Psychotherapy and the Highly Sensitive Person

1. High sensitivity is a normal trait affecting 20% of the population

Sensitivity, high sensitivity, and sensory processing sensitivity are terms used in this book to identify a single innate temperament trait expressed as an awareness of subtleties in stimuli as well as a potential to be overwhelmed by too much stimuli.

Innate trait. High sensitivity is an inherited characteristic found in approximately 20% of humans and over 100 animal species. This trait is not a disorder or weakness, but rather a normal variation in temperament. Sensitive individuals possess a more reactive nervous system that processes information more deeply before responding.

Evolutionary strategy. Sensitivity represents an evolutionary strategy of "pause and check" before acting, as opposed to the more common "act first" approach. This strategy can be advantageous in certain environments, allowing for more careful decision-making and heightened awareness of potential dangers or opportunities.

Cultural differences. The perception and value of sensitivity can vary across cultures. Some societies, particularly older ones like those in Europe and Asia, tend to appreciate sensitive traits more than younger, immigrant-based cultures such as those in North and South America, Australia, and New Zealand.

2. Sensitive individuals process information deeply and are easily overstimulated

Depth of processing, overarousability, emotional intensity, and sensory sensitivity (easily remembered as DOES) are the four basic characteristics of the trait.

Deep processing. Highly sensitive people tend to reflect more thoroughly on experiences and information before acting. This can lead to more insightful decision-making but may also result in difficulty making quick decisions or feeling overwhelmed by choices.

Overstimulation. Sensitive individuals are more easily overwhelmed by high levels of sensory input, such as:

• Loud noises or bright lights
• Crowded or chaotic environments
• Time pressure or multiple tasks
• Strong smells or textures
• Intense social interactions

This heightened sensitivity to stimuli can lead to feelings of stress, anxiety, or exhaustion when exposed to overstimulating environments for prolonged periods.

3. Highly sensitive people experience stronger emotional reactions

Clearly this definition is informed by the problem that dysfunction is to some degree in the eyes of the beholder.

Intense emotions. Sensitive individuals tend to experience both positive and negative emotions more intensely than others. This can lead to:

• Greater empathy and compassion
• Deeper appreciation of art, music, and nature
• Stronger reactions to criticism or conflict
• More pronounced feelings of joy, love, and excitement

Emotional regulation. Due to their intense emotional experiences, highly sensitive people may need to develop strong emotional regulation skills to manage their reactions effectively. This can involve:

• Practicing mindfulness and meditation
• Developing self-soothing techniques
• Learning to set appropriate boundaries
• Seeking support from understanding friends or therapists

4. Sensitivity can be mistaken for shyness or introversion

Further, being a minority, they are not normal in the sense of being like most people (and like most therapists).

Distinct traits. While sensitivity may overlap with shyness or introversion, they are separate characteristics:

• Sensitivity: Deep processing of stimuli and strong emotional reactions
• Shyness: Fear of social judgment
• Introversion: Preference for less social stimulation

Misconceptions. Sensitive individuals may be perceived as shy or introverted due to their need for:

• Time to process information before responding
• Breaks from overstimulating environments
• Deeper, more meaningful conversations

It's important to recognize that about 30% of highly sensitive people are actually extroverts, challenging the assumption that all sensitive individuals are introverted or shy.

5. Childhood experiences significantly impact sensitive individuals

Individuals display this trait mainly if they had a troubled childhood, which makes them more prone than nonsensitive persons to depression, anxiety, and shyness; although those who had good childhoods do not display these problems any more than nonsensitive persons.

Heightened impact. Sensitive children are more strongly affected by both positive and negative childhood experiences. This can lead to:

• Increased vulnerability to depression, anxiety, and shyness if raised in a troubled environment
• Enhanced resilience and well-being if raised in a supportive, nurturing environment

Parenting strategies. Parents and caregivers of sensitive children can support their development by:

• Providing a calm, stable home environment
• Offering plenty of downtime and opportunities for reflection
• Encouraging their unique strengths and interests
• Being patient and understanding of their heightened emotional responses

6. Therapists must adapt treatment approaches for sensitive patients

If you as a therapist are not highly sensitive, you have much to offer a sensitive patient: the special meaning of your appreciation of the trait; experience communicating effectively with a nonsensitive person; your calm during intense, potentially threatening emotional moments; and your firm encouragement.

Tailored approach. Therapists working with highly sensitive patients should consider:

• Creating a calm, soothing office environment
• Allowing extra time for processing and reflection
• Being mindful of the patient's heightened emotional reactions
• Adapting communication style to avoid overwhelming the patient

Recognizing strengths. Therapists can help sensitive patients recognize and leverage their unique strengths, such as:

• Deep empathy and intuition
• Creativity and attention to detail
• Strong sense of ethics and conscientiousness
• Ability to pick up on subtle cues in their environment

7. Sensitive people face unique challenges in relationships and work

Career choice is more difficult for the highly sensitive, and they may change directions several times before finding their niche, as they need work to be meaningful yet not overstimulating, have the talent to do many things well, and often feel pressured by others.

Relationship dynamics. Highly sensitive individuals may experience:

• Difficulty in finding partners who understand their needs
• Challenges in managing conflicts due to heightened emotional reactions
• Deep, meaningful connections when paired with understanding partners

Career considerations. Sensitive people often struggle to find satisfying work environments that:

• Align with their values and desire for meaningful work
• Provide a balance between stimulation and quiet reflection time
• Allow them to utilize their strengths without becoming overwhelmed

Many sensitive individuals may change careers multiple times before finding the right fit, or may excel in roles that allow for creativity, strategic thinking, and attention to detail.

8. Self-care and lifestyle adjustments are crucial for sensitive individuals

When sensitive patients are ready to stand up for themselves, they still need practice learning what to say.

Boundary setting. Highly sensitive people must learn to:

• Communicate their needs clearly and assertively
• Say "no" to overstimulating activities or commitments
• Create space for downtime and reflection

Stress management. Effective self-care strategies for sensitive individuals include:

• Regular exercise and proper nutrition
• Mindfulness practices and meditation
• Time spent in nature
• Engaging in creative or artistic pursuits
• Maintaining a consistent sleep schedule

Sensitive people may need to be more proactive about self-care than others to maintain their well-being and prevent burnout.

9. High sensitivity offers both advantages and challenges in daily life

Sensitive persons generally make excellent parents. However, they need help with their worrying and with being easily overwhelmed.

Strengths. Highly sensitive individuals often excel in areas such as:

• Empathy and understanding of others' needs
• Attention to detail and quality in their work
• Creativity and innovation
• Intuitive decision-making
• Appreciation of beauty and art

Challenges. Sensitive people may struggle with:

• Overstimulation in busy or noisy environments
• Difficulty making quick decisions
• Tendency to overthink or worry excessively
• Feeling overwhelmed by others' emotions
• Need for more recovery time after stressful events

By understanding and embracing their trait, highly sensitive individuals can learn to leverage their strengths while developing strategies to manage the challenges associated with their sensitivity.

Last updated: October 8, 2024