<DL><DD><DL><DD><DL><DT>AD/HD & Relationships: Communication is the Key! </DT></DL></DD></DL></DD></DL><DL><DD><DL><DD><DL><DT>By Dr. Ron Weinstein, Ph.D. Clinical Director
and Marlynn Block, M.A.
The A.D.D. Center </DT></DL></DD></DL></DD></DL>


<CENTER><TABLE cellPadding=6 width=600 bgColor=#ffffcc border=0><TBODY><TR><TD>"We don’t see things as they are, we see them as we are." Anais Nin (1903 - 1977) "...one can change things by the manner in which one looks at them." Tom Robbins

"Tell me and I will forget. Show me and I will remember. Involve me and I will understand." Confucius

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<CENTER><TABLE width=600 bgColor=#ffffcc border=0><TBODY><TR><TD>Many of the arguments and the resulting rages, tantrums or cold shoulders that arise between people in close relationships can often be traced to differences in perception and communication style. How we see and make sense of the world around us influences how and what we communicate to others. This usually becomes apparent to anyone involved in a relationship with someone who has AD/HD. Developing an understanding of these differences is essential to effective communication. As therapists who specialize in AD/HD, we work with children, adults, couples and families in numerous capacities. Our experiences with these folks is "in the trenches", often as part of a school PPT team, as coaches when emotional support is needed, or as objective observers in the heat of family battles, helping to prioritize issues that are causing unbearable discomfort.

We, ourselves, must deal with AD/HD in our own relationship. Ron’s AD/HD was undiagnosed during the first half of our marriage and there most likely would not have been a second half had it remained undiagnosed! We are fortunate to have been armed with a professional knowledge of AD/HD and first hand exposure to how it affects couples, so we have been able to work on our own lives and relationship with a clearer understanding of the differences between our communication styles. We use this knowledge to help our clients resolve issues that may have dissolved relationships in the past.

It's not difficult to understand how the "triad" of AD/HD symptoms — impulsivity, inattention and hyperactivity/restlessness, can affect relationships. However, we believe that these "visible symptoms" have somewhat less direct impact than the ways in which they have affected a variety of "hidden" developmental characteristics.

Most adults with AD/HD were not diagnosed until they were adults. Throughout their lives, they have suffered a great deal of pain. Many have had to develop coping mechanisms to help them survive. Over time, the constant pressure of trying to cope with their problems brought on by their new ways to cope can bring about stress. As a result, some adults become overwhelmed, depressed, anxious and lose confidence. Since we can't go back and change this history, we need to move forward and realize that the efforts we put into our personal growth create hope for a changed life. Newly diagnosed adults finally have an opportunity to closely examine their lives in a more reflective and meaningful manner and to understand why they made the choices they did. But as we are aware, just understanding doesn't guarantee anything will change.

Therefore, we work closely with our clients to help them understand who they are; identify their strengths, weaknesses, and the hurdles they have to overcome; learn what they need to do in order to grow and experience a sense of well-being.

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Who are you? At our initial meeting, one of the first things we ask a client is — "Who are you?" This usually catches them off guard. They might have thought about the concept during times of turmoil, but for the most part, the question never entered their minds. Are they comfortable with their "gut" reactions to things? Do they believe that what they feel is appropriate? Do they feel guilty about not doing something or then resent it if they do?

Adults with AD/HD typically have a problem identifying who they "really" are since throughout their lives they've tried to change their personalities to fit the situation at hand. Adding to this confusion is the fact that they can't often trust what they feel. For example, people may pretend they are wise and sophisticated, while worrying about being "found out"!

</TD></TR><TR><TD>Making Sense of Interpersonal Communication Good communication depends on people understanding one another's true thoughts, regardless of the words they happen to be using. Since our brains work so much faster than our mouths, we often use a kind of shorthand, which might have an entirely different meaning for another person than it does for us.

When two of us interact, we often experience what goes on in such different ways. If either of us could see the way the other views the relationship, it would probably make no sense at all. Adults with AD/HD must also contend with the three-ring circus performing in their heads — they are paying attention to the sound of the other person’s voice, experiencing past and future fears, becoming aware of the freedom to or fear of saying what they are feeling, and concentrating their efforts to get meaning from the other person’s words. The more involved they are in trying to be less distracted, the less involved they are in the conversation!

Unlike a "non-AD/HD" brain, which runs on batteries, the brain of an adult with AD/HD is like a wind-up watch that requires winding periodically throughout the day. The non-stop circulation of thoughts and ideas in the brain of a person with AD/HD provides stimulation and is a wonderful source of creativity, but it often creates difficulties with communication.

Words and meanings are not always the same.

From our experience, it seems clear that many of the difficulties experienced in relationships result from the fact that the meanings of the words spoken and the priorities placed on tasks are quite different for the individual with AD/HD. It's as if they speak a different language. This results in miscommunication, misinterpretation and misunderstanding! Thus we often hear, "That's not what I meant!" or "You don't understand!"

Problems with word retrieval cause misunderstanding. You must know where a word is "mentally filed" in order to retrieve it. Individuals with AD/HD often have difficulty maintaining an organized "filing" system since the AD/HD brain creates so many options. For example, a person with AD/HD may file the word "apple" under the letter "A," or "F" for fruit, or "R" for round or red and so on. She may file it differently every time. However, the person who does not have AD/HD will probably file it the same way each time, under the most universal choice — A for apple.

The disorganized filing system of a person with AD/HD impacts communication in a big way, causing him to seem hesitant or unsure while he searches through his mental file cabinet for the right word or phrase. During this time, the "lottery ball effect" takes over. Instead of numbered balls flying around until they drop down the tube, a word, idea or fragment of an incomplete thought may randomly and impulsively come out of the individual's mouth. If it is inappropriate, he may then respond by saying, "Oh, I didn't mean that!" Oftentimes, however, The recipient of the remark has difficulty believing he didn't mean it, especially if inappropriate remarks are made frequently.

A thought process begins when a question is asked. The person responding must stop, listen to what is being asked, compare this information to previous experiences, choose an option and then respond. The person with AD/HD most often has difficulty in step one - stopping. As such, the process does not occur and, like the balls in the lottery machine, what comes out of the mouth is often a surprise even to the person who said it! This happens because of the difficulty isolating individual thoughts in a brain that's constantly being filled with new ideas. The spoken word only becomes real when it is uttered aloud. It is only after the word leaves the mouth that the AD/HD individual can decide whether or not it make sense, and whether or not it's appropriate. So the statement, "I didn't mean that" should be taken literally.


Priorities

The level of importance we place on something determines our priorities. In our clinical experience, many couples have never even considered that their different priorities can profoundly affect their relationships. For instance, simple day-to-day activities that require planning and organizing may not be high priority tasks for adults with AD/HD. A task that is more stimulating, or one to which he may respond in a more extreme or "emotional" manner, is more likely to be a higher priority.

Differences in priorities and time urgencies are often reflected in the "no big deal" response. For example, walking past a bag of garbage without picking it up, leaving the lawn covered with leaves, or even driving past the library with overdue books and not returning them may not make any sense to some. In the mind of the adult with AD/HD, however, it is "no big deal", since their thought is "it will get done eventually."

Becoming Aware, Accepting Our Differences and
Developing an Action Plan

Adults with AD/HD are complex individuals. Adding to this inherent complexity are the emotional defenses resulting from years of being misunderstood and not trusted or believed. One goal is to be aware of what triggers these defenses, thereby reducing anxiety and anger, which allows the AD/HD adult to incorporate the tools for improving interpersonal relationships.

Acknowledging and accepting differences helps the adult with AD/HD to feel respected as a separate person. Only at that point, can the process of successfully negotiating differences and working on those issues or behaviors that may be inappropriate begin.

An "action plan" usually involves change, either in behavior, attitude, environment, or responsibility. Change is an essential part of life, yet one which can be extremely painful for many people. There is not much hope for a relationship in which one person takes no steps to change. Often, we find that the non-AD/HD person is more hesitant to change, because it has been easier to blame all past problems on her partner’s AD/HD. On the other hand, partners with AD/HD often believe that the partner must accept AD/HD as an "excuse" for certain behaviors.

Neither partner in a relationship has to accept unacceptable behavior. When a person who does not have the disorder seeks a support group to help deal with a partner with AD/HD who is sloppy, has frequent outbursts, or is unable to hold a job, in some cases, our advice is to forget it! Behaviors that lead to disorganization, screaming or unemployment can be changed, but only if the person with the problems is able and willing to make an effort to change. If he is not, we suggest re-thinking the reasons for remaining together.

Getting out "poisonous" feelings like resentment and anger is important, yet it's often difficult when one or both partners have a hard time keeping quiet or listening without interrupting. We use and suggest "emotion dumps", which are similar to the "10 & 10" sharing time encouraged by the Marriage Encounter movement. In this case, because adults with AD/HD are often impatient, we suggest making it a "2 & 2" — two minutes for each person to write on paper or via email about how they felt that day, what may have bothered them or share positive experiences. We suggest using "I" statements, reflecting how the person writing feels, rather than what he perceives has been done to him by others. Since this format is not face-to-face, neither partner can interrupt, be distracted by the other's words, or impulsively make a judgment leading to a blowup.

Another tool which helps gain clarity in the relationship is the Top Priorities List. Each partner compiles a list of what he or she feels are the most important daily and long-term issues to be dealt with. In many cases, the long-term priorities are similar. However, the differences in daily priorities are typically great. What the adult with AD/HD may consider "top priorities" is often in direct opposition to what the non-AD/HD partner gives weight to, revealing possible causes of tension.

Essentially, mutual trust is fundamental in a relationship that works. Mutual trust is based on the ability to correctly interpret what our partner is trying to communicate and vice versa. That process is the one that takes the most work, but as we tell our clients, life never gets any easier, we just hope to get better at dealing with it!


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another one to go with it

How Adult ADHD Affects Relationships: Strategies for Coping
Contributed by: Melinda White (Posted on 2004-10-20)


An adult with ADD walks into a relationship carrying a great deal of emotional baggage. This is especially true if he or she was not diagnosed until adulthood. Growing up knowing something isn't quite right but not knowing what it is, can lead one to make many erroneous conclusions. This can lead to the development of a negative and usually distorted self-image.



The messages an adult with attention deficits often carries with her, as well as her ADHD traits greatly affect her relationships. Looking at both the positive and negative traits that come with ADD can help shed some light on how strongly relationships are affected. There are as many differences in adults with attention deficits as there are similarities, however. Each person I've seen in my private practice as an MFCC is quite unique. Some of the traits I'll describe in this article, therefore, fit for some people but not for others. There are differences between men and women and between those who exhibit traits of hyperactivity and impulsivity compared to the more inattentive, disorganized type of person.



In this article, I'll discuss messages ADD adults bring with them into relationships, ADD traits, and strategies for coping with relationships when one partner has ADD.



An adult with ADD or ADHD (I'll be using the two terms interchangeably) grows up hearing many negative messages from others. Parents, teachers, coaches, and peers notice the ADD individual's difficulty sitting still, following through, attending to what they are supposed to and they often comment on it. After being criticized over and over for traits he has no control over, this often undiagnosed child starts to feel bad about not measuring up to other's standards. He begins to internalize the messages he hears from others. Over time a sense of shame develops. This child isn't trying to break all the rules. For the most part, he'd like to please the adults around him but he can't figure out how. He has no idea when his brain will kick in and allow him to finish his math sheet or play quietly with a sibling.



As an adult, these feelings of shame often continue. Most of my adult clients tell me they've spent their lives feeling ashamed because they were unable to complete the tasks asked of them, couldn't concentrate even when they wanted to, or just stood out as being the class space cadet.



This has led them to make erroneous conclusions about themselves. I've been amazed at how many times an obviously bright, articulate, and interesting ADD adult has sat in my office and told me that he thinks of himself as stupid. Frequently, a woman who I clearly believe is bright has spent years telling herself she is stupid because she can't figure out why she can't perform as well as others around her.



Other messages adults with ADD internalize include, "He (she) always blames me. If he (she) wouldn't be so picky, things would be fine. It's really his (her) fault for making such a fuss about those little things." Still other individuals have made numerous attempts to be organized, on time, and to follow through on tasks with little success. Many of these people say to themselves, "I can't do it no matter how hard I try." Another prevalent message I've heard in my office is more common with the higher achieving adult with attention deficits. He or she carries the belief, "I am a fraud and it's only a matter of time before "they" find out." This person manages to get his job done but may do so by putting in many extra hours to keep up with his non- ADD co-workers or the individual may get overwhelmed by lots of verbal directions and be petrified that her boss will discover incomplete tasks that she missed because of overload. These adults describe the feeling of always waiting to be found out.



Growing up with attention deficit disorder also means repeatedly receiving certain messages from others. Some of these messages are confusing at best while others are clearly damaging to one's self-concept. Such messages include: "If only you'd try harder." This can be an especially destructive thing to say because trying harder doesn't allow someone with ADHD to sit still any longer, to concentrate, or to complete tasks. Telling someone who is trying and still can't do it to try harder can only lead her to think poorly of herself for her lack of success.



"Don't do it that way." "Your way is wrong." Many children and adults with ADHD can see novel or unique ways to approach a task. Unfortunately, these creative ideas are often squelched by traditional thinkers who insist things be done "the right way".



Other ideas imparted to those with ADD include, "Why can't you just...do it ?" The "it" might be concentrate, get started on the assignment, clean up your room, or sit quietly. A child with ADHD doesn't know why she can't do it and often begins to see herself as inadequate when continuously confronted with her shortcomings. She is told time and again, "Sit still", "Wait your turn", "Don't call out", "Look at your mess!", "You'd forget your head if it wasn't attached to you!", "Pay attention", "You're just lazy!" These messages which usually come from well-meaning but frustrated adults can be very harmful to the child's sense of self.



Despite carrying this emotional baggage with him, an adult with ADD can be quite attractive to people he meets. He brings excitement and energy to life. He knows how to have fun and may show a wonderful sense of humor. This can be stimulating to others he encounters. An adult with ADD is often creative and sees new perspectives. Many of the adults I have met have a fresh or innocent way of perceiving the world. They have multi-faceted viewpoints and varied interests. I've met men and women who have a breadth of knowledge due to their varied interests and others who have a depth of knowledge in specific areas because they focus better on one thing at a time. Clients I've seen have usually been caring and empathic people. Despite their numerous setbacks, they manage to pick themselves up and try again. They have been both persistent and determined.



Being in an ongoing relationship with an adult who has attention deficit disorder brings one face to face with the problematic traits also associated with ADHD. It is often difficult for an adult with ADD to stay tuned in to conversations. She may become easily bored or just distracted by other stimuli. Due to the many obstacles encountered daily, he may believe he can't do "it" and may not bother trying. He may be unrealistic about time commitments, truly believing it will only take five minutes to make a stop and then comes home two hours late, infuriating his partner. An adult with ADD may have problems saying no to demands placed on her. After years of being criticized by parents, teachers, and partners, she may say yes to get others off her back. She often does this automatically without thinking through whether she can or wants to do what is asked. A related trait is difficulty setting clear limits. If one is easily distracted, underestimates how long it takes to do things, and feels external pressure to do his share, he probably has trouble setting a clear limit for himself. He, therefore, takes on more than he can do and as a result leaves many tasks unfinished or forgets important appointments in his harried state.



An adult who has ADHD may begin to resent the criticism she receives from significant others. This resentment makes her less likely to even try to find ways to be more responsible about the areas her partner is constantly complaining about.



Another recurrent theme I hear from adults I work with is that they have trouble trusting themselves. When a woman with ADHD repeatedly can't complete tasks within the time she expects, wastes entire days trying to get started on seemingly easy projects, and misses important details in conversations, she has trouble believing her intuition is right. She may, therefore, go along with what someone else tells her, even when she doesn't agree. These same people are then prone to let others determine their self worth. A man whose boss is always pushing him to do more, despite his record sales figures, may see himself as a failure at work.



In addition to the issues I've elaborated on above, adults with ADHD often have problems noticing social cues. If one is not attending to the nuances of facial expressions, voice tone, and body language, he is likely to miss the meaning of his spouse's words. This can lead the partner of a person with ADD to feel her spouse may not care about what she is saying.



Given all the difficulties, is a person with ADD, therefore doomed in his relationships? I do not believe this to be the case at all. An adult with ADD will, however, have to work harder at her relationships than her non-ADD peers. Relatives, friends, and significant others will need to be patient, flexible and understanding. The following strategies will help adults with ADD cope with important interpersonal relationships:




Be self-accepting. Your brain is wired differently. That does not mean you are inadequate. It means you will need to learn and practice techniques that will allow you to function up to your capacity. You and your physician may decide that medication is advisable.
Have realistic expectations of yourself. Figure out what you can realistically do. Begin by leaving extra time for tasks. You can also time yourself on your daily responsibilities to get an actual picture of how long things really take.
Give yourself credit for what you have accomplished. Allow yourself recognition even for the small steps you take. If partners, friends, and parents, comment on the positive steps that the adult with ADHD makes, it is likely to increase her efforts.
Understand your own limitations and plan for them. Determine what your most alert time is and have important interpersonal conversations then. Take breaks as needed to help compensate for your distractibility and to prevent getting overloaded, but agree to a follow-up discussion time.
Anticipate your needs in advance and make plans to deal with them. If, for example, you know a four hour Sunday dinner at your in-laws will leave you antsy, irritable, and impulsive, let your spouse know in advance that you will need to take a walk midway through the evening.
If you tend to forget appointments or responsibilities you've agreed to, or are constantly running late, use datebooks, a family calendar, Post-it notes, or other reminders.
Allow for burn-out time. Learn to recognize what activities leave you feeling spent and schedule time to recharge your batteries.
When making agreements with your significant other about chores, obligations, or even social events, plan a follow-up meeting. Decide in advance how to deal with it if the adult with ADD forgets to do what he agreed to. What is the best way for his partner to notify him? How can the partner be reminded to break her unhelpful patterns? If each member of the couple lets the other know what would feel like a kind and helpful reminder, success is more likely.
Significant others need to strike a balance. Recognize the limitations of your partner, but don't overcompensate for them as that may leave you feeling resentful. Rather than just doing the job for the forgetful adult with ADD, try job swapping so each person is taking on tasks that are more in line with their liking and abilities. Parents of ADD adults need to give their adult children room to try it their way and flounder if necessary. The adult can only learn to do it himself if parents don't take over for him.
Be honest with yourself and others as to commitments. Think through whether you have the time, energy, and desire to do what's being asked of you. If you feel "on the spot" and need time to determine this, tell your significant other you need to think about it and you'll get back to her about it. Admit when you've messed up. Others are more forgiving if you are not defensive about your mistakes. Make a plan to improve your performance and tell your partner how you will attempt to avoid that particular problem again.
Set limits for yourself. This ties back to accepting yourself and ADD's effect on you and to being honest with important people in your life. Say, "No" when it's appropriate. Recognize you can't do it all and don't even try. Kindly let others know when you feel overloaded or need space to recharge your battery.
Set up your environment to match your abilities and limitations. If, for example, you hate doing yardwork and can't afford to hire someone to do it, get a low maintenance yard. If sitting still for hours is difficult for you, pass on the invitation to see a three hour movie with a friend. If you concentrate best in a quiet setting with no distractions, create that area to use for bill paying or paperwork.
Do things your way if it works for you and doesn't hurt anyone. Your way may seem strange to others, but it's important to honor your uniqueness and creativity.


It is important for the spouse or partner of an adult with ADHD to understand the myriad of emotional issues that ADD adds to significant relationships. When a partner can understand these issues and accept them, the relationship has the best chance of success. Furthermore, the partner needs to recognize that an adult with an attention deficit cannot choose to turn her symptoms on or off.



The adult with ADHD can improve his relationships by getting appropriate treatment both to deal with the effects ADD has had on his life and to develop strategies for coping with current issues. Appropriate treatment should include working with a professional who has experience with adult ADD. Educating oneself about attention deficit disorder through reading and attending workshops is an important step. Medication is another component to consider. Couples counseling, group therapy, or behaviorally oriented individual therapy may also be be indicated, depending on each adult's needs.

Mspen, thanks for sharing these articles. A lot of good information.