How to Support Your Partner with Rejection Sensitive Dysphoria

As a couples therapist, one of the things I am always listening for is criticism during conflict. Criticism is known as one of John Gottman’s “Four Horsemen of the Apocalypse.” It escalates conflict and causes harm rather than repairing the interaction.

What is Criticism?

Image of a man and woman sitting in bed while the man is far away. This image illustrates what a couple experiencing conflict before working with a couples therapist in San Francisco, CA may look like. If you have a partner with ADHD and rejection s…

Criticism can sometimes be hard to define. But, some common things I hear in the therapy room include:

  • “I’m not being critical, but…” followed by a direct criticism of their partner or their partner’s behavior.

  • Or, “It’s not criticism! It’s the truth! You’re terrible at keeping the sink clean. You never think about the other people in this house who may have to use the sink.”

  • Often people will try to avoid being critical by using “I” statements. Like, “I feel like someone in this room is being selfish.” But, that doesn’t exactly avoid criticism.

These kinds of statements can sting and often cause a partner to become defensive. Defensiveness makes tension in the relationship worse. The criticism/defensiveness cycle is the culprit of most escalated relationship conflicts. Critical statements can be especially harmful in relationships where you or your partner have ADHD.

As clinicians, we’re seeing more research documenting emotional dysregulation in individuals with ADHD. Often when individuals with ADHD feel rejected or criticized they react with extreme emotional responses and sometimes even hyperarousal. This is often called Rejection Sensitive Dysphoria (RSD).

What is Rejection Sensitive Dysphoria?

Image of a man sitting on a couch and holding the sides of his head as if having a headache. This person represents someone who is struggling with ADHD and rejection sensitive dysphoria experiencing conflict in their relationship. A couples therapis…

For most people who experience RSD, the description above rings true. You may even be able to recognize it in others who demonstrate this sensitivity through extreme anger or emotional outbursts. But recognizing it from the outside can sometimes be trickier than you might think.

Upbringing and early-life experiences can create behavioral patterns that are shaped by an individual’s RSD. For example, one may develop a conflict-avoidant communication style in an effort to avoid criticism altogether. In other situations, your partner may bring up an innocuous comment days later, demonstrating that they may have been ruminating on a critique for days.

A partner with ADHD may have a harder time recovering from conflict, especially if overt criticism was present. In couples therapy, people often come in hoping to repair something that has already happened. Typically, in a trusting and loving relationship, there is always a space for repair. However, in this situation, being proactive about the way you manage conflict may be a much more successful tactic.

What’s the Solution?

So, how do I avoid criticism to avoid conflicts and problems in my relationship?

Try to keep in mind that criticisms are born out of complaints. While most of us are prone to pointing out what is going wrong or what we don’t want, a quick way to turn criticism on its head is to talk about what we do want. Focusing on feelings rather than facts is also a good way to avoid “getting in the weeds” over the details of what happened. So, “You always forget the eggs,” becomes, “I’m feeling really stressed about how I am going to make the cookies for the bake sale.” These small changes can soften the interaction and reframe a potential criticism as a “need” or a “feeling.”

Sometimes when I first suggest these changes in communication, I’m met with resistance. “I love my partner, and they know that I don’t mean it like that. They are just looking for an argument.” This may feel true to you, especially if you know you didn’t intend to hurt your partner. But the reality is that most people do have a hard time listening to criticism. People experiencing RSD, or emotional dysregulation in the face of criticism, are very unlikely to read between the lines of what you actually meant.

If your goal is to ultimately be heard (which, let’s be honest, for most of us, that is the goal), approaching your ADHD partner from a softer starting place will more likely set you up for success. Lead with your own feelings and needs rather than what your partner is doing wrong and see if the conversation goes differently.

Looking for more help? Give couples therapy in San Fransisco, CA a try!

Image of two people holding hands while sitting on a couch. This image depicts what a couples therapy session may look like. For partners with ADHD and rejection sensitive dysphoria, conflict can be tough, but meeting with a couples therapist in San…

If you’ve found yourself in a cycle of criticism and defensiveness with your partner, it’s common to feel like there’s no solution. But a skilled couples therapist who specializes in ADHD and RSD can really help. A couples therapist can help you meet each other in the middle and find ways to deescalate conflict before it goes too far. You and your partner should be on the same team, not against one another. So, if you’re ready to start healing your partnership and finding a connection again, schedule a free 20-minute consultation call with us. One of the compassionate couples therapists at our San Francisco-based counseling center will discuss your goals for therapy and get you all set up with appointments in person or online.

Other Services at California Integrative Counseling Center

If you’re looking for an expert ADHD therapist, you’re in the right place. Our therapists have extensive knowledge about ADHD and Rejection Sensitive Dysphoria. Additionally, our San Francisco therapy center provides counseling for couples therapy and life transitions to help in other areas of your life. If you have questions about our counseling center, online therapy, or services in general, please feel free to contact us.


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Corey Barber