The Psychiatrist Who Discovered RSD: "RSD Dies When You Do THIS!" | Dr. William (Bill) Dodson
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What is Rejection Sensitive Dysphoria (RSD) and how is it experienced?
This for me is very surreal. It's not every day I get to speak to somebody who coined one of the most used, recognisable, yet, I think, painful acronyms in ADHD history. ADHD royalty. I truly believe you are. I was saying just before we started, I got my diagnosis two and a half years ago, and your work was one of the first I dived into. So on a personal note, thank you ever so much.
My pleasure.
Why did Dr. Dodson coin the term 'RSD'?
Thank you.
Let's start off, Bill, with a simple but probably not an easy question about rejection sensitivity dysphoria, and I'll refer to it as RSD from this point on. And then perhaps we'll build up to some more advanced and specific details about RSD. But to start with, what is RSD and how is it experienced?
RSD is a phenomenon that I first noticed because I'm a practitioner, I'm not a researcher.
Is RSD a lonely experience for those who suffer from it?
And so when you sit with a thousand people and you hear the same thing, coming from every single one of them, you may not know that it's important. I mean, what it is, but you know that it's important. And so I have to give all the credit to my patients because they were the ones who described it to me. And what RSD is, is an exquisite sensitivity to the perception, doesn't have to be real, the perception that someone has withdrawn their love, approval, or respect. And I mean, nobody likes being criticized. Nobody likes being rejected. But for people who have an ADHD-style nervous system, it is catastrophic. In fact, that's why the name of it includes the word dysphoria, which is literally Greek for unbearable.
And so it's...
How does RSD relate to emotional dysregulation?
It's like sort of other people's experience of rejection, only it is suddenly hit. It goes from zero to 100 in the blink of an eye. It's incredibly painful. It's physically painful. You'll see people clutch their chest or hunch over or grimace because it's not just emotionally painful. It's physically painful as well.
What is the darkest side of RSD?
One of the other odd features of it is that people cannot describe what the pain is like. It's wordless. I always think of it as having been so primitive it came before there were words. But people can describe the intensity of it. And so they use words like, it's awful, it's terrible, unbearable, catastrophic, overwhelming. And the person can't just keep going. It knocks them to their knees instantaneously. And so that's one of the problems is that it hits so suddenly, so completely that most people can't see it happening in advance and bring up all the stuff that they learned in cognitive behavioral treatment or dialectical behavioral treatment. You just get slammed with it. People report feeling totally cut off from their surroundings, totally cut off from everybody else, just a profound loneliness.
and that they've been cast out from everybody, every place that they know. I feel totally bereft. It's an awful, awful feeling. It then will continue an unknown period of time. It can be minutes, it can be days. But during that time, there's really nothing much that you can do. You just have to let it run its course. One of the most important things I found that people need to know up front is that it will end. Most people, when they're in an episode of RSD, have the conscious fear, this is never going to end.
Can RSD be comparable to PTSD?
I'm going to be in torment forever. So letting people know that every time it does come to an end, you will survive it, is just extremely unpleasant.
How does RSD impact romantic relationships?
Whether or not it's only seen in ADHD is unknown. Now, we did some research last year. We're turning the numbers on to try and answer that question. So talk to me in six months. I'll be able to give you at least the preliminary of the results. But for right now, in my own practice... When I asked sort of a screening question for RSD, somewhere around 90% to 95% of people say, oh, my God, yes, you've been following me around my entire life. It's not, well, no, it's wow. And about half of the people who say no come back later and say, well, yeah, I sort of lied to you. It just caught me by surprise and I panicked and masked it and all that. The screening question that I use in my practice for the last 15 years is look back over your entire life, just as well as you can.
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Chapters
8 chapters
1
What is Rejection Sensitive Dysphoria (RSD) and how is it experienced?
0:00–0:32
2
Why did Dr. Dodson coin the term 'RSD'?
0:32–1:08
3
Is RSD a lonely experience for those who suffer from it?
1:08–2:10
4
How does RSD relate to emotional dysregulation?
2:10–2:36
5
What is the darkest side of RSD?
2:36–4:22
6
Can RSD be comparable to PTSD?
4:22–4:34
7
How does RSD impact romantic relationships?
4:34–6:34
8
What tools and strategies can help stop RSD?
6:34–1:21:14
Speakers
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