ADHD for Smart Ass Women with Tracy Otsuka EP. 382: What’s Really Behind RSD? with Dr. Shawn Horn Pt 2
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Apr 29, 2026 Dr. Shawn Horn, a clinical psychologist who studies shame, trauma, and social functioning in adult ADHD. She unpacks shame as a social emotion, explains why ADHD creates a ‘perfect storm’ for shame and RSD as a trauma-like response, and explores neuroception, how screens amplify threat signals, and practical nervous-system–matched tools for healing.
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Shame Is A Social Survival Signal
- Shame is a social emotion triggered when we violate someone else's standards rather than internal self-judgment.
- Shawn Horn explains shame's purpose as social correction measured by 15 months of age and distinct from guilt, which develops later as internal moral processing.
ADHD Creates A Perfect Storm For Shame
- ADHD creates a 'perfect storm' for shame: delayed executive development, heightened sensitivity, and frequent social correction.
- Shawn Horn notes the 30% developmental delay and how repeated corrections and exclusion make neurodivergent people internalize being 'wrong'.
Pool Exclusion Triggered Childhood RSD
- Tracy and Shawn describe experiences of social exclusion like being left out of kindergarten pool groups to illustrate RSD activations.
- Tracy shares a personal pool anecdote about her son not being included and how that triggers 'why weren't we there' RSD feelings.