Does Rejection Sensitivity Dysphoria Affect Your Family?

Both this month & last call our awareness to individuals with some form of neurodivergence. You may be seeing more of this discourse online and wondering what some of these phrases and acronyms means. Today we’re tackling RSD, or Rejection Sensitivity Dysphoria. What is this and what does it impact? Continue reading to find out!

WHAT IS RSD?

Rejection Sensitivity Dysphoria (RSD) is not a medical diagnosis but a way to understand a type of emotional dysregulation. As human beings we experience a myriad of emotions – joy, fear, worry, anger, frustration, etc. Regulation is how we manage those emotions – do we react intensely, immediately, not at all? Dysregulation is when an individual does not feel in control of emotional responses. People are labeled drama queens and kings, having anger issues, or being too sensitive. When, in fact, this is not a choice but linked to executive function or a sympathetic (fight/flight/freeze/fawn) nervous system response.

RSD is a heightened emotional response to perceived rejection, criticism and failure, often triggering feelings of depression, rage, anger, or severe anxiety. RSD is commonly associated with Attention Deficit/Hyperactivity Disorder (ADHD); however, RSD can be experienced by individuals with Autism Spectrum Disorder, Social Anxiety, and Trauma.

The cause of RSD is not fully understood. Experts believe that RSD may be linked to the differences in brain structure that make it harder to regulate these types of feelings, resulting in more intense emotional experiences. The brain’s sensitivity to social reward and rejection found in ADHD may also be a cause, relating to the nature of a person. Whereas correlations between the increased propensity of criticism, failure or invalidation endured by those with ADHD and ASD as children have a nurture effect on this heightened perceived response.

REJECTION SENSITIVITY DYSPHORIA CAN LOOK LIKE:

• Extreme defensiveness
• Replaying upsetting events obsessively
• Avoiding situations where rejection MIGHT happen
• People-pleasing and Perfectionism
• Low self-esteem and social anxiety
• Reacting strongly and/or quickly to feedback, abandonment, failure, or rejection
• Instantly assuming “I’m wrong, at fault, in trouble” and constant doublechecking with others that “you’re not mad.”

REJECTION SENSITIVITY DYSPHORIA CAN FEEL LIKE:

• SEVERE anxiety, avoidance, or big emotions before anticipated rejection
• Sudden OVERWHELMING pain after criticism or feeling left out
• Intense shame, embarrassment, or sadness
• Feeling REJECTED in situations others see as minor/neutral
• Rumination on the perceived rejecting situation, and an inability to shift these thoughts and perceptions or think about something else
• Rapid mood shifts
• Fearing Failure
• Abundant approval-seeking in relationships
• High/unrealistic self-expectations and extreme self-criticism
• Hopelessness

UNDERSTANDING RSD

RSD can affect personal relationships, work, and self-esteem. RSD affects both adults and children. The more we address RSD and how it affects ourselves, loved ones and co-workers, the more manageable and treatable RSD can be with the right strategies.

HOW DOES RSD AFFECT CHILDREN?:

School:

1. Fearing mistakes results in avoidance, limiting an ability to fully learn. School becomes a place to avoid embarrassment rather than a beacon for learning.
2. Interpreting correction as harsh criticism with possible extreme reactions
3. Missed assignments to avoid rejection or face possibility of imperfection
4. Often feels like a “target” of dislike from teachers
5. Oppositional behavior or shutting down
6. Emotional dysregulation disruptions
7. Low academic self-confidence and missed school

Friendships:

1. Misinterpreting social cues—always assuming the worst
2. Strong emotional reactions to minor conflicts, confusing peers
3. Difficulty handling conflict, resulting in trouble repairing – an essential skill for maintaining relationships
4. Constant reassurance-seeking behavior, leaving peers feeling overwhelmed and saying things such as, “you’re too needy.”
5. People-pleasing or over-attaching to one friend
6. Social Withdrawal—possibility of rejection is too overwhelming and not safe
7. Friendship instability—intense, fast relationships that can fall apart quickly
8. Low self-esteem, self-worth and self-confidence

HOW DOES RSD AFFECT ADULTS?:

Work:

1. Criticism/feedback at work can feel deeply personal, hindering work growth and creating anxiety.
2. Overthinking and misinterpreting social cues, assuming the worse
3. Avoidance and procrastination
4. Perfectionism and overcompensation, resulting in burnout and poor work/life balance.
5. Emotional reactions at work
6. Difficulty with authority due to intimidation, defensiveness, or conflict avoidance
7. Possibility of job instability, hesitation for new opportunities due to rejection-fear, or leaving jobs too quickly after perceived rejection

Relationships:

1. Intense fear of rejection/abandonment
2. Misinterpreting neutral situations – e.g. delayed text response = rejection/dislike; partner being quiet = you’re mad at me; constructive feedback = I’m always wrong
3. Emotional reactivity—defensiveness, anger, shutting down, depression
4. People-pleasing & accommodating = lack of boundaries leading to burnout and resentment
5. Fear of vulnerability = difficulty engaging vulnerably with loved ones
6. Reassurance-seeking cycles can put a strain on partners
7. Low self-esteem affecting relationships
8. Conflict escalation – minor arguments are experienced as catastrophic threats to the relationship, and become such

Parenting:

1. Emotional overreactions to child’s behavior, feeling intense pain when a child: talks back, does not listen/focus, or prefers one parent over another.
2. Guilt and self-doubt—overanalyzing small mistakes, leading to parenting insecurity
3. People pleasing/permissive parenting resulting from poor boundaries and fear of rejection
4. Difficulty with feedback from co-parents, teachers, family members, doctors, etc.
5. Emotionally withdrawing from child, affecting parent/child relationship
6. Inconsistent parenting styles due to emotional reactiveness, confusing children and creating a stressful home environment.

SO WHAT CAN WE DO?

First and foremost, give the benefits as much (or hopefully more!) air time than the costs. This particularly shines when considering its positive impact on one’s relationship to others. Those with rejection sensitivity dysphoria can be highly empathetic and understanding parents, partners, and workers. They often care deeply about others’ emotional experiences with a particular focus on inclusion. They can be highly sensitive and understanding to the needs and feelings of others, a skill necessary in successful parenting, leadership, and management. Individuals experiencing RSD can build very close, emotionally rich relationships because of this perception and focus on inclusiveness. They often stick up for the underdog and those in need. TODAY’S DIFFICULT TRAIT IS TOMORROW’S SUPERPOWER!!!!

Secondly, rather than avoidance, self-acceptance of your sensitivity to rejection is key, understanding the plethora of strengths that comes along with emotional sensitivity, not just its pitfalls. Seek support, such as therapy, targeting this specifically. It can help you learn to separate behavior from rejection, create and maintain boundaries, and learn that repair after conflict is what makes relationships successful, not avoiding conflict.

Here are some mindfulness strategies for RSD that can help:

• Nonjudgmental observation of self and others
• Pausing before reacting. It only takes the brain 3 seconds to reset from an emotional trigger. Take a breather before responding.
• Naming the emotion/experience and accepting it takes the fear out of rejection, creating empowerment of self. This signals the amygdala (fear brain component) that “we got this.”
• Setting clear boundaries with self and others to deter overcompensation and burnout.
• Accepting that RSD most likely won’t go away can also increase empowerment and decrease fear.
• Practice Does Not Make Perfect. PRACTICE IS PERFECT. FOCUS ON EFFORT NOT OUTCOMES. Practicing strategies to live with Rejection Sensitivity Dysphoria prepares one for life’s challenges with more peace and acceptance.

— Melanie K. Summers, LPCC