Therapy and PDA

Pathological Demand Avoidance is characterized by living with a nervous system which experiences dysregulation or ‘activation’ with everyday demands, expectations and needs.

For some of us it can just be when we lose autonomy due to external demands such as having to go to school, work or an event. Others experience it with 'internal demands’ such as the need to drink, eat and use the restroom.

Knowing this, it can make therapy a different kind of experience for PADers as therapy itself can be experienced as a demand.

While each PDAer is different in what dysregulates us and how we need to be supported in therapy, there are some basic tenets which may help to better understand both if you are a PADer seeking therapy (or in therapy, already) as well as someone who provides support services.

Note: I am a PDAer so when I say “we” and “us” i mean myself and those in the PDA community.

Communication

PADers can become dysregulated with certain types of communication. This is one area where we may vary widely - yet any form of communication which is perceived (or is meant to be) demanding is sure to activate our nervous systems.

It is best practice to discuss with the person you are working with to learn what is best communication-wise. Example: some of us do better with declarative language. Some of us do not.

Intake

The amount of paperwork required at intake is generally a LOT.

The demand to fill out alllll of the forms can prove to be too much pressure for us and we may benefit from having more time to complete forms before our initial appointment.

Others need the pressure of getting the paperwork completed as quickly as possible in one go.

Scheduling

Some PDAers will prefer to have regularly scheduled appointments because it is something which can be anticipated and we do not have the need to continue to communicate about scheduling next week’s appointment.

Others feel dysregulated by the pressure of knowing there are future appointments set and benefit from being able to schedule as needed (while this is not always an option for all services).

Ideally we always work on an individual level to advocate for ourselves when we are the client and explore what ways we can best support our clients when we are the service provider.

For more information on PDA - I recommend:

• Kristy Forbes (PDAer who also parents PDAers)

• Sally Cats PDA (Internalized PDA)

• Asiatu Coach (Black Agender PDAer)

• Eliza Fricker (parent of a PDAer)

• @LowDemandAmanda (on IG, parent of PDAer)

• @LindsayIsDoingHerBest (on IG, also parent of PDAer)