Understanding Pathological Demand Avoidance (PDA)

In pathological demand avoidance (PDA), multiple daily situations are avoided because they're perceived as demands or threats. Here, you can find out more about this little-known profile on the autistic spectrum.

Written and verified by the psychologist Elena Sanz.

Last update: 31 July, 2024

We all avoid certain situations, either because we don’t like them or because we don’t feel like doing them. For instance, we postpone projects that we find boring or refuse to do favors for acquaintances we don’t feel like helping. This is natural. However, for some people, this rejection occurs frequently and inevitability, in the face of all kinds of demands. It’s known as pathological demand avoidance (PDA).

In this case, the individual doesn’t evade the situation out of mere displeasure or because they decide to do so, but because the high level of anxiety it causes in them gives them no other option. Consequently, others may see their behavior as oppositional or defiant. However, in reality, it’s simply a way of dealing with their internal discomfort.

Pathological demand avoidance

Pathological demand avoidance falls on the spectrum of autism. The autistic spectrum encompasses extremely different realities about which we still don’t possess sufficient knowledge. Therefore, the characteristics and needs of people with PDA aren’t well understood and attended to.

The term was first used by the psychologist, Elizabeth Newson. However, it wasn’t until a couple of decades ago that it began to receive attention. Then, it started to appear in scientific publications and was mentioned at conferences.

The concept refers to a constant resistance or avoidance of the demands of daily life. Faced with any daily demand, however small it may appear to be, the individual reacts with rejection. Moreover, they use various strategies to evade or get rid of it.

This is the main characteristic of PDA which manifests during childhood and usually lasts until adulthood. But, why does it happen? In effect, when faced with a certain request or demand, the individual experiences the feeling that they’re on the losing side. That’s because they think the other person is in a position of authority. For example, when a child is asked not to touch a delicate object.

A loss of autonomy

On the other hand, the individual also feels that they’ve lost their autonomy as someone is directing them. Although for most of us, this isn’t a problem, the individual with PDA perceives the demand as a threat. This means their nervous system becomes dysregulated. Somehow, they feel like they’re losing control which leads them to do everything possible to recover it. They perform various actions, like:

• Actively rejecting the claim.
• Avoiding it by changing the subject, making excuses, or leaving it for later.
• Focusing on doing exactly the opposite of the request. For instance, using the previous example, the child might focus on repeatedly touching the object they were asked to stay away from.
• If they can’t evade the demand or regain control, or the other person insists, the individual may suffer a crisis or meltdown, due to their levels of anxiety.

The perception of demand

This kind of rejection, or fight or flight reaction can appear in anyone. However, in PDA, it’s triggered by various requests that seem to be of no great importance. For example:

• Direct requests, such as “You have to make the bed”.
• Questions, such as “What do you want to eat?”
• The imposition of schedules and time limits for completing a task.
• Changing, novel, or uncertain situations over which the individual has no control.
• Anything that implies a feeling of obligation or having to fulfill a task, even when it’s due to personal needs. For instance, having to get up at a certain time, to eat, or to bathe.
• Situations in which a demand or expectation is created toward the individual. For example, when they receive a compliment, they perceive it as a demand to perform at the same level on future occasions.
• Events or situations that produce sensory overload.

In short, they avoid any unpleasant situations that generate discomfort, alter their routine, or are of no interest to them. That said, they might even perceive a hobby, an appealing plan, or a basic need as a demand that triggers this imperative need for avoidance.

Understanding and interventions

It’s important to understand that, by avoiding the demand, the individual with PDA isn’t being rebellious or seeking to challenge. It’s an inevitable reaction to the feeling of demand and loss of control. It also shouldn’t be forgotten that the individual is on the autistic spectrum. 

It’s been evidenced that this particular profile often presents greater sociability and good functioning. For this reason, their needs and particularities tend to be overlooked. However, they continue to experience difficulties in understanding social codes. Moreover, their emotions are intense and overwhelming, and they have obsessive or restricted interests.

A fundamental first step (which must be taken by both the individual with PDA and their environment) is to understand their reality and accept it as it is. Then, the necessary adjustments and adaptations can be made.

Adjustments and adaptations

• Disguising requests. For example, in the case of children, turning them into a game. Or, in adults, seeking to make them more enjoyable or bearable.
• Sharing demands. They’re more likely to fulfill a task in the company of another than to accept the requirement of fulfilling it alone.
• Offering explanations and a sense of control. As far as possible, making them understand why they should perform a task and giving them some autonomy to comply with it can be helpful. For instance, children could be offered multiple options. While adults could be given jobs of low hierarchy that offer flexibility.
• Giving the individual time for themselves without demands, in which they can feel completely free.

In short, the individual should become aware of their pathological avoidance of the demand, understand why it occurs, and what strategies they can use to evade it.

With this understanding, they’ll be better able to implement adjustments that help them cope with the anxiety that the condition produces. In the case of children, the adults in charge may need professional support to understand their child’s needs and know how to proceed.