Lack of Empathy: ADD or something else?

I'm really struggling with something here folks, and I hope there is someone out there who can provide a little clarification. My wife was diagnosed 3 years ago with ADD, after struggling with depression for 10 years before that. I was excited, and, believe it or not, happy to finally have a diagnosis, and a course of treatment that I thought, by all indications and suggestions by her doctor and many other ADD experts, would improve her condition and the quality of our life. She is under medical supervision by one of the best psychiatrists in town, has had neurofeedback therapy, and has worked now for 2 and a half years with an ADD/ADHD only behavioral specialist who has helped her attempt to start to organize and refocus her life based on proven and well known behavioral techniques, in an attempt to improve the Executive Function in her brain. But recently, to his and my alarm, we've concluded that there has been only marginal and temporary improvement. And in some ways, I think she's getting worse. And as she gets worse, so does our relationship. I keep going back over all of the books and literature trying to see if I've missed something in her behavior so I can pass it onto her medical supervisors. Clearly, her behaviors match those that are so well documented in Melissa's and other author's books. But one of the symptoms that affects me and our daughter most, as we interact with her, day to day, is her lack of empathy. She truly struggles with the idea of why my young daughter would be so hurt and angry when she forgot to come home one night while out with with her visiting college buddies, or my being angry when she forgot to take me home after Lasik surgery, or why my daughter doesn't want her to take her to and from school, after forgetting to get up in the morning and pick her up afterwards. You know the story, folks, the hundreds of ADD moments like these that slowly cut to death even the most compassionate of mates. But her apologies just don't sound sincere. They just don't ring from the bottom of her heart. I really don't think she "gets it". (Even our daughter senses it) I've made a concerted effort to try to listen to her voice, body language, eyes, everything....and I've come to the conclusion that she really can't feel us, the other people in her life and how her behaviors affects the rest of us in her world. Clearly, to me at least, there seems to be something else going on here. SO I went back to the drawing board (internet), and researched the symptoms of Aspergers Syndrome and found, among many things, an Australian govvernment sight that described her to a "T". www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Asperger_syndrom... Could this be it?? The one variable I hadn't put my finger on? It's still only a guess, but I reported the idea to her behavioral therapist and he said that it's easy it miss an Asperger symptom as the distracted ADD mind can simply be too overstimulated to reach the depth of compassionate understanding the "non's" may be emotionally expecting. He said he would look into it further and he would consider my theory after some more research on his part. Time and more medical investigation will prove my concern right or wrong. Which brings me to my now well belabored point. (I certainly invite Melissa into this part of the conversation if she is available to comment.) How many people have had Asperger's diagnosed along with their adult ADD? Is this common? And how can a marraige heal/survive if one partner cannot neurologically connect with the other. I've read a lot of stories over the years on this site in which people descibe very similar behaviors of this condition. It also seems to me that this particular disability could be regarded as incompatible with marriage. To my untrained eye, it seems hard to distinguish between some of the symptoms because on some levels, they can seem so incredibly similar. Three years later, I can now easily recognize her ADD symptoms, but I'm now, more than ever, convinced that there is another script be played out here. I'm truly at my wits end. I've given everything I have (time, compassion, health, faith) to this relationship and I have very little left. If you are familiar with "Friedman's Fables" short stories, I'll be the one on "The Bridge". (You can google " Friedman's Fables The Bridge". It's a short, 3 page story about how to set and live with the outcome of setting your most powerful personal boundary) This avenue of investigation is the last chance before I open my hand. I await your thoughts, insights and experiences.

One therapist suggested that

One therapist suggested that my husband might have Asperger's.  I can see why, for two reasons:  a lack of empathy for me (although somewhat greater empathy for other family members and much more when watching sad movies and TV shows; and difficulty reading social cues.  It is very frustrating.  I think that whatever the cause of these behaviors in my husband's case, they are extremely difficult to deal with and they make marriage difficult for me (although easy for my husband, as long as it is a marriage in which little is expected of him from me).

I don't think that the

I don't think that the therapist or my husband followed up on this.  So many other problems to deal with....

My husband seems to get stuck in therapy.  He goes, he talks about his feelings, he comes home and complains that I don't want to listen to him talk about his feelings, he tells me that me talking about my feelings causes an "F*** you" response in his brain such that he does things to spite me.  He has not made appreciable progress with ADHD-type behaviors.  It seems as though he does not consider this to be a priority in therapy; the priority is talking about his feelings.  

Tired old man's picture

Talking only makes it worse

I'm sorry you're the target of his misdirected aggression.  Therapy is supposed to clarify, not subvert, a relationship.   In  my case.......my wife wants to talk, but when I tell how I feel because of an unmet emotional need, she immediately shuts down communication because it overloads her some process in her mind. (Empathy, or connection, with my emotions should create an experience feedback loop that seeks to modify or nullify her offending behavior!)  Instead,  her withdrawal further intensifies my unmet need for communication and my sense of abandonment, making everything worse.    Clearly this is a case of "the road to hell is paved with good intentions".

I think that the therapist

I think that the therapist gets what's going on but hasn't been able to break through some of my husband's defenses yet.  

Oh, yeah, my husband wants to talk, but not about things that make him uncomfortable, such as any of our big problems that relate to him, such as him not looking for a job since getting fired four years ago.

The Bridge.

I read the fable. Wow. I can relate. Why do we spend so much time on the conversation and trying to understand why they won't help themselves before we can let go?

Tired old man's picture

My favorite story in the world.

A therapist gave me that story to me 25 years ago to help me with a codependent relationship I was struggling through, and I've kept it next to my bed ever since.  I love the story because it cuts right to the center of our experience.  Let's hope others can find stength in it.  Peace.

Tired old man's picture

Congratulations.

Lauren, I've been following your story now for the past few weeks.  Congratulations.  Your mission is accomplished.  Best Wishes!

Tired old man's picture

BTW

I'm sorry I forgot to ask you this when I responded....did your partner seem to experience any of these potential Asperger's symptoms???  I am so struggling to get a perspective on this.

I'm not sure, but he has a

I'm not sure, but he has a lot of the symptoms. I just chalk it up to ADD-inattentive. 

Tom- Thank you for that

Tom- Thank you for that story, I've never read that before. What an accurate description of the situation that so many of us are in. I'm printing it off to have on hand.

In Re: your question, I don't see Asperger's in my spouse, he's actually overly emotionally sensitive at times. 

I'm curious, how does your wife see her progress as being? Does she think she's doing well?

Tired old man's picture

That's a good question.

My wife has made tremendous gains with the help of her behavioural therapist.   She now logs and schedules all of her tasks and responsibilites in her calendar book that she takes everywhere.  She's now able to consciously remember to clean up after herself when she uses and cooks in the kitchen, which is her assigned "reponsibility" given by the therapist, to allow her to develop the skills of staying on a regularly scheduled task.  (Sad, but true, she'll remember to wash the kitchen floor, but the cat box just around the corner (her responsibility) but in clear sight, doesn't get cleaned but once a week.  (I used to do it daily, but the therapist insists that she learn and expand her area of responsibility.  The cat thinks that sucks!)  Also, because of her use of her notebook and schedule, she can stay on top of our daughter's school and afterschool needs, another area that I've been responsible for for 10 years.  All these ease the condition of living, but what has not improved, even in therapy, is the emotional environment in the house.

Everyone makes mistakes.  Sometimes people's feet "get stepped" on.  No one is perfect and I don't claim to be.  But in an ADD inattentive environment, there is naturally going to be more occurences of offense, more hurt feelings and an eventual build up of frustration.  The healing is suposed to begin when our individual emotions are addressed by recognizing and validating the underlying unmet need that produced the emotional result.  (Example:  I'm mad at you...why?...because you didn't turn off the tv last night.......why?.....because I have a need for your attention right now....why?....because your important to me.  An emotional response (anger) cueing from an undisclosed emotional need , intimacy.)  My issue with my wife is that she creates (unintentionally) an offense (through an ADD behaviour) but cannot see to understand and validate why I might be hurt by it when I explain it to her, and second, cannot create the emotional experience of my pain to prevent her from doing the same thing again and again.  If I hurt someone and they tell me, I can see what I've done to them and make an effort not to do it again.  My wife doesn't get my or my daughter's experience and pain, hence we don't heal the hurt.  Deeper and deeper we fall into this emotional pit of unresolved and unvalidated hurt.  On the surface, Aspergers Syndrome seems to describe this emotional disconnection with other people's experience.  With the ability to sincerely say "I'm sorry", coming from a place of genuine concern and validation, we can move on.  Without it, relationships, like an old dry tree, will break.

Which is why I brought up the story of the bridge.  Is my wife not connecting because of a neurological issue or an emotional, codependent issue?  I don't know.  But if sure affects what I now do on "The Bridge". 

If I mention something my

If I mention something my husband has done to hurt me or neglect the house, he tends to turn it around and blame it on me. Or, my favorite, he'll find little things to tell me I should be/not be doing. It's laughable and I'm over it. Sometimes I feel bad that I'm not a die hard "stand by your man" girl, but I know what I need to be happy. I refuse to let another person hurt me over and over, whether they mean to or can't help it. 

My husband has said

My husband has said repeatedly that when we talk about what I call the big issues (him not looking for a job since being fired four years ago; him not contributing more around the house despite my oft-expressed wish that he do so, especially because I'm the main breadwinner now), his brain's reaction to my expression of negative feelings is to encourage him to do things other than what I've said I'd like him to do.  Yep, he blames me for him not doing the stuff.

coping strategy

I used to wonder if my husband was on the Asperger's spectrum before I discovered ADD.  Now, knowing him very well and knowing how ADD affects him, I truly believe his appearing without empathy is really a coping strategy for realizing he hurts people he cares about, but needing to protect himself from the pain that realization causes--if it didn't happen, then he didn't do it.  I call his three techniques deflection, distortion and denial, The Three Stooges.  My guy, too, has trouble apologizing.  "Sorry."  just one word.  But it's actually better if I just get the one word.  Most of the time, I get Sorry, but you didn't..... or Sorry, but I didn't....  or Sorry, but that's not what I meant.....    I try very hard not to make ADD caused behaviors be about HIM, but about the behavior.  Naturally, that is very hard for him to separate.  We are all taught, after all, that what we do matters more than what we say.  Since discovering adult ADD, I have many more problems accepting my husband's Three Stooges than I do his ADD symptoms.  I feel if we can both acknowledge and work with the symptoms, there is less blame and hurt.  But if he continues to need these things to protect himself, it is MUCH more painful for me.  Because there is no acknowledgement of both our situations, just his. 

My husband seems to accept

My husband seems to accept ADHD only to the extent that doing so benefits (i.e., excuses) him.  But he is very resistant to working on his behaviors.

ADHD and empathy

Aspergers and ADHD are both on the autistic spectrum, and so are quite similar...in fact it is my understanding that the most recent diagnostic manual has done away with Aspergers all together, calling it an autistic spectrum disorder.  Named or not, it doesn't change your experience of what's going on.

I do see some with ADHD who simply don't "get" that ADHD impacts others.  However, as you describe it, I wouldn't expect your wife to continue to be in that group.  She has had significant help with her ADHD, it seems, and so it would seem likely that she would understand by now that ADHD impacts those around her.  I do see, sometimes, that in a power struggle between two spouses an ADHD spouse will be defiant in a way that would be a "I don't really care what you think" attitude, or "I will do as I please, not what you want me to do."

All marriages take the ability to negotiate your differences.  Without knowing more about your situation, I would simply advise you to make sure the conversation around your feelings on this are transparent and that she is given every opportunity to explain to you why she is behaving the way she does.  Ask her if she thinks you are trying to control her life in some way and if her behaviors might result from that.

On a related, but somewhat different topic, your description of yourself sounds as if you have "lost" yourself in this relationship.  I applaud your patience, but you would likely be healthier (and happier) if you focused a bit more energy on yourself rather than on your spouse.  Make sure you are engaged in the activities that make you happy and give you the energy that you have lost.  (Exercise can be good for this - it's an anti-depressant as well as energy-builder.)