What Is Pathological Demand Avoidance?

Most of us know what it feels like to hit a wall of resistance when life asks too much of us. But for some people, that resistance isn’t just about stress or burnout. It’s a deep, overwhelming need to avoid everyday demands, even when those demands are simple or self-chosen. This is called pathological demand avoidance, often shortened to PDA (not to be confused with the more commonly known PDA for public displays of affection).

First described by psychologist Elizabeth Newson in the 1980s, PDA has gained more attention in recent years as researchers and advocates push for greater awareness within the autism community and beyond. Although it isn’t yet recognized as a separate condition in major diagnostic manuals like the DSM-5, many clinicians and families find the term helpful for describing a very specific pattern of behavior.

Defining pathological demand avoidance

At its core, PDA is an extreme anxiety-driven response to perceived demands. These demands can be direct (“Can you please take out the garbage tonight?”) or indirect (“It’s time to get ready for dinner”). For someone with PDA, even internal goals—like deciding to brush their teeth—can trigger avoidance. According to the PDA society, anything that restricts someone’s freedom or sense of control can become a demand.

Here are more examples of how perceived demands can come up in daily life:

• Requests – "Put your coat on."
• Expectations – The car is ready, and they're waiting for me to put on my coat.
• Thoughts – "I can't put my coat on, it's too much."
• Desires – "I really want to go outside, but I can't put my coat on."
• Praise – "You put your coat on so well yesterday."

Unlike typical procrastination, PDA isn’t about laziness or defiance. It’s a nervous system reaction. The demand creates an intense feeling of threat, leading the person to resist, distract, or shut down.

The PDA Society, a UK-based nonprofit, explains it this way: “Everyday requests and expectations of life are experienced as overwhelming and lead to high levels of anxiety.”

What causes pathological demand avoidance?

Researchers believe PDA is rooted in the brain’s threat response. When faced with a request, the nervous system reacts as if danger is near. This may be linked to differences in how autistic people process social and emotional information.

Genetics and environment likely play roles too. While research is still emerging, one theory suggests that PDA may be related to difficulties with emotional regulation and a heightened fight-or-flight response.

The correlation between PDA and autism

The PDA profile is widely recognized as a specific presentation within the autism spectrum. While not a formal medical diagnosis, the concept of PDA helps to explain an anxiety-driven need to avoid demands that are distinct from typical autistic traits.  

While many autistic individuals may prefer routine and predictability, those with a PDA profile are often driven by a constant need for autonomy and control, and they may use a variety of social strategies to avoid demands. This is not defiance, but rather an innate response to the perceived threat of a demand, which can lead to a fight, flight, or freeze response. 

Understanding PDA as an autism profile is crucial because it highlights the need for a different approach to support,—one that emphasizes flexibility, collaboration, and indirect communication rather than the more structured, compliance-based strategies often used with autistic people.

Judith Eaton, a consultant clinical psychologist and research associate at King’s College London in the U.K., told The Transmitter, “My own clinical view is that it is a behavior profile seen in some autistic children and young people. However, it is not clear what this ‘profile’ is—it could be a personality type interacting with autism; it may be something else entirely.”

Pathological demand avoidance in adults

Most articles about PDA focus on children, but many adults experience it too. For adults, the signs may look different.

• Avoiding job tasks despite knowing they’re important
• Struggling with bills, appointments, or emails
• Using humor, distraction, or charm to steer conversations away from expectations
• Sudden withdrawal from relationships when demands feel too high
   

They may struggle with time management and organization, leading to missed deadlines and unpaid bills, not because they are irresponsible, but because the implicit demand of the task triggers an avoidance response. In the workplace, this can manifest as a persistent challenge to authority or a refusal to follow specific instructions. Living with PDA as an adult can bring shame or misunderstanding, especially in workplaces where productivity is prized.

They might use charm and social manipulation as a primary strategy to deflect demands, employing wit, excuses, or even creating a diversion to avoid a task. This can be particularly confusing for others, as the person may appear perfectly capable and charismatic, making their avoidance seem like a deliberate choice. PDA in adults can also lead to relationship difficulties, where they may struggle to maintain long-term commitments or friendships due to an inability to tolerate the demands of intimacy.

Examples of pathological demand avoidance

To make this real, let’s look at everyday situations where PDA might show up:

1. Schoolwork: A child who loves writing stories refuses to complete a simple worksheet because it feels like a demand.
2. Self-care: An adult avoids showering for days, not due to depression, but because the act of “having to” shower feels unbearable.
3. Relationships: A partner agrees to make dinner, then distracts with jokes or changes the subject when reminded.
4. Workplace tasks: A skilled employee misses deadlines, not because of skill gaps, but because even opening the file feels impossible.

These examples highlight why PDA can be so confusing. People with PDA often want to do the thing—they may even enjoy it—but the demand itself sparks anxiety.

Oppositional Defiant Disorder vs PDA

Oppositional Defiant Disorder (ODD) is often conflated with PDA. However, they are not the same, and the key difference lies in the motivation behind the behavior. Think of it this way:

• ODD is about "won't": Someone with ODD often chooses to defy a demand because they are feeling angry, resentful, or rebellious toward the person making the request. Their behavior is often a power struggle, driven by a need for control or a desire to provoke a reaction. For example, a child with ODD might refuse to clean their room out of anger and a desire to challenge their parent's authority. Their defiance is an act of will.
• PDA is about "can't": Someone with PDA isn't refusing a demand out of defiance—they’re avoiding it because it triggers an overwhelming sense of anxiety or a loss of autonomy. The demand itself—no matter how small—feels like a threat to their sense of control, which is essential for managing their anxiety. Their avoidance is a coping mechanism, not a power play. For example, a child with PDA might refuse to put on their shoes not because they are angry, but because the request feels like a monumental, unmanageable pressure that their nervous system can't handle.

This distinction is crucial for parents and educators. Treating a child with PDA as if they have ODD—using punitive or confrontational methods—will likely backfire, escalating their anxiety and their need to avoid the demand. Understanding that their resistance is rooted in anxiety allows for a more compassionate and effective approach, one focused on reducing pressure and building trust rather than imposing control.

Coping strategies and support

There’s no one-size-fits-all approach, but certain strategies can help reduce the cycle of anxiety and avoidance.

For children

• Offer choices instead of commands.
• Use playful language, such as turning tasks into games.
• Give extra time for transitions.
• Focus on collaboration rather than control.

For adults

• Break tasks into tiny, self-directed steps.
• Reframe demands as preferences (“I want to send this email” vs. “I have to send this email”).
• Use external supports, like reminders or accountability partners.
• Seek therapy to address underlying anxiety.

Some adults also find mindfulness and body-based practices useful for calming the nervous system. While research is limited, small studies show that mindfulness may lower anxiety in autistic adults.

From chains to choices

Demands are everywhere in modern life. Deadlines, alarms, expectations—they press on us constantly. For someone with pathological demand avoidance, these pressures can feel like walls closing in. But walls can also be climbed, decorated, or even dismantled with the right support.

Maybe the question isn’t only how to meet demands, but how to reshape them—so they feel less like chains and more like choices.