When Rejection Sensitivity Meets the Dating Scene

Rejection sensitivity and rejection-sensitive dysphoria have received significant attention in the last few years. While rejection-sensitive dysphoria is not a diagnosis listed in the DSM, it does appear that some individuals experience stronger reactions to rejection than others. The construct has held particular relevance in the neurodiversity movement and when associated with ADHD.

Although emotional dysregulation is unlisted in the DSM-5 criteria for ADHD, nine focus groups of young adults with ADHD found that the majority reported difficulties with emotions, including rejective sensitive dysphoria (Ginapp et al., 2023).

Rejection-sensitive dysphoria can look like a difficulty in recovering from criticism, exclusion, and other forms of dismissal. As people with ADHD have often had such experiences repeatedly over a lifetime, it may, in part, be a sort of trauma response. Research suggests that individuals with ADHD typically have altered patterns of functional connectivity between brain regions, and fMRI research showed a correlation between emotion dysregulation and particular patterns in youth diagnosed with ADHD (Musella et al., 2023). With this in mind, there may also be a biological component.

Rejection Sensitivity and Dating

There are a few arenas where rejection sensitivity is more relevant than the dating scene. It takes immense courage to begin the interaction, and anxiety often follows as the couple determines if the relationship is worth pursuing. The pain of rejection, a breakup, and unrequited love are usually some of the most memorable hurts of a lifetime.

For people who already have rejection sensitivity, these experiences can be magnified. This may be especially true for young adults. Research on young adults has found that those who experience rejection sensitivity often react with distance, uncertainty, and anxiety in romantic relationships, all of which can be deleterious to the ties (Shulman et al., 2024).

For some, the reaction to rejection in a romantic relationship can reach a dangerous level, with the recent loss of a relationship being a risk factor for thoughts of suicide (Afzul et al., 2024). Others may choose to remain in unhealthy relationships for fear of the loss. Indeed, people with ADHD are at higher risk for intimate partner violence than their neurotypical peers (Wymbs et al., 2017).

Psychotherapy

Individuals with ADHD who struggle with rejection sensitivity may benefit from a strengthening of identity and self-esteem through psychotherapy. Psychotherapy can also provide a space to process the turbulence of romantic relationships, particularly for young adults. While some predispositions to rejection sensitivity may be difficult to change, it is possible to learn from patterns, grow, and build a support system.

Dialectical behavioral therapy (DBT), in particular, is a psychotherapy approach that can assist individuals in developing skills to tolerate distress, regulate emotions, and approach relationships effectively. DBT has been implemented effectively to empower individuals with borderline personality disorder who experience rejection sensitivity (Choudhary and Thapa, 2012).

Another approach is trauma-focused therapy. If someone has developed negative core beliefs, such as "I am not good enough," from traumatic life experiences that fuel rejection-sensitive dysphoria, trauma-focused interventions, such as EMDR, can assist in processing the core memories associated with those beliefs.

Lastly, interpersonal therapies, which highlight relationships, could be a promising approach. While these have not been researched specifically for application in rejection-sensitive dysphoria, interpersonal therapies have been utilized for decades to assist individuals from a variety of backgrounds in understanding their relationship patterns and improving their social circles.

Rejection Sensitivity Essential Reads

Re-Enchanting Your Romance

3 Science-Backed Ways to Heal Relationship Insecurity

Other Supports

Measures to support individuals at risk for intimate partner violence are rarely neurodiversity-specific, however access to these supports and education for domestic violence providers of ADHD and other neurodivergences is necessary. The needs of an ADHDer who has struggled with intimate partner violence or a pattern of intimate partner violence may be different from those of a neurotypical person.

In Closing

Through support, awareness, and education, the negative impacts of rejection-sensitive dysphoria on relationships can be minimized.