Couples therapy with neurodiverse partners
Navigating Neurotypical and Neurodivergent Dynamics in Couples Therapy: A Closer Look at Unique and Nuanced Challenges
When a relationship includes one neurotypical (NT) and one neurodivergent (ND) partner, the couple may face challenges that go beyond the common issues seen in therapy.
Communication differences, sensory needs, and contrasting ways of showing love can create misunderstandings that aren't immediately obvious — even to experienced clinicians.
Without proper context, these challenges can be mistakenly interpreted as personality flaws, emotional coldness, or lack of commitment. In reality, they often stem from deeper neurological differences.
Here, we explore some of the more unique and nuanced issues that neurotypical/neurodivergent couples encounter — and why understanding them is crucial for meaningful therapeutic work.
1. Different Models of Empathy and Connection
Neurotypical partners often expect emotional mirroring — matching tone, facial expressions, or validating emotions — as a sign of empathy. Neurodivergent partners, however, may express care differently, such as by offering advice, solving problems, or simply being quietly present.
This mismatch can lead to both partners feeling unseen or invalidated, even when both are making genuine efforts to connect. It’s not a failure of love — it’s a difference in emotional language.
2. The Double Empathy Problem — and the Weight of Social Expectations
Coined by Damian Milton, the "Double Empathy Problem" highlights that communication breakdowns between NT and ND individuals are reciprocal. Both partners can struggle to interpret and meet each other's social expectations.
However, in practice, this tension plays out unevenly. The broader social world — including families, therapists, media, and cultural narratives — typically holds neurotypical standards as the default or ideal for relationships.
For neurodivergent partners, this often means:
Constant pressure to adapt — to communicate more verbally, to respond faster emotionally, to enjoy socially normative activities, or to prioritise certain emotional disclosures.
Masking or self-censoring their natural expressions of love, distress, or enthusiasm to better align with NT expectations.
Being pathologised for authentic neurological differences — such as interpreting direct communication as rudeness, emotional regulation needs as coldness, or sensory boundaries as selfishness.
Meanwhile, NT partners are rarely asked to stretch their own definitions of connection or intimacy to meet ND experiences.
Even well-intentioned therapeutic approaches can subtly reinforce the belief that the ND partner must "catch up" or change in order for the relationship to succeed.
In short:
The Double Empathy Problem is mutual — but in a neurotypical-majority world, the burden of adaptation falls disproportionately on neurodivergent people.
Recognizing this hidden asymmetry is crucial for creating truly affirming, balanced relationship support.
3. Sensory Processing Differences in Intimacy
Sensory sensitivities (to touch, sound, smell, or environment) can greatly affect physical affection, sexual intimacy, and cohabitation. A neurotypical partner might misinterpret a sensory boundary as rejection or disinterest, when it’s actually a protective adaptation for the neurodivergent partner’s nervous system.
Understanding that intimacy must be tailored to both partners’ sensory needs can transform feelings of rejection into opportunities for deeper trust.
4. Pacing and Processing Speed
Many neurodivergent individuals require more time to process emotional information or formulate responses during difficult conversations. In contrast, neurotypical partners may expect quick feedback and interpret delays as avoidance, apathy, or even passive-aggression.
Therapists must help couples recognise and respect different processing speeds to prevent unnecessary conflict and emotional escalation.
5. Masking and Burnout in the Relationship
Neurodivergent partners often "mask" — consciously or unconsciously suppressing their natural behaviours to meet neurotypical social expectations. In relationships, this can initially lead to seeming harmony but eventually cause severe emotional exhaustion, resentment, and even autistic burnout.
When masking drops, the relationship may feel like it has "changed," leaving the neurotypical partner confused and the neurodivergent partner feeling isolated or misunderstood. Addressing masking dynamics openly can help rebuild authentic connection.
6. Different Definitions of "Closeness"
For many NT individuals, closeness is tied to frequent verbal communication, emotional disclosure, and shared activities. In contrast, some ND individuals find deep intimacy through "parallel play" (being near one another while engaging in separate activities) or through shared special interests rather than emotional storytelling.
Without awareness of these differing intimacy styles, partners may miss the ways the other is already reaching for connection.
7. Executive Function and Invisible Labour
Executive dysfunction — difficulty with planning, organising, and initiating tasks — can create imbalance in household or life responsibilities. NT partners may feel they are shouldering an unfair share of "invisible labour," while ND partners may feel micromanaged, infantilised, or overwhelmed.
Framing executive challenges as neurological rather than character flaws can open the door to compassionate, collaborative problem-solving.
8. Social Energy Mismatch
Social fatigue is another major point of friction. A neurotypical partner may have greater capacity or desire for regular social engagements, while the neurodivergent partner might find frequent socialising overwhelming or physically exhausting.
Repeated misunderstandings around social obligations can lead to resentment if not openly discussed. Couples benefit from creating shared "social scripts" — agreements on how to balance external commitments with internal energy needs.
Final Thoughts
Neurotypical/neurodivergent couples bring tremendous resilience, creativity, and depth to their relationships. However, traditional therapy approaches may fall short if they don’t account for the complex, bidirectional nature of their communication differences — and the broader societal pressure that often weighs heavier on neurodivergent individuals.
When therapists, and the couples themselves, move beyond a deficit model and embrace a neurodiversity-affirming perspective, it becomes possible to build rich, sustainable connections based on mutual understanding, flexibility, and respect.