Doctors increasingly are ditching the prescription pad. The latest count shows more than a third of the nation’s prescriptions now are electronic.

All romantic relationships have challenges and require some work. Being in a relationship with someone who has Asperger’s syndrome (AS) can create an additional challenge, according to psychologist Cindy Ariel, Ph.D, in her valuable book, Loving Someone with Asperger’s Syndrome.

That’s because you and your partner think and feel very differently, she says. And that leaves a lot of room for misunderstanding and miscommunication.

In her book, Ariel provides wise advice and practical exercises to help you improve your relationship and overcome common obstacles. (She suggests keeping a journal to record your responses.) Here are five ideas you might find helpful.

1. Don’t put the blame solely on your partner.

Your partner isn’t solely to blame for your relationship problems. As Ariel writes, “The true problems lie in the blending of two different modes of being. It is not your partner’s fault that he doesn’t understand certain social expectations, just as it is not your fault that you don’t understand how the pipes in your house work.”

2. Learn as much as you can about AS.

If you don’t know much about AS, it’s easy to misinterpret your partner’s actions and think they don’t care about you. Educating yourself on how AS functions can be a huge help in better understanding your partner and feeling compassion toward them.

Individuals with AS don’t process information the same way everyone else does. According to Ariel, research using brain scans have shown differences between the brain structure and shape of people with AS vs. people without AS.

People with AS have a tough time picking up on nonverbal cues in interactions and understanding people’s emotions. They may misinterpret a loved one’s needs. They may fixate on their own interests and appear like they’re self-absorbed and just don’t care about others. Essentially, people with AS see and experience the world differently. But they absolutely do care and experience emotions — again, just differently.

Learn more in our article on myths and facts about Asperger Syndrome.

3. Reframe your partner’s behavior.

You might think that your partner knows precisely what you need but purposely ignores it or intentionally does something to hurt you. And when you think your partner is cold and mean, you not only get upset and angry, but you also might view all of their actions and intentions negatively, Ariel says.

Reframing your partner’s behaviors helps you refocus on your relationship and work to improve it (vs. stewing in the negativity). It also might help you come up with creative solutions.

You still might disagree with their actions and feel hurt. But you may better understand your partner and work to move forward.

To help you reframe your partner’s actions, Ariel recommends creating three columns in your journal: Behavior or Situation; How it Makes Me Feel; and Another Perspective.

In the first column, describe a behavior or situation that upsets you. In the second column, record your feelings and why you think your partner acts this way. In the third column, try to think of a different explanation for their behavior.

Say you were upset recently about how your spouse handled you being sick. According to Ariel, here’s how your columns might look:

1st column: “When I was sick in bed for three days, she came in only at dinnertime. She left food without asking how I felt.”

2nd column: “This proves how self-centered she is. She didn’t care that I felt lonely and sad because of our lack of connection.”

3rd column: “She likes to be alone when she feels sick. She thinks asking people how they feel when they’re sick is dumb.”

It helps if both of you do this exercise and can discuss it.

4. Be specific about your needs.

Many of us expect our partners to automatically know what we want. Or to know what we want after the many hints we drop.

In reality, that’s rarely the case. And it’s especially not the case with AS partners. Rather than expecting your partner to naturally know what you want or hinting at it, communicate your needs as specifically and directly as possible.

This can be tricky because you might think that you’re already being very obvious. Here’s a simple example: According to Ariel, you might say, “I’m going out for a few hours. Can you please do the yard work?” To you this obviously means bagging the leaves because it’s fall and they’re everywhere. To your partner, this might mean weeding.

Instead, it’s more helpful to say: “Can you please rake the leaves and put them in the leaf bags by the curb for Friday’s pickup?”

5. Talk about how you’d like to connect with each other.

Because you and your partner experience emotions differently, having an emotional connection also can be challenging. Remember that people with AS have a difficult time understanding and identifying emotions, and they may show very little emotion or express inappropriate emotions. You also might miss displays of deep connection from your partner because you express emotions so differently.

Ariel includes the below exercise to help you and your partner articulate how you can improve your emotional connection.

• Using index cards or slips of paper, write down what you do to help you feel more connected to your partner.
• Next write down at least five things you’d like your partner to do.
• Have your partner do the same and list what they do to help you feel connected and what they’d like you to do.
• Read each other’s cards and talk about how you’d like to connect in the future.
• Put the cards in boxes: one box for what you’d like your partner to do; another box for what they’d like you to do.
• Try to do a few of these behaviors each week, and regularly review your lists.

Even though being in a relationship with someone with AS may add additional challenges, together, you can absolutely learn to better understand each other and improve your relationship.

You can learn more about Cindy Ariel at her website.

By Rob Lamberts, MD

I saw a gentleman in my office recently.  He was having severe pain radiating from his lower back, down to his calf.

I was about to describe my plan to him when he interrupted me saying, “I know, Doc, I am overweight.  I know that this would just get better if I lost the weight.”  He hung his head down as he spoke and fought off tears.

He was clearly morbidly obese, so in one sense he was right on; his health would be much better if he would lose the pounds.  On the other hand, I don’t know of any studies that say obesity is a risk factor to ruptured vertebral discs.  Besides, he was in significant pain, and a lecture about his weight was not in my agenda.  I wanted to make sure he did not need surgery, and make him stop hurting.

This whole episode really bothered me.  He was so used to being lectured about his obesity that he wanted to get to the guilt trip before I brought it to him.  He was living in shame.  Everything was due to his obesity, and his obesity was due to his lack of self-control and poor character.  After all, losing weight is as simple as exercise and dietary restraint, right?

Perhaps I am too easy on people, but I don’t like to lecture people on things they already know.  I don’t like to say the obvious: “You need to lose weight.”  Obese people are rarely under the impression that it is perfectly fine that they are overweight.  They rarely are surprised to hear a person saying that their weight is at the root of many of their problems.  Obese people are the new pariahs in our culture; it used to be smokers, but now it is the overweight.

The fear/disdain of obesity has reached into areas where it should not be.  I regularly have to tell mothers of chubby babies that it is perfectly fine for their child to be that way.  Children under three generally regulate their eating to what they need.  I do not believe a baby can become obese on breast milk or formula.  Now, if they are giving the child french fries and burgers, that is a different matter.

Instead of patronizing obese patients with a lecture, I try sympathizing with them.  Just because something is simple doesn’t make it easy.  How do you quit smoking?  You just stop smoking.  We should just pull out of Iraq.  There should be peace in the middle east.  People should stop hurting each other and start being nice.  All of these are good ideas, but the devil is in the details.  Losing weight is a struggle, and it really helps to have people giving you a hand rather than knocking you down.

Don’t get me wrong, I don’t deny the health risk of obesity.  I do my best to work on weight loss with my patients.  But the idea that their personal worth lies on their BMI is extremely damaging.  There are a lot of screwed-up skinny people out there; just look at super-models.  It is a lot easier to lose weight when you actually like yourself and want to do something about your health.  Our culture of accusation and shame simply makes obese people hate themselves.  If you hate yourself, why should you want to take care of your body?

Is obesity a problem?  Sure it is.  But we need to get off of our self-righteous pulpits.  Obese people should not be made into a group of outcasts.  The “them” mentality and the finger-wagging are no more than insecure people trying to feel better by putting down others.

It sounds a lot like Junior High.

If we really want to help with obesity, we need to grow up.

Rob Lamberts, MD, is a primary care physician practicing somewhere in the southeastern United States. He blogs regularly at More Musings (of a Distractible Kind) where this post first appeared. For some strange reason, he is often stopped by strangers on the street who mistake him for former Atlanta Braves star John Smoltz and ask “Hey, are you John Smoltz?” He is not John Smoltz. He is not a former major league baseball player.  He is a primary care physician.