Playing Dead: The Truth of the PDA Nervous System and its Exclusion from Trauma-Informed Care
There’s been a lot of talk in recent years about how “the body keeps the score.” But that understanding seems to evaporate when the conversation shifts toward Pathological Demand Avoidance (PDA), also known as Persistent Drive for Autonomy. Because PDA doesn’t just challenge individual relationships—it confronts the very structures of ableism, capitalism, childism, and how we define safety, success, and survival.
PDA isn’t noncompliance. It is a nervous system-driven, trauma and survival response for a subsection of autistic children and adults—one that fundamentally challenges the compliance-based norms embedded in our education systems, parenting and behavioral paradigms, workplaces, and clinical practices. It is not a choice, a phase, or a lack of discipline. It is an autonomic response to perceived threat—a response often misinterpreted as defiance or oppositional behavior.
As a clinician with lived PDA experience, I want to speak directly to what it feels like when the world demands things that your nervous system registers as life-threatening—not metaphorically, but literally. PDA isn’t “resistance” in the way most people think. It’s not oppositional, defiant, or spoiled. It’s not an impulse control issue or a character flaw. It’s the nervous system saying, “I am in danger and don’t have a way out.”
This loss of autonomy can trigger a physiological cascade akin to a life-or-death threat—this is not hyperbole. For those of us with PDA, demands—even benign or routine ones—can activate a fight, flight, freeze, or fawn response rooted deep in the nervous system. It feels like a bear is charging at you in the woods, and then someone says, “it’s just school,” or “it’s just work,” or “everyone has to do this.” When these demands compound, it can even feel like a deep loss of self—like death.
As a PDA adult without a co-occurring intellectual disability, I feel I’m inherently given more autonomy in society than I was as a child. But children, especially disabled children, have less autonomy than any other marginalized group. So when a PDA child resists a demand, adults often escalate pressure—reframing it, disguising it, rewarding compliance, or punishing refusal. We may call in behavioral support. We may even pathologize or label the child “rigid,” “controlling,” “oppositional,” “dramatic,” or “manipulative”—narratives which, by the way, will stay with that child for the rest of their life.
When we do this, we fail to understand the fundamental dysregulation that’s occurring beneath the surface. We retraumatize, and call it evidence-based.
As clinicians, we would not tell a trauma survivor to repeatedly place themselves in a triggering setting “because it’s just how things work.” We would not ask someone with PTSD to rationalize their survival response while ignoring the warning bells sounding off in their body. But is what we ask of PDA kids and adults every day in schools, workplaces, and homes. We insist that because we cannot see the bear in the woods—and maybe sometimes we actually can, but pretend we can’t because it’s inconvenient—it must not exist.
The bear can be many things: capitalism, ableism, neuronormativity, behaviorism, compliance culture, childism.
The PDA nervous system tells the truth about the impact of these systems—truths that are uncomfortable, especially for adults and systems conditioned to value order, obedience, compliance, and the performance of regulation above authenticity, safety, or true regulation. The reality is that honoring the PDA experience often means de-centering adult comfort and convenience. It means challenging deeply held beliefs about parenting, schooling, professionalism, behavior, neuronormativity, and therapeutic intervention.
Many of us entered this work wanting to be “trauma-informed.” But if our frameworks do not include PDA—if we continue to force these individuals into systems and situations that their bodies experience as unsafe—we are not trauma-informed. We are perpetuating trauma.
I want to be transparent: I have participated in behavior plans in the past, before I knew more and before I understood my own neurodivergence. I have recommended reward charts to parents of neurodivergent children, while overlooking the root of the child’s dysregulation. I have encouraged compliance because it was normalized in my workplaces, by colleagues and supervisors, by those positioned as experts in the field, by agency culture, by trainings and educational curriculums, by policy, by evidence-based, ‘gold standard’ practice itself. I now recognize the well-intentioned harm I’ve caused and say all of this with deep humility.
So this is not a callout—it’s an invitation for clinicians, educators, and caregivers to reexamine what we’ve normalized, and to ask: What does trauma-informed care really look like for PDA children and adults?
The cost of ignoring this is high. PDA individuals are so often misdiagnosed, mislabeled, mischaracterized, and misunderstood. Many of us become adults carrying complex trauma not just from families of origin, but from systems that repeatedly dismissed our internal experiences, boundaries, fear, and needs. In my work with Unmasked Lineage, I view PDA not just as profile or subsection of autism but as a signal—a nervous system language that calls attention to structural harm. In this way, PDA intersects with broader conversations around intergenerational trauma, childism, and the invisible architecture of societal power and control.
How can we center sovereignty over compliance? It’s not enough to be neurodiversity-affirming in name only. We have to begin deconstructing the ways we interpersonally and culturally demand compliance, re-enforce masking, uphold childism, and pathologize valid nervous system responses. It’s especially important for us to do this when it is inconvenient and when it requires us to change.
What’s at stake isn’t just therapeutic best practice—it’s people’s lives, wellbeing, dignity, and ability to exist in the world without feeling like they’re constantly unsafe or under threat. It’s an entire lineage of misidentified PDAers. The children and adults who were scapegoated, misunderstood, punished, and pathologized for years. The families who carry that trauma through generations. The clinicians and caregivers who were never given a new map.
This is the work, and for PDA children and adults, it can’t wait.
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About the Author
Claire McCulley, LCSW, is a social worker, therapist, researcher, writer, disability justice advocate, and theorist based in NYC developing the Unidentified Autistic Family Systems framework. Drawing on lived experience, clinical practice, and systems thinking, she explores the intergenerational impacts of masking, misattunement, and collective trauma in unidentified neurodivergent families. Her work centers autistic self-understanding, relational healing, and culturally attuned theory that speaks to real-world patterns.