Lee Crespi, LCSW

The same week that the New York Times printed a very good article entitled, "Attention Disorders Can Take a Toll on Marriage"   I was contacted by web journalist Jaleh Weber to be interviewed for a piece on the same topic.  I am so glad to see that this subject is getting attention.  So here is a copy of the interview:

What is attention deficit disorder?

Attention Deficit Disorder (ADD, also referred to as ADHD – the H being Hyperactivity) is a broad syndrome, usually identified in children, and believed to be a neurological developmental difference characterized by hyperactivity, impulsivity and distractibility as well as problems reading visual social cues.   In more recent years, it has been increasingly understood to continue into adulthood and more adults are being identified as having some features of ADD .  Adults with ADD may be highly disorganized, chaotic, and forgetful, often lose things, are impulsive and distract easily. Their social skills may be compromised by their inability to read visual cues, and they may sometimes seem inappropriate or self involved.  Many adults with ADD, despite these challenges, may be highly successful but usually need to work harder and longer hours to be productive. Others, however, may find their work life suffering as a result of their ADD and consequently their self-esteem as well.  Secondary related problems may also include dependence on alcohol and drugs, or depression related to the difficulties in self-management.

What type of impact does attention deficit disorder have on relationships?

ADD can put a great deal of stress on a relationship.  It is easily mistaken for a lack of sensitivity or caring for one’s partner.  Forgetfulness may seem inconsiderate and even hostile.  Disorganization in the home can result in fights over “messiness” and “clutter” and also be seen as inconsiderate, indifferent and passive-aggressive.  Often, adults with ADD marry partners who are competent and efficient and this may result in either the non-ADD partner taking over many of the other’s tasks and responsibilities and feeling resentful and alone in the relationship.  Partners of people with ADD often complain that they cannot ever count on or depend on their spouse and that is a very lonely feeling.   The partner with ADD may feel devalued or experience low self-esteem as a result.  In couples that I have treated in therapy, the ADD is often a major source of conflict in the relationship.

How does a therapist help a person who has attention deficit disorder have a healthy relationship?

First of all, it is very important for both partners to fully understand the nature and impact of ADD.  For the person who has it, there may be some resistance to facing the reality of it because it is so much a part of one’s personality and it is has many positive features such as spontaneity, liveliness, adventurousness, creativity and extroversion.  Behind this reluctance to face the ADD may be fears of inadequacy and shame.  Most people with ADD have had to struggle to do what others take for granted, and blame themselves for being lazy, stupid, messy, etc.  However, by fully understanding the nature of ADD as a neurological difference, the individual may feel a sense of relief and greater empowerment to take steps toward improving their functioning.  This might mean working with an ADD coach who can help with tools and strategies for organizing one’s time and compensating for distractions and memory problems.  It might also mean taking ADD medication such Adderall or Strattera, which help improve focus and concentration. 

Equally important for the relationship, the partner of the person with ADD needs to understand that many of the characteristics that are so frustrating  are not really in the ADD partner’s control and are not the result of unconscious hostility, or a lack of caring, but result from a genuine inability to process information in an organized way.  This doesn’t mean that they shouldn’t or won’t have feelings about being let down, or burdened, or frustrated, but rather that the root of those frustrating behaviors is not a lack of love, but rather a genuine disability. 

What advice do you have for someone who has attention deficit disorder and is having difficulties in their relationship partly because of the disorder?

I would recommend that both partners learn as much as they can about ADD – “Driven to Distraction” is a good book with which to start - and also to visit some websites such as www.drheller.com/spouse_add.html.   I would also encourage them to consider couples counseling with a therapist who has experience working with couples where one partner has ADD - both as a way of expressing and processing pent up feelings and also to strategize and find ways to work together to address the ways that the ADD is interfering in their lives.