How to Choose a Therapist for your Neurodiverse Relationship

If you are a Neurotypical in a relationship with an adult on the Autism Spectrum, you will know in a minute of conversation if your new therapist has a clue about Empathy and Empathy Dysfunction. If they don’t get it that your spouse or partner (parent or sibling) lacks empathy, and that this is painfully disruptive of the relationship — then move on to another therapist. 

It’s important for you to remember that an inexperienced therapist is potentially quite damaging to your self-esteem. Don’t take the risk.

Below are some red flags to look out for when choosing your therapist:

  • The first red flag is that your therapist relies mostly on her empathic nature to provide a healing environment for her clients. While this is nice, and will work for you, it won’t work for your ASD family member. And it will backfire.
  • The second red flag is that she becomes annoyed with you for trying to explain your partner’s Empathy Dysfunction. She will see you as complaining instead of trying to guide her toward a more fruitful approach.
  • The third red flag is her assumption that your ASD partner will develop insight from therapy and become more aware of you as a result. Because she fully believes that all people have empathy to some extent, she will keep using this approach and likely go nowhere.

Trust your intuition. If you like the therapist and so does your ASD spouse, it may be worth it to teach her how to work with you. She may be willing to read some books or take a course at the local university. At the very least, her desire to get it, is a big deal, as long as she can handle confrontation from you when she has wandered afield.

Obviously, your best bet is a therapist who has a solid education in the specialty of Autism Spectrum Disorders, and she has experience treating NT/ASD couples and families. If you can find an NT therapist who has personal experience living with Autistics in her family, all the better. But make sure she has really come to terms with her own psychological trauma — and that she can work with Empathy Dysfunction.

There is a small group of the opinion that only Autistic therapists should work with these relationships, but that seems an oxymoron if you ask me. Why would you want a therapist with an Empathy Dysfunction, advising a couple where the primary breakdown in the relationship is due to EmD-0?

Relationships between Neurotypicals and people on the Spectrum can be very tough, but as a seasoned professional I will help you through the dark times. Focusing on the Neurotypical partners and family members of someone with ASD, I help my clients understand “Asperger Syndrome” and then take a closer look at how it impacts their relationships. If you need professional help, you can contact me to schedule an online appointment on my Contact page.


Footnote: Since I first wrote this blog, I have modified the meaning of some terms. Please read this excerpt from my new book:

  • Neuro-Typical or NT refers to those folks who have what is considered the normal neurological brain development. I would add that they have the full range of empathy skills.
  • Neuro-Diverse refers to those folks who are outside the range of Neuro-Typical, such as those with Autism, and other disorders. In my books and blogs, I reserve this term exclusively for Autists. People who are Neuro-Diverse are referred to as “Asperger Syndrome,” ASD, High Functioning Autism, Autist, and “Aspie.” They lack the full range of social skills one sees with NTs, including empathy.
  • Neuro-Divergent is sometimes used interchangeably with Neuro-Diverse, by other authors. I prefer to use this term to describe a couple or family, where one person is Autistic and the other Neuro-Typical. That is, the types diverge. It is this divergence within the couple and family system that is most troublesome for my clients. I will also refer to Neuro-Divergent couples as ASD/NT.

4 Replies to “How to Choose a Therapist for your Neurodiverse Relationship”

  1. This is so true. I have not succeeded in finding a therapist that is properly educated/experienced in NT/ASD relationships, or just in understanding Autism. The couples therapist we have now, whom I had high hopes for, says she is sure she is ‘On the Spectrum’, and her daughters BF has ASD. My Boyfriend hasn’t officially been diagnosed by an MD yet, he hasn’t fully accepted this idea.
    This is our 2nd couples therapist, in 3 years to ‘Help us communicate better’. I KNOW we NEED one already educated in Autism. My Boyfriend is 66 and I am 58, he relies on CA Medicare only so it’s difficult enough to find a good therapist who accepts full payment from Medicare, he might be able to do a very small co-pay. He also wants 2 hour blocks. (If we had THE RIGHT kind of therapy, I doubt we would need that long) I have Kaiser, it’s hard to find one in or out of network with those qualifications when I tried.
    ‘Therapy’ often consists of his going through his list (sometimes physical list) of events where I displeased him, reliving every detail magnified from his perspective. I try to be calm, quiet, and listen, apologize again (as we had previously resolved these issues when they happened).
    I’m not perfect, sometimes I get very tired of going to therapy just to get picked apart so sometimes I’ll get defensive. I don’t like that in me. This therapist doesn’t jump in, she doesn’t offer any specific support, suggestions, daily exercises, rituals, guidelines that we can both refer to- especially that HE can, something tangible, I know he would like something with specific steps we can utilize. Off handily there’s been a couple of the typical Couples Communication books suggested. Books I already have, already have read, and have tried unsuccessfully for years to get him to read or listen to with me. We also have some on DVD- there’s never the right time/or enough time according to him. Even when we are in quarantine!

    1. You bring up a good point Peggy, which is how to find a competent therapist when you are limited by your health insurance. Maybe others have suggestions from their experience.

      1. I found a therapist through the University of Washington’s autism center.

        One therapist, not the UW one, told me that everyone is a little bit autistic. Her wild ideas weren’t therapeutic for me, so I got out of there.

        Another issue I’ve run into occurred when I saw the same excellent therapist for four years straight. I felt like she got bored of me- I was kinda bored of me. I’d come to sessions with the same autistic problems over and over that don’t fix or go away.

        I am therapist-free now trying to avoid “eye contact” with my autistic steeped life- instead of constantly looking at it and talking about it. I’m trying the distraction/avoidance route.

        1. I understand the feeling, Kay. I realized this morning I’m just sort of ‘numbing’ myself to what is going on around me. Am I accepting my situation and just hoping it will just stay there forever & not come back at a later date? There’s no point in hoping any conversation will help solve the issues because it won’t, so I’m just distracting myself with things that I enjoy.

          We see a psychologist together who specializes in ASD and I see a personal therapist also trained in it. She suggested I start getting ‘myself’ back slowly but surely by trying not to anticipate his reactions (or lack of usually) of negativity and me not being myself around him because of it, but rather still share my excitement of life’s small enjoyments as if he was a friend with normal reactions. She said at least I will feel good and normal about sharing because by not sharing I’m changing who I am to fit the house (mirroring), and I’m losing myself. If I share with no expectations, at least I’m still sharing and being myself. I’ve actually caught myself humming lately so maybe it’s working! Still not sure if it’s acceptance or avoidance though…

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