San Francisco Couples Therapist for Neurodivergent & Cross-Neurotype Relationships
For neurodivergent and cross-neurotype couples who love each other but keep losing each other in translation
Who I Work With
You still love each other. That's not the problem. You want to be together, but you keep having the same fight, and it keeps going to the same dead end, where neither of you feels heard, despite talking at each other for the better part of an hour. And it seems to get harder the more your lives merge: moving in together, combining finances, planning a wedding, navigating in-laws, having kids. Every step that should bring you closer brings more to manage, and more opportunities to misunderstand each other.
Maybe one of you processes things verbally, finding your way as you speak, while the other gets lost trying to follow and needs the short version.
Maybe one of you needs to organize and prepare a response beforehand, and the other needs to hash it out right now, before bed.
Maybe you struggle to read each other's emotions, finding out later that something was urgent, but your partner's voice sounded calm to you.
Maybe one of you needs things expressed verbally and explicitly, and the other expects you to understand what they're implying. So you walk away from the same conversation having lived through two different realities.
These are all common experiences for neurodivergent and cross-neurotype couples that make talking about difficult emotions feel like you're just not getting anywhere. Maybe one of you was diagnosed with ADHD, autism, or AuDHD later in life, after you had already built years of habits and roles around a version of each other that didn't have a label. Now this diagnosis is asking both of you to reconsider what you thought you knew about each other.
Sharing the Load: When Executive Function Differences Strain a Relationship
It shows up in the everyday logistics of sharing a life, too. One of you has quietly become the household's memory, the calendar, the reminders, the one who notices the toothpaste is running low and buys more before it's a problem, while the other partner is genuinely trying, and still losing track of time, forgetting something they meant to do, or getting pulled into something else before finishing it.
But it rarely stays about the calendar for long. It turns into: you don't care about me. I can't rely on you. I'll never be enough for you. So one of you feels increasingly alone in carrying the relationship, and the other feels increasingly like a disappointment inside of it.
These are important conversations, and they can be an opportunity for your relationship to improve and deepen: to know yourself and your partner better, and to actually be able to talk in a way where your partner can hear your experience and listen to understand theirs. But to do that, you have to slow down enough to sort out what's neurodivergence, what's an old pattern, and what's actually happening between you now, so each of you can name what you want, for yourself and for your relationship.
You've probably tried the standard advice already, but couples therapy is not one-size-fits-all, especially when it comes to neurodivergent couples. You have to have the context of neurodivergence to see each other clearly. Sometimes you need help finding the words for your experience, or creative strategies for approaching your unique challenges. That's where I love to help.
My Approach: Neuroaffirming, Somatic & Relational Couples Therapy
Hi, I’m Sarah (she/her), I'm a Licensed Marriage and Family Therapist practicing since 2018, and I have a soft spot for working with neurodivergent couples.
Sessions are available via telehealth throughout California, with limited in-person availability in San Francisco.
My approach is warm, collaborative, and grounded in deep emotional work. I integrate neuroaffirming therapy, Emotionally Focused Therapy (EFT), the Developmental Model, psychodynamic psychotherapy, Sensorimotor Psychotherapy, and parts work (IFS) to help you shift out of painful patterns and into moments of genuine connection.
I also bring lived experience as a queer, neurodivergent, mixed-race woman to this work, which means I know firsthand what it's like to be neurodivergent and date across neurotypes.
I'll never just hand you a list of communication tips and send you on your way. Instead, I help you slow down, feel safe enough to speak honestly, and begin to understand what's really happening beneath the surface, and beneath your different neurotypes.
We'll explore the emotions, needs, and protective patterns driving your relationship dynamics: not just what you argue about, but why it keeps happening, and how ADHD, autism, or AuDHD shapes the way each of you experiences and expresses it.
“To truly love we must learn to mix various ingredients—care, affection, recognition, respect, commitment, and trust, as well as honest and open communication.”
— bell hooks
What it feels like to work with me
The goal isn't to decide which partner has the "right" version of what happened. This isn't a courtroom, and I'm not the judge and jury. It's to understand each other well enough that you don't have to keep filling in the blanks with the worst possible interpretation.
You don't have to keep translating each other alone. You can build a shared language and relationship that has room for both of your minds, both of your nervous systems, and both of your ways of being in the world.
My hope is that you leave this work not just communicating better, but knowing each other differently: more able to recognize what's actually happening for your partner, ask for what you need, and remember that you're on the same team.
If this sounds like you and your partner, I'd love to chat about working together.
Together, we'll slow down the moments right before things go off the rails: when you hear the tone that feels like criticism, see the forgotten task that starts the story that they don't care about you, the silence that feels like rejection, or the shutdown you can't get through.
We'll get curious about what was happening underneath it, and I'll help you talk to each other about it. What story did you tell yourself? What did you assume your partner meant? What were you trying to protect yourself from? What did you actually need from them in that moment?
We'll also learn to recognize each of your sensitive places and how you protect yourselves, even from each other. The goal is to catch those moments earlier and communicate them in a new way, before you get pulled all the way into the familiar fight to nowhere.
Is couples therapy right for you?
This might be a good fit if:
You love your partner, but keep landing in the same disagreement, over and over
You're ready to understand each other's neurotype instead of assuming the worst about each other
You're both willing to explore new ways of relating, even if it feels scary or unfamiliar
It might not be the right fit if:
You're looking for a quick fix, or a list of communication hacks, without deeper emotional work
One of you isn't open to looking at your own role in the pattern, not just your partner's
Even couples who deeply love each other can feel stuck sometimes, especially when your minds work differently and no one ever explained why. You don't have to keep figuring this out on your own.
If you're ready to understand each other, feel like a team again, and build a relationship that has room for both of you to be heard and understood, please send me a message.
