Solutions for Intimacy Problems for Adults with ADHD

By Richard B. Austin, Jr., Ph.D.

Chapter 1
 How it impacts relationships and what to do about It. 

I will offer a few tools to turn the tide on ADHD’s power to disrupt, disturb, and often destroy valuable relationships. In the book Driven to Distraction, Edward Hallowell, M.D., and John Ratey, M.D., who are both experts on ADHD and who wrestle with the symptoms themselves, make the point that ADHD adults often do not know ordinary social rules that most people take for granted about relationships. “Social ‘reading’ can be as difficult for these people as the reading of words” (p. 281), but it has a major impact on intimacy.

This article will cover key communication skills that must be working well to avoid a breakdown in successful intimacy. The following three communication problems will be addressed: (1) not listening, (2) interrupting, and (3) not keeping promises. Probably the single most important issue to address is active, careful listening with a feedback loop to make sure the listener "gets" the speaker's message.

If you have ADHD, you can improve your listening skills by asking yourself some questions. Am I really paying attention to what the person is saying, or is my mind “drifting off” to something else or being distracted by things in the environment irrelevant to the conversation? The real test is whether you can repeat the conversation back in your mind or to the person speaking. It helps to acknowledge out loud what a person says, especially when you are beginning to train yourself to be a 100% listener rather than a 40%-50% listener. After time, acknowledgement becomes automatic even if you don’t acknowledge out loud.

There is a gender difference here which I talk about in my booklet, “How to Talk to a Woman in Four Simple Steps” (c 1994). Women, particularly in close and family relationships, feel devalued if not listened to. If you don’t really listen, you will not remember what is said which can lead to other relationship problems.

As an antidote to one’s mind drifting off during a conversation, not unusual with adult ADD, put in place the rule that nothing is as important as the person I’m talking to and what that person has to say. If it’s a spouse or child, this is especially true. This is training for success where it counts the most--your intimate relationships. You have to have “mental space” for information to be received and perceived at a cognitive level. How can you let someone’s information in through one of your attention pathways if these pathways are crowded with what you have to say or with many thoughts unrelated to the conversation subject matter?

Interrupting is another common barrier to effective communication with ADHD adults, but one that can be easily corrected. When a person is interrupted in the middle of a sentence, thought, or dialogue, it not only breaks the flow of conversation, but also gives the message that what you have to say is more important than what the other person has to say. This is probably not true for you, but that doesn’t change the message. Practicing self-awareness of everything you say is a good starting point. Make sure you are listening to yourself and thinking before you speak. Stay connected to the conversation flow. Allow pauses, even silent moments, to give the other person the opportunity to fully respond, or to not respond, before you speak.

A good training technique here is “pacing”. Pacing is where you pause after saying a few things and wait for a response before continuing to talk. This helps break down the ADHD tendency to monologue, not dialogue, in conversation, which creates distance in relationships. When you have give-and-take in a conversation with two people listening and taking turns to talk, you stay connected, intimate, and meet the true emotional needs of the other person. Problems with not listening and interrupting impact intimacy satisfaction in a profound way. Although these are typical ADHD adult problems, they can be corrected with training. Medicines help that training along, but medicines do not teach you what you need to know about your ADHD related communication problems and how to solve them.

The third point in this series is not keeping your promises. Often a well-meaning adult with ADD promises to do something but forgets about it. Then an intimate feels betrayed or “let down” by the thing they expected to happen, like picking something up from the grocery store or calling a friend. If you are like me, you need to write down what you promise to do and place it in a clearly visible place in the house where you can check it out daily. Don’t trust your memory to remember your promises. When you haven’t delivered as promised, tell the person you were wrong, that you are sorry for that oversight, and that you’ll make up for it. Always give yourself a target date to deliver on a promise. This way you will not procrastinate and will be able to meet expectations. Also, your self-esteem will be enhanced.

Listening, having true dialogue and not interrupting, and keeping your promises will jump-start your intimate relationships to new levels of satisfaction—you can start seeing results right away!

Chapter 2
The effect of ADHD on relationships

This is the second in a series of articles on the effect of adult ADHD on relationships. Understanding the different styles of communication between men and women, and acting on that understanding, is essential for relationship harmony. The many barriers to overcome in communication for a person with ADD, such as overtalking, interrupting, not listening, or getting off track, are magnified with cross gender conversation issues.

If you watch same-sex communication you’ll note some obvious differences. Men often talk parallel to one another, and may only occasionally have face-to-face contact. They seem to assume that the speaker was heard by the other man, while women generally acknowledge what is being said by words, or by a nod of the head. A woman may feel devalued if not acknowledged or listened to , but a man doesn’t place the same importance on being heard. Let’s examine some typical gender differences in response to often used phrases.

1. “Let’s talk.”

Women: “Great, we’re finally taking time to talk. Now we can solve some problems.”

Men: “Oh, no! What now? What have I done. I’d better find a way to avoid this encounter.”

Men tend to avoid conflict in personal and business relationships, as studies in business show that men would prefer to avoid confrontations and unpleasant encounters. Men do not like to face an unknown situation with little control of the outcome, while women frame such a situation as one that might improve if it is faced up to and talked about. There also may be a psychological explanation for the difference as research indicates that men have more extreme, and unpleasant, physiological reactions to conflict compared to women.

The bottom line is for women to be more empathetic about the male experience of “Let’s talk” being a threat, while men need to reframe the phrase to mean a win/win situation as talking about problems invariably helps. If a man refuses to talk, set up a future time to talk by agreement.

2. “Let me help you.”

Women: Women respond to this offer much like they respond to psychotherapy, in a positive way; they expect to receive benefit and to get something of value for themselves.

Men: “This implies I’m needy, somewhat weak, and may mean I’m lacking in competence.”

Women also may not elevate the advice of a therapist above that of their best friend or mother, and check it out carefully before accepting it. Men, on the other hand process an offer for help as suggesting that they need it (help), and further that it may imply inadequacy, which is a very sensitive male issue.

If that is not negative enough, the “let me help . .” phrase may activate the vertical hierarchy in men, which means that being helped puts them in a subordinate position to the helper. Scientific studies by linguists spell out this dynamic. Ever wonder why men avoid asking for directions, even when they are lost? That’s why. The person with knowledge they do not have puts them in a superior position from the male framework.

As men and women usually respond differently to an offer of help, a preliminary statement might be useful like, “You might not need this advice but in case you find something of use let me share this information with you.” An attitude of acceptance of the gender related differences to the word “help” is perhaps the most important point to keep in mind.

3.“You’re Wrong.”

Women: “That’s their opinion. I’ll listen with some skepticism to see if they have a valid point.”

Men: “It sounds like a putdown to me, or even a challenge. I'll defend my position. I'll prove I'm

not wrong.”

Women are not necessarily threatened or have their egos on the line if someone tells them “You're wrong.” They may take it with a grain of salt, throw it out, or carefully examine the reasoning behind the statement. Men, on the other hand, feel somewhat offended, or somehow diminished, by that phrase and often become defensive, which shuts down communication. As women deliver a “you're wrong” message in more subtle ways and couch it with a positive comment both before and after the phrase, it will be better received. As described in my booklet about 10 steps to get a man to talk, men need a safe place psychologically to hear that they are wrong.

However, men need to consider the reward they'll receive when they not only say “Sorry” but “I'm wrong” to the primary woman in their life. It reaps rich dividends.

4. “You're Right.”

Women: “He's probably just going along, and doesn't really buy into it. Or he's just admitting how it really is.”

Men: “Music to my ears. Play that melody some more. What good judgment; she finally sees the light.”

Sound familiar? Of course a general theme has exceptions, but 40 years of practice and observation tell me it's so. I'm so sure I'm right here that I will not be offended if you think I'm wrong.

Make support groups and business groups, spend time validating and supporting each other with the veiled message “You're right”. The underlying male dynamic, based on the male code, is that a man must continually prove himself to others; thus the need to be affirmed. This male code was summed up by writer/therapist Virginia Satir forty years ago in three edicts: “Don't cry, don't feel, and don't talk about it”, which is taught to males from preschool through teenage years, reinforced by fathers, peers, and coaches. After a while, as feelings are externalized, they tend to be blocked from conscious awareness. This breeds more impulsivity in the male and acting out of feelings, which ordinarily is an issue with ADD. Holly Sweet, Ph.D., in the fall 2000 Journal of the Society for the Psychological Study of Men and Masculinity (APA Division 50) stresses “mindfulness training” associated with the Eastern wisdom tradition, that is a way to “experience freedom to be aware and accept raw emotions, memories, and unpleasant events.” It is a way to become aware of the self more fully in the present moment. This training is helpful for a person with ADD, and goes beyond the relaxation/concentration training. Mindfulness training allows a person to receive negative feedback with empathy and to be more objective, countering distractibility.

In summary, four often used phrases show gender differences in processing information from the initial input in meaning to typical responses as a function of gender. Today, ADD adults, and others for that matter, will benefit to understand gender differences in communication and decide to reprogram conventional response patterns to better relationships, lower stress and support primary intimacy.

The phrases “Let's talk”, “Let me help you”, “You're wrong” and “You're right” may be viewed by women in terms of their impact on men, or as coded, knee jerk male reactions. Men may choose to view "Let's talk" as an opportunity to improve a relationship, "Let me help you" as adding to their competency, "You're wrong" as a valued point of view irrelevant to personal worth and adequacy, and "You're right" as not proving anything, but pleasant to hear from an intimate.

Richard B. Austin, Jr., Ph.D., a clinical psychologist in private practice, treats adults with ADD and has tapes available on ADD issues from professional presentations. His office number is (713)780-7700, or e-mail him at Drrichardaustin@aol.com.

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