Chapter 12: Solving ADHD’s Double Whammy

Solving ADHD's Double Whammy - partners working together on ADHD treatment

 

What is ADHD’s Double Whammy? I use that informal term to describe a common phenomenon. That is, ADHD symptoms themselves can impair self-awareness about problematic behaviors.  Even when there is ready acknowledgement, though, ADHD symptoms can also sabotage one’s attempt to pursue an evaluation and treatment.

Many partners of adults with ADHD (diagnosed or not) face this doubled-edged quandary:

  1. Their partners don’t recognize their ADHD-related challenges. They might blame other factors (including everyone around them, childhood, etc.) or simply not perceive the issues.  Instead, they “deny and minimize”—and sometimes deflect blame, too.
  2. ADHD key traits such as disorganization and poor initiation can make it really hard to “get off the dime” to  seek, select, and follow through with  an evaluation and solutions.

This is off-the-chart complexity. No “tips and tricks” are going to break the logjam. A solid ADHD education. Getting validation for your perceptions. That’s all very important. But so is one thing largely not acknowledged by mainstream mental health workers:  The best treatment results often come from teamwork with a spouse or other loved one.

Solving ADHD's Double Whammy

Welcome back to the “You, Me, and ADHD” Book Club

This is a chapter-by-chapter discussion of my first book, Is It You, Me, or Adult A.D.D.?

Taylor J., a wife and mother of four children, has late-diagnosis ADHD. So does her husband. This is a dual-ADHD marriage. With several children diagnosed as well. I asked her to write these essays for two main reasons:
1. Strong writing skills!
2. Her situation demonstrates that an ADHD-challenged marriage isn’t an issue of ADHD vs. Non-ADHD.  (In 20 years, I’ve never used that adjective.)

Here, Taylor writes her memories of first reading Chapter 12: Solving ADHD’s Double Whammy. In that chapter, I explain why pursuing an ADHD evaluation and treatment often involves teamwork. This runs counter to cultural therapy-speak that says, “Adult should take care of themselves” or “Don’t parent-i-fy your partner.”  This is not yet another manifestation of the parent-child dynamic I first explained in 2008.

Rather, once we understand the nature of ADHD, we realize this can be an entirely different ballgame.

Taylor J. Takes It From Here

My husband: “I don’t have ADHD. I can’t have ADHD. I’m a super-important, intelligent, successful, capable person who couldn’t possibly have ADHD.”

Me: “Yes, you’re super-intelligent. You’re super-important. You’re definitely capable. Yes, I love you with all my heart, and would never, ever want to live without you. My love, ADHD has nothing to do with your intelligence, importance, desire, or capability. ADHD means that you can’t always make your intelligence work when you want it to work.

Sigh. My husband still didn’t get it. Okay, well. Now what do I do?

Stop Banging Your Head Against the Wall

When we as partners of adults with ADHD hit the wall of denial, it’s very, very tempting to bang our heads against that wall.

Instead, we must remember what Gina calls “ADHD’s Double Whammy”: That is, the brain impairments troubling our ADHD partners can also inhibit their ability to accurately perceive, much less solve, those problems.

Underline that. Glue glitter around it. Make it your screensaver. Do whatever it takes to keep that thought in front of you.

(Okay, dear readers do not have ADHD, you have an easy time remembering this stuff! Well, not me! I have ADHD, too. And, sometimes I still forget that my husband isn’t doing these things on purpose.)

Sure, maybe you’re frustrated with always being “the responsible one” or “the adult” or “the one who fixes all the problems” that your ADHD partner creates. But guess what? Your actions and input might be the most effective way to turn that situation around—and help to ensure a competent evaluation and treatment.

The Trouble With Many Mental Healthcare Providers

Chapter 12 (and heck, every other chapter in the book) brims with stories from support-group members whose ADHD partners received rotten treatment because the mental healthcare provider:

  • Didn’t “believe” in ADHD, as though it were Santa Claus or the Tooth Fairy.
  • Concluded: “You’ve made it this far in life, so you’ll be fine without meds.”
  • Said, “Why reach for labels?” or “All men/women are like that!”
  • Here! Take this medication and see how it goes.
  • And many more potential responses that fathom belief.

Third-Party Information: Often Critical

Let me tell you about just one of the all-too-common obstacles to getting a proper evaluation. That is, the mental health provider relies entirely on the patient to provide accurate information. Overlooked? The need for third-party  corroboration (from a partner or other family member, close friend, etc.).

ADHD's double whammy

I remember once, when we were seeking counseling for our oldest daughter, the therapist asked my husband if there was any history of mental illness in his family. He said, “No.”

My jaw hit the floor.

I was already resentful that he tended to think of the “mental illness” problems being solely on my side of the family. Yet, I managed to simply state: “Well, what about your uncle who takes four hours to wash his hands and shave?”

“Oh, well, yeah, there’s him.”

“What about your grandmother, who checks the light switches fifteen times upon leaving a room?”

“Oh, yes, her too.”

“And your sibling, who just got diagnosed with ADHD?”

“Right, I keep forgetting about that.”

Here’s the Bottom Line:

It all comes down to this: We cannot expect a person with Executive Function deficits to give a reliable account of their own Executive Function deficits!

As Gina emphasizes: Our actions and input as partners can be crucial to helping our ADHD partners benefit from effective treatment.

The chapter quotes ADHD expert and psychologist Michelle Novotni, PhD:

Over time, the ADHD partner will be able to assume more responsibility for his or her own treatment. That, however, should be a goal in treatment, not a demand for beginning it.

 I couldn’t force my husband into treatment, especially if he didn’t see that he had a problem. However, I did continue to learn about and adapt coping mechanisms for my own ADHD. Some of those technique just happened to “spill over” into my interactions with my husband.

Examples of New Approaches:

  • “Hey, is it okay if I call you to remind you to pick up the kids today?” Sure enough, he’d forgotten, or lost track of time, so he was thankful for my call.
  • “Don’t forget, you have to leave a half an hour early tomorrow. I’ll get your lunch together, set the coffee, and make sure you wake up in time.” Wow, thank you honey! You just made wife of the year! How did you think of all that? “It was in ADD-Friendly Ways to Organize Your Life’” (Then I’d get the stink-eye.)
  • “Okay, I know you’re mad, but I don’t think you saw how you acted toward the kids. Can we go over it step-by-step?”  Finally: “Stop using your ADHD coaching techniques on me!” “Ooookay…fine,” I said. “Then you go deal with the kids’ meltdown.” He responded: “Um…okay, let’s go over it step-by-step.”
  • “Wow, I can’t believe I got all of that stuff done! The medication is really life-changing.” My husband: “I don’t want to hear it—I’ve got a ton of grading to do today.”

I couldn’t actively recruit him to embark on the Good Ship ADHD. Yet, by showing him my better life after my own treatment, I was able to help him — as Gina puts it — “long for a vast and peaceful sea.”

My Jaw Hit the Floor Again

Fortunately, my husband eventually was evaluated by my psychologist. That way, there were no “skips and gaps” in either of our evaluations. The psychologist could see through any wool either of us might try to pull over his eyes. Intentionally or not.

Eventually, he said to my husband, “You have the most severe case of ADHD I’ve ever seen. I have no idea how hard you had to work to get a PhD.”

My jaw hit the floor again.

Remember, before I was diagnosed and read Gina’s book, everything was my fault.

Discussion Points on ADHD’s Double Whammy:

  1. What’s been your experience with your own or your ADHD partner’s evaluation treatment?
  2. Did the clinician solicit your input during the evaluation or treatment process?
  3. If that happened, do you perceive it as making a positive difference?
  4. How did the clinician respond when you or your partner asked that you be involved in the evaluation process?

Next:  Chapter 13, Psychological Denial, the FEAR Factor

An earlier version of this post appeared February 15, 2015

—Gina Pera

 

We welcome your thoughts below in a comment. Your story will help others. 

Here is a hyperlinked list of all the posts in this series:

Read More in The You, Me, ADHD Book Club Series:

And now for the preview of the chapter-by-chapter lineup: the book’s table of contents.  Chapter titles appearing as hyperlinks correspond to an essay in the Book Club. Click to read. 

We stopped at Chapter 20. Would you like to submit your own essay to the Book Club?  We welcome it!   “Finding Your Voice” is an essential part of slowing your ADHD Roller Coaster.                              

Part One

From the Tunnel of Love to the Roller Coaster: Could Your Partner Have ADHD?

Section Introduction

1    Who Has a Ticket to Ride? Spotting ADHD’s Surprising Signs 

2    Laying the Track’s Foundation: What Is ADHD, Anyway?

3    Deconstructing Your Coaster: Why Each Is Unique

4    Financial Loop-the-Loops: “It’s Only Money, Honey!”

5    Driving While Distracted: The Roller Coaster Hits the Road

6    Peaks and Valleys: ADHD in the Bedroom

7    More Mystifying Twists and Turns

Part Two

Roller Coaster Whiplash and G-Force Confusion: How Many Plunges Before You Say, “Whoa!”

Section Introduction

8    First Plunge: Explaining the Inexplicable

9    Second Plunge: Managing the Unmanageable

10  Third Plunge: Breaking Down in Illness—Or Through to Truth

Part Three

Your Relationship and the Art of Roller Coaster Maintenance: Four Success Strategies

Section Introduction

Success Strategy #1: Taking Care of Yourself

Introduction: The Amusement Park’s Emergency Room

11  Strategies for Right Now

12  Solving ADHD’s Double Whammy (this post)

Success Strategy #2: Dealing With Denial

Introduction: Roller Coaster? What Roller Coaster?

13  Psychological Denial: The Fear Factor

14  Biological Denial: Not Unwilling to See—Just Unable

15  Reaching Through ADHD Denial in a Loved One

16  More Solutions and Strategies

Success Strategy #3: Finding Effective Therapy

Introduction: Calling in a Consultant to Help Retrofit Your Ride

17  Why the Wrong Therapy Is Worse Than No Therapy

18  Therapy That Works for ADHD

19  More Solutions and Strategies

Success Strategy #4: Understanding Medication’s Role

Introduction: Tightening the Brakes on the Roller Coaster

This post from Jaclyn at The ADHD Homestead touches on a range of issues within this section on medication

20  Making Connections Between Brain and Behavior

21  Rx: Treatment Results That Last

22  Maximizing Lifestyle Choices, Minimizing Rx Side Effects

23 Catch Your Breath and Take Five

Appendix A:

Adult ADHD Evaluation and Diagnosis

Appendix B:

“But I Heard That…”: More Background for the Unconvinced

Appendix C:

Three Views from Decades on the ADHD Roller Coaster

Resources

Endnotes

Index

 

9 thoughts on “Chapter 12: Solving ADHD’s Double Whammy”

  1. My husband is on psychiatrist #2 (part in thanks to insurance changes). I have never been to an appointment with him. After reading this chapter, this is going to change.

    While DH is still in denial that he really has ADHD (despite being dx’d and taking meds), he did humor me by going to individual therapy for a little while. He eventually quit because he would go to his appointment, the therapist would ask him how things were going, and he would say “fine.” Ugh!!!! Things were very much NOT fine but he couldn’t remember or didn’t have the ability to notice and perceive what was going on.

    I found a local CHADD chapter….gonna check it out.

    1. Hi Deb,

      Yes, I remember when I used to leave my husband’s Rx to him and the MD.

      My first BIG mistake.

      Good for you, for realizing the “teamwork” that often needs to happen.

      g

  2. Wow, Lorre. Thanks for detailing your experience in a “dual-ADHD” couple.

    That’s so often the way it plays out. One partner with ADHD “over-functions” and the other “under-functions.” As you say, your husband’s penchant for using external strategies might have hidden his other ADHD-related challenges. (Which is one reason I caution about overly relying on external strategies and ignoring the rest.)

    How wonderful that Chuck Parker got through to your husband. And, yes, it doesn’t matter what your husband calls his “ADHD”– or calls it nothing at all. If he is on board with treatment, and he’s doing better, hurrah!

    Congrats to the both of you!

    g

  3. My husband was diagnosed with ADHD when my daughter was, by realizing he had the same struggles she did, and was also in a depressed state. He embraced the medication with a good doctor but never followed through with a therapist as recommended.
    We are currently in financial ruin after an explosive business success (over 6 years) crashed and burned badly in large part due to the constant pressure, his desire to “do something else”, and his refusal to remotely plan for anything going wrong. With no income for months we needed to make decisions and he refused to consider anything “I can’t go through all the different scenarios and it’s a total waste of time”. Months went by, IRAS raided, former employee getting a judgement for not being paid, taxes not filed (“3 different businesses are very complicated”). I found a job and family was helping. It took my wages being garnished for him to consider bankruptcy.
    My problem is if I question him on anything, he takes it as an insult and dishes out a defense that only an attorney could spew after weeks of preparation. At the same time, he wants me to be cheering him on all the time but how can I do that when I don’t agree with his decisions. You would think this whole mess would make him realize he doesn’t know everything. Instead he acts even more arrogant, which of course is due to his ego getting beat up.
    What kind of help does he need? We are digging out and can maybe afford a therapist soon but I don’t know how to find a good one – therapist or coach. What’s the difference? Yes. Totally medicated for the last 3-4 years although the only time I get the full benefit of that is on the weekends since it’s mostly worn off when I get home. Ugh. What a mess. I’m exhausted, frustrated, scared for my future, and committed to him.

    1. HI Roseanne,

      I am so sorry to hear what you and your family are going through.

      You say that he was “totally medicated,” but I think not very well.

      The fact that it was wearing off by the time you got home is only one clue.

      You don’t mention your age, but I would definitely remind you that “life is short”. And, if you continue to put your future in this man’s hands, you’re going to get more of the same.

      Some people with ADHD do not “learn from their mistakes” — their longtime bad habit is to deny and minimize, and blame other people.

      The “denial” chapter of my book goes into good detail. Also, the medication chapters detail what competent medication treatment looks like.

      You’re going to have to take this bull by the horns, perhaps even being prepared to temporarily separate in order to get through to him that you mean business. Sorry, but there is doubtfully any other way.

      best,
      Gina

  4. Oh gah. This could take some time. DH was already in therapy as part of his SSI requirements, but it was for the wrong diagnosis. They were into talk therapy and while he loves to talk, if they ask him something and he doesn’t remember, he’ll just make something up that he will actually believed happened.

    This part:
    “But one of the biggest obstacles to a proper evaluation was the patient providing inaccurate information and the mental health provider failing to solicit third-party information (a partner or other family member, close friend, etc.).”

    His various psychiatrists (once he was diagnosed as ADHD & medicated) almost all resented him wanting me to come in with him for his office visits. It didn’t matter that I tried to be in the background until needed (or he told some lie he thought was truth). They’d say, “how did things go this week?” and he’d say “fine” or something that was minor. And I’d say “remember that rage you had on Wednesday about the video game you were having trouble playing?” and he’d say, “oh yeah”.

    I about came to blows with a therapist that questioned why I would want to present her with a history of his testing so she might form a therapy for him that suited his issues. She said “Vy voud I vant that?” Yes, Russian accent there. She was a trip and the only therapist he actually asked to have changed.

    I’ve come to the conclusion that most therapists are therapists because they want to know what is wrong with themselves and often having trouble figuring that out.

    The one we found that was really good, had to let him go because he wasn’t crazy enough for their program! Sigh. Now he doesn’t have a therapist. For now, that’s ok.

    But, yes, there is the constant reminding that sometimes is greeted with gratitude and other time greeted with growls. I never know which it will be and I have to remind him of that.

    I don’t know if we’ll be looking for any more therapists. They just haven’t seemed to really help or are incapable of providing the type of help that would be useful for him. I’ve pretty much given up.

    1. Hi Penny,

      I feel your pain. Been there and did that.

      I think the situation is better now, but still not nearly where it should be.

      My new book, Adult ADHD-Focused Couple Therapy, is a professional guide designed to train couple therapists in helping ADHD-challenged couples. Therapy for ADHD is much more than “talk” — it should encompass what too many therapists are leaving to the coaches (organizational and time-management strategies, etc.). And too many of them do that badly, or don’t do it at all, instead applying the worst of 1970s psychobabble.

      My co-author and I, Dr. Arthur Robin, will have online training for therapists and for couples/individuals. That’s what I’m working on right now.

      http://www.ADHDFocusedCoupleTherapy.com

      g

    2. Thanks Gina. I’m looking forward to it coming out. BTW – the box that says to buy the book click here doesn’t seem to be working although the link in the previous paragraph takes you right there. At least it didn’t work for me. Just a head’s up.
      🙂

    3. Thanks, Penny. I’m confused. I don’t know which box you mean, or the “link in the previous paragraph.”

      tx
      g

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