Melissa Orlov's Blog, page 10

Dos and Don'ts for Finding a Couples Therapist if You or Your Partner Has ADHD

Diagnosis and Treatment of ADHD

As you might imagine, working with couples is quite different than working with individuals.  Professionals have two people to address, two perspectives to sort through, and a need to help couples find a mutually beneficial path forward to resolve their issues together.  This work does not resemble individual counseling.  With this in mind, we offer some tips for finding a couples therapist versed, as well, in working with couples impacted by ADHD.

DO make sure you find someone with specialized training in couples therapy

Many well-intentioned therapists take one couples therapy class in graduate school and then begin to work with couples, relying mostly on their instincts. While this is common practice, unfortunately, there’s just too much at stake in couples work to be reliably helpful without dedicated couples therapy training. Additionally, the specific dynamics that can come up with adult ADHD for ADHD impacted couples requires specialized knowledge in these patterns and how to address them. Working with someone who has focused training in these two areas will set you and your partner up for a much more positive, productive couples therapy experience. 

DON'T stay with a couples therapist that leaves you chronically feeling worse when you leave the session.

While being in couples therapy is certainly hard work, it should be clear that you are learning and/ or working towards a new normal, even if it feels difficult. If the sessions just feel like rehashing your fight at home and don’t get you somewhere new on a consistent basis, it’s time to look for a new therapist. Importantly, if your couples therapist doesn’t know about ADHD relationship dynamics, you could be spending a lot of time, energy and money on therapy that isn’t addressing the real crux of the issue – that ADHD impacts how you both relate to one another. 

DO look for someone who uses evidence-based and possibly state-dependent couples therapy models.

Evidence based couples therapy models have been subjected to research, and proven in their approach to have the best chances of helping couples to repair old hurts and enact new dynamics.  State dependent models make sure you aren’t just talking about the last fight, but actually doing something about HOW you navigate conflict and connection.  

Some solid evidence-based and state-dependent models that each has its virtues for ADHD couples therapy are: Gottman Method Couples Therapy, Pragmatic Experiential Couples Therapy (PEXT), the Psychobiological Model of Couples Therapy (PACT), Emotionally Focused Couples Therapy, and Internal Family Systems for Couples (IFS).  For couples impacted by ADHD, IFS is a particularly robust model.  The ADHD-based model that we use in the ADHD & Marriage consulting group has not been through a paid research test, but is based upon over a decade of in-field use and improvement. The fact that it is attuned to ADHD couple specific issues makes it quite effective.

Consider sessions that are longer than 50 minutes long

Evidence shows longer couples therapy sessions are more effective for all couples – and I would argue that’s even more true for couples with ADHD relationship dynamics. Longer sessions – 75 or 90 minutes weekly, or even intensives – allow you time to discuss the issues AND work through them before you leave. Folks with ADHD often appreciate the extra time to work through getting to the bottom of the issue, lean into hyperfocus, and not have to task-switch out of therapy in the midst of a high intensity emotional moment. 

Questions to ask

So, some great questions to ask a new couples therapist are: In which couples therapy models have you trained? How many couples have you worked with? Do you have consultation or supervision tailored to couples therapy? How do you see those models being useful for us as a couple with ADHD relationship dynamics? 

Any couples therapist who takes the practice seriously will have great answers for these questions. 

...and the bottom line

Taking into account all of this guidance, the true measure of whether a couples therapist is a good fit for you is whether you both feel helped, like you understand one another more deeply and are finding more ease together as time goes on. Good luck!

Rachel Ban, LiCSW is a veteran couples therapist who has specialized in couples intensives for over a decade. She is a consultant with the ADHD and Marriage Consultants program and the Program Director for Intent to Action. You can find her private practice at: www.rachelbanlicsw.com

Tags:  therapy couples ADHD ADHD professional

Au-DHD resource request

Forum: Resources

I've come here by way of Orlov's first ADHD Marriage book following my wife of 10+ years diagnosis of ADHD last year. The book was tremendously helpful in my ability to both name my feelings and develop empathy for my spouse. Her therapist was unsurprised to hear of her diagnosis and, at that time, also suggested that she may be mildly autistic. I had originally focused on the ADHD portion of her diagnosis but am now looking to grow in my understanding of her autism as I often keep coming back to a core concern of not being able to understand her (feelings, frustrations, desires, etc). Does anyone have any resourses to share with me? Thank you! 

Where to Start

Forum: Support for the ADHD Partner

Hi all,

I am the ADHD partner to my husband of almost twelve years. It has been a journey, and not an easy one combined with my husband’s OCD and depression/bipolar disorder and two of our four children having special needs, one of them quite severe. We both got a lot from Melissa Orlov’s book some years ago and it is becoming more apparent that I need to put in some serious work apart from organizational changes and going on medication, which I did do five years ago after a lot of resistance. 

i have tried therapy in the past, and some couples therapy. No one has really gotten our situation like Melissa does in her original book (just ordered the newer one). I feel like therapists tend to take my side way too readily or downplay what my husband is experiencing. We need an affordable option, so the self paced study is under consideration, but I also need accountability in order to keep this a priority. I also will probably need to do most of the work myself at least at first to show my husband that I am serious this time. Does anyone have any suggestions? 

-wife who just wants to get it right for her husband

Accountability for impulsive spending

Forum: Negotiation and Setting Boundaries

Hello—longtime reader, first-time poster.

Apologies if this has been discussed before—I'm open to any helpful links. I also welcome other perspectives to potentially illuminate blind spots. I am aware we come from a place of privilege with having the luxury of dual-income.

I’m a 33M (non-ADHD) married to a 33F (ADHD). I manage our finances well, allocating money toward our family's needs, wants, and savings. Since our 2023 wedding, we’ve given ourselves individual allowances from each paycheck to cover any non-family expenses and "fun", which has worked well—until recently.

My wife just told me she’s accumulated several thousand dollars of credit card debt. I was grateful for her honesty and initially wondered if her allowance wasn’t enough. But after reviewing her spending together (at her request), it’s clear the issue was mindless purchases, not insufficient funds.

In couples therapy, I’ve learned I should not be managing her spending for her (parenting)—she needs to take responsibility for improvement. That said, she’s always struggled with this. Unlike some who get defensive, she feels deep shame, and I often give her leeway out of empathy. I’m starting to worry that might be enabling her.

So here’s my dilemma: is the boundary I need to set that she will no longer receive extra funds until her credit card debt is paid off? Do I let go of control, stand back and let her learn through experience, even if that means more debt? Do I wait for her to ask for help? And if she does, how do I handle it if she ignores my advice? We’re married—her debt is now my debt—and I will continue to grow more and more concerned if this continues.

Thanks so much.

Detaching

ADHD & Marriage News - May 7, 2025 Quote of the Week

“For each of us there comes a time to let go.  You will know when that time has come.  When you have done all that you can do, it is time to detach.  Deal with your feelings.  Face your fears about losing control.  Gain control of yourself and your responsibilities.  Free others to be who they are.  In so doing, you will set yourself free.”

     - Melody Beatty, in Co-Dependent No More

Detaching

Beatty is not talking about separation or divorce here.  She is talking about letting go of the illusion of control, and setting strong boundaries around what is our own responsibility vs. what is our partner’s responsibility.  Many couples impacted by ADHD don’t have great boundaries – in fact, it’s quite possible you have the parent/child dynamic going in your relationship.  That’s an excellent example of disordered boundaries.

The idea of freeing others to be who they are is particularly scary for many non-ADHD partners, who may fear that their ADHD partner is not capable of adequately managing ADHD…and for some (certainly not all) this is the case.  So non-ADHD partners tend to spend too much time trying to control their situation - and their partner - in an effort to affect change and move that partner closer to what the non-ADHD partner hopes for.  Sadly, the most likely ADHD partner response to that pushing or parenting behavior (sometimes called codependence) is defiance, escape, and digging in.  Sometimes depression, anxiety or chronic anger may set in, too.  The most likely outcome for the non-ADHD partner is frustration, anger and hopelessness.

The healthier and more effective approach would be for both partners to take control only of their own issues, and support the other partner’s efforts to rise to their potential.  In other words, dramatically improve their boundaries.  Life will still have ups and downs, but your relationship will be significantly healthier with better boundaries in place.

Focusing on your own needs, and better enacting your own boundaries, can free you both to love each other based upon who you both truly are.  Or, once you are viewing each other based upon accepting your amazing parts as well as your imperfections, you may discover that you aren’t as good a fit as you thought you were.  In which case it frees you to move away from a relationship that ultimately wasn’t going to work well for you.

 Is it time to let go of the illusion of control and to set strong boundaries around what is your own responsibility vs. what is your partner’s responsibility?

HIGHLIGHT: 

Intent to Action (i2a) Membership Program - Ongoing support for couples dealing with ADHD, from professionals you can trust.  Questions? Review our i2a on demand information session and Frequently Asked Questions. Register for our May 21 Information Session with Melissa and Rachel. 

Resources For Those in Relationships Impacted by ADHD SEMINARS, GROUPS:

NEW: Intent to Action (i2a) Membership Program (Registration Open)  - Live expert support, a great community and lots of ADHD management tools, encouragement and accountability to help change your good intentions into new dynamics with your partner.  

ADHD Effect In-Depth Couples' Seminar - Is your relationship in trouble? Melissa and senior consultants help partners improve their lives together in this premier 9-session ZOOM seminar that has changed the lives of many, many couples impacted by ADHD. 

The Self-Study Seminar - (Ongoing) Move at your own pace. Includes materials and recordings from the recent '24 live seminar.

Non ADHD Partner Support Group - (Full) Be part of a community of people exploring similar issues; learn from each other's successes and struggles; find new, more effective ways to be your best self in your relationship. Group leaders include Tami Anderson, Amy Borla, Lee Crespi, Lisa Magel and Ashley Paradise.  NEW: LGBTQIA+ and Consensual Non-Monogamy group!

Foundations in Habit Development - (Registration Open) - Starts June 4th. This special series is for ADHD partners who have completed The ADHD Effect Couples' Seminar. This two month program helps you solidify the changes you have started to make.

ADHD & Marriage Consulting Group - (Registration Open. Ongoing). Are you interested in doing individual or couples work with someone who is an ADHD expert?  This is a group of professionals who understand the issues faced by individuals and couples impacted by ADHD.  We STRONGLY recommend you also take the ADHD Effect In-Depth Couples' Seminar

Couples Support Group - (Full) Navigating Parent-Child Dynamics. seven sessions. Participants obtain a deeper understanding of what drives their Parent-Child Dynamic, In this group 5 couples will work with Internal Family Systems (IFS) master facilitator, Jason Weber, to understand what ‘parts’ of themselves are participating in the parent-child dynamics and learn how to compassionately move away from it. 

Therapist Training & more - For counselors, therapists, social workers, coaches, and other professionals who currently work with adults and couples impacted by ADHD, or who would like training to help improve their skills in this important therapeutic area.

FREE RESOURCES: Weekly Marriage Tips email newsletters; Free Treatment E-book "How to Optimize Treatment for Adult ADHD"; A community forum with other couples facing similar issues; A large number of blog posts on various topics; Referrals for ADHD-Savvy Therapists; Chore Score Worksheet; Recommended Reading for Couples Impacted by Adult ADHD

The Hidden Grief of ADHD: What It Is and Where It Comes From

ADHD Voices

For people with ADHD (Attention-Deficit/Hyperactivity Disorder), grief often shows up in quiet, subtle, and complicated ways. It’s not always loud or dramatic. Sometimes it’s just a heavy feeling in your chest, a sense that something’s been missing for a long time.

If you’ve ever thought, “Why didn’t anyone notice this sooner?”, or “I wish I had known earlier,”—you’re not alone. That feeling is grief. And it’s completely valid.

1. Grief for the Person You Could Have Been

One of the biggest sources of grief for people with ADHD is looking back and wondering: “What if I had known sooner?”

You might think about how school could have been different if you had accommodations. Maybe you’d have had more confidence if you weren’t constantly being told to “try harder” or “pay attention.” This kind of grief is about lost time and missed potential. It can feel like decades of your life were shaped by misunderstanding.

This grief often surfaces after a late diagnosis, when everything suddenly makes sense.

2. Grief From Misunderstanding and Shame

Before diagnosis, many people with ADHD go through life thinking they’re lazy, scatterbrained, or not trying hard enough. This leads to internalized shame and years of self-doubt.

Grief comes from:
- Being mislabeled
- Feeling broken
- Trying harder without seeing results

It’s grief for a self that was always doing their best—but never recognized as such.

3. Grief Around Relationships

ADHD impacts time management, emotional regulation, and impulsivity—things that can strain even the best relationships. You might grieve lost friendships, romantic breakups, or misunderstandings with family.

It’s painful to feel like your symptoms pushed people away, even though you never meant to hurt anyone.

4. Grief from Constant Comparison

In a productivity-driven world, ADHD often feels like being left behind. You might see others achieving milestones while you struggle to start or finish tasks.

This leads to grief through:
- Comparing yourself to neurotypical peers
- Feeling like you’re always playing catch-up
- Wondering why it’s harder for you

But it’s not about ability—it’s about brain wiring and support systems.

5. Grief for Missed Dreams and Burnout

Because ADHD can cause difficulty with follow-through, many people start projects but rarely finish them. Over time, this leads to:
- Burnout
- Abandoned dreams
- Lost confidence

It’s grief for the versions of you that never got to fully blossom due to a lack of understanding or support.

6. Grief After Diagnosis (Even If It's a Relief)

A diagnosis often brings clarity and validation. But it can also trigger sadness and regret:

- Why wasn’t this caught earlier?
- Why did I blame myself for so long?
- What could have been different?

This grief is layered with relief and anger. It’s part of the healing process.

7. Grief from Feeling 'Different' Your Whole Life

People with ADHD often feel like outsiders. From school to work to friendships, there's a constant feeling of not fitting in.

Grief comes from never feeling fully accepted, or from masking your true self to meet expectations.

You’re Not Alone

If you see yourself in these words, please know: You are not broken. You are not alone. And your grief is valid.

This isn’t about weakness. It’s about surviving a world that wasn’t made for your brain. Now that you understand more, you can begin to heal—on your own terms.

What You Can Do If You Are Grieving

Here’s a user-friendly guide to help you navigate loss with tools that work with your ADHD brain, not against it.

Learn About Grief and ADHD

 First things first: You’re not doing it wrong. Grief might show up as zoning out, forgetting things, or sudden emotional surges. ADHD affects how we regulate emotions, focus, and process memories—which means grieving can look really different. Understanding this can take away a lot of unnecessary guilt.

Ground Yourself with Mindfulness (But Make It ADHD-Friendly)

Traditional mindfulness might not work if sitting still feels impossible. Try:

Walking meditations Fidget toys during reflection Guided audio mindfulness apps Sensory grounding (holding a soft blanket, lighting a candle, hugging a pillow)

                  These ideas help anchor your body when your mind feels scattered.

Express It Creatively 

Grief often lives in places words can’t reach. Let it out in ways that feel good:

Structured grief journaling (use prompts like: "What do I miss today?" or "What would I tell them right now?") Art, music, or movement Build a "memory box" filled with things that remind you of your person or loss Find the Right Kind of Therapy 

Not all therapy is created equal. Look for:

Grief coaching, counseling, or trauma-informed therapy ADHD-aware therapists CBT (Cognitive Behavioral Therapy) or ACT (Acceptance and Commitment Therapy), especially when they use visuals, movement, or hands-on activities Structure Helps When Emotions Don’t 

Grief can mess with routines, and ADHD makes that even messier. Try:

Setting gentle reminders for food, water, and sleep Using planners or visual schedules Making daily checklists or care cards ("Today I will: eat, rest, drink water, take 3 deep breaths") Connect With People Who Get It 

Isolation is common in grief, especially when you feel like your brain isn’t doing it "right." Reach out to:

ADHD or grief-specific support groups (online or in-person) Friends who let you be real and messy Online communities where you can scroll or share when you’re ready Use ADHD Tricks to Care for Your Grieving Heart Set visual timers to keep track of time (grief time warp is real) Use metaphors or analogies to understand what you’re feeling (grief = waves, memory = scrapbook) Schedule "grief time" so your feelings have a space to breathe Final Thoughts

Grief in ADHD is real. It’s the silent thread in your story—the “what-ifs” and the weight you’ve carried.

But now you have a name for it. You’re not imagining it. You’re not overreacting. And most importantly, you’re not alone.

Your grief is valid. And it’s not the end of your story, it’s the beginning of self-compassion, healing, and growth.

Becky Brotemarkle, PhD (and more) is a consultant with the ADHD & Marriage consulting group with multiple areas of expertise.  With many years as an RN and hospice care provider she has a great deal of expertise in how to effectively process grief. You can learn more about Becky's work through her site: https://www.macrolifecoaching.com.

Sources

- Ramsay, J. R., & Rostain, A. L. (2015). *The Adult ADHD Tool Kit: Using CBT to Facilitate Coping Inside and Out*. Routledge.
- Barkley, R. A. (2011). *Taking Charge of Adult ADHD*. The Guilford Press.
- Hallowell, E. M., & Ratey, J. J. (2010). *Driven to Distraction (Revised)*. Anchor Books.
- CHADD.org – Children and Adults with Attention-Deficit/Hyperactivity Disorder
- ADDitude Magazine – www.additudemag.com

Tags:  Grief adult ADHD adult diagnosis sadness structure

My ADHD wife keeps insulting me and blames me for everything

Forum: Anger, Frustration & ADHD

Dear all,

I am new to this forum as I am looking for some help. I am married and my wife has ADHD and our 2 daughters (6 and 9) also have ADHD. I am trying to manage my daughters but it is all starting to be a bit overwhelming.

Especially with my wife, who is more and more depressed and she blames me for everything that is wrong in her life, for everything that has ever gone wrong, etc. She sometimes has anger outbursts and starts insulting me, using every example of things I shared with her and seems to want to hurt me as much as possible.

She has now also started to do it in front of the kids and even when I tell her to stop, not do say certain things in front of the kids, she gets even more angry and insults me even more. It is so bad that I am sometimes scared to go home as I do not know if she will again freak out.

I am mentally exhausted and cannot control myself when I am tired and then start fighting back and also insult her. Normally when she starts, I just leave the room and go somewhere else however I sometimes cannot manage and respond by fighting as well.

Yesterday we had another fight and she insulted me quite a bit, so this morning my temper was a bit short and I shouted at my 6 year old daughter. She used this and started insulting me again and managed to turn my daughters against me, saying that I was a horrible father, etc. 

It was so bad that my daughters did not want me to drop them at school but asked for my wife to drop them, even though I normally drop them every day. 

I feel terrible as I should not have shouted at my daughter but I was just still angry from yesterday and instead of helping, my wife used this moment of weakness to turn the kids against me. When she is calm, I try to talk to her and tell her that it is not correct what she is doing, that she should never use the kids in our argument but she does not want to hear it.

This morning I heard her tell the kids that they should never marry a person like me, that they will be unhappy if they marry someone like their father. It is such a horrible thing to say to the girls. My wife is not working and I am working hard to try to get everything for my wife and kids but nothing is appreciated. We have 2 cars, pianos, 2 houses (one for holidays in Italy) and I keep on trying to give more and more to them but I never seem to have anything back. 

This really bad mood changes started during the pregnancy of my 2nd child and have only been getting worse, especially the last 2 years. My wife does not want to seek therapy and I am starting to not see any way out apart from divorce.

I guess what I am asking, should I still be fighting for this and if so, how? Or as there has been no improvement since years now, should I say that it is enough and leave? I am afraid if I do this that she will completely push the kids against me. I feel quite trapped and all I want is for the situation to get better...

Rebuilding social life

Forum: Communication with ADHD

Sorry, everyone. I wish I could report more happiness 1,5 years after ADD divorce, but it’s still hard.

How does one rebuild social life after having lost confidence? 15+ years of ADD-associated shame and avoidance, and hundreds of attempts at connection with people who seemed slightly uncomfortable, probably smelling misery, have eroded me. There are very few invitations. How do you find common ground with others when your life has been thwarted by an ADD partner?

He had depression and magnificent social anxiety but also hid it effectively from everyone. Only I knew the shameful truth of our life: together we were socially helpless, and other people took advantage of it to hurt me. It’s changed me from who I was.

I’m afraid of everything socially now. Of being too nice and seeming desperate. Of being boastful by mistake. Of boring somebody. Of not being able to listen well enough and ask the right follow up questions. Of being hurt.

At work it’s the same thing. I’ve been there ten years and have enjoyed many good moments with people, but also felt a lot of dread. Of being disliked, or dismissed in hierarchies I don’t quite understand. Many colleagues are friends outside work and for me that has always seemed impossible. Like I’m encapsulated in my strange predicament. I fail to imagine what life is to others, and they can’t understand me.

For many years, the only people I’ve been able to see privately have been close personal friends. 

Possibly the social insecurity is the worst residue of my marriage. 

Does anyone else feel like this? 

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Forum: Support for the ADHD Partner

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Perpetual Cycle of Hurt

Forum: Communication with ADHD

I am the ADHD partner. I have been with my partner for 10 years. With increasing frequency, it feels as though that I become distracted when she's speaking, or she feels I am not paying attention to her. This recently reached a head last week, where she feels that yet again I chose to not pay attention to her. She has responded with anger, as I've tried to apologize. She even said to me that she doesn't think I'm sorry, but she will make me feel sorry. How do I weather this? How do I get her to see that I do truly care about her, how do I take care of myself as she seems more out to deliver punishment than seeking a path forward?