Rejection Sensitivity

Rejection Sensitivity is a strong reaction to perceived rejection or actual rejection. Rejection Sensitivity can be triggered by the fear that you have something wrong, even if it is tenuous, and that the other person will act on it, it can be triggered by feedback that is either perceived or actual negative feedback. Rejection Sensitivity can drive behaviours that you later regret, but in the moment you feel powerless to stop them. Rejection Sensitivity is often experienced as a secondary symptom by people with Social Anxiety, Autism and ADHD. Rejection Sensitivity is most commonly caused by biological conditions, and exacerbated by real life experiences.

Understanding Rejection Sensitivity

Rejection Sensitivity is primarily a consequence of biology.

We can manually shift our mood a step or two on a 10 point scale. It is very hard to maintain a shift beyond that. If you are 3 or more steps out of alignment to your surroundings, it is probably a biological origin. Biological problems need biological solutions.

Rejection Sensitivity Feels Like…

When we perceive rejection, or think it may have happened, we will feel a strong physiological and emotional response.

Rejection Sensitivity can feel like:

  • Physical:
    • A tightening or clenching in the guts.
      • Sometimes it can feel like we have been punched.
    • A tightening of the chest.
      • Breathing can feel hard.
      • Our heart can beat faster.
      • We may mistake this for a heart attack.
    • Tingling in the arms.
    • Ringing in our head.
    • A feeling of nausea and or disiness.
  • Emotional, feelings of:
    • Shame
    • Guilt
    • Fear / Anxiety / Worry
    • Anger
    • Ruminating on conversations and looking for:
      • Signs of danger from others; that is, indications from their body language, choice of words or cadence that they meant something more. We are seeking the early warning signs of rejection and or abandonment.
      • Indications that we said something that was either deliberately mean, or would be taken as wrong by the other person.
  • Behaviour:
    • Analysing conversations.
    • Frequently checking with people that they weren’t offended.
    • Frequently checking with people that they don’t hate us / still like us.
    • Avoiding people.
    • People pleasing / conflict avoidance.
    • Agression:
      • Picking fights.
      • Trying to find fault in others.
      • Prematurely ending friendships / relationships before they can abandon or reject you.

Rejection Sensitivity is a flavour of a miss-triggered Survival Response – Freeze, Fawn, Flight or Fight.

Biology – Threat Detection Errors

Our brain is trying to predict what to do, whether that is to work out how to defeat a threat / problem, or to heal and prepare.

To do this, it looks at the current perceived situation, made of a combination of sensory input and understood context clues from historical patterns and making assumptions from interpolation (filling in the gaps); then it triest to identify what is going to happen next by applying prior learning to the current perceived pattern and extrapolating (extending the pattern) the next outcome. If you know what is coming next, you might change your actions to shift the outcome to be more favourable. This is true for all consciously awake people.

A part of perception is how our Amygdala (part of your midbrain limbic system) assigns risk value to events that you perceive. It does this by looking at the raw feed of your sensory inputs at the cerebellum (hindbrain, just above your spine) and comparing that to information in your thalamus and hypothalamus. When this works well, you can recognise problems and may even have some solutions primed to those problems, or that you are not in danger and therefore safe. If we recognise the genre of problem, our prefrontal cortex (the front 1/3 of your brain, behind your forehead) will receive a feeling of fear, anger or disgust. If it can’t identify the genre, but also can’t confirm that you are safe, you feel a general feeling of unease. This can trigger the feeling of anxiety or aggression. If your Amygdala knows that your current situation doesn’t match a problem, then it will report “safe” and you will feel comfort, at ease and joy is available.

If you detect “safe”, you might use this time to heal, relax, recuperate, prepare for the future, create and so on.

If you detect “unsafe”, your prefrontal cortex, once armed with a feeling of fear, anger, disgust or unease, will try to identify the problem, looking for the threats in the environment. If you detect a threat, you will start to solve for that. If you have no time, then you’re response will focus on the Survival F’s – Freeze, Fawn, Flight and Fight. If you have time, your method for solving the problem can be more creative and nuanced.

Image of male indicating rejection with the "thumbs down" hand sign
Being Rejected – “You have been voted off the team…”

For Rejection Sensitivity, your Amygdala continually reports to you that you are “not safe“, but doesn’t specify why. Your prefrontal cortex looks for a clear and present danger, but usually can’t find it. Then it checks for subtle threats, such as signs of a predatory animal, signs of a predatory human, or some other disaster. If you convince yourself that this is not true, then the next likely threat must be societal. That is, ‘what if something is wrong with the people you think you can trust and who you hope love you – and maybe you caused it?’

There are several reasons why your Amygdala can’t confirm that you are safe.

The most common and likely is biological problems, most commonly with the Dopaminergic System. This can be exacerbated by historical conflict and or present conflict. Sometimes, this can be caused by a historical traumatic problem.

We’ll cover those in another section.

Rejection Sensitivity or Rejection Sensitivity Disphoria?

Rejection Sensitivity is an umbrella term that includes both the specific experience of over reacting to actual, perceived or expected rejection; and the rest of the RS family (covered below). It was first described by Downey, Khouri, & Feldman in 1997 as a model to describe how prior rejection plus some physical aspects could lead to an over sensitisation to being rejected, leading to a higher reaction the next time a person perceives rejection.

Dr William Dodson, a psychiatrist, shared a paper in 2017, where he discussed how ADHDers can often have a mood dysregulation especially around feelings to do with rejection. Dodson proposed that RSD, Rejection Sensitivity Dysphoria, should be added as a selection criteria to the DSM for ADHD diagnosis, and that this trait had been deliberately not included “because it was not always there, it was often hidden by
the person with ADHD, and because there was no way to measure rejection.” Dodson added the “dysphoria” to emphasis the extreme feeling of pain and aversion that this symptoms has over the typical discomfort from being rejected.

To date, RSD has not been added to the DSM 4 or 5, nor the ICD 10 or 11.

Amongst some sectors of mental health, there was push back about this new proposed initialism, as the existing Rejection Sensitivity definition isn’t just referring to a momentary discomfort from being rejected, it is referring to the sensitivity someone may develop to being rejected due to extenuating circumstances and how that may affect you. As an analogy, chronic pain rather than just pain. Adding on “dysphoria” is like saying chronic pain max (we really mean it!).

Despite this redundancy, RSD has become the de facto standard in online communities.

Social Acceptance and Masking

Masking is a mechanism used by neurodivergent people, such as Autistic and ADHDers, to fit in with others. Masking is not evil. All people do it to some extent – no one is 100% themselves. Part of working with other people is adapting and adjusting, that’s part of civilisation.

Masking becomes a problem when:

  • It is used to negate the authentic self (ABA).
    • This is beyond the scope of this page.
  • You lose track of who you are behind the adjustments.
    • This is also beyond the scope of this page.
  • Rejection uncertainty.
    • Covered below.

Why do we mask?

When we try to make new friends (or positively interact with strangers), we hope the other person is a good person who is worth being friends with. To help them like us, we want to “fit in” with them. What does “fit in” mean?

We are seeking connection with someone else because we need something. Humans are social creatures, we do poorly on our own. At the least we want to spend some time around reasonable people for our own mental health. Sometimes, we want specific help. Navigating the conventions of a different neurotype can be very hard.

The reciprocal aspect of us needing something from them is that we need to provide them something that they want or need. Our own low self worth often suggests that we are not enough in and of ourselves for them to seek us out for just human connection, so surely, our brains tell us, we have to give them something more.

We try to figure out what they want or need, and if we can find that, if we can fulfill that. To decrease the risk of immediate rejection from the group, we may offer gifts, services and work extra hard to compensate for our perception of our own low worth. It is not uncommon for us to put so much work in, that we are doing the work of 2 or more people (consider how many people it would take to replace you at work).

Every group has a set of rules of inclusion and exclusion that defines this group as different to another group. Some of these rules are explicit, written down for social clubs or clearly voiced by someone. Most of the rules are implicit, where you are expected to read between the lines, pick up on the standards by observing people or work it out after you have broken them and received scorn. We are terrified of rejection.

Me mask to fit in.

Rejection Uncertainty

If you are masking heavily, and you are not accepted by a person or the group we want to work out what went wrong.

We are uncertain about the rejection for various reasons.

  • Was something was wrong with your mask?
  • Did they see you behind the mask, and didn’t like you?
  • Did someone else said something about you?
  • Was it the Uncanny Valley?

Uncertainty is a huge trigger for anxiety. In not knowing, we often create so many scenarios that are far worse than what actually happened.

The Rejection Sensitivity Family

Rejection Sensitivity is an umbrella term for a host of feelings beyond just Rejection Sensitivity.

Rejection sensitivity

  • An over strong reaction to perceived or actual rejection.

Imposter Syndrome

  • A persistent inability to believe that your success is deserved, and or has been legitimately achieved as a result of your efforts or skills and the fear that you will get caught by someone at any minute.

Fear of Betrayal

  • Fear that people whom you trust and are vulnerable to will betray you sooner or later.

Fear of Abandonment

  • Fear that people will leave you behind, especially when you need help.

FOMO (Fear of Missing Out)

  • The feeling you have when you think other’s are having fun or an experience, and you are falling behind them.

Fear of Failure

  • The worry about how people will react when you inevitably make mistakes
  • The fear that you are responsible for the consequences these mistakes will have to you or others.

Fear of Being Alone

  • Fear that you won’t have friends or anyone you can trust.
  • Fear that you will never have anyone be kind to you again.

Fear of Conflict / Conflict Avoidant

  • Fear of conflict that leads to avoiding people, anything that resembles conflict and can trigger People Pleasing Behaviours.

People Pleasing Behaviours

  • The automatic “yes” you say when asked to do anything, which you often regret later.
  • The Faun part of the emergency system, Freeze, Faun, Flight and Fight.
  • People Pleasing tries to pre-empt the danger someone may pose to you if they are upset or angry by making them very happy with you at all times.

PDA (Pathological Demand Avoidance)

  • The automatic “no” you say when asked to do anything, which you often regret later.

To manage each of these, people can form People Pleasing and conflict avoidance behaviours, where you avoid ever pointing out someone else’s mistakes and take on far, far, far too much responsibility. You do this until you collapse in exhaustion and likely experience burnout.

More on PDA, Pathological Demand Avoidance

Managing Rejection Sensitivity

Medications

Noradrenaline is a neurotransmitter that strongly affects how our Amygdala manages threat detection. Depending on if we detect a threat or determine that we are safe, our priorities and feelings (mood) will adjust. If our Noradrenaline is outside of the Goldilocks Zone (too high or too low), our Amygdala cannot correctly identify when we are safe, so it will continually erroneously report that we are not safe.

When our brain thinks we are not safe, our prefrontal cortex (just behind your forehead) will try to manually work out what the threat is. If there is a problem, it will be clear and present – that is, obvious. When we fail to notice a clear and present danger, as the feeling of unease has persisted, we begin to look for subtle, to explain why we feel unsafe. Subtle means the next most likely contender for a threat – other people.

We covered this in more detail above in the section Threat Detection Errors.

The two most common disruptors of the Amygdala are Dopaminergic problems, such as ADHD (and common in Autism, BPD, OCD and other conditions), and body adrenal complications common in cardiopulmonary conditions.

If your noradrenaline and or adrenaline is too high, you’ll need different medications compared to if your Noradrenaline and adrenaline is too low. There is no specific medical test for this, other than to trial the medication and see how you respond.

There is an unorthodox test that can give you a clue. People who have a naturally high level of noradrenaline and adrenaline tend to avoid caffeine, not because of an aversion to bitterness, but because they don’t like how they feel when they consume caffeine. People who are naturally low in noradrenaline and adrenaline tend to consume a regular quantity of caffeine that is higher than the average person.

Caffeine if frequently found in: Tea, coffee, energy drinks / patches, some soft drinks.

Chocolate can also cause a negative response in some people as it is a related but different molecule.

An indicator that your caffeine use is higher than average is regular (almost daily or daily) consumption of 120 mg or greater.

Medications to discuss with your doctor:

  • Caffeine avoidant (likely high noradrenaline):
    • Guanfacine.
    • Clonidine.
    • Beta Blocker (Eg Propranolol).
      • The above three medications need you to have average or higher blood pressure. May not be suitable for people with low blood pressure.
  • Caffeine daily (likely low noradrenaline):
    • Desvenlafaxine.

Managing Self Worth

We have a section on Anxiety and Self Worth.

The central error in this is mistaking your worth as your product – gifts, services and sacrifice.

Your worth is in you as a person, not what you do for others. You are a Human Being, not a Human Doing.

This reorientation of worth allows the Human to make mistakes without being a mistake, and from those mistakes, learn, grow and change.

This allows you to produce a reasonable amount, instead of a superhuman amount. After all, the person in the team who does the least is still getting paid just as much as you are.

This makes it easier to spot those who are abusing your generosity and cutting them off. This allows you to walk away from that toxic situation.

When a neurodivergent person begins to arc up with extra sensitivity from any of the above trigger situations, they can query themselves – am I experiencing Rejection Sensitivity? Then take a pause and separate the feeling of personal failure from the situation. You haven’t changed – the situation has.

Sometimes the neurodivergent person has made a mistake, and if so, it will be clear and obvious. We don’t lose friendships over subtle problems, and a person who claims we made a subtle or illogical and non-evidenced error is someone to be aware of – they are likely toxic and may also be abusive (take the opportunity to get out of that relationship). Once we have identified the error, what can we learn from it? Can we adapt and adjust our actions, plans etc to factor in this new information? How can we grow?

We have turned a mistake into a growth opportunity.

Managing Toxic People

We have an extensive section on Toxic People, from spotting them, managing / avoiding them, and escaping them.

When we do connect, we can mistake ourselves for the mask we used to fit in. This can feel empty, dishonest and false. We can lose ourselves in thinking that we are only worthy because we produce things, or do services, rather than recognise that all people have inherent worth.

These are all roles, and are not you.

Abusive people love to take advantage of this sensitivity and extra goods from the neurodivergent person.

Learning how to identify toxic people is very important. The odds are that if you have a high rejection sensitivity response and it is frequently triggered, then you are likely “surrounded by arseholes (TM)” [a ‘diagnosis’ I sometimes give my anxious people in hostile social situations].

I find the red, amber, green flag system useful for doing evaluations of the person/people who trigger the Rejection Sensitivity.

Red flags are “red alert” style behaviours (double standards, moving goal posts, claims of error without evidence, faulting you for not reading their mind).

Amber flags are “wake up and take a close look” behaviours, where something seems off, but it isn’t clearly a red flag, but it might be. This is the time to take the rose tinted filters off our eyes and take a cold hard look. Is this odd behaviour an anomaly, or is it actually a trend? Everyone has the right to a bad day.

Green flags are indications that our relationship (work, intimate, friend) is on the green – aka good. Things like “does what they say”, “informs you of the important bits in a timely fashion”, “asks for reasonable things”, “believes you”, “has a single standard”, “understanding”.

Once you’ve started to learn about how to spot the toxic people, and that their behaviour isn’t your fault or responsibility, you can start to yeet the toxic people.

Then, with a bit of retraining, your Rejection Sensitivity can calm down.

There is a strong caveat here. Even after internalising the above, you can still struggle with rejection sensitivity. Two main causes for that is past trauma – get some trauma counselling; and an adrenaline/mood problem – investigate medication.

Managing Humble Theory

See our page on Beating Social Anxiety – Humble Theory.

Mostly social anxiety disorder is a side effect of a biological condition, mostly frequently errors in the Amygdala, secondarily various forms of exhaustion. While circumstances can contribute and exacerbate social anxiety, it is rare for a social anxiety disorder to be caused by trauma.

The biological condition should be diagnosed and treated to manage the underlying cause of the anxiety.

What is left is the Social Anxiety Mindset – the cognitive errors primarily caused by the condition. The fear of judgement and the Rejection Sensitivity.

The Social Anxiety mindset can be distilled down to “People’s opinions will focus on the mistakes I make, and that is going to cause problems.”

This leads us to two erroneous solutions:
1. To avoid judgement, you must be perfect all of the time.
2. If you can’t be perfect, don’t be seen.

These lead to a host of unhelpful behaviours.

*Humble Theory* focuses on the basis for the fear or people –
1. The fear of being judged for making mistakes, and thereby hurt or controlled, and
2. The inability to tell who is trying to be helpful versus who is being harmful (toxic).

Embracing being Humble assumes that we will make mistakes at times, and that growing is a good thing.

Embracing being Humble enables us to welcome being corrected and give opportunity for other’s to be a part of our growth.

Humble Theory also helps toxic people (who want to use false claims of mistakes, or who want to use our errors to manipulate & control us) to stand out from those who are genuinely being helpful. Humble Theory helps to identify who needs Toxic Person Management. Knowing how to spot abusive people reduces the fear of being hurt by everyone.

References

Early interpersonal trauma and later adjustment: The mediational role of rejection sensitivity, Downey, Khouri & Feldman, 1997, APA PsycNet. (n.d.). Psycnet.apa.org. https://psycnet.apa.org/record/1997-36663-003

Emotional Regulation and Rejection Sensitivity, Dr William W. Dodson, 2017, https://chadd.org/wp-content/uploads/2016/10/ATTN_10_16_EmotionalRegulation.pdf

New Insights Into Rejection Sensitive Dysphoria. Dodson, W. (2020, July 29). ADDitude. https://www.additudemag.com/rejection-sensitive-dysphoria-adhd-emotional-dysregulation/

‌