Transcription
Welcome clients and guests to my channel. I'm Jason Cerro, and I'm a licensed professional counselor. My videos are designed to educate and empower you to make informed decisions about your mental health. If you want to watch my latest videos, subscribe and be sure to hit the notification bell so you never miss a video. If you happen to like this video or learn something, be sure to give it a thumbs up because it really helps the channel.
Rejection sensitive dysphoria (RSD) is a relatively new concept involving a person who experiences extreme emotional pain due to feelings of rejection and shame. It is a very common symptom of attention deficit hyperactivity disorder (ADHD) and it is both neurological and genetic. At the end of this video, I will explain a few ways on how to deal with this condition, but first, I will do my best to explain what rejected sensitive dysphoria actually is.
The key feature within the condition includes a disproportionate response afterward to the perceived or real rejection. For example, if someone doesn't text them back immediately or leaves them unread, they may send a scathing text message back or internalize the non-responses. "They must hate me. I must have done something wrong. I'm such a loser. I'm just not good enough for anyone." They may even delete, block, ghost, or unfriend that person from all contact on social media. This overlaps with what's referred to as twisted thinking or cognitive distortions that includes assumption making, fortune telling, jump to conclusions, and all-or-none thinking.
While being rejected is not a pleasant experience for anyone and it can absolutely hurt, a good percentage of people have the internal fortitude to recover either internally or process the rejection with someone they trust and move on about their day. For RSD, the rejection can feel like getting hit by a Mack truck, and for some, recovery never happens. It snowballs into something worse over time if it's not caught and properly addressed. Deep-seated cognitions and behaviors are embedded into the person acting as a protective shield. This protective shield serves as a defense mechanism for individuals with RSD in order for them to function in the environment that poses a threat to their mental, emotional, and physical freedom.
People with RSD have such a strong emotional reaction to criticism, judgments that imply there is something wrong with them, and any type of exclusion from an activity or group. Even constructive feedback can be twisted into something completely off beam and turn into something that it is not. In relationships, when a partner is simply sharing their own thoughts and feelings assertively and constructively, individuals with RSD will often not listen to the actual words and default to, "I must be the worst partner ever. I can't do anything right." This, of course, frustrates their partner, and they feel like the person with RSD is missing their point entirely, resulting in poor overall communication and understanding.
Individuals with RSD have incredibly low self-esteem, feel like they disappoint the people they love, and tend to be perfectionists. The perfectionist mentality allows for a fragile psyche to be in denial from a possible flaw. These types spend so much time preoccupied with not making a mistake or disappointing others that they come off as self-centered and better than others, when in fact, they actually feel inferior to others and sometimes feel defective. It is this extreme fear of being disliked, excluded, or even having imposter syndrome, which are feelings of severe inadequacy and self-doubt where they may be exposed as a fraud, that relationships can be fleeting and full of stress and conflict.
I'll often see RSD with individuals that have experienced controlling or invalidating parents and environments, restricting much of their physical freedom, where they go, who they interact with, as well as their mental and emotional freedom, the freedom to freely express their thoughts and feelings, to be heard, acknowledged, and validated. Instead, they were either shut down emotionally by their parent or family member or told their feelings were wrong when they expressed them. "I don't want to hear it," or "I'm sorry you feel that way, but you shouldn't have done X, Y, and Z," are two common examples of poor parenting behaviors that greatly contribute to the problem. It's the authoritarian parenting style that unfortunately de-emphasizes verbal give and take, expecting their orders to be obeyed without question. They say things like, "I'm the parent because I said so," or control children through shaming or disproportionate consequences, like grounding their child for two months for minor infractions. They may be passive communicators, not wanting to make any waves, disagreeing with others but giving off the impression that they agree, which frustrates assertive communicators because it's difficult to know what they truly think and feel, often resulting in mistrust.
In children, we will often see RSD manifest through various ways. Children can get very nervous when they perceive their friend will not want to play or listen to them, get angry if they believe they'll be the last kid chosen for a group project or group activity, and even angry if they believe the teacher is excluding them in any classroom activity. You will see big emotions or behaviors in response to the perceived or real rejection. A child may interpret some friendly, well-intentioned teasing as evidence that their friends hate them. They may act out in rage. The notion that friendly jabbing amongst peers contributes to the intimacy of the relationships is a lost concept on the extra sensitive child. It's helpful to provide context, alternative possibilities, and guidance to the child when they have these experiences so they don't form this black and white thinking, creating a lifelong struggle with that social situation.
Individuals with RSD feel like failures and tend to exaggerate their struggles, how people have wronged them, how much people dislike them, and they carry tremendous amounts of shame. In my experience as a clinician, I'm convinced that they simply haven't been taught or haven't learned the language skills necessary to communicate exactly what they think and feel. The pain is sometimes so deep they can't even muster up the required energy to effectively communicate. It's not their fault. People do not want to be this way. It is crippling and exhausting for them. We do not grow up in a vacuum and therefore should not isolate and condemn individuals with RSD and tell them it is solely their responsibility to cope with their emotions. Collectively, we contribute to the problem, and collectively, we must engage to come up with the solutions. We tend to take more accountability for our part when we feel the collective group is actively participating on their end as well.
The following three strategies can assist those who are dealing with RSD.
Number one: Self-compassion. Self-compassion is not created in one day. It's a brick-by-brick construction that involves a few things. First, it's recognizing that you are suffering, feel like a failure, and feel inadequate. Validate that pain. Do not ignore or avoid it or put on a fake front so you appear to have your together when you know you don't. Next, self-compassion includes accepting that you're not perfect. You do and will make mistakes, and that frustration is actually a tool for understanding how to problem-solve more effectively. My apologies to all my unicorns, princesses, and princes out there who prefer to live in an alternative world, but this is part of the human experience: being able to recognize our personal inadequacies and suffering.
Number two: If you can appreciate how difficult this condition is to live with, then you can probably understand that it can require mental health therapy that mainly uses dialectical behavioral therapy (DBT) as a framework to make great emotional intelligent improvements. I have found that this approach combined with cognitive behavioral therapy (CBT) really encapsulates the mindset and emotion regulation approaches and its subsequent evidence of individual growth. DBT teaches us how to learn emotion regulation skills to reduce our emotional vulnerabilities and increase our emotional resilience. DBT includes an intervention called opposite action. Opposite action has four steps:
1. Identify your emotions. Are you angry, sad, frustrated, jealous, or envious?
2. What is the urge that accompanies the emotion? Do you want to punch someone, throw something, yell, isolate, or even shut down and sleep all day?
3. Does the urge fit the facts of the situation? Is the urge to yell right now really appropriate? Will it cause more good or damage if I yell right now? This mindfulness process, in combination with CBT's "examine the evidence" strategy, provides further clues as to whether you should yell or not. For example, one might think to themselves, "The last time I yelled, the person told me I scared them and that they don't feel safe around me. I don't want to be that type of person." That's part of a mindset.
4. If your emotions and urges don't fit the situation, do the opposite of what the urge wants you to do. In the yelling example I provided, the person may instead listen, pause, and do nothing while waiting the situation out. Maybe ask a question or further clarify. And remember, if you're yelling, it's after the fact, and you can't stop it anyway. It's past tense once you actually yell, and that's not how people would change anyway, no matter how loud you can yell.
For the third strategy, let's go back to how I mentioned earlier that RSD is neurological and genetic. Best practice may include combining the previous two strategies with psychotropic medication. Dr. William Dodson, a board-certified psychiatrist, explains in his work that alpha-agonist medications like guanfacine and clonidine provide mild relief for some people, and that the medication can be a game-changer. He goes on to suggest that for some, the alpha-agonist medications work better than stimulant medications like Concerta, Adderall, and Vyvanse. For example, I attached a link to his work in the description below, so be sure to check out his findings.
Please set up an intake with a qualified licensed clinician who has experience working with this type of condition and get properly assessed. Or, if you have a doctor, therapist, or counselor at this time, I encourage you to reach out to them if you haven't already. Please continue to spread mental health awareness to help yourself and maybe even someone who may need a little nudge to get some help. If you like this video or found it useful in any way, please share it to someone you believe it may help. Please like the video and subscribe, and don't forget to put the notification bell on so you know exactly when my next video comes out. Thank you for watching, and as always, be where you are, be resilient.