Rejection is not a tasty dish. The feelings we experience when we feel rejected are not pleasant. In fact, rejection has been shown to activate the same brain regions as physical pain.
However, some people experience a greater sensitivity to rejection than others. These people can perceive a greater rejection than what really exists and this generates a level of anguish and emotional pain that becomes overwhelming and persistent. In those cases, it is possible that it is a rejection-sensitive dysphoria.
What is rejection sensitive dysphoria?
The word “dysphoria” means dissatisfaction or discomfort and refers to a general state of unhappiness, hopelessness or discomfort. Rejection-sensitive dysphoria is not a psychological disorder itself, but an intense feeling of unhappiness and emotional overflow that occurs as a result of rejection and criticism.
Basically, it goes beyond rejection sensitivity to become an overreaction to real or perceived rejection that stems from hypersensitivity. That means these people often view events through that filter, so even valence-neutral comments or interactions where most people wouldn’t feel rejected, generate an exaggerated response.
In fact, the concept of rejection-sensitive dysphoria has points in common with the construct of interpersonal sensitivity, according to which the person shows an excessive awareness and sensitivity towards the behavior and feelings of others. People with high interpersonal sensitivity are particularly preoccupied with situations of criticism or rejection, remain overly attentive to the behavior and moods of others, and are overly sensitive to problems in interpersonal interactions.
Rejection-sensitive dysphoria is often associated with ADHD. In fact, the concept was coined in the 1960s by Paul Wender, who was the first to recognize emotional dysregulation as a persistent, prevalent, and highly detrimental component of what we now know as ADHD.
However, new studies have also linked extreme rejection sensitivity to depression, anxiety, and borderline personality disorder. The truth is that anyone can be extremely sensitive to rejection without suffering from some of these psychological conditions.
The origin of extreme sensitivity to rejection
A study conducted at the University of California indicated that extreme sensitivity to rejection can develop as a result of an early experience of rejection, neglect, or abuse. In general terms, it can be the result of exposure to situations in which the physical or emotional acts of others, whether overt or covert, active or passive, have communicated rejection.
Those experiences may explain differences in brain responses to rejection. Neuroscientists at the University of California also found that people with rejection-sensitive dysphoria had increased activity in the dorsal anterior cingulate cortex in response to facial expressions of disapproval, but not to facial expressions of anger or disgust.
That finding suggests that, at the neural level, people with higher rejection sensitivity may be more sensitive to potentially rejecting facial expressions, but not to threatening facial expressions in general. Therefore, rejection-sensitive dysphoria may be qualitatively different from general sensitivity to threat.
It is likely that rejection-related and potentially traumatic life experiences have generated an activation response of a hypersensitive nervous system that can cause the person to react more strongly to threats and criticism.
The problem is that, once set in, that hypersensitivity perpetuates itself by leading people to process information in ways that prioritize detecting and responding quickly to rejection threats by becoming defensive.
In fact, rejection-sensitive dysphoria involves three different mechanisms:
1. Anxious expectation of rejection or criticism
2. Quick and slightly distorted perception of rejection or criticism
3. Exaggerated emotional reaction to rejection or criticism
Symptoms of Rejection Sensitive Dysphoria
Rejection Sensitive Dysphoria is not about having too thin skin or being the king of the drama, the person actually experiences genuine and intense pain from feeling rejected. Some of the most common symptoms are:
• High sensitivity and apprehension about the possibility of being rejected, criticized or excluded, which generates anxiety.
• Frequently experiencing a physical reaction of discomfort due to a feeling of not fitting in or being misunderstood, some people may feel nauseated or have a knot in their stomach while others have chest pain or palpitations.
• Need for approval and validation that makes self-esteem depend on what others think, generating intense frustration and unhappiness when it is not received.
• Incessant and negative ruminative thoughts about rejection situations, which can last for days after the event, causing considerable emotional distress.
• Exaggerated emotional responses to a perceived offense, such as crying or uncontrolled anger.
People who are highly sensitive to rejection pay too much attention to details in interpersonal relationships and often jump to conclusions out of context that validate their fear of rejection. A delay in responding to a message, for example, will be perceived as a rejection.
As a result, they tend to dwell on what they said or did “wrong.” They also often self-sabotage and end up pushing the other person away because their defensive attitude conveys the idea that they are not interested in the interaction.
Some people with rejection-sensitive dysphoria may manifest it by continually second-guessing their actions and seeking confirmation from others. Others may become shy and isolate themselves to prevent rejection. Some very controlling people may also have rejection-sensitive dysphoria since controlling others is their way of keeping them from abandoning them.
The 5 keys to dealing with rejection hypersensitivity without breaking down
1. Accept rejection as part of life. Although it is difficult to manage, criticism and disapproval are part of life. We can’t always avoid these situations, so it’s best to understand that we can’t fit in with everyone, in every place, and in every circumstance.
2. Focus on the circle of trust. It is not about confining ourselves in our circles of trust, but about balancing our vision and understanding that, just as there are people who support us, there are also people with whom we do not fit. That will help us eliminate the negativity linked to hypersensitivity to rejection.
3. Practice Mindfulness meditation. Mindfulness meditation can help us recognize the thoughts and feelings that we experience when faced with criticism or a feeling of rejection, but without clinging to them. This way we will avoid falling into a toxic loop.
4. Delay response. To deal with rejection-sensitive dysphoria we have to learn to control the first impulses. It is about learning to respond, instead of just reacting. Waiting a few minutes can give us the necessary time to evaluate if our reaction is proportional to the situation or if we are exaggerating.
5. Take care of yourself and love yourself. Rejection sensitivity stems primarily from focusing on others. However, when we shift focus to ourselves, everything changes. If we learn to treat ourselves with love and respect, we will be less dependent on external validation and rejection or criticism will affect us less.
Sources:
Bedrossian, L. (2021) Understand and address complexities of rejection sensitive dysphoria in students with ADHD. Disability Compliance for Higher Education; 26(10): 4.
Gao, S. et. Al. (2017) Associations between rejection sensitivity and mental health outcomes: A meta-analytic review. Clinical Psychology Review; 57: 59-74.
Berenson, K. R. et. Al. (2009) Rejection sensitivity and disruption of attention by social threat cues. J Res Pers; 43(6): 1064–1072.
Ayduk, O. et Al. (2008)Applying the cognitive-affective processing systems approach to conceptualizing rejection sensitivity. Social and Personality Psychology Compass; 2(5): 2016-2033.
Burklund, L.J. et Al. (2007) The face of rejection: Rejection sensitivity moderates dorsal anterior cingulate activity to disapproving facial expressions. Social Neuroscience; 2(3-4): 238–253.
