{"id":4582,"date":"2023-06-28T01:50:00","date_gmt":"2023-06-28T01:50:00","guid":{"rendered":"https:\/\/childanxietysupport.com\/?p=4582"},"modified":"2023-07-19T13:26:26","modified_gmt":"2023-07-19T13:26:26","slug":"how-does-pathological-demand-avoidance-or-pda-fit-with-regular-anxiety","status":"publish","type":"post","link":"https:\/\/childanxietysupport.com\/how-does-pathological-demand-avoidance-or-pda-fit-with-regular-anxiety\/","title":{"rendered":"How does Pathological Demand Avoidance or PDA fit with regular anxiety?"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"4582\" class=\"elementor elementor-4582\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section data-exad-particle-enable=\"false\" class=\"elementor-section elementor-top-section elementor-element elementor-element-19a10238 elementor-section-boxed elementor-section-height-default elementor-section-height-default exad-parallax-effect-no exad-background-color-change-no exad-glass-effect-no exad-sticky-section-no exwb-magnet-no\" data-id=\"19a10238\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-67a2c6a2 exad-glass-effect-no exad-sticky-section-no exwb-magnet-no\" data-id=\"67a2c6a2\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7a8a842 exad-sticky-section-no exwb-magnet-no exad-glass-effect-no elementor-widget elementor-widget-html\" data-id=\"7a8a842\" data-element_type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<iframe title=\"Embed Player\" data-src=\"https:\/\/play.libsyn.com\/embed\/episode\/id\/27271971\/height\/192\/theme\/modern\/size\/large\/thumbnail\/yes\/custom-color\/495867\/time-start\/00:00:00\/playlist-height\/200\/direction\/backward\" height=\"192\" width=\"100%\" scrolling=\"no\" allowfullscreen=\"\" webkitallowfullscreen=\"true\" mozallowfullscreen=\"true\" oallowfullscreen=\"true\" msallowfullscreen=\"true\" style=\"border: medium;\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" class=\"lazyload\" data-load-mode=\"1\"><\/iframe>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-374225a8 exad-sticky-section-no exwb-magnet-no exad-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"374225a8\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><!-- wp:paragraph --><\/p>\n<p>This week&#8217;s question is a pretty long one that I shortened for our title. The question in full is:<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:quote --><\/p>\n<blockquote class=\"wp-block-quote\"><p><!-- wp:paragraph --><\/p>\n<p>How does PDA, which some people prefer to call Demand Anxiety, fit with regular anxiety, and should it be treated any differently? The advice seems to be to reduce demands (for example, with my home-educated son who gets extremely upset whenever he&#8217;s put under any formal pressure to write or do maths, the advice is to do more child-led learning, games etc.), but is this a form of avoidance which will therefore make the problem worse? Or is waiting till the child is a bit older for these things harmless?<\/p>\n<p><!-- \/wp:paragraph --><cite>podcast listener<\/cite><\/p><\/blockquote>\n<p><!-- \/wp:quote --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>I have been getting different versions of this question for some time and so I wanted to sit down and dig into the research and see what we really know about pathological demand avoidance or PDA. What I discovered is that we&#8217;re still figuring it out. There isn&#8217;t a clear definition for what constitutes PDA, there is still ongoing research to try to figure out which kids meet criteria and which do not, and because we are still looking at the criteria that means we&#8217;re still arguing about how to manage it.<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>When I say we hear, as in we&#8217;re trying to figure it out, I&#8217;m talking about people in the mental health and behavioral fields. That&#8217;s therapists, psychologists, educators, etc.&nbsp;<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>This makes it really difficult for parents to find good information that&#8217;s appropriate for their particular child and their particular family. But difficult does not mean impossible.<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>It&#8217;s always true that as parents we have to figure out where to get our information. Who are we going to trust to help us figure out how to best parent our kids \u2014 anxious or not. There are as many good ways to raise kids as there are kids. Every child needs a different kind of parent.<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>For kids who have challenges \u2014 whether that\u2019s&nbsp; an anxiety diagnosis, a neurodifference, any kind of special needs \u2014 we need to be particularly discerning since you have the controversies and opinions of typical parenting and then you have the added complications of our child\u2019s particular needs. This feels especially true when we\u2019re talking about children who might fit a PDA profile.<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>And let\u2019s talk about that PDA profile for a minute \u2014 there\u2019s still a lot of discussion about who fits that profile. For those of you who aren\u2019t aware, PDA is generally used to describe children who become anxious when faced with demands to the point that their everyday functioning is disrupted.<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>What is a demand? Well, just about anything can be a demand. Requests, commands, expectations from someone else or from the child themselves like needing to eat or go to the bathroom, and the general requirements of existing. So for some kids facing a cold day can be a demand if they are sensitive to cold. Putting on a sweater may be a demand because your parent asked you to. Going outside to play in the snow may be a demand because the child is looking forward to it and is afraid of being disappointed.<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>Every child \u2014 every person \u2014 will have some demand avoidance now and then and there does seem to be correlation with anxiety because the demand itself \u2014 the feeling of needing to perform or show up or respond in some way \u2014 can create anxiety.<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>Currently the belief is that PDA is under the <a href=\"https:\/\/childanxietysupport.com\/if-child-anxiety-treatment-should-include-parents-what-about-treatment-for-adhd-or-autism\/\" target=\"_blank\" aria-label=\"autism spectrum umbrella (opens in a new tab)\" rel=\"noreferrer noopener\" class=\"ek-link\" data-wpel-link=\"internal\">autism spectrum umbrella<\/a> but again, this is still being discussed and the woman who coined the term, developmental psychologist Elizabeth Newsome specifically argued that it did NOT belong under this umbrella. See? Controversial.<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>And while demand avoidance is discussed in the context of anxiety, there are those with lived experience \u2014 <a href=\"https:\/\/www.pdasociety.org.uk\/resources\/pda-by-pdaers\/\" target=\"_blank\" aria-label=\"adults who identify as PDAers (opens in a new tab)\" rel=\"noreferrer noopener nofollow external\" class=\"ek-link\" data-wpel-link=\"external\">adults who identify as PDAers<\/a> \u2014 who do not see anxiety as part of what\u2019s happening for them. Which makes me think we need to be open to a more nuanced discussion about what PDA might be for individuals.<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>That said, I think there is value in thinking about demand avoidance as part of an anxiety profile. And I do not think we need to \u2014 at this moment \u2014 get hung up on PDA diagnoses since that\u2019s still in flux. Remember that ultimately a diagnosis is a cultural construct as well and at this moment, at the time of this recording, a PDA diagnosis doesn\u2019t really exist here in the states. Therefore children who might fit this PDA profile will not get supports like an<a href=\"https:\/\/childanxietysupport.com\/what-can-teachers-do-to-help-students-with-anxiety\/\" target=\"_blank\" aria-label=\" IEP or a 504 (opens in a new tab)\" rel=\"noreferrer noopener\" class=\"ek-link\" data-wpel-link=\"internal\"> IEP or a 504<\/a> because they fit that PDA profile. However, adults who care about, are taking care of or who are educating kids who have some PDA in their make up can benefit from considering this as they talk about how best to support and serve these children and their families.<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>Further, it\u2019s not just PDA kids who might balk at demands. There are other kids with neurodifferences who are demand avoidant and there are neurotypical kids who are demand avoidant. Heck, we as parents may have \u2014 and likely do have \u2014 our own demand avoidance. The more we learn about it, the more we might bring new understanding to how we all function.&nbsp;<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>In other words, let\u2019s focus on understanding demand avoidance if that seems present in our children and \u2014 because this is The Child Anxiety FAQ \u2014 what does this mean for anxiety treatment.<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>My take and observation in working with families whose children fit this profile is that there may need to be some time for everyone to consider how seeing things through the lens of demands might shift our perspective. How might that helps us see where our child sturggles and where we struggle.&nbsp;<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>Demands are often invisible so if we\u2019re looking for them, might we better understand why our child might sometimes meltdown about quote nothing. Looking for demands might help us realize that mornings are more difficult than we realized. When we see that waking up is a demand, getting dressed is a demand, eating a breakfast our parents made fro us is a demand, we can recognize that our child is running an exhausting gauntlet every morning and isn\u2019t just trying to be difficult. We may be more forgiving of ourselves recognizing that dragging a child through a series of demands is tough on any parent and no wonder then we are having such a hard time.<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>So what to do about it? That\u2019s going to be very individualistic. A child who is demand avoidant may not fit the usual advice about parenting. In fact, I\u2019m going to say they definitely to do not.<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>A lot of the advice I see among lay people around PDA is to dig into demand avoidance and help their child avoid demands. In talking to my clinical colleagues, I\u2019m not 100% behind this approach. I think there still needs to be exposures to demands but I think those exposures need to be more judicious and go more slowly. I strongly feel that parents need space, too, and do not just need to be told to shape their life around their child\u2019s demand avoidance. The family system is still a system and we need to be realistic and aware that parents have needs, too, that other siblings have needs, too, and that they need to be part of the equation.<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>Referring to the original which asked if demand avoidance \u2014 like homeschooling with child led learning would make things worse? The answer is complicated. There is nothing wrong with doing more child-led learning and in fact, I\u2019d say that\u2019s a great plan if you can do it because it will relieve some bandwidth to tackle other demands that you can\u2019t avoid. And that\u2019s really what we\u2019re talking about here. Instead of twisting ourselves in knots to avoid all demands, we can and should start recognizing demands so we can prioritize them. We\u2019re basically going to need to triage.&nbsp;<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>I guess as I think about it, I\u2019m uncomfortable with the word worse. Demand avoidant kids grow up to be demand avoidant people \u2014 at least as far as we can tell from the anecdotal research \u2014 but that doesn\u2019t mean that they can\u2019t learn to face and overcome necessarily demands or those demands they need to face to do the things they want to do. That\u2019s what I mean about priorities. If we can avoid unnecessary demands or get creative in how we face them, then we can focus on skill building in the inevitable demands. Because we are going to have to face demands. We\u2019re just going to have to. Demands are built into our lives. Like I said, cold weather can be a demand. So how we be creative? Maybe there are ways to keep warm or deal with cold that are less traditional. Maybe kids will want to wear footie pajamas instead of a coat and maybe that can work.&nbsp;<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>Recognizing and facing demand avoidance is an opportunity to wrestle with what\u2019s really important for us as individuals and as families? What is a cultural construct we can reject? Parents&nbsp; of demand avoidance are going to need to be more flexible, more open to alternative solutions, and be more honest with themselves about their boundaries.<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph --><\/p>\n<p>I created a training called <a aria-label=\"Anxiety Through the Lens of Demands (opens in a new tab)\" href=\"http:\/\/ChildAnxietySupport.com\/demands\" target=\"_blank\" rel=\"noreferrer noopener nofollow external\" class=\"ek-link\" data-wpel-link=\"external\">Anxiety Through the Lens of Demands<\/a> that digs into this topic further, looks at the controversies a bit more closely, and discusses what we do know and how we can apply it to anxiety. I encourage you to check it out and let me know if you have any questions!<\/p><p><br><\/p><p><br><\/p>\n<p><!-- \/wp:paragraph --><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>We do a quick dive into the controversies around the PDA diagnosis then jump to how it relates to anxiety treatment.<\/p>\n","protected":false},"author":1,"featured_media":4583,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"footnotes":""},"categories":[16],"tags":[17,69,70,26],"jetpack_featured_media_url":"https:\/\/childanxietysupport.com\/wp-content\/uploads\/2023\/06\/how-does-pathological-demand-avoidance-or-PDA-fit-with-regular-anxiety.png","jetpack_shortlink":"https:\/\/wp.me\/pdNXfO-1bU","publishpress_future_action":{"enabled":false,"date":"2024-05-15 08:10:42","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category"},"_links":{"self":[{"href":"https:\/\/childanxietysupport.com\/wp-json\/wp\/v2\/posts\/4582"}],"collection":[{"href":"https:\/\/childanxietysupport.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/childanxietysupport.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/childanxietysupport.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/childanxietysupport.com\/wp-json\/wp\/v2\/comments?post=4582"}],"version-history":[{"count":0,"href":"https:\/\/childanxietysupport.com\/wp-json\/wp\/v2\/posts\/4582\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/childanxietysupport.com\/wp-json\/wp\/v2\/media\/4583"}],"wp:attachment":[{"href":"https:\/\/childanxietysupport.com\/wp-json\/wp\/v2\/media?parent=4582"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/childanxietysupport.com\/wp-json\/wp\/v2\/categories?post=4582"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/childanxietysupport.com\/wp-json\/wp\/v2\/tags?post=4582"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}