As I've mentioned in a number of my posts, my ADD spouse and I separated several years ago because I just couldn't take dealing with his ADD issues any more.  Even though he had been on medication and in counseling for 10 years, there were still many problems, especially in the area of communication.  As our marriage disintegrated, the communications got worse.  So when we decided we wanted to try to salvage our marriage, my husband's counselor (who also knew me from some joint counseling sessions we had done) suggested that we should try a different approach to communication.  Instead of discussing things at any old time, and getting into communications problems constantly, he proposed that we have several formal meetings each week where we would talk about problems and conflicts, matters that might require negotiation, plans, and status -- just like in a business meeting.  The rest of the time outside the meetings we would only converse on pleasant topics -- like social chit-chat, or anything else we both enjoyed, unless it was something exceptionally urgent (like, "the house is on fire").  The intent was to create a context for my husband to be able to focus his attention on the items we needed to discuss, while freeing him the rest of the time from having to try to pay attention when his mind was already engaged with something else.

With some reservations on both sides, we began scheduling meetings and trying to work within this framework.  I found it frustrating to "hold off" talking about matters that arose that were important to me, until our meeting -- when I see a problem, I want to tackle it NOW! --  and my husband initially had trouble with being prepared for the meetings, but we adjusted after a couple of months.  Business meetings are usually set for definite periods of time, and we quickly learned that we needed to do the same -- at first, my husband could only maintain focus for an hour at best.  Often that meant that topics got deferred to a later meeting, which was very frustrating for me.  But as we became more practiced, he was able to increase his focus time, so this problem eventually went away. Normally, people don't yell at each other in a business meeting, it's unprofessional -- at first we didn't implement this concept in our meetings, and we ended up with some meetings being just one concentrated yelling spree.  Since my husband can't think at all when he gets upset, our discussions were going nowhere, so we adopted this business policy as well.  This was very difficult for me to implement, since I'm an impatient angry sort of person by nature, but it was well worth it since the reduction of the emotional tension made it much more possible for my husband to apply his mind to the subjects at hand.

Other problems arose:  my husband took few notes, and so some of things we'd talk about never got "on his radar screen" for follow-up; when he took notes, they were often so vague that he'd misinterpret them later on and then we'd be at odds about what had been discussed;  and worst, he'd forget the date/time and not show up, or show up late (even though we created a regular schedule!!).  These were serious roadblocks, and it took some pretty hard work to deal with them.  To help my husband take better notes, we'd compare notes at the end of each discussion, or at the end of the meeting, to make sure we had both captured the same information -- he would read back his notes, and I'd identify any discrepancies with mine, and then we would mutually resolve the discrepancies.  In the process of making sure we were "on the same page", we'd also be able to ensure that his notes were more detailed and less vague.  As far as the lateness/forgetting problem went, we agreed to implement a rule that if he failed to renegotiate a meeting date/time ahead of time, and was late or a no-show, that the meeting would be rescheduled at *my* convenience (but I had to be fair and not just schedule a bad time for him as "pay-back"). 

There were other policies we found useful to implement, through trial and error. Since it wasn't certain there would be enough time to cover everything, we decided to cover "logistical" topics first (e.g., who has what appointments coming up this week, who is picking up the dry cleaning when, etc.), then topics where some decision was necessary, project status, and such, and finally more nebulous topics that involve some negotiation or conflict or exploration.  Before we instituted the meetings, my husband often felt that I was always the one driving the discussions, so to avoid that we developed a policy that we would address his agenda before mine (not necessarily his entire agenda -- but his logistics before mine, his project status before mine, etc.)  When my husband would agree to take on some task in our meetings, he'd make notes about it but wouldn't necessarily set a particular target date -- and without a target date, he would have no reminder alarm in his PDA or anywhere else, so it often wouldn't get done -- so now we set up a target date in the meeting as well.   When I would ask for status on some item that he was supposed to be working on, he'd sometimes have a hard time remembering what he was supposed to have been doing, and it slowed down our meetings a lot to go over it -- so now he does a brief review of his notes of the previous meeting before we start each new one.  We fiddled with the frequency of our meetings at times, but generally have found that three times a week works best for us.  We both sometimes relapse into bad old habits, but we now have the mechanisms in place to correct those problems when they occur.

Once we ironed out these wrinkles (after about six months), we found that the meetings not only accomplished their intended purposes of providing a structured context for discussion and negotiation plus better interactions outside the meetings, but they some pleasant unexpected results as well.  My husband has become much better at follow-through, because he knows there will be a status check in an upcoming meeting, and this has reduced my need to nag.  I've learned how to address conflicts without yelling (well, most of the time).  We have a much more structured dynamic for communications, which leads to fewer misunderstandings.  My husband's note-taking has improved so greatly that we rarely need to do re-caps anymore, which shortens the meetings and again contributes to better follow-through.  And the meetings as we have set them up provide a method for coming back to unresolved problems, with the chance to review the notes and reflect during the intervening time -- this has been an important element in reaching an accord on many of the more fundamental complex problems surrounding ADD behaviors.

I've resisted the urge to end with a bullet-list summary of "rules" for setting up such meetings:  this kind of setup should not be a straight-jacket, and I think that each couple has different problems and therefore needs for different rules which only they can discover as they work through this kind of process themselves.  I think the only real rule is the original intent -- to create a context for focused attention on interpersonal matters, and to exclude those discussions from the rest of your interactions.  This isn't a perfect system -- it doesn't always work smoothly every time -- but it's a very helpful framework.  Suffice it to say that these meetings were a key component in ending our separation -- I really don't know if we could have resolved our communications problems without them --  and we have found them so helpful, we are still holding them more than four years later!  They can definitely be a powerful tool in the ADD-coping toolbox.