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Living With PDA For A Year Now.

Pathological Demand Avoidance.

After 12 years working in the mental health field I thought I had seen it all.
From dementia with the elderly through learning difficulties and challenging behaviour.
Nothing could have prepared me for the boy – PDA on top of Autism on top of..?

His behaviour meant he could not be schooled so his mother taught him to read and write.
Reading enabled him to daydream and escape into a world of his own creation.
A world in which he controls and feels less threatened.

Anxiety is a major issue.
The need to control all situations and outbursts of violence has led to him becoming isolated.
His vocabulary is huge which he uses to insult and demean others – leading to more isolation.

He takes no interest in the ‘real’ world, largely due to his fear of people ‘knowing’ more than him.
Low self esteem means he constantly tells people ‘I’m better than you, her, him, them etc.’
Leading to more isolation, lower self esteem and more withdrawing from the world and people.

A cycle that damages the relationships with those that care for him and those few that are willing/able to work with him.

The PDA – avoiding anything that he perceives as a demand on him – has left him incapable.
He cannot bathe himself, cannot even tie his own shoelaces – things which when he does notice shatters his self esteem even more, leading to meltdowns with the threat of violence always bubbling under the surface.

I left London and moved in with the mother because of the boys violence towards her.
A year ago, I believed that he would end up in a secure unit somewhere, chemically coshed.
Today, I believe that there is a small hope that will not happen.

The boy attends a youth club where he interacts with other teenagers who have issues.
He is no longer as aggressive – still rude and obnoxious – but he is learning to remain calm.
He – like all of us – just wants to be accepted.

The mother now takes him on overnight stays to the theatre and other places of interest to him.
Hotels, restaurants and classical concerts.
Socialisation rather than isolation and he is responding.

Because of complications with the parents and the Care(?) package he receives, I get as frustrated as the boy.
Am I doing a good job ?
I am doing a great job.

Is it enough ?