Introduction

The literature and materials circulated on attention deficit and impulsivity disorder, with or without hyperactivity (1), in children are abundant, some of excellent scientific and clinical quality and of great pedagogical value; those concerning adults are far fewer. That AD/HD continues beyond adolescence in an enormous proportion of people (over 50%) is now being studied: it weighs on daily life, and the areas of personal relationships, performance at work and the management of money would be good examples of this.

It is usual for the symptomatic profile to be more complex in adults and, precisely because they are adults, one observes multiple facets and secondary consequences accumulated in powerful dynamic entanglements. This brings them a series of difficulties in carrying out certain important activities in their lives, such as work, and also weighs on their personal relationships and their affective life. This presentation will refer in particular to the situations frequently found in couple bonds, which circumscribes the theme to be considered.

The person who suffers from AD/HD presents weaknesses relating to self-regulation which, over the course of development, go hand in hand with a deficit in performance and effectiveness in conducting and controlling themselves at will. This entails limitations in the continuous execution of activities, in their sustained accomplishment.

We consider the human being in his biopsychosocial unity and, in working with people who have AD/HD, we situate ourselves in this territory of complex articulations.

AD/HD is neurobiological in its basis, and in its evolution and unfolding contextual characteristics and phenomena actively intervene.

Thus, the quality of interrelationships, the form of communication, beliefs, affects and the organisation of the bond will undoubtedly be participating phenomena. Other aspects, such as socio-economic and cultural factors, will also be weighty variables to be considered in the interaction of the different factors present in this diagnostic picture. And, dynamically, the most typical attitudes and behaviours of these people, like their communication and their emotional manifestations, actively influence others, their relational environment.

In this joint construction, we wish to make clear that our position, supported by solid research data, shows that family dysfunction, for example, does not generate AD/HD, but that it does indeed facilitate the symptoms, helping to trigger them with greater frequency and intensity. These are, characteristically in AD/HD, variable in onset and related to diverse circumstances, internal or external. The environment therefore notably influences its evolution.

The client with AD/HD and his individual and family development

There are adults with AD/HD who, through their spontaneous ways of living, obtain satisfactions that “fit” their circumstances: more independent, they can seek wider horizons and find or develop their own modes, respecting their interests and their way of being; they thus compensate for the effects of their difficulties. A context endowed with certain support structures, good stimulation and effective communication, in respectful exchanges, is fundamental. A satisfying quality of affective life, in conditions of security and committed emotional contact, is another essential aspect.

When a choice of life more in harmony with one’s own authentic style and interest is not accessible, daily life tends to be more intensely coloured by the symptoms. Likewise, emotional conflicts, strong tensions, stress and fatigue generally contribute to an increased frequency and severity of symptoms.

Among unfavourable environmental factors, marked poverty plays a predominant role as regards the seriousness of the secondary consequences at risk.

The chronic deficits in the behaviours essential to an effective and coherent life, and their accumulation with secondary consequences, can range from low and perpetually wounded self-esteem, with chronic frustration and poor achievements, to the inability to complete one’s studies at adequate levels of training and qualification, deficient functioning of cognitive processes, the impossibility of keeping a job, of maintaining a satisfying couple relationship or of properly supporting the children’s development. These difficulties, indeed these failures, reach serious horizons with explosive and aggressive attitudes, accidents, significant financial losses, promiscuity or carelessness in sexual relations, addictive tendencies, serious disconnections in the couple, with possible problems that link up in cascade, in self-perpetuating vicious circles.

Characteristic behaviours of the syndrome and their impact on the couple

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The primary and secondary symptoms have an impact on the bond; they never occur in a vacuum… (to be continued).