Can Mask Refusal be a Demand Avoidant Behaviour?

There are many videos circulating the internet featuring adults having disproportionally large and public negative reactions when they were told to wear a mask. What is causing people to behave so differently? What is driving this extreme resistance behind mask-wearing, from a mental health standpoint?

British Columbia has one of the best successes with flattening the COVID curve despite being one of the earlier provinces to get their first cases. British Columbians, in general, seem to have adapted to the social distancing measures and many have happily adapted to wearing a mask even when it is not enforced. So what worked?


Dr. Bonnie Henry, our provincial health officer, has become a household name in BC. Listening to her soft calm words has become a soothing daily routine for many British Columbians, but it is not just her voice and presence that matters.

The content and delivery of her messages are Trauma-Informed and Demand Avoidant.

Demand avoidance or oppositional defiance is not unique to children on the spectrum. Lots of neurotypical adults also reject or bristle under the authority or have difficulty complying with requests and rules. Everyone can probably think of an adult relative or two who have a hard time adjusting to new expectations or making compromises for others. Anger, irritability, arguing, defiance, or even vindictiveness can arise when they feel their sense of control or their personal identity is threatened. The more external pressure is exerted, the more they dig in.


According to Dr. Dan Siegel, a healthy mind construct and understand the personal identity as in relationship with others and our environment. There is "me", "we" and "mwe". The way we experience ourselves changes in a dynamic and fluid way in different environments. Who I am when I am talking to a client during a counseling session is drastically different than who I am when I am hanging out with friends, in more ways than just my behaviours.


Due to neurology and/or experience, sometimes people have a more detached and static concept of self-identity that has difficulty meeting changes in the expectation of the environment. Conscious or unconsciously, they believe making certain changes in behaviors, believes, or ways of thinking would change or damage their self-identities.


So how does Dr. Henry able to get us British Columbians to drastically adjust our lifestyles with so much success?

  1. She avoids making direct orders, except when absolutely necessary.

  2. She always gives choices on how to social distance. And uses words such as "we hope" and "we encourage".

  3. She focuses on positive personal strengths: be calm, show kindness, protect others, and protect ourselves. She inspires us to rise to moral obligation from our own desire to be a good citizen.

  4. She also frontloads repeatedly that her messages and decisions will change based on new information.

These are some of the same strategies I give parents to support their children with ODD and PDA. These are also simply respectful and positive ways for us to treat each other.


A recent survey showed that BCers are most willing to continue practicing social distancing than the residences of other major cities. I believe, because of Dr. Henry's methodology, we are rewarded with a sense of pride, accomplishment, and competence in our efforts. We are also more willing, even more than before, to trust and follow her advice.

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©2019 by Cherish Pediatric Therapy, Burnaby,British Columbia, Canada