The term CADD – Cassandra Affective Deprivation Disorder (Aston, 2009) may be given to NT (neurotypical) partners experiencing distress as a result of their emotional needs not being recognised, or met by their AS (autistic) partner, the effects of such including low self esteem, loss of self-identity, feelings of anger and guilt, anxiety, depression and physical symptoms including weight changes and premenstrual tension.
It is not claimed that this disorder arises as a result of any intent by the AS partner, with a survey by Simons & Thompson (2009) concluding that the concept of affective deprivation disorder proposed by Aston (2009), satisfies the criteria for a relational disorder (Diagnostic and Statistical Manual of the American Psychiatric Association, 2013), which positions such disorders between partner behaviours, rather than solely on the individual.
A social constructionist view might suggest we are looking increasingly to our partners to meet more of our needs within a relationship compared with previous generations (Attwood, 2015; Finkel, Ming Hui, Carswell & Larson, 2014), with the current normative idea of romantic relationships involving a significant amount of social interaction and work to meet the needs and expectations placed upon it. AS partners may experience considerable distress as a result of such demands which may or not be obvious, but can lead to the AS partner’s autism being problematised, rather than such wider contextual factors being taken into account, and more systemic perspectives being considered. My work with NT/AS couples has led me to propose an equivalent concept to CADD (Aston 2009) for AS partners in relationships, to begin to address these issues more relationally.
NT-CADD and AS-CADD
Using the same acronym, CADD, the term reflects Communication and Demand Distress, as a result of ableist expectations or a lack of autism understanding and support by partners or family members. As with the NT related CADD, there is recognition that this is an unintentional consequence, the NT partner does not mean to put such pressure on their AS partner, and are often upset to learn they have caused their partner distress, but their epistemological position as NT, together with a lack of accurate understanding of autism may prevent them from recognising this process. Being ‘seen’ is reported to be important for the NT, often relating to the more subtle nuances of communication being interpreted correctly by their AS partner (Aston, 2012), however this can be recognised as a multi-directional process, if the AS partner’s relevant AS experience is not acknowledged and understood, this can create an oppressive situation, and whilst the AS partner might not articulate, or have the means to articulate such need, this does not negate the importance of such recognition (Heasman & Gillespie, 2018).
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An example of this might be when an AS/NT couple come to see me for the first time. The journey to a new place, the anxiety of meeting someone new, the sensory overload as a result of both of these processes, and the expectation to respond to questions verbally creates AS-CADD, leading to either a shutting down, or an aggressive response by the AS partner. The NT partner then interprets this as the AS partner not caring, not being committed to the process, or rejecting attempts to connect, triggering a NT-CADD response, this process often perpetuating as shown below:
In many cases, my observations in my therapeutic work have been that AS-CADD (Communication and Demand Distress) is a significant contributing factor to NT-CADD, (Cassandra Affective Deprivation Disorder) and vice-versa, and once this can be understood and accepted by both partners, both AS-CADD and NT-CADD can be minimised.
I have conceptualised this idea based on the current NT/AS narrative of relationships, but it is important to acknowledge that similar patterns are also observable in two autistic partners. Some AS partners default AS-CADD response is to become less verbal, whereas for others the response is more active, or perceived outwardly perhaps as aggression, however these partners often say this is more a reflection of their frustration rather than anger, and some may respond in both ways, according to the situation.
Association, A. P. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®) (5th ed.). Washington: American Psychiatric Publishing.
Aston, M (2012). What men with asperger syndrome want to know about women, dating and relationships. London: Jessica Kingsley.
Aston, M. (2009). The Asperger couple’s workbook: Practical advice and activities for couples and counsellors. London: Jessica Kingsley.
Attwood, T. (2015). The complete guide to Asperger’s Syndrome. (Rev. ed.). London: Jessica Kingsley.
Finkel, E. J., Hui, C. M., Carswell, K. L., & Larson, G. M. (2014). The suffocation of marriage: Climbing mount maslow without enough oxygen. Psychological Inquiry, 25(1), 1-41. doi:10.1080/1047840X.2014.863723
Heasman, B., & Gillespie, A. (2018). Perspective-taking is two-sided: Misunderstandings between people with asperger’s syndrome and their family members. Autism, 22(6), 740-750. doi:10.1177/1362361317708287
Simons, H.F., & Thompson, J.R. (2009). ‘Affective deprivation disorder: Does it constitute a relational disorder?’ Retrieved January 29, 2020 from https://www.maxineaston.co.uk/research/Affective%20Deprivation.pdf