Pathologizing Among Romantic Partners of Autistics Who Use Online Support Groups: An Emergent Theory

Background:

As many as 25% of autistic adults report they have been in intimate relationships, and few studies have explored these relationships from the perspectives of neurotypical (NT) partners. Studies that exist have indicated patterns of miscommunication, unmet need, and abusive behaviors, and NT partners are increasingly using peer-mediated online support groups to manage these challenges. Anecdotal evidence and informal review of public online forums suggest that NT partners using online support groups have symptoms of depression, anxiety, and dissatisfaction in their relationships, warranting further investigation.

Objectives:

The purpose of this study was to capture a theory that reflects the basic social experience of partners of autistics who use online support groups and the basic social process they use to navigate that experience.

Methods:

A classic Glasieran grounded theory was used to allow a theory to emerge from data. Participants were recruited via online support groups and participated in asynchronous online interviews and telephone interviews. Theoretical sampling was used and interview questions evolved throughout the study based on emergent findings. Data were concurrently collected and analyzed using constant comparative analysis. The sample included 162 NT individuals who used online support groups and believed their partners had autism.

Results:

A basic social problem was identified as an imbalance in the need for emotional intimacy between NT and autistic partners. NTs attempted to resolve this problem through pathologizing, or attributing negative aspects of their relationships to autism rather than to their partners as individuals. The degree of pathologizing resulted in five behavioral profiles of the NT partner that created relationship contexts. In order of increasing pathologizing, contexts included: mutual partnership, in which partners were viewed as equals and NTs showed respect and gratitude for autistic partners’ contributions; companionship, where NTs viewed autistic partners positively but believed symptoms of autism prevented them from forming a deep connection; caregiving, in which NTs viewed autistic partners as dependent and compared their relationships to parent-child dyads; detachment, in which NTs believed their relationships were broken beyond repair due to the effects of autism and viewed giving up as a means of self-protection; and abusive context, where NT partners made negative generalizations about autism beyond their relationships and felt compelled to warn others about the perceived dangers of neuromixed relationships.

Conclusions:

While some partners used pathologizing as a coping mechanism to maintain a positive view of their partners, others used it to relieve themselves of internal pressure to invest in their relationships or to justify detachment or abuse towards autistic partners. This study highlights the need to explore risks versus benefits of unmoderated online support groups, as pathologizing is common in these groups and may perpetuate negative views of autism that create toxicity within relationships. Professionals must monitor for patterns of abuse of the autistic partner and assist both partners in creating balance in their needs for emotional intimacy while minimizing pathologizing. Future studies should explore the presence of pathologizing in neuromixed relationships outside of support group users and in couples affected by conditions other than autism.