(Flatiron, 283 pages)
Two years ago Dr. Sasha Hamdani filmed a TED talk in Kansas City on the subject “How to Hack Your Brain for Better Focus.” A psychiatrist who was diagnosed with ADHD in childhood, Hamdani was so nervous about the presentation and how it would be received that she ran out of the room after finishing, heart racing, one of her shoes coming off. “In my head, there was a relentless ticker tape that read: You sounded like an idiot. … Everything felt urgent. I had to get out of there.” To this day, she hasn’t been able to bring herself to watch the whole speech in full.
Hamdani confesses this and a whole lot more in Too Sensitive, her prescription for recovery for anyone who has ever been told they should toughen up. She comes to the subject by way of personal experience. In childhood, she realized that she seemed to take things much harder than other people, a condition that followed her into medical school, where her tendency to cry made it especially difficult to work in her intended field: pediatric intensive care. When an attending physician finally told her, “You can’t do this for a month, let alone the rest of your life,” Hamdani realized her boss was right and asked herself “What specialty can I cry in?” That’s how she came to be a psychiatrist looking for ways to help herself and other people who have repeatedly been told they are “too sensitive.”
Hamdani believes she has “rejection sensitive dysphoria,” or RSD, a condition that is not recognized as a clinical diagnosis in the Diagnostic and Statistical Manual of Mental Disorders but is widely considered a deviation in “how the brain anticipates, perceives and stores emotional pain.” It is, Hamdani says, most common in people with ADHD but can exist outside of that diagnosis. It’s a kind of emotional dysfunction that can grow worse over time, even causing people to experience physical pain. Hamdani argues that the condition is not a personal failing, but a sign of certain parts of the brain overcompensating to try to keep us safe — “the nervous system working overtime to protect you” is how she describes it.
Cynics might be inclined to call this “snowflake syndrome” and will certainly roll their eyes at Hamdani’s promise to keep readers emotionally safe with “clean fonts, shorter sections, and plenty of white space” to keep them from feeling overwhelmed while reading her book. “Each section focuses on one main idea at a time so the material feels manageable, especially when the topic is emotionally heavy,” she writes, adding, “this book respects your emotional limits.”
It does not, however, respect our intellect.
While Hamdani’s experience with excessive sensitivity is one familiar to many of us, particularly young adults wracked with anxiety, she has turned what could have been a useful magazine article into a highly repetitive book that is, at times, highly annoying. It begins well, and ends badly, like that season-opening Patriots game in Seattle.
RSD, she explains, is the result of neurobiological, genetic and environmental factors; in short, you can blame your body, your parents and job, or any combination of the above. It is the result of dysregulation in two important parts of the brain — the amygdala and the prefrontal cortex. “This neurocircuitry becomes overly responsive to social cues, misinterpreting them as threats.” This is compounded when a person has a history of bullying, trauma or chronic criticism, Hamdani says. As a result, “the brain becomes primed to detect rejection even where none exists, triggering the same physiological response as actual danger.”
The evolutionary reasons for this are well-established. For much of human history, our continued existence depended on strong social bonds. Without a tribe, it was almost impossible to survive. “Being excluded wasn’t just emotionally painful; it could mean starving, being attacked, or failing to reproduce.” Hamdani writes. “That is why rejection activates the same pain pathways in the brain as physical injury.” Researchers have found that the region of the brain that processes physical pain (the anterior cingulate cortex) responds to rejection by a friend or a lover the same way that it responds to a physical wound. That’s true for all of us, to varying extents, but in people with RSD, Hamdani says, the response is heightened, and when others tell us to “deal with it” or “toughen up,” it creates a cycle of shame and self-blame, making the sufferer feel even worse.
Hamdani offers a test of 25 questions in order for us to self-diagnose our own RSD, although it seems more like one of those Captcha “Are you human?” tests. The questions include “Do you frequently feel anxious or upset when you think others might not like you?” and “Do you feel a deep sense of inadequacy or failure when someone expresses disappointment in you?” (My own score might make her wonder how I even get out of bed in the morning, let alone leave the house.)
She then offers help in the form of a “Calm Your Mind toolkit,” using science-backed strategies from cognitive behavioral therapy, dialectical behavioral therapy and other forms of therapy employed in mental-health treatment. It is here that the structure of the book begins to work against us. For the next 184 pages Hamdani presents the myriad challenges that people with RSD face, from repeated negative thoughts to catastrophizing to being emotionally devastated or paralyzed from ghosting, criticism or even something as minor as a text that goes unanswered. The strategies she offers are at times physical (movement, like a brief round of jumping jacks, or taking “three slow grounding breaths” as a way to tell your amygdala to settle down); other times, mental (“think of five things you can touch, four things you can see, and so forth).
And there are an exhausting number of questions that she wants us to ponder, many of which are anxiety-inducing in themselves. (“Think of a time recently when you felt invisible or unappreciated … Think of the last time you felt triggered by your appearance … Think back to the last mistake you spun out about.”)
Hamdani wants us to realize how often negative feelings have more to do with the past than the present, and to cut ourselves some slack by recognizing that we are not the sum of an overreactive part of our brain the size of a shelled peanut. She wants us to know how to tell that brain, “You are safe. You can come down from high alert.” There is value here, for sensitive people and people who love them, and kudos to Hamdani’s insistence that difficult relationships, especially those with family members, can be worked through instead of cut off altogether. C+
Featured Photo: Too Sensitive, by Sasha Hamdani
