YanLin Tso, LCSW
Pathological Demand Avoidance (PDA) has been described either as a type of neurodivergence within itself or associated with other types of neurodivergence (abbreviated here as ND), such as autism and ADHD. What is PDA? It is defined in Wikipedia and elsewhere as a greater than usual refusal to comply with requests and expectations. In children, it can be associated with Oppositional Defiant Disorder. I agree with other professionals that it would be beneficial to rename it as the “pathological” descriptor isn’t necessarily accurate or helpful. I suggest referring to it as simply Demand Avoidance.
What does Demand Avoidance look like? Sometimes it manifests as refusal for what someone externally might deem as a “reasonable request.” Other times it manifests as something that someone avoids doing because they believe it is something they “should” do in order to get what they want.
What PDA is not. It is not general defiance towards authority figures, it is not resistance to treatment, it is not laziness, it is not a fixed character trait that cannot be changed and it is not necessarily animosity towards a caretaker (unless a caregiver is doing something that makes it reasonable for a person under their care to be defiant). It is not necessarily pathological either.
Could PDA be a way of coping with ableism?
Many ND people, whether diagnosed or not, have had the experience of having someone expect them to be able to do things that they cannot do, or they are expected to be able to do things in the same way that neurotypical people do. But people who are neurodivergent by definition, may think or experience the world differently. Thus they may have their own ways of doing things that work best for them. It is this misunderstanding that can lead people to believe that they are just being difficult, lazy, irresponsible or that they are somehow inferior because they cannot or will not do what is being asked of them. ND people tend to internalize this type of feedback, believing that they are inferior in some way, thus it can be a trauma that is the result of internalized ableism.
Demand Avoidance can be positive, as a means of self advocacy. If one is trying to work with someone who displays Demand Avoidance, it is possible that they are not able to do what you are asking them to do in the way you are asking. It is possible that they are having a reasonable response to someone who is trying to take away their autonomy or a similar projection based on past experiences. It is also possible that this behavior is a barrier that gets in the way of their goals and it is treatable.
For the latter situation, I suggest an Internal Family Systems (IFS) approach. If you aren’t familiar with this framework, see Richard Schwart’s book, called, “No bad parts.” In the context of IFS, we can view Demand Avoidance as a part, specifically as a protector that helps the individual avoid the feelings that they have historically experienced as a result of not meeting the expectations of others. Perhaps they experienced feelings of shame, inadequacy, or guilt. In the IFS framework, we can view the part as having the positive intention of helping someone to not have to feel these difficult feelings. Likewise, neurodivergent people often internalize the authoritative part that says what we “should” be doing and have a demand avoiding part that responds to that part. In treating Demand Avoidance, in the IFS framework, we would help the client to flesh out the parts and understand the needs of the parts.
Perhaps the therapist and the Self would try to help the part(s) that are being protected. Then we might find boundaries or an appropriate role for the protector part so that it does not need to be exiled and it operates in a way that is beneficial to the whole Self.
YanLin Tso, Licensed Clinical Social Worker and Autistic Person