Counselling for couples where one or both is autistic

As a relationship therapist, I frequently see couples where one or both partners either already has a diagnosis or believes they may be autistic.

If the couple has children, the impetus to get an adult diagnosis often begins when one of their children was identified as autistic.

Autism in adults

There is something about answering questions, such as, “Does your child get upset if their daily routine is disturbed?” and “Does your child have any problems with understanding jokes?” that can be a lightbulb moment for a parent, prompting the thought, “Never mind the child – this sounds a lot like me!” Whether adults choose to get a formal diagnosis or prefer self-identification and peer confirmation, accepting their autism can be painful.

One client said to me, “I know I’m different; we’re all different, but I don’t want to be different in an 'abnormal way'”. For others, the realisation that the difficulties they’ve been experiencing are not character flaws, but understandable responses to a world that is not well adapted to their needs, can be liberating. Another client told me, “I think all my life I’ve recognised that I find some things challenging, but I’ve been thinking that if I just try harder, I’ll be able to do these things. But having the diagnosis, it’s made me think, maybe there’s a reason that this has been so hard.”

Autism and the couple

Couple relationships can bring particular challenges for autistic individuals. While there are countless ways in which autism is expressed, many autistic people struggle to mentalise, that is to understand what others may be thinking or feeling. The belief that we 'know our partners inside out', or that they 'get us' is part of the lure of a couple relationship. Experiencing this kind of intimacy can echo the attunement we experienced as babies when we depended on our caregivers to help us understand and manage our emotions by mirroring them back to us.

For a neurotypical (the word the autism community coined for non-autistic people), being with a partner who struggles to know what they are thinking or empathise with what they are feeling can be frustrating and painful. The autistic partner, meanwhile, can feel criticised for not being a mind-reader. Sometimes the couple collude in a fantasy that, if the autistic partner just tries a bit harder, things will change, which can result in cycles of disappointment and blame when they do not.

Learning to compensate

It is a common misperception that autistic individuals do not care what others are thinking or feeling. In my experience, autistic people care deeply about what others are thinking and feeling; they just find it hard to intuit.

Sometimes, I see them 'working it out longhand', following a reasoning process along the lines of, “l noticed you are doing such-and-such. The last time you did that, I asked you about it, and you told me it was because you were feeling sad. I wonder if you might be feeling sad about something now?” Whether this sort of reasoning increases empathy or just heightens whatever distress the other person might be feeling can depend on the reaction of the neurotypical partner. If they are able to recognise their partner’s attempt to empathise, and the care underlying it, this can be hugely beneficial, increasing closeness. If it just reinforces the sense of not being known, it can force the couple apart. 

While there is something powerful in a partner who can immediately understand what we’re feeling and know what we need (as in “you’re looking sad, come here and I’ll give you a hug”), my experience as a relationship therapist is that this level of empathy is rare. Neurotypicals may assume they know their partners inside out, but often what they believe their partner is feeling is only what they would be feeling if they were in the same circumstances. The “you’re sad, come here and I’ll give you a hug…” offer can, as often as not, provoke the response, “I’m not sad – I’m furious with you and the last thing I want is a hug!”

In neurotypical couples who come for couple counselling, refrains of “he’s not the man I thought he was” or “I thought I knew her, but then she did something that I’d never have believed possible” are common, often after decades of a life lived together. In some ways, the autistic, 'longhand' method of working out what another may be thinking, though slower, may be more reliable than false 'intuition'.

Making counselling easier for autistic people

Coming to couples therapy takes courage. All counselling requires us to do something uncomfortable – talk about our innermost, often painful, feelings with a relative stranger. Couples therapy requires the same, but we also have to reveal these feelings in front of the person we care most about in the world. Sometimes I am amazed anyone does it. Where one or both partners is autistic, there are additional challenges. As therapists, we are often, without realising it, geared to neurotypical needs and expectations. We tend to seek eye contact, for example, which can be experienced as intrusive by many autistic people.

In a couple session, we may cut one partner off if they speak for too long, but many autistic people can get stuck in a monologue, especially when made anxious by an unfamiliar situation. Simple adjustments to the way we work can, I believe, make it easier for autistic people to tolerate the therapeutic encounter. 

If that can happen, there is the potential for neurodiverse couples to use counselling to learn about their respective neurological differences. While these differences will sometimes cause conflict, or just have to be put up with, at other times they can be accepted and even embraced, resulting in a deeper and more authentic relationship.

If you or your partner are or believe you may be, autistic, and you’d like help understanding the impact this has on your relationship, please email me to book an initial consultation.