Perkins School for the Blind Transition Center

A How-To Guide to Emotional Support for Neurodiverse Couples

In my neurodiverse couples therapy practice in New York City, many central themes are addressed including communication, intimacy, sex, and parenting. However, one of the most consistent themes brought up by neurotypical partners is feeling a lack of emotional support in their relationship. Their neurodivergent partner is often well-meaning and very committed to the relationship, but despite these good intentions, there is a disconnect between what a neurotypical spouse requests and what their neurodiverse partner provides.

A happy neurodiverse couple sitting together on a couch

Recognizing Differences

When approaching challenges in a neurodiverse relationship, it is important to consider how they may be related to neurodevelopmental differences between partners. Individuals on the autism spectrum experience deficits in Theory of Mind, which is the ability to consider both their own perspective and that of someone else, and then make considerations based on the other person’s thoughts and perceptions (Andreou & Skrimpa, 2020). The antiquated view of autism was that individuals on the spectrum were not empathetic. However, adults on the spectrum, along with copious amounts of research, have debunked this and shown that individuals “are capable of recognizing dynamic emotions and the emotional states of others” (McKenzie et al., 2022). Empathy is not as different from their neurotypical counterparts’ as previously thought, except for cognitive empathy or Theory of Mind (Greenberg et al., 2018). Thus, we can understand this to mean that other areas of empathy are largely not impacted. However, there are differences related to one’s ability to intuitively see something through another person’s perspective, and how to translate that into a way to meet the other person’s needs.

Another aspect of difference in neurodiverse relationships is that some people’s brains are wired more emotionally, while others are wired more logically. Neurodiverse partnerships often have one person who is skilled in understanding and navigating the emotional experience of an event, while the other partner is skilled in thinking through the logistics or information needed to have the desired outcome. Both of these roles are important and can make for strong relationships when they are able to complement each other. However, when partners are having miscommunication due to the ways they are perceiving something, either emotionally or logistically, it can also cause stressful interactions. Greenberg et al. (2018) describes “empathizing-systemizing theory” and notes that individuals on the spectrum tend to be more systemizing. While this is an important and useful quality, especially professionally, it does not always help to offer a practical strategy when a partner is only looking for emotional support.

Identifying Emotional Support Needs

Once a couple begins to understand the foundational differences in their neurology, they can have conversations about each of their needs for emotional support. Emotional support varies greatly from person-to-person, so there is not a universal definition that applies to everyone. For all couples, there is a need to operationalize what emotional support means for each person. It is rare that a partner does not want to be supportive, but often what they need to feel supported is vastly different than what their partner may need in the same situation. Clearly discussing these expectations helps decrease miscommunications in the moment when someone needs emotional support. If someone’s intrinsic needs are different than their partner’s, it is impossible to intuitively know that they should do something, let alone what to do, in these situations. In my clinical practice, I recommend couples use the code phrase “support or strategy.” This takes away any difficulties with cognitive empathy or assumptions about what the other person needs and allows for direct, clear communication about whether the person wants emotional support or needs a practical strategy in that moment.

Providing emotional support for a partner does not mean that you need to be a therapist or say all the “right” things. Rather, it means making an effort to meet an expressed need that has been identified, in the way that has been clearly outlined between partners. Next, I offer some strategies to begin strengthening the ways in which partners approach integrating meeting emotional support more effectively in their relationships.

Strategies to Implement Emotional Support

Allow for Task Shifting – Task shifting, or switching from one activity to another, ensures that both partners have the opportunity to be present in the conversation. Before beginning a conversation where support is needed, clearly state there is an important topic to be discussed or give a partner a “heads up” earlier in the day that a conversation is needed. This allows for both partners to be fully focused on the discussion and not distracted by the previous task they were engaging in.

Manage Expectations – Go into the conversation with realistic expectations. Both partners brains are wired differently and needs for emotional support vary. Emotional support from a partner may be different than the support one might give their friend, sister, or relative, but that does not inherently mean it is not valuable or supportive. An individual on the spectrum can say “do you need support or strategy?” if the need is unclear. A neurotypical partner can say “I need support not strategy” if they feel their partner is seeing the support need as different from what they want in the moment.

Acknowledge and Validate – For many neurodiverse clients who have struggled with providing emotional support in the past, their fight, flight, or freeze response kicks in when faced with more emotional conversations. This is typically rooted in the fear of doing it incorrectly again and continuing this negative pattern with their partner. However, when there is a concrete plan for what to do in a situation, it is easier to move forward and decreases the chance of freezing up. This is an opportunity to acknowledge that a partner is sharing something difficult and to validate that fact. An individual on the spectrum does not have to agree with their partner’s perspective of a situation, and may in fact have a vastly different viewpoint. The goal of providing emotional support is not to agree but rather to identify that something is “a difficult situation” for a partner. By listening and validating, it shows someone is working to meet their partner’s needs and making an effort to provide emotional support.

Communicate Desire to Support – After acknowledging and validating, a partner does not need to offer sage advice or say exactly the right thing. Asking a partner “How can I help?” or “How can I support you?” shows the desire to provide support to a partner. This allows a spouse to communicate whether they need their partner to listen to them vent, need help with a tangible task that will make the situation better, or something else. Since all brains are wired differently, the only way to determine this is by asking clearly and directly.


As with all relationship strengthening tools, providing emotional support takes time and repetition to become part of a couple’s pattern. This process requires couples to understand neurodiversity within their specific relationship, operationalize what emotional support means to each of them, and use practical strategies to change the way they are supporting each other. Through practice, this approach can begin to reshape how emotional support is offered and received within a neurodiverse relationship and make for stronger, more fulfilling connections.

Leslie Sickels, LCSW, works with neurodiverse couples and individuals on the autism spectrum in New York. For more information about Leslie’s therapeutic work and neurodiverse couples therapy visit


Andreou, M., & Skrimpa, V. (2020). Theory of Mind Deficits and Neurophysiological Operations in Autism Spectrum Disorders: A Review. Brain Sciences, 10(6), 393. MDPI AG. Retrieved from

Greenberg, D. M., Warrier, V., Allison, C., & Baron-Cohen, S. (2018). Testing the empathizing–systemizing theory of sex differences and the extreme male brain theory of autism in half a million people. Proceedings of the National Academy of Sciences, 115(48), 12152–12157.

McKenzie, K., Russell, A., Golm, D., & Fairchild, G. (2022). Empathic Accuracy and Cognitive and Affective Empathy in Young Adults With and Without Autism Spectrum Disorder. Journal of autism and developmental disorders, 52(5), 2004–2018.

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