A Guide to Handling Rejection Sensitive Dysphoria in Your Partnership

Dec 12, 2023

Therapist doing online therapy Telehealth

Imagine feeling furious because you were looking forward to a party only to learn that a friend had to cancel plans at the last minute. Or feeling crushed by sadness because your most recent post didn’t get many likes. Maybe you’ve been feeling guilty and ashamed for days because you forgot your friend’s birthday.

Nobody likes to be rejected or fail at something. However, for people with Rejection Sensitive Dysphoria (RSD), the emotional distress caused by rejection is excruciating.

What is Rejection Sensitive Dysphoria?

Imagine you tell a joke at the office and no one laughs. Most people would feel a bit uncomfortable, but they would brush it off and carry on as if nothing had happened. But the embarrassment may be unbearable for you.

When you have Rejection Sensitive Dysphoria, your fear of being judged or rejected can lead to overwhelming emotional reactions. You may dread criticism or feel so upset by rejection that you can’t control your emotions. When you only think about failure or disappointment, anxiety might swamp you.

Rejection Sensitive Dysphoria is much more than just being sensitive. People with RSD are extremely sensitive to criticism, rejection, or the perception of failure. For them, even a hint of rejection or failure can trigger much hurt, embarrassment, or anger. Typically, these feelings are out of proportion to the actual situation.

Can You Be Diagnosed with RSD?

Even though RSD is not an officially recognized medical diagnosis, it is believed that people with ADHD experience it far more frequently than other populations. So, you will not be diagnosed with RSD. Still, if you have ADHD, you might experience difficulties with emotional dysregulation, which is typical for RSD.

RSD can make it challenging to manage your reactions. It may cause you to feel overly self-conscious or to engage in people-pleasing behaviors. You may have low self-esteem and struggle with negative self-talk, which can lead to relationship problems, social anxiety, depression, eating disorders, and other mental health difficulties.

How Can Rejection Sensitive Dysmorphia Affect Your Relationship?

RSD might cause you to have trust issues or constantly fear rejection or criticism from your partner. You may struggle to commit to a relationship or need constant validation. You might read too much into your partner’s behavior or lack thereof, feeling profoundly hurt, sad, or angry. You might overreact to minor issues, seeing them as signs of rejection and a threat to your relationship. This can lead to ongoing conflicts and anxiety, creating frustration and emotional distance.

For example, you might get deeply hurt if your partner does not respond to your text message quickly, interpreting it as a sign that they don’t like you. This feeling goes beyond disappointment or hurt; it is an overwhelming, debilitating emotional pain.

When you have Rejection Sensitive Dysphoria, it’s like your brain keeps telling you, “Your posts are barely getting any likes. They think you’re a total failure,” or “They didn’t text you back/laugh at your joke. They must not like you at all.” So, you need constant reassurance, which can be overwhelming for your partner. They may feel attacked and exhausted. Such relationship dynamics can lead to communication breakdowns, breach of trust, and intimacy issues.

How to Manage Rejection Sensitive Dysmorphia in Your Relationship

RSD can create real issues in relationships. However, navigating Rejection Sensitive Dysphoria in a relationship, like many other skills, can be learned. So, to get you started, here are a few practical steps.

RSD can cause some serious problems in relationships. But navigating RSD in a relationship is something that can be learned, just like any other skill. So, here are a few practical steps that can help.

Insist on Openness

If you have RSD, make sure to express how certain things your partner says or does make you feel without assigning blame. Use “I” statements instead. Instead of saying, “You never call from work because you don’t care about me,” you may say, “I feel unwanted when I don’t hear from you all day.”

If you are on the receiving end, ask your partner with RSD to share how they feel, actively listening, expressing genuine empathy and concern, and validating their experience.

Take Time Out

When emotions become unbearable, it might be helpful to pause and reflect on your feelings before accusing, lashing out, or stonewalling your partner. This can help you understand your emotions better and prevent communication breakdowns and conflicts.

Challenge Your Thoughts

If you are a partner with RSD, use journaling to track your triggers and understand what situations or behaviors make you feel overwhelmed. Journaling can help challenge your negative thoughts and acknowledge that the rejection you often think is not based on facts.

Seek Professional Support

If Rejection Sensitive Dysphoria is straining your relationship, it’s okay to seek treatment from a qualified couples counselor. Counseling can offer techniques geared to your specific situation and relationship, allowing you and your partner to better understand and manage RSD in your relationship.

Let’s connect soon so we can set up a consultation.

Filippo M. Forni, LMFT is a certified AASECT individual and couples sex therapist. Mr. Forni sees patients throughout California and Florida. His goal is to provide high-quality and effective goal-oriented therapy services to his clientele. He has extensive training in sexuality and multiculturalism and serves as an adjunct professor at Pepperdine University Graduate School of Education and Psychology.