What do we mean by internalised and externalised PDA?
To understand what internalised and externalised PDA are, I think it’s first necessary to understand what PDA is.
PDA stands for both a specific type of irrational, “pathological” type of avoidance, and the distinct neurotype it belongs to.
PDA-style avoidance is only experienced by people fitting the PDA neurotype.
PDA as a neurotype involves more traits than the irrational avoidance it’s named for:
~ massive need for personal control
~ ultra-high inborn anxiety
~ interest in fantasy and role-play
~ using social strategies to avoid every day demands (like having to put shoes on)
~ enjoying novelty
PDA, as a neurotype, hasn’t been studied much. The huge majority of existing studies have focused on children with obvious traits:
I.E., children who’ve kicked and screamed publicly enough for researchers to notice them.
But there are more PDAers than children who’ve stood out as obviously difficult. Many of us, for example, are adults. And many of us never kicked and screamed to begin with: we internalise our stress so no one notices its existence.
What people may notice, if they’re paying close attention, is our failure to socially gel, or, maybe, quiet failure to perform as expected.
Externalising PDAers express their PDA, and other feelings, issues, etc, openly, but internalisers swallow their feelings and issues inside so they’re hidden to observers. This can manifest in school children as compliance and/or muteness.
All the stresses and self-generated restrictions of PDA are in operation, but they’ve been internalised so they’re not blasted out for observers to easily see.
Internalising PDA kids – like me as a child – still seek to avoid things like school, but use hidden means to do so.
I avoided school using “sneaky” methods:
pretending I was sick
forging my parents’ handwriting to write sick notes after playing truant
Why is internalised PDA harder to spot?
Externalising PDAers are the ones who’ve been studied and classified because they’re behaviour and avoidance are noticeable.
However, although externalising PDAers avoid demands in obvious ways and have visible meltdowns, internalisers are just as “PDA”.
The difference is that we contain our triggered reactions so their impact is hidden to observers.
Our internalising drive is very strong (otherwise, why would we bother?)
I believe it’s inborn.
There’s been very, very little written about internalised PDA. Hardly anyone has ever noticed us. That’s how good we are at hiding our differences!
So much of internalised PDA is unexplored.I think of it as an uncharted continent. The type of landmass which antique maps label with “here be dragons”
I can only talk from my experience:
~ coming to understand my own, complicated self
~ my daughter (equally complicated)
~ what fellow internalising PDAers have said
~ what parents of internalising PDAers have said
My daughter, Millie, denied being in pain from the moment she possessed enough communication ability to do so – about age one.
I learnt to calmly hold my arms open for her without making a big issue out of it or commenting on her injury so she could come to me without feeling exposed.
This wasn’t because me or her dad had ever told her to hide her pain. Not at all.
I intuitively sensed her hide-reaction was instinctive.
The internalising drive seems to be innate. I have it myself.
Autistic people often talk about dropping masks as if this is good and possible.
It’s really not good or easy for me. Trying to drop my mask takes huge effort and feels traumatic!
I had to drop my mask recently to navigate a disability benefit assessment. I knew I’d score badly if I hid my anxiety, but revealing it felt awful. Like being naked in a supermarket or something! My personal comfort lies in masking my vulnerability. Pausing my mask was hard work and unpleasant.
My whole instinct is to mask.
I believe this is natural for me and not something I should change to make me “better off”.
I believe we internalising PDAers pit our wits to hide what’s going on inside us.
We’ll chuck massive amounts of energy and learnt skills into doing this, because we’ve been ordered to, but because our brains tell us to.
This might not match popular theories, but it’s what I’ve observed going on in myself and in my daughter. And what many other fellow PDAers, and parents of PDAers, have observed too.
Seeing us demands effort
Parents, carers, educators, etc, are often over-stretched and tired and without any spare energy.
If a kid is quiet and not demanding attention, then the easy course is not expend attention on them. After all, there’s enough other stuff clamouring at them already.
Specific needs and vulnerabilities of internalised PDA
We internalisers, by nature, tend not to self-advocate or ask for help. We shrink from having our differences observed. This means we hide each and every difficulty we have.
Roller-coaster emotions and alexithymia
Our PDA guarantees super-high anxiety and other strong emotions surging on privately in our heads and bodies, but, as we’ve seen, internalising PDAers want to hide it.
Many of us have “alexithymia” AKA emotion blindness.
As PDA anxiety is nonstop from birth, it’s hardly surprising that we are commonly blind to our anxiety. It’s our normal.
All the fun and fireworks of PDA, and any other invisible difficulties, are still there, but we instinctively don’t want you to know about them.
Not wanting obvious accommodations
We may not want accommodations that’d mark us as different – e.g., being permitted to leave a classroom if we’re stressed.
We don’t want to stand out as different, and we don’t want anyone to spot our vulnerabilities.
We are distressed if we’re treated as needy.
Internalising PDAers need sensitive, respectful support which doesn’t spotlight us.
Not asking for help
Help can feel demandy to all PDAers because it entails giving up that personal control we so badly need. But we internalisers also have the issue of not wanting to be seen as vulnerable.
Aged about ten, I fell off a high wall. My whole drive was to get back into our house and sneak upstairs without my parents noticing I was vulnerable!
At this same time, I fantasised about a knight in shining armour charging into my life to rescue me from all the stuff I couldn’t cope with.
My daughter, in school, doesn’t ask for help when she’s stuck in assigned work. It took her until year six to first let her teacher know she needed a toilet break. After a few years of accidents, she developed an iron-strong bladder!
We internalising PDAers are the kind of people who – young or old – will harm ourselves by not asking for our needs to be met.
Surface level success
We may get along very well academically. Great! But our hidden, underlying anxiety can escalate to horrendous heights.
These kids, who appear to be model pupils, implode so they can no longer access school. Or even leaving their rooms.
Quietly avoiding school, doctors, etc
We may pit our wits to avoid school sneakily. E.g., by feigning illness and playing truant.
We may put ourselves in danger.
I was chased for miles by a strange man when I was playing truant aged about ten.
Internalising PDAers can, and do, avoid necessary medical support.
Tragically, a dear friend, I met through an online adult PDA support group, died from pneumonia that had escalated because she kept avoiding GP and hospital appointments.
A trait of PDA is social focus: being interested in people.
We may be very naive and be led by people who don’t care for our welfare.
As a young adult, I was desperate to connect with others, but paralysed by social anxiety. I self-medicated by taking a dangerous quantity of party drugs and alcohol. I didn’t care about the danger. I was, in fact, impressed by my body’s ability to keep going! My priority was to quash the anxiety that crippled me unless I knocked it out of my brain via drink and/or drugs.
I wanted to be relaxed and able to talk to others. But I couldn’t unless I was high. I noticed that I couldn’t speak to the friends I’d made whilst high when I was sober.
I repeatedly made brave efforts to forge friendships when I wasn’t high, but I always failed.
That horrible wall of anxiety wouldn’t go away, no matter how much I’d willed it to. The only thing that made it disappear was drink, drugs, or being with the rare few people I felt OK with sober (these were out of my control to choose and totalled between zero people and three).
Obsessions about people
PDA social focus can become obsessive.
People obsessions made my life hell. When my PDA brain fixated on someone, or a group of people (normally it’d be a man I fancied) it drove out all other thoughts and puppeted me to blindly, and obsessively, throw myself at them… whilst too scared to be able to chill out and connect with them in a fruitful way. This tended to make me very depressed, and even suicidal.
Tell tale signs to look out for
How can people spot the needs of people, including children, who are driven to evade having their needs detected?
Think of an overworked teacher in a classroom full of lively, demanding children...and of an internalising PDA kid muddled in with them who’s critically stressed, but hiding it.
Hard to connect with
This is the child who likely evades eye contact and is, maybe, a bit rigid. They might be hard to warm to because of this, and because they don’t reach out emotionally. Also, they might behave weirdly. Or come across as sullen. Or as a daydreamer.
School refusal is very common for all PDA kids, but internalising PDA kids are likely to evade school more subtly than externalising ones.
Whilst externalising PDA children may simply try to run away from the school building, or yell at teachers that they don’t want to be there.
Internalising PDA children – as I was – maybe more likely to feign illness and use their wits to get away with playing truant.
Playing the clown
They may also play the clown in class. I did this as a child.
“Funster” is coming to be recognised as an adrenaline response (like Fight, Flight and Freeze) that’s socially oriented. There’s high anxiety going on behind the loud, clowning facade.
Other internalising PDA kids, my daughter included, comply in school. They bend their entire beings into being model pupils who mix, as perfectly as they’re able to, with their peers, and with school expectations
If parents say their children are loud and demanding at home, teachers can assume this is due to poor parenting because they’re perfectly well-behaved in school.
What’s actually going on is high anxiety triggering the adrenaline responses of fawning and social freezing (tonic immobility).
Situational mutism is, I believe, tonic immobility.
My daughter was, as I was, situationally mute in school.
“Situationally mute” is preferred to “selectively mute” because terming our silence isn’t a choice.
It feels like being trapped behind a solid, icy cold wall of fear that I can’t penetrate
A signifier is having a rigid facial expression. This was blindingly obvious to me in every, single photo taken of my daughter in school, but no one else seemed to notice.
A good pointer is “spare play” – a term coined by a young client of speech and language therapist, Libby Hill. It means actively moving around & making gestures so it looks like a child is actively playing with their peers. Close observance reveals that the child is actually playing entirely alone.
I engaged in it because no one wanted to play with me.
My daughter seems to have spare played because she preferred to play alone.
Our internalised style of avoidance is less-confrontational, but can still feely “stressy” to others. Instead of having no-holds-barred meltdowns, we pull our anger and stress in, but it’s still there and will come out as being irrationally argumentative or even verbally cruel. It may also divert into self-harm.
Arguing like a lawyer
It’s common for PDA kids to argue like little lawyers. Anxiety, I think, can up the tempo of this.
When our daughter does this, it feels like there’s ill-ease and panic underlying her lawyer-style dissection of everything we say.
PDA type demand avoidance may be a driver too, because accepting what we say is always going to be a demand (that’s the nature of PDA type avoidance) and when she’s overloaded she has no resilience spare to handle it.
What are the main differences, and similarities, between internalising and externalising PDAers?
We’re all different. Even within PDA, one size doesn’t fit all.
~ deep-level irrational avoidance of anything and everything
~ massive need for personal control
~ ultra high anxiety (if we’re conscious of it or not)
~ likely comfortable in role-play or quiet fantasy
Externalising PDAers express their PDA traits in external, easy to spot ways (e.g., via the Fight adrenaline response)
Internalisers express their PDA in harder to spot ways:
~ Fawn (become people-pleasers)
~ Funster, even
How to support internalising PDA children and adults
Supporting internalising PDAers can be challenging because we don’t want anyone to know we need support!
Accepting us as we are
The best way to support internalising PDAers, in my opinion, is to accept:
~ we have massive anxiety going on inside
~ we don’t want it spotted
~ we have irrational PDA-style demand avoidance in operation
~ our ultra-high need for personal control
Don’t try to fix us
I think it’s important to accept PDA traits as hard-wired, rather than trying to cure them.
I’ve had therapists assuming I need to overcome being anxious. But my path to happiness took me through accepting my anxiety (and other quirks) and living with them.
Give kids time
Trying to rush internalising PDA kids into behaving like other children won’t work.
We advised our daughter’s teachers against trying to force her to speak more. She’ll do it her own time.
We sensed her unspoken terror of lying alone in the dark. She co-slept with us until a month or two ago, despite conventional “wisdom” that 11 year olds should have been sleeping alone for many years – some would say since birth.
I think we need to feel safe from being negatively judged, and that it’s important to avoid panic-prompts (triggering the child to panic more).
We don’t make a big deal of it when our daughter gets into an irrational mood or suddenly wants to avoid something she’d just asked for.
Light humour and distraction can be effective.
We might feel frustrated to our cores when this happens, but we don’t blame her.
We keep calm and carry on (though I actually hate that phrase because it has a demand in it!)
Be open about our own stress
We’re only human. Our daughter can and does overload us.
I’m PDA too so very prone to overloading, especially because we both have an innate need for personal control.
If I snap at her, I apologise later and explain that I’d found it too much and I still love her and I’ll do my best not to snap at her again.
My own mum used to deny ever having been stressed and this confused me massively because I clearly sensed her stress.
Health and safety are priorities for us. We explain concerns factually so our daughter can understand why we think certain things are important.
We give her space to disagree too (she has a natural inclination to argue like a natural born lawyer!)
She tends to come to accept our reasoning.
Summary of strategies
~ be accepting
~ maintain a calm attitude
~ be flexible
~ use gentle reasoning
~ be honest if you’re stressed
~ pick battles
~ give space for disagreement