Understanding Rejection Sensitivity and How to Manage Emotional Responses

a person rejecting a rose being offered by another

Being able to take criticism or rejection in stride isn’t just a lovely idea, it’s a superpower. At least, that’s how it may seem to someone who experiences rejection sensitivity. Why? Because they would experience these things with extreme, unbearable intensity. Here are some things you may have said or heard related to rejection:

“I am slouching really bad and I feel nauseous. I am scared he/she doesn’t like me anymore.”

“My heart is beating faster and I have to think hard about breathing. I am terrorized by the fear that they hate what I said.”

“It's hard for me to explain, but I feel devastated about needing to talk to my boss. What if she wants to fire me?”

“My partner said they didn’t mean it the way I took it. So why am I feeling such disproportionate criticism and abandonment?”

Rejection sensitivity can manifest as interpreting social cues (“my partner didn’t pick up the phone when I called”) as outright rejection (“they are mad at me”), disregarding logical explanations (“they are at work/driving/with their friends”) and reassurances (“they couldn’t get to the phone and they said they loved me”). Something increasingly being referred to as Rejection Sensitive Dysphoria can push others away, creating a self-fulfilling prophecy (“I knew they would leave/I knew I was unlovable”)  and actually be the cause of the rejection one fears. (1)(2)(5)

It’s valuable to note that rejection sensitive dysphoria is not a mental health diagnosis with empirically quantifiable criteria. It is an observed emotional response that some may experience in any of the following mental health diagnoses: 

  • Depression

  • Borderline Personality Disorder

  • Autism

  • Social anxiety

  • PTSD

  • ADHD (2)

Understanding Rejection Sensitivity

The experience of sensitivity to rejection is described as extreme despondency, distress, or failure that may reach a point of panic or high anxiety when possible rejection is perceived. There is a community of clinicians and psychologists that see the high co-occurrence of rejection sensitivity as a part of the general emotional reactivity already present in populations with certain mental health conditions. It is not fully understood why this manifests, but some theorize that the parts of the prefrontal cortex and amygdala (processing, responding to, management of emotional awareness and negative messaging) that incrementally become better at self-control, organization, and processing signals as one ages, may not be able to regulate signals properly or typically, thus making negative emotions too painful to bear or too heavy a burden to keep in check (Emotional dysregulation). Others see a connection to biology, and inherited traits, as playing a role. More research, however, is needed to definitively link these theories. (4)

It is reported that rejection sensitivity typically is marked by a mood change that has a clear trigger, is seemingly instantaneous, and doesn’t last very long (a couple of hours, tops). Triggers are commonly real or perceived rejections of love, approval, or respect. This can come in the form of teasing, criticism (positive or negative), or negative self-talk initiated by a perceived or real shortcoming. As the mood may instantaneously shift, the person may seem to be experiencing a major mood disorder episode (sometimes with thoughts of self-harm). If the trigger is not clear, unconnected to what is occurring in the person's life, and sets in gradually, the shift in mood may not be a mood disorder episode. (2)(3)(4)(5)

What can it look like?

  • Emotional outbursts: sudden, and coupled with rejection or criticism, real or perceived 

  • Isolating or withdrawing from social events or spaces, or avoiding anything that they believe they could fail at something or be criticized 

  • Thoughts involving self-harm or negative self-talk, becoming their own worst enemy 

  • Low self-worth, or a persistent negative self-perception

  • Rumination

  • Report being “constantly attacked” by people they are in relationships with and responding defensively (2)(3)(5)

This sounds familiar. What can be done?

  1. Treat co-occurring mental illness

Treating symptoms in the above-mentioned diagnosis may effectively help with relieving the intensity of rejection sensitivity. Sometimes just being aware you have an increased sensitivity can offer compassion a place to develop. This can help a person cope more effectively. Learn more about mindfulness and how to identify negative thought patterns that spur feelings of rejection. (1)(2)

2. Compassion

Trying to challenge rejection sensitivity can be a street fight in your head. Sadly, pitting logic against feelings in this case results in “feelings” coming out on top. Trying to ignore it is often not effective either. Try personal validation and acceptance, while also having compassion for yourself. What you feel may not align with what is true, but those feelings will need to be heard and validated before you can offer logical course correction. (1) (2)

3. Report to yourself

How does someone acknowledge the negative projections (worry, fear, abandonment) that accompany rejection without agreeing with it? One way is to report to yourself about what your bodily sensations are. First, say out loud what the emotions are making your body feel: heavy ball in your tummy, tight muscles in your neck and throat, tenseness in the shoulders or hands, buzzing in your head. Next, report that the sensations are connected to feelings, not facts. This is not the same as pushing feelings away. Reporting to yourself is helping you get to know your feelings and sensations better. (2)

4. Cognitive reframe

Failure, rejection, and imperfection are a natural part of growth and development. When we experience these things we can grow from them. Try spinning the story to acknowledge that we are all imperfect, and normalize the experience despite its difficulty. Practice saying to yourself that not every rejection is about you, and when we experience rejection, it does not identify or define us. (2)(3)

5. Couples Therapy

Break out of the conflict cycles caused by one partner's recurrent rejection sensitivity. Hypersensitivity to perceived slights from a partner can negatively impact relationships, leading to negative thinking and relationship sabotage. People with rejection sensitivity often misinterpret neutral or positive actions as negative, causing unnecessary withdrawal. By improving communication skills and understanding rejection sensitivity signs, coping strategies can be developed to build healthier relationships. (3)(4)

6. Minimize social media

Social media often highlights positive aspects of others' lives, triggering someone to sense they are not “enough”. This is, of course, an unhealthy comparison, which fuels feelings of inadequacy and perceptual exclusion and rejection (“no one is liking my post” “no one is commenting on my post”). Awareness of how engaging with social media affects you personally and setting boundaries can help manage the effects of rejection sensitivity.

Some medical interventions exist and have been found to be helpful

Talk with your doctor about what medication might aid with building “emotional armor.” One report outlined “clonidine and guanfacine” were effective at relieving symptoms of rejection sensitivity and emotional dysregulation  “in about 60% of adolescents and adults” with ADHD.

Rejection sensitivity is not found in the DSM as a formal diagnosis, but it is a common and disruptive manifestation of emotional dysregulation among certain mental illnesses. As disruptive as this emotional expression can be in relationships and the lives of those experiencing it, there is hope for change. Where there is willingness, there is a way. 

https://www.psychologytoday.com/us/basics/rejection-sensitivity

2 https://www.urmc.rochester.edu/behavioral-health-partners/bhp-blog/august-2023/rejection-sensitivity.aspx

3 https://www.calm.com/blog/rejection-sensitivity

4 https://www.webmd.com/add-adhd/rejection-sensitive-dysphoria

5 https://www.additudemag.com/rejection-sensitive-dysphoria-adhd-emotional-dysregulation/


Roubicek & Thacker Counseling is Fresno’s premier provider of individual, couples, family, and group therapy. We offer in-person and online remote therapy sessions. Contact us today to change the way you feel.

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