Dealing with criticism and rejection is difficult for everyone, especially if it has come from loved ones or from someone you look up too. Whilst some people are able to recover and move on from rejection easily, others can find it catastrophic to the point where it triggers an intense emotional outburst. This could be a sign that the person has Rejection Sensitive Dysphoria (RSD).
What is rejection sensitive dysphoria?
RSD is an extreme emotional sensitivity or pain that can be caused by criticism or rejection by another person1. These intense emotional reactions can also be internally triggered if a person feels that they have not met their expectations or feel like a failure. We know from research that children and adults with executive function challenges, particularly ADHD, are more susceptible to experiencing RSD2. A study found that 99% of teens and adults with ADHD reported that they are more sensitive to rejection, with 30% reporting RSD as the most impairing part of their ADHD3.
Why is it common in ADHD?
Difficulties managing emotions and controlling inhibitions are already recognised as ADHD symptoms. When this is paired with RSD and the experience of intense emotional distress, the ability to self-regulate emotions and behavioural responses can become more challenging4.
When we find ourselves experiencing intense emotions and distress the prefrontal cortex of the brain becomes disconnected which is key to using our executive functions. Research has shown that the experience of intense emotions reduces our ability to use many of our executive function skills including working memory5, attentional control6, cognitive flexibility7 (i.e. our ability to ability to think flexibly and manage unexpected change), metacognition (i.e. thinking about ones’ own thinking)8 and response inhibition5.
RSD does not just co-occur with ADHD. Individuals with other neurodiverse conditions such as dyslexia and autism spectrum disorder are also more likely to have significant challenges with their executive functions, resulting in similar difficulties with emotion and behaviour regulation.
What does RSD look like?
Those who experience RSD will often protect themselves from the extreme pain of criticism and rejection by avoiding trying anything new due to the fear and pain of failing or letting themselves or others down9. Other signs of RSD include avoiding situations in relationships where they could be hurt emotionally, social anxiety, setting exceptionally high standards for themselves and also low self-esteem. Research into self-esteem and ADHD estimated that by the age of 12, children with ADHD get 20,000 more negative messages about themselves, compared to positive messages, than their peers10.
Is there support available for me or my child?
Seeking support can help you understand your triggers and develop strategies for handling rejection so that you can regain control of your emotions and your life!
Working with an executive function coach on your ability to self-regulate your emotions and behavioural responses is one form of support. In fact, research suggests that self-regulation may be the key to coping with rejection sensitivity11. For example, when you perceive a potential sign of rejection, your coach can help you develop strategies so that you can stop and reflect on the situation rather than responding immediately. Several executive function skills are key here including response inhibition, emotional control, metacognition and cognitive flexibility.
Making these changes for yourself, or even your child, can easily start by booking a free 30 minute Insight Session with Sarah, our Client Services Manager. Sarah will help you find out more about the coaching process and will also discuss your needs, strengths and challenges more specifically. To ensure we match you with the perfect coach you will be able to schedule free chemistry sessions with up to 3 coaches of your choice.
Is there support available for my family, friends or work colleagues?
Yes, there is! We know from research that using empathy (i.e. feeling the emotion with the person) will support the validation of intense negative emotions which will help people with RSD move through these emotions. With this support from a family member, friend or work colleague, you will be able to have a rational conversation and work towards a solution together. Check out our short courses on ‘Using Empathy at Home’, ‘Using Empathy at School’ and ‘Using Empathy at Work’ on cimlearning.com. This is our online learning platform which has been developed to give everyone access to support and is the home to a range of affordable strategy-building courses, our Connected Minds Parent course, free resources and executive function toolkits.
By Becky Tyler, Connections in Mind
1Downey, G., Feldman, S. (1996). Implications of rejection sensitivity for intimate relationships. Journal of Social Psychology. 70 (6), 1327-1343.
2 Dodson, W. W. (2006). Real-world office management of ADHD in adults. Psychiatric Times, 23 (13).
3Scharf, M., Oshri., Eshkol, V., & Pilowsky, T. (2014). Adolescents’ ADHD symptoms and adjustment: The role of attachment and rejection sensitivity. American Journal of Orthopsychiatry, 84(2), 209-217.
4Kross, E., Egner, T., Ochsner, K., Hirsch, J & Downey, G. (2007). The neural dynamics of rejection sensitivity. Journal of Cognitive Neuroscience, 19(6), 945-956.
5Lindstrom, B. R., & Bohlin, G. (2012). Threat-relevance impairs executive functions: Negative impact on working memory and response inhibition. Emotion, 12(2), 384-393.
6Spada, M. M., Georgiou, G. A., & Wells, A. (2008). The relationship among metacognitions, attentional control, and state anxiety. Cognitive Behavioural Therapy, 39(1), 1-17.
7Caouette, J. D., & Guyer, A. E. (2016). Cognitive distortions mediate depression and affective response to social acceptance and rejection. Journal of Affective Disorders, 190, 792-799.
8Ayduk, A., Zayas, V., Downey, G., Cole, A., & Shoda, Y. (2008). Rejection sensitivity and executive control: Joint predictors of borderline personality features. Journal of Research in Personality, 42(1), 151-168.
9Canu, W. H., & Carlson, C. L. (2007). Rejection sensitivity and social outcomes in men with ADHD. Journal of Attention Disorders, 10(3), 261-275.
10Jellinek, M. S. Don’t let ADHD crush children’s self-esteem (2010). MD edge Psychiatry.
11Aduk, O., Mendoza-Denton, R., Mischel, W., & Downey, G. (2000). Regulating for Interpersonal Self: Strategic self regulation for coping with rejection sensitivity. Journal of Personality and Social Psychology, 79(5), 776-792).
