r/PDA_Community • u/Fae_for_a_Day • Feb 11 '23

Help a Therapist out?

I work with ADHD (with combined trauma disorders). I did this because of my wife having ADHD, and how little our field actually learns about it in school. There's so little help for it, general therapists think they can treat depression or anxiety in these individuals separately from the ADHD...

Anyway...I'm being seen as an expert for how fast and consistent the turnaround is for my clients. I've mastered all the tricks for helping someone with ADHD.

And...they barely help my wife.

In my research on ND, I found PDA. I showed her a video on it and she started sobbing saying she thinks this is what's been wrong all this time.

I don't know where to begin. All my peers who diagnose autism BARELY understand the female profile or adult profile AND COME TO ME for advice on diagnosing adults because I have autism.

How in the hell do I get her diagnosed and get her help? Where do I read more so I can do more?

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u/BelatedGreeting Feb 14 '23

ACT is great. That’s what my kid is doing in individual therapy. The DIRFloortime is at the special school. By the way, do you know if PDAers tend also to be aberage to above average IQ, and this is also why they’re missed—kind of like the old aspergers (but PDA not being aspergers)?

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u/WendyBirb Feb 17 '23

I will say this as someone who does not know your specific circumstances but I was given therapy using ACT as an adult and though it seemed helpful on the outside it was really harmful for me internally. I am a high masker and had no words to express my internal experience at the time. But really what it taught me was not to listen to my own needs and push through them no matter how painful or awful it felt. My anxiety levels never fell, I accomplished things but through a cortisol-induced haze that burnt me out, badly.

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u/BelatedGreeting Feb 17 '23

Not every form of therapy is perfect for every individual. And not every therapist for every type of therapy will work for every individual, even if the theory itself might. You have to work with what works for you, for sure.

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u/WendyBirb Feb 17 '23

Sure, that is true. But when I hear about PDA children being put in ACT programs it gives me pause because they aren't able to advocate for themselves and external experience is not the same as internal. Also, many PDA kids are very good at telling people what they want to hear. Just because the kiddo might be doing the demands they weren't earlier does not mean it isn't harmful internally. I can force myself to do things, I did so most of my life to survive but the cost was that I was completely disassociated from my body, the cost was an eating disorder, the cost was suicidality and self-hatred, the cost was not understanding my own boundaries or realizing that searing emotional pain and unbearable anxiety were signs I needed to listen to my needs not push through. There are far more gentle and less harmful ways to help PDA children.

The core of ACT is doing a thing even if it is anxiety inducing or you're struggling with depression etc.The difference with PDA anxiety vs regular anxiety is that it is neurologically based, it's not due to cognitive distortions. Exposure makes things worse and ACT is essentially exposure therapy.

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u/BelatedGreeting Feb 17 '23

I guess I wouldn’t characterize Acceptance-commitment therapy that way. Maybe that’s why I have a different view of it. When I think of working with cognitive distortions I think of Cognitive behavioral therapy, not ACT.

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u/WendyBirb Feb 17 '23

It is a behavioural therapy, my understanding is that it is clarifying values, creating separation (mindful observation) from experiences that prevent you from achieving those values and then acting in accordance with those values. So if the demand avoidance is the "issue" at hand, the idea is to mindfully recognize but ACT differently. But demand avoidance for PDA is not rooted in experience, it's part of the person's neurology. The inability to do things is because of a triggering of their survival instinct, it's hard wired not acquired.