Rejection Sensitivity

Rejection Sensitivity or what is often referred to as Rejection Sensitive Dysphoria (RSD) is common for individuals with ASD and/or ADHD, regardless of gender. It is commonly defined as patterns of intense, disproportionate emotional responses to actual and/or perceived social rejection, criticism, and/or failure. Common ways it presents include:

• Highly sensitive to personal feedback

• Frequent need for impression management in social interactions

• Easily hurt by what others would consider mild social slights

• Attempting to prevent loss of relationships at all costs

• Breakups are extremely painful

• Losing important relationships feels more devastating for you than it does for others

• Excessive preoccupation with planning, worrying, or rehearsing future social interactions

• High levels of social anxiety

• Intermittent depressive episodes ignited by instances of social failures

• Negative criticism is unbearable and is experienced as a personal attack

• Excessive rumination after social interactions

• Significant shame, and often harsh internal criticism, about one’s social-emotional capacities

• People-pleasing patterns

• Social avoidance of overwhelming contexts or high-risk interactions

• Covert or Overt defiance when given feedback that your way of completing a task is not right or effective and then given instruction on how to correct it

• Significant social withdrawal over time due to feeling like social engagement is not worth the risk or the necessary emotional/energy investment

For individuals with ASD, rejection sensitivity is often driven by a chronic history of social and communication difficulties. For example, poor ability to pick up on social nuances, reliance on scripting behaviors, poor understanding of social/communication rules, etc. Over time this creates significant social and personal shame, especially as repeated social failures accrue. These individuals often feel misunderstood and struggle to sustain motivation for social engagement. They are at high risk for socially withdrawing, retreating into internal fantasy, hyper fixating on personal interests to the exclusion of being social, and/or for only being social with a select few (e.g., other neurodivergent others or those that are deemed safe).

For individuals with ADHD, rejection sensitivity often becomes a complex system of compensation for variable executive functioning, especially at it chronically impacts how others’ perceive you and your functioning. Social masking is certainly a part of it, although a deeper and more complex system of shame management is often undergirding it.

Imagine an individual with ADHD who in social situations struggles with:

• Paying attention if a conversation is not stimulating

• Being easily distracted by external/internal stimuli mid-task

• Interrupting others as they know they will forget what they want to say if they wait until their turn to speak

• Retrieving the words they want to say and/or organizing the right words in the right order efficiently

• Processing auditory information efficiently

• Organizing their simultaneous, rapidly moving thoughts in order to avoid taking tangents in conversations

• Regulating their emotions in the moment

• Fidgeting excessively and often unknowingly

• Impulsively saying what they do not want to say

I could go on and on about how executive functioning impacts social communication and functioning. The important part to understand is that for individuals who experience all of these issues simultaneously, and chronically over time, social functioning is significantly impacted by ADHD. The most common result is rejection sensitivity, which is often apparent in their 24/7 preoccupation with social interactions. They are likely to prematurely worry about their ability to complete executive functioning in specific future social interactions and will plan or rehearse accordingly. Despite their planning and preparation, social interactions rarely go as expected, which means damage control is the name of the game in the moment. They attempt to conceal their variability in executive functioning and related social errors from others. And then after said interactions they ruminate on the real and perceived social errors they made due to their variable executive functioning. As rejection sensitivity becomes a mainstay in an individual’s social lifestyle, social anxiety tends to increase.

Part of what I help individuals to understand in a comprehensive evaluation is how rejection sensitivity has developed uniquely for them and what functions it serves to maintain. Everyone is different. Sadly, rejection sensitivity is often mislabeled as simply, and only, being signs of an anxiety disorder.