What is PDA Autism
PDA: No, Not a Public Display of Affection
Have you heard a this term in teh neurodiversity community? This term describes a condition called Pathological Demand Avoidance (PDA), though some people prefer calling it Pervasive Drive for Autonomy (PDA).
This new name focuses less on avoiding demands and more on the need for autonomy, or the ability to make decisions for oneself. PDA isn't officially recognized in the DSM-5 or ICD-10 (which are medical guides used to diagnose conditions), and it's not very well known in the United States. However, it is more familiar in the United Kingdom.
What is PDA?
The main feature of PDA is an anxiety-driven need to stay in control. People with PDA avoid any demands or expectations placed on them because they feel they must keep control over their lives. Even small requests, like putting a glass in the dishwasher, solving one math problem, or taking a shower, can cause extreme reactions. This can happen even when the person wants to do the task, but their anxiety makes it feel impossible.
People with PDA often experience an intense feeling of “I can’t let anyone take away my freedom.” As a result, they are easily pushed into "fight, flight, or freeze" mode, which means they may respond by acting out, running away, or becoming paralyzed with fear. Because of this, they may have meltdowns that seem uncontrollable, which can make them appear to have mood disorders like Bipolar Disorder or Intermittent Explosive Disorder. They might also struggle with going to school or adjusting to adulthood.
Characteristics of PDA
People with PDA often confuse those around them, such as parents and healthcare workers. Here are some traits that make them hard to understand:
Social Skills: PDAers often have better eye contact and social interaction than most people with autism. This can make them appear more socially typical, leading people to question if they are on the autism spectrum at all.
Social Savvy: They may seem socially smart and can even use manipulation (or as some prefer, "strategy") to get their way. This is their way of regaining control.
Difficulty with Authority: People with PDA often don't recognize social hierarchies. For example, a child with PDA might not see themselves as a child and may act like they're one of the adults.
Sudden Changes in Behavior: They might do really well in certain situations for a while but then suddenly struggle, leading others to believe their behavior is deliberate when it's not.
Need for Novelty: Unlike many people with autism, PDAers might not do well with routine and often crave new experiences.
Different Behaviors in Different Settings: Some PDAers do well in one environment, like school, but struggle at home. Others may thrive at home but find school very challenging.
Role Play: They often enjoy role-playing games, sometimes to an extreme.
These traits make people with PDA often misunderstood. They can experience years of trauma from constantly being in "fight or flight" mode, which can lead to even more anxiety and depression. This also takes a toll on families, affecting parents, siblings, and marriages. Families might try different therapies, medications, behavior plans, or schools without success, leaving them feeling frustrated and hopeless.
How to Help Someone with PDA
Here are some recommendations for working with people who have PDA:
- Understand that it’s all based on anxiety. It’s like having a fear of losing autonomy.
- Build relationships and practice radical acceptance. Don’t judge them, just accept them as they are.
- Collaborate. Work with the person to help them cope with demands in a way that makes them feel in control. Give them choices whenever possible.
- Use novelty and role play. Since many PDAers enjoy new things and role-playing, use these to engage with them.
- Avoid threats and ultimatums. Don’t take their behavior personally, and avoid talking down to them.
- Recognize anxiety signs. When you see signs of anxiety building up, back off.
- Offer recovery time. People with PDA and their families often experience either trauma or recovery periods. Give them time to recover from stressful situations.
PDA is a condition driven by anxiety and the need for control. While it can be challenging to understand and manage, patience, understanding, and collaboration can make a huge difference for those who have PDA and the people who support them.
