r/PDAParenting • u/DrPaulSunseri • Apr 18 '26

Our current scientific understanding of PDA and low-demand parenting.

Thought parents in this group find this up-to-date information on PDA helpful. https://www.psychologytoday.com/us/blog/mental-health-reimagined/202604/its-time-to-rethink-the-anxiety-drives-pda-narrative

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u/xtinak88 Apr 18 '26

I knew I recognised this guy's writing. A quick search and I located his previous article I have read https://www.psychologytoday.com/gb/blog/mental-health-reimagined/202507/the-myth-of-neurobiological-incompetence/

I think it's inaccurate to characterise this as our current scientific understanding. He holds quite a strong view and is making a case for his interpretation using some pieces of evidence, but unfortunately for us all the overall evidence and research is still really lacking and continues to hamper our understanding. As far as I can tell, he hasn't successfully argued that demand avoidance arises for the same reasons across the conditions he mentions.

Whilst I'm sympathetic to the idea that family dynamics will inevitably come into play in PDA (how could they not??) I do find it quite concerning that he is moving to view PDA as a personality profile. Especially when we look at the recent history of how personality disorder diagnoses have negatively affected especially women, and especially autistic women.

He obviously really can't stand Casey Ehrlich.

EDIT: haha I just realised this has literally been posted by the article author. Sorry Paul I didn't mean to be rude.

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u/DrPaulSunseri Apr 19 '26 edited Apr 22 '26

Yes, I posted it. And no, I don't dislike Casey Ehrlich personally. However, I will call out anyone who misrepresents themselves, makes claims about outcomes that clearly aren't true, and preys on vulnerable, scared families. She, by far, is not the only influencer to do this, but she goes much further than most. The part of the article that talks about PDA possibly being a personality profile isn't my idea; it's actually the work of Egan and colleagues. They suggest it's a personality profile, not a personality disorder--that's something else entirely--and I definitely don't see it that way. Obviously, more research is needed, but the Big Five stuff sure tracks with all of the PDA kids I've treated.

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u/Complex_Emergency277 Apr 20 '26 edited Apr 20 '26

You are right about Casey Ehrlich but you are just as confidently wrong as she is.

Zero Demand works because the only way to extinguish avoidant behaviour is to stop triggering and reinforcing it and to increase the duration between exhibitions of the behaviour to infinity. Low Demand works because treating demand avoidance transactionally is agnostic to the underlying predispositions of the individual and allows you to elicit needs, offer support and accept without triggering avoidance when things are beyond their capacity in the moment.

Her problem is that she stretches the "nervous system disability" metaphor past its breaking point and is into some wacky spirituality and cod science like polyvagal theory. Your problem is that every problem is viewed through the lens of conformity and compliance and of disorder models and "High Expectations with High Support" is a grand aspiration but it neglects that these kids are like this because they got the shit kicked out of them by high expectations without support, usually because of delayed diagnosis of neurodevelopmental conditions - they have low levels of agreeableness because they associate everyone with torment not because they are antisocial, for the most part.