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ADHD Chatter Podcast

Renowned Therapist: 3 Ways To SAVE A Failing ADHD Relationship - Karen Doherty

👉 How a neurotypical can effectively communicate with a neurodivergent partner 👉 How to manage RSD in relationships 👉 Tips on how to make an ADHD marriage work

Alex PartridgehostKaren Dohertyguest

Mar 19, 202441mWatch on YouTube

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CHAPTERS

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Chapter summaries

Hyper-Obsession vs. Real Love in Early Relationships
Alex asks how someone with ADHD can tell a hyper-obsession from real love. Karen Doherty says you can't tell at first, describes the intense merging typical of neurodiverse couples, and says the two-year mark is when you really know.
- •Limerence is common to everyone, but neurodiverse relationships often show an intense, passionate merge at the start
- •Merged couples lose the ability to be autonomous, and a child arriving can break the merge
- •Alex defines love as being unable to bear the thought of the person not being in your life
- •Karen says it takes around two years, once limerence fades, to know whether you are in love
Communication Breakdowns and the Bins Example
Karen explains that communication between neurodivergent and neurotypical partners always involves problems, usually starting with an emotional trigger. She uses a bins example to show how a defensive response ends a conversation, and notes how timing and sensory overwhelm affect it.
- •Partners often read from different pages
- •An emotional trigger makes executive function falter, so the neurodiverse partner stops listening
- •The bins sketch shows a defensive response and two people having different conversations
- •Couples recognize the pattern in the sketch from doing it a thousand times
- •Overwhelm after work means the neurodiverse partner needs 10-15 minutes before conversation
Emotional Dysregulation and RSD
Karen calls emotional dysregulation possibly the most difficult challenge in these relationships and names RSD as the best-known form. She says it stems from the intensity and sensitivity of the ADHD psyche, and that talking about it early makes partners more tolerant.
- •Emotional dysregulation is possibly the hardest challenge for the partner to understand
- •RSD is a visceral reaction to unintentional criticism or rejection
- •High sensitivity is part of the intense, passionate ADHD psyche
- •Open communication early on helps partners read a reaction as a trigger rather than a personal attack
Managing RSD: Codes, Time-Outs and Spirals
Karen describes tools such as a shared code word to pause escalation, followed by a process conversation the next day. Alex describes how RSD can spiral into impulsive statements like wanting a divorce, and Karen says hurtful words stick more with the neurotypical partner.
- •Couples can agree a signal or code word for the benefit of the couple, not to shut anyone down
- •Partners can often see dysregulation coming before the neurodiverse person
- •Most triggers are forgotten quickly if the moment is avoided, then discussed the next day
- •Alex describes how acting on a trigger can spiral into impulsive threats to leave
- •Much of Karen's work is helping couples let go of resentment after arguments
Guilt, Triggers and Taking Responsibility
Asked about guilt after lashing out, Karen says it is hard to let go of and is a conflated sense of guilt that must be seen for what it is. She adds that trauma triggers are not specific to ADHD and that each person must eventually take responsibility for managing their own triggers.
- •A healthy relationship lets someone say that guilt is crippling them
- •The intense guilt is conflated and shouldn't be allowed to swamp you
- •Anyone can be triggered by past trauma, though the neurodiverse response is likely more intense
- •Individuals and the couple must take responsibility for the here and now
- •Taking responsibility means owning, understanding, sharing and communicating triggers
Success Factors, Divorce Rates and Infidelity
Karen says successful couples both want to learn and work at it. She doubts the 66% divorce statistic still holds given younger, diagnosed couples, and is cautious about linking ADHD with infidelity, saying there is usually a crack in the relationship.
- •Successful couples both want it to work and neither wants to leave
- •Long cycles of resentment can make letting go hard
- •Karen hopes divorce rates will converge as younger couples arrive diagnosed
- •She doesn't want to tar the ADHD community with infidelity, pointing to cracks in the relationship
What Couples Bring to Therapy and How They Seek Help
Karen says clients mostly ask for help to stop fighting, and sometimes want her to confirm a partner's diagnosis. In sessions she works in the moment, looking at how the ADHD plays a part and also how both partners respond.
- •Common first requests are to stop the fighting and break vicious cycles
- •Neurodiverse clients do a lot of research, which is their comfy chair
- •In-the-room work looks at what both partners are doing, not only the ADHD
- •Cycles hurt the couple, their kids and their quality of life
Warning Signs: Parallel Lives and Lack of Intimate Reciprocity
Karen points to couples living separate, parallel lives as a sign of trouble, especially when undiagnosed, with the neurotypical partner pulling away and left lonely. She identifies lack of intimate reciprocity as a primary issue and discusses broken plans caused by the neurodiverse partner's emotional state.
- •The gap between partners growing bigger is a feature of undiagnosed neurodiverse relationships
- •The neurodiverse partner can be happy alone while the partner becomes lonely
- •Lack of intimate reciprocity (chatting, joshing, not sex) is a primary issue
- •Plans may fall through because of the neurodiverse partner's emotional state, so compromises are needed
The Parent/Child Dynamic and Couple Fit
Karen reframes the parent/child dynamic as a couple fit, where a brilliant neurodiverse partner pairs with a capable partner who has life skills. Inequality grows once children arrive and the capable partner is overloaded, producing resentment, and she says warning signs include total disconnection and withdrawal on both sides.
- •A common fit is a neurodiverse partner with a capable, early-adultized partner
- •Both partners carry vulnerability and trauma
- •The relationship starts equal but the capable partner gets overloaded, especially after children
- •Resentment, anger, loneliness and exhaustion follow
- •Pushed too far, a relationship can't be fixed, and mutual withdrawal is a warning sign
Laziness vs. Overwhelm: Knowledge, Compassion and Communication
Alex raises that a neurodivergent person can look lazy when overwhelmed. Karen says there are physiological reasons such as lethargy and needing meds before getting up, and that knowledge, compassion and communication help the partner tell the difference.
- •Nobody is lazy; lethargy and fogginess have physiological causes
- •Some people need their meds before they can get out of bed
- •Knowledge helps a partner respond with compassion instead of resentment
- •Karen sums it up as knowledge, compassion and communication
Masking in Early Dating
Karen describes masking as a defensive strategy that everyone uses early in relationships, though neurodiverse people have developed it more. She says greater authenticity early gives a better chance of good communication, and that a history of negativity makes showing the true self harder.
- •Everybody puts on a show early in dating
- •More early honesty gives better communication
- •Neurodiverse people have often had more negativity, leaving them fragile and less confident
- •Core self is built through positive reinforcement
- •Awareness helps people recognize masking they did unknowingly
Are ADHD Partners Hard to Live With? Strengths and Loyalty
Karen says ADHD partners can be difficult to live with and that it is a challenge, but one that education and strategies can mitigate. She and Alex emphasize the positives of fun, spontaneity, loyalty and security, and Karen says the positives outweigh the negatives.
- •Neurodiversity is a challenge in many ways, especially undiagnosed
- •Highs are high and the lows can be mitigated with knowledge and strategies
- •Fun, charm and passion draw partners in
- •The sensitivity behind RSD also brings deep love and huge loyalty
- •Many partners describe the neurodiverse person as safe and stable
Boredom, Stimulation and Communication
Responding to a question about an ADHD partner who is bored in a loving relationship, Karen says boredom is common to everyone and is a couple's job to manage through joint and individual projects. She says communication is the foundation, and that a partner needing stimulation should voice it, since it is not the partner's fault.
- •Everyone gets bored in relationships; it isn't only the ADHD partner's job to fix
- •Couples can look to joint and individual projects
- •Many neurodiverse partners avoid boredom through constant work
- •Communication is the fundamental basis of a relationship
- •A need for stimulation should be voiced to the partner
Washing Machine of Woes and Karen's Therapy Approach
Alex reads a community question about what partner an ADHD woman needs, and Karen says ADHD isn't an identity and the person matters most. She also explains her dual-lens approach to working with couples, starting with behaviors and cycles before moving to family histories.
- •No single partner type suits ADHD women, though stability and security help
- •ADHD shouldn't become someone's whole identity, as social media can suggest
- •Karen's courses first identify how neurodiversity impacts the couple dynamic
- •The second phase integrates traits with family and psychodynamic histories
Three Marriage Tips and Three Positives of Neurodivergent Partners
Karen gives three tips for making a marriage work: communication, holding onto your own lives while being dependent, and not taking it all so seriously. She then names three positives a neurodivergent partner brings: newness, authenticity and passion, and fun.
- •Communication is essential
- •Partners should balance autonomy and dependence
- •Humor and not taking things too seriously matter
- •Neurodivergent partners bring something new, authenticity and passion, and fun

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