Can AI chatbots truly provide empathetic and secure mental health support?
Author: Laura Petracek

Author: Ella Ryan

​Rejection from a friend, partner, or family member is a distressing experience.
Source: Photo by Dexon Dave Silva

Rejection sensitivity, a term coined by psychologist Geraldine Downey, refers to an individual's heightened sensitivity to perceived rejection or criticism in social situations. This phenomenon can have significant implications for mental health and interpersonal relationships. Research suggests that rejection sensitivity can stem from early experiences of rejection, neglect, or invalidation, which may contribute to hypersensitivity to social cues (Downey & Feldman, 1996).

The Impact of Rejection Sensitivity on Mental Health
Numerous studies have linked rejection sensitivity to various mental health challenges, including anxiety, depression, and low self-esteem. Individuals with high levels of rejection sensitivity may experience chronic feelings of inadequacy, social anxiety, and avoidance of social interactions (Ayduk et al., 2003). Moreover, the constant fear of rejection can contribute to a negative self-image and persistent feelings of loneliness and isolation

Rejection sensitivity can also significantly impact interpersonal relationships, leading to difficulties forming and maintaining close connections. Individuals with high rejection sensitivity may engage in self-protective behaviors such as avoiding emotional intimacy, preemptively ending relationships, or overreacting to perceived rejection, which can strain relationships and lead to conflict. (Mendoza-Denton et al., 2002).
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Effective Coping Strategies and Interventions
Cognitive Restructuring: Cognitive-behavioral techniques such as cognitive restructuring can help individuals challenge and reframe negative thoughts and beliefs about rejection, reducing the intensity of emotional reactions. Through this process, individuals can develop a more balanced and realistic perspective on rejection, leading to greater emotional resilience.

Emotional Regulation: Learning practical emotion regulation skills, such as mindfulness and relaxation techniques, can help individuals manage intense emotional responses triggered by perceived rejection (Berenson et al., 2009). Individuals can navigate challenging social situations with greater ease and composure by cultivating a greater awareness of their emotions and employing effective coping strategies.

Communication Skills: Improving communication skills and assertiveness can empower individuals to express their needs and boundaries effectively in relationships, reducing misunderstandings and conflicts (Downey et al., 2000). Straightforward and assertive communication can foster mutual understanding and respect in relationships, helping mitigate rejection sensitivity's impact on interpersonal dynamics.

Therapy and Support: Seeking therapy, particularly approaches such as dialectical behavior therapy (DBT) or acceptance and commitment therapy (ACT), can provide individuals with the tools and support needed to address underlying issues related to rejection sensitivity and improve overall mental well-being.

Rejection sensitivity can have profound effects on mental health and interpersonal relationships, but it is not insurmountable. By understanding the underlying factors contributing to rejection sensitivity and employing effective coping strategies and interventions, individuals can learn to navigate social interactions more confidently and cultivate healthier, more fulfilling relationships.

References
Downey, G., & Feldman, S. I. (1996). Implications of rejection sensitivity for intimate relationships. Journal of Personality and Social Psychology, 70(6), 1327–1343.

Mendoza-Denton, R., Downey, G., Purdie, V. J., Davis, A., & Pietrzak, J. (2002). Sensitivity to status-based rejection: Implications for African American students’ college experience. Journal of Personality and Social Psychology, 83(4), 896–918.

Ayduk, Ö., Downey, G., Testa, A., Yen, Y., & Shoda, Y. (1999). Does rejection elicit hostility in rejection-sensitive women? Social Cognition, 17(2), 245–271.
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Berenson, K. R., Gyurak, A., Ayduk, Ö., Downey, G., Garner, M. J., Mogg, K., & Pine, D. S. (2009). Rejection sensitivity and disruption of attention by social threat cues. Journal of Research on Adolescence, 19(3), 491–505.

About the Author: 
​Laura Petracek, Ph.D., LCSW, is the author of The DBT Workbook for Alcohol and Drug Addiction and The Anger Workbook for Women. ​
Online:
Personal Website, Facebook, LinkedIn, Instagram

Names hold incredible power. They are among the first things people learn about you and often leave a lasting impression. The impact can be profound whether you're considering changing your name after a significant life event to align with your identity or for a fresh start. Changing your name might just catalyze change in many areas of your life, from personal identity to how others perceive you.

1. Create a New Identity
Changing your name can signal a transformation, particularly if the old name is associated with negative experiences or a version of yourself that no longer fits. Some individuals make this change after significant life events such as marriage, divorce, gender transition, or relocating to a new place.
For instance, transgender individuals often select names that better align with their gender identity, which can affirm their true selves. Research published in the Journal of Adolescent Health highlighted that using a chosen name significantly reduces depression and anxiety among transgender youth, illustrating the profound emotional impact of a name change; those recovering from trauma, such as leaving an abusive relationship, may change their name to reclaim power and rewrite their narrative symbolically.

2. Free Yourself From Labels
​Names often come with cultural, familial, or societal expectations that might not align with your aspirations. A name change allows you to redefine yourself, shedding limiting associations that no longer serve you.

Celebrities often adopt stage names to craft distinct public identities; for example, Reginald Dwight became Elton John, and Stefani Germanotta transformed into Lady Gaga. These changes were more than just rebranding efforts; they enabled these artists to build unique personas that supported their goals. This principle holds for everyone: Changing your name can empower you to break free from stereotypes or inherited expectations.

3. Shift Psychological Factors That Shape Your Sense of Self
A study in Psychological Science found that implicit egotism—an unconscious attraction to things that resemble ourselves, including our names—affects major life choices, such as where we live and whom we marry. Feeling disconnected from yourself may subconsciously limit your confidence or willingness to engage in certain activities. Changing your name can help shift this dynamic, enabling a more positive self-perception and openness to new opportunities.

4. Change How Others Perceive You
Names are loaded with cultural and social assumptions. Unfortunately, studies have shown that individuals with "ethnic-sounding" names may face bias, particularly in the job market. A study by the National Bureau of Economic Research indicated that applicants with traditionally "white" names were 50 percent more likely to receive interview callbacks than those with African-American names. While changing a name to navigate such biases raises questions about authenticity and cultural identity, for some, it can serve as a strategy to mitigate discrimination and create more opportunities.

5. Symbolize Personal Growth
Changing your name can accelerate personal growth. After overcoming challenges such as addiction or mental health struggles, taking on a new name may help solidify your sense of renewal and underscore your resilience. For those distancing themselves from toxic relationships or estranged family, a name change signifies letting go of a painful past and focusing on the future. This deliberate act can mark a turning point, reinforcing a mindset centered on hope and progression.

Legal and Practical Considerations
The process of changing a name comes with its own legal and social implications. Preparing for this transition means anticipating how friends, family, and colleagues might respond. Also, consider whether your choice will be respected and how comfortable you are explaining the change. Before proceeding, weighing these factors and understanding the potential risks and benefits are essential steps.

Conclusion
​Your name is more than just what people call you; it's a cornerstone of identity. Changing it can be one of your most empowering decisions, offering renewed self-confidence, freedom from past limitations, and the opportunity to take control of your narrative. It’s not a decision to be taken lightly, but for some, the rewards—a fresh start, a deeper sense of alignment, and the affirmation of your true self—can be life-changing.

Sources:
Bertrand, M., & Mullainathan, S. (2004). Are Emily and Greg more employable than Lakisha and Jamal? A field experiment on labor market discrimination. American Economic Review, 94(4), 991–1013.
Pelham, B. W., Carvallo, M., & Jones, J. T. (2005). Implicit egotism. Current Directions in Psychological Science, 14(2), 106–110
Chosen Name Use Is Linked to Reduced Depressive Symptoms, Suicidal Ideation, and Suicidal Behavior Among Transgender Youth, Russell, Stephen T. et al. Journal of Adolescent Health, Volume 63, Issue 4, 503 - 505

Author: Ana Norio Bran

Author: IAP Staff

Author: Marisol Caldera

Author: Alejandra Hilbert

Author: Cate Cabri

About the author:
Cate is a student at Loyola University Chicago where she is majoring in Psychology with a minor in Psychology of Crime and Justice. She plans on attending graduate school to become a clinical social worker. In her free time, she enjoys hiking and spending time with family and friends.

Author: Katie Borrman

My work friends and I were all freshly vaccinated and looked forward to having another dinner party together after a year of isolation. Most of us had kept to our “pods” (a limited group of friends/family to socialize with during the pandemic), and hadn’t risked socializing outside of that. It was the first time in a year I expanded my social circle to an indoor party with friends in different pods. I was excited. What I didn’t expect was to feel an inescapable level of anxiety. I remember feeling like I was watching myself in the group, asking myself, “Why aren’t you talking more? Why are you so tired? Do they think you’re not having fun? Do they think you have changed during this year of isolation? Have I changed for the worse? Do you have anything to contribute? Why are you being so boring? Does anyone else feel like the volume is too high?” This anxiety-induced questioning led me to a full bodily shutdown, and I felt paralyzed. The last thing I expected during this reunion was for me to excuse myself at 9:00 pm to read a book and fall asleep before anyone else. After this event, I tried my hardest not to judge myself, and instead, evaluate psychologically what was going on.

The DSM-V describes social anxiety disorder with 10 main criteria, but for my situation, the first 3 criteria pertain the most directly:

1.  “The essential feature of social anxiety disorder is a marked or intense fear or anxiety of so­cial situations in which the individual may be scrutinized by others. In children, the fear or anxiety must occur in peer settings and not just during interactions with adults.”  
2. “When exposed to such social situations, the individual fears that he or she will be neg­atively evaluated. The individual is concerned that he or she will be judged as anxious, weak, crazy, stupid, boring, intimidating, dirty, or unlikable. The individual fears that he or she will act or appear in a certain way or show anxiety symptoms, such as blushing, trembling, sweating, stumbling over one's words, or staring, that will be negatively eval­uated by others.”  
3.  “Social situations almost always provoke fear or anxiety.”  

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These symptoms checked out with how I was feeling at the reunion. Social anxiety had never been a controlling element in my life, and I knew that the Covid-19 lockdown was a major contributor to this psychological state. As a society, we are going through something difficult, unpredictable, and traumatic. According to the Center for Disease Control and Prevention (CDC), “Elevated levels of adverse mental health conditions, substance use, and suicidal ideation were reported by adults in the United States in June 2020. The prevalence of symptoms of anxiety disorder was approximately three times those reported in the second quarter of 2019 (25.5% versus 8.1%).” Whether or not you have had experiences with social anxiety before, or are recently feeling its crippling effects, there are many reasons why an increase in this type of unhelpful habit of thinking may have developed over the past year:

Expectations for personal growth during lockdown
Lockdown brought about many opportunities for people to explore new interests, pick up old hobbies, or “reset” their bodies in a way that was not afforded to them while working full-time. It’s hard not to compare your own personal growth to those who share their experiences freely on social media. But not all experiences during lockdown are seemingly “self-enhancing.” According to the American Psychological Association’s Stress in America Report, since the pandemic started: 61% of adults reported experiencing undesired weight changes, nearly 1 in 4 adults reported drinking more alcohol to cope with their stress, nearly half of Americans said they delayed or canceled health care services, essential workers were more than twice as likely as nonessential workers to have been diagnosed with a mental health disorder, and Gen Z adults were the most likely generation to say that their mental health has worsened.

Those dealing with social anxiety might fall victim to an illusion of unworthiness, or a cycle of thinking that minimizes their own experience. If this thinking has dominated your thoughts during the lockdown, then assimilating back into social circles face-to-face might bring about the same negative cycles of thinking - that your own experience is inadequate, disappointing, or depressing compared to those around you.

Conflicting media information 
There are endless amounts of information one can digest through media outlets pertaining to Covid-19, and after a year of deciphering which information feels the most accurate, we are bound to come into conflicting points of view on the safety, regulation, and validity of the information we are taking as truth. The CDC has methods for tracking the deaths, outbreaks, and hospitalizations of Covid-19, as well as which public health measures seem to be working. However, according to the CDC, “...counting exact numbers of COVID-19 cases is not possible because COVID-19 can cause mild illness, symptoms might not appear immediately, there are delays in reporting and testing, not everyone who is infected gets tested or seeks medical care, and there are differences in how completely states and territories report their cases.” This ambiguity can cause tension within our community and social circles due to a lack of consensus and trust. These disagreements can turn into confrontation or avoidance, and in turn, exacerbate anxiety levels while socializing with new or familiar groups.


Grief, loss, and survivor’s guilt
For anyone grieving the loss of loved ones close to them, or feeling loss and grief on a “global community” scale, reemerging from lockdown can feel emotionally overwhelming. According to the CDC, “...the prevalence of depressive disorder was approximately four times that reported in the second quarter of 2019 (24.3% versus 6.5%)”. Depression almost always contributes to anxiety levels, and after a year of isolation and social distancing, the question of how to reintegrate can feel nearly impossible to answer. The pressure to “reopen” may feel like too much too soon, and it’s important to let the phases of grief happen naturally and at whatever timeline feels right.

Unwillingness to return to “normal”
The “reopening” of our community structures is a relief for some, while for others creates a sense of dread. For some, this time in lockdown has given a much-needed dose of self-reflection and an opportunity to change personal circumstances and values. For others, reopening might feel simply unsafe. According to the APA Stress in America Report, when asked about feelings concerning the future, “...more than half said they feel uneasy about adjusting to in-person interaction once the pandemic ends (57% Black, 51% Asian, 50% Hispanic and 47% white).” The pressure to return to whatever “normal” was for us pre-pandemic might feel unaligned. I think the pressure becomes particularly more intense when our usual socializing habits have changed over the course of lockdown. Whether that be switching your social scene completely or having new boundaries around the time you spend socially, a new way of being can cause a lot of anxiety when confronting your peers. 


These are only a few of the endless reasons why we may be facing social anxiety at this point in a major world transition. It might be hard to end cycles of negative thinking that are based on realistic responses to a global pandemic; so the question of how to manage this type of anxiety can be tricky to relieve. Acceptance Commitment Therapy (ACT) has the goal of adjusting the language we use in talking to ourselves about our anxiety. This method is not trying to eliminate the symptoms themselves - which oftentimes creates more of a problem as the more you try to get rid of it, the worse it can become - but rather manage the anxiety through acceptance, mindfulness, and committed action based on our personal values. This means going towards one’s values, despite the anxiety, rather than waiting to overcome the anxiety to move in the direction of your values.


Acceptance Commitment Therapy
The first step in this therapeutic process is Cognitive Defusion. The goal of this technique is to separate yourself from the personal sensations, (such as thoughts, feelings, images, and memories), that send anxiety down a self-deprecating spiral; to create space between our private experiences and the reactionary impulse of having judgments and trying to control them. A huge component of this technique is accepting that thoughts of pain and suffering inevitably happen. Trying to eliminate them is like swimming upstream - the harder you try to control them the more the anxiety will build. Ways to practice cognitive defusion are by the use of labeling thoughts as they pop up into your mind. For example, the thought I had at the reunion, “I am being boring”, could have instead been phrased as, “I am having the thought that I am being boring.” In this way, we are becoming mindful of the “judgment” aspect of the thought, without trying to eliminate the thought from happening. Instead, we are acknowledging that it is a thought, as opposed to an objective truth. 

The second step is Acceptance. Letting unpleasant emotions come and go without resistance is a key factor in this therapeutic process. When we notice the anxiety emerge, we have a choice. We can let ourselves feel it - meaning we can let the anxiety be noticed, remaining in a state of curiosity. The other, more automatic, choice is having an anxious response to the experience of anxiety (i.e. having anxiety about having anxiety). This can be seen as the panic that follows social anxiety, focusing on your future actions, perceptions of others, and shaming oneself into a deeper level of discomfort (also known as “secondary emotions”). Meditative imagery is a useful tool in the acceptance process -  imagining the anxious feelings being invited to sit down to tea with you; it can be there, without having to engage or push it away.

The third step is Mindfulness. Being in contact with the present moment is at the heart of Acceptance Commitment Therapy. It is necessary to be in a state of mindfulness to achieve acceptance and cognitive defusion. Remaining present will help you not become lost in your thoughts, and will help heighten your level of awareness around the secondary emotions that emerge during episodes of social anxiety. The most simple and effective tool for mindfulness is breathwork. Paying attention to your breath keeps your body regulated and fixated on the present moment.

The fourth step is establishing your Values. Affirming oneself in their values builds a strong emotional foundation. From this foundation, one can feel confident and assured in situations that might shake their emotional stability. By reverting to our values we can feel assured that our actions align with our emotional goals and commitments. In my situation, my value was to be connected with my friends and our community. Rather than going to the other room and going to bed early, I chose to stay with them, despite the anxiety and the anxious thoughts, and chose to instead be present with them and my experience.

And finally, Taking Action is the last step. Once one’s values are established, it becomes easier to take steps toward fulfilling goals. For people with symptoms of  social anxiety disorder, those goals might be something like, “I want to reach out to someone I haven’t spent much time with”, or “I want to call a friend who lives in a different city”, or “I want to make sure I’m giving myself enough alone time, so I won’t feel drained in social situations.” Whatever the “action plan” is, the important thing is to keep the plan aligned with one’s values.

Conclusion
I tried to recall the feeling I had during the beginning of lockdown and remembered the “mourning” phase I went through in saying goodbye to the normal routine I had and prepared for the social, economic, and personal changes that were about to happen. This process changed my social routine, the way I interact with others, and the relationship I have with myself in ways that I didn't come to realize until being put back into a situation without the restrictions I had grown comfortable with. Having the psychological tools to ground yourself during moments of instability can make this journey all the more manageable. Unfortunately, we still have a long way to go. The next psychological phases have yet to present themselves, but they are surely going to change the way we live in a post-pandemic world. Looking at this time as an opportunity for growth and exploration is a comforting truth. We can all look to therapeutic techniques to support ourselves and each other. 

​Sources:
American Psychological Association (2021, March 11). Stress in America 2021 One Year Later, a New Wave of Pandemic Health Concerns. American Psychological Association. https://www.apa.org/news/press/releases/stress/2021/one-year-pandemic-stress

Arlin, C. (2021, March 23). The Use of Acceptance and Commitment Therapy in Treating SAD. VerywellMind. https://www.verywellmind.com/acceptance-and-commitment-therapy-for-social-anxiety-3024910
Centers for Disease Control and Prevention. (2021, March 23). About CDC Covid-19 Data. Center for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/about-us-cases-deaths.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fcases-updates%2Fabout-us-cases-deaths.html

Czeisler MÉ , Lane RI, Petrosky E, et al. Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1049–1057. DOI: http://dx.doi.org/10.15585/mmwr.mm6932a1external icon.

American Psychiatric Association: Diagnostic and Statisti­cal Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Associa­tion, 2013.