Adult ADHD Question-and-Answer: on ADHD and "Denial"

A few years ago, I participated in an Ask the Expert Chat on "ADHD and Relationships", sponsored by the National Resource Center on ADHD. In this free forum, the public is invited to ask questions of a top ADHD expert in a live online chat. This text-based Q&A is later stored in the CHADD Ask the Expert archive (you can view the topics at that link but access is limited to CHADD members). Among CHADD membership's many benefits, I consider this one of the best!

      

Reprinted courtesy of "Kev" 
http://www.kevscartoons.com

The Internet is chockablock with information on ADHD, but some of it is unreliable. You can count on these Ask the Expert chats to be solid. (The latest one was with Dr. Russell Barkley.) Moreover,  back issues of CHADD's excellent Attention magazine are stored in the archives for members' access. So, if you're not a CHADD member, I encourage you to sign up now (it's tax-deductible, too!).

During my Ask the Expert chat, the questions came in massive quantities!  So many that I didn't have time to answer them in the chat itself. Fortunately, I saved the file. In the coming months, I will be sharing the most topical questions and answers with you.  This month: What do you do when an adult in your life is "in denial" about what seem obvious ADHD-related challenges?



Question: How do I help my husband understand he needs help for ADHD? Our son has AD/HD, we need stability. Our life is chaotic, and we would have a more stable life if his father sought treatment. Any advice to a man not willing to change? It’s very destructive to our lives, I have lost my patience with him.  – Michele

Hi Michele,

That’s the million-dollar question for so many people dealing with a loved one who has ADHD. According to a survey I conducted a few years ago, one of the top reasons the partners of adults with unacknowledged ADHD seek couples therapy is to gain help in reaching through their partner’s denial. Unfortunately, most therapists simply lack the knowledge or skills to help. 

It might help to know that denial can have both a psychological as well as a less-talked-about physiological foundation. I devote a few chapters in my book to “Getting Through Denial,” including an in-depth interview with psychologist Xavier Amador, the leading authority on denial and mental illness whose research has shed a pivotal light on a long-ignored phenomenon. He addresses the topic comprehensively in his book I'm Not Sick, I Don't Need Help.

So much animosity can build up around the misperception that someone is "refusing" to see reality, rather than being lost in their neurocognitive dysfunction. So it’s quite an important subject – and one rarely discussed. Thanks for asking!

First Identify the Reason for Denial

Most experts would agree with you, I think:  Children need stability, especially children with ADHD, and a parent’s unaddressed ADHD symptoms can be destabilizing. In fact, some research indicates poorer outcomes for children with ADHD who are also dealing with a parent’s unaddressed ADHD symptoms. (Personally, I cringe when encountering a family wherein one or both parents have problematic ADHD behaviors yet only the child with ADHD is being treated. Over time, I've seen that many of these children finally rebel and reject treatment entirely.)

At the CHADD conference a few years ago, a young father attending my presentation (on ADHD and couples) said his wife finally got through to him by saying, “Can’t you see how you are hurting the children and me?”  In fact, he hadn’t seen it. And that’s the problem: ADHD symptoms themselves can impair one’s ability to  “connect the dots” – seeing how ADHD-related behaviors and actions negatively affect themselves and others. 

The adult with ADHD can be so “in the moment” that they just don’t notice it – or remember it long enough to make an impact. Their attention and focus is just too fleeting, not to mention empathy is often impaired. Moreover, unless there is a swift and significant consequence to their actions, they often don’t see the import. I hear from so many 50-something adults with ADHD who said they never appreciated the gravity of their spouses’ complaints until divorce court. That's when they started taking spousal complaints seriously, especially if it was the second or third divorce.

Even if these “in-denial” adults notice problematic behaviors and feel badly about the fall-out, they don’t always know what to do. So the tendency is towards "shutdown" and "head in the sand syndrome." In fact, there is often a certain amount of resignation with these adults. They tried dealing with their challenges their whole lives, they will tell you, and they’ve given up on being able to change. It does little good to give these adults ultimatums; it typically only alienates. For these adults, offering hope and optimism that true change is a possibility might help you get through – as long it doesn’t sound simply like more of what they tried in the past, without success. 

In other cases, however, the response from the "in-denial" ADHD adult is, “Nothing needs to change; I’m just fine. It’s YOU who has the problem.”

To Get Through, Get Clear

In general, the first step towards getting through a loved one’s denial is getting very clear in your own mind about the nature of ADHD and the way it might be manifesting in your loved one. 

The more you can step off the "ADHD roller coaster" and find solid ground, the less you risk being spun around in confusion and talked out of your perceptions by your less-than-insightful ADHD partner.  The less you’ll feel pressured to capitulate to poor business schemes and risky investments, for example, or other exercises in poor judgment, lest you be called "negative." (This more “realistic” economy is hitting many people hard, but especially some people with ADHD. Because money flowed so freely previously during the “go go” economy, consequences were rarely faced, just postponed.)

Getting clear involves educating yourself about ADHD and getting validation for your perceptions. You can read books, attend a support group, or talk with an ADHD-savvy therapist. The point of ADHD education is not to “accept” problematic behaviors, as so many people mistakenly believe; the point is to learn why they happen so that you develop empathy for your partner instead of locking horns, and then work on realistic strategies for change.

If your partner has ADHD (or you think it's a possibility and want to learn more), you can access free support through the ADHD_Partner yahoogroup, sponsored by Northern California CHADD and moderated by a dedicated team of longtime members, including  me.


Gina Pera