Beyond 'Too Sensitive': Rejection Sensitivity. A Therapist's ADHD and AuDHD Perspective
Rejection Sensitivity represents a distinct and profound aspect of human emotional experience, in neurodivergent individuals and particularly salient in those with ADHD or AuDHD. While often conflated with other experiences like social anxiety or self-rejection patterns, rejection sensitivity stands as its own unique phenomenon, characterised by intense, immediate emotional and physiological responses to actual or perceived rejection.
The Nature of Rejection Sensitivity
At its core, rejection sensitivity manifests as an acute, reactive response rather than an anticipatory state. Moreover, this isn't simply about feeling hurt by rejection, which is a universal human experience (to varying degrees). When we talk about rejection sensitivity in this way, we are highlighting that it can manifest as Rejection Sensitive Dysphoria (RSD) and goes beyond typical emotional responses.
RSD differs because it is about the intensity, immediacy, and overwhelming impact of that communicated rejection as it is recieved. I am saying that it is a ‘reaction’ because the impact of the rejection creates what many describe as an overwhelming wave of emotional pain that can trigger fight, flight, or freeze responses. The 'dysphoria' component accurately captures the profound distress and intolerable emotional overwhelm.
And it happens very rapidly. When triggered, the experience can feel akin to a panic response, or like being "on fire". It is experienced as an overwhelming cascade of emotional and physical responses that completely flood one’s system, and can feel unbearable in the moment. Some people may find themselves in tears, or choked up. Others may feel shocked and silenced. And yet others may feel fury, hostility, or exasperation.
The Physiological Dimension
Understanding rejection sensitivity requires appreciating its deeply physiological nature. When triggered, people can experience:
Rapid heart rate and breathing changes
Intense physical pain or discomfort
Overwhelming sensory experiences
Immediate stress response activation (including shock)
Physical exhaustion following episodes
This physiological component distinguishes rejection sensitivity from more cognitive or identity-based experiences. It's not primarily about thoughts or beliefs but about immediate, embodied responses that are beyond conscious control.
Triggers and Contexts
Rejection sensitivity typically responds to specific triggers rather than operating as a constant background state. Common triggers include specific incidents of:
Feedback, evaulation comments, or direct criticism
Social exclusion communicated in the moment
Situational changes in relationship dynamics
Professional evaluation scenarios
Incidents of subtle shifts in social interaction
Importantly, these triggers can be either actual or perceived rejection – the physiological and emotional response remains equally intense regardless of whether the rejection is intended or accidental.
The Professional Impact
In professional contexts, rejection sensitivity can create particular challenges. The workplace often presents multiple potential trigger situations:
Performance reviews and evaluation meetings
Team dynamics and feedback sessions
Project critiques
Professional development discussions
Leadership ‘opportunities’
For neurodivergent individuals, these situations can become especially challenging when the critical comment comes because they are being ‘marked’ as unacceptable in some way as a result of using neuronormative standards and measures of social appropriateness. The intensity of rejection sensitivity can make standard workplace feedback feel threatening, even when delivered constructively, because it can contain this risk of whole-person rejection, and not merely critique based on the intended focus of it.
Relationship Dynamics
Rejection sensitivity significantly impacts relationship formation and maintenance. In intimate relationships, it can manifest as:
Intense reactions to perceived distance
Difficulty with conflict or disagreement
Overwhelming responses to minor changes
Challenges with trust development
Responses and strategies of connection and protection
However, it's crucial to note that these patterns differ from self-rejection patterns related to feelings of worthlessness. While there may be overlap, rejection sensitivity focuses specifically on the immediate, intense response to perceived rejection rather than ongoing relationship patterns or identity-based struggles.
Distinguishing Features of RSD (and Differentiation)
It's important to differentiate rejection sensitivity from related but distinct experiences:
Unlike Social Anxiety, RSD is:
More reactive than anticipatory
Focused on rejection, specifically, rather than general social evaluation
Immediate rather than building anxiety
More physiological than cognitive
Triggered by specific incidents rather than general social situations
Unlike Self-Rejection, RSD is:
Not primarily about identity or self-concept
More situation-specific rather than a constant background
Focused on external triggers rather than internal state
More immediate and acute rather than chronic
Primarily reactive rather than persistent
Supporting and Understanding Rejection Sensitivity
Workplace Considerations
In professional contexts, supporting individuals with rejection sensitivity requires thoughtful adaptation of standard practices and procedures. Traditional approaches to feedback and evaluation often need significant modification to create safer processes that don't trigger overwhelming responses while still maintaining professional development and growth.
Creating supportive team environments becomes crucial, with particular attention to communication patterns and relationship dynamics being free of clouding from neuronormative standards of social appropriateness. Developing ways to navigate necessary professional processes that focus on the facts of the work and tasks assigned, and avoiding personal comments about tone of voice, or facial expression in the workplace is a good guide for avoiding all potentially triggering situations. Feedback, critique and evaluation can be delivered then, while maintaining emotional safety and support for the receiver.
Professional accommodation can balance the requirements of the workplace with understanding of rejection sensitivity's impact. This might be thought of as an opportunity to develop approaches to performance review, team communication, and professional development that are neurodivergent inclusive, as well as ones that create more encouraging ways of engaging with workplace processes.
Therapeutic Support
Supporting clients with rejection sensitivity begins with a fundamental understanding of its unique nature. The experience of RSD represents a distinct way of processing and responding to perceived rejection that goes far beyond ordinary sensitivity. Recognition of its validity forms the cornerstone of effective support, acknowledging that this isn't merely heightened emotional reactivity but a profound physiological and emotional experience that deserves serious attention and understanding.
The physiological component of rejection sensitivity cannot be overstated. When supporting individuals experiencing rejection sensitivity, we must appreciate that they are navigating an intense bodily experience, not simply an emotional or cognitive one. This understanding shifts our approach from purely psychological support to one that recognises and works with the whole-person impact of rejection sensitive experiences.
Common Rejection Sensitivity Triggers and Relationship Manifestations
A Note About Common Experiences
In sharing this information about rejection sensitive experiences, it feels important to acknowledge the patterns that many people have described in their journeys. Understanding these common experiences can help validate what you might have noticed in your own life, while recognising that everyone's experience is unique.
Some people find it helpful to know that their experiences are shared by others, whether it's noticing particular sensitivity to changes in text message patterns, feeling impacted by subtle shifts in social dynamics, or experiencing intensity around workplace feedback.
If you recognise your own experiences here, you're not alone, and your responses make sense given the depth and immediacy of rejection sensitivity. While each person's journey is distinct, knowing that these experiences are common enough to be recognised and understood can be an important part of self-understanding.
Professional Context Triggers:
"We'll need to go over this again"
"This isn't quite what I was looking for"
Being interrupted in meetings
Not being directly addressed in group emails
Receiving more detailed feedback than colleagues
Having work reassigned without discussion
Being left off meeting invites
Being told that your tone of voice or facial expression impacts others
Social Context Triggers
Direct Communication Triggers:
"You're being too sensitive about this"
"Why can't you just let it go?"
"Everyone else managed to understand this"
"You're making this more complicated than it needs to be"
A friend saying "Maybe later" when suggesting meeting up
Someone responding with a shorter text message than usual
A delayed response to a message in a group chat
Changes in someone's usual communication pattern
Social Exclusion Moments:
Discovering friends met without you
Seeing social media posts of gatherings you weren't invited to
Overhearing colleagues making lunch plans
Someone switching to private messaging in a group chat
People forming natural groups while you're left out
Others sharing inside jokes you don't understand
Finding out about an event after it happened
Being the last person chosen for a team or group
Intimate Relationship Manifestations
Perceived Distance Triggers:
Partner taking longer than usual to respond to messages
Changes in typical greeting patterns
Different tone of voice in routine conversations
Partner spending more time on phone during time together
Partner sharing news with others first
Changes in usual terms of endearment
Conflict Navigation:
Partner saying "We need to talk"
Any form of criticism, even constructive
Partner expressing disappointment
Discussions about relationship expectations
Conversations about future plans
Different opinions about shared decisions
Discussion of past incidents
Trust Development Challenges:
Difficulty believing positive feedback
Questioning partner's motives for kindness
Constant verification of relationship status
Needing frequent reassurance about feelings
Difficulty accepting partner's independent activities
Questioning commitment without constant proof
Struggling with partner's friendships
Difficulty with physical or emotional distance
Family Context Triggers
Parental Interactions:
"I expected more from you"
Comparisons with siblings or others
Subtle shifts in emotional tone
Different response to achievements
Changes in family tradition participation
Differences in attention distribution
Sibling Dynamics:
Different treatment at family gatherings
Varied responses to similar achievements
Differences in parental attention between siblings
Variations in inclusion in family events
Different levels of consideration in plans
Varied responses to similar requests
Friendship Context:
Changes in usual meeting frequency
Different response to reaching out
Change in shared activity pattern
Different emotional availability
Shifts in usual support pattern
Change in group dynamic inclusion
Variations in usual friendship rituals
A Personal and Professional Note on Rejection Sensitivity
Drawing these threads together, I'm struck by how rejection sensitivity represents both a challenge and an opportunity in our understanding of human emotional experience. As both a psychotherapist and someone who is AuDHD, I've observed rejection sensitivity from multiple perspectives - professionally, personally, and through the experiences shared by clients and supervisees.
What becomes clear is that the intensity of these experiences - whether in professional contexts, intimate relationships, or social situations - speaks to the complexity of the shallowness and depth of human connection and the impact of acceptance and rejection at a fundamental level.
For those experiencing rejection sensitivity directly, I hope this exploration helps validate your experiences and maybe it could also have provided examples of experiences that you now reconise as RSD. Perhaps you now feel that your responses make sense in the context of your neurology and experiences? The intensity of your feelings isn't a flaw or weakness, but rather a reflection of how deeply and immediately you process relational experiences that criticise and reject you based on neuronormative assumptions of appropriateness of acceptability.
For partners, family members, and colleagues of those with rejection sensitivity, this understanding can help create more compassionate and effective ways of maintaining connection while navigating challenging moments. Small adjustments in communication and awareness of potential triggers can make significant differences in relationship quality and mutual understanding.
For fellow therapists and counsellors working with clients experiencing rejection sensitivity, I hope this detailed exploration provides useful frameworks for understanding and supporting your clients. In clinical supervision, we can explore these dynamics further, not only considering clients situations, but also thinking about how rejection sensitivity might manifest in the therapeutic relationship itself and how to be mindful of accidental whole-person rejection.
As we continue to deepen our understanding of neurodivergent experiences, rejection sensitivity offers important insights into the variety of human emotional experience, and the complexity of overt and covert communication between people and the impact that it can have.
If you're interested in exploring these experiences further, whether as a client seeking therapy or a professional seeking supervision, I welcome the opportunity to work together.
Author. Vauna Beauvais.
Vauna Beauvais. Contact me here.
You can see the rest of my Vauna Beauvais psychotherapy practice blog posts here, and if you’d like to listen to a YouTube podcast of myself and a fellow therapist talking about Rejection Sensitivity here and you might want to watch my new (and growing) video series on neuroaffirming therapy here.