HSP - What a Therapist Needs to Know About High Sensitivity

High Sensitivity (HS) and Highly Sensitive People (HSP)at by therapist and client the work that needs to be
are concepts elaborated by Dr. Elaine Aron beginningdone is the every-day work of therapy...
with her original publication in 1997 and popularized in- Construction of appropriate boundaries,
her book "The Highly Sensitive person: How to thrive- Developing communication skills,
when the world overwhelms you (1996). Dr. Aron is a- Re-building self esteem,
psychological researcher and a practicing Jungian- Integrating or "working through" past traumas
analyst. Much of her research has been done in- Overcoming learned fearful responses.
tandem with her social psychologist husband Dr.This work is appropriately done in any therapeutic
Arthur Aron, who is well known for his academicmodality but when they overcome their fears and
research into love and close relationships.feel safe in therapy, these individuals do very well in
HSP is not a DSM-IV diagnosis.psychodynamic or psychoanalytic therapies because
It is instead a description of the experience of the 15they often have an unusually strong ability:
to 20 % of the population who appear at the top- to be self-reflective,
end of the human continuum for physical and- to think deeply,
emotional responsiveness stimuli. Like left handers in a- to be aware of their physical responses to their
world geared to right handedness, they oftenthoughts and feelings
struggle physically and psychologically in a cultural- to be aware of and interested in unconscious
environment which is geared towards the 80% whoproducts such as fantasies, dreams and active
are less easily stimulated.imagination.
High sensitivity is a double edged sword.HSP's are an "education" for their therapist.
HSP's are highly sensitive to both danger and rewardThere is an enormous amount that a therapist can
in the environment.learn through working with these clients.
- They appreciate subtlety and nuance and are often- Acceptance, respect for, and interest in a client's
creative and empathicdifference is not just healing for the client but
- But.... They are often overwhelmed by situationsexpansive for the therapist.
which others can take in stride- HSP responsiveness means that they react in ways
With prevalence in the population of 15 to 20% thatthat are strong enough to be undeniable to
makes almost one in five of our friends and relativesexperiences that might also bother others but which
or clients "highly sensitive."less sensitive individuals succeed at repressing ...
HSP research suggests that High Sensitivity arises outsometimes to their cost.
of three predisposing factors:- The combination of responsiveness and a willingness
- Introverted Temperament: (MBTI Introversion)to be reflective means that these clients can often
- Extra cognitive processing : Lower Latent Inhibition...shed light on thoughts and feelings which emerge
lower ability to screen out stimulifrom others with much more difficulty. They can
- High Arousability or "reactivity": (High BIS - low BAS,expose and illuminate interpersonal dynamics in a way
Gray, 1997)that is generally informative.
These three factors create a particular configuration- They are often sensitive to the leading edge of
of strong responses to stimuli ...disturbances in their group, their society or their age
...which lead to behaviors...cohort.
...............which lead to experiences...Sensitive rather than neurotic.
.............................which can often, but not always , lead toTo suggest that someone's response is "neurotic" is
psycho-pathologies...to imply that it is exaggerated or inappropriate to the
..............................................which then bring these individuals tocircumstance. It is another way of saying that their
therapy.experience is "not real." It also implies that once the
The most common problematic responses are relatedpsychological "fix" is made that the problem will go
to stress and chronic over-arousal, such as anxiety,away and that the individual will be "just like
panic attacks and psycho-somatic responses. Theseeveryone else" in their responses to stimuli. Given
individuals are also susceptible to depression, feelingsthat a temperament is a basic, inborn and "given"
of low self esteem and feelings of vulnerabilityattribute of the individual which is almost impossible
created by a lifetime of being "out of step" with theirto alter, this proposition can only lead to frustration
peers or misunderstood by those around them.and a continuing feeling of being different and wrong
If a therapist is not aware of the existence of thisin their experience of the world.
natural variation in sensitivity, it is very tempting toBy contrast, when we approach an individual
see the sensitive response as "neurotic" In fact therespectfully and curiously with the belief that what
client themselves, may not debate or object to thisthey are experiencing is "real," we come with a more
because they do not have an alternative explanationempathic point of view. Empathy and openness to
either.individual differences are ideally the therapist's
15% of the population but probably more than 15%stock-in-trade...the greatest tools for healing that we
of psychotherapy clients....can offer. Therapeutic empathy is a big part of what
It is rare that a client will seek therapy knowing thatmakes the therapeutic relationship safe, healing and
they are HSP's. Very often they have nogrowth producing.
understanding that their problems emerge from theirIf you do not treat Highly Sensitive individuals as
sensitivity rather than the reverse.neurotic you will be better able to appreciate them
When High Sensitivity has been mismanaged for aas the responsive, reflective people that they are...
lifetime the cumulative effect often leads to anxiety,and they may well become your favorite kind of
depression and low self esteem. It is theseclients!
psychological disturbances which bring individuals toRecommended reading for the curious therapist:
therapy.E.N. Aron (1996). The Highly Sensitive Person: How to
Not "mentally ill"Thrive When the World Overwhelms You, New York,
Having the concept of High Sensitivity in yourBroadway Books.
therapeutic repertoire takes many clients out of theE.N. Aron & Aron, A. (1997b) Sensory-Processing
category of the "mentally ill" and makes themSensitivity and Its Relation to Introversion and
interesting and struggling human beings like oneself.Emotionality, Journal of Personality and Social
They become a person with a difference that needsPsychology,73, (2), pp. 345-368
to be managed and deserves to be respected.E.N. Aron (2004). Revisiting Jung's Concept of Innate
Ordinary therapy....Sensitiveness.Journal of Analytical Psychology, 49,
Once the understanding of their sensitivity is arrivedpp.337-367.