How To Overcome Rejection Sensitivity Dysphoria (RSD)

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0:30Jessica Summers:If you're experiencing RSD, the really important thing to remember, we cannot trust it. That is the difficult bit because it's giving us this really urgent message. You must do something about this. This is serious. You must take action on this. But actually, it's completely disproportionate. So we have to learn to not trust that response. But it's a bit like an addiction. It's very difficult to separate the trigger from the reaction. Jessica Summers is a world-leading ADHD expert specializing in rejection sensitivity dysphoria. As a qualified psychotherapist, she can help you understand why you overthink, struggle with shame, and why you're triggered by that one small comment.

1:06Jessica Summers:RSD is an experience that is a nervous system that's out of whack, but there's nothing wrong with your threat assessor. You have a working threat assessor, so it should be telling you that. It just needs recalibrating. It is a healthy response, but it needs dialing down. Can RSD sometimes manifest itself as aggressive behavior, as a means of defense? This is the saddest part about it.

1:30it's Jessica thank you so much for joining us oh I'm thrilled to be here it's amazing we're going to be talking about a big topic today RSD rejection sensitive dysphoria which when I ask people what the hardest part of ADHD is time and time again now people are saying rejection-sensitive dysphoria. So what is RSD and why does it hurt so much?

1:57Jessica Summers:Well, rather than saying what it is, we hear a lot about looking for a text message that hasn't come and getting stressed. We hear about the little things that go to making up what RSD is, but I just really want to give you the experience of what it feels like. So I'd just like you to imagine that you are sat in a vast auditorium right now. And around you is everybody that you've ever known in your life. The people that you've looked up to, the people who have looked down on you, maybe your family, maybe your children, maybe teachers, maybe university lecturers. And while you are sat in this auditorium, a screen begins to play at the front of the auditorium.

2:43Jessica Summers:And on that screen is every terrible thing that you've ever done in your life. everything you're ashamed of, everything you've forgotten that you've done and that now is coming up to stare you in the face. And the worst thing is everybody can see it. Every single person in that auditorium can see it and you see their eyes on you. Except that feeling can get triggered at any time of the day. You can be standing up in a meeting and you could see somebody look at their watch while you're speaking and that feeling is triggered in you. And the worst thing is you feel as if everybody can see those memories playing.

3:20They can't, but that is the feeling, the deepest

3:23Jessica Summers:shame you could ever imagine. And I think that explains why it hurts so much. Wow, what a visual. And I'm experiencing quite a lot of shame now just imagining that example, such a tsunami of emotional pain in response to a perceived or real criticism. I think it's genuinely brutal. out of the people you've spoken to regarding RSD how have they described the feeling well some people have described it as like thousands of paper cuts all over their body so it's very visceral physical language other people have described it as like a burning prison inside their body that they can't escape from but I would say the more worrying thing is when people don't have the words to describe it.

4:10Jessica Summers:And I think that's what we both care about, is that we want to make sure people know that it exists and they have the words to describe it. So I think it's important we hear what it feels like from people who experience it, and then other people watching can say, oh, I recognize that. Thousands of tiny cuts, and I want to talk about the potential cause of it a little later, those 20 ,000 tiny cuts, those extra criticisms, children with ADHD experience in their early years. But when I hear someone like yourself talk so passionately about a subject such as RSD, I always wonder where their motivation comes from.

4:48So what is your mission in regards to ADHD, rejection-sensitive dysphoria?

4:54Jessica Summers:Okay, my mission is to make sure that as many people as possible are aware of it, to make sure that people who experience it are seen, heard, and understood. And the reason for my work is that I experienced RSD triggers and I have done all of my life. I remember being drunk in my GCSE exams because I could not bear the pain of failing. I remember nearly dropping out of university, which I didn't go to till my late 20s for the same reason. I nearly dropped out because I was so afraid that my SA mark would be a fail. And I queued up to get my SA mark very reluctantly I thought I'll just sneak off and I got 92 % and I burst into tears and I ended up getting a first but it was a very close run thing that I wouldn't and as time has gone on I've developed in my work I've become a hypnotherapist I've worked with clients for 10 years but the RSD triggers still did not stop and my supervisor would have conversations with me like but when are you going to realize the work you do and I didn't know and I've been on a journey of discovery really for the past four or five years solely focusing on this.

6:04When you mention ADHD to someone, you often hear people assume it means hyperactive child or someone who interrupts a lot or can't keep still. They don't automatically jump to this horrible thing called RSD. Why do you think people are shocked to hear that this emotional sensitivity as part of ADHD?

6:28Jessica Summers:I think there's a real lack of understanding of what ADHD is. And I think just again, to go back to a personal note, if I tell people that I have ADHD, what I'm met with is disbelief because people assume that these are the characteristics that you're going to have. But in actual fact, there is a whole spectrum of symptoms and unwanted and difficult behaviors that we experience. And I think the key here is that people need to listen to each other more because there's an assumption that we are talking about these troublesome symptoms of ADHD, such as RSD and the emotional dysregulation, because we want someone to listen to us.

7:12Jessica Summers:We want someone to understand us. And sometimes that can be the case. But what we really want is just to be acknowledged for that person to say, I hear that you're having these difficult symptoms that you're in pain. We're not doing it for recognition. We're doing it because we want to understand ourselves and we want other people to understand us. I think the worst thing is if you experience this horrible, crippling shame, this intense emotional reaction to criticism or rejection, and then you tell someone about it and they just brush you off as crazy. And I don't use that word lightly. I've heard people report going to their doctors and explaining this this manifestation, this intense shame that gets triggered in the face of a tiny, sometimes, criticism, and the doctors brush them off as crazy or simply too sensitive.

8:02Do you think some people, because RSD potentially is a bit of a left-field trait of ADHD and still relatively unknown, do you think there's a risk that people will tell somebody who is suffering with it that they're just making it up?

8:16Jessica Summers:Yeah, I definitely think that's a risk because everybody that you come across assumes that their experience is everybody's experience and that's not the case and I think attached to RSD and we are the worst ones those of us who suffer with it there is this intense shame that we're weak or that we're failing in some way for responding the way we do and so sensitively but we're all different we all experience things differently and I think over the past few years we're seeing a lot more of that being acknowledged that we all have a different spectrum of experience. And I hope that people will see that this particular experience of RSD is horrendous and in no way should it be normalized or brushed off.

8:58RSD for me, it feels like everyone is continuously mad at you or you're always on the edge of letting someone down and you're about to find out about it. It's the tiniest triggers sometimes, I think you mentioned earlier, a reply to a text message with a full stop or a thumbs up emoji. The tiniest little thing like that can have such a drastic trigger and emotional response from me. Why do you think such small triggers can have such a big impact on someone with ADHD?

9:32Jessica Summers:Well, the important thing to remember is that language is a code. And when somebody puts a thumbs up on a message, quite often it does mean passive aggressive. You know, we're not always imagining it. But I think the important thing to realize here, it's the uncertainty that we cannot tolerate. We just, we can't cope with not knowing. We can't cope with knowing that we may have upset someone. We can't cope with not knowing how they may feel about us or that they're upset with us. And there's a really clear reason for this. RSD has come about to protect us, which, hey-ho, I know sounds absolutely insane.

10:07Jessica Summers:But it is attempting to protect us. And so that thumbs up or the little full stop instead of a heart at the end that you're used to getting is your nervous system telling you there is something to worry about here. Hey, you may be at risk of being ostracized. And although it's incredibly maladapted in order to react like a physical emergency to a full stop or a thumbs up, that is what's happening. I guess in the absence of absolute clear positivity and approval, we can jump to the negative very quickly. We can catastrophize. Like if you don't explicitly invite someone with ADHD to a social event, if you say, oh, you can come if you like, that's not explicitly saying they want you there.

10:50So you could easily take that uncertainty that you were saying and assume that, well, if I go to this social event, they haven't explicitly invited me. So I'm just going to be a nuisance. and I'm probably going to annoy people. Where does it come from? Because we've spoken a lot on this podcast about ADHD children are exposed to so many more horrendous, nasty little comments in their early years. 20 ,000 extra little micro criticisms. Stop fidgeting. Why are you so weird? Why are you so lazy? Can't you just start the task? Be normal. Why are you so loud? It's not that loud in here. And they're not sound that damaging in their isolated form, but if you add them all together over a childhood, they could compound to create someone who truly believes that they're different and broken.

11:39Do you think the theory of the 20 ,000 comments is accurate? And if so, why do you think ADHD children are more susceptible to criticisms?

11:50Jessica Summers:Okay, and I can't give a definitive answer here. I think it's definitely a theory that's worth considering. But I think you've said it when you said, although the criticisms may be small, they go in very deeply. And I can remember similar situations. And I often wonder whether ADHD children are just born more sensitive. They're more highly sensitive because I know that I've heard people who would not necessarily feel that they've been overly criticized, but they still have RSD. And what I think is those voices are inside a lot of the time. And particularly with women that you'll find they're not speaking out about it and they internalize a lot of it.

12:32Jessica Summers:And I think we have so many internal voices all performing the same function. So I think whether it's out loud, which I know lots of ADHD young people have experienced, because we're more intense and it can be unsettling for people, let's put it that way. But also let's not forget, it's an internal experience as well. And every little comment, we've internalized it and saved it for later. Our brain's a pattern recognition tool and it recognizes that pattern of negativity and looks for more of it. It's a bit addicted to it actually. So what are some examples of some nasty things that women will internalize and tell themselves?

13:08Jessica Summers:Well, I've seen some really startling examples of very high powered women who inside are waiting to be fired. They are waiting to hear that every time when they get a message to go see somebody who's superior to them in the company that they're going to get the sack they also tell themselves that they're a failure and there's no point trying and that it's no good so I would say with women who come to me what I see more than than with guys is that they experience pre-failure so they just are unable to try because they already feel that whatever they do, they're just going to fail. So that's the most common.

13:51Do you think generally men and women experience RSD differently?

13:57Jessica Summers:Yes, I would. I was really interested to hear that a lot of guys will experience a short episode of RSD and it will be quite explosive and then move on. with women I find there is no I do have women who have outbursts but I would say they're the healthy ones although you might get criticized for having an outburst of sensitivity I would say the really damaging cases that I've seen amongst women are that they don't explode they internalize everything and they swallow it all and I think this is very damaging for your health and the nervous system And if you internalize that intense emotions, can that cause problems in romantic relationships?

14:42Jessica Summers:I think definitely. And I think romantic relationships can be difficult for men and women with RSD. The thing that you have to remember about RSD is that it's essentially a protector. It is a part of you and not a conscious part of you, that has to be said, that's trying to protect you from harm. And the way it can show up is that we become defensive. so there might be a question from a partner oh did you get the bread oh I'm always messing up aren't I you're always telling that I'm messing up because we just cannot take to be any more wrong the pain is too great and I'm not excusing it it's very very difficult to live with RSD I think partners feel that they're walking on eggshells and that it doesn't matter what they say or do they're not going to be able to get it right.

15:32Jessica Summers:So it's difficult all ways around. I think it can be devastating, not necessarily just the pain of RSD. We're very acutely aware of just how painful it feels to be criticised. But because of that pain, do you notice that people put up blockades around themselves sometimes, certain behaviours as a defence against to protect themselves from that pain? I think it's really important to remember that RSD, what we're talking about, might initially look like a trigger and maybe someone observing what's happening inside them at the trigger or someone outside of them observing how they behave at the trigger.

16:10Jessica Summers:But that really is the tip of the iceberg. As far as I can see it, that pain of RSD and avoiding it can completely warp a life. It can warp us from true. You could start off as a beautiful sapling, as a tree, and then by the time you've been through enough of this stuff and enough for the pain of RSD. You're warped completely out of your natural shape in order to avoid feeling this way. So we don't apply for the jobs that we should be applying to. We do work that maybe is not as satisfying to us, but that we're not going to be criticized for. Maybe we don't end up with the right people as well.

16:48Jessica Summers:Even worse, maybe we end up with the people who are matching those voices in our heads that say that we're no good. It's a serious issue. Could it go as far as somebody they're so scared of being criticized or rejected by their partner that they actually take the drastic step of ending the relationship first as a defensive mechanism? Absolutely that can happen but I want to say even the way you're talking about it as if it's some conscious event there's very little that's direct about RSD. I always like to describe RSD as like a sheepdog that's nipping at your heels and you'll see the sheep moving hither and thither but none of it looks very direct and I think what I see more often is that people repeatedly choose partners who they have no chance of success with and who are going to hurt them so it's like a terrible self-fulfilling prophecy but also infidelities because that intimacy and the uncertainty that happens after the chemistry is worn off we just don't know will we be rejected we don't know what's expected of us and that is the time when we can back away and finish a relationship, but not consciously.

17:56It can cause perfectionism as well, right? Like this blockade, this defensive, you don't want to be criticized. So how can I possibly be rejected if everything is done to such a high standard? But what are the costs of perfectionism?

18:09Jessica Summers:I was smiling then because that's my particular forte. Yeah, this podcast was perfect in my head. You know, but this is the thing. We have these ideas in our heads and they're always perfect when they're in our heads they're always perfect until they've been done and I think this is the real danger I think this is a big part of my mission that there are people out there who have something really valuable to offer the world that we need to hear from and we're not hearing from them because it has to be perfect or they will not come out and speak and they won't do it I recently spoke to somebody on the podcast called Pete Warmbie, and he was sharing new evidence that suggests that actually neurodivergent people are innately different.

18:53And because of that, we can be quite unlikable to neurotypicals. Certain behaviors we put out in the world are met with an unlikability because people don't know how to react to us. And therefore, sometimes the perception of being criticized or not liked isn't imagined, it is true because we are picking up on genuine metrics and markers of unlikability from our neurotypical peers. Can you see that being true?

19:25Jessica Summers:I think I want to come at this from a nervous system angle. I think that neurodivergent people are really very often at war with their own nervous systems because we don't live in a world that's designed for us. We repeatedly have to put ourselves under stress. And if you are highly stressed, it can come out in different ways. It can come out as a certain level of intensity, but also our laughter is louder. We'll laugh for longer, for example. And I think that that underlying stress can possibly through mirror neurons trigger other people around us to feel stressed also. So that's maybe an angle with that.

20:06And in the acronym RSD, rejection-sensitive dysphoria, how important is that word, dysphoria?

20:13Jessica Summers:I think it's incredibly important for anyone who suffers from it, and so it should be. The minute I say to clients, dysphoria literally means unbearable. They relax. Some people have cried on a call with me because just to have that pain recognized is incredibly important. But also it's been a source of controversy because many people feel that it medicalizes what is a normal human range of emotions. For me, I see the dysphoria as absolutely vital because this is what gives us an indication that this is a nervous system event. Yeah, basically our nervous system is being set off to such a degree like a maladapted stress response that what is an emotional pain is being flagged as a serious physical emergency by our nervous system.

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22:14Fascinating. And you have written a book talking about coping strategies and hacks to deal with this horrible thing called rejection-sensitive dysphoria. How does someone start to ease the pain that comes with RSD?

22:28Jessica Summers:So the most important thing for easing the pain with RSD is something that's been sadly lacking in a lot of our lives is installing a sense of safety. Because until you begin to feel safe in yourself, you can't take any new learning on. You can't challenge old patterns. It's just too difficult. So that's the very first place that we begin. I use different hypnotic tools. I love which makes it much more easy to handle rather than doing inner child work. Do you think if you are triggered, your nervous system has been snapped back to those 20 ,000 horrible comments you had as a child? And therefore, if you respond in the moment now to something someone said today, it probably isn't going to be a proportionate response to the comment that has triggered you?