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PDA Autism - your right to autonomy

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PDA (Pathological Demand Avoidance) comes up a lot in my work with neurodivergent clients so I thought I'd just share some info here for those who are exploring their neurodivergent identity.

In my counselling practice I don't use pejorative labels, and so when I work with PDA I use the term Pervasive Drive for Autonomy (PDA) coined by Tomlin Wilding. This newer interpretation shifts the focus from the avoidance of demands to the underlying need for autonomy.

At its core, PDA is characterised by an intense, anxiety-driven desire for personal control. Individuals with PDA may react strongly to expectations or demands, even seemingly minor ones, as a way to maintain their sense of autonomy. It's crucial to understand that this isn't about being difficult or defiant - it's a genuine, often overwhelming need to preserve one's freedom from external pressures. PDA usually sits within an autistic profile but I notice in my work that it can appear in any of the neurodivergent profiles ie. autistic, ADHD or AuDHD.

Is this something you relate to? Share in the comments below!

Interestingly, those with PDA often struggle with demands they actually want to meet. In my practice people have shared with me all sorts of challenges with demands, including struggling with getting water when thirsty and making food when hungry. PDA can hide in the most subtle of places. A person with a PDA profile might genuinely desire to be productive, compliant, or engage in activities they like, but find themselves unable to do so due to intense anxiety and demand-pressure.

People with a PDA profile often display a unique set of characteristics that can be confusing for the people around them such as partners or family members. They may have better social skills than typically seen in autism, making their challenges less immediately apparent. They might struggle with social hierarchies, experience unpredictable periods of coping well followed by difficulties, and have a greater need for novelty than many autistic individuals.

These traits can lead to misunderstandings and misdiagnoses. The years of being misunderstood can result in trauma and additional layers of anxiety and depression. It's also important to recognise the significant impact on families, who often feel at a loss after trying numerous interventions without success.

How I work with PDA in the counselling room

As a neurodivergent-affirmative therapist, when I'm working with a client who has a PDA profile I approach the therapy with a deep understanding of the person's need for autonomy and control. Part of this involves creating a collaborative therapeutic relationship, where the client has significant input into the pace, structure, and goals of therapy.

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I help the client explore and understand their PDA traits, framing them as a natural part of their neurotype rather than as deficits to be corrected. I might work with the client to develop strategies for spotting the anxiety-demand-pressure hypervigilance that appears in the subtleties of everyday life, and helping the person to consider ways of navigating around the demands of daily life, always emphasising the client's agency in collaborating to find a way through the choppy waters of adulting.

Ultimately, the goal is in helping build self-understanding, develop coping mechanisms, and find ways to shape a life that is PDA-friendly. It also involves ways to attune to the nervous system so that approaches to demands can be reframed in a way that the nervous system feels ok to go ahead. This can involve using conversational reframes and approaches that allows the nervous system to say - yes, I'm ok to go ahead!

What are your thoughts, does this profile resonate with you. Find out more about PDA here.


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