Rejection Sensitive Dysphoria is the New Hysteria

neuroqueering the origins of a common experience among neurodivergent folks

(This is the text of a short essay I just posted on IG. It’s too long to put into the caption, so I am repeating it here for accessibility reasons. (ID: a black silhouette of a woman in an elaborate Victorian dress in front of a background of vintage yellow wallpaper with a plush damask and striped pattern)

divergent_design_studios

A post shared by @divergent_design_studios

Just over 100 years ago, "hysteria" was considered a diagnosable physical disease in women (note: this is in my own grandmother's lifetime). Symptoms included shortness of breath, anxiety, insomnia, fainting, amnesia, paralysis, pain, spasms, convulsive fits, vomiting, deafness, bizarre movements, seizures, hallucinations, inability to speak.

French neurologist and anatomical pathologist Jean-Martin Charcot, known as the "father of modern neurology," theorized that hysteria was a hereditary, physiological disorder caused by impairments in the brain. Hysteria was also believed to be related to the female reproductive tract (the name is derived from the Greek word for uterus, hystera, also related to the word hysterectomy).

Many of the symptoms of "hysteria" in women can now obviously be attributed to trauma, oppression/repression, and to simply being passionate, sensitive, creative human beings—an unforgivable phenomenon in women. The diagnosis of "hysteria" was clearly just misogyny masquerading as science and medicine.

In 1892 (just a few years before my grandmother was born), Charlotte Perkins Gilman published a short story called "The Yellow Wallpaper," written in the voice of a woman whose physician-husband has diagnosed her with "temporary nervous depression—a slight hysterical tendency." As a form of treatment, he shuts her up in the nursery of an old mansion he has rented for the summer.

Central to the unnamed woman's "cure" is “rest”—not just physical rest, but also “rest” from anything that might stimulate her mind. In other words, she is prescribed boredom as a cure. She is forbidden from reading, writing, or any form of work. This so-called "rest cure"—i.e. boredom—was often prescribed to women diagnosed with hysteria.

Left with nothing to do but contemplate the yellow wallpaper that adorns her room, she begins to imagine there is a woman trapped on the other side of the pattern. Eventually, suffering from the psychosis induced by her husband's "cure," she begins creeping around the perimeter of the room on all fours, clawing off the wallpaper in an effort to free the trapped woman.

Gilman perfectly illustrates the gaslighting, abusive circular logic of this type of diagnosis:

1) the very symptoms the diagnosis purports to explain are actually the result of trauma and repression related to some form of oppression (misogyny in the case of hysteria);

2) the diagnosis then attributes the "disorder" back to that very oppressed identity—i.e. hysteria is a disorder of "femaleness"; and

3) the "cure" prescribed is just more of the same oppression that caused the trauma and the symptoms in the first place.

Let's look at how this same logic is at work in the "diagnosis" of Rejection Sensitive Dysphoria, a "disorder" invented by Dr. William Dodson.

Dr. Dodson observed, over the course of decades of treating ADHD people, a set of symptoms that are, indeed, common in many neurodivergent people:

intense sensitivity and reactivity to actual or perceived rejection, resulting in either sudden, uncontrollable, angry outbursts, or, alternatively, the repression and internalization of those feelings, often leading to depression and anxiety.

(Please note I am not disputing the existence of these symptoms, just one explanation of their cause.)

Despite the fact that these symptoms can simply and elegantly be attributed to the complex trauma of being neurodivergent in a neurotypical world (just as the symptoms of hysteria were easily explained by the trauma of misogyny), Dr. Dodson has a different theory.

Just as Dr. Charcot attributed the symptoms resulting from misogyny to the very object of misogyny—i.e. "femaleness" and specifically the female reproductive tract—so too, Dr. Dodson would like to blame the ADHD brain for its own oppression.

With exactly zero peer-reviewed scientific evidence (by his own admission), Dr. Dodson theorizes that the cause of sensitivity to rejection in ADHD people is caused not by a life-time of pathologizing by clinicians like himself, and rejection by society at large, but rather by some genetic, neurological disorder in our brains.

Moreover, he theorizes, there is no cure for this terrible brain defect, and the only therapy is the off-label prescription of a few specific medications (whose on-label use is to treat .... trauma! You can’t make this shit up.)

Do you see what a neat trick this is?

First pathologize difference as “disorder.”

Next traumatize a whole population by calling them "disordered" and failing to accommodate the different ways they are in the world.

Then blame them for the symptoms of their trauma. Locate the cause of the symptoms of their trauma in the very "disorder" you invented because you can't tolerate and won't accommodate difference.

Then prescribe a "cure" that doesn't address any of the underlying causes of trauma, but instead keeps everything neatly in your own pathologizing paradigm.

---

These are the sorts of ideas we will be exploring in the upcoming course I am co-teaching this fall:

Neuroqueering Your Creative Practice

This course is a deep dive into a variety of ‘neuroqueering’ practices, geared towards artists and creatives. As a community, we will deconstruct capitalist/colonialist concepts of time, work, productivity, shame, ‘executive function’, giving and receiving feedback, and more, while simultaneously constructing new systems, languages, narratives, and ways of being/creating that subvert, defy, disrupt, and liberate us from neuronormativity and heteronormativity.

Session descriptions, facilitator bios, dates, and pricing information.

Get notified of Early Bird ticket discounts, on sale for two weeks beginning 8 August, 2024.

We’ve had an amazing response to this course, and it’s possible it will sell out just through Early Bird tickets. If you are interested and haven’t already registered your interest, there is absolutely no obligation and we won’t add your email to any lists unless you proactively opt in.

If you have any questions at all about this course, don’t hesitate to email me at marta@martarose.com (or you can just hit reply to this post, or drop a comment!)