People with borderline personality disorder (BPD) typically have a heightened sensitivity to any form of rejection, often leading to people-pleasing behaviors to avoid it and angry reactions when it’s perceived.
Rejection can be painful and disheartening for all of us, and everyone experiences it in some shape or form throughout life. But when you live with borderline personality disorder, the feeling of being rejected can go beyond discomfort and feel more like an emotional emergency.
This page can help you understand rejection sensitivity in BPD by exploring:
- The link between BPD and rejection sensitivity.
- What rejection sensitivity can look like.
- What rejection can feel like to someone with BPD.
- Causes of rejection sensitivity in someone with BPD.
- Steps you can take to manage rejection sensitivity in BPD.
Link Between BPD Borderline Personality Disorder and Rejection Sensitivity
People living with borderline personality disorder (BPD) have heightened rejection sensitivity, meaning they’re extremely vigilant to signs of being disliked or abandoned. Research supports this. In an analysis of research in 2019, the analysts found that rejection sensitivity was consistently linked with BPD. They also found that childhood rejection, especially emotional abuse and neglect, could contribute to this pattern.[1]
Furthermore, research shows that rejection may feel especially threatening for people with BPD because it shakes one’s sense of belonging and control. In a study of 53 people with BPD and 34 people without, the BPD group reported that perceived rejection seriously threatened their sense of:[2]
- Belonging.
- Self-esteem.
- Control.
- Meaning.
What Does Rejection Sensitivity Look Like in Real Life?
Some typical thoughts that might arise for people living with BPD when they perceive they’ve been rejected in some way include the following:
- A delayed message? They’ve lost interest.
- A simple change in tone? They’re angry.
- A canceled plan? This is evidence that I’m unwanted.
But let’s also take a closer look at some real-life examples of what this might look like to other people.
Reactions to Unanswered Messages
A common real-life example of what rejection sensitivity can look like is the response to an unanswered message.
In a 2017 study of outpatients with BPD and depressive disorders, daily prompts that were seen to be followed by rejection or disagreement resulted in immediate increases in sadness, fear, and hostility. And this rejection–hostility link was especially strong in the people with BPD.[3] What this might look like is:
- Sudden anger.
- Withdrawal.
- Defensiveness.
Responses to Social Distance
Another example of rejection sensitivity in people living with BPD is the typical reaction to social feedback. Perhaps a friend says, “I can’t meet tonight,” or a colleague gives mild criticism. Someone without BPD might take these instances at face value, but someone with BPD might interpret them as messages like “You are not wanted here” or “You are not good enough.” This might then lead to BPD episodes, such as hostility, distress, or anger.
Interestingly, research has found that people with BPD may enter social situations with low expectations of being socially accepted. But they don’t adjust their expectations of how much they’ll be accepted after positive feedback – only negative.[4] In other words, a single canceled plan can be held onto and feel more convincing than five kind messages.
Interpretations of Body Language
In BPD, unclear social cues may not feel neutral at all. Reading someone’s face or mood and interpreting it as personal rejection is not uncommon for people living with BPD. As a result, you might see behaviors that seemingly don’t match the situation.
Even if you say something validating, if your body language seems distant in any way, the other person might override your words with thoughts like, They’re being cold with me. Supporting this, a study found that stronger BPD features were linked with rating emotionally neutral faces as less trustworthy.[5]
What Does Rejection Sensitivity Feel Like?
Now that we’ve covered what rejection sensitivity can look like, what does it feel like for people with BPD?
Rejection sensitivity can feel different from person to person. However, one common thread that helps people identify it is that rejection sensitivity is often felt in the body prior to being played out as a thought. You might also experience emotions that don’t immediately relate to feelings of rejection.
For instance, before you have a thought like I don’t matter to this person, you may experience things like:
- Physical sensations like a sudden drop in your stomach and/or tightness in your chest.
- Panic, anger, shame, or despair.
- An urgent need for reassurance.
- An impulse to send repeated messages.
- The desire to withdraw from someone before they can leave you.
- Numbness, withdrawal, or dissociation.
Causes of Rejection Sensitivity in BPD
There is no single cause of rejection sensitivity in BPD. Instead, research points toward several interacting influences, including the following:
1. Early Adversity
Studies over the years have found that people with BPD are substantially more likely to report childhood adversity than people without a psychiatric diagnosis.[6] For instance, parental invalidation, such as dismissal of a child’s needs, is linked to BPD symptoms in adulthood.[7]
If care and safety were unpredictable growing up, monitoring others closely might have been a very useful tool. After all, back then this could have given you important information about how you could survive and get your needs met. So, for example, you might have become highly attuned to small changes in caregivers’ expressions or behaviors.
2. Attachment Experiences
Linked to childhood adversity is the concept of insecure attachment. “Attachment” in psychology refers to how we learn to understand closeness, trust, separation, and emotional safety. The attachment styles are made up of secure attachment and, on the opposite side of the spectrum, insecure attachment. The insecure styles include avoidant, anxious, and disorganized attachment styles.
A review in 2004 found people with BPD mostly have insecure attachment patterns. Many of the participants with BPD in the review showed attachment patterns that involved intense concerns about abandonment alongside difficulty trusting or depending on other people.[8][9]
Therefore, a slow response, or a partner needing space, may feel immediately like abandonment to someone with BPD and insecure attachment. As a result, BPD symptoms are commonly associated with romantic relationship dysfunction.
3. Brain Differences
In a brain-imaging experiment involving 20 women with BPD and 20 healthy controls, participants with BPD felt more excluded even during a condition designed to include them. Therefore, it was concluded that people with BPD may have difficulty clearly distinguishing between inclusion and exclusion in ambiguous social situations.[10] In fact, people with BPD may fill in missing information with the explanation their brain has learned to fear most.
How Rejection Sensitivity Affects Relationships
When you expect abandonment, you may try to prevent it through:
- Reassurance-seeking.
- Repeated checking.
- Testing.
- Withdrawing.
- Apologizing excessively.
- Becoming angry.
Even though the underlying reason for these reactions is likely an attempt to feel safe, rejection sensitivity can unfortunately take a toll on relationships.
Research shows how this cycle can hurt both people in the relationship. People with BPD symptoms perceive more rejection and less acceptance in daily life. So when the perceived rejection comes from a romantic partner, they report heightened hostility.[11]
This may show that people with BPD might be drawn to partners with similar backgrounds to their own, which, without support, could continue the cycle of rejection and abandonment.
Actions You Can Take When You Feel Rejected
Research tells us rejection sensitivity is associated with several mental health outcomes, including depression, anxiety, loneliness, and aggression.[12] For this reason, it’s important to know what to do when the rejection alarm is triggered.
The first goal should be to try to reduce the intensity of the situation by putting a buffer between yourself and impulsive action and making clearer thinking space.
DBT skills training has been shown to reduce self-harm, depression, and crisis-service use in people with BPD.[13] At the same time, research on emotion regulation suggests that accepting an emotion, rather than trying to suppress it, can support healthier emotional processing in people with anxiety and mood disorders.[14]
So, to pull these skills together, perhaps try the following:
- Separate the facts from the interpretation: Remember, thoughts like They have not replied for three hours are factual, as opposed to ones like They no longer love me, which are interpretations.
- Label emotions: Put a name to how you feel, for example, “I feel rejected, frightened, and ashamed.” This is not agreeing with the feeling; it is identifying it.
- Pause action: Avoid any major decisions during high stress. For example, draft the message, but don’t send it yet.
- Regulate your body: Slow your breathing, take a short walk, use cold water, or focus on physical details in your surroundings.
- Find other explanations: Ask yourself, What else could explain this? Maybe they are busy, tired, distracted, overwhelmed, or simply not near their phone.
What BPD Treatment Can Help?
Psychotherapy is the main treatment for BPD and its associated emotional dysregulation.
Dialectical behavior therapy (DBT) was designed for treating BPD and can help you:
- Tolerate distress.
- Regulate intense emotions.
- Check interpretations.
- Communicate your needs more effectively.
Additionally, mentalization-based treatment helps you become more curious and less certain about what another person is thinking.
Dialectical behavior therapy shows benefits for self-harm and psychosocial functioning, while mentalization-based treatment showed benefits for self-harm and suicide-related outcomes.[15][16]
Long-term studies have challenged the old belief that BPD is inevitably lifelong and unchanging. Research following people with BPD over many years has found that symptom reduction is common, although rebuilding work, relationships, and wider functioning may take longer.[17][18]
The right mental health professional can support you throughout your treatment, helping you rebuild relationships across all facets of life.
Mental Wellness Designed Around Your Life
Mental Wellness, Wherever You Are
Life keeps you moving, and your care should too. Our virtual program gives you access to a wide range of mental health services from the comfort of your own home, office, or anywhere you feel most at ease. It's the same high-quality care, just with more convenience. Available from anywhere in California, Virginia, and Washington!
Virtual ProgramMental Wellness, With a Human Connection
Sometimes, you just want to talk to someone face-to-face. Our in-person program provides a calm, supportive environment where you can connect with our team and focus on your well-being without distractions. Experience personalized care and build a strong relationship with your provider in a space designed for healing.
In-Person ProgramMental Wellness, The Best of Both Worlds
Can't decide between virtual and in-person? You don't have to. Our hybrid program offers the best of both. Mix and match virtual and in-person sessions to create a schedule that's truly yours.
It's the ultimate flexibility, so you can get the care you need, no matter what your week looks like.
Hybrid ProgramFind Support for Rejection Sensitivity in BPD With Mission Connection
Ongoing fears of rejection can make daily life feel like a minefield of criticism and anticipated abandonment. It can be difficult to process the experiences that led to these fears alone. Support and guidance is available to help you.
At Mission Connection, our team of licensed mental health professionals goes beyond traditional treatment and provides life-changing care. We offer several options for effective outpatient treatment, including in-person programs at our locations in California, Virginia, and Washington, virtual telehealth, and a hybrid program that combines in-person and virtual care.
We create a structured care plan for every patient that consists of evidence-based therapies (CBT, DBT, and trauma-informed approaches) and medication management.
Mission Connection is Joint Commission-accredited. We also accept most major insurance providers, so that your recovery is not hindered due to financial issues.
We understand that rejection sensitivity may feel deep and immovable, but it is not fixed. If you’d like to know more about how we can help you move towards steadier responses and a calmer-feeling life, reach out to us online or call us at 866-833-1822. The start of more fulfilling and balanced relationships awaits.
References
- Foxhall, M., et al. (2019). The link between rejection sensitivity and borderline personality disorder: a systematic review and meta-analysis. British Journal of Clinical Psychology https://doi.org/10.1111/bjc.12216
- Dixon-Gordon, K. L., et al. (2013). A laboratory-based examination of responses to social rejection in borderline personality disorder: the mediating role of emotion dysregulation. Journal of Personality Disorders https://doi.org/10.1521/pedi.2013.27.2.157
- Hepp, J., et al. (2017). Interpersonal problems and negative affect in borderline personality and depressive disorders in daily life. Clinical Psychological Science https://doi.org/10.1177/2167702616677312
- Liebke, L., et al. (2018). Difficulties with being socially accepted: an experimental study in borderline personality disorder. Journal of Abnormal Psychology https://doi.org/10.1037/abn0000373
- Miano, A., et al. (2013). Rejection sensitivity is a mediator between borderline personality disorder features and facial trust appraisal. Journal of Personality Disorders https://doi.org/10.1521/pedi_2013_27_096
- Porter, C., et al. (2020). Childhood adversity and borderline personality disorder: a meta-analysis. Acta Psychiatrica Scandinavica https://doi.org/10.1111/acps.13118
- Lee, S. S. M., et al. (2022). Parental invalidation and its associations with borderline personality disorder symptoms: a multivariate meta-analysis. Personality Disorders: Theory, Research, and Treatment https://doi.org/10.1037/per0000523
- Agrawal, H. R., et al. (2004). Attachment studies with borderline patients: a review. Harvard Review of Psychiatry https://doi.org/10.1080/10673220490447218
- Hill, J., et al. (2011). Attachment, borderline personality, and romantic relationship dysfunction. Journal of Personality Disorders https://doi.org/10.1521/pedi.2011.25.6.789
- Domsalla, M., et al. (2014). Cerebral processing of social rejection in patients with borderline personality disorder. Social Cognitive and Affective Neuroscience https://doi.org/10.1093/scan/nst176
- Kroener, J., et al. (2023). Relationship dysfunction in couples when one partner is diagnosed with borderline personality disorder: findings from a pilot study. Behavioral Sciences https://doi.org/10.3390/bs13030253
- Gao, S., et al. (2017). Associations between rejection sensitivity and mental health outcomes: a meta-analytic review. Clinical Psychology Review https://doi.org/10.1016/j.cpr.2017.08.007
- Linehan, M. M., et al. (2015). Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: a randomized clinical trial and component analysis. JAMA Psychiatry https://doi.org/10.1001/jamapsychiatry.2014.3039
- Dixon-Gordon, K. L., et al. (2017). Emotion regulation in borderline personality disorder: an experimental investigation of the effects of instructed acceptance and suppression. Behavior Therapy https://doi.org/10.1016/j.beth.2017.03.001
- Stoffers-Winterling, J. M., et al. (2022). Psychotherapies for borderline personality disorder: a focused systematic review and meta-analysis. The British Journal of Psychiatry https://doi.org/10.1192/bjp.2021.204
- Bateman, A., & Fonagy, P. (2009). Randomized controlled trial of outpatient mentalization-based treatment versus structured clinical management for borderline personality disorder. American Journal of Psychiatry https://doi.org/10.1176/appi.ajp.2009.09040539
- Zanarini, M. C., et al. (2012). Attainment and stability of sustained symptomatic remission and recovery among patients with borderline personality disorder and axis ii comparison subjects: a 16-year prospective follow-up study. American Journal of Psychiatry https://doi.org/10.1176/appi.ajp.2011.11101550
- Gunderson, J. G., et al. (2011). Ten-year course of borderline personality disorder: psychopathology and function from the collaborative longitudinal personality disorders study. Archives of General Psychiatry https://doi.org/10.1001/archgenpsychiatry.2011.37