61: Is Rejection Sensitivity Dysphoria Real? with Dr. Lesley Cook
Nov 6, 2023
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Dr. Lesley Cook, a psychologist who works with those with ADHD and other neurodivergences, discusses rejection sensitivity dysphoria (RSD). They cover topics such as KC's personal experience with RSD, the differences between RSD and sensory sensitivity/autism, finding regulatory strategies for RSD, and the challenges of communicating the nuances of interpersonal difficulties.
Rejection Sensitivity Dysphoria (RSD) is a symptom commonly experienced by individuals with ADHD, characterized by an intense sensitivity to rejection or criticism.
Accurately categorizing and discussing RSD can be challenging due to its complex manifestation, intersection with other conditions, and the individual nature of its symptoms and experiences.
Deep dives
Rejection Sensitivity Dysphoria and its Controversies
Rejection Sensitivity Dysphoria (RSD) is a commonly described but not formally diagnosed symptom, often experienced by individuals with ADHD. It refers to an intense sensitivity to and emotional response towards real or perceived rejection or criticism. While it is seen more frequently in people with ADHD, the exact cause and nature of RSD are still under-researched. Some debate exists regarding whether RSD is an environmental response resulting from a combination of ADHD symptoms and life experiences, or an innate nervous system difference. This controversy arises from the challenge of isolating RSD as an independent phenomenon in the presence of comorbidity and individual differences. The debate surrounding RSD involves considerations of cognitive restructuring, distinguishing it from emotional dysregulation, the potential for pathologizing natural reactions, and how to support individuals with RSD while acknowledging its impact on interpersonal dynamics.
The Difficulty of Describing RSD
Due to the nuanced nature of Rejection Sensitivity Dysphoria (RSD), accurately categorizing and discussing it can be challenging. The intricacies of RSD arise from its primarily interpersonal manifestation and the intersecting factors such as trauma, neurological differences, and personal experiences. As a result, differentiating RSD from other conditions like borderline personality disorder, trauma responses, or emotional dysregulation becomes complex. Adding to the complexity is the difficulty in conducting concrete research that solely focuses on RSD, as ADHD, comorbidity, and various life experiences often contribute to its expression. The lack of clear terminology and widely accepted conceptualization further complicates meaningful discourse regarding RSD.
RSD and the Need for Nuance in Communication
Efficiently communicating the nuances of Rejection Sensitivity Dysphoria (RSD) becomes challenging due to the individual nature of the symptoms and experiences associated with it. While RSD is a valid explanation for heightened emotional responses to rejection, criticism, or teasing, caution is necessary to avoid over-pathologizing these reactions or using RSD as an excuse for mistreating others. Balancing empathy for individuals with RSD while addressing the impact of their behavior on others is crucial. Furthermore, understanding that RSD can coexist with trauma, sensory processing difficulties, and other conditions adds complexity to discussions about this symptom. Encouraging growth, self-reflection, and understanding the intersectionality of personal experiences remain key when addressing RSD.
Challenges of Research and Qualitative Perspectives
The research surrounding Rejection Sensitivity Dysphoria (RSD) faces numerous challenges due to the complex nature of this symptom's manifestation and its intersection with other conditions. Quantitative studies struggle to isolate RSD as a single independent factor in the presence of comorbidity and diverse life experiences. However, qualitative research can provide insights by delving into personal narratives and common experiences. RSD's connection to trauma, emotional dysregulation, and neurological differences creates difficulties in defining the boundaries and origins of this phenomenon. Acknowledging the limitations of research and the value of qualitative data can lead to a better understanding and awareness of RSD and its impact on individuals with ADHD.
I’m back with one of my favorite guests who is always up for the challenge of a podcast–no matter what the topic is! I want to explore the term rejection sensitivity dysphoria and get Dr. Lesley Cook’s take on it because I have so many questions. Let’s learn more together!
Dr. Lesley Cook is a psychologist who works with those with ADHD and other kinds of neurodivergence. Born and raised in Hawaii, she now lives in Virginia and works with children, adolescents, adults, couples, and families.
Show Highlights:
● What RSD (rejection sensitivity dysphoria) is and how it is manifested
● KC’s personal experience with RSD and feelings of worthlessness
● How RSD is different from sensory sensitivity and autism
● Thoughts about the strong word dysphoria in RSD
● KC’s personal experience with RSD and being told she is “too sensitive”
● How we can grow, change, and find regulatory strategies for RSD
● Why it is difficult to communicate the facets and nuances of RSD and other interpersonal difficulties
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