How RSD might impact feeding, Nutrition & relationship to food

What is Rejection Sensitive Dysphoria (RSD)?

RSD is an extreme emotional response to perceived or actual rejection or criticism, often experienced by Autistic people and ADHDers. RSD can occur for both adults and children. It can cause intense feelings of shame, anxiety, or anger, leading to avoidance of situations where rejection might occur. RSD can manifest as trauma and self-stigma associated with systemic oppression (e.g., discrimination, marginalisation, gaslighting, invalidation, bullying). RSD can significantly impact relationships and self-esteem, making even minor events feel deeply painful.

RSD is intrinsically linked to our innate need to belong. Human connection, acceptance and belonging is profound and primal. RSD can signal us when our sense of belonging is at risk and when emotional wounds and triggers are ignited. This signal alerts us when something doesn’t feel quite right which prompts us to take action and protect ourselves. Sometimes we avoid certain situations to avoid experiencing rejection and the immense pain that can arise from it.

RSD might impact feeding, nutrition & relationship with food in these ways

• Comments about food and eating may be perceived as criticism and/or rejection, which may be felt as a personal attack. This may activate primal responses to threat, activating the “fight/flight/freeze/fawn” response and cause feelings of distress & rejection. This can deeply impact self esteem and cause intense emotional pain.

• People with RSD may “people please” or fawn and eat unsafe foods as a way to gain approval and avoid the risk of rejection.

• It may be difficult to eat in social settings due to a gnawing fear of food choices being criticised and encountering rejection.

• Many people with RSD have experienced invalidation and gaslighting from friends, family and the medical system about their feeding differences & ARFID. This creates intense feelings of rejection, which creates a lack of belonging and intense emotional pain.

• Visceral bodily reactions may occur due to the act of perceiving rejection such as struggling to breath, feeling sick, physical pain and more. These visceral bodily sensations may impact ones ability to eat, absorb and digest food adequately.

  All these things may impact a persons relationship with food and ability to eat.

  
  Strategies for working with RSD: Adapted from Neurodivergent insights

• Identify Triggers: Learn what your triggers around RSD and food/eating are. Having awareness around triggers may help you to process and work through triggers more effectively.

• Radical Acceptance: Radically accept yourself and/or your loved one with feeding differences/ARFID. Allow the sensations and emotions that arise with RSD and try not to judge or criticise them. By accepting things for what they are, you can acknowledge your emotions without denying, avoiding, or ignoring the situation.

• Compassion: Compassion for yourself and others with feeding differences/ARFID may help to counteract the cycle of rejection.

• Curiosity and kindness: If you love someone with RSD, approach food/eating situations with genuine curiosity and kindness.

• Nervous system regulation: Our nervous system can become activated and triggered by RSD. Regulation strategies might look different for everyone, if you are ND and you find mindfulness or breath work triggering, you might try a cold wet face washer or the back of your neck, stimming, moving your body, humming or singing.

• There are more wonderful strategies on Neurodivergent Insights blog post ‘Rejection Sensitive Dysphoria and Its Painful Impact’.

  
  References

  https://neurodivergentinsights.com/blog/rejection-sensitive-dysphoria

  https://nedc.com.au/assets/NEDC-Publications/Eating-Disorders-and-Neurodivergence-A-Stepped-Care-Approach.pdf

  https://neurodivergentinsights.com/blog/up-and-down-regulation
  https://reframingautism.org.au/the-unbearable-heartache-of-rejection-sensitive-dysphoria/

  Written by Margo White, your Melbourne-based neurodiversity affirming clinical nutritionist and Neurodivergent advocate.

  This article is intended as general advice only and does not replace medical advice. It is recommended that you seek personalised advice specific to your individual needs.