Pathological demand avoidance or persistent drive for autonomy?

-

Pathological Demand Avoidance (PDA) is a neurodivergent profile that is associated with high levels of anxiety, an intense need to avoid everyday demands, and a desire for personal control. The condition is complex, and its expression varies between individuals. However, there are common threads that unite those of us who identify with it.

The term "pathological demand avoidance" (PDA) is not without controversy. The adjective "pathological" is  disliked by many in the PDA, and wider autism communities, because of its negative implications. The word is often associated with disease or dysfunction, which can be stigmatising. As a result, some prefer the alternative phrase “pervasive drive for autonomy”, which was proposed in 2019 by myself, Sally Cat, and fellow PDA individual T. Wilding. The phrase reframes our demand avoidance as a by product of seeking autonomy, and in many ways, it sounds much more positive, almost poetic.

However, my personal view—and that of others in the community—is that we shouldn’t prioritise the desire for a more palatable term in place of an honest reflection of our lived experiences. For some of us, the need for autonomy feels secondary to the overwhelming drive to avoid demands. Our need for autonomy can therefore be seen as a side-effect of our avoidance, rather than the other way round.

If we consider the fact that our hallmark PDA-type of avoidance is essentially irrational, in that it can indiscriminately drive us to avoid things that are beneficial or pleasurable (like drinking when thirsty because our brain has flagged our body's need as a demand), the concept of autonomy-seeking may seem less on point.

There's danger, too, in framing PDA as seeking autonomy, because it can cause people to assume we are never impeded by the condition, so never need help or support.

No Pressure PDA says:

'The word “autonomy” can bring to people’s mind that it’s best to step back and be hands off, but because PDA impacts the things even we want to do I think it’s good to realize that PDA people do rely on safe partnerships to accomplish things.'

I believe it is more important to honour the collective experience of the adult PDA community rather than prioritise a term that may sound more appealing but doesn’t truly reflect the combined reality of the condition.

In this context, I think it's crucial to discuss the term "pathological" and why I believe it should not be discarded. Although the word is often criticised for implying disease, I feel it’s the most accurate term to describe the severity and impact of the demand avoidance we experience. Myself and some fellow PDA advocates, such No Pressure PDA, want to reclaim the word "pathological" in the same way that the disability community has reclaimed the term "disabled". Once seen as a negative label, "disabled" is now embraced as a term of empowerment and identity. Similarly, in the context of PDA, we hope to reclaim the word "pathological" to indicate that our demand avoidance is biologically-rooted, rather than caused by trauma.

Ultimately, I believe that each individual should be free to use the terminology that feels most fitting for their personal experience of PDA. For me, the term "pathological" simply means that my demand avoidance is beyond my conscious control.


Comments

Post a Comment

Popular posts from this blog

Internalised PDA - the quieter, but equally impactful presentation of PDA that's hard for people to spot

-
Image
This blog article is also available as an animated video: click here to view it PDA research & writing has focused on externalised, freely-expressed presentations of PDA.   However, internalised PDA is often completely missed because our meltdowns are concealed and demands tend to be avoided subtly, and we slip below the radar. We internalisers though are not "less" PDA. Just like an iceberg isn’t smaller than a same-sized lump of ice on dry land: the iceberg merely looks smaller because the majority of its body is hidden from view under the water. Internalising PDAers’ driving forces are just as strong as those that drive externalising PDAers, and can lead to self-harm, dropping out of school & employment, and even suicidal ideation. I believe that internalised PDA needs to be brought into the radar. As we’re so good at concealing our traits, it takes internalisers like me to signpost people to our quieter, less accessible half of the little-explored PDA continent. T...
Read more

Internalised PDA

-
Image
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 adul...
Read more

How I understand PDA (in language kids can understand)

-
Image
Some people, both children and adults, have brains that say “no” to everything. It’s a bit like a switch that flicks down as soon as we think of doing anything, even things we wanted, like eating cake. It makes the idea of doing these things feel very bad so we want to avoid them. This is known as pathological demand avoidance . About pathological demand avoidance Although pathological can mean a having a bad habit (like pathological liars), when doctors talk about pathological, they mean something is caused by an illness or by the body itself. The doctor who named pathological demand avoidance wanted to show that it is caused by the way brain is built - a bit like how wanting to run away from foxes is built into rabbits. Pathological demand avoidance happens without us thinking about it, so we often don’t notice it, and the bad feelings it gives us (like eating cake being horrible) can seem real. We often only notice it when something is pushed on us by someone else, l...
Read more