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URMC / BHP / BHP Blog / August 2023 / Rejection Sensitivity

Rejection Sensitivity

By: Melissa Nunes-Harwitt, LCSW

As a child, you may have heard a refrain ending with “…but words can never hurt me.” Did this ever sound wrong to you?  Not only can sharp words hurt, but you may feel wounded by speech or behavior that was intended to be neutral or even positive. If you often feel put down, criticized, or abandoned, especially to a degree disproportionate to the facts of the situation, you may be experiencing rejection sensitivity. 

Note that while you may see people on social media discussing rejection sensitive dysphoria  the professional mental health community does not consider this to be a separate condition. Rather, rejection sensitivity is a type of emotional response. It is particularly common in people with any of the following diagnoses: depression, social anxiety, borderline personality disorder, posttraumatic stress disorder, ADHD, or autism.

There is disagreement about the origin of rejection sensitivity. It has been defined as an innate neural tendency, a stable but non-permanent personality disposition, a learned response to recurrent rejection, or a combination of these three. In other words, the answer could be nature, nurture, or - mostly likely - both.

The thoughts that accompany rejection sensitivity can be intense and extreme.  A boss giving feedback on your work may lead to fears of being fired; a friend turning down an invitation could make you wonder if you’re being kicked out of the social group. “We need to talk” are words that send you into a downwards spiral. Some people describe the sensation of rejection sensitivity as being as bad or worse as physical pain.

Arguing with rejection sensitivity thoughts is not effective. When you pit logic against emotion, the feelings usually win. Dismissing your worries even makes the fear flare up: “I knew I was worthy of being rejected. Look, I’m even rejecting myself!”

Instead, try to treat yourself with compassion. Provide soothing acceptance and validation. Though your feelings may disagree with the facts, you have to honor the emotions fully before you can get them listening to logic.

How do you acknowledge fears without agreeing with their content? Start by listing the sensations in your body that accompany the emotions. Literally say them out loud to yourself: pit in the stomach, tightness in the throat, tense shoulders, clenched fists. Then name these as being associated with feelings, not facts. Remember to be compassionate: you’re not pushing the feelings away, you’re getting to know them better.

For example:

I am hunched over and feel queasy. I am feeling scared that they don’t like me anymore.

My heart is beating fast and my breathing feels blocked. I am terrified that they hate what I said.

Repeat these steps a few times to make sure you are fully accepting your emotions. You can pair this activity with box breathing or other grounding exercises to help bring down the intensity.

As with any other emotion, being hungry, tired, or overwhelmed often exacerbates the sensations of rejection sensitivity. Getting a snack, having a glass of water, or taking a short walk may also help you feel better.

When you are ready to integrate logic, use “yes / and” to pair it with emotion.

Yes, I am lonely and scared that my friend doesn’t like me anymore. And I know this particular friend is flaky with everyone, even people he likes.

Yes, I am feeling alone right now and I will not always feel this way.

Yes, I am worried that my boss wants to fire me, and I heard her say she wants to help me improve so I can be successful in this job.

Sensitivity to perceived or actual rejection can affect mood and interfere with social functioning. If you find it difficult to manage this type of intense emotion, therapy may help. The team of mental health professionals at Behavioral Health Partners can assess your symptoms and provide support. To schedule an intake appointment, give us a call at (585) 276-6900. BHP is brought to you by Well-U, offering eligible individuals mental health services for stress, anxiety, and depression. 


Jittayuthd, S., and Karl, A. (2022). Rejection sensitivity and vulnerable attachment: associations with social support and PTSD in trauma survivors. European Journal of Psychotraumatology, 13(1):1-11. DOI: 10.1080/20008198.2022.2027676

Lin, X., Zhuo, S., Liu, Z., Fan, J., and Peng, W. (2022). Autistic traits heighten sensitivity to rejection-induced social pain. Annals of the New York Academy of Sciences, 15(17):286–299. DOI: 10.1111/nyas.14880


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