHD brain. Edward Hallowell, MD, coined the term recognition responsive euphoria or RRE. No doubt, praise and recognition can motivate the ADHD brain to create unbelievable things, while slight or perceived rejection or criticism can freeze one in their tracks.

3. Positive Acceptance
Simply put, this is loving and accepting someone for who they are. All adults with ADHD bring different strengths and struggles to relationships because so much of their challenge is finding motivation to do things they are not interested in. Due to the differences in the ADHD brain, they do not experience the usual reward that comes with a sense of completion for having done the dishes or put away the laundry. Setting boundaries comes from this pillar.

4. Games
This pillar is about novelty and play, something we all need yet are taught to dismiss. An ADHDer’s love of play and novelty is often what is attractive to their partner in the beginning.

5. Acknowledgement
Recognizing that what is easy for one can be hard for another goes a long way in staying connected. So much of the conflict comes from the interpretation that the person must not care because they do not do the “thing.” This pillar helps give high quality praise for those mundane tasks at home because it is harder for their ADHD partner.

Couples that have been to counseling for years find that using the Five Pillars and ADHD-affirming tools found in my book, ADHD & Us, changes things drastically because their efforts finally have an impact. These small tweaks help partners speak each other’s language, reducing the chances of things getting lost in translation.

Techniques for incorporating the pillars

Here are three techniques that incorporate the Five Pillars for your ADHD partner:

Praise, praise, praise. If you want someone to do the dishes (or any mundane task), make a huge deal of how amazing it was for them to do it. What may be a simple task to you is actually a really challenging task for an ADHD brain, and a big praise reflects the amount of effort they made. Commenting “it’s about time” or “it isn’t that hard” minimizes the effort they’re making. A big authentic acknowledgment will go a long way in reinforcing the motivation to work at something the ADHD partner thinks shouldn’t be that challenging. The belief that giving praise will reinforce bad behavior is working against an ADHD brain.

Defuse defensiveness. If you notice your partner becoming defensive over a question or comment, try asking if they heard criticism or blame and let them know that you didn’t intend it to come off this way. A lot of ADHD brains hear blame when other brains don’t. Knowing this can help de-escalate or prevent potential conflicts.

Value the gifts. Each type of brain contributes to the relationship. When you’re talking about things you need from one another, acknowledge the positive qualities that each of you brings to the table. For example, someone who may tend to run late may also be particularly flexible when something doesn’t go according to plan.

Here are three techniques that an ADHD partner can use to communicate better with their non-ADHD partner:

Repeat back what you heard. If you hear blame or criticism, ask your partner if you heard it correctly by repeating it back. Your brain may be drawing from past experiences that could make it sound like the statement is bigger than what the person actually intends. For example, when your partner says, “We’re out of coffee,” they may just be making an observation that they’re simply out of coffee, without a lot of feeling behind it. To an ADHD brain, it may sound like, “It’s your fault that we’re out of coffee,” which then triggers explanations as to why you aren’t at fault for not knowing the coffee is gone. Avoid jumping immediately to defend or overexplain and simply ask for clarification.

ADHD and Relationships - SheUse sensory tools during an intentional conversation. Your brain is able to process so much information so fast that it’s easy for you to jump in or change directions in a conversation without even realizing it. This can leave your partner feeling unheard or like there isn’t space for them to contribute to the conversation. Waiting three seconds to make this move (which will feel like an eternity, but only to your brain) allows the other person’s brain to connect with the topic at hand in a way that works better for them. Pressing hands together or using a sensory tool (like a fidget or swing) can give you the sensory input you need to pause to give your partner the time they need to share.

Value the gifts. Acknowledge and appreciate that your partner may do more of the small stuff or the mundane organizing. You can acknowledge how planning ahead helps your relationship stay organized and, by being so efficient, makes more time for fun activities to do together.

REMEMBER THAT YOU DO NOT HAVE TO FIGURE OUT EVERYTHING BY YOURSELF. Relationships benefit from outside support. Finding an ADHD relationship therapist or coach is a gift to your relationship. It is easier to learn new things—and prevent your love from being lost in translation—with the right support, and when things are feeling good!


Anita Robertson, LCSWAnita Robertson, LCSW, is a psychotherapist in Austin, Texas, and the author of ADHD & Us: A Couple’s Guide to Loving and Living with Adult ADHD. She is the creator of the ADHD Relationship Bootcamp to help neurodiverse couples develop new skills to improve their relationships. She believes in the power of a relationship to transform people’s lives in meaningful ways and loves seeing couples grow together. She received her Master’s in Social Work from the University of Texas at Austin and her Bachelor of Arts in Psychology from the University of Rochester. She loves spending free time with her family, hiking, traveling, and socializing.

ADDITIONAL READING & REFERENCES
Blum K, et al. Attention-deficit-hyperactivity disorder and reward deficiency syndrome. Neuropsychiatric Disease and Treatment. 2008 Oct; 4(5): 893–918.
Breaux R, et al. Longitudinal Associations of Parental Emotion Socialization and Children’s Emotion Regulation: The Moderating Role of ADHD Symptomatology. Journal of Abnormal Child Psychology, Volume 46, pages 671–683, (2018).
Dellapiazza F, et al. Sensory processing related to attention in children with ASD, ADHD, or typical development: results from the ELENA cohort. European Child & Adolescent Psychiatry 30, 283–291 (2021).
Fosco WD, et al. Evaluating cognitive and motivational accounts of greater reinforcement effects among children with attention-deficit/hyperactivity disorder. Behavioral and Brain Functions. 2015 Apr 29:11:20.
Hallowell E, Recognition Responsive Euphoria,’ or RRE, blog dated June 11, 2019 on drhallowell.com.

 

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