Appreciating the highly sensitive person

 Do you sometimes feel so overstimulated by your environment – bright lights, strong smells, loud noises – that you have to retreat to a quiet place or wear noise canceling headphones to find relief? Does that cup of coffee leave you feeling jittery, on edge? Do you find yourself easily immersed in your inner world of fantasies and ideas? When you’re hungry, do you tend to lose focus and become easily irritable? (I love how that informal word “hangry” captures this feeling).  These are some of the items psychologist Elaine Aron lists in her Highly Sensitive Person (HSP) Scale. You can take the self assessment here.

Aron, who herself identifies as a highly sensitive person or HSP, has published numerous books and papers on this topic, some with her husband, psychologist Arthur Aron. Among her popular books are The Highly Sensitive Person: How To Thrive When The World Overwhelms You and The Highly Sensitive Child: Helping Our Children Thrive When The World Overwhelms Them. She has developed scales for younger populations – from adolescents to preverbal children – that professionals and parents can use to identify highly sensitive children, and has also written about love and relationships for HSPs. Aron also has a list of therapists on her website who use HSP informed approaches in their clinical work.

 In her book, The Highly Sensitive Person: How To Thrive When The World Overwhelms You, Aron points to HSP research that looks into genetic and neurobiological determinants that contribute to high levels of sensitivity in individuals. What I found interesting about this research is that many species, from fruit flies and fish to deer and monkeys, have been found to have highly sensitive individuals among them (which leads me to believe I have a highly sensitive cat).

Beyond introversion

Many introverts would likely endorse a good number of the items on Aron’s HSP scale. After all, introverts have rich inner worlds, need to withdraw in order to recharge, and experience sensory overload when they are in loud, busy environments. Read more on introverts in my previous blog post.  It is therefore easy to attribute sensitivity to introverted personalities. Yet Aron’s research tells us that 30% of extraverts are HSPs. They are the neglected minority. Aron gives them a shout out (not too loud) in her work, encouraging us to become more aware of them and give them room to be themselves. 

Introversion has been popularized by Susan Cain, author of Quiet: The Power of Introverts in a World That Can’t Stop Talking, whose Youtube video on introversion has over 14 million views. I think this demonstrates the changing attitudes that society is gradually developing towards introverts, which is about seeing introversion as a personality trait and not a defect.

Aron’s background and training in Jungian psychology is evident in her work. Psychiatrist Carl Jung’s theory of personality as used in the Myers Briggs Trait Indicator or MBTI has been a popular entry point for people to gain a better understanding of differences in personalities, and specifically introversion as a trait. Introversion is also prominent in other personality assessments, like the Big 5 Personality Test (also known by the acronym OCEAN) and Eysenck’s Personality Inventory (EPI).

Aron describes the concepts of introversion and extraversion as they were outlined by Jung, providing information and examples to help dispel myths, negative stereotypes, and misconceptions about introverts. In the same way, she challenges the negative social judgment and cultural biases we have against HSPs and invites us to open our minds to a broader understanding of sensitivity as a trait. What I find particularly valuable in Aron’s work is that she provides scientific evidence from research studies that can help HSPs reject false labels and acknowledge their gifts. 

The pathologizing of HSPs

Highly sensitive people, like introverts, are often pathologized, especially in American culture, where the average “well adjusted” individual is supposed to be outgoing, lively and gregarious. Highly sensitive children particularly tend to be misunderstood and mislabeled. Their sensitivity is trivialized, seen as an impediment, or misdiagnosed as an abnormality.

Highly sensitive children, for instance, may choose to enjoy the quiet of their rooms instead of watching TV with the family, since the noise, lights, or violent images on TV can be an assault to their senses. For this reason, they may be labeled as fearful, fussy, shy, withdrawn, or lacking confidence. They are often compared to their more outgoing siblings or peers: “Why can’t you be more like your sister who loves hanging out with us?” or “Stop making such a big deal about it, it’s just a movie.” These negative messages can follow children into their adulthood and make them think there’s something wrong with them. And precisely because they are sensitive to their surroundings, Aron tells us that HSPs learn to adapt to fit into different environments based on what is required of them, thereby disguising their sensitive nature.

In discussing mental health outcomes among HSPs, Aron distinguishes between the term “vulnerability” which indicates risk, versus “differential susceptibility”, which demonstrates a responsiveness not only to negative but also positive environments and experiences. This means that while HSPs can develop depression and anxiety if they have had difficult childhoods, negative parenting styles, or changes and unpredictability in their environment, they also tend to integrate positive experiences in their lives more readily. This is because their high level of sensory awareness and responsivity to their environment accentuates positive influences, such as natural beauty, art, music, pleasant scents and soothing textures, that can enhance their lives, all of which can have lasting positive effects on their mental health. 

SPS vs SPD

Aron’s research helps us see sensitivity as a trait and not a disorder, a strength and not a weakness. She differentiates between sensitivity on the one hand, and shyness, introversion, neuroticism, fearfulness and inhibitedness on the other, which are often erroneously used to describe sensitivity. She distinguishes between Sensory Processing Sensitivity (SPS) which is not a diagnosis or disorder, and Sensory Processing Disorder (SPD), which is different from and unrelated to SPS.

On a separate note, WebMD defines SPD as “a condition in which the brain has trouble receiving and responding to information that comes in through the senses”, which could involve both under-responsive and over-responsive reactions. While SPD is not listed as an official medical diagnosis in the DSM 5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) or ICD-10 (International Classification of Diseases, Tenth Revision), there have been arguments in favor of making it an official diagnosis, particularly so that children can receive early clinical interventions like occupational therapy and psychotherapy. These can help children develop coping skills to better adjust to school and peer environments that can be overstimulating and disruptive for them. Proponents add that making SPD an official diagnosis would also help families pay for these interventions using their health insurance. 

DOES

Aron clarifies that she didn’t discover sensitivity, she merely provided a more descriptive (and accurate) explanation of it to help people better understand and appreciate this complex trait. She created the acronym DOES to describe sensitivity as a trait.

D stands for depth of processing. HSPs tend to pause and take in their environment with a higher level of awareness and responsivity than the average person. They pay attention to details that others may not notice, for better or worse.

O is for overstimulation – attending to small details and noticing everything in one’s environment can be overwhelming and lead to sensory overload.

E refers to the high levels of empathy and emotional responsivity that come naturally to HSPs.

S describes sensitivity to subtleties. HSPs perceive and process information carefully, both information that is coming from the outer world of people, things and situations, and their inner world of perceptions, reflections and emotions.

Perhaps you or someone you know (maybe a child or even a pet) may be highly sensitive. Aron’s work helps us appreciate HSPs and celebrate their gifts to the world.

 

Photo by Nubelson Fernandes on Unsplash