Volume 5, Number 3  Winter 1998

The Magazine of Children and Adults with Attentional Disorders
AD/HD & Relationships: Communication is the Key!
By Dr. Ron Weinstein, Ph.D. Clinical Director
and Marlynn Block, M.A.
The A.D.D. Center


"We don’t see things as they are, we see them as we are." Anais Nin (1903 - 1977)

"...one can change things by the manner in which one looks at them." Tom Robbins

"Tell me and I will forget. Show me and I will remember. Involve me and I will understand." Confucius


Many of the arguments and the resulting rages, tantrums or cold shoulders that arise between people in close relationships can often be traced to differences in perception and communication style. How we see and make sense of the world around us influences how and what we communicate to others. This usually becomes apparent to anyone involved in a relationship with someone who has AD/HD. Developing an understanding of these differences is essential to effective communication.

As therapists who specialize in AD/HD, we work with children, adults, couples and families in numerous capacities. Our experiences with these folks is "in the trenches", often as part of a school PPT team, as coaches when emotional support is needed, or as objective observers in the heat of family battles, helping to prioritize issues that are causing unbearable discomfort. 

We, ourselves, must deal with AD/HD in our own relationship. Ron’s AD/HD was undiagnosed during the first half of our marriage and there most likely would not have been a second half had it remained undiagnosed! We are fortunate to have been armed with a professional knowledge of AD/HD and first hand exposure to how it affects couples, so we have been able to work on our own lives and relationship with a clearer understanding of the differences between our communication styles. We use this knowledge to help our clients resolve issues that may have dissolved relationships in the past.

It's not difficult to understand how the "triad" of AD/HD symptoms — impulsivity, inattention and hyperactivity/restlessness, can affect relationships. However, we believe that these "visible symptoms" have somewhat less direct impact than the ways in which they have affected a variety of "hidden" developmental characteristics.

Most adults with AD/HD were not diagnosed until they were adults. Throughout their lives, they have suffered a great deal of pain. Many have had to develop coping mechanisms to help them survive. Over time, the constant pressure of trying to cope with their problems brought on by their new ways to cope can bring about stress. As a result, some adults become overwhelmed, depressed, anxious and lose confidence. Since we can't go back and change this history, we need to move forward and realize that the efforts we put into our personal growth create hope for a changed life. Newly diagnosed adults finally have an opportunity to closely examine their lives in a more reflective and meaningful manner and to understand why they made the choices they did. But as we are aware, just understanding doesn't guarantee anything will change.

Therefore, we work closely with our clients to help them understand who they are; identify their strengths, weaknesses, and the hurdles they have to overcome; learn what they need to do in order to grow and experience a sense of well-being. 

Who are you?

At our initial meeting, one of the first things we ask a client is — "Who are you?" This usually catches them off guard. They might have thought about the concept during times of turmoil, but for the most part, the question never entered their minds. Are they comfortable with their "gut" reactions to things? Do they believe that what they feel is appropriate? Do they feel guilty about not doing something or then resent it if they do? 

Adults with AD/HD typically have a problem identifying who they "really" are since throughout their lives they've tried to change their personalities to fit the situation at hand. Adding to this confusion is the fact that they can't often trust what they feel. For example, people may pretend they are wise and sophisticated, while worrying about being "found out"! 

Making Sense of Interpersonal Communication

Good communication depends on people understanding one another's true thoughts, regardless of the words they happen to be using. Since our brains work so much faster than our mouths, we often use a kind of shorthand, which might have an entirely different meaning for another person than it does for us. 

When two of us interact, we often experience what goes on in such different ways. If either of us could see the way the other views the relationship, it would probably make no sense at all. Adults with AD/HD must also contend with the three-ring circus performing in their heads — they are paying attention to the sound of the other person’s voice, experiencing past and future fears, becoming aware of the freedom to or fear of saying what they are feeling, and concentrating their efforts to get meaning from the other person’s words. The more involved they are in trying to be less distracted, the less involved they are in the conversation!

Unlike a "non-AD/HD" brain, which runs on batteries, the brain of an adult with AD/HD is like a wind-up watch that requires winding periodically throughout the day. The non-stop circulation of thoughts and ideas in the brain of a person with AD/HD provides stimulation and is a wonderful source of creativity, but it often creates difficulties with communication.

Words and meanings are not always the same. 

From our experience, it seems clear that many of the difficulties experienced in relationships result from the fact that the meanings of the words spoken and the priorities placed on tasks are quite different for the individual with AD/HD. It's as if they speak a different language. This results in miscommunication, misinterpretation and misunderstanding! Thus we often hear, "That's not what I meant!" or "You don't understand!"

Problems with word retrieval cause misunderstanding. You must know where a word is "mentally filed" in order to retrieve it. Individuals with AD/HD often have difficulty maintaining an organized "filing" system since the AD/HD brain creates so many options. For example, a person with AD/HD may file the word "apple" under the letter "A," or "F" for fruit, or "R" for round or red and so on. She may file it differently every time. However, the person who does not have AD/HD will probably file it the same way each time, under the most universal choice — A for apple. 

The disorganized filing system of a person with AD/HD impacts communication in a big way, causing him to seem hesitant or unsure while he searches through his mental file cabinet for the right word or phrase. During this time, the "lottery ball effect" takes over. Instead of numbered balls flying around until they drop down the tube, a word, idea or fragment of an incomplete thought may randomly and impulsively come out of the individual's mouth. If it is inappropriate, he may then respond by saying, "Oh, I didn't mean that!" Oftentimes, however, The recipient of the remark has difficulty believing he didn't mean it, especially if inappropriate remarks are made frequently.

A thought process begins when a question is asked. The person responding must stop, listen to what is being asked, compare this information to previous experiences, choose an option and then respond. The person with AD/HD most often has difficulty in step one - stopping. As such, the process does not occur and, like the balls in the lottery machine, what comes out of the mouth is often a surprise even to the person who said it! This happens because of the difficulty isolating individual thoughts in a brain that's constantly being filled with new ideas. The spoken word only becomes real when it is uttered aloud. It is only after the word leaves the mouth that the AD/HD individual can decide whether or not it make sense, and whether or not it's appropriate. So the statement, "I didn't mean that" should be taken literally. 


The level of importance we place on something determines our priorities. In our clinical experience, many couples have never even considered that their different priorities can profoundly affect their relationships. For instance, simple day-to-day activities that require planning and organizing may not be high priority tasks for adults with AD/HD. A task that is more stimulating, or one to which he may respond in a more extreme or "emotional" manner, is more likely to be a higher priority.

Differences in priorities and time urgencies are often reflected in the "no big deal" response. For example, walking past a bag of garbage without picking it up, leaving the lawn covered with leaves, or even driving past the library with overdue books and not returning them may not make any sense to some. In the mind of the adult with AD/HD, however, it is "no big deal", since their thought is "it will get done eventually."

Becoming Aware, Accepting Our Differences and 
Developing an Action Plan

Adults with AD/HD are complex individuals. Adding to this inherent complexity are the emotional defenses resulting from years of being misunderstood and not trusted or believed. One goal is to be aware of what triggers these defenses, thereby reducing anxiety and anger, which allows the AD/HD adult to incorporate the tools for improving interpersonal relationships. 

Acknowledging and accepting differences helps the adult with AD/HD to feel respected as a separate person. Only at that point, can the process of successfully negotiating differences and working on those issues or behaviors that may be inappropriate begin.

An "action plan" usually involves change, either in behavior, attitude, environment, or responsibility. Change is an essential part of life, yet one which can be extremely painful for many people. There is not much hope for a relationship in which one person takes no steps to change. Often, we find that the non-AD/HD person is more hesitant to change, because it has been easier to blame all past problems on her partner’s AD/HD. On the other hand, partners with AD/HD often believe that the partner must accept AD/HD as an "excuse" for certain behaviors. 

Neither partner in a relationship has to accept unacceptable behavior. When a person who does not have the disorder seeks a support group to help deal with a partner with AD/HD who is sloppy, has frequent outbursts, or is unable to hold a job, in some cases, our advice is to forget it! Behaviors that lead to disorganization, screaming or unemployment can be changed, but only if the person with the problems is able and willing to make an effort to change. If he is not, we suggest re-thinking the reasons for remaining together.

Getting out "poisonous" feelings like resentment and anger is important, yet it's often difficult when one or both partners have a hard time keeping quiet or listening without interrupting. We use and suggest "emotion dumps", which are similar to the "10 & 10" sharing time encouraged by the Marriage Encounter movement. In this case, because adults with AD/HD are often impatient, we suggest making it a "2 & 2" — two minutes for each person to write on paper or via email about how they felt that day, what may have bothered them or share positive experiences. We suggest using "I" statements, reflecting how the person writing feels, rather than what he perceives has been done to him by others. Since this format is not face-to-face, neither partner can interrupt, be distracted by the other's words, or impulsively make a judgment leading to a blowup.

Another tool which helps gain clarity in the relationship is the Top Priorities List. Each partner compiles a list of what he or she feels are the most important daily and long-term issues to be dealt with. In many cases, the long-term priorities are similar. However, the differences in daily priorities are typically great. What the adult with AD/HD may consider "top priorities" is often in direct opposition to what the non-AD/HD partner gives weight to, revealing possible causes of tension.

Essentially, mutual trust is fundamental in a relationship that works. Mutual trust is based on the ability to correctly interpret what our partner is trying to communicate and vice versa. That process is the one that takes the most work, but as we tell our clients, life never gets any easier, we just hope to get better at dealing with it!