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ADHD Chatter PodcastADHD Chatter Podcast

How To Manage Rejection Sensitivity - Dr. Samantha Hiew, PhD (4K)

Dr Samantha Hiew is the Founder of ADHD Girls and a neurodiversity and ADHD expert. In this episode, Samantha explains how you can deal with Rejection Sensitive Dysphoria in your personal and romantic life.

Alex PartridgehostDr. Samantha Hiewguest
Jan 22, 202443mWatch on YouTube

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Transcript

  1. 0:00 – 1:30

    A description of RSD / What is RSD?

    1. AP

      Why are people with ADHD so sensitive to rejection? Where does it come from, and what are some simple strategies that you can use to help manage it in your personal life and in your romantic life? These are the questions I ask today's guest, Dr Samantha Hiew. This is a conversation I wish I had when I was younger. Thank you so much, and enjoy the episode. [upbeat music] Samantha, thank you so much for joining us.

    2. SH

      Yeah, nice to meet you, Alex.

    3. AP

      Samantha, I asked my community to describe Rejection Sensitive Dysphoria, and they said, "I'll get a small rejection, and it'll make me feel like trash for days. I'll feel intense sadness or rage. I'll continue to think about it for months, and even years later, it might pop into my head and make me feel like trash again." Do you think that's a fair representation of RSD?

    4. SH

      Yeah, definitely. I guess it also, um, depends on the intensity of that, uh, reaction and what the source of that react- the, the source of the challenge is. You know, 'cause some rejections you can let it go a lot quicker, but some last for a lot longer. And I do find that the ones that do last a lot longer are more relationally, uh, related. You know-

    5. AP

      Mm

    6. SH

      ... things that, you know, perhaps are said by someone who means something to us.

    7. AP

      Mm.

    8. SH

      You know, and then we can bring it up at a later date, [laughs] you know?

    9. AP

      Yeah. [laughs]

    10. SH

      Because-

  2. 1:30 – 4:45

    Where does Rejection Sensitive Dysphoria come from?

    1. AP

      Where, where does RSD come from?

    2. SH

      Yeah, so, um, well, Rejection Sensitive Dysphoria in relation to ADHD, you mean?

    3. AP

      Mm.

    4. SH

      Like, that was, um, well, I guess it was William Dodson, the American psychiatrist who worked with thousands of, uh, children and families with ADHD over the years, you know, who noticed, yeah, this, um, intense, uh, reaction to perceived rejection, you know, um, by somebody with ADHD, you know, in a situation. And the scale of the reaction can be so much bigger than the actual rejection, that, you know, he's seen that quite universally in a lot of, uh, ADHDers.

    5. AP

      Mm. Do you think it's because people with ADHD are exposed to so many more negative criticisms when they're growing up, that they're sort of, they have a subconscious feeling of being different, so they're more primed to react defensively when they encounter-

    6. SH

      Yeah

    7. AP

      ... criticism?

    8. SH

      That's completely it. But then I tend to look at the stories of where we come from and what happened to us along the way, and our current life in motion. To answer that question, I really need to look at the context. So from the very beginning, you know, if we're, we're, we're born with this neurodevelopmental difference, you know, that will, um, perhaps, you know, cause some challenges with the relationship that you have with your caregiver, you know, if they also have undiagnosed neuro- uh, ADHD themselves, you know? So research has shown that less than 10% of, uh, ADHDers have secure attachment, and I can see the stories behind why that is, you know. Whether that is the story of, you know, genetics or the environment or social deprivation or adverse childhood experience, you know? So if you imagine a child who's coming into the world, and they're very much reliant on the adult that, you know, look after them in order to learn how to regulate their emotions and how to form, you know, that emotional regulation. And so in the absence of that or, you know, we're not just talking about, you know, anything that necessarily happened to- in an abusive way to us, but in an environment where perhaps there's neglect, you know, where things, where, where we should have gotten the support when we haven't, you know? And, and then, you know, this can cause challenges within ourselves, where we're then trying to figure out how to navigate these huge emotions by ourselves. And that, um, if you never learn that over time, you put in maladaptive strategies, you know, in your life whilst contending with a world that you're trying to fit in. And, you know, if you are receiving so much more negative messages because of the way you do things and the way you are, whether it's because of the executive functioning challenge or emotional regulation or relational issues and, and problems, then you are less likely to have really learned how to get over your past or to deal with emotions, you know, if that makes sense.

    9. AP

      Mm.

  3. 4:45 – 6:55

    Is RSD more common in ADHDers

    1. AP

      Do you think people with ADHD are more susceptible to, to Rejection Sensitive Dysphoria?

    2. SH

      Yeah. Well, um, I suppose you have to see what this rejection brings up in us, right? 'Cause we would navigate the world, as, as human beings, anyway, we navigate the world through our nervous system. You know, it's our nervous system that has embedded memories from the past. And when we encounter a similar situation, then your nervous system will flare up in the way that it's always known how. And a lot of, uh, ADHDers have a poor relationship with stress. And when we have that, then if there is a trigger, whether it's... And relational injury tends to bring that up more because of that insecure attachment piece. And, um, it can land us into a state of hypervigilance, where we are hyper anxious or hyper acting up or dissociative, where you're, you know, internalizing things. And so when these triggers present in our day to day as a form of rejection, we will, um, experience it, and then our nervous system will decide which route to go. You know, if you externalize it, as someone who's always prone to that fight or flight, then it can come out as rage, anger, you know, relational challenges and problems and breakdowns. You know, maybe withdrawing from things because you don't wanna be in that situation where you are likely to be ridiculed. Whilst if you, um, internalize it, it can look like major depressive disorder- You know, you can be depressed because of that relational injury, um, or you can, um, you know, have rumination, you know, this loop that goes in your brain on and on and on. And also, the inner critic and suicidal thoughts, you know-

    3. AP

      Mm

    4. SH

      ... things like that. And often, the worst type of rejection is the ones from people closest to you, where you feel like you don't have to mask or be someone else, you know? And, and that's when it hurts more because we are masking when we're at, you know, w- we're outside, we're dealing with the rest of the world, aren't we?

    5. AP

      Mm.

  4. 6:55 – 11:20

    Can RSD cause physical pain

    1. AP

      Is it, is it possible for the response to a criticism, the pain that we can feel, is it possible for it to be physical?

    2. SH

      Yeah. So, you know, um, there is a part in your brain that ensures, um, that you feel that pain from traumatic memories or, you know, s- uh, s- past somatic triggers. You know, um, there's a part of your brain that ensures you feel it in your body. When you encounter RSD, that brings up that shame and guilt, you know, inside you. And the p- that part of the brain is called posterior insula.

    3. AP

      Mm.

    4. SH

      And I came across this when I was going to therapy myself, and I was encountering, uh, encountering a situation where it was a moral dilemma, and my therapist brought this up, and it actually made me think, "That could be why it hurts in my body when I feel rejected." Because it's bringing up all the ways in which I wasn't welcome or I wasn't loved, you know? And that is not a wound that I got today. It's from a long time ago, you know? So when we say the reaction does not equate to the actual reality-

    5. AP

      Mm

    6. SH

      ... because we're not even responding to the person in front of us or the source of the reaction, the, the, the source of the rejection in that moment. We're reacting to something that we never got over-

    7. AP

      Mm

    8. SH

      ... a long time ago.

    9. AP

      So you sort of get snapped back to a past trauma from your early years?

    10. SH

      Yeah. It doesn't have to be early years. It could be trauma in motion, [laughs] you know? 'Cause we think of trauma as just something that happened a long time ago-

    11. AP

      Mm

    12. SH

      ... you know, with, um, our parents, but actually, a lot of individuals with ADHD, we have had to learn to adapt very quickly, think on our feet, you know, and going into every situation and trying to adapt to be like everyone else, you know? And that doesn't, that is really hard.

    13. AP

      Mm.

    14. SH

      You know, because I think the whole hallmark of ADHD, having executive functioning challenges, you are trying to... You know, when, when you're in a situation, you're trying to get your brain to engage and do the thing that it's expected to do, and the anxiety that comes from not being able to give people what they need in the moment, in every situation that you goes in from the moment you were born until now, that brings on, you know, challenges that researchers have put down to look very similar to the nervous system of somebody who has encountered post-traumatic stress disorder. I'm not saying that people, everyone with ADHD has post-traumatic stress disorder, but the challenges and the adaptations that you go through every day, research has shown that that looks like post-traumatic stress disorder in your body.

    15. AP

      That's fascinating. So is, is that because you have spent your whole life fitting in, shape-shifting, altering who you are, masking, essentially, desperately trying to be what you think society wants you to be, that that constant not knowing who you are, adapting to the situation in front of you, that can look like PTSD?

    16. SH

      Yeah. 'Cause also, whilst we're doing that, we're learning to give people the version of us that they like, the p- the version of us that are most likely to love, to, to be loved and to belong.

    17. AP

      Mm.

    18. SH

      And over time, that can look like what will make other people happy, but not you. And, you know, if that happens over a long period of time, you can be trapped inside, and then one day wake up and wonder, "Why do I work so hard? Why does this have to be perfect? And why do I look for validation in other people and things? At the end of the day, none of that really matters, and I'm not happy."

    19. AP

      Mm.

    20. SH

      You know? Then you're gonna have to start asking yourself how to get out of all that layers of conditioning and archetypes that you've built for yourself.

    21. AP

      So interesting. So I think everyone listening will, will recognize and, and really relate to the feeling.

    22. SH

      Mm-hmm.

    23. AP

      The, the feeling of intense sadness or, or rage when they're triggered by a criticism or, or a rejection. And I, so I suppose the, the next question

  5. 11:20 – 17:56

    Tips to manage Rejection Sensitive Dysphoria

    1. AP

      is, are there any tips to manage it? And I suppose breaking it down into immediate tips short-term that you can do in the moment, and then also slightly longer term tips that you could do over time, working on yourself to sort of make you more sh- stronger and resilient-

    2. SH

      Yeah

    3. AP

      ... for when you encounter future rejections.

    4. SH

      Yeah, yeah, yeah. So I think in order to do that, you gotta look at your current environment and your context. So short-term wise, you know, there are strategies you can do, um, to snap yourself back into the moment, 'cause when we encounter RSD, we are in, essentially in an amygdala hijack, right? 'Cause your body has sort of, uh, gone straight to feeling those emotions so intensely, 'cause you're unable to tap into your prefrontal cortex to think what are you gonna do about this, right? And if you wanna snap yourself out of that, into the here and now, you gotta focus on something that you can see and feel and hear, you know? But it's gotta be strong enough to- Transfer your attention from the emotional circuit into the thinking and the here and now circuit. And so in order to do that, um, I know that there are, you know, some methods that, uh, DBT, you know, uh, dialectical behavioral therapy people recommended, um, to say, uh, you could use something, um, like an ice shard, you know, that may- maybe you've frozen some fruit juice. And that takes planning by the way. It's not something that, you know, you just open your fridge and it will get. [laughs] Like, so i- it's part of living with ADHD is to navigate this day-to-day.

    5. AP

      Yeah. [laughs]

    6. SH

      Like, when can I enter, you know, this amygdala hijack.

    7. AP

      Mm.

    8. SH

      If your situation is stressful, um, how can I help myself, you know, with my emotions? And if you know that you're entering a s- a stressful situation, it's useful to have something like that. So whether it's something sharp or, um, something that tastes sharp like, um, the, the lemon juice [laughs] that-

    9. AP

      Mm

    10. SH

      ... um, you shared with me. And also, you know, something that's cold and maybe sweet. It's gotta be something that works for you. 'Cause for me, it's like cold and sweet can snap me back into the moment. But for you, it might be something else, you know? Um, maybe [laughs] that's why so many people do, um, comfort eating, you know? [laughs]

    11. AP

      [laughs]

    12. SH

      To kind of try to get themselves back to regulation. But, um, I find the most effective way is to call a friend, and it's gotta be a very compassionate friend as well.

    13. AP

      Mm.

    14. SH

      'Cause without compassion, we're just gonna go further down the self-chastising, right?

    15. AP

      Mm.

    16. SH

      You almost need someone to reflect back the good in you and the reality of the situation, to tell you that, you know, you're okay, what you're feeling, you know, is valid, and then, you know, just sharing that and maybe having someone, you know, tell you that you're okay. And it, it really helps, you know, in the here and now, or take yourself out for a walk in nature. But say if it's, um, long-term, then we're really looking at the different parts of us that are involved during the reaction, you know, in the rejection sensitivity dysphoria. What kind of a character is brought up? You know, what do you see when you feel rejected? 'Cause as the... When you externalize it, it looks like rage, right?

    17. AP

      Mm-hmm.

    18. SH

      You could end up shouting at the people around you, even though they had nothing to do with, you know, why you feel rejected. But why do you feel like that? You know, what is that feeling? Is it because some time ago, you know, someone has made you f- feel worthless, and your compensation strategy is to work really hard to maintain that self-worth? And when there is a criticism to your work, then your self-worth is then at stake, because you have associated your self-worth with how well you work and how much you achieve.

    19. AP

      Mm.

    20. SH

      And so if that, um, criticism is towards that, you know, the external archetype, then of course you're gonna crumble, right? And part of, um, understanding yourself is to build those scaffolding, you know, that perhaps you never really learn how from the beginning. You know, and to re-parent yourself, to understand what is it that makes you feel strong in yourself without using external, you know, archetypes, um, or people or things to validate you.

    21. AP

      Mm.

    22. SH

      External validation, basically. So, uh, over time, um, that can be done through therapy, and there's, um... I, I would always say go for therapist that shows you compassion, and there is a modality in, um, trauma therapy where you look at the internal family systems. And I think this is really what it is when the scale of the rejection, right, the, the, the, the, the reaction is so high is that there are different parts at war within yourself, and there's obviously a very intense part that is very hurt and very injured. And, you know, the internal family systems look at all the different parts of you and try and find a part of you, you know, that truly believe in yourself in order to navigate, um, situations going forward. And ultimately, it is really about building that sense of self and self-belief, you know, and deconditioning ourselves from the archetypes that we have built for s- external validation, and finding the environments for us to move forward.

    23. AP

      Mm.

    24. SH

      But, you know, um, medically, you know, there are non-stimulants that have been prescribed for RSD, so guanfacine and clonidine. And people have said that when they take guanfacine, they, they tend to know when the reject- the, the re- the re- uh, the rejection is coming, but they let it go more. You know, so they don't let it get, um, really bad or manifest. But then taking that guanfacine then helps them to build skills to navigate that situation. Over time, people have said that they don't really need guanfacine anymore.

    25. AP

      Mm.

    26. SH

      You know, so I think over time it's really understanding, you know, how we react to things and who we are as people.

    27. AP

      Mm.

  6. 17:56 – 27:22

    RSD in relationships

    1. AP

      Do, do you think you should share that understanding with, with your romantic partner? Do you think you should have, like, an open conversation at the beginning of relationships to say, "RSD is something I [laughs] contend with"? Do you think you should open that and sh- and share that with your partner?

    2. SH

      Yeah. In a new relationship, I think it's a good idea to say that you do, you are quite a sensitive person, especially when we talk about this, this, and this, you know? But I would always say, you know, God is fair, right? What we're- What they give us and what we perceive as a negative, it can be a good in other situations.

    3. AP

      Mm.

    4. SH

      You know? So what makes us bad in situat- this situation can be what makes us good in other situations and context. So I always believe that we attract people, um, who reminds us of the part of ourselves that need to heal. And if, you know, we are attracting people because we are sensitive to rejection, but also sensitive in nature, that sensitivity is also a strength when we look at how we can be emp- empathic, you know, to other people. And, um, individuals who are, who, who have ADHD-

    5. AP

      Mm

    6. SH

      ... they tend to feel things in their body rather than, you know, um, have empathy through, you know, thinking. So it's having empathy through what we feel for others in our body. And so if we're able to be this, this person that, you know, have that level of empathy and nurture for s- for, for somebody, and they see that as something that they want in their lives, you know, to have in their corner, then, you know, dealing with us when we're feeling, you know, a sense of rejection to something that is said, or, you know, in a day-to-day, that is a very small exchange, I think, [laughs] you know-

    7. AP

      Mm

    8. SH

      ... for the good that you're getting in us as well. So basically, I'm just saying that what makes us bad, what makes us, what ma- is, is also what makes us good, um, is we balance in our discussion with our, with our partners as well.

    9. AP

      Mm. So true.

    10. SH

      Yeah.

    11. AP

      I think the, the, the bits that might cause the issue in the relationship, the, the Rejection Sensitive Dysphoria, is a small price to pay, because the part of them that causes that reaction is probably also the part of them that creates all the fun and exciting-

    12. SH

      Yeah

    13. AP

      ... and the spontaneity and all the amazing things that you fell in love with that person for. So it's kind of like a balance, and that's the, that's the negative, but there's also all of these positives on the other side.

    14. SH

      Yeah, yeah. Exactly. I know. So, you know, we all have strengths and challenges, right?

    15. AP

      Mm.

    16. SH

      So it's not just us, you know, it's the other side as well, you know? Maybe we're just better able to talk about it because we have the words and awareness about it now. But, you know, the other side also, you know, have stuff, and hopefully that they, you know, are aware enough [laughs]

    17. AP

      [laughs]

    18. SH

      ... you know, to contribute to this conversation. It's not just-

    19. AP

      Mm

    20. SH

      ... all about us, you know what I mean?

    21. AP

      Mm.

    22. SH

      So then we don't just hyper-focus on these big challenges that we have-

    23. AP

      Mm

    24. SH

      ... when actually you bring some stuff, too.

    25. AP

      Yeah. [laughs]

    26. SH

      You know? Come on. [laughs]

    27. AP

      When I, I, I, I asked my community that I was going to be speaking to you today about Rejection Sensitive Dysphoria, and the main question I got was, "Please can we have some advice on how to manage RSD in relationships?" And I know we've just touched upon that there, but do you have any other, like, headline advice that people might find useful in, in navigating RSD in romantic relationships?

    28. SH

      They say a lot of the mental health challenges that manifests in our lives is caused by the relationships that we have.

    29. AP

      Mm.

    30. SH

      And I do believe that it's our closest relationships that brings out, you know, that in us, because we're going back to that internalizing RSD and externalizing RSD and what that hap- what, what that, you know, uh, creates. So it's either that rage, you know, outwards or dissociative inside, and this can look like argument patterns in relationships. Some of us might be the type of people who need to discuss it there and then, right? We are more kind of like, "Tackle it now because I need to talk about things," and you're externalizing, right? But then the, the, the other person is like, "I'm just gonna mull over this and just keep it all inside for a bit as I process." We're talking about different processing style as well, you know, so it's useful to understand what kind of partner you have, what their neurobiology is, [laughs] which is a bit complicated. But you know, like just, just to understand what is their level of emotional maturity and how they handle stress.

  7. 27:22 – 31:52

    How Menstruation/Testosterone cycle affects RSD

    1. AP

      when women go through the menstrual cycle and men go through the daily testosterone cycle, that can affect how they respond to criticism. Can you explain what you meant by that?

    2. SH

      Yeah. So looking at the oscillation of, uh, our sex hormones, so the changes that happen, you know, when in the month, you know, our sex hormones are higher and lower, uh, for both men and women, except that for a woman, the changes happen over the course of the month, so it's cyclical, whereas for a man, it happens on a daily basis. So for a woman, I liken it to having four seasons of the year within the month, and that is spring, summer, autumn, and winter, and that is distributed to different phases of your hormonal cycle.

    3. AP

      Mm.

    4. SH

      So when I'm in the spring and summer, I'm really happy. I'm going towards ovulation, and I'm verbally very articulate, and I sleep better. I have more energy, more able to regulate my emotions. This is the best time for me to give a talk and, you know- [laughs]

    5. AP

      [laughs]

    6. SH

      ... to have, um, constructive arguments, you know? [laughs]

    7. AP

      [laughs]

    8. SH

      Without really taking too much to heart.

    9. AP

      Mm.

    10. SH

      My mental health is in a better place. But take me towards, uh, s- the autumn and the winter, going towards luteal phase, and I have trouble sleeping because with the decrease of estrogen and increase of progesterone and decrease of acetylcholine, um, and serotonin, what is impacted is my wellbeing. I'm feeling less happy because there is a chemical change in my body, and I'm also less able to sleep and less able to be verbally articulate, and I don't remember as much, which, which means that my day-to-day might be a m- a bit more chaotic. And so when you put that context into then navigating rejection, whether it's, like, work or whatever, you know, it feels like an extra atom bomb thrown on top of a detonation-

    11. AP

      Mm

    12. SH

      ... uh, you know? So there is really so much that I can take in that time, you know, and if we are aware of that and we can educate our partners about it and maybe tell our work, [laughs] you know-

    13. AP

      [laughs]

    14. SH

      ... when we need a duvet day, you know, 'cause apparently some countries have that, and actually some countries have menstrual leave.

    15. AP

      Mm.

    16. SH

      Um, Spain has just legalized that. And so that helps us a great deal because we are dealing with our biology, which impacts our psychology, whereas for a man, your oscillation of testosterone is happening on a daily basis. And actually, by the way, this happens to women as well, except that we have lots of backup sex hormones to [laughs] you know-

    17. AP

      [laughs]

    18. SH

      ... help ourselves. Um, but generally, yeah, testosterone goes up in the morning, and that's when you feel vitality and happy. Um, you are, you have more energy, and you're tackling the day, whereas, um, this goes down as the day goes by. Um, the, the, the, the days c- the day goes on, and your testosterone dips around 5:00 or 6:00, and that's when you would try and eat, before that happens, and maybe go to the gym and exercise, 'cause that brings up the testosterone level as well. And so it's so important we understand that, because if you're, if, if you are taking medication for ADHD, and you need to, you know, um, understand that there is a part of the day where your medication will start to taper off, and your blood sugar will start to crash, alongside your testosterone going down, and you haven't had your dinner-

    19. AP

      Mm

    20. SH

      ... then there's, that is when you're likely to have arguments with somebody.

    21. AP

      Mm.

    22. SH

      And they might say something that will incite a RSD. But not knowing that, people are unwittingly going into situations that really is quite harmful-

    23. AP

      Mm

    24. SH

      ... to themselves and their relationships.

    25. AP

      It's so fascinating. So there's a natural chemical reason for a man to, to react differently to rejection throughout the day, and a woman, and a chemical reason why a, a woman might react differently throughout the month, and then if you zoom out, actually throughout her life, depending on where she is, menopause, premenopause, post. With, with, with talking about the chemicals, a- and from my experience and s- with speaking to others,

  8. 31:52 – 34:14

    How alcohol affects RSD

    1. AP

      if I'm h- hungover, for example, after I've been drinking alcohol, I find that I'm much more susceptible to a flare-up of RSD. Is, is alcohol a, have a, have a big impact on the, the levels of dopamine and serotonin?

    2. SH

      Yeah, 100%, 'cause you're not just looking at the neurotransmitter levels, you're looking at the impact of, on, uh, of alcohol on your sleep, and how that helps you navigate stress.

    3. AP

      Mm.

    4. SH

      Because, uh, research has shown that once you have a glass of wine, that decreases your sleep, uh, your, your deep sleep level by, like, 20%. And then once you have, like, two or three glasses of wine, that goes down by 40%. So your sleep quality is affected-

    5. AP

      Mm

    6. SH

      ... which means you're waking up the next day more grumpy, because you are groggy, your body is lacking the vitamins and minerals that it needs, you know, to feel balance, and a decreased ability to handle stress. And so anything that happens then means that you have less ability to handle that emotionally.

    7. AP

      Mm.

    8. SH

      Of course, you're also looking at other areas of your life. You know, like, is this something you're doing every week, or is it a one-off? You know, do you have protective environments that allow you to recover, or protective relationships that allow you to just lie in bed, you know? [laughs]

    9. AP

      [laughs]

    10. SH

      And watch Netflix through the day, and you're fine. You know-

    11. AP

      Mm

    12. SH

      ... you recover and then, you know, you don't need to have harm yourself or anybody. But most of us don't have that, right?

    13. AP

      Mm.

    14. SH

      'Cause we live with people.

    15. AP

      [laughs]

    16. SH

      If we're lucky. [laughs] Um, um, you know, we, um, yeah, so we gotta look at out of context, but yeah, generally, the research has shown that alcohol is the most destructive drug-

    17. AP

      Mm

    18. SH

      ... when you put, um, alongside MDMA or, or LSD, uh, alcohol being culturally accepted as well-

    19. AP

      Mm

    20. SH

      ... you know, is, is something that a lot of people use as a crutch for social anxiety, and, you know, um, just to help themselves feel more confident in situations. Which, you know, unfortunately is, is [laughs] like I say, I feel like a party pooper when I say that.

    21. AP

      [laughs]

    22. SH

      Because I have gone out with my friends, and I know that, you know, it will help me loosen up as well.

    23. AP

      Mm.

    24. SH

      But then I think too much about the consequences-

    25. AP

      Mm

    26. SH

      ... that I rather be awkward for two hours in order to not suffer-

    27. AP

      Mm

    28. SH

      ... the next few days, you know?

  9. 34:14 – 36:50

    How to differentiate between rational sensitivity and RSD

    1. AP

      Do you think there's a way for someone with ADHD to differentiate an irrational reaction to criticism or rejection between, against a justified reaction to criticism? In other words, is there a way for someone to tell if they're having an RSD flare-up, which is irrational, or are they having a genuine, justified reaction to someone being-

    2. SH

      Mm

    3. AP

      ... an asshole? [laughs]

    4. SH

      Yeah. I, I, I hear you. [laughs] Um, I, I, I think you know when you know you're seeing yourself. It's almost, it's interesting, because it's almost like you're stepping aside and someone else has gone into your body.

    5. AP

      Mm.

    6. SH

      You know? And just in the moment where you have that, if you're externalizing it, that anger, it's so big and it doesn't make any sense. And also, at times, it's channeled to people who didn't even cause you that pain in the first place. And then when that has happened, you feel that shame, right?

    7. AP

      Mm.

    8. SH

      Because if you are hurting so much, your immediate reaction could be, "I'm gonna just show somebody how much it hurts by hurting them."

    9. AP

      Mm.

    10. SH

      You know? And it really doesn't make any sense, but it helps people feel better. But that's not good, because sometimes the skill of that reaction can cause harm, and that's when it's totally unjustified, when s- you're, you know, going through this pain and you're letting it out on somebody who is quite innocent, is a innocent bystander. So really, it goes back to working on yourself-

    11. AP

      Mm

    12. SH

      ... because they don't deserve it, and then you feel more shame as a result of that, right? And then if you internalize that RSD, then you start telling yourself, "Well, there's no place for, for me here," you know? But you also know that, "Why am I saying that?" You know? [laughs]

    13. AP

      [laughs]

    14. SH

      Because actually, yesterday I was feeling fine. Pretty sure tomorrow I won't be that bad.

    15. AP

      Yeah, yeah.

    16. SH

      But in that moment, you're like, "This is not right."

    17. AP

      Mm.

    18. SH

      You know? And n- and then you gotta develop that self-questioning. I know we have voices anyway. You know, I, I don't know if you do.

    19. AP

      [laughs]

    20. SH

      I, I do. [laughs] You know, we all have different parts, by the way.

    21. AP

      Mm.

    22. SH

      Um, I don't know, like, who, who, who doesn't, but I, I do, and there are different voices telling me sometimes I'm all right and sometimes I'm not, and why is it I'm not all right? And that goes back to the work we do in analyzing the different parts of ourselves.

    23. AP

      Mm.

    24. SH

      You know? And, and try and integrate them. You know?

    25. AP

      You said something fascinating which I wanted to mention. You, you said

  10. 36:50 – 39:10

    ADHDers in the wild

    1. AP

      if ADHDers, and there was a study on this, that if, if we're sort of left to live in nature and out in the wild, the traits or the struggles that we associate with ADHD decrease, and I imagine therefore the RSD response might decrease. Is that... Could you explain more about that?

    2. SH

      Yeah. So there is, uh, yeah, I was looking into this whilst I was looking at our relationship to stress.

    3. AP

      Mm.

    4. SH

      I'm trying to work out, is that chicken and egg question, were we stressed first before, you know, do we have a genetics or, you know, biology that predisposes us to stress or the other way around, 'cause a lot of us need a bit of or a lot of [laughs] stress-

    5. AP

      [laughs]

    6. SH

      ... in order to get into motion-

    7. AP

      Mm

    8. SH

      ... and get motivated because that's how we learn to work and, you know, to kick into gear. But if you take away the stress from the day-to-day, and I'm sure if we are in a position to take ourselves away from the rat race and the day-to-day, you have in your life benefited from times when you're able to unplug and be a more patient version of s- yourself. You know, when you feel that, you know, with the right elements involved and, you know, with nature, with, uh, good nutrition and, you know, with less stress from the outside world, your ADHD isn't as bad.

    9. AP

      Mm.

    10. SH

      Right? So that research was looking at how when you take someone in nature for two weeks without their cellphone, [laughs] you know, their ADHD traits miraculously disappear, you know? [laughs] And, uh, that is not the case in the capitalist world-

    11. AP

      Mm

    12. SH

      ... in the modern day to day when we have demands, you know, that are coming from the outside world, but also a lot of it come from ourselves inside, you know? So there's definitely an element of being mindful about the amount of stress that's coming into your life-

    13. AP

      Mm

    14. SH

      ... you know, and how that impacts your ADHD and the, your ability to navigate emotional stress, which is really what RSD is.

    15. AP

      Mm. That's fascinating. Maybe we should all go camping [laughs] and see.

    16. SH

      I have thought about that, Alex.

    17. AP

      [laughs]

    18. SH

      I actually thought that could be a really good business idea, but then I thought that I have to organize it.

    19. AP

      That's true, yeah. [laughs]

    20. SH

      [laughs]

    21. AP

      Yeah.

    22. SH

      That stopped right there.

    23. AP

      You'll probably lose interest after two weeks.

    24. SH

      That idea went away immediately. [laughs]

    25. AP

      Oh,

  11. 39:10 – 43:40

    Washing machine of woes

    1. AP

      Samantha, just finally-

    2. SH

      Yeah

    3. AP

      ... I think we should do the washing machine of woes. Um, and I think we've got a rejection special this week.

    4. SH

      Okay.

    5. AP

      Every week I ask my ADHD community to send me a woe-

    6. SH

      Mm-hmm

    7. AP

      ... which I throw in a washing machine-

    8. SH

      Mm-hmm

    9. AP

      ... because people often forget their laundry. Do you forget your laundry?

    10. SH

      Oh, yeah, definitely.

    11. AP

      Sometimes. [laughs]

    12. SH

      Like, I forgot, I left my heating on and my lights on, and I left, and I missed a train, by the way. So, [laughs] you know.

    13. AP

      You did today, you missed a-

    14. SH

      Yeah. [laughs]

    15. AP

      It would be, I wouldn't, uh, I'd, I would doubt your, um, diagnosis if you-

    16. SH

      Oh, yeah

    17. AP

      ... missed a train.

    18. SH

      Don't, don't worry about that.

    19. AP

      [laughs]

    20. SH

      [laughs]

    21. AP

      Let's see what the woe is this week. "When I get a rejection, I'm not trying to be mean or hateful. Sometimes it's just so painful that I can't handle the big feelings, and I get angry like it's a defense mechanism. It doesn't have to be a big rejection either. A friend could simply say they're too busy to see me, and it feels like I've been punched in the stomach. It's unbearable." Do you relate to that?

    22. SH

      Yeah. Well, in a opposite way, [laughs] I think I would be quite glad to, [laughs] you know-

    23. AP

      [laughs]

    24. SH

      ... have a friend cancel on me-

    25. AP

      Relief

    26. SH

      ... because... Yeah, I mean, for me, I don't take it personally when a friend does it, because I've gone past the point in my life where I rely on friends as a validation, but, a- and that's where I see that the reason we feel sensitive to someone saying no to us is because we have put our self-esteem outside of ourselves.

    27. AP

      Mm.

    28. SH

      You know? And we need to validate it, whether it's through, you know, someone else liking us, and that's why the people pleaser, or, you know, someone else loving us and someone else think we're capable and achieving and, you know, important, which, you know, is the other part of the perfectionist, high achiever [laughs] type of archetype.

    29. AP

      Mm.

    30. SH

      Or, you know, someone finds us funny, that's the class clown archetype. [laughs]

Episode duration: 43:40

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