Demand Avoidance: What is it & how could it be pathological? Part I

 Pathological Demand Avoidance

What is it?

Pathological Demand Avoidance is an extreme reaction or response to being asked or told to engage in everyday, routine demands and expectations. Many research scholars and lay people, alike, argue over what term should be used to describe the behaviors of people who automatically, and many times, reactively, demand autonomy & control of their environment. Some of the other terms I have come across are extreme demand avoidance, pervasive demand avoidance, and persistent drive for autonomy. There continues to be a debate over the proper terminology for these behaviors.

Examples of Pathological Demand Avoidance:

When someone asks you to take out the trash, what does your mind immediately do? Or what about when you are at work, and your boss tells you to complete a task in a specific amount of time? What does your mind do? 

Or think about a time when your parents or teacher commanded you to do something? Did your mind, immediately, react or respond in a manner that seeks to avoid complying with the command?

Demand avoidance is something many people engage in when they are not interested in doing something OR when they simply want to complete a task at their own pace. Many of us, like to have freedom to complete routine tasks and expectations when & how we want to complete them. However, there are some people who experience extreme avoidance to a everyday commands and requests. 

Elizabeth Newsom coined the term Pathological Demand Avoidance in the 1980s. Back then, there were people on the autism spectrum, service providers, researchers, and scholars who criticized this term selection. Despite the criticism, the term Pathological Demand Avoidance helped doctors, psychologists, and teachers who encountered the "pathological" degree of demand avoidance better explain how it differs from "demand avoidance". This distinction between demand avoidance and pathological demand avoidance helped in taking the blame away from parents for the behaviors of the "unsocialized" child.

People with a Pathological Demand Avoidance (PDA) profile respond in an extreme manner when asked or told to complete a task or behave in a specific way. Pathological Demand Avoidance (PDA) behaviors may be expressed in the following ways: 

• push back, resistance, or meltdowns (intense & emotional feelings & behaviors that may lead the individual to cognitive perseverations) when coping with everyday routine tasks
• increased levels of anxiety-riddled expressive behaviors even when the individual is able to 100 percent complete the asked or commanded task
• displays difficulty being taught by others even when they want to learn the subject or a talent or skill---they prefer to teach themselves or learn on their own
• traditional methods to engage or include people with a PDA profile are not effective (e.g., positive praises & reward system--the strengths of these usually fade away quickly, punishment, and bribing)
• the I do, We do, You do teaching method is effective for only a short period of time
• difficulty with attention when asked to engage or conform to something that is not-of-interest
• impulsive behaviors that direct the person away from expectations, commands, or tasks
• after the individual is provided time to cope with or manage their anxiety over a command, they complete the task without issues
• an individual with a Pathological Demand Avoidance (PDA) profile may carefully and effectively take control of an uncomfortable situation in a way that relieves them of having to deal with conflict or engaging in the task
• the person may experience shame, guilt, embarrassment, or sad feelings that causes them to say they do not like themselves or they want to kill themselves so others do not have to be hurt by them
• becoming defensive when others attempt to guide, direct, or explain something to them---may feel the need to correct or control the conversation or discussion
• individuals with a PDA profile may cope with negative & self-deprecating thoughts and a lack of self-confidence and a fear of failure when asked to complete a task or an assignment or an activity

The next post will further discuss PDA and specific evidenced-based interventions that have been used to effectively guide and direct people with this profile. - Maranda Marvin, School Director at Paradigm Development Center

References

Newson, E., Le Maréchal, K., David, C. (2003) Pathological demand avoidance syndrome: a necessary distinction within the pervasive developmental disorders. Archives of Disease Childhood, 88(7), 595-600.