The term “Pathological Demand Avoidance (PDA)” has gained attention in recent years as a way to describe a previously overlooked profile of autism. In short, PDA is marked by an extreme avoidance of everyday demands. (Read more about PDA here.)  While “Pathological Demand Avoidance” has provided folks with new language to describe their experience, the language itself can be problematic — particularly the word “pathological,” which implies illness, defect, or dysfunction and is rooted in white supremacy. 

In relationships where one partner has Pathological Demand Avoidance (PDA), the dynamic of autonomy and control plays a central role. The PDA nervous system is highly sensitive to perceived demands—whether external (“Can you do this?”) or internal (“I should do this”). Even small expectations can trigger a threat response that looks like withdrawal, shutdown, sarcasm, or explosive defiance.

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. 

Maybe you know someone who struggles to comply with what seems to be simple requests—brushing their teeth, answering a text message, doing an activity that they want to do. You might be tempted to call them stubborn or controlling. But for people with Pathological Demand Avoidance (PDA), it’s not about being difficult. It’s about safety.