Rejection Sensitive Dysphoria (RSD) is best described as an extreme and intense emotional response to perceived or real rejection, criticism, disapproval or failure. Rejection sensitivity is similar however it doesn't usually create the same level of emotional pain. Although not officially recognised there is a link between RSD and neurodivergence due to differences in emotional processing in the brain.
Hypnotherapy is a focused state of inattention, during this we can imagine, recreate and rehearse various scenarios while in control and feeling relaxed. This allows us to experiment with our belief systems, adding context and perspective. This can be extremely effective with RSD as we are able to think about both how we would like to manage this in the future and how we might be able to re-frame and create a more supportive belief system.
What are the signs of rejection sensitive dysphoria?
Hypervigilance to criticism, always assuming the worst in situations where you might be given feedback. Taking it extremely personally and hard to move on.
Fearing that you will be rejected by those around you, partners, friends, work colleagues. Looking for signs that they be unhappy with you or your behaviour.
Low self-esteem, thinking that people will be critical of you, expecting them to judge or misunderstand you.
Extremely self aware and over analysing your words and behaviours after social situations. Worrying about going to events or situations.
Self critical, always thinking you should have done better and that people are secretly disappointed in you.
People pleasing, going along with plans, not speaking up, fearing saying anything that might not be agreed with or seen as conflicting.
Finding relationships exhausting from the constant need to be sure everyone likes and is happy with you and second guessing their reactions.
Extreme emotional reactions, intense feeling of shame, hurt, embarrassment, sadness when faced with potential rejection or criticism.
Avoiding putting yourself in new situations due to fear of not being able to cope with the potential embarrassment or judgement.
How is RSD different to normal fear of rejection?
Of course everyone has a fear of rejection, its natural to want to be accepted and liked. It serves an evolutionary purpose as belonging to a tribe or community meant you were cared for and protected, you pooled resources and were able to contribute meaning you had a greater chance of survival. It was important that people saw you as a positive contributor to the tribe and not a drain or a risk.
We all feel embarrassed, self aware, self critical, upset when we are not greeted with kindness or understanding. However, it is the intensity of the response and how you are able to then manage that response and your behaviour. Most people will get over an embarrassment fairly quickly, with RSD that memory may create such anxiety that you change your actions in the future to avoid ever feeling that way again.
The link between RSD and ADHD
ADHD is a medically recognised condition effecting in-attention, hyperactivity and impulsivity, it is estimated around 7% of children and 2.5% of adults have ADHD, although this number is changing due to better recognition, even on these estimates that would be around 1.7 million adults in the UK.
The DSM IV is the official guide to diagnosing disorders and currently it does not recognise emotional dysregulation to be a criteria for ADHD diagnosis, however there is advanced research using fMRI that show the areas of the brain affected in ADHD also play a part in emotional regulation. Rejection Sensitive Dysphoria is linked to ADHD and thought to be due to this inability to properly assess and assign emotional responses to situations.
Social rejection in even it's mildest form, causes similar brain activity to physical pain. Research suggests the brain of someone with ADHD doesn’t have the same internal communication as the brain of someone without ADHD. Areas of the brain that filter and regulate signals aren’t as active. This means there’s less of a filter on brain activity, stronger emotional reactions can get through the channel that would otherwise not reach the awareness of a non ADHD person. Similarly the rational and context driven messages don't get through to the emotional regulating area, so these areas are working in silo and unsupervised.
Hypnotherapy for rejection sensitive dysphoria
Hypnotherapy accesses the default mode network, an area of the brain that is activated in wakeful daydreaming when relaxed. The DMN is responsible for self-reflection, mental projection, cognitive time travel, and the ability to interpret others’ mental states. This means during this state we can recreate moments from the past and imagine the future, we can add rational and intellectual processing to these situations and effectively try out how it would feel. It is a safe way to experience both other peoples intentions and add context, as we aren't in heightened state of anxiety or under real threat.
We can also address the automatic nature of our emotional responses, giving a new a supportive way to manage the emotional regulation when we are faced with these potentially painful situations.
We develop and grow when we experience things in the here and now, this is a new learned response to a situation that we can then use as a frame of reference in the future, during sessions we explore this using our rational and problem solving mind and then use our imagination to visualise how that would be beneficial in the future.
Dissociating is something our brain does naturally when faced with danger or threat, to turn off the rational part and just get through the experience. This is helpful in real threat but not when we have to evaluate and make decisions that will help us in the future. Hypnotherapy can help in these situations by having a pattern for this ready to use, meaning we feel less threatened and therefore no longer need to dissociate.
Finally we use mindfulness and grounding techniques to future re-wire the brain and stay present and rational under stress. We want to increase the connections between our rational and emotional brain so that the correct messages do make it through.
If you are interested in finding out more about hypnotherapy for RSD book a free 15/20 min call with me, there is no pressure to work with me, it is a chance for you to ask questions and meet me.
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