All of us can recall experiences of rejection, whether in our professional lives, social circles, or romantic relationships. For many, the initial disappointment fades quickly, managed through effective Coping strategies. However, for some people, rejection can trigger an intense emotional reaction that feels disproportionate to the situation. This response can spiral into a cycle of hurt feelings, conflict, and negativity. In such cases, it might be more than just rejection sensitivity but Rejection Sensitive Dysphoria (RSD) may be at play.

What does Rejection Sensitivity look like in relationships?

To better understand how RSD manifests in real-life situations, we can imagine a common scenario between a couple, Jamie and Taylor. One evening, after a long day, Taylor mentions that they’ve been feeling distant and suggests they set aside some time to reconnect and talk about their feelings.

Jamie, who experiences Rejection Sensitive Dysphoria (RSD), might react very strongly to this suggestion. Instead of seeing it as a constructive opportunity, Jamie’s heart starts racing, and they feel an intense wave of shame wash over them. They are overwhelmed with thoughts like “I’m a terrible partner,” “I must be unlovable,” or “Taylor is going to leave me.” Rather than engaging with curiosity with Taylor’s suggestion, Jamie might withdraw emotionally or respond defensively, saying something like, “I can’t believe you think I’m not good enough!” This reaction could lead to a heated argument or prolonged silence between them, creating a cycle of hurt feelings and misunderstandings. This cycle might go on for days, with neither of them knowing how to stop it.

In contrast, if Jamie didn’t have RSD, they might hear Taylor’s suggestion and feel some initial sadness or worry, and they may want some time to process what Taylor said. But Jamie’s response to this suggestion would not cause enormous disruptions in their relationship. Before long, Jamie might respond with appreciation, saying something like, “Thank you for bringing this up. I’d love to talk about how we can reconnect. Let’s set aside some time for this conversation when we have more energy.” This interaction would foster connection and understanding between them. 

Research on rejection sensitivity

It’s important to note that RSD is not an official diagnosis in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). Rather, it’s a term used to describe a pattern of intense emotional experiences related to perceived rejection. The term was coined by Dr. William Dodson, a prominent figure in ADHD research and treatment, to describe the extreme emotional sensitivity and pain triggered by the perception of being rejected, criticized, or falling short of expectations.

Research indicates that adults with ADHD (Attention Deficit Hyperactivity Disorder) or Autism Spectrum Disorder (ASD) are more prone to experiencing Rejection Sensitive Dysphoria.  This may stem from differences in emotional regulation and brain structure. Moreover, adults with ADHD often report experiencing higher levels of criticism throughout their lives compared to neurotypical adults, potentially fostering an increased sensitivity to negative feedback or perceived rejection. 

What Are the Differences Between Rejection Sensitivity and RSD?

To differentiate between “normal” rejection sensitivity and Rejection Sensitive Dysphoria (RSD), it’s important to understand some key distinctions in how rejection is experienced and understood.

Emotional Responses:

When people without RSD experience rejection, these reactions may feel proportionate to the situation, and don’t cause major upheaval in their lives. While upsetting, these experiences are usually short-lived, without a major impact on emotional well-being. On the other hand, those with RSD experience emotional pain that can lead to dramatic mood shifts and a feeling of overwhelm or being out of control. And the emotional response to rejection can sometimes last for days.

Perception of Rejection

People without RSD have occasional concerns about rejection, but don’t have an overwhelming experience of being rejected. People with RSD are constantly on the look-out for rejection, and find signs of it all around them. They may be more prone to perceive rejection even when it isn’t actually happening.  

Impact on Daily Life

When people without RSD experience rejection, they can generally handle it without overwhelming distress and disruptions to their life. On the other hand, those with RSD find that rejection causes significant issues with various aspects of daily life, such as productivity and ability to focus. As a result, people with RSD may avoid social or work situations out of fear of the impact of rejection.

Self-Perception

People with RSD often have a chronic, negative self-perception, including feelings of a lack of self-worth and shame. In contrast, people without RSD may experience some sporadic and temporary self-doubt in the face of rejection.

How to Deal with RSD

There are several important strategies that couples can use in order to address the impacts of RSD on their relationship.  Using the example of Jamie and Taylor, where Taylor’s request for a conversation about their relationship triggered Jamie’s RSD, the following strategies could help.

Utilize Honest and Respectful  Communication

Using techniques such as softened start-up can help create a foundation of open communication. For example, “I feel worried when you approach me with relationship issues at the end of a busy day” instead of “you’re always complaining about something I did wrong.”

Develop Fondness and Admiration

Cultivating positive feelings towards each other can help buffer against RSD-related negativity. Both partners should regularly express gratitude to build a positive emotional bank account. Taylor could say  “I really appreciate your willingness to work on our connection,” and Jamie could respond with “Thank you for being patient with me when I struggle with these feelings.” 

Recognize Flooding and Develop a Time-Out System

When someone is overwhelmed and in a state of Diffuse Physiological Arousal, emotions can become overwhelming. In these moments, it’s critical to implement a time-out system, so that both partners can pause and re-engage when they feel calmer. Jamie could say something like “I need a moment to breathe and calm down. Can we pause for fifteen minutes?”

De-escalate Conflicts

Learn to recognize signs of escalating conflict and use techniques to calm the situation before it worsens. Jamie and Taylor could both implement a repair phrase to use If tension escalates, such as “can we take a step back? I want to understand you better.”

Practice Patience and Understanding

Managing RSD can be an ongoing process. If couples are able to acknowledge progress and appreciate each other’s efforts, they will be able to better deal with the challenges that they face. 

Seek Professional Support

If you or your partner feel that rejection sensitivity is impacting your relationship, individual and/or couples therapy may be helpful. Individual psychotherapy can help people with RSD to gain insight into their emotions, and learn skills for managing their responses. In addition, couples therapy can help both partners understand each other better, and develop tools for handling the impact of RSD on their relationship.