What Is Rejection Sensitivity Dysphoria?
While fear of rejection can be, to a certain degree, considered part of the average human experience, those who experience rejection sensitivity dysphoria, or RSD, are highly attuned to both real and perceived threats of rejection and criticism. For these individuals, rejection can feel unduly debilitating as the pain and exclusion associated with it is felt by them in a deeper way, making it more challenging to bear. Already, we are relational creatures who evolved needing contact and community to survive and thrive; it can be encouraging to hear that awareness of that which could threaten this contact or sense of belonging comes from a socially adaptive motivation.
Rejection sensitivity dysphoria is most often seen in neurodivergent people, namely those who are diagnosed or who self-identify with attention deficit hyperactivity disorder, or ADHD. Research now recognizes RSD as a normal neurological, and often genetic difference of this neurotype. It is important to note however that other factors can impact emotional sensitivity, such as upbringing and lived experiences of trauma.
As a psychotherapist trained in psychodynamic models of practice, I understand that when an emotion is out of someone’s window of tolerance, their capacity to cope with it effectively is challenged. They may defend against it using strategies that demand less of their psychological resources in the moment to preserve a temporarily diminished coping capacity, while potentially causing them long term consequences.
They may turn against themselves wholly internalizing rejection or criticism, act out against and blame others, chronically behave opposite to how they feel, or deny their feelings altogether, setting the stage for long-term relational issues, like resentment.
It is not uncommon to use a pre-emptive strategy towards fending off rejection or the pain of prospective criticism as well, by hiding one’s true self from others, people pleasing, avoiding conflict, employing perfectionistic standards to behavior, or shutting down realistic efforts to remain in relationships compounding the impacts of isolation or social injury.
While psychotherapy may not change how intensely rejection sensitivity dysphoria is felt, it can help grow and improve an individual’s ability to cope or respond to it more effectively. Psychotherapy may expand our ability to tolerate and soothe difficult emotions particularly when approaches are rooted in showing acceptance and compassion, even for the parts of us that aren’t easy to deal with.
When our ability to tap into emotional resourcefulness grows, we may be less inclined to reach for quick fixes to strong feelings but be more able to bear the complexity of our internal landscape, communicate around it in a way that does not attribute the same level of blame or negative intent to others, and problem solve so that we can feel better.
Insight, context, and self-knowledge are also viewed by psychodynamic psychotherapists as powerful foundations for adaptive change. Naming our rejection sensitivity is often the first step to unblending from it. We can experience it while at once observing ourselves experiencing it; being in this space between can afford us greater choice about how to respond, particularly when we feel buttressed and seen in our struggles.
Psychotherapy can also serve as an exploratory field for testing our assumptions of other people, whether rejection is in fact occurring in relationship, and if it is, improving our ability to self-advocate in a way that preserves our self-respect as well as the dignity of others. It can also support us in fostering relationships where hypervigilance feels less necessary.
If you’re navigating rejection sensitivity, or rejection sensitivity dysphoria, connecting with a registered health care practitioner such as a psychiatrist, psychologist, or psychotherapist may support you in managing associated overwhelm, protective behaviors, and potential relational strain, while offering hope.