Working with Pathological Demand Avoidance In Intimate Partnerships
Pathological Demand Avoidance (PDA)* is a neurodivergent profile characterized by an intense need to protect one’s autonomy. This can often result in an avoidance of internal or external demands. In intimate partnerships, this can create real confusion, conflict, and emotional distance if not well understood. In couple’s therapy, recognizing and effectively supporting the PDA profile is essential for healing tenuous connections rather than reinforcing shame or power struggles in the intimate or therapeutic relationships.
It’s integral to understand that folks with PDA are not trying to be oppositional or” difficult.” Their nervous system registers demands—requests, expectations, even internal goals—as threats. This can trigger anxiety, avoidance, deflection, or even explosive pushback. In a relationship, something as small as “Can you take out the trash?” may be perceived not as a simple task, but as a challenge to autonomy and control. That reaction isn’t a reflection of their love or commitment—it’s a protective response.
In therapy, it's important to shift the dynamic from blame to understanding. Rather than framing behaviors as “defiant” or “selfish,” partners can begin to see the avoidant behaviors as nervous system-driven, protective responses. This opens the door to safer communication, creative flexibility, and collaborative problem-solving in the relationship.
Therapists can support PDA-identified partners in session by:
Reducing direct demands and instead offering choices. Alleviate perceived pressure in session with questions like “Would you be up for xyz?”.
Emphasizing autonomy and shared control. Encourage collaboration, flexibility, and shared power in the relationship dynamic.
Validate the anxiety beneath the reaction and encourage neurodivergent-informed self-regulation.
Helping both partners reframe avoidance as self-protection rather than rejection.
For the non-PDA partner, therapy can explore how to express their needs in ways that both consider their PDA partner’s nervous system and needs and also feel honest and honor their own boundaries and emotional experiences.
PDA in relationships doesn’t mean connection is impossible—it means the path to connection needs to be paved with deeper understanding, emotional safety, and mutual respect for each partner’s nervous system.
*Note: The term “pathological” is rooted in white supremacy and not one we use at Embodied Therapy Collective. Many behaviors that the mental health field has deemed “pathological” are reasonable responses in the context of trauma and systemic oppression. However, we are using the term here as it is, unfortunately, most recognizable in this context. Many folks with PDA prefer the label “Persistent Drive for Autonomy”.