Giftedness, Pathological Demand Avoidance and Burnout in Adults: My Story | Ep. 163

In this episode I talk about how I understand my autistic brain, my internalized pathological demand avoidance, and why it took me six years of working in this space before I felt certain enough to say this publicly. I also walk through my life, from childhood to the present, with renewed understanding, in the hope of sharing insights that can help you.

This episode is for parents of high-achieving young adults who burn out, for women exploring whether they might be autistic or pathologically demand avoidant, and for anyone who just wants to know more about the person behind this work (me!).

Key Takeaways

Why Casey Resisted Identifying Publicly for Seven Years | 00:06:29 Casey names three reasons she held back. First, she genuinely was not sure, because her experience did not feel like the veil-lifting moment many autistic adults describe, and she had other diagnoses that made the picture muddy. Second, her early experiences engaging with the autistic and PDA online community involved sustained harassment and cancellation attempts, which made that space feel unsafe rather than affirming. Third, her resistance to being labeled by others mirrored exactly what she teaches about pathologically demand avoidant children who reject diagnoses: it is a survival drive for autonomy, and that include identity.

What Her Internalized Profile Looked Like in Childhood and School | 00:18:25 Casey describes herself as an extraordinarily compliant and academically gifted child whose two special interests were academics and people. She explains that school functioned as a natural accommodation: it was predictable, she was consistently above her peers, and cause and effect was clear. At home, her parents' divorce introduced chaos, and her nervous system defaulted to freeze, fawn, and shutdown rather than fight or flight. She started writing in journals for hours as a way of processing social interactions and exerting control over her environment, which she now sees as the same mechanism as a child spending hours on a screen.

Burnout at 26 and the Panic Disorder Years | 00:27:55 Casey describes her first panic attack during a graduate economics exam at Columbia, followed by a full dissociative episode in the law library weeks later. She lost 20 pounds, could not eat or sleep, and could only function when physically close to safe nervous systems. She was prescribed medication, but she refused to take it for fear of addiction. She frames this period as a burnout triggered by the first situation in her life where she was not the best at something, in an environment where the rules of the game were no longer ones she could win.

Postpartum Burnout and What Cooper's Birth Revealed | 00:38:40 Casey describes going off her medication during pregnancy, an emergency C-section after 48 hours of labor where she felt she lost control of her body, and the 18 months of suicidal ideation and intensive outpatient psychiatric care that followed. She was diagnosed with postpartum OCD, anxiety, and depression. She now understands this as a profound loss of bodily autonomy compounding a nervous system that was already primed for that response.

Acceptance as the Shift That Therapy Alone Could Not Produce | 00:42:15 Casey describes reaching a point after years of EMDR, somatic experiencing, safe and sound protocol, havening, and meditation where she recognized that some of what she was experiencing was not going to be "fixed" by more therapy. It was brain wiring. She shares how she now applies to herself the same accommodation framework she teaches parents, including using the 4S's of regulation, attending hot yoga for sensory regulation, and protecting her close relationships as her primary nervous system resource. The intrusive self-critical thoughts, she explains, are her version of self-equalizing: a nervous system response to perceived loss of control that she is learning to accept.

Relevant Resources

What Is PDA — Foundation for understanding the internalized pathological demand avoidance profile Casey describes in this episode.

Burnout — Free class with context for the burnout patterns Casey traces across her own life.

Finding Meaning — Free class relevant for parents and adults exploring acceptance and long-term perspective.