Rejection Sensitivity: Why it doesn’t have to be hidden anymore

A teenager expects his classmates to exclude him. This leads him to withdraw from social situations, resulting in feelings of isolation.

An employee attends a presentation and, despite receiving positive feedback, dwells on a single piece of constructive criticism for days or possibly weeks. She experiences low mood, reduced productivity, and is convinced that her job is at risk.

Rejection sensitivity is not a mental health disorder. Rather, it is a psychological trait that causes significant distress to the individual.

Rejection sensitivity (RS) is a dispositional tendency to expect rejection intensely, rapidly notice signs of rejection in the environment, and then react emotionally intensely. Individuals with a high level of rejection sensitivity are likely to perceive indefinite or neutral social signals as signs of rejection. This may invoke strong emotional and physical responses, negatively affecting the individual’s overall well-being. 

Features of Rejection Sensitivity

• Rejection vigilance- Always on the edge of one's nerves– looking for signs that other people might shun or exclude you from their group and often interpreting very ambiguous clues in this direction.

• Strong emotional reactions- People with RS feel extreme emotional responses such as emotional pain, guilt, or anger to real or perceived rejection 

• Behavioral effects- Individuals with Rejection Sensitivity often engage in defensive or self-protective behaviors like hostility, withdrawal, or excessive people-pleasing. These can ironically elicit actual rejection from people and reinforce a cycle of negative social experiences. This often leads to social withdrawal, people-pleasing, or engaging in conflicts. 

• Associated conditions- Common among people with depression, social anxiety disorder, ADHD, and borderline personality disorder,  

Symptoms of rejection sensitivity 

• Extreme distress in response to criticism or disapproval

• Recurrent fear of abandonment or failure in relationships

• Overthinking social interactions to identify negative cues

• Extreme people-pleasing behaviors or social withdrawal

Certain studies have shown that individuals with high rejection sensitivity react more negatively, both emotionally and behaviorally, to social rejection than those with low sensitivity. They may even overreact to situations that were not negative. Another study found that highly sensitive individuals avoided physical or social contact after real or perceived social signals of rejection, acting as a shield to protect them against anticipated distress. Tasks like the Emotional Stroop test used in research have found that people with high RS are more likely to have their attention disrupted by social threat cues, and not necessarily by negative cues in general. This shows that their focus can be easily shifted by anything that could signify rejection, impacting their behavior.

Causes of Rejection Sensitivity

• Early Experiences- Childhood experiences of persistent rejection, harsh criticism, or neglect increase the sensitivity of individuals, and they overreact to social stimuli in adulthood.

• Cognitive-Affective Processing- Some models suggest that RS is influenced by learned internal working models. Expectations of rejection get automatically switched on by certain social situations. This is quite common in late adolescence when peer relationships become central to one’s wellbeing.

• Biological Factors- Biological and genetic factors may contribute to heightened emotional reactivity in RS. 

Why should we take rejection sensitivity seriously?

1. Interpersonal issues- Rejection Sensitivity can cause problems within peer, romantic, and family relationships. In romantic relationships, Rejection Sensitivity leads to jealousy, distrust, and conflicts arising from perceived issues or insufficient attention, resulting in reduced relationship satisfaction. Particularly in adolescence, a significant decline in social competence over time has been observed, as the expectation of rejection leads to behaviors that lead to isolation.

2. Mental health disorders- RS is implicated in several clinical conditions, particularly borderline personality disorder, avoidant personality disorder, and social anxiety disorder. It can also result in the development of depressive symptoms and feelings of loneliness, especially in settings where peer acceptance is important, such as in the workplace and schools.

3. Self-Perpetuating Cycle- This creates a vicious cycle where the individual’s defensive actions to prevent rejection can lead to more social difficulties, validating the individual's fears and strengthening their sensitivity.

Are Rejection Sensitivity Dysphoria and rejection sensitivity the same?

Rejection Sensitive Dysphoria (RSD) is defined as an intense and unbearable emotional pain triggered by the mere perception (real or imagined) of rejection, criticism, or failure. Rejection sensitivity refers to an anxious tendency to perceive rejection or criticism. RSD, however, describes the dysphoric response—an immediate, extreme emotional reaction that feels intolerable and can interfere significantly with daily life and relationships. 

RSD may also appear in people with mood disorders like bipolar disorder, autism, PTSD, and borderline personality disorder, but it is discussed mostly in the context of ADHD. The differences in brain structure that make emotion regulation more difficult for individuals with ADHD can be a potential reason for RSD in ADHD patients. 

Symptoms of RSD

• Immediate, intense emotional pain in response to criticism or perceived rejection, even if the incident seems minor to others.

• Extreme mood swings or outbursts that are disproportionate to the situation, like crying, anger, or rage. 

• Sense of devastation, feeling “wounded” or as if the pain is physical.

• Immediate social withdrawal, avoidance, or giving up on activities, especially after experiencing rejection or failure.

• Perfectionism and constant fear of making mistakes to avoid criticism or disappointing others.

• Low self-esteem and persistent self-doubt

• Excessive people-pleasing behaviors for approval and validation.

• Avoidance of new or risky social situations due to fear of criticism or failure.

• Difficulty calming down after emotional episodes, leading to prolonged social withdrawal

Though neither RSD nor RS is a formal psychiatric diagnosis, these traits can lead to real and challenging emotional experiences for many individuals. Psychologists can help manage rejection sensitivity in a better way through therapeutic interventions. 

• Cognitive-behavioral therapy (CBT)- CBT is increasingly used to challenge the maladaptive inner beliefs, improve emotional regulation, and frame positive beliefs.

• Medication- In the case of ADHD, mental healthcare professionals may suggest medicines that help in managing RSD symptoms. But evidence regarding this is limited, and more research is needed.

• Personal strategies- Develop healthier responses to emotional triggers by improving social skills and assertiveness, which in turn reduces the chances of rejection and even the impact of perceived rejection.

• Self-compassion- RSD is not a character flaw, but instead a byproduct of neurodevelopmental or emotional regulation differences. The key to better emotional regulation is self-compassion and effective support.

Hiding due to the fear of rejection is difficult,

But it doesn’t have to be difficult anymore,

Koott is there for you. 

Our team of therapists can help you emerge from your shell and live a more confident life. 

Book your session today.