How Couples Therapy Works When One Person Has Asperger’s And The Other Does Not


Couples therapy for Asperger's

A few considerations are essential to the success of Asperger’s couples therapy

Asperger’s syndrome is predominately a relationship disorder, yet many people with Asperger’s seek out intimate, committed relationships. What happens when those relationships develop problems and the partners look for help? What help can they get and how does the process of improving the relationship occur?

I have worked with many couples, one of whom has Asperger’s and the other does not, to help them address the strife and conflict brought about by the presence of Asperger’s. My experience has illuminated a number of considerations that are crucial to improving the quality and success of these relationships.

  1. The person with Asperger’s must genuinely accept the diagnosis of Asperger’s as accurate and valid. Just as it is true that one cannot change without acknowledging there is a problem, an Asperger’s relationship cannot change when the presence of Asperger’s is rejected, denied or discounted. The first step in couples therapy is assessing whether both parties concur with the Asperger’s diagnosis. If they do not, this must be resolved for the therapy to proceed.
  2. Motivation to change is essential to the success of couples therapy. There needs to be an honest, genuine desire to improve the relationship in order for it to take place. Each partner has to be willing to put time, effort, and commitment, sometimes a considerable amount of each, into the process of change, and the motivation to do this must be assessed early in that process. I do not assume couples want to make a change just because they ask for help. There must be a frank, honest conversation about whether one or both partners are motivated to put in the work before any change can happen.
  3. Typically, the next step in couples therapy is to assess the communication patterns between the couple. Given the nature of this syndrome, adults with Asperger’s (AS) have a tendency to talk “at” rather than “to” the other person and show little concern for their partners’ responses. They think in black and white terms, focus on details rather than the big picture, experience trouble reading interpersonal cues, have intense and narrow interests, and lack desire to engage in and contribute to interactions with their neurotypical (NT) partners.

In contrast, NT partners seek emotionally connected intimate interactions with their AS partners. They prefer talking with their partner and focusing on emotional affairs within the relationship rather than external matters.

The difference in the needs, interests, and goals of AS and NT partners are reflected in their communication patterns. These patterns and what they reflect about the differences between the partners must be uncovered and discussed, as a crucial step in moving towards more honest and effective communication.

  1. More often than not, both the NT and AS partners see the other person as the main offender and thus responsible for the majority, if not the entirety, of the couples’ problems. This is not realistic. Just as it takes two people to tango, it takes two people to have a relationship, and the particular qualities of that relationship are a product of both parties’ contributions.

For most NT partners, this is difficult to accept. They see their AS partners as “relationship challenged” and therefore don’t view themselves as bringing many, if any, problems to the scene. Regardless of what they do contribute and how much of it they bring, the fact remains that they must be prepared to accept their partner’s limitations, learn new ways of communicating with them, find more effective ways of interacting, and open their eyes to ways in which they are blocking the path to greater intimacy and satisfaction.

  1. My experience has taught me that a mutually agreed upon commitment to the therapy process is key to its success. Change is difficult for many people and even more so for those with Asperger’s. That change is possible only when there is an incentive, motivation, and commitment. One of the ways to encourage a commitment to change is through contracting for a certain period of time for therapy process to take root. The amount of time may vary, depending upon the particular circumstances of each couple, but a rough estimate is three months.

These considerations are not all that go into successful Asperger’s couples therapy but they are core features of that success. In a future blog, I will describe other considerations and how these enhance the success of this therapy.

Dr. Kenneth Roberson is an Asperger’s psychologist in San Francisco with over 30 years of experience. To ask a question or schedule an appointment, please call 415-922-1122.