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How to Find a Neurodiversity-Affirming Couples Therapist

A neurodiversity- affirming couples/relationship counselor:

  • Recognizes relational issues may not pertain to neurotype difference, and may be simply relationship issues, such as finances, sex, parenting, making big decisions, opening up relationship, gender identity and sexual orientation.

  • Recognizes relational differences between different neurotype partners as an interface problem, not a result of characteristics of the more stigmatized or minority neurotype.

  • Recognizes the stigma that neurodivergent people experience and how this experience affects the relationship.

  • Does not assume that one partner is neurotypical and one neurodivergent..

  • Does not assume or promote, in marketing media or in communication, a standard of conventional relational structure — cisgender, heterosexual, monogamous, sexual and romantic. Images and descriptions of couples in marketing materials do not promote any one norm. Nor do they present only people who belong to privileged race, ethnicity, age, class, or body-types groups.

  • Communicates awareness of privilege related to dominant cultures they belong to and understanding of the impact of that privilege on the therapeutic relationship.

  • Provides resources created by and for neurodivergent people and mixed neurotype couples (books, social media, websites, videos). Resources include other intersectional experiences of race, class, sexual orientation, gender identity, etc.

  • Does not provide resources that pathologize neurodivergent people (with the rare exception of some supportive research studies where authors have been forced by research or publication requirements to use pathologizing language (e.g., ASD, “on the spectrum, functioning levels).

Questions to ask before the first session:

  • When mixed-neurotype couples experience improvements in relationship, what changes might have made these improvements possible? (Answers may include: greater understanding of the other partner’s experience, greater ability to communicate needs and boundaries and have these respected, even if needs can’t be met, increased self-regulation and understanding of personal contributions to relational dynamics, creative problem solving that accommodates each person’s neurotype without judging or acquiescing.)

  • If you have been in a mixed neurotype partnership, how has your experience in this affected your work with neurodiversity in relationships? (Look for experience of finding out there were other perspectives than their own, seeking out the experience of neurodivergent people as well as neurotypical people, adapting existing couples strategies, or throwing them out and starting anew.)

  • When you are of a different neurotype than one or more of the relationship partners you counsel, how do you discuss this cultural difference and its impact on therapy? (Looking for cultural humility here, and recognition of the power imbalance in the room when two people share a cultural connection and one doesn’t.)

  • What articles, presentations, books, or other media have you found helpful in understanding neurodiversity and neurodiversity in relationships? (Check them out and look for pathologizing or patronizing language or constructs about the neurodivergent person. Consider whether strategies in these materials feel right for you and your relationship. If a problem, discuss with the provider your concerns.)

What to look for in initial contact and sessions:

  • When session is arranged, provider communicates with both partners about their reasons to seek relationship counseling

  • Provider interrupts pathologizing statements and provides education on the neurodiversity paradigm and on the history and effect of pathologization of neurodivergence. Provider is able to convey: how stigma and ableism can impact recognition of an individual’s neurodivergence, developmental history, societal experiences, and mental and physical health. . Provider is also able to convey how norm-matching experiences can affect developmental history, societal experiences, and mental and physical health.

  • Provider asks how the setting and communication (in person and online) can be made more comfortable for each person. This includes changes to lighting, sound, welcoming of stimming, using text-based communication, using alternatives to standard talk therapy, adapting therapeutic protocols, not expecting eye contact, giving time for processing, normalizing different touch and tactile needs, etc.

  • Provider works with partners to develop practices that support connection and communication that work for each person’s sensory, communication, and cognitive processing style.

NOTE #1: I, Finn Gratton, do not specialize in couples therapy, though I work with individual clients on relationships.

NOTE #2: Thank you to Nick Walker and Kate McNulty for their review of this document.

NOTE #3: You have my permission to repost this in it's entirety, crediting Finn V. Gratton.


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