The consensus among AD/HD experts is that Imago Relationship Therapy often works well for these couples. This approach trains people to communicate and slow down enough to understand their partner's point of view. The structure of the dialogue is especially useful, because it encourages the person with AD/HD to stay on track and focuses on empathy, often a casualty of the untreated symptoms. Cognitive-Behavioral Therapy (CBT) seems effective, although it's important to bear in mind that recent studies touting it have utilized a form of this treatment specifically tailored to AD/HD and in conjunction with medication.
Individual or Couples Sessions First?
Each partner in a couple has been suffering a different type of fallout from unrecognized AD/HD, and it's admittedly tricky to meet both persons' needs at the same time. At least initially, Jeanine and Bart might benefit from individual therapy that would allow them to deal with their pent-up frustration and provide the psychoeducation about AD/HD that's a critical first step. The sooner each partner can start separating the symptoms from the person, the better. Later on, joint couples therapy with a therapist skilled in AD/HD would add an important component.
Starting out with joint couples therapy might be worth considering, however, because the therapist would have a greater chance of hearing the full story. "My partner's inaccurate self-observation with therapists has been a tremendous problem," one client in an AD/HD support group explained. "They all believed her characterization of events, and just encouraged her misperceptions, which only made her work life and our family life worse. Couples therapy has been a little better, because I can provide some checks and balances."
The good news is that adult AD/HD is eminently treatable. The first and most essential step for therapists is to reverse the trend and learn to recognize and diagnose its symptoms.
Gina Pera is the author of the bestselling Is It You, Me, or Adult A.D.D.? winner of four national book awards, including ForeWord Reviews' Psychology Book of the Year. An international speaker on adult AD/HD, especially as it affects relationships, she leads workshops and support groups for adults with AD/HD and their partners. Contact: www.ADHDRollerCoaster.org.
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