Attention Magazine February 2023

ADHD symptoms can profoundly affect intimate relationships such as dating and marriage. But even though ADHD is present, it doesn’t mean that the person with ADHD is the sole cause of the problems. Transforming a relationship starts with both partners understanding the role that ADHD plays and the importance of non-defensive listening, says Melissa Orlov, founder of ADHD Marriage. She spoke with Attention executive editor Susan Buningh about how couples can create a responsive relationship that feels “just right” for both individuals. Excerpts from their ADHD 365 conversation appear below, edited for length and clarity.

Considered one of the foremost authorities on the topic of how ADHD affects adult relationships, Orlov helps couples affected by ADHD to rebalance their relationships and learn to thrive through her seminars, consulting practice, and books. She also teaches marriage counselors and other professionals about effective marriage therapy for couples affected by ADHD.

SUSAN BUNINGH:
Melissa, you’ve worked with a lot of couples whose relationships are affected by ADHD. Why are you thinking about “just-right” relationships?

MELISSA ORLOV:
That’s a really good question. I have been working with couples for a long time now, and one of the things I see is that there are expectations couples have—or particularly the neurotypical people in these relationships have—that the relationship is going to look exactly like what they envisioned it was going to be even before they got married. And with an ADHD-impacted couple that typically isn’t what actually happens, because the neurotypical vision of the perfect relationship doesn’t fit very well with how the ADHD brain actually functions. I’ve been giving a lot of thought to what the “just right” relationship looks like, where both partners are satisfied or very happy with what they’ve got, but that it typically isn’t what either one of them envisioned when they went into it.

BUNINGH:
What are the basic characteristics of a “just right” relationship?

ORLOV:
You have to back up to What does a really good healthy relationship look like?

When ADHD is part of the picture, statistically speaking, couples are probably struggling, getting embroiled in the fights about what they’re having in between them rather than in the base level question, “What does a healthy relationship look like?” And so if you back up to what people want out of relationships, you back up into things like a respectful relationship, one where you’re loved, one where you’re heard, those kinds of things. That’s not what’s going on for most of these couples at the time. So, it’s good to get that perspective and to understand that regardless of who you are, there are some very baseline, basic elements that must be in a relationship in order for it to be healthy, including being respectful toward each other.

BUNINGH:
Where does ADHD treatment fit into creating this sort of relationship?

ORLOV:
ADHD doesn’t have to be a problem in a relationship; some of these relationships have no issues at all. But if it is a problem in the relationship and the couple is struggling, ADHD symptomatic behaviors are probably playing a role in that. And that’s not to say the ADHD partner is responsible for marital problems, because it’s the expression of whatever symptoms either partner brings to the relationship and then the responses to those symptoms from the other partner that really creates the dynamics. So, both partners are in it.

But ADHD treatment takes a person who is almost by definition what I call consistently inconsistent, and helps make that person more reliable, more in control of where they’re going and what they’re doing, and how they’re expressing themselves. So if you have impulsivity as a key characteristic of your ADHD, or distractibility, treatment helps you take the pause that you need to think: “Do I want to do this thing? Do I want to say that thing?” It’s just a fraction of a second or two, but just having that pause puts you as the person with the ADHD back in control of your life. You get to express yourself the way you want to.

BUNINGH:
There seems to be a conflict between maintaining trust and the inconsistency that can come with ADHD. How can couples put this into perspective?

ORLOV:
If you say to somebody who’s walking down the street, “What does it mean to trust your partner?” Lots of times what they’ll say is, “We’ll agree to something and I will know for sure that my partner will do it.” That’s one element of trust; it’s not the only element of trust, but it’s a critical one that if you have ADHD, it’s pretty hard to fulfill. That isn’t to say you’re not a good person, it just means you have these symptoms.

People with ADHD can be and are trustworthy people, but they need to have a slightly different system in place with their partners. One that includes the fact that there may be inconsistency in their performance. They need a way to get back to their partner pretty quickly and say, “Oh, you know what? I said I was going to do this thing by Tuesday, but it turns out that something came up on Monday and got in the way, so I know I’m not going to get to it by Tuesday, or I’m not sure I’m going to get to it.” Or not even agreeing to it by a specific deadline in the first place.

There needs to be a very realistic, open communication back and forth between the partners. At that point, then, what you have, hopefully, is two partners who understand that this inconsistency is there, but it isn’t an indication of whether the person is trustworthy. It’s an indication of having the symptoms of ADHD, which is a very different thing.

BUNINGH:
How much accommodation of ADHD is too much?

ORLOV:
I’ll tell you where it ends up being too much—when you have what I call “parent-child dynamics,” where the non-ADHD partner is over-functioning. They take on a managerial role, a sort of bossy role, “We’re going to do it this way.” They start educating the ADHD partner, “If you did it this way, it would be faster,” and they become the sort-of leader and the ADHD partner takes on a sort of a childlike role in that relationship. They under-function in the relationship and you end up turning the ADHD partner into somebody who’s incapable. And that’s not the case. It’s not that these partners are incapable, that’s not the issue at all. The issue is they do things very differently. A good accommodation of ADHD is accommodating the way that a person with ADHD does things, accommodating the speed with which they do things—which typically, but not always, is a little slower than the non-ADHD partner for a variety of reasons. And then really integrating that into the relationship—how you understand each other.

BUNINGH:
So—please answer for both partners in the relationship—how do you get your own opinions heard when you disagree?

ORLOV:
The first issue is one of being calm. One of the characteristics of people with ADHD is they often have what’s called emotional lability, which means that they have a more extreme response emotionally, and also a faster response emotionally, than people who don’t have ADHD. Keeping that relationship calm and expressing yourself, not in the heat of the moment if there is heat, but withholding that and then coming back in a way that doesn’t trigger defensiveness. But, in a nutshell, it’s non-aggressive speaking and non-defensive listening, and this is a skill that couples can build. You’re not born with it, but you just practice it. That’s a great way to be heard on both sides. If you’re non-defensively listening, your partner in theory can be heard. You can hear what your partner is saying, and even if you don’t agree with it, that’s okay. The fact that one of you holds an opinion makes it worth being explored.

BUNINGH:
What if controlling and defensive behaviors are really entrenched? What do you do with the partner’s continuing effort to control?

ORLOV:
In a therapeutic situation, typically I would confront those partners. I’m aggressive that way. I call myself an “activist counselor.” I don’t sit back and go, “So, how do you feel today?” That’s not my style. You really have to hold up that mirror and show people how destructive the behavior that they’re holding onto is to them personally. So, the thought often is, “If I behave this way, I will teach my partner something, or I will demonstrate in a really obvious way how I feel.” But, if you’re making your partner defensive, that partner is closed down, they have a wall up, they’re incapable of hearing how you feel.

So, you really have to shift the conversation around to something which is, it’s in your best interest to be calm, honest, open, respectful, et cetera, and teach people how to do that. And it’s not an issue of putting lipstick on a pig. It is really genuine; if you want to have a healthy relationship, respect has to be part of this. How do we both diminish the anger and the frustration? And that’s where ADHD treatment can come in and a lot of other things. So, long-term work on that, and also improve the communication skills between you so that there is mutual respect and very importantly, equal status in that relationship between those partners. You can’t have the over-function, under-function thing going on.

Listen to the full recording at https://podcasts.chadd.org/e/adhd-and-the-just-right-relationship.

Melissa Orlov is the founder of ADHDmarriage.com and the author of two award-winning books on the impact of ADHD in relationships: The ADHD Effect on Marriage (2010) and The Couple’s Guide to Thriving with ADHD (2014). Orlov blogs for psychologytoday.com and ADHDmarriage.com, where she also hosts a large community of adults learning about ADHD in relationships. She has been interviewed by many publications and media outlets, including the New York Times, CNN, Today, and US News and World Report.

Susan Buningh, MRE, is CHADD’s director of communications and media relations and the executive editor of Attention magazine.