ADD, OCD, BPD, NPD: The ABC's That Influence The Coupledom

Personality Styles and/or Disorders: Tara Parker Pope’s New York Times Well blog this past week tackled the topic of ADHD (Attention Deficit Hyperactivity Disorder) and marriage. Researchers are hard at work studying the impact of a partner with ADHD on their relationships. No surprise to find out that indeed there is an “impact”.

Bewilderment in The Coupledom: Many years ago, prior to the full outing of adult ADD, a patient was incredulous at the repeated forgetfulness of her spouse. Requests to pick up milk were forgotten: follow-up and follow through on chores were out of the question. A partner lost in space and time with piles of unfinished business, seeming oblivious to the family needs and dynamics. What is up with that?

Driven to Distraction: Then a book Driven to Distraction by Edward M. Hallowell, M.D. was published and the puzzle pieces fell together for patient and couple. This was not an uncaring man; this was just an adult with ADD. Whether easily diagnosable or not, individuals have tendencies, styles and sometimes disorders that have subtle and profound influences on the Coupledom. ADD or ADHD is only one of many alphabet soups of difficulty that impact families and marriages. The good news is that education and information open pathways that enable couples to reclaim their relationship from the brink of disaster. When awareness of styles, tendencies and or disorders which may be oozing poisons into the relationship’s core are identified and tackled, recovery is possible.

Won’t You Come And Play With Me: My glorious great-niece was singing her ABC’s with that wonderfully sweet invite at the end……..won’t you come and play with me, and that is what I would like to offer couples. Learn the particular ABC that might be worming its way into your relationship. Not so much fun as singing the ABC’s with a two year old, but taking the stigma out of the search and using the following as a guide, can re-open the option of “fun” in the Coupledom.

As described in my post Depression and The Coupledom: The Secret Menace, matching up painful experience with a name, a label, a description and a plan, can empower and heal. Forgiving one’s partner for foibles that may be neurologically wired, and not personally intended, coupled with said partner’s taking ownership for their difficulties and demonstrating sincere remorse, is a new beginning and a key to a viable Coupledom.

Armed With Knowledge: The aforementioned alphabet soup are abbreviations of diagnostic categories: Attention Deficit Disorder; Obsessive Compulsive Disorder; Borderline Personality Disorder, and Narcissistic Personality Disorder. I picked a few of the many personality disorders listed in the DSM (Diagnostic and Statistical Manual of Mental Disorders). Providing diagnostic categories is not an enticement to play psychiatrist, a very dangerous game, nor to consider one’s partner “sick” or disordered. Nor to provide fodder for a custody or divorce settlement battle. Rather, the focus here is to introduce a language for “styles” which may be viewed as annoyances at best or experienced as cruel and purposely hurtful behaviors at worse. Each diagnostic category provides a list of features that when totaled, may qualify the person as potentially benefiting from treatment for this “disorder”. This “medical model” mirrors the diagnostic methodology for physical disorders; e.g. matching up symptoms with diagnosis.

IF USED AS A WEAPON, WAR WILL ENSUE: Diagnosing patterns of behaviors is sticky business. People feel frightened and stigmatized, whether it be their diagnosis or that of a family member. In the case of diagnostic criteria for personality disorders or styles, these labels are not defined by blood tests or skin cultures. They are accumulations of clinical observations over the decades that cluster under an umbrella terminology and need to be interpreted as such. In marital warfare, these very diagnoses can be harnessed to shoot bullets of shame and blame at each other, rather than as tools to relieve pain. However once individuals get beyond the shame and blame game, the labels can provide a directional map to change.

Patterns of Behavior are Normal: It is commonplace for couples to exhibit opposite tendencies in many areas of life. One member of the Coupledom may be more organizationally endowed, the other more spontaneous and free wheeling. Someone is the emotional barometer of the relationship, the other a source of pragmatic thinking, what works, not what one feels. Mixed together in a collaborative process, and voila, you have a perfect cocktail. However, at times, one or the other style may cause dysfunction or derailment of the partnership. Folks who lean toward the obsessive compulsive category can feel so threatened and out of control by disarray and disorder of objects or disruption in schedules that they lash out at others or remain rigid and unbending when flexibility is needed. Others may derail an entire family outing by hysterical reactions to fairly benign disturbances….as fear and adrenaline pumps through their veins. Someone may need to crank up attention in order not to feel invisible.

The post Can You Say No To A Narcissist? Co-Narcissism and The Coupledom, provides a description of Narcissistic Personality Disorder; yet many of us suffer at times with a preoccupation of self. In Borderline Personality Disorder, individuals often feel mistreated and define reality in terms of their emotional experience exclusively, leaving out a wide range of other factors, including the separate emotional reality of their partner. All of these perhaps misguided perceptions can trigger unfathomable rage at the supposed “uncaring” partner, leaving painful tracks across the body of the relationship. BPD is also aptly referred to as Emotional Deregulation Disorder. Recognizing the narcissistic, emotionally reactive, distorted or obsessive tendencies in ourselves can inspire empathy for our partners who are impacted by these behaviors and lead to change.

ADD Adult Who Remained Undiagnosed Throughout a Lifetime: A woman in her sixties came to see me and unpacked a lifetime of shame at what she feels is a fraudulent presentation of self. “I always feel like a fraud”. Growing up years before ADD was identified, and scrambling to cover up signs of chaos plaguing her for decades, this professionally successful and admired woman was worn down by the effort required to hide and disguise the true challenges of everyday life. “I don’t want people to see my closets, my drawers.” Sadly, the greatest victim of this cover-up is her self-image, so butchered by these feelings that it doesn’t recognize and own the talents and achievements of a life time’s hard labor. The impact on the marriage was profound. Rather than feeling worthy of respect and caring from her partner, the combination of poor self esteem and other factors made unkind behaviors acceptable. A sufferer of a disorder long unidentified and untreated now has to reconfigure a sense of self that acknowledges her challenge and values her achievements and personal integrity.

The OCD Mate: Little snippets of a marriage may emerge in banal places. A couple shows up at the same airport as my family and provides a lasting image of marital tension when the spouse snaps angrily at his wife as he wrestles with suitcases, rental cars and waiting grandparents. Years later it is clear that this decent man was unraveling under the strain of travel pressures and his obsessive and compulsive style. Partners who share lives with obsessive and compulsive mates can describe countless examples of unreasonable and perfectionist behaviors or endless ruminations but may not recognize the underlying anxiety at its root. The need for order and control is actually a psychological strategy, though perhaps subconscious or unconscious, to offset feeling out of control, chaotic and frightened. Repeated transactions of this nature can wound and with time, permanently damage the spousal bond if left unacknowledged and the partner unrepentant. Justifications and accusations that someone else is at fault adds scarring to the relationship. Treatment is always an option…whether it takes the form of talk therapy and/or medication. Prevention of accrued and fatal damage to the relationship is the goal.

Shyness, Phobia, Avoidance and Temper Tantrums: They all impact the Coupledom (the domicile where in the relationship resides) and they all have roots somewhere in the psyche and neurology of the individual. As with our narcissistic, obsessive and attentional tendencies, so too all socially anxious behaviors can find labels, descriptions and treatments that will benefit the individual and the Coupledom.

DON’T BE AFRAID TO LOOK: Google or Wikipedia any terms that appear relevant. Don’t let fear impede knowledge. Arm yourselves with options for help and strive to eliminate harmful notions of “stigma”. Use the diagnostic language for informational purposes only, not as confirmation of defect or insanity. We all have styles, tendencies and dysfunctional behaviors. “Live Love and Learn” (and not necessarily in that order)!

Note To Mental Health Colleagues: Pardon my taking license here with the DSM Manual by clumping ADD together with personality disorders for discussion purposes. My reasoning is that the impact on the Coupledom is comparable.