when someone with PDA wants help

There’s a fundamental question to address when caring and working with someone who is autistic with a presentation of Pathological Demand Avoidance (PDA).

The question arises when a person with PDA presents as wanting to understand and respect boundaries, and commit, and become better aware of consequences. Reaching this point of expressing a need for help is often because of trust erosion and conflicts arising, but these individuals are struggling and want help, having tried and perceived themselves as failing time and again.

So, what can you do to support someone with PDA in keeping to promises they make not only to others but to themselves regarding self-control and getting things done? 

It isn’t easy. It’s very difficult. It isn’t quick. Nor is consistent, across-the-board success in any way guaranteed. Supporting individuals with autism and PDA in maintaining self-control and fulfilling commitments involves several key strategies. 

Encourage Autonomy

Individuals with PDA have a strong need for autonomy. Involving them in decision-making and offering choices can reduce anxiety and resistance. Collaborative problem-solving approaches, where the individual actively participates in creating solutions, can be particularly effective.  

Implement Sensory Regulation Techniques

Sensory sensitivities are common in individuals with autism and PDA. Providing sensory supports, such as opportunities for movement (e.g., using a scooter or trampoline) and access to sensory toys, can help in managing sensory needs and improving focus.  

Use Visual Supports and Structured Routines

Visual aids like checklists (which of course only work where there is no presentation of severe dyslexia,, in which case the use of pictures may be appropriate assuming good eyesight and understanding of what is being seen) and timers can help in breaking down tasks into manageable steps, making it easier for the individual to understand and complete them. 

Structured routines provide predictability, which can reduce anxiety and enhance the ability to follow through on commitments.  

Adopt a Low Arousal Approach 

Managing stress and emotional responses is crucial. Maintaining a calm environment and avoiding confrontational situations can help in reducing stress and preventing escalation of challenging behaviours.  

Provide Positive Reinforcement

Recognising and rewarding efforts and achievements, no matter how small, can boost motivation and reinforce desired behaviours. Positive reinforcement encourages repetition of these behaviours, aiding in the development of self-control and task completion skills.

It’s essential that these strategies are tailored to the individual’s unique needs and preferences, as personalised approaches are often the most effective. It follows that getting plans in place takes time and energy. 

If you care for someone who fits this profile, you can start developing your understanding right now. It will help you to deal with the difficulties they present. 

Where there is ignorance – by which I mean a simple absence of knowledge – it’s hard to contextualise and manage your own feelings in response to whatever the person is doing. Read. Watch YouTube and Tiktok videos on the subject of PDA. Talk to those who may know more than you do, if you can. 

Most of all, talk with the person who is struggling, listen to them, ask for their opinions and thoughts and be guided by them. Think about what you can do to address their fears and your own upset – because, inevitably, there will be upset, mistakes, things to learn from.

Many carers report feeling isolated from others close to them, who do not understand and do not have the same drive to gain understanding. Unless we are invested in the welfare of another person or group of people, we don’t have the impetus to learn. As hard as it can be for those who do, it’s important to recognise that as human beings we tend to understand only that which we need to understand for ourselves.

The fact that you do feel this need to understand – which brought you to this article, of course – signifies your direct involvement with, and care for, the person who is wanting your help. You are, as they say, invested.

Practice self-care and ensure you have support for yourself. As I wrote earlier on the page, this isn’t an easy challenge for anyone to begin trying to tackle. To experience PDA presented by someone else is confusing, feels bizarre, is often upsetting and frustrating. Look after yourself as well as those you look after. What is easy is forgetting to do the self-care, which you should try to not do. You need to prioritise it, for your own wellbeing.

Get in touch with Xander for a free 30-minute initial assessment and to work out a fee that’s right for your circumstances should you decide to proceed further. Xander has spaces currently available to welcome new clients.

Xander, trading as xph therapy, offers integrative counselling, which means working with multiple therapy types, including CBT, psychotherapeutic and person-centred to develop a therapeutic pathway just for you, whatever outcome you’re hoping to achieve.