You have probably tried to explain it before. To a friend. To a GP. Maybe even to each other.

Why the same conversation keeps happening. Why one of you feels invisible and the other feels constantly criticised. Why something as simple as an unanswered text can ignite a reaction that leaves both of you confused and exhausted. Why the early weeks of your relationship felt so alive, and somewhere along the way things began to feel more like a management problem than a partnership.

If ADHD is part of your relationship — you may have a diagnosis, suspect one, or be the partner trying to make sense of what is happening — you already know that the standard relationship advice rarely fits. The workbooks, the date nights, the suggestions to “just communicate more clearly.” They assume a symmetry that ADHD relationships often do not have.

This guide is written for couples in Brighton and Hove who are trying to make sense of that gap. It covers what ADHD actually does to relationships, the patterns that tend to form, the therapeutic approaches that address them, and what to look for in a therapist who genuinely understands the territory.

Why ADHD changes relationships in ways that go deeper than organisation

ADHD is a neurodevelopmental condition. That matters, because it means the challenges it creates in relationships are not primarily about attitude, effort, or emotional investment. They are rooted in brain structure — specifically in how the ADHD brain processes attention, impulse, working memory, and emotional regulation.

When a partner with ADHD forgets an agreement made the night before, arrives late to something important, or seems distracted mid-conversation, these are not signs of indifference. They are expressions of a brain that genuinely struggles with the executive functions most people take for granted: planning, initiating, sustaining attention, and holding information in short-term memory.

Understanding that distinction — thoroughly, not just intellectually — is where meaningful change in ADHD relationships typically begins.

The numbers give some sense of the scale. NICE estimates that around 3–4% of UK adults have ADHD. Across Brighton and Hove’s population of approximately 284,000 people, that points to somewhere between 8,500 and 11,000 adults living with the condition — most of them undiagnosed. The Adult Psychiatric Morbidity Survey 2023–24 found that roughly one in twenty adults in England believes they have ADHD, yet only 1.8% hold a professional diagnosis. In Sussex, NHS waiting lists for adult ADHD assessment have stretched to five years or more in recent years. Many Brighton couples are therefore managing the effects of ADHD in their relationship long before either partner has a formal clinical picture of what they are dealing with.¹²

The patterns that form — and why both partners are affected

ADHD does not affect only the person who has it. Its relational impact is bilateral, and the patterns it creates — if unaddressed — tend to harden into something that both partners find painful and difficult to interrupt.

The parent-child pattern

The most widely documented pattern in ADHD-affected relationships is one where one partner gradually takes over more and more of the organisational weight of shared life. Managing the finances. Remembering appointments. Chasing things that have been promised and not followed through. This is not usually a conscious choice. It happens incrementally, as a practical response to real gaps.

But over time, the partner absorbing that weight often becomes resentful and exhausted. And the partner whose difficulties prompted the shift often begins to feel managed, sidelined, or quietly infantilised — which generates its own kind of withdrawal. The pattern feeds itself. The more one partner controls, the less the other engages. The less the other engages, the more the first partner feels they have no choice but to take on more.

Research suggests that nearly 60% of ADHD-affected couples show significant relationship difficulty related to this kind of imbalance.³ Both partners typically feel the relationship has lost something — but neither can easily name what started it, or who is responsible.

Rejection Sensitive Dysphoria

Many adults with ADHD experience what clinicians call Rejection Sensitive Dysphoria (RSD). This is an intense emotional response to perceived criticism, rejection, or the sense of having let someone down. It is not dramatisation. It is a feature of how the ADHD brain processes emotional pain — quickly, intensely, and sometimes disproportionately to what triggered it.

In a relationship, this can look like an explosive reaction to a mild comment. Or shutting down when a partner raises a concern. Or constant reassurance-seeking that the other partner finds difficult to sustain. The non-ADHD partner often describes beginning to feel as though they are walking on eggshells — that raising even reasonable concerns has become too costly. Over time, this erodes honest communication.⁴

The person with ADHD is not usually aware of how much their responses are shaping the relationship. The partner on the receiving end is often not aware that what they are seeing has a neurological explanation. Both end up isolated in their own interpretation of events.

The hyperfocus question

Many ADHD couples trace the beginning of their difficulties to a shift that happened after the early period of the relationship. The person with ADHD was, in those first weeks or months, intensely attentive. Thoughtful. Present. Seemingly more connected than anyone the other partner had known.

That intensity is real. The ADHD brain responds powerfully to novelty — a new relationship delivers a sustained dopamine stimulus that produces something close to hyperfocus on the other person. When the novelty settles, that dopamine stimulus naturally reduces. Attention drifts. The partner who experienced the earlier intensity often reads this shift as loss of interest, or even as having been misled.

Neither interpretation is accurate. The hyperfocus was genuine. What followed is neurological, not emotional withdrawal. Understanding this removes a layer of pain from the story both partners have been telling themselves.⁵

Communication that breaks down quietly

ADHD-related communication difficulties are often not dramatic. They are cumulative. A partner who interrupts without meaning to. A partner who changes subject before the other has finished. A partner who agreed to something yesterday and genuinely has no memory of it today. A partner who appears to be listening but whose attention has wandered involuntarily to something else.

None of these behaviours are deliberate. But their effect, repeated over months and years, is that one partner feels perpetually unheard, and the other feels perpetually misunderstood. Both are right, and both are hurting.

What ADHD couples therapy actually addresses

Generic couples counselling, when it is not ADHD-informed, can sometimes make things worse. A therapist who interprets the ADHD partner’s forgetting as passive aggression, or who frames the non-ADHD partner’s frustration as controlling, is working from the wrong map. ADHD-informed therapy begins from a different starting point: that many of the couple’s most painful patterns are downstream consequences of neurological differences, not character failings.

From that foundation, several therapeutic approaches have good evidence behind them.

Psychoeducation: the starting point

Before communication skills, before structural changes, before anything practical — both partners need a shared and accurate picture of what ADHD actually is. This is not about excusing behaviour. It is about establishing a common framework from which both people can begin to address the relationship as a shared challenge rather than a mutual accusation.

Psychoeducation reduces self-blame for the partner with ADHD and reduces resentment in the partner without. It reframes the question from “why do you keep doing this to me?” to “what are we actually dealing with, and how does it work?”⁶ That shift is not small. For many couples, it is the first time they have been able to talk about their difficulties without the conversation becoming personal.

Cognitive Behavioural Therapy (CBT)

CBT is the psychological treatment most strongly supported by clinical evidence for adults with ADHD. NICE recommends it as a first-line psychological approach. For couples, adapted CBT addresses the negative thought patterns that both partners have developed — the ADHD partner’s shame-based internal narratives, and the non-ADHD partner’s habitual attribution of intent to behaviours that are actually neurological.⁷

Structurally, Cognitive Behavioural Therapy suits ADHD couples well. It is goal-directed, organised, and creates the kind of external accountability that an ADHD brain often needs to build new patterns. Multiple large-scale analyses of CBT trials for ADHD adults have found meaningful improvements not just in ADHD symptoms but in communication, problem-solving, and relationship satisfaction.⁸

Dialectical Behaviour Therapy (DBT)

DBT was developed specifically to address emotional instability and intense interpersonal reactivity. Its skills — mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness — map directly onto the relational challenges most ADHD couples describe.

Emotional dysregulation affects an estimated 34–70% of adults with ADHD.⁹ DBT teaches both partners to slow down their responses, tolerate difficult feelings without acting immediately on them, and communicate needs in ways that are more likely to be heard. For couples where RSD has created a cycle of reactive conflict followed by withdrawal, DBT skills offer practical tools to interrupt that cycle before it escalates.

EFT Tapping (Emotional Freedom Technique)

EFT Tapping is a somatic approach — meaning it works through the body rather than solely through thought or conversation. It involves gently tapping on specific pressure points on the face and upper body, similar to acupuncture points, while focusing on a difficult feeling or experience. The aim is to reduce the emotional intensity attached to a memory, belief, or current stressor.

One clarification worth making: EFT Tapping is sometimes confused with Emotionally Focused Therapy, which is a completely different therapeutic approach. EFT Tapping is a body-based technique in the tradition of energy psychology. Emotionally Focused Therapy is a structured couples model rooted in attachment theory. The two share an acronym and nothing else.

For ADHD brains in particular, EFT Tapping holds specific practical appeal: it delivers results relatively quickly, it involves physical movement (which suits many ADHD presentations), and it is straightforward enough to use independently between sessions. A growing body of research has found EFT Tapping effective for anxiety, emotional dysregulation, stress, and trauma — conditions that co-occur frequently with ADHD and that tend to fuel relational difficulties.¹⁰ It is also well-suited to addressing the emotional residue many adults with ADHD carry: years of criticism, failure, and shame that sit beneath current relationship conflicts. Claire Sainsbury at The Hove Counselling Practice holds an Advanced Level 3 certification in EFT Tapping — a credential that reflects both clinical depth and practitioner commitment to this approach.

The role of medication

For adults with ADHD, medication and therapy work best together. Medication — where appropriate and prescribed by a GP or psychiatrist — reduces the neurological noise that makes sustained attention, impulse control, and emotional regulation so difficult. With symptoms partially stabilised, the relational work in therapy becomes considerably more accessible.

NICE guidelines recommend a personalised approach, and not every adult with ADHD will use medication. But for couples where ADHD symptoms are significantly disrupting the relationship, discussing medication options with a GP alongside engaging in couples therapy is worth considering. Therapy cannot resolve what medication is needed to support, and medication cannot address the relational patterns that therapy can help shift.

ADHD couples therapy in Brighton: the local picture

Brighton and Hove is a city where ADHD is likely more prevalent than in many other parts of the UK. The city has a notably young adult population — around 18% are aged 20–29 — and is home to roughly 35,000 university students at the University of Sussex and University of Brighton combined. Brighton also has the highest rate of LGB+ identification in the UK at 10.7%, against a national average of 3.2%.¹¹ Research has found significant overlap between LGBTQ+ identity and neurodivergent presentations — one study found that 61% of ADHD participants identified as non-heterosexual.¹² For LGBTQ+ couples in Brighton managing ADHD alongside other layers of identity, finding a therapist who holds all of that complexity without collapsing it matters.

Sussex Partnership NHS Foundation Trust provides adult neurodevelopmental services for the region, but demand has far outpaced capacity. BBC reporting from 2023 found that ADHD assessments in Sussex could take over five years. Nationally, as of December 2025, there were over 560,000 open referrals for ADHD diagnosis in England.¹ Many Brighton couples are therefore managing the full weight of ADHD’s relational impact without any clinical support in place — and without, in some cases, even a confirmed diagnosis.

The Right to Choose pathway allows patients to request GP referral to approved independent providers, typically reducing waits to months rather than years. But working through that process adds a further burden to couples who are already stretched. Seeking private ADHD-informed couples therapy while pursuing a formal assessment pathway is something many Brighton couples find helpful — it means the relationship work does not have to wait for a system that is significantly under pressure.

Local support alongside therapy

The Brighton Adult ADHD Support Group — part of ADHD Aware, a local charity with over 1,000 members — holds drop-in meetings at Friends Meeting House on Ship Street on the second Wednesday of every month.¹³ The Brighton ADHD Social Evening (BASE) runs monthly social meetups for adults with ADHD. Amaze Sussex provides family-focused support across Brighton & Hove and East Sussex. These community resources sit alongside rather than replacing therapeutic support — they offer normalisation and peer connection, which carry their own value.

What to look for in an ADHD-informed couples therapist

Not all relationship therapy training includes ADHD. A therapist working with an ADHD couple without that grounding may inadvertently reinforce the very patterns the couple came to address.

When considering a therapist for ADHD couples work, it is worth asking:

• Do they distinguish between ADHD-related behaviour and deliberate action?
• Can they work with both partners without positioning either as the problem?
• Are they trained in psychological approaches with a specific evidence base for ADHD (such as CBT or DBT)?
• Do they understand Rejection Sensitive Dysphoria and its relational impact?
• Are they comfortable holding the emotional experience of both partners simultaneously?

An ADHD-informed therapist understands that the non-ADHD partner’s exhaustion is real and deserves to be named. They also understand that the ADHD partner’s shame is real, and that progress stalls when it goes unaddressed. Effective therapy holds both.

The Hove Counselling Practice: specialist couples therapy in Hove

The Hove Counselling Practice is based at 126 Shirley Street, Hove, BN3 3WG — a short distance from central Brighton and accessible from Hove and Aldrington stations, with bus connections across the city.

The practice is led by Claire Sainsbury, who holds a BSc in Psychology, an MA in Counselling and Psychotherapy Practice, and an Advanced Postgraduate Diploma in Integrative Counselling and Psychotherapy. She is an accredited member of the BACP (British Association for Counselling and Psychotherapy), BACP number 91081.

Claire’s training spans multiple approaches that are directly relevant to ADHD couples work: CBT (NICE-recommended for ADHD), DBT (with a particular focus on emotional instability — an area she also teaches at postgraduate level in London), and EFT Tapping (Advanced Level 3 certification), which she uses specifically in the treatment of trauma, stress, and emotional dysregulation. The practice also draws on psychodynamic, attachment-based, and transactional analysis frameworks within an integrative model — meaning the approach is shaped around what a particular couple needs, rather than applied as a fixed template.

The practice explicitly affirms neurodiversity as part of its core positioning. As stated on the website: “Your brain works differently, and that’s not something to fix — it’s something to understand and celebrate.” For ADHD couples who have spent years being told, implicitly or explicitly, that something is wrong with them, that stance is not incidental.

The practice holds a 5.0 rating across 49 verified reviews. Multiple clients have specifically noted the impact of the couples work — including one who said Claire helped them “save” their marriage, and another who described her as identifying emotional patterns in their relationship that had been operating invisibly for years.

Couples sessions are priced at £110 for a 55-minute session. Individual sessions are £90 for 50 minutes. Sessions are available Monday to Friday, 10am to 9:30pm, face-to-face at the Hove practice or online — which can be particularly useful for couples managing the scheduling demands that ADHD often creates.

What it actually means to begin

Many couples arrive at the threshold of therapy — and then wait. Sometimes for months. The waiting often feels protective. Starting therapy means acknowledging that something is genuinely difficult. It means sitting across from someone else’s account of your relationship and not being able to dismiss it.

For ADHD couples specifically, starting is often complicated further by the pattern that has already formed: one partner who has been waiting for the other to take initiative, and one partner for whom initiating feels impossible. The very symptom that damages the relationship also makes it harder to begin the process of addressing it.

A first conversation with a therapist is not a commitment to a particular number of sessions or a defined outcome. It is a starting point — a space to say what has been difficult to say at home, with someone who understands the territory and is not invested in either partner being right.

You do not have to have this entirely figured out before you make contact. Most people do not.

If you would like to find out more or arrange an initial conversation, you can reach The Hove Counselling Practice at thehovecounsellingpractice.co.uk/contact or by calling 07947 073298.

Sessions are available Monday to Friday, in person at 126 Shirley Street, Hove, or online. You are welcome to make contact by whichever route feels most manageable.

References

1. NHS Digital / House of Commons Library. FAQ: ADHD Statistics (England). 2024–25. commonslibrary.parliament.uk
2. NHS Digital. Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England 2023–24 — Chapter 9: ADHD. digital.nhs.uk
3. Orlov, M. The ADHD Effect on Marriage. Specialty Press, 2010. Referenced in ADDitude Magazine and ADHDMarriage.com.
4. Dodson, W. Rejection Sensitive Dysphoria in Adults with ADHD. Attention Deficit and Hyperactivity Disorders, 2024.
5. Barkley, R.A. ADHD and the Nature of Self-Control. Guilford Press, 1997. Updated frameworks via ADDitude and ADHD Evidence.
6. Pera, G. & Robin, A.L. Adult ADHD-Focused Couple Therapy: Clinical Interventions. Routledge, 2016.
7. NICE. Attention Deficit Hyperactivity Disorder: Diagnosis and Management (NG87). Published 2018, reviewed 2025. nice.org.uk
8. Knouse, L.E. & Fleming, A.P. Randomized controlled trial of metacognitive therapy for adult ADHD. Journal of Attention Disorders, 2013. See also: Liu et al. (2023). Effectiveness of CBT-based interventions for adults with ADHD: A meta-analysis. PubMed / PubMed Central.
9. Hirsch, O. et al. (2019). Emotional dysregulation in adult ADHD. Journal of Attention Disorders. Referenced in ScienceDirect (DBT meta-analysis, 2025).
10. Church, D. et al. (2020). Acupoint tapping — EFT clinical evidence review. Healthcare (MDPI). See also: PubMed (2025). How tapping works: physiological and psychological mechanisms in energy psychology.
11. Brighton & Hove City Council. Sexual Orientation in Brighton & Hove. Joint Strategic Needs Assessment. brighton-hove.gov.uk
12. PMC. The Transgender and Gender Diverse and ADHD Nexus: A Systematic Review. PMC10989732. 2024.
13. ADHD Aware. Brighton Adult ADHD Support Group. adhdaware.org.uk; AADD-UK directory listing.