Explicit forms of rejection, ostracization and exclusion can make most, if not all people feel rejected. However, those who are highly sensitive to rejection tend to see intentional rejection even in situations that are ambiguous, for example, when a partner does not return a call immediately, or a friend is preoccupied with work and therefore can’t pay attention.

People who fear and expect rejection are hypervigilant for rejection cues, therefore, they readily perceive intentional hurt in others’ behaviour even when it may not exist. Even when real rejection occurs, they tend to react more intensely and defensively to it than someone who wasn’t expecting to be rejected, because their minds and bodies automatically switch to fight-or-flight mode in interpersonal situations. Ironically, these reactions serve a self-fulfilling function and eventually rejection sensitive people experience relationship disillusionment. Given this pattern, it would be helpful for people to have awareness of their own rejection sensitivity, in terms of their propensity to overinterpret and overreact to rejection. Such awareness may then be coupled with practices to alter negative expectations and interpersonal schemas (e.g. cognitive restructuring through CBTW), and/or enhance emotion regulation ability (e.g. mindfulness practices, self-distancing training).

Rejection sensitive people are at heighted risk to self-silence – that is, they suppress, hide, or subjugate their own goals, desires, preferences to that of their partner in order to avoid rejection and secure acceptance. For example, adolescent girls sensitive to rejection are more likely to do things they know are wrong or illegal to please their boyfriends. Therefore, one boundary rejection sensitive people need to be aware of is how much self-harm or self-sacrifice a relationship may be (implicitly or explicitly) asking of them.

Although no-one likes to be rejected, those people who have positive expectations about their self-worth and likelihood of acceptance, tend to respond less strongly and negatively to rejection when it does occur. Two related processes underlie this phenomenon. First, people who are not overly sensitive to rejection and thus by default expect to be loved and accepted tend to have a higher threshold to interpret ambiguous, even mildly negative behaviors as intentional rejection directed at them. Second, their reactions to rejection tend to be milder and less defensive. Because their fight-or-flight system is not in overdrive most of the time, they can be more deliberate and thoughtful in how they respond when they do feel rejected.

It may be difficult to implement any regulation strategy when people are in the heat of the moment. Nevertheless, strategies broadly construed as cognitive restructuring include decentering, mindfulness, big picture appraisals, self-distancing, positive reappraisal and objective reappraisal. Avoidance is not a healthy strategy though could be instrumental under certain conditions. For example, it may be better to avoid discussing an issue until emotions cool off and people have time to reflect on their reactions than to run into a confrontation.

I can’t speak to this based on direct scientific evidence. But based on everything we know about desensitization as well as CBT, exposure should be helpful if certain conditions are met. Exposure starts out with mildly threatening situations (and build up in intensity as people develop more stamina); people practice social response scripts that can be readily implemented under threat; people have a safe haven to return to in the face of failure (could be a therapist); people have a box of tools to thwart rumination (e.g. decentering or mindfulness practices, big picture appraisals, self-distancing, positive reappraisal).