What happened in this episode?
Chris Williamson interviews US psychiatrist Dr Sasha Hamdani about emotional sensitivity, with a focus on rejection sensitive dysphoria (RSD) and how intense emotional responses can affect relationships, work, and self-image. Hamdani describes emotionally sensitive people as those who feel emotions quickly, deeply, and for longer periods, and says heightened responses can be driven by neurobiology including amygdala reactivity, weaker prefrontal ‘braking’ and dysregulation of dopamine and norepinephrine. She also argues hormonal fluctuations can shape regulation: she says drops in oestrogen can reduce dopamine and increase vulnerability to emotional overwhelm, and that falling testosterone in later life may contribute to increased emotional sensitivity in some men.
A significant section addresses gender and mental health. Hamdani argues boys and men are often socialised to suppress most emotions and to channel distress into anger, and she connects avoidance in adult men to fear of rejection and lack of emotional tools. Williamson challenges popular narratives around male suicide and support, asserting (without citing evidence in the episode) that many men who die by suicide have already engaged with counselling.
Hamdani discusses how RSD can fuel reassurance-seeking, ‘vulnerability hangovers’, and pre-emptive relationship sabotage. She shares a personal account of being discouraged from pursuing paediatric intensive care because she “cr[ied] all the time”, which she says contributed to her move into psychiatry. The pair close with practical regulation strategies Hamdani recommends, including movement, delaying impulsive reactions, and mindfulness as non-judgemental observation.
