Episode 12: Demand Avoidance and PDA: Exploring the Overlap and Difference [Featuring Tara Holmquist]

Show Notes

In this episode, we explore demand avoidance, a common experience among neurodivergent people. We delve into the factors contributing to demand avoidance, including executive functioning challenges, sensory issues, and a desire for autonomy. Additionally, we take a closer look at Pathological Demand Avoidance (PDA), also known as Pervasive Drive for Autonomy, a complex and often misunderstood subtype of autism. Join us as we navigate this important topic, gaining a deeper understanding of demand avoidance and its impact on neurodivergent lives.

Dr. Megan Anna Neff, an AuDHDer psychologist and mother of a child with PDA, describes it as "anything that comes at the person that threatens autonomy invokes an extreme fight-flight response," and says that it can be seen through a lens of "nervous system through stress response," making it different than something like oppositional defiant disorder or conduct disorder.

Individuals with PDA sometimes develop sophisticated and subtle masking strategies to appear compliant and cooperative on the outside, even though they may struggle internally, which can involve imitating expected social behaviors and responses while suppressing their genuine feelings of overwhelm and resistance.

In this episode, Patrick Casale and Dr. Neff speak with Tara Holmquist, PsyD, about PDA and her personal experience as an AuDHDer with PDA.

If you're interested in learning more about PDA, trauma, and demand avoidance, this episode is for you.

Top 3 reasons to listen to the entire episode:

1. Understand how PDA shows up in the lives of those who have it and how it both internally and externally impacts their lives.
2. See how demand avoidance is often a coping mechanism rooted in trauma.
3. Learn coping strategies and skills for managing demands.

PDA can be a painful and overwhelming internal struggle that also manifests in ways that aren't always received well on the external side of things when the pressure of demands just becomes too much. 

This episode aims to shed some light on the complex world of demand avoidance and PDA to gain a deeper understanding. 

More about Tara Holmquist:

Tara is a clinical psychologist licensed in CA and WI. She has been in private practice for about 5 years working with adults with relational/attachment trauma, as well as addiction/substance use. Her practice is exclusively telehealth, and her practice values include a heavy examination and challenge of implicit biases, internalized capitalism, and patriarchal leanings. Her practice is trauma and social justice informed. And she's a pretty cool regular human too.

Tara's Facebook: facebook.com/tmhpsych

Tara's Instagram: instagram.com/tmhpsychotherapy

Additional Resources:

Dr. Neff's blog post on "Autism PDA Explained: The Core Characteristics of Pathological Demand Avoidance"

PDA MasterClass: For an in-depth clinical definition of PDA, check out Neurodivergent Insights MasterClass featuring Dr. Donna Henderson.

 

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Transcript

PATRICK CASALE: Hey, everyone, you are listening to the Divergent Conversations Podcast. We are two neurodivergent mental health professionals in a neurotypical world. I'm Patrick Casale.

MEGAN NEFF: And I'm Dr. Neff.

PATRICK CASALE: And during these episodes, we do talk about sensitive subjects, mental health, and there are some conversations that can certainly feel a bit overwhelming. So, we do just want to use that disclosure and disclaimer before jumping in. And thanks for listening.

PATRICK CASALE: Hey everyone, you're listening to another episode of the Divergent Conversations Podcast. Today we've got a wonderful guest on, a good friend, and colleague, Dr. Tara Holmquist. She is a PsyD in California, lives in Wisconsin. And today we are going to talk about PDA. So, Tara, thank you so much for coming on and just share a little bit about who you are. 

TARA HOLMQUIST: Yeah, and thank you again for having me. Megan, very, very nice to meet you. I'm excited about today. I'm excited about this experience. So, as far as my neurodivergence, I'm definitely ADHD. I am about 90% sure that I'm autistic as well, so I'm sort of late identified, still exploring, but pretty sure. And as of late, I've really been, it's like exploring, and excited, and learning about the PDA profile. So, I thought we could have some conversations about that today, our experiences, and just, you know, the difference between just having demand avoidance and actually like a PDA profile, what that looks like, you know, as an adult really isn't a fab for me.

PATRICK CASALE: Cool. Well, I'm going to turn it over to Megan, who this is her wheelhouse, for sure, to kind of give the listeners, if you don't know what PDA means, or what that looks like a brief overview, and then, we'll kind of jump into why we're doing this podcast today, too.

MEGAN NEFF: Yes, so PDA, it has historically stood for pathological demand avoidance, which, again, I mean, so many of these things are defined by what the outside observer might see, and so, that's a classic definition from the outside, a person with PDA is going to have a lot of demand avoidance. I prefer the term, oh, my brain is foggy today, I would know who coined it [CROSSTALK 00:02:03].

But, well, yeah, pervasive drive for autonomy, I was trying to think of, I think, it's an Australian person, perhaps, who coined the term, a PDA. And I really like that term, the pervasive drive for autonomy because that captures the internal experience. It's anything that comes out the person that threatens autonomy, invokes an extreme fight/flight response. So, we really have to see this through the lens of nervous system, through stress response, which is what makes it so different than something like oppositional defiant disorder, or conduct disorder, which is often what, especially, these kids get diagnosed with, typically, is the main like oppositional defiant disorder, but it's their bodies are going into fight/flight mode, sometimes freeze mode. 

So, we also can talk about internalized PDA versus externalized PDA. And it's, I think, conceptualizing it through anxiety. And then, fight/flight is a really helpful way of understanding these children and these adults. 

Increasingly, we're seeing more and more adults talk about PDA, which I'm also super interested in. I have a ton of demand avoidance. I'm a parent to a PDAer, so there's things that I don't relate to about the full PDA profile. But I think most autistic people have a ton of demand avoidance. 

So, I'm really also interested in teasing out that conversation, kind of like you were saying, Tara, but like, what's demand avoidance? What's PDA? How do we tell the difference?

TARA HOLMQUIST: Mm-hmm (affirmative). Oh, me too-

PATRICK CASALE: Tara, you…

TARA HOLMQUIST: Oh, go ahead, Patrick.

PATRICK CASALE: We're going to find ourselves in this today where [CROSSTALK 00:03:41]-

TARA HOLMQUIST: This is going to happen. 

MEGAN NEFF: Well, even where like robotic, like, you talk, you talk, you talk or we'll talk over each other.

TARA HOLMQUIST: Yeah, yeah, that's what's going to happen today. Like, I'm just going to dominate everything.

PATRICK CASALE: Good I'm glad because I wanted to use this episode for like exposure therapy in a way for Tara. Tara is a good friend and DMed me about like, what you were experiencing that's why I wanted to have you on. And do you mind sharing, like, I don't know if you remember the specific example that you gave me, but what's happening for you when you were like, "Oh, shit, this is something I really associate with, this is something that's starting to make a lot of sense." And you're starting to conceptualize it through that lens.

TARA HOLMQUIST: Yeah, I don't remember the specific thing. But now that I'm thinking about it kind of all the time it's like, oh, it could be an example. But I guess for me, you know, I had a client that was talking to me about, you know, like, shame, and guilt, and stuff like that. And she was saying, "This is why I do everything so fast all the time because, like, I just don't feel worthy of taking up space or whatever."

And I was like thinking about that for a while, and then, started to apply that to me because that's historically and everybody that knows me in person will laugh because I'm constantly like running around doing everything. I'm running wherever I go, I have to do everything as fast as possible. All of the things that are on my to-do list is going to get done in like one microsecond because I just have to. 

So, I started thinking about my experience, and I'm like, it's not a worst thing for me, but it's an extreme discomfort for me. Anytime that I am expected to do something, even if it's just feed myself, or step away from whatever task I'm doing right now, anytime that I have that it's like, extreme discomfort in my body around having to do something, whatever it is, and so, the way that I've coped with that, or the way that I've kind of understood it is just like, just get it done as fast as possible so that I could just sit down on the couch and stare at the wall type thing, you know? That I'm just like, just do it, and then, it's like a loop. 

But this is my constant experience, where I'm just like having to do something, I'm extremely anxious about it, go do the thing as fast as possible, and then, go sit down, and wait for the next thing to happen that I have to do. And then, go, repeat, repeat, repeat, repeat forever.

MEGAN NEFF: So, Tara, I'm smiling because I'm having a memory from my summer before I went into my doctoral program. I was kind of loosely connected to the program, so I was able to find all the syllabi from the program. And what I did, I ordered all of my textbooks, and I ferociously read cover to cover all of my textbooks, we're talking about thousands of pages, for my first semester of grad school during the summer before I even started the program. And it was kind of what you're describing as the idea of having a task on my plate was so anxiety-inducing, that it was like, "I'm going to do this as fast as possible, and then, I can rest." 

And it totally stole my summer, right? Because it's like, I cannot rest until this is done. And that becomes a loop for me of, I work through my tasks really quickly because it's like, there's this fantasy, once this is done then I can rest. But of course, life doesn't work like that because, you know, bodies need maintenance and work keeps coming. But that's absolutely the fantasy. Do you relate to that? I felt like I heard some of that when you were talking.

TARA HOLMQUIST: Yeah, 100%. I mean, constantly. And I don't even know at this point what rest feels like, right? Because I'm not even resting when the task is done. It's just, okay, what's going to be the next thing, you know? And depending on who it's going to come from because internally, I can manage my own tasks that I set for myself, feeding myself, or doing work, going to see clients, whatever. But if my partner calls me or one of the kids calls and is like, "Hey, can you start the oven for me so I can throw in a pizza." I'm like, you know, just totally dysregulated and I'm like, I hate my life, and now I can't move. 

So, yes, yes, yes, yes, very much resonate with that and question myself a lot because then when I go to explore kind of, like, demand avoidance in general, right? When I go to explore this, you know, watching the mastermind or whatever that you did with Dr. Henderson, like, I'm like, oh, that's not my experience of like outward, you know. It looks like your opposition or looks like you're just applying all of these things. But on the outside, I'm like, I'm getting everything done all the time. I'm constantly going inside and I'm struggling, though. Inside it's torture, yeah.

MEGAN NEFF: So, can I put you on the spot a little bit? 

TARA HOLMQUIST: Yeah. 

MEGAN NEFF: Clinically. So, I'm curious how or if you can tease apart like what is difficulty with task switching versus demand. I keep hearing you say it's like the demand will do the [INDISCERNIBLE 00:08:51]. We know task switching is hard for ADHD and autistic brains, right? That switching from I'm in flow, you're now asking me to like, get out of hyper-focus, or out of hyper fixation, and shift tasks. Can you tell the difference between like, what is task switching struggle and what is like, this is a demand coming in that I wasn't expecting that is, you know, threatening my autonomy.

TARA HOLMQUIST: That's a good question. I think, in the moment, and if I'm in it, I can tell the difference. It feels different for me. I will say this, anything that is not something that I'm currently obsessed with is a task for me. And, you know what I mean?

MEGAN NEFF: Yes, yes. I already [CROSSTALK 00:09:33].

TARA HOLMQUIST: Yeah, so if I'm pulled away from Ted Lasso, or if I'm pulled away from Schitts Creek, or if I'm pulled away from scrolling through TikTok because I'm just, you know, resting or whatever, anything is considered a task for me, and when it becomes something that I now have to do, that's when the anxiety starts coming in of like, I don't want to. I don't want to at all, and then it takes a lot of energy for me to get up and do it. So, it kind of merges. I can tell the difference. I don't really know how to articulate it, though, if that makes sense.

MEGAN NEFF: Yeah, yeah, no, and that's what I was curious about because like, you have the experience, and then you're a clinician, I was curious if you're able to tell that subtle difference. I think I could also tell the subtle difference, but I don't know that I'd be able to articulate it either.

TARA HOLMQUIST: Yeah, yeah. It's just something. It's just a feeling in my body of like, stress. Yeah, I don't know. It's just like a stressful feeling. It's a frustration when I have to switch tasks and then pulled away from something I love to do, you know? It's a frustration and it's like, okay, get it done. 

But as soon as like, I have perceived it as an expectation, then it's like, oh, now I'm going to throw a tantrum along doing them. I'm still going to do it, still get it done, but I'm going to be huffing and puffing, and like, agitated about it while it's happening. And then, I don't know if I can even get back into Schitts Creek, or Ted Lasso, or whatever the hell else I'm doing because now I'm waiting for the next thing.

MEGAN NEFF: I think that captures it well. I think I experience more frustration if it's a demand coming from someone else. If it's a task switch, I feel more pressure. Like, I've got to finish this before I can like mentally kind of evacuate the space and go to another one. So, like panic, frustration, and I would say, in my case, irrational frustration if a person requested a demand.

TARA HOLMQUIST: Yeah.

PATRICK CASALE: Tara, you mentioned to me when we were first talking about this, like a visceral reaction because I think it was a, I'm remembering the example now, like, I think it was like furniture shopping or something like that or some type of shopping with your partner, and then, all of a sudden that got canceled. And then, it was so hard to switch into, like, a mindset of let's go get a drink, or let's go do something else because you had already built up the mental energy to say, "I'm going to do this thing that I don't want to do, and now because the task is switching, I have such a avoidance to what's coming up, and it's going to come up viscerally, and it's going to come up physically, and I'm going to get really irritated and really frustrated about this."

TARA HOLMQUIST: Yeah, yeah. Thanks for reminding me because now I totally remember it. And that, like, I attribute more to, like, I have the intense need for sameness. Like, my routine is set. I already know what I'm doing, and if you're going to change that on me, don't do it five minutes before, you know?

So, the situation was we were supposed to go to soccer game, my partner is the coach at his son's soccer team. We were supposed to have a soccer game, game's at one o'clock, whatever. We're going up, we were waiting for it, waiting for it, waiting for it. And then, literally, like a half an hour before we were supposed to be there for the game, the other team canceled for weather. Okay, nothing we can do about it, fine, it's fine, it's fine. So, we kind of sat there for a minute, and then, all of a sudden he was like, "Okay, well, we have time now, let's go grab the furniture that we wanted to buy." 

And immediately I like lost my shit. I was like, "I'm not prepared for this. Like, even though we've been talking about it for weeks, we just needed to find a time." I was like, "I'm not prepared for this." I had like, a totally, like, visceral response of like, but just anxiety. And I attributed that to like, just pulling me out of my routine, my structure of what I had going on, you know? 

And I mean, I had that paralysis when that happens anyways. Like, I wasn't doing shit until up into the game. Like, nope, I have to sit here because the game is at one, and I can't do anything until this game is over. I've watched and cheered as much as I can. And then, we can go do furniture. But now that you've changed this on me, it was really, really difficult to even regulate that after that, you know, and we did it. We bought the thing, but I didn't have a good time. I don't know, it was a hard transition for me as most things like that are, yeah.

PATRICK CASALE: And all three of us have the unique perspective of being mental health workers and trained in regulation, and techniques, and strategies. So, it's interesting, you know when we're experiencing it ourselves when this stuff is coming up, and then we're like, shutting down or melting down, so to speak. And then, we have to reregulate and figure out a way to be able to push through to do the things that we don't expect to do or don't want to do. And like Megan mentioned, the transition switches are so challenging, especially, unexpectedly.

And I imagine, you know, if we're going to frame this for like kiddos, and teens, and young adults who are not mental health workers, or don't have the language, or don't have the skill set, that is where we would see the misdiagnosis of ODD or the things that come up, and where all of a sudden it's like we need behavioral modification here because this person can't, you know, switch from these tasks or when this is placed upon them, they melt down or shut down.

TARA HOLMQUIST: Yeah, 100% and, you know, one of the interesting things that came up, and maybe this is a similar conversation that you had with our mutual friend, Patrick, around the intersection of like trauma and PDA, or even just like, you know, there was three things that we're talking about, like masking, and trauma, your trauma triggers, and then, like PDA stuff. 

So, my experience, and this is where I get confused, and, you know, wonder about what this looks like as an adult versus what we see with kids is like demand avoidance or even the PDA profile is so focused on like outward behaviors, right? Or outward experiences of, you know, the kid that's going to sit in the therapist chair and go, "I'm a therapist today, and I'm the boss, and, you're not…" You know, all of those things. 

Like, I love that. But for me, and like, my trauma history is I was raised very, very, very like hyper independent. So, like, I do everything for myself all the time. And I do everything for everyone else. Like, I'm super, super hyper-independent. And there's a trigger around, like, if I don't do everything I'll get in trouble in some way. If I cause anybody to, you know, question my behavior or question something, then immediately I did something wrong, and I'm in trouble, right? 

So, I learned at a very young age to just take care of it, figure it out, take care of it, rely on myself, do all these things. So, you're never going to see me outwardly defying anything, you know? As soon as somebody gives me a suggestion, or an expectation, or a demand, or tells me to do anything, I'm doing it right away, and you're never going to see me from the outside and go, "You know, she's having trouble." You'll never know. 

But internally, I'm dying inside, you know? Internally, I'm like, I don't have the energy, I don't have the strength, I don't want to do any of this stuff. Like, now, it's expected of me because of how I've coped with, you know, emotional neglect, how I cope with not getting all of my needs met, you know? 

When I was a child, you know, this hyper-independence is not actually me being like, "I don't need help." Self-reliance and all that. It's like, actually, I need a lot of help, and stop telling me to do stuff.

PATRICK CASALE: Yeah, I can definitely relate to that. So, I think, like, it's a struggle, especially, when you are still managing to get everything done because if people don't see the other side of it, of how much energy it's taking, and how much sensory overwhelm it's causing. And, yeah, I'm curious about your thoughts on that, Megan.

TARA HOLMQUIST: Yeah.

MEGAN NEFF: I had thoughts then they flew away. I think I was thinking how adaptive it is if your trauma environment was one of, kind of, overreliance. And if so much of your energy was going to your own survival, how any demand on top of that would just be like, are you kidding me? And what a kind of brilliantly adaptive response to your environment.

TARA HOLMQUIST: Fair, fine, will be nice to myself. It was adaptive and also exhausting.

MEGAN NEFF: Well, that's the thing, right? Like, those things that help us survive, like, non-ideal environments stop being adaptive when we're adults, right? And that's why we exist as therapists.

TARA HOLMQUIST: That's right, that's right.

PATRICK CASALE: That's true, that's true. Megan, for you, and you mentioned like, you know, sharing some of these tendencies and traits with the PDA profile and having a kiddo who does as well who's a PDA or what does that look like for you on your end? 

MEGAN NEFF: Yeah, I mean, tons of... I think, and maybe I get a little nitpicky here, what I'm noticing, at least in social media, I feel like people are conflating demand avoidance with PDA. And so, that's where I like to be a little bit specific with my language of like, having parented a PDAer and like, experienced a very visceral experience around parenting them. Like, I can tell, okay, when I'm experiencing demand avoidance this is different. And so, that's where, yeah, I definitely relate to a lot of the demand avoidance.

And the internalization, I'm very similar to Tara, and that it's on the outside. Like, someone says, "Jump." I'm like, "How high?" Although, that's actually not always true. Like, I've been recently working through some shame on this of, I was collaborating with a colleague, we were going to do some public speaking, and I realized that public speaking is where my demand avoidance just goes full throttle. Like, I will fantasize about getting sick, I will try to figure out how in the world to get out of it. Like, I'll often commit to public speaking because I'll be excited for the first 24 hours when someone reaches out. And then, I will have so much demand avoidance that it makes me actually pretty flaky. 

So, I've decided to stop saying yes to public speaking for the next year just to see like what set like because I will, for months and months and months have so much anguish around it, and I'll procrastinate which isn't common for me. So, it is one place where professionally I really notice my demand avoidance causing some tension. 

But then otherwise, yeah, a lot of the internal experiences of I do a lot of tricks to get myself to do things. It's interesting just hearing other people talk about their internalized PDA. It's one of those moments where it's like, "I thought everyone did this." Like I thought everyone tricked themselves into kind of multitasking, or doing these things, or making it a game to get themselves to actually do the thing. But yeah, I spend a lot of mental energy if it's something outside of my interest. 

I think it's one of the reasons I'm shifting away from clinical work, and right now two of my five days in a week I don't have any demands on me unless I'm placing them. I have a lot of work to do, I have a lot of writing, I have a lot of content to create. But those days feel so different to me because I'm waking up and it's demand free. It's whatever I want to do. And so, I am moving towards structuring my life more and more that way because it just works better for me.

TARA HOLMQUIST: Yeah, that sounds like a dream.

MEGAN NEFF: I know. I'm sorry. Are you doing five days of clinical work?

TARA HOLMQUIST: It's like four and a half. My Monday's are-

MEGAN NEFF: That's a lot. 

TARA HOLMQUIST: Well, they're such a good job of like, my Mondays are dedicated to me. But now I've started to fill up my Mondays with doing ADHD and autism evaluations, and like, absolutely love doing it but absolutely hate writing reports.

MEGAN NEFF: Obviously, that is a big demand.

TARA HOLMQUIST: It is.

MEGAN NEFF: I have a mixed relationship to assessments too. I love it and we need so many more assessors and the report, that's a big demand.

TARA HOLMQUIST: It is. And that's why I'm still sort of, you know, Patrick's always like, "Let's go. Whenever you're ready to go into it, like we're going to support you, we'll go full force." And I'm like, "I don't know because I love doing it. I love meeting with people. I love the assessment part." And then, yeah, it's just that writing part that I'm just like, "Well, can I just tell you? Like, can I just tell you instead of writing all this stuff down?" Like, yeah, just, you know.

MEGAN NEFF: Mm-hmm (affirmative), I mean, I know this isn't a consult call, but you probably could. Like, for people who aren't looking for accommodations, you probably could find a way to make a much briefer report, and then, do more of it verbally, depending on what they're needing.

TARA HOLMQUIST: Yeah, I had someone actually last week that we had that conversation, and they were like, "You know, I don't necessarily want it written down anywhere. But I do want to explore this and like, what are our options? So, can we talk about that?"

MEGAN NEFF: Yeah, I'm seeing more and more people wanting that. They're wanting confirmation, but they're not wanting that medically anywhere, which kind of makes sense to me.

TARA HOLMQUIST: Yeah. 

MEGAN NEFF: That's your that's your demographic, that's your like, ideal client, and people who want they're like, "Yes, I anoint you as a psychologist with this diagnosis, but I'm not going to medically put it anywhere."

TARA HOLMQUIST: Exactly, exactly. I mean, it's just good [CROSSTALK 00:23:47]-

PATRICK CASALE: …if you're able to just anoint people with these things and then you validate, and support, we don't have to, you know? I think that speaks to this profile in a way, right? Like, the demand for I have to write this report, but I absolutely don't fucking want to for a myriad of reasons. 

And then, I notice that myself for so many things, and what I hear you saying, Megan, is like really creating a schedule in your life where it's much more flexible in terms of demands and demands that are put on you, and if they're going to be there they're demands that you put on yourself. 

And I know that not everyone has the privilege to do that with their schedule or create around it. But I do think that's a great strategy for people who are listening who need some relief, first up from some of this stuff is to figure out ways to lessen the load of demands that are coming on you from other people and less that you're putting on yourself. 

TARA HOLMQUIST: Yeah. 

MEGAN NEFF: Yeah.

TARA HOLMQUIST: Absolutely.

PATRICK CASALE: Tips, strategies, techniques, anything that we can offer the audience about, you know, when they're struggling or when they're experiencing anything like this that we're talking about. 

MEGAN NEFF: I mean, similar to what we're just talking about, I think, if, again, if someone has, like if this is accessible to a person, having one day a week that is demand free. And it could be a weekend day, right? But just the relief of, like my daughter and I will both talk about this, like the relief when we wake up and it's like, it is an open day, there are no demands. Having at least one day a week where… I think that's really soothing and to be able to depend on it too.

TARA HOLMQUIST: Yeah. Even the idea of like, oh, like it's a free weekend, right? And like even the thought of, "Oh, maybe we'll go to dinner later on Saturday night." Or something like that, if that's planned on Friday night, that's not a free day for me on Saturday, you know? It's not an open day for me because I'll like, all right, I'm going to do nothing literally until whatever time dinner is going to be, you know?

MEGAN NEFF: So, are you like this? I'm very much like this, like spontaneous socializing. I cannot make plans with people. Otherwise, there's something on my day. So, if I'm trying to connect with someone on the phone or see someone that doesn't happen much anymore, but it's got to be like, "Hey, are you free right now?"

TARA HOLMQUIST: Yeah, absolutely, you know? Even scheduling this, right? It was like, "Hey, here's your options for this." And I'm like, I just want to say no to all. Like, first of all, I should say, like, reactionary for anything, I say no, first of all, you know? "Tara, can you turn on the oven for me?" "No." "Can you do…" So, everything is no even though I'm going to get up and do it. 

But absolutely, like scheduling even this time to talk it was like, okay, I'm going to do it in the middle of my clients. I mean, it was limited time anyway, but like, I'm going to do it in the middle of my client so that I can't get out of it, I can't say, you know, yes, I'll do it, and then find some excuse on a Saturday to not do it, absolutely. Like, it has to be now or never, and preferably never. But let's do this now.

MEGAN NEFF: That's another good strategy is packing demands. Like, same thing with Patrick, when we started this podcast, I was like, "Well, Tuesday is my busy clinical day so let's do it Tuesday to record." Because it's like, it's a demand day, and that means that my Wednesday can tend to be low demand, but by packing my demands, like that's one strategy, and it sounds like you kind of did that too.

TARA HOLMQUIST: Yeah, without even knowing.

PATRICK CASALE: I have to do that with scheduling stuff. Like, scheduling my own stuff I'm fine with it, but I notice every time I scheduled someone else's podcast, or someone else's speaking engagement, or someone else's anything I'm like, rescheduling, rescheduling, rescheduling, pushing it back, pushing it back, pushing it back. And there was a part of my brain that's like, "Just fucking get it done." But I don't want to, so then, I can't. 

And I've rescheduled on one person in particular that I'm thinking about right now, Porter, like conversation about, like, come on my podcast, be a guest. And every time I pick a time, like, I don't want to do that that day. I don't want to do that at that time, like, so now it's in August, and I'm sure once we get to August it'll now become October, and it'll just never happen. And I'm sorry if you're listening, I-

MEGAN NEFF: Do you all do that fantasy thing where it's like, "In August, I will want to do this. Like, this is going to be a big deal." So, I'll commit to things, so like the speaking thing I mentioned that I then got out of, but I also had things out off my plate since then. But it was like, "Oh, in September, like I'll be this whole new person who would love to do public speaking." And it never happens. But the fantasy always stays that, you know, four months from now I will just, you know, love that demand but…

TARA HOLMQUIST: 100% or right now, like, I always take the week between Christmas and New Year's off, and here we are like almost in June and I'm like, "Oh dude, that week is going to be so good. I'm going to come back to the New Year just a whole new person."

PATRICK CASALE: That's such a fucking lie too, like, it's just a fucking lie. I get kind of romanticized idea of that. And I don't know if you all relate, but I think you do because I saw you both like nodding in agreement when Tara was talking about something, but like rushing from demand to demand or task to task to get them over or to give yourself like breathing room, I'm always telling myself like once I get this done, or once I've created this thing, I can finally breathe and like have nothing to do. And that never happens. And that feels like this internalized torturish pressure of like, I just want to disappear from all of this. But when could that actually happen?

MEGAN NEFF: Yeah, disappearing fantasies. I've had that since I was a child. Like, where, oh, this sounds so morbid. It sounds so morbid. I don't have this fantasy as much since realizing I'm autistic and adapting my life, but like, fantasizing that everyone I knew… This is-

PATRICK CASALE: You can say it [INDISCERNIBLE 00:30:15].

MEGAN NEFF: Oh, my God, that everyone I knew died. And that I was like, starting over nowhere, with no expectations on me, no demands on me. And I think part of that was the mask of like, I could actually be myself if everyone who ever had known me didn't exist, or if like, I moved to another country, that's a much less morbid fantasy, just me, but then, I'd live with the guilt of like having left and moved to another country. But it was about a demand avoidance and about like authenticity of I can't actually be my authentic self until everyone I've ever like, touched in my life as a human doesn't have, like, a known history of me in their memory.

PATRICK CASALE: You're really hoping for like the [INDISCERNIBLE 00:30:57] fingers snap, and then, half of those people are just gone.

TARA HOLMQUIST: Gone. 

MEGAN NEFF: Yeah, obviously, not a real fantasy, but I-

TARA HOLMQUIST: Maybe they could still exist, but just their memories are wiped. It's like a Men in Black thing. 

MEGAN NEFF: Yeah, yeah. 

PATRICK CASALE: Yes, yes. I can relate to that. I think that there is this fantasy of starting over or just not having anyone know anything. And you can just start naturally. Maybe that feels like a common fantasy for a lot of neurodivergent people who have struggled so significantly with social struggles, and just the day-to-day lived experience of what it's like to live inside a body with a nervous system that we have. 

I mean, what I'm hearing all of us say is that a lot of just getting through life is really fucking challenging. And we're constantly figuring out ways to do things so that we can get through another day, and that it's exhausting, and it's a different type of exhausting than like a neurotypical person saying, "Counting down the days to that beach trip, and that's going to rejuvenate me." It's like, we don't really have an escape. I think that's what we're saying.

TARA HOLMQUIST: Yeah, yeah, I even like, rest and relax in private, if that makes sense. Like, I'll do, you know, all of the things that I'm supposed to do and expected of, and that's my role, and my family, and my life, and everyone involved, I'm a therapist then I'm whatever. And then, as soon as I have like a unexpected break in my day or something like that, like, I ran over into my bedroom, shut the door because my kid lives downstairs for one more day, and so, I'm like, "Oh, I don't want anyone to see me like resting." I'm hiding away because, immediately, as soon as I don't have something to do, somebody's going to ask me to do something, or there's like a shame in resting, and I think that's part of my trauma stuff is like, there's a shame in not doing something all the time, or making sure that someone's okay all the time. So, I'd rather hide away in my room with my snacks and my Tiktok or whatever. And like, pretend, you know? Like, I don't exist to anybody right now. Everyone thinks that I'm doing something else. 

So, it's kind of similar to what you're saying, Megan, which is just like, I can be exactly myself, unmasked, and just no demands on me whatsoever, and I could just literally stare at the wall, like people think I'm joking. I'm like, I just want to stare at the wall for like an hour. Like, I literally just want to stare at the wall.

MEGAN NEFF: Yeah. Well, that's an interesting part of it, too, is I hear a lot of autistic people talk about like how comfortable it is to be home alone because it's not just that not having a demand, but knowing no demands are going to come at me. So, like when you go into your room and retreat, and it's like, okay, how do I create a bubble where someone doesn't just walk in the room and like, assault me with a demand. So, that's an interesting psychological component of it, too, is not just there not being demands, but like the kind of certainty no demands are going to come at me, which is really hard in this world with how kind of interconnected our lives have become with technology. Patrick and I have talked about this a lot, like the incoming pings and pawns like in all these little splintered demands that come at us. It's hard to not be assaulted by demands all day long. 

PATRICK CASALE: It really is. And I think you're so right about… That's the beauty of having the ability to work from home is you kind of do get to set your expectations, right? Of like, who has access. 

But Megan just touched on something I wanted to mention, for those of you listening, like really figuring out a routine to start your day because I know I don't do a good job of this where I immediately as soon as I wake up, check my phone because I put my phone in a different room at night because I have to get away from the demands. I also feel like this unbelievable pressure to always be responsive to things. So, I check it and immediately it's emails, messages, Facebook messages, Instagram messages, group practice messages, and my day can be ruined in a matter of seconds. And it really is important to try to figure out a routine and a strategy where you're not doing that immediately to start your day or end your day because there are techniques that we can put in place to have some distance, even if it's momentarily. Like, we don't get to just disappear all the time. 

But if even those momentary blips or rest, examples or abilities to just step away, even for a minute or two, and build on that, I think, it is about building on those moments as well. And like, then really incorporating them consistently, like Megan said, having a day, even if it's a weekend where you just don't schedule anything, or you don't check your phone, or you don't commit to plans because it's just a day to allow yourself to breathe. And I think that is so crucial. And don't follow my advice of checking your phone first thing in the morning because it's not-

MEGAN NEFF: [CROSSTALK 00:36:16] I do the same thing. And I've been learning so much more about like low arousal mornings and like, I have this fantasy of like an ideal morning routine. But yeah, I am the same way, Patrick, I-

TARA HOLMQUIST: Yes, and then it's a battle, right? Like, okay, I'll go put my phone in the other room, but then the battle is, I want to go in the other room and check, I got to go in the other room and check because how much is building up, you know?

PATRICK CASALE: [CROSSTALK 00:36:45]. Yeah, I tried so hard. It's so freaking hard. And I think that's where my, you know, PDA kicks in. And I have this inner personal feeling, maybe it's my own trauma history of having to respond, and having to clear, and having to constantly be like one step ahead. And that goes into my ADHD profile too, of like, I have to do everything immediately, or I'm going to fucking forget. And that feels like internalized pressure constantly because it's like, "You're so responsive. You responded to this email and this message." I'm like, if I don't, I never will. But that feels like infinite pressure that never ever goes away.

TARA HOLMQUIST: Yeah, I love that you're tied into ADHD because that also, I think, represented demand avoidance. I'm the same way of like, I don't trust my mind to remember to do this later so I will do it now. And it's small and big projects. Like, if I'm excited about a big project, I like have to get hyper fixated, and do it in a week, or like, send an email right now because it's just like, it's so hard to get myself to do it later, or I'll completely forget.

PATRICK CASALE: Yeah, yeah, schedule send has become my best friend for things like that because like, schedule sending emails, schedule sending text, but I can't do that on certain platforms where they don't have that as an option. But like, where it is an option, it is a lifesaver because then I'm like, okay, I can get it out of my head, I can get it cleared off the never-ending list, and I don't have to like message someone at 1:00 AM or whatever their experience. 

So, it is a challenge for sure. But that is something that's just been an accommodation that I've had to incorporate, otherwise, like you said, Megan, like, it would be gone, or it would never happen. And that just, again, feels like constant pressure. So, maybe a different topic, but ultimately, definitely, a part of the experience for sure.

TARA HOLMQUIST: I agree. I think it goes in hand in hand. Like, I know that when I'm under a certain amount of stress like my ADHD symptoms are just out of control, and then, it's this battle between let me get everything done as much as I can because I'll forget. I will forget and then, I'll do a lot of half things. 

And what I'm noticing lately because I've been exploring all this stuff and like what would it be like if I just unmask, like, what am I actually like, you know? And that's when I realized that, "Oh, I can't remember shit." Like, I actually can't remember anything. I don't know how I've survived 40 years of my life. I don't know how I became the therapist that I am. Like, I don't know how I do any of this because when I'm battling, you know what I trust my mind is going to do or not do plus exploring, like, what would it mean if I didn't have all this avoidance around like these expectations, what am I going to be like? And so far I don't like it so much because I'm not very functional, but we're going to learn to adapt. We're going to figure this out. 

Megan, I'm just going to be on your website just all the time. I'm just like, what else is she going to say about this? I need help.

PATRICK CASALE: Megan's resources are incredible. So, you know, I feel very honored to be co-hosting a podcast with you, Megan, because I'm like, geez, I just think everything you're creating, and doing, and how you're showing up for the indie community is really, really amazing. 

And yeah, I think, Tara, you know, a lot of over-functioning for executive functioning and deficits, and like, accommodating, and just figuring it out, and, you know, I think a lot of neurodivergent folks could relate quite a bit to what you just said, and you're not alone in that. I know I feel that way a lot of the time, I know Megan's mentioned feeling that way a lot of the time. Like, it's definitely one of our realities. 

So, I think we're at our awkward goodbye space, which is something we are figuring out as we go. But I do want to thank you for coming on, and just being vulnerable enough to share your side of the story and how you experience this. I think it'll be very helpful for everyone listening.

TARA HOLMQUIST: Yeah, no, I really, really appreciate. This has been very validating for me just having you both here, and just talking, and conversating about this because I feel like I'm doing this alone, and you know, just checking people's resources, and things, and feels lonely. So, thank you. Thank you for having me here, experiencing with me.

MEGAN NEFF: Yeah, thank you so much for coming on and for using one of your, like, demand spoons to be here.

TARA HOLMQUIST: Thank you.

PATRICK CASALE: That's going to be the episode title, something about demand spoons.

TARA HOLMQUIST: I like it.

PATRICK CASALE: I'm sure we will be linking anything Megan has created to the show notes so that you all have access to it. She does have some diagrams on PDA, more information about PDA, and just anything in general. So, that will be in the show notes as well. Megan you got anything to add before we awkwardly close this?

MEGAN NEFF: Yeah, just regarding resources, I've got a fantastic masterclass up with Dr. Henderson who is a really wonderful neuropsychologist, who I would say is one of the specialists in diagnosing PDA. So, if you're a clinician looking for like, is it something I diagnose? What are the core features? We don't actually diagnose it, but we can't talk about it in the report, then I would say definitely check out Dr. Henderson's work. And I have a masterclass up where you can kind of hear more of the clinical definition of PDA.

PATRICK CASALE: Perfect, and we'll link all of that in the show notes so you all have easy access to it. Thanks for listening to another episode of Divergent Conversations on all major podcast platforms and YouTube. Like, download, subscribe, and share. Bye.