Pathological Demand Avoidance or Persistent Drive for Autonomy in Adults

A note on language: The term Pathological Demand Avoidance was developed in the 1980s by UK psychologist Elizabeth Newson to describe a profile, often seen in neurodivergent children, marked by an extreme avoidance of everyday demands. More recently, some people prefer the phrase Persistent Drive for Autonomy to avoid pathologizing language, while others find the original term validating because the experience can feel genuinely disabling.

I respect people’s choice of language. What matters most to me is having a framework that accurately describes the experience and reduces moral interpretations. From here, I will use PDA as shorthand.

PDA comes up regularly in my ADHD skills and accountability group, often before anyone has language for it. Someone describes a sudden drop in capacity. Someone else talks about feeling flooded by a task they technically know how to do. It is usually followed quickly by self-criticism. Lazy. Inconsistent. Bad at follow-through.

What they are describing is not a motivation problem.

What PDA Is

PDA is best understood as a nervous system response to perceived threat. The demand does not need to be objectively extreme. It only needs to register as too much in that moment.

This is not about disliking a task or lacking values. PDA shows up when the nervous system interprets a demand as a loss of autonomy, safety, or capacity and moves into protection mode. By the time that happens, reasoning and intention are already secondary.

Invisible Demands

One reason PDA is so often misunderstood is that the demand load is frequently invisible. Others may see a single task. What they do not see are the layers underneath. Cognitive effort. Sensory load. Emotional labor. Decision fatigue. The residue of everything else already handled that day.

By the time the demand arrives, the system may already be stretched thin.

When the Demand Comes From You

The demand does not need to come from another person.

People are often most resistant to goals they set for themselves. A project they chose. A habit they genuinely want. That resistance can feel baffling and is often taken as evidence that they do not actually care.

Sometimes it is worth examining whether a goal is driven by obligation or by genuine importance. Goals rooted in “shoulds” tend to carry more threat.

But just as often, shutdown shows up precisely because the goal does matter. When something is meaningful, the stakes are higher. The nervous system does not register importance as motivating. It often registers it as pressure.

The problem is not lack of desire. It is overload.

When History Amplifies the Threat

For many adults with ADHD, PDA is intensified by a long history of failure, disappointment, or being misunderstood. Each new demand carries the echo of previous experiences. The nervous system learns quickly. Even neutral demands can begin to feel dangerous when they are associated with shame.

Past experience quietly shapes present capacity.

How This Shows Up in Practice

In my group, PDA most often appears as resistance to things people genuinely care about, including goals they chose intentionally. Avoiding email. Delaying scheduling. Freezing around tasks that matter.

What stands out is how quickly people move to moral explanations. They minimize how often they actually follow through. There is an automatic story that they are irresponsible or unreliable, even when the evidence is mixed.

That story becomes another demand layered on top of everything else.

What Helps

We do not work on forcing compliance.

The first step is recognizing PDA as it unfolds. The tightening. The urge to escape. Naming it matters because it creates space between sensation and self-judgment.

From there, the focus is on reducing threat and increasing autonomy. Adding real choices. Allowing high-effort and low-effort options. Naming that some days require conservation rather than optimization.

This is not about lowering standards. It is about working with the nervous system you actually have.

A Different Frame

PDA is not a character flaw or a lack of care. It is a protective response shaped by nervous system sensitivity, lived experience, and real demands.

When you understand it that way, the question shifts. Not why can’t I just do this, but what would make this feel safe enough to approach today.