Demand Avoidance Is Autistic History

PLUS: thoughts on Highly Sensitive disavowal, what it could mean to have an autistic politics, and a few good podcasts and video essays

Hello slugs! I’ve been taking a little summer break, seeing family and reconnecting with old friends, and it’s been really nice. In this week’s scrapbook of things I’ve been pondering of late, I have thoughts on what the history of Nazi psychiatry can tell us about ideas like Pathological Demand Avoidance and Highly Sensitive Persons, plus some podcast and video essay recs for paid subscribers.

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Asperger in his clinic, trying to contain dis-order

I’ve finally gotten around to reading Asperger’s Children, a history of how Nazi psychiatry shaped ideas about autism by Edith Sheffer, and it is fascinating. Throughout the book, I keep thinking of another text by my friend Devon Price: I’m Pathologically Demand Avoidant. It Rules.

Devon’s piece responds to the recent surge in popularity around the idea of Pathological Demand Avoidance, which many consider a specific subtype of autism, proposed by British psychologist Elizabeth Newson in 1980.

The PDA infographics are multiplying. Parents, therapists, and self-described PDAers are trying to nail down what exactly PDA is, with many insisting it’s distinct from trauma responses while simultaneously using trauma terminology to describe it, or that it must be some kind of genetic or neurological, hard-wired part of “the survival brain” yet to be discovered.

Even professionals in the PDA world are having trouble writing diagnostic guidelines for it, as one popular PDA blogger Sally Cat writes, “The presence of PDA is something they can feel, but this isn't tangible enough to put down on paper.”

I don’t think demand avoidance is a separate piece, but rather, a key thread running through autistic history, and Sheffer’s book illuminates just how central demand avoidance was to early theorizing about autistic children.

Asperger called it “autistic psychopathy” back then — we did not get the term Asperger’s Syndrome until Lorna Wing revived Asperger’s research in the 80’s. While he never officially joined the Nazi party, Asperger was an enthusiastic member of far-right-wing medical organizations, many of his professional mentors were Nazi party members, and he worked within a Nazi psychiatric system that shaped his theories.

“Autistic psychopathy” was based around the Nazi idea of Gemüt, an untranslatable German word that was used to describe the “fundamental capacity to form deep bonds with other people,” as Sheffer writes. This was crucial for Nazi collectivism — loners, rebels, and deviants of any kind were threats to the nation, so children who had “deficient Gemüt” were singled out by psychiatrists and institutionalized, sterilized, or euthanized.

As Sheffer notes, these ideas were already circulating amongst Nazi doctors — Asperger just put a label on them. Documentation from his children’s clinic is full of lines about demand avoidance:

Fritz “never did what he was told.” He did “just what he wanted to, or the opposite of what he was told.”

Harro purportedly “did not do what he was supposed to do,” rather “exactly what he wanted to.”

Margarete was said to have “impossible conduct at home.” .. According to the district commissioner, “If the mother then talks to her, she just jumps out of the window (apartment is at ground level) and runs away, suddenly disappears, and simply stays out for half a day.”

Asperger based his thesis on autistic psychopathy around boys like Fritz and Harro — “the autistic personality is an extreme variant of male intelligence,” he wrote. Despite describing girls like Margarete similarly in his notes, he chalked their behavior up to hormones and menstruation. Where the boys got special tutors, the girls were marked “ineducable” and sent to Speigelgrund, the clinic where child euthanasia was performed.

Newson’s theory of PDA described what she considered a subtype of autism characterized by “imaginative ability”, being “unusually sociable” and sometimes engaging in “social manipulation”, and she identified many more girls with this profile than was typical for “classic” autism.

Devon argues that we should consider this masked autism instead, something that arises not just in girls, but in anyone with a marginalized identity that is forced to learn to navigate social situations to survive. You can see this in Sheffer’s descriptions of the girls at Asperger’s clinic.

Margarete, having been sent to Speigelgrund twice, tried to perform good behavior to the staff. They noted that she hung around trying to listen to their meetings, aware that she was being discussed and anxious about what they might say. Staff did not believe her performance, however, calling it “suspicious piety” and “completely unreliable”.

Both girls and boys at Asperger’s clinic were imaginative, but where he praised the poetic speech and wordplay of the boys, he was annoyed when the girls made up rhymes, with one note in Margarete’s file saying it could be due to “manic depressive insanity”.

“Diagnoses reflect a society’s values, concerns, and hopes,” Sheffer writes, and PDA is no exception. In a critical paper on PDA, the scholar Damian Milton writes:

“The avoidance of demands is interactional in nature, and much like a lack of social reciprocity cannot be located solely in the mind of any one individual.”

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A Few Thoughts on Highly Sensitive Disavowal

Sheffer’s book also has given me an angle for thinking about another autism-adjacent identity term — the Highly Sensitive Person.