BFRB Treatment: Does a Child Have to Want to Stop?

It’s true we can’t force another person to be ready to change. But with Body-Focused Repetitive Behaviors (BFRBs), like hair pulling, skin picking, and nail biting, ambivalence about stopping isn’t resistance. It’s expected because the behavior is serving a function. It may be regulating arousal, soothing a difficult feeling, providing reliable sensory input in an […]

Parenting a Child With Pathological Demand Avoidance

I work with many parents who suspect their child might have pathological demand avoidance (PDA). They are overwhelmed and report difficulty finding health care professionals who understand their experiences. What Is Pathological Demand Avoidance (PDA)? PDA is a pattern of behavior that occurs in some children and adults with neurodiverse presentations, such as autism, ADHD, […]

Where Did My Loving Child Go?

It is not unusual for me to hear from parents whose now-estranged adult child once expressed deep gratitude for their upbringing and for the role their parent played in their life. Often, these affirmations were written or spoken not long before the estrangement occurred. Then, sometimes abruptly, communication stops—or resumes in ways that feel hostile, […]