by Sarah Swenson, Licensed Clinical Mental Health Counselor in Seattle, WA

Don’t Give Up on Couples Counseling! Find a Therapist Who Understands Neurodiversity Instead  

In my work with neurodiverse couples around the world, the most common and the saddest comments I hear relate to their previous attempts to seek counseling. Instead of providing support and insight into their experience, counseling seemed at best ineffective or at worst (and not infrequently) downright harmful. Naturally, these negative encounters create a strong disinclination toward further attempts to seek help. If this describes your views of couples counseling, and if you fear it would be hopeless for you and your partner, please mull over these comments and consider giving it another try. 

Understanding Neurodiversity 

First, let’s make sure we’re talking about the same thing when we speak of neurodiversity. It’s a term that has only been around since a graduate student coined it in her master’s thesis in 1997 to describe individuals who felt they didn’t fit comfortably into the larger social patterns of expectations. She included those with ADHD, dyslexia, and autism under this umbrella.  

Her efforts were based in her concept that these are variations, not deficits, in the normal spectrum of human brain development. When I say neurodiverse couple, therefore, I am specifically referring to a couple in which one partner is what we call neurotypical (that describes roughly 97% of the global human population) and the other is neurodivergent with the traits of autism, whether diagnosed or undiagnosed. I often see ADHD accompanying autism as well, since it is frequently a diagnosis given to individuals whose autism was not diagnosed at the time of evaluation. 

Treating Neurodiverse Couples 

Remember that autism is a result of differences in the structure of the brain, when compared to what we call the neurotypical brain, and these differences affect an individual’s perception of the world as well as their responses to it and, therefore, social interactions. The key word is differences. These differences need to be identified, accommodated, and supported within the counseling framework in order for both partners to feel heard and understood by themselves, by their partners, and by their therapists. 

Faulty Assumptions Lead to Frustrating Sessions 

Besides the normal range of relationship complications faced by all couples, neurodiverse couples experience unique challenges that set them apart from the neurotypical couples that licensed therapists are trained to treat. Traditional couples therapy modalities are generally emotion-focused and insight-based, often embedded in a cognitive-behavioral frame, and they can offer profound help to struggling neurotypical couples. However, these treatment modalities present two great challenges for an autistic individual. For various reasons, the autistic partner is likely to shut down completely in the counseling environment, where presumptions are based in the neurotypical experience and where departures from those expectations are misconstrued to be resistance, reluctance, or manipulation.  

This likelihood needs to be identified and embraced with compassion toward both partners, but what often happens instead is that the autistic partner is pushed in ways that don’t make sense to them, while the neurotypical partner may feel slightly vindicated in the moment but ultimately frustrated when they sense that “there is no follow-through by my partner after counseling sessions,” as it is often described to me. 

Ignorance Leads to Misunderstanding 

A key point is this: graduate counseling education and post-graduate internships across the country lack deep emphasis and training in the concept of neurodiversity as it applies to couples. The best and most competent therapists, therefore, often miss signs of autism and proceed as if a couple were neurotypical and difficult or intransigent.  

Seeking Help, Finding Frustration 

Sometimes, therapists do consider autism, and suggest to a couple that they work with a neurodiversity specialist or consider pursuing an evaluation to rule out autism or to diagnose it. This suggestion can be met with resistance by an undiagnosed autistic partner, who feels blindsided and labeled abruptly. The couple leaves in tatters and often never returns to a counseling room because the therapist did not adequately explain their reasons for making the suggestion nor describe the benefits to the individual and to the couple seeking an evaluation. 

The more common reason couples leave counseling and don’t return is that they feel they are getting nowhere. The therapist’s ideas may sound good, but the couple senses they don’t address the root of their challenges, which they often struggle to express in a way that the therapist understands. They leave in great frustration, and often aggravation, especially if one partner inadvertently feels blamed for the other’s distress or feels identified as responsible for the dysfunction in their relationship. An autistic partner, for example, is often primed by life experience to feel blame where there is no intention to blame. This fact also needs to be understood and normalized for a couple, both to help them understand where they’ve been and preventively for the future. 

Getting What Neurodiverse Couples Experience 

Getting Neurotypical Partners 

In my years of work with neurodiverse couples, I have heard absolute horror stories. Not a small number of women, for example, have been misdiagnosed with Borderline Personality Disorder by therapists who interpreted their frustration inaccurately. I often hear about vague mentions of dependent personality or co-dependency on the part of the neurotypical partner whose legitimate struggles are misinterpreted. It is often suggested to the neurotypical partner that they stop viewing themselves as a victim in the relationship when they try to describe their inability to communicate clearly to their partner, no matter how they try. 

Getting Autistic Partners 

The autistic partner, on the other hand, is seen as aloof, disinterested, even intentionally cruel. A common misconception, and one that makes me seethe inside, is that autistic persons lack empathy. Pushing an autistic partner to express their thoughts or feelings in session can intensify the baseline anxiety already present in most autistic individuals. The experience is overwhelmingly unpleasant. 

Getting the Neurodiverse Couple’s Sexual Relationship 

A couple’s challenges in their sexual relationship are also frequently misunderstood. If the suggested antidotes to their problems don’t make sense to the autistic partner for reasons that make perfectly good sense to someone who understands autism, there is no follow-through. Use of porn, affairs, flirtation, alcohol use, struggles related to holding a job, and legal problems are all misattributed, and therefore suggested solutions by a well-meaning therapist most often do not align with the root issues. 

Finding Couples Therapy That Can Help 

The miracle is that so many couples do take a deep breath and are still willing to give counseling another chance.  

If you believe that either you or your partner might be autistic, and you are struggling to feel understood and supported by your therapist, please don’t give up. Instead, seek a specialist who understands the neurodiverse relationship and the implications for both partners. It truly is possible to feel embraced in a therapeutic relationship. 

The therapist directory here at GoodTherapy.org is a good place to start. You can search by location and clinical specialty. Many therapists work online now; thus, your choices regarding therapists are not so location-dependent. 

Find someone who can help you both understand what neurodiversity is and what it means, who can work as an interpreter between you and your partner, so that you understand yourself and your partner in ways that help you develop successful communication strategies. In this way, you can identify and explore the differences between you in good faith, with hope and compassion, and, in doing so, develop deeper connection and intimacy.  

Isn’t that why you sought therapy in the first place? 

by Mary Romm, Licensed Professional Counselor in Gloucester, VA

The Scoop on Parent-Child Interaction Therapy

Are these some of the thoughts inside your head?

“My child is out of control.”

“I don’t enjoy spending time with my kid anymore.”

“My kid hits/bites/kicks me.” 

“Another daycare kicked my child out today.”

Are you ready for help? 

Who PCIT Can Help

As a therapist, I’ve utilized Parent-Child Interaction Therapy (PCIT) to help children ages 2-7 who have extreme behavioral challenges and seen them learn to listen and behave. I’ve used PCIT in my work with kids who had to wear a monitoring bracelet because they ran away so much, broke mirrors in a rage, and used the shards to carve up furniture, or parents were ready to commit them. Those same kids then listened to their parents, no longer engaged in extreme attention-seeking behaviors, and were able to calm down when they were upset and even talk about their feelings. I’ve seen it work with less intense cases, too, but those aren’t as fun to write about. PCIT works. 

PCIT can treat most concerns related to children’s behavior. This includes ADHD, anxiety disorder, autism spectrum disorder, oppositional defiant disorder (ODD), selective mutism, trauma-exposed children, and more.

So What Is PCIT?

Parent-Child Interaction Therapy is an evidence-based approach that has 50 years of research behind it. Research shows it keeps children out of therapy for up to seven years, when they hit adolescence and their brain begins to rewire. Lots of the skills you will learn in PCIT will always be relevant — many of them are as good with 6-year-old kids as they are with teens or even adults. PCIT is not a therapy where another adult takes your child and works with them for an hour before bringing them back to you, and you don’t know what they did in that hour. As a therapist, I love working with this age range because I know early intervention is key. (Also, angry 5-year-olds throwing chairs aren’t nearly as scary as angry 14- or 15-year-olds.)

How Does PCIT Work?

There are two phases to PCIT. The first phase is called Child-Directed Interaction, or CDI. I like to picture CDI as laying the stable foundation of a house. CDI teaches you the skills that play therapists use. It helps you begin to enjoy playing with your child again and learn how to manage their behavior with positive attention alone. In this first phase, you’ll already see a huge reduction in behavior issues due to the child receiving quality, purposeful time with the adult and the adult learning many new tactics to manage that child’s behavior without yelling or accidentally reinforcing the behavior. This is foundational work.

The second phase is called Parent-Directed Interaction, or PDI. PDI is where you get specific discipline skills to help you control your child’s behavior. Now that the relationship foundation is completely stable and your skills are memorized, we can move into learning how to consistently and effectively discipline your child.

Throughout PCIT, you’ll track the reduction in your child’s problematic behavior on a form called an Eyberg Child Behavior Inventory, or ECBI. As a parent, you get to rate your child’s behaviors and see how those behaviors change as treatment goes on.

Is PCIT Forever?

Great news! You will graduate from PCIT in as little as 3-6 months if you do the homework and work hard in sessions. PCIT is not a vague therapy where things end when it feels right; there are specific guidelines and instructions on how to graduate from therapy, all of which are parent-driven. 

How Does PCIT Compare to Other Therapies?

Ideally, because PCIT builds that strong foundation in the Child-Directed Interaction phase, it should be done before any other therapy, even before trauma therapy. Trauma therapy does include several PCIT elements; thus, it is done after PCIT. PCIT should especially be done before talk therapy, as PCIT has the research base behind it. Once kids feel safe and secure in their relationship with their parents, and once parents know how to consistently handle their child’s behaviors, then other therapies can be attempted. However, they usually are not needed at that point. 

Is PCIT Covered by Insurance?

Yes, as long as your insurance has mental health care coverage and your therapist accepts insurance or is able to be an out-of-network provider, PCIT should be covered.

 To learn more about PCIT, please visit this PCIT info page and PCIT International’s page for parents.

 If you live in Virginia and want to start online PCIT for your child, please visit check out Mary’s practice, Willow Tree Healing Center.  You can find more therapists who use PCIT by searching for therapists in your area and filtering your results by Type of Therapy > Parent-Child Interaction Therapy. 

Editor’s note: Sarah Swenson, LMHC is a private practice psychotherapist in Seattle, Washington, where she specializes in working with neurodiverse couples. Her continuing education presentation for GoodTherapy, titled “When Your Partner is on the Autism Spectrum: Individual Therapy for the Neurotypical Partner,” will take place on February 21, 2020 and is eligible for two CE credits. This event is available at no additional cost to Premium and Pro GoodTherapy Members (Basic Members and mental health professionals without membership can view this event live for $29.95). Learn more and register here.

Author’s note: Sometimes, of course, the neurotypical partner in a neurodiverse relationship is a man. I also work with gay and lesbian couples, and couples who are polyamorous. This article describes the client I encounter most frequently, a neurotypical woman married to an autistic man. Also, please bear in mind this guiding principle: If you’ve met one autistic person, you’ve met one autistic person. Nothing in this article will apply to everyone.

In my clinical practice as a therapist and in my international work as a coach, my clients are neurodiverse couples in which one partner is autistic and the other is not. As a result, I have come to know well one of the most misdiagnosed clients you will likely encounter. I’m speaking of a woman married to an autistic man who may or may not be formally diagnosed with autism (ASD).

When this woman comes in for individual counseling, she may have a flat affect. Her presenting concerns might sound vague, including hints of depression or anxiety. She may be self-effacing and ready to blame herself. She may stop and start, not seeming to know how to explain herself. She may appear embarrassed to be taking up your time.

Or she may seem full of rage. Her language might sound pressured, disorganized. She may be close to tears. She is the victim here, and she is furious.

Or she may simply present as hopeless.

I am not describing three separate women. You are likely to see all of this in the same woman in one session. Would you know how to understand her and offer her the support she needs?

She will not fully understand that over time, she has learned to minimize her needs and desires because conflict avoidance has become her chief survival strategy.

Meeting the Neurotypical Partner in Therapy

Most often, these clients are experiencing complex trauma (C-PTSD). They won’t be able to identify a specific traumatic injury because they are in a relationship that inadvertently creates the conditions of ongoing trauma. And since in this relationship there in no intention to harm, no intention to abuse, she is confused. She loves–or did love–her husband. She will tell you he is a good man.

She will not fully understand that over time, she has learned to minimize her needs and desires because conflict avoidance has become her chief survival strategy. She will tell you that she has changed. She will tell you she is not the woman she used to be. She feels less joy in life. She has let friendships fall away. She can’t muster interest in the things that used to give her pleasure. When asked, she is unlikely to be able to express her needs. She can’t remember what she needs. She knows this, however: she feels alone. And she may fear she’s losing her mind.

You’ve read her intake paperwork, so you will know that her husband is successful in his career, which may be in a highly competitive and well-respected field. When you talk to her, you’ll hear about his high intelligence and how well-regarded he is at work. As you get to know her better, she will tell you that everyone thinks that the two of them have the perfect marriage because that’s what it looks like from the outside. She realizes all marriages have problems. Her well-meaning friends certainly share enough of their stories that she feels a little guilty when inside she’s thinking, “Yes, but you don’t understand what it’s like for me…it’s different…I can’t explain it…”

She may sound petulant, self-involved, or impossible to please, due to the fact that she can express her pain but can’t put her finger on exactly what the problem is. She knows it has something to do with her husband and the way he treats her. Yet she has painted a picture of him that impresses you. You may think she is exhibiting narcissism as a result.

Another possibility is that he is a good man, but for some reason, he cannot seem to keep a job. He’s intelligent. He’s talented. But the financial strain of his chronic unemployment has pushed her to the brink. She is the sole earner. She manages the household. She supervises and provides for the children. She hides this internal familial dysfunction from her friends and her family. She has no one else to rely on. She is embarrassed. She is utterly exhausted. She can’t see a way out of her distress and she fears it may kill her. You may diagnose depression.

Sometimes, from session to session, you’ll see her condemn her husband and the way he cannot seem to do anything right, from loading the dishwasher (“I even made a little diagram and taped it to the counter!”) to listening to her when she’s upset (“He always wants to fix everything and doesn’t even notice I’m crying!”). Next session, she will be filled with compassion for him because he honestly seems to be doing the best he can. She’s just expecting perfection from him. He’s human. (“Why do I always have to be like this? Why can’t I just let him be himself?”) You may wonder if you’re seeing borderline personality.

And when she paints a complex picture of her experience with him that screams “Run for your life!” you may wonder why she can’t decide to leave. You consider codependency.

This is the woman married to an autistic man before she understands that he is autistic and before she understands what autism means in a relationship. I agree with you that it is difficult to identify her based on the information described above. Here are some important things to consider that may help you sort this all out.

Signs You’re Working with the Neurotypical Partner in a Neurodiverse Relationship

The primary area of conflict for many neurodiverse couples can be broken into two components: emotional connection and communication. Many of the women I work with identify the courtship phase of their relationship as short, comfortable, and consistent. More often than not, however, they can look back and identify what they call red flags: his quirky manners, his deeply focused conversations on things he’s interested in and silence when he’s not, his apparent discomfort at expressing emotion. At the time, they interpreted these things to be endearing eccentricity, intelligence and skill, and admirable reticence–the stiff upper lip.

For reasons of misinterpretation like this, they went forward to the commitment of marriage. Only with time did the veil slip away, and they realized they were habitually filling in with projections about what their partner’s behaviors and comments meant on the basis of what they would mean if they did these things themselves. In other words, they applied neurotypical standards and expectations to the behavior of an autistic individual. Slowly but surely, their sense of who their husband actually is erodes until they often become quite uncertain about who he actually is.

The primary area of conflict for many neurodiverse couples can be broken into two components: emotional connection and communication.

Over the course of the marriage, this woman will feel minimized and criticized. She will express her husband’s constant negativity and say that she’s begun to feel negative about everything, too. Her descriptions of their sex life will be particularly illuminating.

Generally, by the time these women come to therapy, their sex lives are completely ruptured. They have to think when you ask them about it. They’ll tell you they don’t remember precisely when or how, but at some point, things just stopped. For some, it has been months, but for most it’s been a matter of years. And, frankly, when their sex lives were more active, it wasn’t all that rewarding: it felt mechanical, always the same, with no foreplay and no sense of intimacy.

She doesn’t miss the specifics of sexual encounters with her husband, but she craves sexual intimacy. She craves intimacy, period. She wonders whether she should have an affair, though she doesn’t really want to go outside her marriage to have her needs met. She’ll just stifle them for a while, hoping they subside. Instead, she worries that they will continue to grow. She may not be able to look you in the eye at this point. She is desperate not to be viewed as promiscuous, and she fears you will judge her.

There are exceptions. Sometimes, a woman will tell you she feels like a sex doll to her husband’s routine and frequent sexual demands. She continues to participate. She hates herself for her inability to stand up for herself, but she has tried, and it just seems pointless. She continues to acquiesce. She is becoming numb to her own sexuality, to any physical sensations at all. She cannot afford to feel aroused because she knows she will be disappointed once again.

As you know, diminished sexual intimacy in a relationship is usually a sign of severed communication. In the neurodiverse relationship, this is most often the case. The woman needs emotional connection before she can feel sexually vulnerable. She is unlikely to feel this with her autistic husband. I often hear from these women that they don’t feel safe enough emotionally to present themselves sexually to their husbands. She does not feel seen or heard or known by her husband, whose sexual needs are often more physiological than emotional. He doesn’t understand her withdrawal any more than she understands the way he treats her.

Work with Neurodiverse Couples: Moving Forward

If you see enough of these signs in your client, I suggest asking whether she has considered that her husband might be autistic. In order to do this well, you’ll have to be certain she understands what you mean and why you’re asking. If she has not thought of this possibility herself, you’ll need to explain to her that autism is a result of neurological variance and not mental illness or personality disorder. You don’t want her to reject your suggestion on the basis of having misunderstood you.

Many times, though, women come in for counseling after having read articles of mine or other material on the internet and already suspect autism (some still call it Asperger’s) in their husbands. They want to know what to do. In this case, we discuss all the points mentioned above in terms of what it would mean if their husband were in fact autistic. I do not ever volunteer a diagnosis of autism without having met someone, but we do reality testing to rule it in or out as a differential. Then I suggest couple work. I help her with language for bringing this up to her husband, which is a sensitive task in itself.

Sometimes, after several sessions, we schedule a couple session, if the husband is willing to explore the possibility. It is often a watershed moment in a couple’s life to learn that there are reasons that explain their problems and that we can work together on psychoeducation and on communication strategies and skills that offer a path toward improved intimacy. The relationship will never be neurotypical or autistic, but it can become more rewarding for both partners.

Sometimes, the husband is unwilling to consider autism and will not come in for a couple session. He fears being judged. Labeled. Vilified. She cannot get through to him that this is a supportive process. He locks into his fears and there is nothing more to be done. In this case, I continue to work with the woman alone to help her understand her choices. They are not always binary. There are more options than staying married or getting divorced. We explore them all.

It is important never to minimize the experience and challenges faced by the autistic partner.

It is important never to minimize the experience and challenges faced by the autistic partner. This work is about identifying differences and creating more successful ways to communicate. There are good reasons why the autistic partner behaves the way he does and says the things he says. I have never met an autistic person who sets out intentionally to hurt his wife, and seldom have I encountered an autistic person who lies. Misrepresenting something has its own rational pathway for an autistic person, and I distinguish this from intentional lying. This is an example of the kind of subject we explore in couple sessions. Sometimes, the intense anger of the neurotypical partner can be diffused with education and compassion. Sometimes, the weight of this anger and feeling responsible for the relationship is too much for her.

If you have any suspicion about autism in a client’s partner, please tread carefully to explore the possibility. But do take the chance: otherwise, you could be missing the core challenge your neurotypical client is facing, which is the hub from which all her other apparently confusing behaviors emanate. The challenges to communication in the neurodiverse relationship are not insurmountable, but to ameliorate them requires sensitive counseling support. Educating yourself on the nature of autism, how it creates the lens through which a person experiences and interacts with reality, and how to help a couple bring implicit expectations to explicit and comprehensible statements are essential in this work. For initial solid grounding in the field of autism, I refer therapists to the work of Tony Atwood, PhD, and Simon Baron-Cohen, PhD.

Loneliness can be one of the most painful experiences in a relationship—especially when the relationship is neurodiverse. If you love your partner but still feel unseen, unheard, or emotionally distant, you are not alone. Many couples face this challenge, and understanding its roots can be the first step toward healing.

While loneliness can occur in any partnership, the dynamics in neurodiverse relationships bring unique emotional and communication challenges that deserve special attention.

Understanding Loneliness in Neurodiverse Partnerships

Many people experience occasional loneliness in relationships, but the loneliness in a neurodiverse partnership often has unique characteristics. Friends may reassure you by saying “that’s life” or “marriage is hard,” but these responses can dismiss what makes your situation different.

A person in this situation may feel guilty or wonder if they are making too much of the problem. They might try to convince themselves that things are fine—until the longing for emotional connection grows too strong to ignore.

How Autism Can Impact Emotional Connection

For some in neurodiverse relationships, deep loneliness becomes a constant presence, not just an occasional feeling. It may wax and wane, but it’s always there—woven into daily life, much like a wedding ring on your hand.

Autistic and neurotypical partners can both feel lonely, but for different reasons. A neurotypical partner may crave affective empathy—emotional attunement and validation—while an autistic partner may respond with cognitive empathy, offering solutions rather than emotional comfort. Neither is wrong, but the mismatch can create feelings of being unseen or unsupported.

Over time, these differences can lead to frustration, hurt, or even withdrawal from the relationship. In some cases, both partners feel equally isolated. 

Common Causes of Loneliness for Both Partners

• Communication gaps: Different ways of interpreting emotions and intentions

• Mismatched needs: One partner seeks emotional reassurance while the other prioritizes practical solutions

• Chronic stress or fatigue: Emotional distance can worsen when mental and physical resources are low (fatigue)

• Self-blame: Both partners may feel they are failing the other

• Depression and low self-worth: Persistent loneliness can lead to depression and negative self-talk

Strategies for Bridging the Understanding Gap

One of the most effective tools for working with neurodiverse couples is psychoeducation (learn more). This involves exploring both the autistic and neurotypical experiences—not to label one as “better” but to understand similarities and differences.

From there, couples can:

• Learn each partner’s communication style and needs

• Make the implicit explicit—clearly stating expectations and emotional experiences

• Develop strategies for expressing affection and empathy in ways the other partner understands

• Practice nonverbal communication (read more)

• Build trust through small, consistent actions

When to Seek Professional Support

If loneliness is leading to ongoing resentment, emotional withdrawal, or repeated conflict, it may be time to seek outside help. A therapist experienced in neurodiverse relationships can help partners:

• Translate and interpret each other’s communication styles

• Rebuild emotional connection

• Develop realistic expectations for the relationship’s dynamics

You can find a qualified therapist who understands both autism and relationship challenges.

Questions to Ask Your Therapist

• How do you help couples navigate neurodiverse relationship challenges?

• What strategies can increase emotional connection when communication styles differ?

• How can we each better understand and meet the other’s needs?

The Path Forward

Every relationship faces challenges, but in a neurodiverse partnership, understanding and acceptance are the keys to a deeper connection. A neurodiverse relationship will never be entirely neurotypical or autistic—it will always be uniquely yours. By learning to navigate your differences, you can deepen your connection and create a partnership that honors both individuals.

You don’t have to navigate this alone—working with a therapist experienced in neurodiverse relationships can help you and your partner build mutual understanding and emotional closeness. Find a qualified therapist on GoodTherapy today and take the next step toward a stronger, more connected partnership.

An autism diagnosis can be challenging for a family. Often, the people affected most are the couple who are parenting the child on the spectrum. When my own son was diagnosed in 2001, my husband and I embarked on an arduous journey. It was not only a journey to help our son reach his full potential, but also an opportunity for our relationship to mature and change for the better. This journey happened before I became a therapist, and it was the impetus for my going on to become one. In my practice, I now help couples achieve the same development. So many therapies and interventions are readily available to autism families, but they are primarily centered on the affected child. Here are a few ways I’ve seen couples counseling benefit the parents specifically.

The Top-Down Approach

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There’s a saying here in the South: “If Mama ain’t happy, ain’t nobody happy.” I’ve found that statement is often true for these couples as well. When parents are dealing with their own issues as a couple, their parenting typically becomes easier. The ability to make decisions, to react appropriately, and to set limits and boundaries for their children can be less stressful when they find support in one another. This is true of any family, but it is even more crucial for the autism-affected family, as their stress tends to be compounded by lack of sleep, health concerns, and the pressure of making decisions that may affect the child’s growth and education.

Children with autism can be extra sensitive to the emotional state of those around them. So when the parents ignore their own emotional and relational needs, the child may have more difficulty coping in the household. Additionally, self-regulation is typically a challenge for kids on the spectrum, so if a parent has not learned how to manage their own outbursts, it’s unlikely the child will either.

Processing the Grief

In my office, the first place I start with a couple is in processing their grief. Couples who have received a new diagnosis of autism for their child are usually in a tremendous amount of emotional pain. This is an experience they did not necessarily sign up for, and adjusting to it can be difficult. In my experience as a parent, my son developed typically during the first year and a half of his life and then regressed. This was both confusing and heartbreaking, as it caused me to question my parenting ability.

The primary area where I see couples struggle is in feeling alone because the other person isn’t “on the same page.”

Grief is generally the source of the couple’s pain and an area that many parents need to be encouraged to venture into. This is where the counselor can be extremely helpful. From a therapist perspective, I like to start by asking about the diagnosis experience. Having each parent tell their story of how it unfolded can have tremendous benefits for the relationship, as it tends to move that grief process forward. Few people ask parents what it’s like for them, and the diagnosis experience has been identified in the research as one of the most difficult. It can even result in posttraumatic stress reactions (Kuhn 2006). This grief also tends to be cyclical, as it may come back around during different times of maturation in the child’s life. A counselor who is aware of these issues can help a couple navigate these rough waters.

Making Decisions Together/Getting on the Same Page

The primary area where I see couples struggle is in feeling alone because the other person isn’t “on the same page.” Often this can be due to being in different stages of the grief process. But it also can come as a result of ineffective communication skills or poor relationship boundaries. I’ve heard comments in my office such as, “If my husband would only read this book I just finished, he would understand our son better!” or, “If my wife would just give our daughter a good spanking, she would behave in the grocery store!” While these statements are not only (in my opinion) untrue, they are also indications the couple may be more interested in being “right” than “connected.” Or perhaps they don’t feel they are being heard.

Since autism encompasses multiple areas of functioning in a child, there are many areas where the couple’s opinions can collide. Special diets, deciding between therapies, and discipline strategies are just a few of the areas where my husband and I have collided. However, it was often less about the decision to be made and more about our own “stuff” that had been there all along. Once we learned how to set healthy boundaries with each other, to communicate effectively and respectfully, and to nurture one another’s needs, we could make these decisions more effectively and without resentment.

Finding a Counselor Who “Gets It”

I’m often told by the people who come to me for help that they feel better just knowing I’ve been where they are. While it is true that a shared experience can be helpful, it is only one of many things a counselor can bring to the table. When looking for a counselor who can help most effectively, it may be best to find someone who has good clinical couples counseling skills, who is licensed to do the work, and who has a few additional skills in the areas of grief, parenting, and even trauma. Someone who specializes in autism spectrum issues would be ideal, but clinicians specializing in coping with chronic illness also have the skill set necessary to help you navigate the autism road. The designation is less about autism being identified as an “illness” (although some of these children have multiple health issues), but rather the self-care and life-balance skills these clinicians incorporate into their specialty.

In the 20 years we’ve been raising my son, I can honestly say the road has not been easy, nor has maintaining a healthy marriage. But as clichéd as it may sound, it has made my husband and I better people, and our relationship has improved as a result of the work we have done. I’m not sure if we would have been able to get here without that pain, but what I am sure of is we wouldn’t have made it alone. Autism cannot be faced without support, and counseling is one of the things that helped us get where we are today.

Reference:

Kuhn, J. C., & Carter, A. S. (2006). Maternal self-efficacy and associated parenting cognitions among mothers of children with autism. American Journal of Orthopsychiatry, 76(4), 564-575. Retrieved from http://dx.doi.org/10.1037/0002-9432.76.4.564