What is Rejection Sensitive Dysphoria? (and why are Rejection, Blame &; Shame such BIG PROBLEMS in ND Marriage?)
- Dan Holmes
- 4 hours ago
- 7 min read
By Barbara Grant, MMFT, ND Couples’ Coach
Many ND people (both ASD and ADHD) report struggles with a painful sense of rejection, which has been labeled as Rejection Sensitive Dysphoria (RSD). In this blog I’ll be discussing RSD and how shame and blame are often reactions to perceived rejection. Buckle up!
First of all, rejection, shame and blame affect us all, regardless of neurotype. Most of us don’t realize that from our earliest years, the Enemy has used our experiences of these things to train us – and our loved ones – to at times feel worthless, insignificant and expendable. Most of us have some form of “insecure attachment styles” and we’ve very possibly developed unconscious habits of thinking and behavior around them. These habits may have evolved to become trauma or dysregulation triggers, which can go off like land mines in ND relationships. To diffuse these triggers and accompanying dilemmas, it’s important to first understand how the curse – and habit – of shame effects each of us personally.
In ND marriages, many of our needs (emotional, physical, sexual needs, financial or co-parenting) are not being met: We feel abandoned – we feel rejected. We may even be on the receiving end of outright criticism, control and abuse… hopefully not, but that could be happening.
A healthy response to rejection, shame and blame (and certainly, to abuse) is to speak our truth in love, telling the offender that this hurts us. But there’s also an unhealthy response – that of failing to set a boundary against negative accusations, either because we think we deserve them, or we’ve lost hope, or (most likely) we’re just in the habit of being kicked around. As we dig deep to excavate and discern our own struggle with rejection, shame and blame, we can enter a process of grieving any past rejections that happened to us, and developing self-compassion along with an ever-greater dependence on God’s love and grace. Growing in self-compassion can also lead us to having more discernment and compassion for partners and loved ones who may not be dealing well with shame. This doesn’t mean that, if they’re behaving badly towards us, we should coddle, accommodate, or enable them, but it does mean recognizing the death spiral of shame that the Enemy wants to keep them in – and to drag us down into. Only when we come under grace, and live it, we can escape habits of receiving – and retaliating with – condemnation.
What is Rejection Sensitivity Dysphoria?
The topic of rejection (accompanied by shame and blame) is important to understand, because Rejection Sensitivity Dysphoria is gaining traction in the secular world as a “symptom” that afflicts ND people, especially those with ASD or ADHD, or both. The term RSD was introduced by Dr. William W. Dodson in 2016, and in his presentations about it, he defined RSD as:* (pp10) … an extreme emotional sensitivity and emotional pain triggered by the perception or imagination by the person with ADHD that they have:
been rejected, been teased, been criticized, disappointed important people in their lives, withdrawn their own approval of themselves when they failed to attain their own standards or
goals
In his article, he implies that there is no treatment for it, and he states, “Since RSD is genetic and neurological, psychotherapies have been found to have little benefit.”(pp11). In subsequent articles, Dodson couples RSD with the idea of Emotional Dysregulation (ED), which most of us in ND relationships are familiar with.
Since that early 2016 discussion, RSD has a growing “buzz” around it and continues to be presented as a “chronic condition” by many, meaning, it’s inevitable and there’s no resolution, improvement or cure. There is actually little, if any significant clinical research about RSD, and in a 2023 article on RSD and emotional dysregulation (ED), Dodson wrote, “Even when RSD/ED is present, it can’t be measured, and, therefore, can’t get published in research.” (* 3/18/2025 Dodson). I’m not sure what the logic is there, since there are probably many qualitative research studies (vs. quantitative) that could be done to
measure degrees of anger, fear, anxiety and depression experienced in response to perceived rejection, but in any case, it’s a stretch to classify RSD as inevitable and unsurmountable.
What Hope is There?
If we decide to agree with Dodson (that RSD is rooted in genetics and is something a ND person is stuck with), then we must disregard all Biblical teaching that invites us to become “overcomers” who are able to “do all things through Christ who strengthens [us].” (Phil 4:13, NIV). In fact, the entire chapter of Romans 8 is a discourse on living in grace and not being subject to condemnation (i.e., the essence of rejection, blame and shame). The passage speaks of overcoming the “flesh” by the power of the Spirit. Paul closes by declaring that nothing can separate us from Christ’s love, and that “in all these things we are more than conquerors” (Romans 8:37, NIV).
So why do ND people tend to develop a hypersensitivity to the idea of being rejected? Many neurodivergent individuals come from family backgrounds where neurodiversity was present but unrecognized. They may have had a parent or close relative with undiagnosed autism or ADHD, or grown up in households marked by emotional estrangement between neurotypical and neurodivergent parents. In some cases, trauma, addiction, or abuse—often intensified by undiagnosed neurodiversity—shaped their early experiences. For much of the 20th century, mental health was not widely discussed, and neurodivergence was rarely identified. It’s only in the last few decades, particularly with the rise of the internet, that awareness and understanding of the prevalence of these differences have increased.
Growing up without this awareness, many neurodivergent individuals were never guided to understand their own strengths and challenges, nor to accept themselves for how God made them. If they sensed they were different, they often felt uneasy about it. Many were bullied, teased, or rejected, leading them to develop a habit of masking—hiding their true selves to avoid further rejection. This deep-seated fear of not fitting in made them believe, I must act like everyone else, or I won’t be accepted; Over time, rejection may have become an expectation, a form of self-defense to avoid being blindsided by actual exclusion. Some may have even withdrawn from relationships entirely, believing rejection was inevitable.
This conditioning can lead to such a hyper-sensitivity, that even neutral interactions feel like personal attacks. A simple raised eyebrow from a spouse might trigger an immediate reaction: “What? What did I do wrong? Yu-re always criticizing me!” In these moments of dysregulation, logical discussion becomes nearly impossible because the neurodivergent person is already assuming the worst—both about themselves and their partner. Their ability to process and accept constructive feedback may be significantly impaired, reinforcing a cycle of avoidance and defensiveness.
This avoidance of feedback may also prevent neurodivergent individuals from seeking help. They may struggle to understand that they when they are given input or correction, they are not being condemned, but rather, they are being lovingly helped because they are in a space of grace—both with their partner and with God. True healing begins when they realize they are safe, that their differences do not make them unworthy of love and connection. Recognizing this can be the first step toward breaking the cycle of fear and isolation, and moving toward more authentic and fulfilling relationships.
How Does Rejection Impact Neurotypicals?
Conversely, neurotypical spouses married to neurodivergent partners can also become hypersensitive to perceived rejection: They often feel their emotional needs have been chronically unmet. Over time, this can feel like a slow erosion of their self-worth, a rejection of valid emotions, and a lack of true acceptance. It’s the opposite of what they envisioned when they walked down the aisle, exchanged vows, and committed to a lifelong partnership. They didn’t sign up for a relationship where they constantly had to fight for meaningful connection—they signed up for an equal exchange of love, understanding, and reciprocity. As a result, many neurotypical spouses fall into a pattern of persistently trying to fix their situation.
They believe that if they just explain their needs clearly enough, model the right behaviors, or push hard enough, their partner will eventually change. (I was once such a neurotypical!) This angst over being neglected and seemingly rejected often stems from an anxious attachment style—one that developed from inconsistent emotional validation in early years. When love and affirmation were conditional or unpredictable, they learned to chase connection, to persist even when faced with emotional distance.
This pattern plays out in many ND marriages, where one partner (often the neurotypical) is wired for deep emotional connection, while the other (the neurodivergent) may be more inclined toward logic, analysis, and retreat in the face of relational demands. This creates a frustrating dynamic of pursuit and withdrawal—one partner chases, while the other pulls away. And this cycle can persist for decades, leaving the pursuing partner feeling chronically rejected and emotionally depleted. For some, this unmet need for validation leads to seeking connection elsewhere—whether through deep involvement with their children, emotional affairs, or even physical affairs. It’s not necessarily about betrayal, but rather about seeking the emotional fulfillment that feels unattainable in their marriage. I’ve worked with individuals on both sides of this dynamic—men and women alike—who find themselves at
a crossroads, grappling with feelings of rejection and longing for connection.
Such deep, unmet longing can devolve into what is known as the Cassandra Syndrome, which, like Rejection Sensitive Dysphoria is NOT an insurmountable chronic condition. If each partner can come to an understanding and acceptance of their opposing dynamics, they can take the first step toward healing. They can each turn to the Lord for his unconditional love and acceptance, and begin to reform their identity, not in how the Enemy informed them, but in how God formed them: for temporal and eternal relationship with him.
ND couples who can get on this track may find the grace to do the work within the marriage to redefine expectations and explore ways of connecting or making peace with the limitations of their relationship. Each party recognizing their own worth and finding acceptance in God’s grace is essential for moving forward.
Want to work with me? https://www.christianneurodiversemarriage.com/copy-of-referrals
References:
1. Dodson, W. (2016). Emotional regulation and rejection sensitivity. Attention, Oct 2016, 8-
2. Dodson, W. (2025, March 18). New insights into rejection sensitive dysphoria.
emotional-dysregulation/
Other resources:
The Role of Shame & Blame in Blocking Change in your ND Relationship (NDCC podcast, with Barbara Grant)
The Soul of Shame, Ch. 1 (NDCC podcast, with Curt Thompson)
Guilt, Shame and Grace (online article, by Bruce Greene)
Uniquely Us: Gracefully Navigating the Maze of Neurodiverse Marriage (new book, by Dr.
Stephanie & Dan Holmes)