Guest blog from Jennifer Kemp
Rejection sensitive dysphoria (RSD) is a physiological reaction to painful rejection that can happen in close relationships, friendships, families, communities, healthcare, and workplaces. Autistic people and ADHDers experience frequent rejection and criticism throughout our lives, which can make us more sensitive to rejection. Our nervous systems learn to expect rejection, even when it isn’t occurring, and we can find it difficult to recover afterwards.
Beyond emotional pain
RSD is not just characterised by emotional distress; it often involves intense physical sensations. These may include:
• A sinking or dropping feeling, particularly in the stomach or chest.
• A tight or heavy sensation in the chest.
• Racing heart or a feeling of burning through the body.
• Nausea, stomach churning, or heaviness in the limbs.
• Restlessness, agitation, or even numbness and mental blankness.
• Fatigue, as though the experience has drained all energy.
For some people, thoughts may race uncontrollably, accompanied by a sense of helplessness. Others may experience the opposite; a sense of mental shutdown, as though their mind has gone offline.
Why we remain stuck in dysphoria
The pain of RSD hits our body instantly via the sympathetic nervous system, which activates automatically in the presence of a threat. Normally, the threat response is designed to fire and reset quickly, and our sympathetic nervous system is what calms it down. However, during RSD, the process is disrupted when we have unanswered questions, such as:
- “Why did this happen?”
- “What did I do wrong?”
- “Do they dislike me?”
These unanswered questions lead to rumination, with repeated attempts to analyse events in search of an explanation. When no clear answer arises, we often turn inward and blame ourselves. Self-criticism, fuelled by shame, keeps us in a state of distress that can last hours, days, or even longer. We can stay stuck in this pervasive, painful, dysphoric state long after others have moved on.
What can help
Recognising RSD is a vital first step. Understanding that these experiences are physiological and not a reflection of personal failure can make it easier to respond with self-compassion rather than harsh self-judgement.
There are specific skills and strategies that can help break the cycle of dysphoria, these are rooted in nervous system regulation, self-compassion, and living in alignment with your personal values. While these skills can take time and effort to develop, they can significantly reduce suffering.
Becoming familiar with RSD and learning how to support clients through it is one of the most impactful ways we can positively influence the lives of our neurodivergent clients as a therapist or practitioner. I am pleased to be sharing more of my insights during an upcoming training series with Contextual Consulting:
Rejection sensitivity dysphoria: healing the pain, building safety, and deepening connections
Understand the emotional toll of rejection sensitive dysphoria and gain practical strategies to help your clients process and heal from the pain of rejection. This workshop focuses on fostering self-compassion and creating a safe therapeutic space for deeper emotional connection.
Hope to see you there!