Carly can’t be counted on to get things done on time. Jack is always finding things to straighten up, and can never just sit down. Alan would rather, it seems, play video-games with friends online than hang out with his girlfriend. Kim spends endless hours staring at the TV rather than spending time with the family. The complaints of Carly, Jack, Alan, and Kim’s partners are likely to be that they are self-centered, that they don’t really care about anyone but themselves, that they are unreliable or always in their own heads and preoccupied.
And they may be right — that their partners don’t care, or are self-centered and only do what they want to do. But there may be other underlying issues that are driving their behavior.
Here are some of common conditions, particularly at lower levels, that can cause others to focus, too much perhaps, on themselves.
Yes, most of us know when someone is depressed: They lay in bed all day, can’t sleep; they lose or gain weight; everything is "why bother," "it doesn’t matter," gray or black; there may even be talk of suicide.
But at low levels, depression can look like a quietness, a not-paying-attention-to-what-is-happening- around-them mental preoccupation, a pulling in. They don’t talk much, they don’t seem interested in you and what you are doing, they don’t want to do things, they’re always tired. What underlies this is rumination — having a head filled with depressive thoughts or regrets about the past — and a lack of energy that depression naturally brings.
Obsessive-compulsive disorder (OCD)
OCD is an anxiety disorder, and like depression, most of us know what anxiety looks like — constantly thinking and talking about what-if-worries about the future — and OCD – washing your hands 10 times, making your bed with no wrinkles. But like depression, at low levels, it can be more difficult to spot.
Here the person may be like Jack who is always needing to do something. What is happening in Jack’s brain is that he constantly sees 1000 things all around him that need to be “fixed” — picking up the toys on the floor, straightening that crooked picture — and he feels he can’t relax unless he gets done the things on his endless to-do list; under stress, all this can get worse. For other folks who are more obsessive than compulsive, they can seem withdrawn and detached because their heads are filled with non-stop loops of negative thoughts that they can’t shake.
The result for you is that their constant focusing on seemingly minor things can feel like avoidance, their preoccupation that you are not important. You easily and understandably feel frustrated that he doesn’t ever sit down and focus on you.
In the movie, American Sniper, we see Chris Kyle coming home from war and sitting for hours in front of a TV watching war movies, totally ignoring everyone else in his family; this is the symptom of PTSD that many of us know. But PTSD can be more subtle, less "dramatic" than the experiences of war. Here is where Kim, who was sexually abused as a teen and seemed to put this behind her, stumbles on a news story about sexual abuse and suddenly finds those old events coming back to life, drawing her back into the past. Or she may be suddenly laid off from a job, and the shock and the loss unexpectedly stir up memories of the day her father suddenly walked out of the house, never to see him again.
Like the others conditions, without knowing what is happening inside, only seeing their behaviors, it’s easy to feel like the other doesn’t care, that Kim is in her own world…because she is. PTSD has many faces, but a common one is a detachment, flat emotions. Their brains are processing the past over and over, leaving little room left for thinking about now and others.
Attention-deficit/ hyperactivity disorder (AD/HD)
This is Carly who doesn’t follow through. Folks with this disorder struggle with procrastination, with organization of things and time; they seem forgetful; they can be impulsive and emotionally driven, doing what they want to do when they feel like it.
As a partner it’s easy to interpret the lateness as not caring, the putting off of paying the electric bill and focusing on seemingly less-important things as unreliable, the doing what they want to do as self-centered. The underlying problem is impaired executive functioning that makes impulse control, focus, and organization difficult, a genetic condition. At low levels you can feel like you are living with a 15-year-old who is in his own world, and that you have to do most of the heavy lifting.
The stereotype of the fall-down drunk, the constantly-high pot smoker. But this can also be Alan who, yes, has friends online, but what pulls him in is the gaming itself — he has an addiction. For others it make take the shape of always being on the computer, but secretly looking at porn or gambling.
Again, the results are that you feel pushed to the back-burner because you are. The addiction has taken over life’s priorities, leaving you sidelined and ignored.
Eating disorders have the qualities of both an anxiety disorder and an addiction. Whatever the drivers may be, the end result is a preoccupation, where food — the eating, the not eating, body image, weight numbers — consumes 90% of their mental space. Like addiction you are on the back-burner because food is on the front.
We all know strong and temporary pain — the sprained back, the upset stomach of food poisoning, the twisted ankle. But chronic pain, that steady, everyday lower-level pain from conditions such as arthritis, chronic diseases, irritable-bowel syndrome, can take its toll, leading to an overall irritability or withdrawal. Because it isn’t as "loud" as the wrenched back, the ever-present grumpiness, the always-snappy tone, or the mental preoccupation can feel like withdrawal and neglect.
Those with high-functioning autism can easily slip under the radar. They are often smart and successful in their work, but in intimate relationships can seem uncaring and detached: They don’t like much physical contact; they seem to zone out and shut down when in groups; they nerdy-ness shows up in their more easily talking about things than people and emotions. As a partner you can feel like you are living with Mr. Spock, feel that other person doesn’t “get you," becomes too rational and problem-solving when what you really want is compassion and listening. Even though the other person is doing his best, you feel an insensitivity, a not-caring.
What to do
If any of these conditions or behaviors resonate with you, the hope is that it helps you look at your partner through a different, and maybe more compassionate lens, helps you see that it may be less about you and more about him. That said, it doesn’t mean that you need to simply accept what you get; an underlying problem is not an excuse to avoid change.
Instead, you want to have a conversation — a rational, gentle conversation at a good time — about both your feelings — that you are not getting what you need — and about your concerns — that the other person seems preoccupied, busy and driven, withdrawn or isolated. Say what you’d like the other person to concretely do — spend more time with you, listen when you are upset, rather than rationally trying to fix the problem, spend less time on the computer, follow-through on what she said she would do. And then broach the possible underlying problem: "I wonder if you are struggling with…."
You may get a defensive reaction — expect it, don’t take it personally. The other person may feel caught off-guard or need time to process what you said. Circle back later; see if they are willing to do what you ask; suggest an evaluation by a professional who can has the skills to diagnose the underlying problem; offer support.
And then see what happens. If nothing changes despite your best efforts, decide you want to do next, what you need to do to not feel like a victim.
What seems like a relationship problem is often a symptom of an underlying individual problem. Speak up, get your concerns on the table, be compassionate.
It’s the best you can do.