Treating Couples with an ADHD Member

Many couples come in to therapy because they are frequently in conflict due to their different “brain styles”. As a clinical psychologist, one characteristic brain style I see is the AD(H)D type. The member who has this brain style may actually have the diagnosis of ADD with or without hyperactivity, or have ADD-like behaviors. Whether or not this member actually has ADD or is ADD-like, he or she is difficult to live with, since the other member often has a very different brain style. They have become a couple because of their commonalities and their differences. At first the differences seemed appealing ( “Opposites attract”) and provided a balance in the relationship until they started living together.

Initially, in the typical situation, the ADD member was probably playful, fun- loving, creative, witty, outgoing and spontaneous. However, as the relationship continued, he exhibited poor listening skills, disorganization, bad time management, inappropriate impulsivity, excessive need for novelty, and often, lack of attention to detail and follow through with requests from the other member. The other was found to be more serious, very focused, a good listener and planner, although not particularly spontaneous. The usual complaints come from the non-ADD member, who starts to act critical and parental towards the other, who resents it. The non-ADD=2
0person will often say, ”He’s passive aggressive”. The ADD-like member usually says, ”He’s so critical and treats me like a child. I do my best but nothing pleases him”.

My first job is to talk about brain styles and how they work and don’t work together. Usually, even if it is known that one member has ADD, neither member is aware of the negative as well as the positive impact of this on the relationship. I try to dismiss labels such as “passive aggressive” and “narcissistic”, and reframe various behaviors. I work on having each member becoming aware of adapting to the other’s brain style with the goal of integration. I always point out that the cores of both brain styles won’t change ,but some changes in interactional behavior is possible, if the positives in the relationship are realized. For example, the non-ADDer has to curb her parental tendencies and discuss with her ADD mate specific tasks and deadlines they both agree on. Also, it is often useful for each to have separate domains for chores, finances, planning vacations, using the best skills of each. The need for novelty and stimulation that the ADDer has, often is not matched by the lower level of external stimulation the non-ADDer needs. The ADD member often craves a novel or stimulating activity ( and it shouldn’t be a dangerous one ) by himself while the non-ADD member can enjoy a more relaxing activity in her leisure time (such as reading). An important focus of therapy is having the ADD couple work together as a team that realizes that one brain style is not better than the other, just different. As a result of all the couples with ADD I have treated, my most useful role is as an ADD coach.


To Be Successful, You Need Coaching for ADD

Science News Addressing Concentration in the ADDer

It looks like there’s new technology on the horizon for the ADDer. Read the Science/ Medical Section of the Tuesday NY Times entitled “Ear Plugs to Lasers: The Science of Concentration”.

Scientists at M.I.T. are trying to enhance attention by sending pulses of laser light to an ear plug. The scientists point out that if this ultimately works to improve concentration in the ADDer, it would have fewer side effects than the use of stimulant medication. You would be wearing a device like a hearing aid.


Until the technology comes out, they recommend that you do one task to completion, preferably for 90 minutes, first thing in the morning, then take a 20 minute break (you can do other activities during this break) until the brain is ready to “boot up” and focus in on one other important task.. We ADDers are used to multitasking at all times, and only complete a portion of all the tasks (like reading one chapter of a book, and never going back to it). While multitasking can be a strength for us, it often becomes a weakness. So I think that multi-tasking only during breaks makes good sense.


What is your opinion of the Times article? If you don’t finish reading it, I’d still like to know whether or not you find multitasking a strength or weakness. Be sure to consult with your coach.

Excessive Worrying: Distraction or Stimulation for the ADDer

I am a clinical psychologist who coaches ADDers. But I have to admit that as an ADDer myself, I am constantly learning new things that go along with ADD. For example, I've always been a worrier, I even can worry excessively about happenings I can't control. I always tell my clients to worry only if it's a problem that may have a solution. If not, use cognitive strategies to stop the worrying process. Of course I don't follow my own advice. However, I'm becoming aware that excessive worry can serve several purposes for the ADDer.

First, I found that sometimes I worry about an unsolvable problem during the time I have important tedious tasks to do, so worrying serves as a distraction, and the problem I worry about doesn't get solved, the tasks I had to do also don't get done. As ridiculous as it sounds, worrying can be very stimulating when the current situation is boring, and ADDers crave stimulation even if it's useless.

I used to be quite a hypochondriac, and now realize that I spent an inordinate amount of time examining a whole host of symptoms. Of course, hypochondriacs are inadvertently reinforced by people who will listen to them. I have finally solved this ongoing maladaptive behavior pattern by only checking out symptoms that lasted for a long time or got worse. Now I realize what tasks I am trying to avoid, and find other means of stimulation. However, I'm going to Turkey in a few weeks, and am worrying about how to avoid contracting swine flu, particularly when on planes. Guess what.. I can't solve this, but am I still worrying because I think I can, or for stimulation, or as a distraction from other things I have to do. What do you think?