Pathological Demand Avoidance//

Pervasive Drive for Autonomy (PDA)

PDA was first identified in the 70s in the UK, and has recently had a significant increase in attention and understanding. Like with any newer understanding of the human mind we still need a lot more research, including lived experiences of PDAers, to better understand the why’s, how’s, what’s, and supports needed. Also as a newer perspective it is not yet in the Diagnostic Statistical Manual used by therapists to diagnose mental health disorders. Due to this there is a lot of misinformation about PDA, and there are still many professionals who dismiss PDA as a “trend” or as not existing at all. This is also why there are many different versions of what PDA stands for, and why I include two different versions here. As a PDAer myself and based on all the PDAers and parents of PDAers I have known and worked with, I believe strongly that once the research catches up PDA will be added to the DSM in one form or another. And while we wait and work towards that, I have seen how life changing understanding and supporting behavioral and emotional challenges from this perspective can be.

The first training I ever attended about PDA felt like the lightbulb of a lifetime went on because I could see that without realizing it I’d already started specializing in this work as a therapist. I had already discovered I loved supporting kids with overwhelming emotions and extreme behaviors because I could provide at least a small space of safety for them. I loved supporting their families because most of the suggested approaches in the parenting world just didn’t work for their kids and they weren’t sure where to turn. I loved being a lighthouse in the fog of confusion and contradiction for them.

The more I worked with PDAers, the more I realized I’d grown up with PDAers in my family, and that I myself am a PDAer with the internalized profile. For the first time in my life, I could have compassion for the extreme emotions and behaviors that had shaped my life.

I am now excited to be part of the growing field of professionals that specialize in supporting PDAers. Below is a presentation I designed as an introduction to professionals interested in learning more about PDA and how to provide PDA affirming services.

My approach to supporting PDAers as a therapist focuses on meeting them exactly where they are at with a radical acceptance of what they are capable of in that moment. I support them in moving towards compassion for the unique internal and external struggle of PDA. It is HARD to be a PDAer and have the world expect and want us to be able to do things we just cannot.

If there is burnout from forcing themselves to meet demands, we explore what accommodations are needed to help their system come back to a sense of at least moments of safety. We explore sensory processing supports that can help widen the window of tolerance for demands that life requires. We find ways to lower and remove demands that are not absolutely necessary, or at least build in times with low to no demands.

It is often very slow work to build a positive or neutral relationship to PDA. I focus on providing encouragement and validation for the struggle. The moments when a child expresses they like themselves for the first time in their life, or the moments when an adult can handle a demand that used to send them into freak out or shutdown make it all worth it.

PDA Resources