[00:00:15] Come on and take a seat. I will hurt you.
[00:00:21] Hey, everybody, welcome to this episode of The Virtual Couch. I'm your host, Tony Overbay. I'm a licensed marriage and family therapist. And let's let's get right to it. I am going to talk today about rejection. How often do you feel rejection and have you ever had that sense where you are going into a conversation with somebody, particularly somebody that you care for and you almost have this anticipatory rejection. So we're going to talk about something called rejection sensitive dysphoria. And boy, today is going to be a day of tangents, I can already tell you that, because this this has been a topic that I've wanted to talk about for quite a while. And there is a new book out called ADHD 2.0 that I it's one of the first books I think I have listened to, finished it and gone back and started again because I typically just I don't like watching movies the second time or shows the second time or reading books the second time this one spoke to me. I mean, this this just it validates my own experience with ADHD and the authors, Edward Hallowell and John, I think it's right or ratty both doctors. I think they said this is their seventh book that they've written about ADHD. And their book Driven to Distraction was one that I talked often about when I first did two or three parts on my own ADHD, Awakening or awareness back in the episodes around 150 or somewhere around there.
[00:01:39] And the more that I think that that I talk about it, the more feedback that I get from other people that, you know, it's that concept where I think sometimes we're almost embarrassed that we may, heaven forbid, we have something different. I was going to say wrong about us, but a way that we show up or present that might be something like ADHD or depression, anxiety, that sort of thing. And we feel like we have to hide that. And the more that we talk about it and get that out into the zeitgeist or conversation with people, you start to find out that we all have some things that that we have challenges with and there is some comfort numbers or there's validation and hearing that other people struggle with similar things to. And so in reading ADHD 2.0, which I want to, I'll just do a deep dove on the book in general at some point. But there the authors list these they call them paradoxical traits of ADHD. And that section alone is just fascinating because you think of ADHD is this thing of deficit or hyperactivity, but they talk about that. The paradox of of ADHD is that know I'm going to read that right here. They talk about how you can have an unexplained underachievement. The person simply isn't doing as well as they they their innate talent or their brainpower warrant. And there isn't an obvious explanation. So they talk about paradoxical tendencies.
[00:03:00] And I think that they I love where they lay out this concept early on. They say it helps to think of ADHD as a complex set of contradictory or paradoxical tendencies, a lack of focus combined with an ability to super focus, a lack of direction combined with highly directed entrepreneurial ism, a tendency to procrastinate combined with a knack for getting a week's worth of work done in 2 hours. Impulsive, wrongheaded decision making combined with intuitive out of the blue problem solving interpersonal cluelessness combined with an uncanny intuition and deep empathy. And he said, The list goes on. And so then they go through more of the, the formal signs of ADHD that they talk about. You might see in a clinical setting, unexplained underachievement, a wandering mind and trouble organizing and planning. So far I'm checking all these boxes, but also a high degree of creativity and imagination. Trouble with time management tend to tendency to procrastinate strong will stubbornness, refusal of health, often generosity, restlessness, that sort of thing. But and I like that they say a unique and active sense of humor, trouble sharing and playing with others early on, but at the same time, a desire to make friends. And now we're starting to get into what leads right into the next concept, they say exquisite sensitivity to criticism or rejection. And before you think this is just going to be a eight and ADHD podcast, I want to talk about this sensitivity or criticism to rejection.
[00:04:23] And this is where I'm just going to lay out my thoughts on this. I'm not going to say that I have data or studies to back this up, but I feel like the more that we understand about what those attachment issues look like that we bring from our childhood, where we just desperately want to be loved, we want our needs to be met because we're coming from this factory setting as a baby that if our needs aren't met, if someone doesn't take care of us, if they don't feed us and change their diaper and love us, that we will we will die. I mean, we're sent from the factory with those settings because that's true. Because we don't we don't sire offspring that can get up and run around within a few seconds, man. It can take a long time. And so we do require others initially to to meet our needs. So how do we get our needs met? Well, when you're a baby, you're adorable and cute and you smell great. And so it's easy to just be a baby and get your needs met. But as we become more of an adult and we we start to complain or we're trying to just demand that our needs are met, or we we get loud and angry, we cry, we withdraw, that we all have these still immature ways that we're trying to get our needs met.
[00:05:27] So then we do this thing where if people aren't meeting our needs, which people are not going to always meet your needs? Rarely as you get older. Well, they they meet your needs. We have to learn how to become self sufficient so that we can show up more confident in our relationships. But that's not the way that it works early on. So if you are going into a relationship or you're going into conversations and you are anticipating rejection, or if you have this rejection sensitivity, it's really fascinating. If you think about people that you interact with that almost feel when they're coming up to you like they've got this agenda or like they just feel like, man, they hate you hate to even ask this of you or and so it just puts the whole conversation into this different tone or different vibe. So so I believe that we all have this this anticipatory rejection in some form. And when we're talking about ADHD, what the authors of ADHD 2.0 talk about, they give a little bit more context as to why someone with ADHD is going to have more of this anticipatory rejection. So William Dodson, one of the smartest clinicians ever to write about ADHD, made famous this term rejection sensitive dysphoria or ASD, which describes a tendency on the part of people who have ADHD to overreact precipitously and disastrously to even the slightest perceived put down diss or vaguely negative remark.
[00:06:48] And so if we go back to this concept of none of us have a sense of self as a little kid, we just don't. We are just in the moment needing our needs to be met. And then if we say that we would like something, I want I want that toy or I want this dessert right now that if someone doesn't give it to us, it is sheer terror in our minds as a kid, because I'm asking for something and I'm asking for my needs to be met. And I don't understand that my parents may not be able to afford the toy or that they may actually know something where saying that you can't just live off of licorice all day and night alone, but we still feel like I want that and so I need to get that or I may die. So I will, I will. I will throw a fit. I will withdraw. I will I will schmooze up and brown nose as we used to call it back in the eighties. Kiss someone's butt, do whatever I have to do to get that candy or to get that toy. And and if my parents eventually give in or whoever my caregiver is, oftentimes they'll just say, okay, this one time, I don't want you to ever ask for it again. The little kid doesn't say, Oh, okay, okay, well, thank goodness I got it this one time. No. It just immediately becomes filed into the bank of the brain that says, this is how I get my needs met.
[00:08:03] I just. Hammer, hammer, hammer. I cry, I withdraw. I do whatever. Little kids again, they show up as little narcissists. These little emotionally immature creatures that are going to gaslight. Gaslight is a childhood defense mechanism. It shifts blame, it gets them what they need. And so when we bring that into our adult relationships, then we're going in to say, and I have to fight for everything I get to get my needs met. And then if that is sometimes the energy that we're bringing in that that we are anticipating this rejection, then there's a lot of ways that that can show up. You can come into a relationship. So then if somebody just says, Oh, what did you say? I didn't hear you, we can say, Oh, no, she's nothing. It's no big deal. We're so anticipatory of this concept of rejection that we show up just insecure, anxious, or we might even show up angry. If we're anticipating that someone is going to tell us no, we might have to feel like we've got to go in and and demand to make sure that we get our needs met. So all of those and I'm so guilty of this, I really believe that this anticipatory rejection is what leads to that concept of an anxious attachment where if if people aren't meeting my needs, if my wife isn't jumping up and down 24 hours a day telling me I'm doing the best job I already as an anxious attachment view that as am I OC Did I do anything? And the process of checking in every 5 minutes is absolutely not something that is going to build a stronger relationship.
[00:09:27] If anything, that is what I've talked about before. It almost pushes your partner away. I feel like we get this this dance of an anxious and avoidant attachment in so many relationships, because as one person comes into the relationship already with this anticipatory, anticipatory rejection, or they want their their spouse to make them feel better because they don't feel good about themselves. Well, you can see where we've got a lot of things that are set in this relationship up to be dysfunctional, because we need to we need to come in with self love appreciation, not a self love deficit. As Ross Rosenberg says in his book, Human Magna Syndrome, that if we love ourselves, then we are more lovable. If we come in saying, Do you love me? And we're constantly saying, Do you love me because I don't love myself? Then what we're going to be doing is continually testing what are they doing to show me that they love me? And and that's really based off of an insecurity or an emotional immaturity of my own. And so if I don't feel good about myself and I need my spouse or I need somebody else to make me feel better about myself, remember, the chances that they're going to get that right are slim.
[00:10:31] I like to say five, 10% of the time they might say the right thing. Where I go, okay, they do love me, because if they don't nail that make me feel better concept, then I get to say they don't care about me and I get to say I'm unlovable or I'm broken. So I believe that all of this plays into this concept of this anticipatory rejection. So yeah, it's bigger with people with ADHD because and I could not find this, I promise you. And this is where I feel like in my more emotionally immature slash narcissistic trait and tendency days that I would just tell you right now there's data that says, but I think I heard an anecdotal bit of data that I desperately can't find. But was the concept that somebody with ADHD has been told? No, a couple of thousand times more than than someone who doesn't have ADHD as a child. And I can I can understand that, because if somebody is just continually hyperactive and they their brain is this ping pong ball and around a million miles an hour, and you that's your kid, they're constantly like, hey, can we do this? Don't do this. What you think about this, Dad, look, mom, look, look, look what I'm doing. And how many times it just hurt? No, not right now, but not right now.
[00:11:39] Jim. Hey, I said no. We'll do this later so you can see that you could get told no 15, 20 times in a day where someone else that isn't that that hyperactive or isn't looking for that dopamine hit of novelty or isn't wanting that recognition that someone that doesn't have that concept is just kind of doing their thing. Where I was that kid that was Mom, mom, look, look. Hey, let me tell you this. Let me just say this. Just continually just trying to interject the humorous things or anecdotes or stories to make me feel better about myself so that others will say, oh, my gosh, you're so awesome. But then if they haven't said, Oh my gosh, you're so awesome in five or 10 minutes, then what I've got to do, I got to get them to recognize me or notice me, which can you can just feel that energy that can feel overwhelming, can feel suffocating. So back to this exquisite sensitivity to criticism or rejection in the book ADHD 2.0. He says that again, that people with ADHD tend to overreact to even the slightest perceived putdown, diss or vaguely negative remark. They can spiral down to the depths and the blink of an eye and then become inconsolable. And then you just say that. On the other hand, there's always another hand in the syndrome. So characterized by pairs of opposite symptoms, we coined another term to describe the opposite of ASD and they say it's called rejection, sensitive euphoria or.
[00:12:57] E, which refers to our enhanced ability to make constructive use of praise, affirmation and encouragement. So as much as we can get down in the dumps over a minute criticism, we can fly high and put you to great use, even small bits of encouragement and recognition, which if you can feel that paradox there between rejection, sensitive dysphoria and rejection sensitive euphoria that if I feel crummy about myself and am anticipating that there is going to be that rejection, oh my gosh, the high when somebody does give me that, hey, you're doing great, you're awesome. And so we just want more of that. We crave it like a drug. And so if that is an ADHD tendency to do that more or to anticipate rejection more, I really believe because of all of our own childhood abandonment attachment issues, that I would imagine that everyone has that to a degree, this anticipatory rejection. So let me move on over into the a couple of articles. There's a there's a website called It's Attitude Mag, but it's Ad Mag. And the tagline here is it's attitude inside the ADHD mind. And that's one of the first places that I read about how ADHD ignites rejection sensitive dysphoria. There's an article there by William Dodson, who we're quoting here, and he says, For people with ADHD or ADHD, rejection sensitive dysphoria can mean extreme emotional sensitivity and emotional pain, and it may imitate mood disorders.
[00:14:25] Then I found a really, really neat chart that shows differences there of a mood disorder versus ADHD based rejection sensitivity. But it may imitate mood disorders, including suicidal ideation, and manifests as instantaneous rage, the person responsible for causing the pain. So William Dodson goes on to talk about in here, he gives the definition of rejection, sensitive dysphoria or raised as extreme emotional sensitivity and pain triggered. And I like that word triggered by the perception that a person has been rejected or criticized by important people in their life. And it may also be triggered by a sense of falling short or failing to meet their own high standards or others expectations. And that that concept as a couples therapist, I've worked with a lot of couples in my in my career. But even when I'm trying to lay out my four pillars of a connected conversation and I am saying, okay, we are going to go in if your spouse says, hey, why? Why did you do what you just did there? Let me give you a real example. If if the let's say it is the wife, this is one that happened recently. And if the wife says to the husband, hey, you know, tell me why you trying to think of a real example? If she says, okay, I had one recently where the wife just said, Hey, tell me why. What a blank I'm drawing.
[00:15:45] Okay. So I had a real example where the wife just said, hey, you know, I noticed that you said that you were going to take the car in to get the oil changed last Saturday. So tell me why you didn't do that. That is a valid question, because the person had said, yeah, I'm going to do this and he didn't do it. So he immediately and I'm trying to put this in my four pillared framework. I'm telling him we are working under this framework of you, or I need you to assume good intentions from her that there is there's a reason why she's asking that question, that she didn't wake up and think, Here's how I can make him feel bad. I'll ask him about the old oil change bit last weekend. So that first pillar seems pretty easy. I would imagine, if you're listening to this, that I don't even have to say, okay, I think she had good intentions. She was very curious. And so then the second pillar is I need him to stay in there. And it's this mindset, this this shift of where even if he thinks that that's ridiculous, she's asking me that or that's wrong. I didn't even say that, that he's not going to say that in the moment, because the goal is to keep the conversation flowing. It's to stay engaged in the conversation. And so then the third pillar is for him to ask questions, to say, okay, well, man, tell me, help me see my blind spots or tell me what you remember about that situation, which you can see in this conversation.
[00:17:01] It may not even need to ask questions if it's a the husband saying, take me on your train of thought, the wife's train of thought might be well, you said you were going to go get the oil changed, kind of the end of the train of thought there. We've reached the station. And then. But here's the trouble. My fourth pillar is for a person to not go into victim mode, for the person to lean in to to stay out of their bunker, to stay present. Because any one of those areas, if you violate any of my four pillars, then that is one of these these areas, this this road of disconnection. And there's these four different places where you can disconnect any of the pillars. If they assume bad intentions, don't assume good intentions. Now we're we're off into the weeds. If the person just says, okay, and I didn't say that again, that's an easy one. We're off into the weeds. If they if they don't ask questions first, if they start with comments, if they say, okay, well, let me just tell you what a day I had, and then and then then I'll try to make sense of what you had to say. They're basically saying you're wrong. This is you don't even understand.
[00:18:00] But that fourth pillar and it's funny because I joke often that that's the one that I am the worst, that that I can assume good intentions and think there's no reason that people are trying to hurt me and I'm not going to tell them that's ridiculous or wrong because that's their opinion. I understand everybody has their perspective, not just opinion, but their perspective. And then I can ask questions, hey, tell me, tell me your version of that. Tell me what you remember. But man, I'll be darned if I don't. Then hear all three of those and at times still have this natural feeling to want to say, okay, I guess my opinion doesn't matter. Real, real example. I worked a lot this week. A lot of my family was down in Southern California. They were at a beach. And we get together and play Mario Kart most every night wherever people are around the country. And we play at a particular time. 9:00 we jump on there, we play Mario Kart. We are. We're on FaceTime, we crack jokes. It's just a it's a blast. And I saw a lot of clients that day, and I think I'd record a podcast, I've done an interview, I've got a book project that I'm working on and so felt a little bit stressed. That's all I really look forward to this time to connect with the family. And so then we send around the text, Hey, we're on at 9:00, and then 9:00 comes 915 comes 930 comes now there at the beach.
[00:19:11] That that is an amazing thing. I want them to live at the beach. I want to live at the beach. And so at 9:00, I'm sitting there and I'm at my house and I've got the switch ready. Right. A place to Mario Kart and nobody's there and nobody is texting. And so, again, pretty easy for me to assume good intentions. They're not trying to hurt me. They're not just sitting there saying, you know what, I know we said that we're going to play Mario Kart with Dad tonight. I know he's used to that. Let's go. Let's not even get back to him. Wouldn't that be funny? I know that wasn't happening. Pillar two From my angle, I can't if I can't, if they just say, Oh, man, I forgot. Or we we just weren't even thinking about it. And we were caught up in a fun time, even if I think that's just ridiculous. You know, you said not going to be productive if I bring that up. And quite frankly, again, they're at the beach pillar three, asking questions before making comments if they show up late. I feel about the only question would be, how's your day? I mean, because again, if they I can assume these good intentions that they were at the beach, but even though I did those things and we eventually popped on, it's nine 930, 935 and now we're ready to play Mario Kart.
[00:20:20] And I did, I assume, good intentions. I didn't try to tell anybody they're wrong. And I jumped right into Pillar three and said, Hey, how would you guys how was your day to day? And they go on and they tell me these stories. It was so difficult if I'm being honest and again, I'm a pro, I develop the four pillars. I've seen 100 couples over the last 15 years. I, I love this stuff. I eat and breathe this stuff, the mental health therapy, couples therapy, all of this. And it was still difficult for me not to just say. Sounds like you guys had a great time. I mean, I was kind of counting on us playing at 9:00, but I mean, it's okay because what a what a what a victim mentality that would be for me, because then I want them to come. I want them to rescue me. I want them to say, Oh, my gosh, Dad, I'm so sorry. You're the man. You're there. You're slaying the dragon. Thank you so much. And it was in that moment that I recognized this anticipatory rejection or this rejection sensitivity, because these people that I care about, I'm making this judgment that if they aren't, if every moment they're not, we have to get back, that we've got to do what we can for Dad, you know, hey, I know that we're about to see the sunset and we just put our food order in because there was a line at dinner.
[00:21:24] But it's 9:00. Dad's going to lose his mind. You know, we need to get home, man. That would kill me if that was the vibe, if that was the energy. And so this this rejection sensitivity, even though I can understand that they do not know what what what it is like to be in my skin or to have this rejection sensitivity. Thanks. Thank you. Adhd and childhood. Thank you. Working on inner dialog to to go away from negative self. Talk to to be okay to know I'm okay to show up self validated into that situation and then to be able to have connection and just be grateful that we're able to have that moment. And so I just think that that just bring an awareness of this rejection sensitivity, whether you have full blown rejection, sensitive dysphoria or you can just identify with when you feel like wronged or when you feel rejected. And then when you take what someone says and you create this meaning and that meaning is about they don't care about me that that is that anticipatory rejection. So back to this article by William Dodson. He says dysphoria is Greek for difficult to bear. So it's not that people with attention deficit disorder, he says, are wimps or weak. And right now, just if you can follow me on this, I want to say that if you have ADHD, then we can say, okay, I'm going to say ADHD, but I want you I want you to feel heard or understood if you just have some of these traits.
[00:22:52] Because I believe that these are traits that also will come through just normal childhood interactions and especially if there was maybe some abandonment issues, maybe if your parents were caught up in their own things, maybe if there was some severe trauma or mental illness and or quite frankly, if there really was physical abuse, sexual abuse, emotional abuse, financial abuse in your childhood, because as kids, we don't even understand that those are things that are happening. We are just experiencing life and those things happen. So if if he goes on again to say that it's not that people with ADHD or A.D.D. or wimps or weak, it's that emotional response hurts them much more than it does people without the condition. But if the person with ADHD is on this far end of a spectrum with rejection sensitivity, then I think it's fair to say that you may not have ADHD, but you might be just slightly, a little bit down the road from that person. As far as how that that emotional response hurts you more than it maybe does someone that had more of a secure attachment in their childhood, he says no one likes to be rejected, criticized or fail. For people with ASD, these universal life experiences are much more severe than what he refers to as neurotypical individuals, but people that don't have the ADHD condition, or maybe they didn't have the severe emotional or physical or that abandonment or neglect in childhood.
[00:24:15] So then he says for people with ASD, again these universal life experiences are more severe, they are unbearable, they're restricting and they're highly impairing. And when this emotional response is internalized, which he says in often it is for people with ASD, then it can imitate a full major mood disorder complete with suicidal ideation because that sudden change from feeling perfectly fine to feeling instantly sad that results from rejection, sensitivity or rejection. Sensitive dysphoria is often misdiagnosed as this rapid cycling mood disorder. And all of a sudden you have people saying in my bipolar or am I borderline? And in my mind, no, you're human. And you've had these experiences in childhood, and now you you are bringing this into your adult relationships and you are anticipating rejection rather than when we are seeking validation and we anticipate rejection, you can see that that can be an unhealthy combination. And Dodson says it can take a long time for for physicians. And I'll add in to their therapist to recognize that these symptoms are caused by the sudden and absolute sudden emotional changes associated with ADHD and rejection sensitivity, while other while all other aspects of relating to others seem typical rejection sensitive dysphoria is in fact the common ADHD symptom, particularly in adults.
[00:25:25] So what does this start to look like when the emotional response is externalized? It can look like a very impressive instantaneous rage at a person or a situation that is deemed responsible for causing that pain. And again, if you are anticipating rejection from somebody going into a conversation, then you may feel like. Almost on a hair trigger. Or if you've been interacting with someone and you feel like they are anticipate the rejection so you're going to say something that will trigger them. The whole vibe, the energy can be so off and then people are kind of tiptoeing around how to have conversations, Dodson says. Then that rejection sensitivity can be hard to tease apart. He said Often people can't just they can't describe the words to the pain. They say that it's intense, it's awful, terrible, overwhelming. And then people with ADHD cope with this. He calls it this huge emotional elephant in two main ways, which aren't mutually exclusive. Number one, they become people pleasers. They scan every person they meet to figure out what that person admires and praises, and then they present that false self to others. So often this becomes such a dominating goal that they forget what they actually wanted from their own lives because they're too busy making sure other people aren't displeased with them. And man, if I can't help myself. But drawing some parallels to my other podcast, Waking Up to narcissism. If you start talking about narcissism or emotional immaturity, and if you are so deeply insecure and fearing rejection, so then you just want to be a people pleaser.
[00:26:49] So you're trying to figure out Who do I need to be to show up so that this person won't get mad at me? And the unfortunate part is a lot of pathologically kind people might hear that description that I just said and say, Oh my gosh, again, am I the narcissist? The answer is no. But where I'm coming from with this is that a lot of times that covert narcissist, the person that's doing things passive aggressively or behind the scenes, is still coming from this place of just such deep insecurities and then trying to put on this mask to get that external validation where the key or the cure is to have what again, Ross Rosenberg calls self love abundance, to really get to a point where you love yourself. So you're showing up as authentic and then you are not as nervous to try and see if I can get this conversation right. You're just able to be in a big part of that is is being able to take ownership and accountability of things that you aren't sure of, things that you don't know. And that's why I love doing podcasts about accountability, because it can feel so scary to say I did that or my bad or I didn't think about that. But once you get past that initial fear, it can just be liberating to start to take ownership of your life because again, you're the only one that is you.
[00:27:59] And so if you say, My bad, I forgot, and somebody says, Oh my gosh, I can't believe that. I would never have forgotten that then. Okay, I appreciate them sharing that, but ultimately it's you and your life and how you show up. But they either become people pleasers or else they stop trying. If there's the slightest possibility a person might try something new and fail or fall short in front of anybody else, it becomes too painful, too risky to make the effort. And he says that they're very bright, capable people that avoid activities that are anxiety provoking and that ends up giving them they give up things like dating or applying for jobs, speaking in public. And so then people though, here's the ironic thing, which is kind of interesting because again, we're talking about traits of ADHD, which are these paradox of symptoms. He says some people use the pain of risk to find adaptations and overachieve. They constantly work to be the very best at what they do and strive for idealized perfection. Sometimes they're driven to be above reproach. They lead admirable lives, but at what cost? And I know that I can identify with some of this because you feel that concept of perfectionism is you feel like, okay, if I have been made fun of or if I've been so afraid of that I'm going to make sure that I do everything I can to not have to feel that way again.
[00:29:08] And we'll feel like the antidote to that is perfectionism. Because then if I can make sure that I appear perfect, then no one will ever think anything less of me or I'm going to go in. And if they view me as perfect, then I may not feel as prone to rejection or that sensitivity. Rejection sensitive dysphoria is characterized by intense mood shifts triggered by distinct episodes. Typically one of the following rejection the real perceived withdrawal of love, approval or respect when people tease and that can trigger again. These are triggers when people are continually teasing or sarcasm or saying, No, I was just kidding. But if you are just kidding constantly to somebody that suffers from anticipatory rejection, then they aren't going to feel like that is very funny criticism, no matter how constructive it can be. If somebody's saying, Can I offer some advice? Again, if you're coming at this place or I'm anticipating rejection, then can I offer some advice? Or criticism is going to be taken very, very harshly. And the person giving that criticism often will say, hey, look, you can shoot straight with me. But that doesn't mean that that person wants to be criticized and also a persistent self criticism or negative self talk, which is prompted by a real or perceived failure.
[00:30:14] And so you have these mood swings. Then the what are the outward signs of rejection, sensitive dysphoria, sudden emotional outbursts, withdrawal from social situations, the negative self-talk? Sometimes that can lead to thoughts of self harm, avoidance of social settings where they might fail or be criticized. And for this reason, rejection sensitive dysphoria is often hard to distinguish from something like social anxiety disorder. But instead of it just being someone who doesn't want to go out in public because they have social anxiety, they don't want to go out unnecessarily because of that fear of rejection. Which can lead to then low self esteem, poor self perception, and then not just negative self talk, but a kind of harsh negative self talk that often leads this person to become their own worst enemy, which is one of those most difficult things. If we're just ruminating and we're kicking around these thoughts in our head and they're continually negative that they are not going to resolve themselves in our head of No, I think I'm an okay person, which is why people then, as much as they anticipate rejection, will often then just continually ask, hey, are we good or am I okay? Or What do you think about this? Because they want that external validation which can lead to relationship problems, especially feeling constantly attacked and responding defensively. There's a chart that I really like in this article I'm referring to that says, How does rejection sensitivity differ from a mood disorder? So on the left side of this chart, they talk about a mood disorder.
[00:31:34] Mood changes are triggered or out of the blue with rejection, sensitive dysphoria and ADHD, a mood change will have a clear trigger. Sometimes I find that fascinating when somebody will just say No, I just went off on somebody. But you can say, break down a game film, take a few steps back, and you can see that the person had been overwhelmed. They had been sleeping a lot. They may have been eating less. They haven't exercised in a while so that there are these triggers that have led up to an outburst under the side of mood disorder. Moods are independent of what's going on in the person's life and with ASD and ADHD, moods match the perception of the trigger. With mood disorder, mood shift is gradual over weeks and then the mood shift is instantaneous with a mood disorder offset to mood episode as a gradual over a period of weeks to months and then rest episodes end quickly in a matter of hours. And then for a mood disorder, typically for diagnosis, you're looking at a duration of greater than two weeks. And RSV is episodes rarely last more than a few hours. So in other words, the moods of ADHD and rejection sense of dysphoria are normal in every way except their intensity. So a couple more thoughts here. One is I found an article and this was again written by William Dodson talking about how the similarities between rejection sense of dysphoria and bipolar, because some people will feel like they're just being bipolar because they can just shift mood so quickly.
[00:32:53] And he said that I thought this was an interesting, interesting fact. He said 40% of individuals with bipolar disorder also have ADHD. And he said the conditions, the symptoms typically overlap. However, clinicians can successfully distinguish between bipolar and ADHD or rejection sensitive dysphoria. According to the patients experience of emotions, patients with ADHD and specifically rejection sensitive dysphoria get triggered by a distinct event and then experience an intense but fleeting mood. People with bipolar disorder experienced a random onset of mood that lasts for weeks or months, which that's the key, again, with ADHD and rejection. Sensitivity, or even if you don't have ADHD portion, you can start to identify a trigger and then you can have an extreme mood swing. But then it may be something that goes away honestly with a good night's sleep rest or later in that day, or if you become distracted where bipolar sets in. And that can be something that takes weeks or months to work through. What causes rejection sensitive dysphoria. I thought that this was interesting. In other article I found on medicine, Netcom says that experts believe ASD really doesn't have a single cause as the result of a combination of multiple factors. So here we've been talking about it a lot with ADHD and I threw out my hypothesis that because of all of our childhood abandonment, rejection, that sort of thing, that then it is going to be a component or there's maybe on a spectrum with anyone.
[00:34:12] And I recorded this yesterday morning, half of this the first half, and then I met with clients all day and I was talking with a couple of people about this and some of the people that I'm working with that are in relationships or divorcing narcissistic individuals or people with extreme emotional insecurities. And one of the people brought up a good point where they talked about imagine then having the ADHD predisposition to rejection before the age of 12. But then if you had a narcissistic parent or and I think I mentioned that earlier and emotionally abusive or even physically abusive parent, then that rejection sensitivity is going to be huge. And I haven't looked at this yet, but when I talk about highly sensitive people, that people that they've grown up and maybe had to deal with a little bit more of that trauma as a child, that they are they are continually watching a situation they are going to watch before entering. They're trying to read people they may feel a little bit more intuitive or not just empathetic, that then if you are continually on high alert trying to view a situation or anticipate a situation, then I can imagine that there might be a correlation to highly sensitive people and rejection sensitivity as well.
[00:35:16] So I think that one might be something to look at. Additionally, genetics may be involved in our esteem run in families. Rejection sense of dysphoria has also been seen to be to affect people with a history of parental neglect and childhood. So where I think that backs up a little bit of the things that I was assuming bullying by schoolmates or a big one can be criticism by your spouse or partner. And how is it treated? There's a couple of medications that there's called MOA inhibitors, monoamine oxidase inhibitors. And that's a whole. Different classification of drugs, which I'm not really familiar with. Also the vaccine and the thing called Clonidine. And there's a belief that that's one of these it's like a mood stabilizer lessens anxiety or maybe flattens your effect a bit so that then you are able to have this built in pause. Or some people have talked about some of the examples that I read, talked about people that just felt like they had on emotional armor. So the anticipatory rejection was still coming at them, but they it wasn't as intense because of some of these medications. But then also they talk about therapy and stress management, sleep, exercise, healthy diet and meditation, deep breathing, yoga, tai chi walking and doing things that you enjoy. And also therapy, talking about relationships. I've done a couple episodes on the virtual couch as well as on the waking up, the nurses and podcast and talked about PTSD complex post-traumatic stress disorder, which that is relationship PTSD.
[00:36:40] And I did find an article that talked about post-traumatic stress disorder, or especially PTSD has also been linked to higher levels of rejection since they say more research needs to be done compared to the research that's been done with ADHD. But a characteristic symptom of PTSD is a heightened emotional state and a response. And according to a 2012 study done by Dr. Grace, Kirkus found that rejection sensitivity was positively correlated to PTSD symptoms severity. But then they think that more study, more studies need to be done there. And then that article also talks about how to cope with rejection sensitivity, and they talk about therapy using my favorite acceptance and commitment therapy, also cognitive behavioral therapy and one called dialectical behavior. And that all of these work on targeting people's harmful thought processes and then helping you move into desired behaviors and then learning coping mechanisms to heal past trauma will then help reduce sensitivity to criticism as well as and I thought this was why I love this comment as well as the anticipation as well as the anticipation of abandonment, because you can get in with a good therapist and work through some of the abandonment issues you have and work through some of maybe the childhood wounding or trauma. Then some of that will start to make more sense and as to how we got to where we are as a person.
[00:37:53] And then that might calm the central nervous system a little bit more. That will help maybe not go all the way into fight or flight or freeze when you're interacting with somebody that you may anticipate could potentially reject you. And and finally, I thought this was I don't even know what to do with this one, but I feel like this is where I pull my old man card out again. But when people text each other and there I have spent more time over the last probably four or five years breaking down texts and timing of when somebody responds to somebody else. And I want to look at that from an anxious attachment standpoint. But there are some people who just very confidently say, you know what, I'm not going to respond right away, because then they're going to think, fill in the blank, but then later they're breaking down. Well, but then she responded this far, this much farther than I did of a time frame in one article in Psychology Today by Andrea Benoit talking about what is rejection sensitive dysphoria, she said, As you may expect, RCD can have a significant impact on having relationships or even seeking relationships. Dating can be especially hard for someone with ASD as they are hyper focused on any perceived slight whatsoever. And I love that she just has the next line. Why did it take so long for them to text back? Because then the person is going to assume that they're being rejected when that could be far from the case should they may ruminate on what they said or did wrong or isolate themselves to the point of self sabotaging and actually driving the other person away due to seemingly not being interested in them.
[00:39:17] That self sabotage vibe is something that I do see often, and we can self sabotage ourselves so quickly. And even just because of someone not responding to a text in a time frame that we believe that they should respond. And as someone that I, I used to be on top of all my texts, I just I get so many that I hate the fact that I'm that guy now that I don't even have that excuse of I didn't get your text. I know I got it. It's probably in the number of the unread ones and so it's easy now. I feel like when I used to try to respond to people right away and then if they didn't respond back, I would think at times like, how dare they? I'm responding to this person and now I understand. Oh, man, some days it's just it would literally be it's impossible to get back to everyone or to stay engaged in a text conversation. So if you're looking at that anticipatory rejection, I can understand, especially in a relationship, how difficult that can be. She said that within relationships, people with rest can have different ways of manifesting their underlying discomfort and fear.
[00:40:10] And she said, sometimes gender roles can make a difference. A person may continually second guess their action, wanting frequent reassurance from their partner that everything's okay. There's that anxious attachment again. They may grow timid or afraid of sharing their real feelings because the fear that those feelings won't be deemed acceptable and then they may escalate. Contact conflicts with anger that feels out of proportion to the situation. And I really I thought this was interesting, she said. Surprisingly, some controlling partners may actually be reacting out of underlying rejection sensitive dysphoria as their anxiety makes them want to keep their partner on a tighter and tighter leash because they're terrified that their partner will, she said. Make no mistake, controlling behavior is dangerous and needs to be taken seriously. Absolutely it does. Because, again, as I said earlier, I think that there's some there's a connection here, a correlation at some point about let's look at again about emotional immaturity, narcissism, those controlling behaviors, sequestering somebody, cutting off friends from somebody that it comes from such an emotionally immature or narcissistic place to then control your partner. But some of that can come from this anticipatory rejection that if I let them just be themselves, then of course they're going to leave me. And so I'm going to I'm so afraid of that, that I need to control the relationship. And that can of course, it forms a trauma bond and it can be toxic.
[00:41:19] But I think that that can make some more sense of if you feel like overly controlled and you can recognize maybe it is this that anticipatory rejection in my spouse. That does not mean that then. Well, that makes more sense. So I will still continue to be controlled because I feel like in that camp I want everyone to have all the information they need that will help them understand that maybe this isn't a healthy relationship. So if you have any thoughts, questions, feel free to shoot them to firstname.lastname@example.org or head over to the website and as per usual, saving the the business. Maybe some of this till the end, but if you're looking for to meet with a therapist and looking at the world of online therapy, go to Betterhelp.com slash virtual couch and you might be seeing someone within 24 to 48 hours, which is phenomenal because it is hard to get into a good therapist right now. And also, I still have my my hour and a half workshop. It's up on my website. It's $19. And you can go to Tony over Macomb workshop there. And I talk about my four pillars of a connected conversation and abandonment and attachment and differentiation and all those good therapists things. So have an amazing week and I will see you next week on the virtual couch taking us out, per usual, the wonderful, the talented Aurora Florence with her son. It's wonderful.
[00:42:34] Compressed emotions flying past our heads and out the other end, the pressures of the daily grind. It's wonderful. And that's the question, Rob. A ghost floating past the midnight hour. They push aside the things that matter most. It. Citing news of discount price a million opportunities. The chance is yours to take or lose. It's worth. Phones are always on the back burner until.