Couples therapy and Asperger’s Autism

Couples therapy is useless if the spouse with Asperger’s syndrome /Autism (AS) do not even recognize his developmental disorder. The same applies when the person with AS lives in denial of the problems his * condition causes and instead blames his neurotypical (NT) partner and children.

That is the statement of the British psychologist Maxine Aston, who is an expert in NT-AS relationships and the author of “The Other Half of Asperger Syndrome” and “Asperger’s in Love: Couple Relationships and Family Affairs.”

In the article “Asperger Syndrome in the Counselling Room” she warns against therapy, when one partner has autism disorder (AS) and the other partner is neurotypical (NT), i.e. neurological normally developed. She outlines the conditions that must be met if – at all – therapy can be of the slightest benefit. But that are conditions, which by nature very seldom will be present.

“There is no cure for Asperger syndrome; it is a lifelong disorder. Some couples may hold the hope that counselling will get ‘him’ better but this hope is false. Change is very difficult to produce in the rigid and inflexible world of Asperger syndrome. Changes though are possible when there is incentive, motivation and commitment; these changes, although relevant, are often quite small“, Maxine Aston explains.


Aspergers syndrome is a Relations Disorder

Aston calls Asperger’s syndrome a Relations Disorder because AS implies a severe deficit in the ability of mutual communication and inability of emotional reciprocity:

“Communication and emotional reciprocity are often fundamental to whether a relationship works or not. They are the key ingredients to maintain a relationship in a workable and functional state. If one of the partners is affected by Asperger syndrome and therefore unable to give or even understand the need for these basic ingredients then the relationship is almost certainly going to run into problems. This almost inevitable possibility will make it far more likely that a couple, in this situation, will at some time in their relationship seek couple counselling.”

Maxine Aston, who is a therapist herself, does not hide the fact that the NT-AS couple looking for help, can easily go from the frying pan into the fire if they consult a therapist:

“Many professionals still do not have an accurate understanding of what Asperger syndrome is. One couple reported they were told by their GP that Asperger syndrome did not affect adults, only children. Others have been told that people with Asperger’s do not have relationships.
These views can be detrimental to a couple who have had the courage to look for help. It is important that the couple is referred to someone who has an understanding of Asperger’s in adults.
….Some women have been told by the counsellor that their AS partner’s behavior was simply being male!”


NT-spouses are not understood

Aspergers syndrome and High functioning autism is a complex and pervasive developmental disorder, which is often not properly understood. There is a tremendous taboo about the realities of aspergers autism in relationships. AS involves, inter alia, severe reduced social intelligence, limited communication skills both verbally and non-verbally, lack of Theory of Mind, empathy disorder, extreme preoccupation with special interests, reduced executive functions and inability to understand and comply with the unwritten codes of conduct between people. Lack of impulse control and the typical tantrums and meltdowns often cause the spouse and children to live in a state of fear, latent violence, emotional violence and often also physical violence.

But thanks to the Asperger person’s masking and copying skills he is often able to appear “normal” outside the home. Unfortunately, this implies that the Asperger person’s developmental disorder is not being observed by outsiders. Therefore, the neurotypical spouse is not believed and not understood by others and does not get the needed support to take care of a spouse with a severe developmental disorder.

“Often it is only those closest to the individual with Asperger syndrome, such as their parents and partners, who are truly aware of the problems the syndrome can cause”, says Maxine Aston and continues:

“By the time the couple gets to the counselling room, the NT partner may appear quite desperate and frustrated by the difficulties and strain, the relationship has placed on her. She will be saying things like ‘He can’t talk about his feelings. He* treats me like an object he is obsessed by routine. He constantly accuses me of criticising him.’ Finally a thought that most NT women seem to express is, ‘I think I am going mad!’ “

The AS partner, by contrast, will be saying, that if only he knew what was wrong, he would do everything to make her happy.

If the therapist does not have professional knowledge of the traumatic impact of aspergers syndrome in relationships and in the Asperger person’s ability to role play and manipulate, then everything goes wrong. Then the therapist “will see a man who is quite likely to be very intelligent and hold down a very responsible job; announce that he really does not understand why she is never happy,” Maxine Aston says.


Important advice for therapists

So how should a therapist or counsellor react when there is a strong suspicion of Aspergers syndrome in the relationship? Maxine Aston’s reply is:

Firstly, a therapist who does not have deep insight into this complex disorder and its impact in intimate relationships should immediately refer the couple to someone who is trained in this special area.

 Secondly, the therapist or counsellor should have personal experience regarding autism spectrum disorders. It is impossible to acquire a sufficient understanding of Asperger syndrome via textbooks. Firsthand experience is required.


“The counsellor will need to assess the AS client’s availability for counselling. Aspergers syndrome is a spectrum disorder and this means it can vary greatly in severity. If the client appears to be severely affected by it or in complete denial that he has any problems and blames his partner or the children, then it is unlikely that counselling will be successful.”


Maxine Aston’s assessment is similar to the assessment of other experts: Couple counselling is useless and may even be harmful in relationships where one partner has Asperger’s /Autism disorder. If the AS-partner doesn’t have a genuine inner recognition of his diagnosis and the problems his disorder causes the spouse and children, all money for therapy is wasted.

* In this article the AS-partner is called “he” and the NT partner is called “she”. But these may well be the other way around.
Maxine Aston’s recommendable article “Asperger Syndrome in the Counselling Room” can be read here:

(Note that some facts about Asperger’s are adjusted since the article was published in 2003. In Denmark it is the assessment that 1 out of 88 have AS /Autism Spectrum Disorder; but new US studies published 2015 point to 1 out of 45. Read more here.)


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Also read:

Where can I find a Therapist for NT Spouses?









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