At Attention Allies we know that RSD (Rejection Sensitive Dysphoria) is an overwhelming challenge for many ADHDers. However, our founder Duncan E. Stafford suggests that by focusing on autonomy, competence and relatedness (the three basic psychological needs outlined in self-determination theory (SDT)) we can begin to build resilience against the intense emotional pain of RSD.
(6 minute read)
If you live with ADHD, you may have experienced the intense, sometimes overwhelming, set of emotions known as RSD (Rejection Sensitive Dysphoria). Although RSD doesn’t yet constitute a formal diagnosis, it’s a term that resonates deeply within the ADHD community.
RSD is generally understood as an extremely intense emotional reaction to perceived or actual rejection, criticism or failure. The emotional pain can be overwhelming, leading people to avoid social situations, withdraw from relationships or, in some cases, express explosive anger. These reactions can deeply affect an individual’s psychological needs, leaving life feeling like a series of high-stakes emotional hurdles.
Sam’s rejections
Sam, who was diagnosed with ADHD aged 38, describes her past experience with RSD as feeling like an “internal ticking bomb”. In her words:
I was hypersensitive to anything that might feel like rejection. When I was in that headspace, neutral or sometimes even supportive comments would feel like attacks.
This hypersensitivity undermined her sense of competence and her belief in her own ability to handle life’s ups and downs effectively. During times of real and perceived rejection, Sam’s confidence would plummet – being replaced by self-doubt and a sense of deep failure.
Before Sam entered coaching and therapy (where she developed skills that helped her to “step back from herself”) she strongly believed the classical thinking about ADHD: that she lacked control because of impaired executive function. Coaching and therapy that used SDT principles began to support and develop her sense of autonomy (our ability to regulate our own responses and manage the emotional world), helping her to become engaged and invested in personal change that no longer felt out of reach:
I went from feeling like my reactions had a life of their own to having a stepped framework to understand I could be autonomous and competent. The intense RSD feelings – the after effects of which could last for a few days – became something I began to deal with as soon as I was aware I’d been triggered.
Therapy helped Sam to recognise specific triggers that tended to precede these emotional surges, gradually supporting and developing her sense of autonomy. By becoming more aware of these triggers, she could manage her emotions before they spiralled out of control.
Connection amid emotional pain
RSD often chips away at our sense of connection to others (relatedness). When minor misunderstandings or perceived slights can feel like intense rejection it’s easy to question whether we’re genuinely accepted or valued by others. For Sam, this played out in her relationships with friends, family and colleagues. A seemingly casual comment, for example, could be misinterpreted as criticism, threatening her sense of security and belonging.
Our need for relatedness runs deep, but when RSD undermines our connections it can lead to social withdrawal or frustrated outbursts. Sam found that coaching and therapy helped to strengthen her communication skills so she could be clearer about her needs, feelings and boundaries, in turn easing the impact of RSD in her relationships.
Feeling with meaning
Many ADHD researchers suggest that emotional regulation issues stem partly from impulsivity and challenges with executive functioning. Yet for those with ADHD, emotional control often aligns with how competent, related and autonomous they feel. For example, when a task feels meaningful and we feel capable, emotional regulation is easier. When an ADHDer feels disconnected or the task lacks value and interest, managing emotions becomes considerably harder.
Ali, another person with ADHD, describes how, “when I’m feeling overwhelmed, it doesn’t take much to set me off. A crowded store or a car cutting me up in a queue would feel very personal, like an attack.” Ali found that his RSD was often connected to previous experiences of times when he’d felt invisible or unimportant leading him to spiral into feelings of rejection – even when he logically knew that wasn’t the case. Through therapy, Ali worked on recognising his emotional triggers and particularly developing his sense of competence. He additionally developed greater autonomy in handling his emotions, further reducing the power of RSD episodes over his life.
Recognition
Being able to recognise situations and people who challenge our fundamental experience of autonomy, competence and relatedness can help us to begin to gain control over RSD. Recognising triggers can begin the process of developing our autonomy, empowering us to manage our emotional responses. Techniques learned through therapy or coaching can help us to release pent-up emotions, fostering a sense of competence and self-efficacy. By nurturing supportive relationships, we can reinforce our relatedness, creating a safety net for times when RSD feels especially intense.
Sam’s journey through therapy highlighted the importance of strengthening all three of these psychological needs. When she learned how to identify her triggers, she gained autonomy; when she practised emotional regulation techniques, she built her competence and when she improved her communication with friends and family, she was able to see and develop her relatedness. Each of these shifts contributed to her ability to better manage RSD, improving her emotional health and overall wellbeing.
Understanding how RSD impacts our core needs of autonomy, competence and relatedness can offer those with ADHD a new way to navigate life’s challenges, build stronger connections and feel more secure within themself.
Read Bruised/RSD – a connected blog article by poet Jackie Fernandez who lets us take a full-force glimpse at the inner world and emotional volcano of rejection, low self-esteem and shame of a person full in the flow of RSD
Click the links if you'd like to visit Duncan's therapy website or her directory entry on Attention Allies.
Published 4 November 2024
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