Imagine sending a text and waiting — minutes pass, then hours. The message sits “seen.” Your stomach tightens, your mind replays every word, searching for what you did wrong.
For many autistic adults, this isn’t just discomfort. It’s a physiological storm — racing thoughts, pounding heart, even physical pain — triggered by the mere possibility of rejection.
A recent phenomenological interview study by Alvin van Asselt and colleagues explored this experience in depth.
Speaking with 19 autistic adults aged 21–71, the researchers sought to understand what heightened rejection sensitivity truly feels like — and how people try to live with it.
Key Points
- Autistic adults often experience intense emotional and physical distress when they anticipate or perceive rejection.
- These reactions can be triggered by small cues — a tone of voice, a facial expression — and may last from minutes to weeks.
- Past rejection and autistic traits (like perfectionism or social misunderstanding) amplify the sensitivity.
- Invalidation by others, including therapists, can worsen the distress and reinforce feelings of isolation.
- Supportive communication, self-education, and acceptance-based approaches can help reduce its impact.
Rejection sensitivity: when the brain’s alarm won’t quiet
Rejection sensitivity is the tendency to expect, perceive, and react strongly to rejection. For autistic adults, it can be especially consuming.
Participants described emotions that “flooded” their system: fear, shame, anger, paralysis. Some said it felt like being “stabbed in the heart” or “constantly kicked down.”
These responses weren’t fleeting. They could replay for days, fueled by memories of past criticism or rejection.
Even neutral or ambiguous interactions could trigger the alarm. One participant said that if someone looked away mid-conversation, she immediately thought, “I’m taking too long — they don’t like me.”
The invisible weight of constant vigilance
Rejection sensitivity shaped how participants navigated everyday life.
Many avoided jobs, relationships, or healthcare for fear of being criticized. One participant hadn’t seen a dentist in a decade after being scolded for missing appointments.
Others became masters of masking — smiling through hurt, performing social ease while feeling panic underneath.
“I can feel incredibly small,” one said, “but just sit there with a smile and nod.”
Over time, this hypervigilance drained emotional reserves, leaving participants exhausted and detached from their authentic selves.
When help hurts: the sting of invalidation
Several participants said their pain was dismissed — by peers, employers, even therapists. They were told to “stop taking things personally,” or had their feelings laughed at.
In therapy, some felt misunderstood or blamed when they tried to explain their distress.
One woman recalled showing her therapist a clay sculpture representing isolation, only to be told it symbolized society’s rejection of her — “No,” she replied, “this is how I feel right here with you.”
Such invalidation deepened their wounds, confirming the very rejection they feared.
Roots that run deep
Participants traced their sensitivity to two intertwined sources: autistic traits and lifelong rejection.
Many described early experiences of bullying, being misunderstood, or told they were “too much” or “not enough.”
Others linked it to traits like perfectionism, intense fairness, or alexithymia (difficulty identifying emotions).
One man compared it to post-traumatic stress: “It’s like PTSD from lifelong systematic rejection.”
Over time, these experiences formed a lens through which every new social cue was interpreted — often as proof of not belonging.
Learning to soften the blow
Despite its intensity, participants found ways to manage their rejection sensitivity — though few felt “cured.”
Helpful strategies included:
- Self-education through articles and neurodivergent communities, which reduced shame and provided language for their experiences.
- Creative expression — drawing, music, writing — to release emotions.
- Talking openly with trusted others to check assumptions (“Did you really mean that I’m stupid?”).
- Distraction and movement, such as immersing in focused activities.
- Self-compassion and acceptance, treating painful reactions as waves that pass rather than enemies to fight.
Therapies like cognitive-behavioral or mindfulness-based approaches helped some participants process emotions more effectively, though not all found professionals attuned to their needs.
One participant put it succinctly:
“It still feels like running into a lamppost. But now I have the cold compress and band-aid ready for afterward.”
The paradox of exposure
A few participants believed they had “built calluses on the soul” — becoming less reactive after repeated rejection.
Yet others disagreed, saying each new hurt made them more sensitive, not less.
This contrast reflects a deeper question: does repeated pain desensitize or deepen the wound?
The study suggests it may depend on context, coping resources, and whether people feel supported or invalidated along the way.
Why it matters
Rejection sensitivity may be an underrecognized driver of mental health struggles in autistic adults — including anxiety, depression, and social withdrawal.
Understanding it could shift how clinicians interpret distress that might otherwise be mislabeled as “overreactive” or “socially avoidant.”
For autistic individuals, the findings validate something long felt but rarely studied: that emotional pain from rejection isn’t weakness — it’s the body’s way of signaling a need for safety and belonging.
For professionals and allies, the message is clear: validation heals. Listening without judgment, framing feedback gently, and recognizing the cumulative toll of social pain can make the difference between retraumatization and recovery.
The bigger picture
Rejection sensitivity isn’t unique to autism, but in autistic adults — often navigating a world built for neurotypical norms — it becomes magnified.
This study turns abstract theory into lived reality: the stories behind the statistics.
It reminds us that behind every perceived overreaction is usually a history — of trying, failing, and still hoping to be accepted.
As one participant said, “You just keep going. You have to choose yourself, really.”
Reference
Roke, Y., Begeer, S. M., & Scheeren, A. M. (2025). ‘Feeling constantly kicked down’: A qualitative phenomenological study exploring rejection sensitivity in autistic adults. Autism. https://doi.org/10.1177_13623613251376893
