Explore the complexities of Pathological Demand Avoidance and its impact on coaching neurodivergent individuals. Discover practical strategies for fostering autonomy and collaboration in challenging situations. Shift focus to Persistent Low-Grade Depression, where insights on behavioral activation shine as an effective treatment approach. Delve into innovative therapies for treatment-resistant cases, while underscoring the importance of hope and identity in one’s journey towards mental wellness.
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Reframing PDA
PDA (Pathological Demand Avoidance) is often described as an overwhelming need to avoid demands.
Many experiencing PDA prefer to frame it as a high drive for autonomy, rather than a pathology.
volunteer_activism ADVICE
Focus on Autonomy
Focus on the student's high drive for autonomy instead of defiance.
Try a collaborative approach, giving the student more ownership in their training.
volunteer_activism ADVICE
Offer Choices and Engage
Offer choices to give the student a sense of control.
Engage with open-ended questions to understand the root of the resistance.
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Episode 431: Pathological Demand Avoidance in Coaching & Persistent Depression
Welcome to another episode of the Hardcore Self Help Podcast with Dr. Robert Duff! In this Q&A episode, Dr. Duff tackles two insightful listener questions on very different but equally important mental health topics.
Question 1: Pathological Demand Avoidance (PDA) in Coaching
A listener working as an individual sports coach seeks advice on how to best support a talented but highly resistant student who displays signs of Pathological Demand Avoidance (PDA). Dr. Duff dives into:
What PDA is and how it manifests in individuals, particularly in relation to autism, ADHD, and other neurodivergent conditions.
The importance of reframing PDA as a high drive for autonomy rather than defiance.
Practical coaching strategies to work around demand avoidance, including collaborative goal setting, offering choices, and making training sessions more engaging and playful.
The significance of open-ended questions and genuine curiosity in understanding the root of a student’s resistance.
A listener describes their struggle with long-term, low-grade depression despite attempts with medication and therapy. Dr. Duff provides insights into:
Understanding Persistent Depressive Disorder (formerly known as dysthymia) and how it differs from episodic major depression.
Behavioral activation as a treatment approach, including strategies for identifying and engaging in potentially enjoyable activities despite a lack of motivation or pleasure.
The five-minute rule to help overcome resistance to activities.
Medication considerations, including alternatives like Wellbutrin (bupropion) and the combination drug Auvelity, which may have fewer side effects.
Non-medication treatments such as Transcranial Magnetic Stimulation (TMS) and ketamine therapy.
The importance of evaluating life circumstances to identify external contributors to chronic depression, such as hidden identity struggles or unsatisfying relationships.
Chapters
[00:00] Intro and updates on Dr. Duff’s upcoming bipolar book [03:00] Question 1: Pathological Demand Avoidance (PDA) in coaching [12:00] Strategies for engaging students with PDA [14:00] Question 2: Chronic low-grade depression and treatment options [19:00] Behavioral activation and the five-minute rule [23:00] Medication alternatives and non-pharmacological treatments [27:00] Life circumstances and their role in persistent depression [28:00] Outro and listener support requests
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The Hardcore Self Help Podcast with Duff the Psych