Pathologic Demand Avoidance: When Clients Dodge Even the Good Stuff

Summary: Pathologic Demand Avoidance (PDA) is not just stubbornness—it’s self-preservation. Why do some people instinctively resist the help they need? How does fear of failure, mistrust, and control fuel avoidance? Understanding PDA means learning to work with it, not against it. The key? Shift from authority to collaboration and watch resistance transform into engagement.

Ah, Pathologic Demand Avoidance (PDA)—the finely tuned art of resisting expectations, even when they’re completely reasonable, beneficial, or exactly what someone asked for five minutes ago. If you’ve ever worked with a client (or, let’s be honest, if you are a person) who will fight tooth and nail to avoid doing something—especially if it was suggested by someone else—congratulations! You’ve met PDA.

Pathologic Demand Avoidance (PDA) is most commonly associated with autism, but many people—diagnosed or not—experience these patterns of resistance. This is not your garden-variety stubbornness. This is fear of failure wrapped in fear of being a chump, wrapped in fear of being ridiculed—a big, messy emotional burrito filled with anxiety, mistrust, and a deep-seated need to not be controlled.

Pathologic Demand Avoidance creates an ongoing internal battle—one between knowing what’s helpful and rejecting it on instinct. So, why do people with PDA (or PDA-adjacent tendencies) balk at even the most helpful, well-intentioned advice? And how can we help them (or, let’s be real, ourselves) actually follow through without triggering a spiral of existential dread and defiance? Let’s dig in.

1. Someone suggests something that is actually a good idea.
"You should try journaling; it really helps with self-reflection."
"Have you considered breaking the task into smaller steps?"
"Therapy could be really useful for you!"

2. Immediate full-body rejection.
NO.
Absolutely not.
How dare you suggest I do something that makes sense?

3. Internal Debate Begins.
Well… okay, maybe it’s a good idea…
But now I can’t do it, because they told me to.
Also, what if I try it and it doesn’t work? Then I’ll look like a fool.
And if it does work, that means I was wrong to resist in the first place, which is somehow even worse.

4. Procrastination & Avoidance.
“I’ll do it tomorrow.” (They won’t.)
“I need to research it more first.” (They won’t.)
“I need to be in the right mindset.” (They never will be.)

5. Crisis Mode.
Life inevitably forces them to do the thing they’ve been avoiding (because deadlines, illness, or sheer necessity are a thing).
They do the thing, often perfectly well.
They resent both themselves and everyone involved.

6. Cycle Repeats.
Did they learn from this experience? No.
Will they fight the next piece of advice just as hard? Absolutely.

At the heart of PDA lies an incredibly deep mistrust of authority, structure, and even one’s own past decisions. It’s not just about avoiding work—it’s about avoiding the shame of trusting the wrong person, following the wrong advice, or realizing too late that you were manipulated.

PDA brains have learned the hard way that trusting others is risky business. Maybe it was inconsistent caregivers. Maybe it was teachers who humiliated them. Maybe it was years of gaslighting that made them doubt their own reality.

And so, the resistance isn’t just defiance—it’s self-protection.

It’s fear of failure, wrapped in fear of being gullible, wrapped in fear of public ridicule.

And the worst part? Even when PDA people agree with the advice being given, they still can’t bring themselves to follow it. This resistance isn’t about logic—it’s about instinct. But understanding how PDA works means we can find ways to work with it rather than against it.

The good news? PDA isn’t an insurmountable obstacle. When we shift from control to collaboration, real progress happens—without the battle.

If you’re working with someone with PDA, do not give direct orders. That will go exactly nowhere. Instead, try these (sneaky, respectful, human-centered) strategies.

1. Give Them Ownership

People with PDA need to feel in control. You can’t just tell them what to do—you have to make them feel like it was their idea.

2. Offer Alternatives (Even If You Secretly Want One Outcome)

PDA brains hate being boxed in. If you say "do X," they will immediately want to do Y—even if they actually wanted to do X five minutes ago.

Give choices: "Some people journal, some people go for walks, and some people just scream into a pillow. What do you think would work best?"

3. Normalize the Fear of Being Wrong

People with PDA often won’t try something because they’re afraid of looking foolish. Acknowledge this up front:

When you normalize failure as part of the process, it defangs the fear.

4. Get Them to Teach YOU

PDA folks love to be the expert. If they feel like they’re being taught at, their defenses go up. But if they are the ones explaining something? That’s a power move.

Instead of giving them a list of coping strategies, ask: "What do you think makes a good coping strategy?" or "What advice would you give someone struggling with this?"

This subtly shifts them from resisting to participating.

5. Make Agreement Feel Like Rebellion

Here’s the fun part: PDA clients love to rebel. So… let them. Frame positive behaviors as ways to beat the system.

When following through on something becomes a power move, PDA clients will sprint toward it.

The strategies above aren’t about tricking someone into compliance; they’re about meeting them where they are and understanding the deep emotional roots behind their resistance. 

PDA isn’t about being difficult—it’s about protecting oneself from past experiences where trust, autonomy, or choice were taken away.

People with PDA aren’t difficult for the sake of it. They’re not intentionally sabotaging themselves. They just don’t trust easily—because at some point in their lives, trust cost them something big.

Working with PDA means understanding that resistance is not defiance—it’s self-preservation. And if we can meet them where they are, respect their autonomy, and make cooperation feel like rebellion? We might just get somewhere.

Because, at the end of the day, PDA brains don’t actually hate doing things.

They just hate being told.