“How Do I Learn to Cope When My Needs Consistently Aren't Met?”
Welcome to the first installment of Ask a Therapist!
A reader submitted the following question:
“How do I learn to cope when my needs consistently aren't met? My partner probably has some level of PDA [pathological demand avoidance], autism and ADHD (we are in the process of discovery). There is certainly something going on that means that for 20 years (we met at 18) I've done a lot of "mental load" type care and support tasks for him. I did it so well that he genuinely thought he was good at stuff like being on time and us being late as a family was my fault (I would get the kids ready, and me, and the lunch, and check he had a coat).
The problem is that now I have been diagnosed with a serious chronic health condition which, among other things, means I experience severe fatigue and brain fog. I had expected he would step up and care for me by taking on some of the mental load and caring for me but he cannot. Over the 3 years since I got ill we have realised how much I did; how much he relied on me; how unreliable/incapable he is at many basic tasks. I can no longer care for him in the same way. If he is able to learn, the pace is glacially slow: 3 years in, a little win is "he offered to get me a drink and remembered to do so."
He is a loving father, employed and earning a good salary and willing to work on this (although probably unable to change much). But I spend a lot of my (very limited) energy dealing with the chaos he creates and flexing so the kids get what they need when he can't cope. If I keep over-doing it, the condition will probably get worse and I could wind up house- or bed-bound in a few years. I already can't work. My question is: I feel like I need to either learn to suck it up or leave. Both options seem awful and I don't know how to do either but trying to care for others while ill without adequate support is destroying me. Is there a third option? How do I decide? NB I've looked at every possible avenue for additional external support from friends and family to the NHS (I'm in the UK) to cleaners and taken everything offered, which is little for a lot (of money, energy). My 4 kids are 10 and under. Thank you.”
Signed: Drowning (But Don't Let The Kids Know)
I’m grateful to this reader for sending this multi-faceted question, as there is so much here to unpack. Some of it was already on my list of things to write about, i.e. how neurodivergence is not a legitimate excuse for shirking an equal share of household labor.
has written about this as well and I agree with her assertion that men often weaponize a potential diagnosis of autism or ADHD against their female partners. Neurodivergence is often misdiagnosed or overlooked in women because women are under a great deal more cultural pressure to mask and keep the ship afloat. Most of us don’t have the luxury of kicking back and waiting for someone else to fill in the gaps left by our lack of executive functioning, so we figure it out. This is true in my own household, where I have ADHD, yet I am the family manager who carries the mental load for my neurotypical husband.Without having met your partner, I’m going to guess that the “something going on” for the past twenty years is that he is comfortable with you doing everything for him and doesn’t actually want that to change. You mentioned that he’s “employed and earning a good salary,” which suggests that his demand avoidance is selective, as it does not appear to be hindering him at work. It’s painful to be confronted with the reality that regardless of what he might say about his willingness to “work on this,” it has been three years and he has not changed. It’s doubly painful that you have been caregiving for him for two decades, and now that it’s his turn to support you, he’s not showing up. I can say from my own experience with injuries and chronic illness that medical crises reveal who you are really partnered with, for better or worse.
I suspect your partner is capable of doing more, but it seems clear that he won’t. Why he hasn’t stepped up is fundamentally less important than addressing what you are going to do about it. It sounds like you’ve reviewed three years of evidence and concluded that he is not going to change his behavior. So where does that leave you?
One of my favorite skills from Dialectical Behavior Therapy is called Four Solution Analysis. In any given situation, there are four possible solutions:
Accept it
Change it
Leave it
Stay Miserable
It sounds like you’ve been trying a change it strategy for the past three years without success. You seem torn between a leave it strategy or an acceptance strategy, but unable to choose between these options, you’re currently staying miserable.
The important thing to understand about successfully implementing an acceptance strategy is that it requires radical acceptance, which Marsha Linehan describes as “complete and total acceptance of the facts of reality” without trying to fight against the facts. If you tell yourself you are accepting the situation, but you’re secretly fuming that it’s unfair or praying for him to spontaneously change, you are setting yourself up to stay miserable because you will still be attached to an outcome that is unlikely to come to pass. Considering the toll this situation is taking on your health, it’s hard to imagine an acceptance strategy where nothing changes being in your best interest.
If you have the means to leave, it’s worth considering this option. According to this study from the University of Michigan, married mothers do an average of seven hours more per week of domestic labor than single mothers. That’s seven extra hours of work that men create for their female partners (that number is likely higher in your household, based on your description). By leaving your partner, you would regain at least seven hours of time to care for yourself each week.
wrote this helpful summary of a new study from the National Bureau of Economic Research that was published in January. Manne writes that the study’s findings “fits with a common experience of divorced women who were once married to men: they were looking after their husband almost like another child, and can subsequently reduce their burdens by becoming a single parent.” Studies consistently show that it is less work for women to parent alone than to parent alongside a heterosexual man. Sadly, leaving is often the only way for women to force men to take on a more equitable share of the work load. (I say “more equitable” because most divorced mothers still do more for their children than fathers do, even when they have equal custody.)If leaving is not a viable option, I could see blending an acceptance strategy and change strategy: accept that he is not going to change, but change your own behavior by going on a labor strike. You could either announce that you will be conserving your energy by no longer doing any work for him, or you could quietly quit. Limit your effort to doing things that need to get done for you or the children, but stop doing anything for him. By withholding your labor, you might force him to do all the things he would have to do for himself if you left. Or those things won’t get done, and he will experience the consequences.
The key to enforcing any kind of behavioral change is consistency. To successfully employ this strategy, you would need to stand firm and not do things on his behalf out of habit or conflict-avoidance. It’s hard to imagine feeling great about your partner or your relationship with this solution, but at least it is self-preserving. It may also improve your mood. I have a client who recently decided to quiet quit her marriage of twenty-five years and she has been delighting in her husband’s incredulous reactions to her small acts of defiance. (Some men react violently when women refuse to do domestic labor. Do what is safe for you.)
Of all the available options, the worst one is to continue to run yourself into the ground on his behalf. I hope you won’t choose to do that. When trying to clarify what you should do next, I encourage you to ask yourself what you would do if you were placing your own needs first. Women are socialized to consider our needs last or not at all. If you were going to do what was best for you, setting aside for the moment how that impacts anyone else, what would you do? Now work backwards from that starting point and consider what is also best for your kids, keeping in mind that running yourself into the ground is not in their best interest. Also keep in mind that there are many instances when separation is actually better for your children, not least of which because it models for them that women have the right to take care of themselves and not live in servitude to men. I encourage you to disregard what is best for your partner. He has enjoyed twenty years of you doing what is best for him. It’s time for his needs to take a back seat.
Click this button to submit your question for Ask a Therapist. I will publish the next installment in October.
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"You mentioned that he’s 'employed and earning a good salary,' which suggests that his demand avoidance is selective, as it does not appear to be hindering him at work." OOOF. I hope I remember this like I remember the observation that people with bad tempers somehow manage to control it when doing so would put them at risk, vs letting them be the one endangering others.
Thank you so very much for naming Dialectical Behavior Therapy and including the Four Solution Analysis. That is one of the most helpful mental exercises that I have ever come across to implement real change in behavior. This installment alone is well worth the subscription price and I look forward to learning more insightful tidbits from you.