What Does PDA in Adults Look Like? Insights from a Neurodivergent-Affirming Therapist

Written by: Melissa Light, LPC, NCC, PMH-C

What is PDA?

Neurodiversity is a broad term. Covering a variety of ways people experience the world. One area that is starting to be acknowledged is Pathological Demand Avoidance (PDA). PDA is a profile of autism, meaning it can be a part of some autistic people’s experience. A PDA profile is also a spectrum and presents differently in different people. It’s important to understand what PDA can look like in daily life and what it actually is. As it can be debilitating and is so often misunderstood. Because there are so many ways PDA can present, this article is meant to provide a broad overview and help you determine if you could benefit from a personal consultation with a therapist and begin neurodivergent therapy in Atlanta, GA.

Imagine if your reaction to everyday demands and expectations caused extreme anxiety. For example, getting to an appointment requires us to meet so many demands that most of us don’t even think about waking up on time, making sure we are dressed, taking our wallets/purses with us, calculating our commute time, and being able to leave the house on time, just to name a few general steps. To someone with PDA (PDAers), this process can feel so overwhelming there is an almost compulsive need to resist or avoid these tasks altogether.

Understanding PDA: A Persistent Drive for Autonomy, Not Defiance

At its core, PDA is not defiance or disobedience. It’s a coping mechanism driven by an intense need to remain in control of one’s environment and circumstances. Because of this, some people prefer the term “Persistent Drive for Autonomy,” and I find this to be more accurate. Everyone wants to feel in control of their lives, but for some this need for control is driven by a deep-seated fear of losing autonomy or facing overwhelming anxiety. The need for control can mean wanting to do things “on your own terms,” such as being able to choose the timing or the order of events. It can involve highly creative strategies to avoid demands, such as negotiation, distraction, or even socially manipulative behavior. Understanding PDA is crucial for fostering inclusive environments where individuals can thrive. Recognizing that someone with PDA isn’t being intentionally disobedient but is instead navigating their world in a way that feels safe to them opens doors to more effective support and communication strategies.

If you recognize this in yourself or in someone you know, please know that this perspective is valid and with support from an understanding therapist, a PDAer can learn to manage responsibilities while honoring their need for security and independence. From coping with anxiety around demands to fostering healthier communication and relationships, therapy with a skilled neurodivergent affirming therapist plays a pivotal role in helping PDAers thrive and navigate their world more effectively.

Neurodivergent Therapy to Address PDA

Neurodivergent therapy for individuals with PDA focuses on understanding the underlying anxieties and helping develop coping strategies that empower rather than overwhelm them. Unlike traditional approaches, therapy for PDA often emphasizes flexibility and collaboration, recognizing the need to work within the individual’s comfort zone to build trust and achieve positive outcomes. 

Some important aspects of neurodivergent therapy include:

Celebrating Strengths

Above all else, it is essential that the therapist is neurodivergent-affirming and works from a strengths-based approach. PDAers often exhibit remarkable creativity, resilience, and problem-solving skills. Understanding the underlying values and goals of each person and honoring their experiences leads to a partnership in therapy that feels safe and helps to tailor strategies to fit each person’s lifestyle.

Building Trust

Establishing trust and rapport is essential. PDAers may be more willing to engage and cooperate if they feel understood and supported rather than pressured. It’s important that PDAers feel in control of their lives and have autonomy to work towards the goals they establish as important.

Developing Flexible Approaches

People with PDA often respond better to indirect requests or choices framed in a way that feels less demanding. For example, instead of saying, “You need to finish your homework now,” offering a choice like, “Would you like to start with math or English first?” can be more effective. Typically for adults, it may mean developing a general routine that allows for flexibility from day to day. For instance, having a “Getting Ready” time period in the morning can include hygiene routines/breakfast/reading the newspaper, rather than a schedule dictating the order in which everything must be done.

Addressing Anxiety

It’s important to approach interactions with patience and empathy, whether for others with PDA or for yourself. Recognize that what might seem like defiance, manipulation, or resistance is often a coping mechanism for managing anxiety. Therapy can use strategies such as CBT (Cognitive Behavior Therapy) to treat anxious thoughts and feelings. This approach not only reduces anxiety but also enhances problem-solving skills and resilience in the face of demands. Mindfulness strategies can also help PDAers overcome symptoms of overwhelm or sensory overload to find a sense of calm as they navigate obligations.

Family and Support Network Involvement

Therapy for PDA often extends beyond the individual to include family members and support networks. Educating loved ones about PDA and its impact fosters understanding and empathy, enhancing communication and creating a more supportive environment. 

Celebrating Progress and Building Confidence

Therapy isn’t just about addressing challenges. It’s also about celebrating successes and building confidence. By focusing on strengths and achievements, therapists help PDAers recognize their resilience and unique abilities. Thus fostering a positive self-image and increasing motivation to continue personal growth.

Neurodivergent Therapy for PDAers at Informed Therapy Group

Above all, effective neurodivergent therapy for PDA recognizes the importance of individualized approaches tailored to each person’s unique needs and strengths. Therapy provides a vital resource for individuals with PDA. Offering strategies to manage anxiety, improve communication, and foster positive relationships. 

At Informed Therapy Group, we create spaces where PDAers can feel valued and understood. Every person deserves the opportunity to navigate the world in a way that feels authentic to them. If you’re ready to cultivate a deeper understanding of yourself, develop effective coping strategies, and learn to navigate your world with greater confidence and resilience, please contact us to schedule an appointment or by calling (404) 444-8974.

Navigate PDA With The Help of Neurodivergent Therapy in Atlanta, GA

If you’re struggling with Pathological Demand Avoidance (PDA) and need support navigating daily life, neurodivergent therapy can offer the understanding and tools you need. Our compassionate therapists at Infromed Therapy Group specialize in helping individuals with PDA build coping strategies that honor your unique needs and experiences. Take the first step toward a more manageable and fulfilling life by following these three simple steps: