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This was the inaugural writing posted on the PDA Practice Corner on Facebook in December of 2023. This writing is informed by psychodynamic and attachment theory as well as my observations and personal insights in practice. This should not be considered a professional consultation. You can reach out to me with a comment or request for case consultation at EliseJacobsonLICSW@gmail.com.

PDA friendly practice creates relationship through demand avoidance not despite it. Practice professionals become adept at running experiences through the “PDA emotional filter” which decides if it will resist or engage. The FILTER absorbs what is overwhelming and confusing to maintain emotional equilibrium. Moving through resistance is about creating relationship that will allow the content to move through the filter.

Resistance is not going to prevent client work it is what makes up the work! It is how someone with PDA reduces their anxiety (as they leave themselves the option to avoid) while remaining partially engaged. See the perspective shift?

But let’s look at the FILTER more closely. The “PDA emotional filter” used to navigate anxious avoidance works by taking something, in this case, entering therapy, and dividing it into organic PDA black and white thinking.

Inviting the PDA adult to explore emotion that may be trapped there uses black and white thinking as a guardrail to maintain their focus without attempting to move past it. It is affirming of autistic processing because it is an intrinsic part of how they process.

Using the FILTER supports the client with big stories and anecdotes as the therapist must search for context that isn’t offered. Without context it is easy to misunderstand. Being misunderstood is often a fear of the PDA person! Do you see how important the use of the filter would be to build rapport and alliance?

Finding context is often a demand resisted day to day as it returns the person to their previous state of dysregulation. If they do return to it, it can often quickly become circular and frustrating. The resistance to therapy and considering feelings is about the overwhelming work of making sense of autistic experience.

You as the therapist can support the work and it is the beginning of an alliance if you navigate resistance in an extremely client-centered manner to honor the autistic need to disengage (avoid) when overwhelmed.

Demand avoidance is a reliable emotional container available until your client discovers more through reflection, validation and personal meaning. Being client centered is therefore a therapy technique that empowers the client and promotes autonomy.

The PDA person can enter a flow state through their black and white thinking because it is a natural entry point for engagement where they no longer feel anxious but in a space to consider context while maintaining regulation.

This can create a great deal of relief. Here in black in white thinking, in suspended anxiety, you can ask how it might be complicated, more nuanced but also hard to understand and do they see anything? Do they see that too? Disengage when it promotes regulation and offer containers to hold what comes up.

Reflection and validation are a safe holding space to keep considering what matters while acknowledging it needs more time, and you are there with them. They are in charge of pacing.

We therapists must respond by offering a natural container for discomfort and not serving up solutions. Hard, isn’t it? It’s hard for our client to be uncomfortable but we are too and must remain there. With them!

A “split” may be created from black and white thinking, where frustration becomes personalized and then externalized when self-recrimination feels so large it gets focused outside the self. This is a reflection of the depth of complex feeling in your client.

They are simply at that moment in your interaction experiencing the internal pressure they feel and may immediately project it outward.

This might push the therapist out of the engagement if they lose regulation. Here, you do what a good therapist attempts to do, and hold a space to acknowledge pressure, frustration and disappointment and that you didn’t mean to create it but nevertheless affirm the client’s perspective. You can’t talk someone out of feeling hurt. It’s terribly invalidating.

If you can do this with regulation and curiosity you can work with this projection. Your client needs you to SEE THEM IN PAIN and be there with them. They are showing you where they need your alliance and rapport. Given how often PDA struggles and confusion are misunderstood they have been disappointed over and over in relationships.

I experience this as their therapist as a “PUSH me pull me” relational space where internal splits resolve by a “meeting of the minds” as the therapist continues to remain curious and without defensiveness why their client feels as they do. Usually my client, on the other side, will say this. They are not actually upset with me but get frustrated when finding it hard to explain themselves.

This is a necessary part of growth for the PDA person not something to change or intervene in to promote better regulation or build skills!

This is a developmental need, a way to promote corrective experiences over and over to move overwhelm through the emotional filter. It addresses complex relational traumas and family of origin struggles. The PDA person KNOWS the skill then as they have experienced it from the inside out through exercising self-directed understanding. Therapies that use technique to teach skill stand in the way of “coregulation” and authentic corrective experience.

How do I work with black and white thinking to search for context without getting STUCK in circular thinking?

I refer to this as “jumping to the big picture or KEY questions.”

These questions interrupt a circular thought process with a question that promotes autonomous meaning making.

It could be “Is therapy important and meaningful? “Am I someone you can talk to”, “Do you wonder if this is a waste of your time”, or “can you hope for change”?

Any or all of these have black and white thinking connected to them, yes? Therapy is either important or a waste of time. Your client can talk to you or not. Big picture questions always encompass both sides of an either/or thinking process and can unlock emotional safe space to build context.

This is what we therapists call ambivalence right?

Acknowledging ambivalence is a way to work through resistance. While many clients enter therapy with ambivalence the PDA person is there much more often as commitment to anything, a person or an idea, implies a host of demands. The PDA emotional filter is constantly used to stop the onslaught of demands, with a no, or a maybe, or an “I’ll think about it”.

It is the therapist’s work to help verbalize ambivalence and then hold the client centered focus there. Big picture questions do this!

They calm the nervous system enough to create an opening for taking in viewpoints to evaluate. Then, coregulation and a deeper attachment to therapy and the therapist can unfold.

Communicating for understanding is one of the biggest challenges for a PDA person making it at the same time one of the largest demands. Therapy itself exposes this DEMAND.

An effort to disengage and resist communication and remain ambivalent can then be seen as a personal boundary necessary for personal integrity. We want to support our clients’ efforts to consider their own thoughts and feelings and find ways to communicate them. This is how a PDA client often does it. So, expect resistance and learn HOW to engage with it.

This is why PDA affirming therapy in my practice is so often relational and psychodynamic. I bring to awareness and navigate my own discomfort in creating a holding space that feels intense and full of possible misunderstanding to reach emotional safety.

Thank you for reading.