Rejection Sensitivity & People-Pleasing
Rejection sensitivity is usually one of those experiences people live with for years before they have language for it.
You might describe it as:
Taking feedback harder than others seem to
Feeling crushed by anything that feels like criticism, even when you logically know it “wasn’t meant that way”
Replaying conversations in your head, looking for where you went wrong
Constantly scanning for signs you upset someone
Over-explaining yourself, people-pleasing, or walking on eggshells to avoid conflict
Swinging between emotional outbursts and emotional shutdown after perceived rejection
For many people, it’s not just emotional. The pain can feel visceral—a searing pain in your chest, a sinking feeling in your gut, feeling as if your face is on fire, or an urge to disappear or armor up.
And often, it’s paired with a harsh internal response, like relentless self-criticism, self-blame, and a deep sense of not enough-ness.
Perfectionism
Procrastination
Lack of self-trust
Downplaying your achievements
Over time, this can lead to entrenched protective patterns:
Difficulty with boundaries
Inauthentic, disconnected relationships
Avoiding risks you deeply desire because there’s a possibility of failure
Why Rejection Sensitivity Makes Sense
Rejection sensitivity isn’t a flaw. It’s an adaptation.
At its core, it reflects a nervous system that is especially attuned to social cues--tone, facial expression, word choice, micro-shifts in connection.
From an evolutionary perspective, this makes perfect sense.
For most of human history, belonging wasn’t optional. Being excluded from our tribe literally meant death: loss of protection, resources, care, and opportunity to procreate.
A system that learned to detect the most subtle signs of rejection early and find them excruciating had a real advantage
Some people are simply born with more sensitive systems. Traits like emotional intensity, sensory sensitivity, and reactivity are partly heritable.
In other words, many people didn’t “learn” rejection sensitivity from scratch, they arrived already wired to feel more and notice more than some people.
However, our inborn traits alone aren’t usually enough to cause problems.
When a naturally sensitive child grows up in a world that responds with frequent criticism, misunderstanding, invalidation, or social rejection, their nervous system is primed to adapt for survival. It learns that connection is fragile and mistakes are costly.
Over time, sensitivity becomes hypervigilance
The ADHD and Neurodivergence Connection
Research suggests adults with ADHD are especially likely to have high rejection sensitivity, often described as rejection sensitive dysphoria (RSD)
And when you look at the lived experience of many people with ADHD, the connection becomes fairly obvious.
Children with ADHD experience much higher rates of peer rejection and are corrected, criticized, and misunderstood more often by adults than their neurotypical peers. Unfortunately, that experience is stable over time, even with treatment for ADHD symptoms
So, is it any wonder that when a child is repeatedly told they’re “too much,” “not trying hard enough,” “disruptive,” or “lazy,” their nervous system learns a clear rule?
Connection is conditional, and I need to monitor myself constantly to keep it.
For late-diagnosed adults, this often cuts deeper. Many grow up believing something is wrong with them, because no one ever helped them make sense of their differences. Without an explanation, kids don’t think “this is a mismatch,” they think “this is me.”
Over time, this often shows up as:
Hyper-awareness of others’ tone, expressions, or mood shifts
Intense emotional pain around perceived disapproval or criticism
Perfectionism, people-pleasing, or pulling away to avoid getting hurt again
None of this means something went wrong.
It means a sensitive system did exactly what it was designed to do: learn from experience and protect against future harm.
The problem isn’t the sensitivity itself
The problem is when those old rules keep running past their expiration date—
When your system still reacts like rejection is imminent, even in relationships that are safer, more nuanced, and more flexible than the ones you grew up in. When you have more power, more agency, more resources, and support than you did back then.
Why “Just Think Differently” Falls Short
If you Google rejection sensitive dysphoria, you’ll probably come across articles recommending Cognitive Behavioral Therapy (CBT) as a treatment path.
This approach often focuses on changing how you interpret rejection: challenging assumptions, reframing thoughts, testing beliefs.
These tools can be useful, especially for increasing awareness and flexibility. But they tend to fall short when it comes to rejection sensitivity for one simple reason:
You cannot reason your way out of a response that happens before reason is online.
Rejection is processed quickly, emotionally, and subcortically. By the time you’re telling yourself “this isn’t personal,” your body has already reacted.
That doesn’t mean cognitive work is useless. It just means it’s incomplete on its own.
Ironically, these protective responses tend to create more disconnection, not less.
Suppress or invalidate their reactions
Shame themselves for still feeling hurt
Double down on control strategies like perfectionism or people-pleasing
Trying to override rejection pain with logic often leads people to:
Shame cuts us off from ourselves.
Appeasing erodes authenticity.
Blame ruptures relationships.
Avoidance isolates.
They don’t create the connection your system was trying to preserve in the first place. Not because they’re bad, but because they’re protective strategies that were once necessary and now cost more than they give.
What Helps (But Often Isn’t Enough on Its Own)
Insight
For many people, learning why rejection hurts can be very affirming.
Understanding that rejection activates ancient survival circuits in the brain can reduce shame and self-blame. It helps people stop asking, “What’s wrong with me?” and start recognizing, “This response makes sense.”
Knowing that rejection pain overlaps neurologically with physical pain, that it’s meant to hurt, and be more important to your brain than physical wounds, can soften the inner critic voice saying, “why can’t you get over this?” and create more self-acceptance.
And insight still has limits.
Knowing that rejection activates your nervous system doesn’t stop the activation. It just explains it.
Skills
Skills also matter. I teach my clients a 4-step rejection recovery process that involves distress tolerance, emotion regulation, and interpersonal skills.
But that’s where we start, not where we stop. Skills are emotional first aid while we work on the deeper wounds creating the pain in the first place.
Coping skills help you survive rejection; they don’t help you stop organizing your life around it.
Meds
Medication can help too, especially for people with ADHD.
Emotion regulation is an executive functioning skill, after all.
Some people find that stimulant or non-stimulant medications reduce the intensity or frequency of rejection reactions.
All these approaches can make life more manageable.
And still, many people notice something frustrating:
They take a lot of effort.
And the reaction still comes.
Why the Reaction Keeps Happening
Rejection sensitivity lives in the parts of the brain responsible for survival and learning from experience, not logic or language.
You can’t reason your way out of a response your nervous system learned through repetition, emotion, and memory.
Skills help you cope after the reaction. Insight helps you make sense of it. Medication can lower the volume.
None of those alone rewrite the underlying emotional learning that says:
I’m in danger.
What Helps (But Often Isn’t Enough on Its Own)
Bottom-up therapy works with the part of the brain and nervous system that actually learned to fear rejection.
Rather than trying to prevent rejection or make you “rejection-proof,” this work focuses on:
Reducing the intensity of the automatic emotional response
Helping your system recover more quickly when rejection happens
Replacing default survival strategies that ultimately create more disconnection
The goal is not to eliminate pain. I wouldn’t want to, even if I could. Rejection is supposed to matter.
The goal is to help your nervous system update old emotional memories and implicit learnings, so rejection no longer feels catastrophic, identity-threatening, or all-consuming.
Feeling hurt without spiraling into shame
Being able to access self-validation and self-compassion naturally
Noticing rejection cues without assuming abandonment
Staying present instead of withdrawing, fawning, or exploding
Showing up authentically and safely in relationships
Having choices in how you respond
In practice, this often looks like:
Bottom-up approaches help the body learn that while rejection still hurts, it’s no longer dangerous in the way it once was.
That’s the difference between managing reactions and actually changing the pattern underneath them.
How This Work Actually Happens
Updating rejection sensitivity at the nervous system level requires working directly with the experiences that taught your system how to respond to threat, disconnection, or loss.
(Psst…this is trauma work).
Many people rule themselves out of trauma-focused therapy because they don’t identify with the word trauma. They think it’s taking away from the weight of accidents, assaults, or singular catastrophic events.
Having your emotions dismissed, minimized, or misunderstood over time
Being repeatedly rejected, excluded, or bullied
Growing up feeling “different” and quietly blaming yourself for it
Feeling chronically misunderstood, criticized, or “too much”
Trauma also includes experiences like:
When these experiences happen over time, your nervous system adapts.
Trauma therapy is simply the process of helping your system recognize that those old conditions no longer define your present.
Two Ways to Work Together
We can work on rejection sensitivity and people-pleasing patterns through ongoing individual psychotherapy or through focused, standalone interventions like Accelerated Resolution Therapy (ART).
In weekly therapy, we work steadily and intentionally. We track patterns as they show up in your daily life, build capacity over time, and revisit old emotional learnings at a pace your nervous system can integrate.
ART intensives take a more concentrated approach. They work directly with emotional memory and implicit learning through structured eye movements and imagery, allowing your brain to reconsolidate old rejection-based memories more efficiently. The goal isn’t to relive the past, but to update it so it stops hijacking the present.
Both paths do the same kind of work at the nervous system level. The difference is pace, structure, and how focused the intervention is.
Both paths start the same way: with a Connection Call.
It’s a chance to get oriented, ask questions, and decide together what kind of support fits best.
High-Functioning Anxiety, Overthinking & Perfectionism
Neurodivergence