How (not) to diagnose your partner

Sometimes clients say something like this:

Client: “I think my husband has Aspergers. I know you’re not entitled to do a diagnostic assessment, but I would be so relieved to know.”

Me: “Do you know how he feels about it?”

Client: “No, but I think it would do him good to know more about himself.”

Or like this:

Client: “My wife sends me here. She says I’m autistic and I should learn more about myself so I can meet her needs better.”

Me: “What about your needs?

Client: “Oh, I’m fine. I just want to make her happy.”*

The “spouse-diagnosed” phenomenon

The “spouse-diagnosed” phenomenon is well-known among counselors. In fact, most of the cases we studied in the neurodiverse couple counselor training fell in this category. Especially among heterosexual middle-aged couples it is often a friend’s remark, a podcast episode one stumbles upon or obsessive (sic) googling of the partner’s personality traits which brings up the suspicion that one of the partners – mostly the other partner – might be on the autism spectrum.

The person who finally has an explanation for their partners quirks feels relieved because they know: “it’s not my fault”. And they also know that their partner is not behaving on purpose in ways that irritate them. They might be hoping for a similarly relieving effect in their partner. Or they even might intuitively think something like: “Now that we’ve got the diagnosis, maybe we can find a cure.” This is essentially pathology paradigm thinking, which conceptualizes autism like a disease. For autism there is no cure, and this is fine.

Before rushing to your partner and sharing your exciting discovery that they might be on the spectrum, before stamping dated self-designations like “Aspie” on them, before urging them to do the “Aspie Quiz” on the internet, before telling them which celebrities are thought to be autistic or before signing them up for a support group, please think again. 

Diagnosing your partner can be a poisoned gift. Some things to keep in mind: 

1.     Your partner will not change to be how you want them once they have discovered who they truly are.

There is some truth in the saying that in order to change, you first must accept yourself the way you are. The same applies to others you want to change. You first have to accept them the way they are, which should entail understanding why their way of being makes sense for them and in certain contexts they move in. Only then can be examined what can and should be changed and what can’t or shouldn’t. One thing that can’t be changed is autism. Of course, autistic people can change some of their behaviors, as everyone else can. But they first need to understand where the behaviors come from. Behaviors that annoy oneself or others often come from needs unmet and sometimes unrecognized. So, if you want your autistic partner to change their ways, first take their needs seriously and be prepared to plan together how they can be met. The biggest benefit of an autism diagnosis for the autistic person is usually that they finally feel entitled to take their needs seriously. Protection from sensory and communicative overload tends to be one of the top priorities here. Only if this is assured, you and your partner can deal with each other’s potentially conflicting needs and wishes.

What you can do:

If you think your partner is autistic, the first thing you should do is take their possibly autistic needs and sensitivities seriously. Only after that you can figure out together which behaviors, routines or structures each of you can and want to change, if any.

2.     A diagnosis is not always an identity. An identity is not always liberating.

An autism diagnosis tends to throw people on an emotional rollercoaster for a few months or even years. Relief is one of the most reported feelings after diagnosis, but so are resignation or even despair. And how people perceive and process the diagnosis is strongly connected to their general wellbeing, perceived success in life and societal privilege. If your partner is already depressed, a diagnosis with autism will not make them instantly feel better. It might enable them to understand the reasons for their depression and get the right kind of treatment, though, if they have the economic means, emotional stamina and social support. If your partner can leverage their strengths in a thriving IT company, changes are they will take the diagnosis more in stride than if they have just been fired out of another job in the service sector. A privileged person might be more interested in having an explanation for their struggles at school or work in form of a diagnosis than someone already affected by multiple oppression and not keen to represent yet another diversity ‘checkbox’. Someone growing up in an extremely ableist time and place like post-world-war Germany might have more internalized ableism and thus a harder time to process a diagnosis than someone growing up in a more inclusive and diversity-friendly environment. Some people just don’t like to think of themselves in labels and checkboxes and prefer to be seen as the individuals they are, especially by those closest to them, which should include partners.

What you can do:

Instead of using psychiatric terms, you can describe in everyday words how you perceive your partner, their behavior and the differences between you and them. Before deciding whether and how to communicate your ‘diagnosis’ to them, think about the risks and benefits for them in their current situation and context.

3.     Check (your) neurotypical privilege. Deconstruct (your) neurotypical identity.

Once one person in a couple or family is diagnosed as autistic, partners or other family members are often automatically labeled and addressed as neurotypical. This seems to happen in counseling, therapy, publications and in everyday conversation. However, it is quite far for common wisdom and professional experience to think that a person whose personality is so peculiar that they qualify for an autism diagnosis is likely to be in a long-term relationship with someone whose personality merits no further qualification than “normal”. In my experience, many autistic people’s partners have a distinct autism profile, have ADHD, are highly sensitive and/or were prone to depression even before the relationship with the autistic person. Yes, they still might be closer to the image of a “Neurotypical” than their autistic partner. But both partners will benefit only if they acknowledge that each has a specific personality. Framing your feelings and needs as specific ones and not as self-understood enables you to start a conversation on level ground and explain to your partner, autistic or not, why you can’t always adapt to them. If one sees themselves as the personification of “normal” and stamps a psychiatric label on the other their relationship will most likely develop into a sort of co-dependency where one partner oscillates between contempt and the desire to help the other. Having said that, it can be helpful to acknowledge that you might pass for “neurotypical” or are somewhat closer to what is perceived as typical in a neuronormative society than your partner. It enables you to see where doors open for you which don’t open as easily for your partner and thus to understand better why they are often exhausted and need the home or close personal relationships as spaces of calm and protection.

What you can do:

Examine which privileges you have in a neuronormative society which your partner hasn’t. Don’t be fast to take on neurotypical as an identity, though. Framing your needs, feelings and wishes as specific ones will create equal footing and enable your partner to understand them better than framing them as “just normal”.

So, should I say nothing at all if I suspect my partner is autistic?

There is not one right answer to that. Know that an autism diagnosis is a major life event for most adults. Some years after a diagnosis most autistic people I know say in some ways it is good to know, while some also say they are glad they didn’t learn earlier. Others say they would have liked to know at younger age. Psychological professionals, including those working with neurodiverse couples, don’t agree on one opinion either.

Keep in mind that it will change the relationship if one receives a ‘diagnosis’ through their partner. Generally, I would advise not to be too straightforward here – even if I recommend direct communication in almost every other situation neurodiverse couples face. You can describe the differences between your partner and yourself in everyday words, you can tell them about something you read, you can talk about your own personality in diagnostic or everyday terms and ask them how they see themselves.

Before deciding whether and how to communicate your ‘diagnosis’, look at your and your partner’s general situation:

• Will there be time, space and access to professional support to process the diagnosis constructively?

• Is your partner in a psychologically stable state, so that chances are they will not fall into deeper despair than before but use this as an opportunity for self-care and growth?

• Would a diagnosis be received in a positive way in your family, your circle of friends and/or your partner’s workplace?

• Are you prepared to love and accept an autistic partner as much or more than the person you thought your partner was?

*If you want to scream “Cassandra Syndrome” at me now: Yes, I do acknowledge that a partner who is not able or willing to recognize, let alone communicate their own feelings places a burden on the other partner who may feel compelled to do the emotional work for both. But I also know that people often have good reasons to keep their emotions to or even from themselves. Traumatization is one of them, fear of emotional overload is another. Leaving negative emotions unnoticed can be a survival strategy for a time. Before recognizing and communicating their emotions people need to have a certain degree of safety.