Ouch! That Hurts: Rejection Sensitivity and Its Internal Scars
Le’Anna Bell-Brown
University of Central Oklahoma
Abstract
Rejection sensitivity can cause adults to suffer greatly in their interpersonal lives. The fear of being rejected is not just commonly seen in insecure attached adults, but it is also present in adults who are securely attached as well. Living with rejection sensitivity has consequences that could negatively affect a person’s interactions with other people. For example, some of the consequences are increased anger, aggression, anxiety, etc. However, rejection sensitivity does have a weak spot that could possibly counterbalance the effects. Psychotherapy is used as a moderator for rejection sensitivity in insecurely attached adults. The benefit of psychotherapy is the certain techniques that are used throughout the session for the overall success of the client. During the session the trained mental health professional goes through a series of steps and phases that are designed to individually target each memory. When the therapist draws out the unwanted negative memories, they use their techniques to associate the negative memory with a positive one. I hypothesize that insecurely attached adults with rejection sensitivity can successfully form secure attachments in their interpersonal relationships upon completion of psychotherapy.
Introduction
Rejection is an underlying fear that sleeps in the back of an insecure attached person's mind and gets comfortable. A hindering thought that ruptures and bursts in any social situation. Rejection sensitivity is an individual difference in the extent to which people are concerned with and vigilant towards being rejected. Those high in rejection sensitivity tend to overreact and interpret ambiguous interpersonal cues as being signs of rejection (Demircioglu &, Goncu-Kose, 2018). This type of vigilance can have unwanted and unintended consequences on interaction partners. For example, People who are rejection sensitive may become hostile towards their interaction partners because they overperceive that their partners will leave. Although, when looking at it from a different perspective the symptoms change based on the situation.
Further exploring the boundary conditions of rejection sensitivity is important because understanding the antecedents, and triggering social situations can help people modify potentially discomforting expectations and behaviors. For example, when someone with rejection sensitivity is turned down multiple times it can cause a barrage of emotions and cognitive consequences for that person. The person being rejected could experience increased sadness, jealousy, anger, depression, and anxiety (Weir, 2012).
However, researchers have advanced our understanding of the role that psychotherapy can play in the rejection sensitivity display by insecurely attached adults. Psychotherapy is structured to reconstruct and reprocess memories and incorporate positive thoughts and considerations in place of the negative ones. I hypothesized that insecure attached adults who go through psychotherapy will positively reduce their rejection sensitivity and be able to form secure attachments in their interpersonal relationships. In the following, I will review rejection sensitivity in more depth; highlighting what leads to rejection sensitivity and the consequences of it. Also, I will go into more depth about attachment theory and the connection between the two. Finally, we will review psychotherapy, how it works, and how it might influence rejection sensitivity in those who are insecurely attached.
Rejection Sensitivity
The consequences of rejection can start during childhood and develop into something greater as people age. The development of rejection sensitivity starts by experiencing intense emotions of rejection. From there these feelings of rejection get internalized and retrieved in late childhood (Nesdale et al. 2014; ZimmerGembeck et al. 2014). During early childhood children seek out social interaction from others with the desire to form friendships, fulfill fundamental needs, and form groups. As children transition into early adolescence the importance of peers starts to increase during their social development (Harris, 1995). Ones desire to belong to a group is important physiologically as group membership provides protection (Baumeister &, Leary, 1995). Not only is it a protective barrier but it solidifies someone's social identity (Dunham &, Emory, 2014). A person battling rejection sensitivity in social interactions has the tendency to angrily or anxiously expect rejection and readily perceive it (Downey, Lebolt, Rincoin, Freitas, 1998). People can also develop a bias in the perception of rejection (Zimmer-Gembeck, et al., 2016). The bias can also lead to heightened emotional reactions to rejections as well. Moreover, there are a couple of negative consequences that people go through when experiencing intense emotions of rejections. A person can experience aggressive retribution and increase awareness of their emotions. Another consequence is when someone is actively perceiving rejection by their peers, it could lead to increased use of aggression (Beeson, Brittain, Vaillancourt, 2020). Those who are rejected also can experience social withdrawal. In other words, they are not looking for or wanting social interaction from people, and are isolating themselves (Zimmer, 2015).
Insecure Attachment
The effects of rejection sensitivity can be greatly influenced by insecure attachment versus securely attached adults. Bowlby (1988) attachment theory defines attachment as the relationship that a newborn has with their caregiver. The caregiver plays an important role in what attachment style a child will develop. For example, if the caregiver is responsive to their children's needs and is dependable the child can develop a secure attachment to that specific caregiver. Whereas if caregivers are unresponsive and neglectful, then children develop an insecure attachment style. There are two different types of insecure attachment. The first one is insecure-ambivalent. An ambivalent child becomes upset upon the departure of their mother. However, once their mother returns, instead of the child embracing with a warm welcome embrace, children respond with an angry response. The second type of insecure attachment is avoidant. An insecure-avoidant child appears not to care, as we do not know the inner workings of an infant's cognitive processes and have no way of knowing. We can only infer based on their actions. Often times children with insecure-avoidant attachment actively suppress their internal feelings of anxiety and fear (Ritblatt, & Longstreth, 2019).
The two insecure attachment styles both have negative consequences that affect adults in their daily lives. For example, insecure attached adults can experience social isolation, anxiety, and depression (Brumariu, Kerns, 2010). Also, insecure-avoidant adults struggle in their close personal relationships, and under stress they tend to give dysfunctional responses (Sümer, et al., 2009). There are several different styles of attachment in relationships that could be considered insecure; including preoccupied, fearful, and dismissive attachment styles. Those with preoccupied attachment styles view themself negatively whereas they view their relationship partner positively. When they are in a relationship with someone, they have a strong desire to be accepted, and approved of even if they are unsure about their self-value (Bartholomew & Horowitz 1991). A fearful attachment style is someone who is fearful of themselves and others. They often adopt negative views about themselves and others, causing them to shy away from intimacy (Bartholomew & Horowitz 1991). Lastly, a dismissive attachment style in general just avoids any and all intimacy from their partners.
Psychotherapy
Psychotherapy has been shown to be effective in treating insecure attachment in adults who have trauma, or a troubling everyday life. Psychotherapy can also be known as talk therapy. Therapists treat people with a wide variety of mental illnesses, and emotional difficulties through talk therapy (Parekh, Givon, 2019). When dealing with clients who have a traumatic background, and are experiencing insecure attachment, there are certain techniques that a therapist uses to draw out those unwanted memories for the benefit of the client. The steps that a therapist goes through are thorough, and precise in that they target each individual memory and aims to associate the negative memory with a positive memory. Treatments for dealing with trauma and grief address several different areas (Armen, et al., 1997). The first area starts by using reconstructing and reprocessing of the traumatic event. That is, people become aware of the associated effects of their troubling memory and clarify any misattributions and cognitive distortions. The second area involves working on the person’s individual traumatic reminders which works on identifying the links and triggers to the traumatic event. Once they identify the triggers, they then work on identifying these triggers all the while enhancing their behavior. After identifying the triggers, they start increasing their support seeking behaviors before and after the triggers. Lastly, they look at post-traumatic stress and its consequences. In turn it looks at helping people adapt to changes and accepting those changes.
When reconstructing and reprocessing memories people are guided through three phases. The first phase happens during anamnesis when positive emotional memories relate to attitudes like self-confidence, positive self-interpretation, and self-esteem. Once those attitudes are recovered and strengthened those attitudes are said to be resilient attitudes. The second phase is training the person to call forth those traumatic memories in order to narrate and understand them. Lastly, the third phase encourages and promotes dislocation of their internal dialogue in order to form new mental representations (Peres, Mercante & Nasello, 2005).
Current Research
Further, Erozkan (2009) conducted a study on six hundred Turkish university students with the intent of investigating social anxiety and attachment styles. During the study Erozkan measured attachment style using the relationship scales questionnaire (Griffin & Bartholomew, 1994). When measuring for social anxiety he used the social anxiety scale (Ozbay & Palanci, 2001). During the course of his study what he found was attachment styles significantly correlated with social anxiety. Psychotherapy will be used with the intent to moderate the relationship between the attachment styles and rejection sensitivity. Specifically, with therapy an insecurely attached person might be able to come to terms with their emotions and memories. Upon recognizing what factors trigger their behaviors, therapists can implement strategies to modify clients’ memories to be viewed in a positive light. Rejection sensitivity relates to insecure attachment in several ways. Adults with insecure attachment have been shown to have lower self-esteem compared to securely attached adults (Foster, Kernis, & Goldman, 2007; Besser & Priel, 2009; Huntsinger & Luecken, 2004; Natarajan, Somasundaram & Sundaram, 2011). I hypothesized that when an insecurely attached adult goes through psychotherapy, the treatment will positively reduce their rejection sensitivity allowing them to be able to form close personal secure attachments with others.
Overview
The current research on rejection sensitivity and insecure attachment looked at to what extent an adult could change their feelings towards ingroup members, and if so, what could moderate that effect? We set out to explore psychotherapy as a moderator for insecurely attached adults with rejection sensitivity. To do so, we manipulated psychotherapy by allowing the treatment group to receive cognitive behavioral therapy with structured course plans set to target each individual memory of the participant. The control group will receive a holistic therapy-based approach that will target the mind, spirit, and body. The dependent variable is rejection sensitivity, and it is measured using the rejection sensitivity questionnaire adult version (ARSQ). The independent variable is insecure attachment, and it is measured using the adult attachment scale (AAS).
Method
Participants
The participants selected in this study will come from a representation of a larger population of undergraduate students from University of Central Oklahoma. All participants volunteering for the study will be recruited from SONA-Systems. Participation credit points will be granted upon completion of the study. Demographic information such as age, sex, gender, ethnicity, etc., will be obtained at the beginning of the study.
Apparatus
The documents used to collect data throughout the study consist of four measurements. The first measurement is the ARSQ which is a questionnaire that is for adults to score their rejection sensitivity on a 6-point likert scale. Revised adult attachment scale is the second measurement that scores on a 5-point likert scale and collects data from three subscales which is depend, close, and anxiety. Information specifically tailored to age, sex, socioeconomic status, highest level of education achieved etc., will be obtained from each participant regarding their demographic history. During therapy sessions the participants will have daily logs to fill out as homework. The daily logs will contain information regarding their current state of emotions. Finally, computed scores will be averaged using SPSS.
Materials
Rejection Sensitivity
The materials used in this study will be an ARSQ (rejection sensitivity questionnaire for adults). The questionnaire will measure an individual's anxiety level when dealing with social interaction with others that could illicit possible rejection (e.g., how concerned would you be with a friend not wanting to talk to you; how concerned or anxious would you be if your significant other is deciding whether or not they would want to make up with you). This measurement uses a 6-point likert scale for both rejection concern and rejection expectancy. Rejection concern is a measurement of how concerned the participants are in situations when they are about to be rejected (1 very unconcerned- 6 very concerned). Rejection expectancy is measuring how likely the participant is readily perceiving rejection in social situations (1 very unlikely- 6 very likely). For measuring each subsection of the scale there are two different formulas present. When scoring rejection sensitivity, the participants responses to the rejection expectancy items were reversed coded, and then multiplied by rejection concern. The second formula for rejection expectancy is the numerical digit 7 minus rejection expectancy score. For example, if a participant rates their concern for rejection a 4 and they rate their expectancy for rejection a 3. According to the formula their rejection concern score is 4 and their rejection expectancy score is 4 (7 – 3 = 4). The product of the score for rejection sensitivity is 16 (4 x 4 = 16). Pertaining to each individual question they all will be scored the same using both formulas.
Insecure attachment
The revised adult attachment scale (AAS) will be used to measure how comfortable the participants are in their interpersonal relationships with allowing others to get close to them (e.g., I find it relatively easy to let others close to me; I do not worry about being abandoned). The measurement is scored on a 5-point likert scale (1 not at all a characteristic of me – 5 very characteristic of me) and it has 18 items. The measurement contains three subscales close, anxiety and depend. When answering questions pertaining to the close subscale it measures intimacy and how comfortable the participant is with letting others get close to them. The anxiety subscale measures to what extent are participants worried about feeling unloved or being rejected. Lastly, the depend scale measures to what capacity does participants depend on others to be available when needed. Reverse scoring is used to average the means of each subscale.
Psychotherapy
Psychotherapy is the categorical independent variable that will be manipulated in the study. Also, talk therapy will be used as the moderator as well to measure possible reductions of rejection sensitivity in insecurely attached adults. The variable will be manipulated during the session by incorporating certain techniques that the control group will not be exposed to. Psychotherapy will last for a duration of 30 sessions that will be scheduled for 60 minutes each. Cognitive behavioral therapy will be used in the treatment group with structured steps on recovering and reconstructing memories. Recovering and reconstructing memories happens in three phases. During the three phases it breaks down the targeted memory and reconstructs it. The phases of the reconstructing and recovering memories are necessary in altering the internal dialogue so they can incorporate negative memories with positive ones forming new mental representations. Whereas the control group therapy sessions will use a holistic approach. Holistic therapy is grounded in psychosynthesis focusing on the relationship between spirit, body and mind. The key point of holistic therapy is to focus on certain issues and how they can lead to concerns in other areas of a person’s life. During therapy sessions trained mental health professionals will treat the person as a whole being that is fully connected with their inner auras and educate them on how to gain awareness on the connections between their thoughts, emotions, physical experiences, and spiritual understandings.
Procedure
The participants will be split up into two groups. The first group will be the treatment group. The second group will be the control group. During the treatment group they will begin with the ARSQ questionnaire about their anxiety levels in social settings that could encourage rejection, and how do they feel currently. They will be encouraged to volunteer to fill out an AAS questionnaire about their attachment levels in their interpersonal relationships. Lastly, each participant will be prompted to fill out a brief demographic information sheet that will collect data regarding their sex, age, socioeconomic status, employment, and highest level of education achieved. Once each participant has filled out the demographic sheet, they will be asked to volunteer to enroll in therapy session for 60 min durations at least once a week. Therapy sessions will be held on campus of University of Central Oklahoma at the center for counselling and well-being. The control group will go through the same steps as the treatment group exactly and fill out all necessary documents. The treatment and control group will each have daily logs to fill out that will have open-ended questions regarding their current feelings and emotions. The control group will be encouraged to attend at least one therapy session once a week. Once both groups have successfully completed their 30-day therapy session they will be prompted to fill out the rejection sensitivity questionnaire once more before departure of the study. The purpose of both groups filling out the questionnaires at the beginning of the study is to track their initial scores and compare them at the end as a baseline.
Results
The data collected will be analyzed using SPSS. A multiple regression will be used to analyze the samples. I predict that results of the experiment will show scores of rejection sensitivity significantly decrease upon completion of psychotherapy. The results will also show that the relationship between insecure attachment and rejection sensitivity would be weaker in the experimental condition than in the control condition.
Discussion
Furthermore, the complexity of rejection sensitivity and all it entails can take a series of trial and error to correct the behavior. Although it is clear that attachment style does not make a difference in the development of rejection sensitivity, the study will specifically focus on insecure attached adults that are battling with rejection sensitivity. Looking further into detail of rejection sensitivity I will focus on how it can develop, and blossom as the person ages into adulthood. The paper goes into detail about the consequences of dealing with rejection sensitivity, and what are the common symptoms. In early childhood rejection sensitivity can start to be present in adolescence's lives and could continue to follow them into adulthood. The consequences are negative ranging from social withdrawal to angry outburst.
Insecure attachment has shown to positively correlate with the development of rejection sensitivity. Adults with insecure attachment suffer from many different symptoms (e.g., anxiety, depression, etc.,). According to Bowlby’s (1988) attachment theory children can develop an attachment style in early adolescence. During the development of the child the caregiver's role is important not only for nurturing purposes, but also attachment styles can start to take shape. When a child is given attention and is cared for they have a greater chance of developing secure attachment to that specific caregiver. Whereas, if their cries ring on deaf ears and they spend most of their time in solitude they have a greater chance of developing insecure attachment to that specific caregiver. Insecure attachment affects adults in their daily lives making it difficult for them to form close interpersonal relationships.
The purpose of this study is to gain perspective on the everyday struggles adults face when dealing with rejection sensitivity and insecure attachment. The study will use psychotherapy as a moderator for rejection sensitivity in insecure attached adults. The goal is to show a decrease in rejection sensitivity over a period of sessions with trained professionals that can treat various forms of trauma. To do so the therapy sessions will work diligently towards dislodging the internal dialogue allowing modification of negative unwanted memories. I hypothesize a significant decrease in rejection sensitivity in adults who have insecure attachment upon completion of psychotherapy. This study would add on to prior work by incorporating different measurements and adding a moderator. The study will be similar to Erozkan (2009) study with using college students, but a moderator and different measurements will be added as an extension to the study. By conducting research on adults with rejection sensitivity I hope to find similar results from prior work showing a relationship between insecure attachment and rejection sensitivity, but I also hope to show a decrease in rejection sensitivity due to psychotherapy being affective. However, by conducting this study if it is shown to be effective in reducing rejection sensitivity in insecure adults, the results could be misinterpreted that only insecure people have rejection sensitivity. Also, trained therapists might implement the strategy on their clients with the hope of successful reduction but could fall short due to several reasons (age, outside factors, etc). The delimitations that the study will hold is the uncertainty of whether therapy was the reason behind the reduction of rejection sensitivity or if it were other outside factors. For example, participants outside the study have a life to live and they will continue to grow as the study goes on. The participant could decide to come to terms with their emotions and move on all on their own without the help of therapy. Also, as they continue to grow older, they may experience changes in their life that makes them wiser allowing them the opportunity to understand their emotions by themselves. Unfortunately, this problem cannot be revised in the current study because it is unethical to tell participants not to live their lives.
Conclusion
In conclusion, hope is not lost for those struggling with rejection sensitivity there are other ulterior solutions to their complicated situation. Rejection sensitivity not only is recognized in insecure attached adults, securely attached adults can also experience symptoms as well. Psychotherapy is a great way for a person to express their built-up emotions, and in turn open the door to their locked away memories since childhood. The strategies used in the talk therapy session have shown to be beneficial in treating those with insecure attachment struggling with their rejection sensitivity.
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