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While living with high degrees of rejection sensitivity is emotionally painful, the good news is that it is totally treatable, with good rates of success.
By DR MIKE GROPPER NOVEMBER 25, 2024 12:38Feeling rejected by a friend, colleague, family member, or romantic partner is a universally painful experience. Some individuals, however, feel the sting of rejection much more acutely than others and also have an exaggerated fear of being rejected by those around them.
Case study: JoeJoe likes people, but at the same time he is afraid that they will not like him.
He grew up in a household with a narcissistic father, a co-dependent mother, and two older brothers. Joe’s mother was like a “firefighter,” always trying to put out the flames of her husband’s hot temper. Joe’s dad favored his older two brothers, who continually competed with each other to win their father’s acceptance and approval.
Joe came to see me in his mid-20s. He was unhappy and lonely. He had completed university and was working in a hi-tech job. But Joe had many interpersonal problems; he did not interact well with his colleagues and had few friends. In therapy, Joe was able to identify that he was always worried that people would not like him.
In order to prevent the perceived rejection of others, Joe would socially pull back. As a result, many of his colleagues became turned off to what they saw as Joe’s cold and unfriendly nature. What they didn’t know was that Joe was, in fact, starving for attention and approval but fearful that he would only get disdain and rejection.
Joe’s self-esteem suffered tremendously. He did not believe in his own self-worth or his intellectual ability, even though objectively speaking he excelled in university.
In therapy, Joe was helped to understand that his sensitivity to what he perceived as rejection from others was a byproduct of his childhood and his adult relationship with a cold, angry, and envious narcissistic father who did not miss a chance to devalue his son. When Joe would tell his father about any of his achievements, his father would minimize them and say, “Anyone can do what you did.” It’s not surprising that Joe developed a high level of rejection sensitivity.
Case study: SueSue never spoke to people at social gatherings. She preferred to sit quietly.
When her husband asked her why she was so quiet, she said that she just didn’t think she had anything important to say. When asked to explain what she meant, she told her husband that she was certain that her views were not as interesting as others’.
In actuality, Sue is very intelligent but avoids any public discourse that will put her in the spotlight. She has been like this most of her life; she remembers kids making fun of her when she was young. During her childhood, she was quite tall for her age and had a slight stutter when she spoke.
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Both Joe and Sue are suffering from what has been labeled as “rejection sensitivity.”
Rejection sensitivity (RS) is the tendency to anxiously expect, readily perceive, and overreact to social rejection. RS affects almost everyone to some degree, but what makes RS problematic is how often it occurs and how it affects feelings and behavior.
Some people seem very resilient to rejection. They don’t look for signs of rejection from others or personalize it. For Joe and Sue, it is quite a different story. They can’t shut off their hypervigilance, looking for cues that imply they are disliked or not valued.
The net result is setting into motion a self-fulfilling prophecy where their behaviors in reaction to faulty or exaggerated perceptions of rejection make them feel worthless, angry/depressed, and often lonely.
Psychological, biological, and environmental factors seem to play a part in the development of RS. For example, children who have a secure attachment to a nurturing parental figure seem to have an emotional buffer that can help to prevent RS. On the other hand, insecure and anxious children often develop a subjective emotional view that people are not reliable or trustworthy, making these individuals more vulnerable to RS, such as in the case of Joe.Bullying and other forms of peer rejection in childhood are another factor that may explain why some children develop RS. When children are consistently teased and left out, they are more likely to develop interpersonal rejection sensitivity, such as in Sue’s background.
Parents, as well as teachers, should be aware of, and look out for, children who have difficulty fitting into their social group. Early intervention is known to be very effective in helping children and teens overcome RS.
Also, people with attention deficit hyperactivity disorder (ADHD) are known to have high degrees of RS. These individuals are biologically wired in a way that makes it very difficult to shut off both the perception of rejection from others and the painful reactions that follow – i.e., anger, withdrawal, and depression.
Diagnosed ADHD youth and adults can get appropriate treatment, which may include counseling and medication, to help them gain control over their hypersensitivity.
Treatment
The most effective treatment for RS is supportive cognitive behavioral therapy (CBT). There are many CBT techniques that have been shown to be very effective in helping people like Joe and Sue, such as cognitive restructuring and exposure therapy.
For example, both Joe and Sue were helped in therapy to confront their fears by approaching people they believed were going to reject them. Use of mindfulness and relaxation techniques such as deep breathing helped both of them to lower their anxiety. During the process of therapy, they were given guidance on how to reinterpret their initial thoughts of rejection from others, which were based on some external cues that they believed were aimed at them.I always ask my clients who suffer from RS to try to think about what other possible explanations could there be for the person’s behavior. In fact, I encourage the person to use the rational side of his brain. There is a lot of learning that takes place in order to help RS clients replace maladaptive beliefs with more realistic and balanced ones.While living with high degrees of rejection sensitivity is emotionally painful, the good news is that it is totally treatable, with good rates of success.
The writer is a cognitive-behavioral adult and couples psychotherapist, with a subspecialty in treating anxiety, adjustment, and depressive disorders. He sees clients in Ra’anana and at his Jerusalem clinic. drmikegropper@gmail.com; www.facebook.com/drmikegropper