ADHD in Relationships: Why Couples Therapy Is a Game-Changer
In today's fast-paced, unwell world, many professionals grapple with professional and parental burnout, anxiety, depression, and relational challenges secondary to inner child attachment components from two individuals’ past history within their family of origin. When Attention-Deficit/Hyperactivity Disorder (ADHD) enters the equation, these issues can intensify, leading to misunderstandings and emotional disconnects in relationships. Through couples therapy in San Diego, CA, these dynamics can be explored and understood in a supportive space. As a specialized couples therapist licensed in California and Pennsylvania, and meeting with couples from all around the world, I understand the intricate dynamics at play and offer therapeutic approaches that address these complexities head-on.
Understanding the Deeper Impact on Interpersonal Relationships
ADHD affects more than just attention and focus; it influences emotional regulation, impulse control, and executive functioning, which directly impacts everyone’s relationship uniquely. As a specialist who almost exclusively works with couples and individuals experiencing these symptoms, as well as a human with her own lived experience with the diagnosis, this can manifest as:
Executive Functioning Differences: Challenges in planning, organizing, and completing personal, couple, and family tasks can lead to frustrations between partners. Hyperfocus and or inability to complete vital tasks for daily functioning can be a real hardship for couples.
Emotional Reactivity: Heightened sensitivity, often referred to as rejection sensitivity and or impulsive reactions can escalate minor disagreements into significant conflicts, which can be very isolating and breed defensiveness, contempt, criticism, and stonewalling, which are indicators of relationship instability per the Gottmans longitudinal research on long lasting relationships.
Communication Breakdowns: Misinterpretations and forgetfulness may cause one partner to feel unheard or undervalued. When tasks and emotional outbursts are not repaired with strategies or effective communication, it can really be hurtful to either partner.
Recognizing these patterns is the first step toward healing and rebuilding emotional and physical safety and connection.
The Role of Trauma in Relationship Dynamics
Unresolved trauma can exacerbate the challenges posed by ADHD, particularly in couples, which research shows us may be an underlying reason for why ADHD is so prevalent in today’s culture. Many children are exposed to negative and shameful caregiving approaches, which can later be shown as adaptive or maladaptive symptoms. Past childhood and past relationship experiences may influence current behaviors, leading to:
Attachment Issues: Difficulty trusting or relying on a partner due to past betrayals or losses. Therefore harder to communicate and trust that the environment around them is currently safe.
Hypervigilance: Constantly being on edge, anticipating conflict or disappointment. Over time, this can lead to burnout and perfectionism. It can also create disconnection caused by shame, judgment, blame, and guilt. These patterns can put a strain on close relationships.
Emotional Numbing: Suppressing feelings to avoid pain, which can hinder intimacy. This can be through somewhat good intentions, not overworking, overstressing, overeating, over-consuming, or overcommitting.
Addressing TRAUMA is crucial for fostering a safe and supportive relational environment.
Therapeutic Approaches to Healing
There is no one correct way to heal a couple struggling with ADHD and Trauma. I’ve found that strictly following one modality often doesn’t work for couples experiencing these symptoms. They need a variety of approaches—eclectic and humanistic—that support emotional connection. These methods help build trust and encourage couples to believe in their ability to heal and restore their relationship. I’ve been studying therapeutic frameworks and evidence-based interventions since 2011. Over the years, I’ve focused on the modalities below because they offer fast, effective, and lasting tools. These approaches help couples connect through shared humanity and work toward their dreams. They also support effective conflict management, friendship building, and activities that encourage vulnerability. These are my go-tos:
Gottman Method Couples Therapy
Developed by Dr. John and Julie Gottman’s research-based approach focuses on:
Doing the small things often: I adore teaching about the small things often, and boy, do they add up and give us more information on the couple bubble.
2-minute partings x 5: Finding your partner and kissing them before you leave for work, and finding them as soon as you get home, no matter what.
5 minutes of admiration x 7: Finding specific things your partner does that make you want to choose them every day for the rest of your life and TELLING them. “Your Saturday morning pancakes make me melt, and I would be lost without them to look forward to every weekend.” “Your foot massages are the best thing, and I would be lost without them. “I’m the luckiest lady in the world, I caught myself a man with a plan!” It cannot be vague and lackluster that you could say it to your roommate, friend, or family member. Try your best here!
20 minutes of destressing conversation x 5: When returning after time away allowing your partner to vent, blow off steam, about a stresser outside of the relationship (i.e. work, family, commute, technology, politics, climate change, social) and you actively listen, postpone all agendas, make eye contact, ask valid question that invoke the meaning “tell me more, I am here to be on your side.” After 10 minutes, switch and you are the speaker and your partner does the same active listening to you while you vent.
Date night 1/7 days: 2 hours of fun activities with shared meaning. Does not mean you will love it every time. This needs to be based on shared values. I recommend that one partner plan the activity one week, and the other plan it the next. The goal is simple: if you’re having fun, your partner likely will too. So they get to have a pass to enjoy it to the best of their abilities (i.e., if you know they cannot participate, have a veto list of items one may want to plan, and the other.
Building Love Maps: Enhancing understanding of each other's worlds to foster deeper emotional and physical intimacy.
Managing Conflict: Teaching constructive communication techniques to navigate disagreements through compromise and true friendship/hero partnership. So many couples are not aware of their non-verbal and verbal comments that are pulling away their connection secondary to the 4 horsemen: Criticism, Defensiveness, Stonewalling, and Contempt. I absolutely LOVE recording my clients (with their permission, of course) to have them see and play back their emotional reactions to help them to grow with love and self-awareness. Just a simple eyebrow, or a curvature of the lip, or pursing that can signify repair, openness, or contempt, and these have a very big deal for a couple to reconnect and repair. This is especially powerful when we monitor our heart rate for flooding and go deeper to explore the deeper trauma work interventions below.
Creating Shared Meaning: Establishing rituals and goals that strengthen the couple's bond are SO MEANINGFUL. So many of us do not play or celebrate or find joy as adults, or continue to date each other with true intention to get to know them, deeply desiring to understand daily repair and tolerance of imperfection, must be established for reconnection, attachment, and keeping the connection to resolve the deeper issues.
This method is especially effective for addressing interpersonal symptoms in relationships. It can help with PTSD, OCD, Autism, ADHD, substance use disorders, and other trauma-related issues.
Internal Family Systems (IFS) Therapy
IFS, created by Dr. Richard Schwartz, posits that the mind comprises multiple sub-personalities or "parts," each with its own perspective. In couples therapy, I have found it to be especially helpful due to:
Identifying Parts: Recognizing the various aspects of oneself that influence behavior. Every single person I have worked with and encountered in my personal life is complex and multifaceted, with various parts that activate them deeply.
Healing Inner Wounds: Addressing past traumas that affect current relational dynamics allows for true attachment healing. As many of us know, there are various forms of attachment: anxious, avoidant, dismissive, preoccupied, and secure. When we are able to heal with our partner, we can heal deeper wounds from the past and become safer and secure.
Restoring Balance: Promoting harmony among internal parts to improve overall well-being. My favorite way to describe this is to embody the 8 C’s of Higher Self, which means no mental health present:
Calm: A sense of inner peace and steadiness, even amidst challenging emotions.
Compassion: Understanding and kindness towards oneself and others, particularly those who are struggling.
Courage: Bravery in the face of fear and vulnerability.
Confidence: Belief in one's abilities and worthiness.
Creativity: The ability to generate new ideas and approaches.
Clarity: Seeing situations and feelings clearly without judgment.
Curiosity: A willingness to explore and understand oneself and others.
Connectedness: A sense of belonging and unity with oneself, others, and the world. One knows what is true for them, they will decline and speak authentically to any part that is not acting right.
This approach is beneficial for individuals dealing with general emotional stress, trauma, and or grief.
Inner Child Work
This modality focuses on reconnecting with and healing the wounded inner child. It’s where many of our feelings of being bad, incompetent, or unworthy begin. These beliefs often stem from an unloving inner child or an unmet need carried by the adult child. This is a deeper wound that often comes from an unresolved trauma, where in our childhood, we were abandoned or shamed for being who we were. I have seen this so many times in deep trauma work, and it’s the most meaningful work I have found. These are often unspoken, interwoven, and deeply stored -taught to us within the first 1-18 years of life by the attachment figures in our lives, how we receive reinforcements for love and affection- engaging in caregiving are aka “empathic” and or control aka “narcissistic” control efforts to mitigate our deeper feelings of 1. Your love and self-worth are more important than mine. 2. My joy and my pain come from outside of myself. 3. I cannot handle the loss of love. The work of releasing this is actually understanding where it’s coming from and staying with it to heal it by:
Emotional Release: Processing suppressed feelings from past experiences and exploring if they are in fact overt or covert control aspects to control fear of abandonment, rejection, or unlovability. This can be so difficult to face due to the shame, silence, withdrawal, and fear of abandonment for so many of us.
Self-Compassion: Cultivating true kindness toward oneself, being the loving adult that you may have needed 0-18 years of age, pause and slow down before responding to these deeper gut inner child responses, which enhances relational interactions with self and others profoundly.
Empowerment: Gaining confidence to set boundaries and express needs effectively. This is a tough one for many of our generational trauma and filial piety folks, and can cause a huge contradiction for our closeness and connection with others if we don’t call out calmly, lovingly, and confidently from the foundation of pure self-love and inherent self-worth from being born and being present.
Inner child work complements other therapeutic approaches by addressing the root causes of emotional distress, often deeply rooted in codependency, so untangling it by compassion and self-love allows for more interdependence.
Integrating Therapeutic Modalities for Holistic Healing
As a couples therapist who specializes in deep shame symptoms such as ADHD, combining the Gottman Couples Method, IFS, and inner child work provides a comprehensive framework for couples dealing with ADHD and trauma-related challenges to communicate their feelings without shame, from a friendship or hero modality, and building self-independence and co-regulation. This integrative approach:
Enhances Effective Loving Communication: Equips couples with tools to express themselves clearly and empathetically, without the pressure to perform, to do it perfectly, or engage in specific interventions to build attachment.
Fosters Emotional Safety: Creates a secure environment where both partners feel valued and understood, as it eliminates judgment, blame, guilt, and shame, which just draws us closer to our loved ones.
Promotes Personal Growth: Encourages individual healing, which positively impacts the relationship. So many of us did not develop to full independence as we relied on our interpersonal relationships to provide us with independence, harmonious relationships with others, and therefore expressing this deeper desire to promote self and couple allows both to grow, connect, and collaborate more easily.
By addressing both individual and relational aspects, couples can build a resilient and fulfilling partnership.
ADHD and trauma can strain relationships more than anything else, especially if not compassionately and courageously considered and communicated about calmly. I know from experience how powerful relational couples counseling and therapy can be. It often helps the healing process more effectively than books, apps, ChatGPT, or trying to figure things out on your own. That’s because humans are imperfect, complex, and messy, and we need real human support. With the right guidance, couples can work through challenges and come out stronger and more prepared for what lies ahead. As a specialized couples therapist at Amy Anderson Therapy, I am committed to guiding professionals & parents through this transformative journey, helping them reconnect with their partners and themselves. If you're ready to embark on a path toward healing and deeper connection, consider exploring relational couples therapy tailored to your unique needs. If you are in San Diego, CA, I highly recommend reaching out to me for a walk and talk, it’s so helpful for this deeper work with couples.
Strengthen Communication and Connection with Couples Therapy in San Diego, CA
ADHD doesn’t have to define your relationship. Together, you can build understanding and new ways of connecting. At Amy Anderson Therapy, we specialize in helping partners navigate the challenges of ADHD through couples therapy in San Diego, CA. Take the next step toward a healthier relationship with support that meets both of your needs. Follow these three simple steps to get started:
Schedule a free 15-minute consultation to see if couples therapy is right for you
Begin meeting with compassionate couples therapist, Amy Anderson
Start navigating ADHD impacting your relationship in a healthier way!
ADDITIONAL SERVICES OFFERED AT AMY ANDERSON THERAPY
Located in San Diego, CA, Amy Anderson Therapy offers a range of services designed to support mental health and encourage meaningful growth. I provide couples therapy for those navigating the unique challenges ADHD can bring to a relationship, as well as walk-and-talk sessions and care for trauma, anxiety, autism, ADD/ADHD, infertility, and infidelity. My practice is affirming and inclusive, with a strong commitment to working with diverse populations, including polyamorous and non-traditional families, driven professionals, military personnel, first responders, healthcare providers, and those in law enforcement. I also offer psychedelic-assisted therapy (PAT) for individuals seeking integrative or alternative healing methods. You can visit my blog for more resources and insights.
