I haven’t been doing too much in the way of creative writing lately. But I have had to write some papers for school, so I figured I might as well share one of them with you here. The prompt was to address a developmental issue from the perspective of its relevance to the counseling profession.
Sensitivity – sometimes also found in the literature as “environmental sensitivity” or “sensory processing sensitivity” – is a normal, innate trait that exists as a continuum of human responsiveness. A minority of the population (15-30%, by different estimates; Lionetti et al., 2018) exhibits high sensitivity, a trait which confers increased perception of sensory inputs (like sights, sounds, and smells) as well as increased cognitive processing of that input. Elaine Aron, an expert in the field, uses the acronym “D.O.E.S.” to describe the main features of high sensitivity (Aron, 2016): depth of processing (taking in many levels of information from a given input), overstimulation (being easily overwhelmed by chaotic environments), emotional responsivity or empathy (feeling deeply and possessing a well-developed intuition about people and relationships), and sensitivity to subtleties (noticing details and small cues that others might miss). High sensitivity is not to be confused with shyness, introversion, or neuroticism, although it may coexist with these qualities in some individuals (Aron & Aron, 1997).
In general, highly sensitive persons (HSPs) are more sensitive to – or more strongly impacted by – the everyday events of life. They are more negatively affected by adverse experiences than less sensitive persons, but they are also more likely to benefit from positive experiences (Belsky & Pluess, 2009). Because HSPs navigate the world with a unique set of sensory and emotional sensitivities, they are best served by professionals who understand the vulnerabilities and strengths that their trait bestows. Counselors, in particular, are apt to encounter many highly sensitive clients in the course of their work, and should take care to understand the nuances of working with this population.
Influences on Sensitivity
Sensitivity can be observed through a variety of lenses, including a biopsychosocial lens, a family-systems lens, and an environmental lens. Each perspective sheds light on the causes, corollaries, and consequences of this fundamental trait.
A biopsychosocial lens recognizes the interwoven influences of nature and nurture on development. Unsurprisingly, sensitivity (like many other human traits) is partially accounted for by genetics. Research has connected certain genes to broad features of environmental sensitivity (Belsky et al., 2009), although it is likely that the underlying operations of cause-and-effect are very complex and many relevant genes are yet to be identified. Variations in hormone levels and brain activity between HSPs and non-HSPs, while requiring more study, certainly provide another avenue for identifying possible physiological underpinnings (Acevedo, 2020). Given that high sensitivity is chiefly defined by a sensitive nervous system, neurological explanations – of both etiology and course of development – seem particularly useful. Animal studies have been helpful, meanwhile, in demonstrating that sensitivity differences also exist in non-human species, implying a biological basis (Aron et al., 2012). It would seem, based on this evidence, that evolutionary processes preserved the trait of sensitivity over many generations because of its role in environmental adaptation. Of course, social influences continuously interact with such biological predispositions to shape sensitivity responses. Cultural ideas and stereotypes surrounding sensitivity may lead to the valuation or devaluation of certain behaviors, which in turn may lead to increased or repressed expression of the outward signs of (and internal messaging about) sensitivity. The interplay of physical, mental, and emotional forces in the development and modulation of sensitivity levels is ongoing, dynamic, and complex.
A family-systems lens places sensitivity in the context of intimate social relationships. It underscores the finding that highly sensitive children are more strongly affected by the parenting quality they receive (Lionetti et al., 2019). Compared to less sensitive children, they are more likely to develop behavioral challenges when raised with negative parenting practices. Conversely, they are more likely than non-HSPs to do better in school and to develop more sophisticated social skills when raised in supportive environments. As a result, attachment patterns (between parent and child) either suffer or strengthen, and the blueprint of family relationships is established. Of course, sensitivity levels among parents affect this dynamic, too. Highly sensitive parents are often more attuned to their children’s needs and more creative in solving problems that arise; however, they can also be more prone to feeling overwhelmed and overtaxed (Aron et al., 2019). When rested and healthy, their deep capacity for empathy shines, but when depleted, their parenting styles can shift toward less adaptive “authoritarian” or “permissive” attitudes (Branjerdporn et al., 2019), or even toward an anxious attachment style, especially with teenagers (Goldberg & Scharf, 2020). In general, we can say that children’s sensitivity levels, parents’ sensitivity levels, and the ability to regulate stress all interact to produce a picture of the family system that is nuanced and frequently shifting. That high sensitivity enhances the effects of home life is not surprising, given the more general pattern of “differential susceptibility” to both positive and negative influences observed among HSPs.
Finally, an environmental lens gives us access to the role of external inputs in shaping sensitivity. Naturally, environment plays a large part; the trait is sometimes referred to as “environmental sensitivity,” after all. HSPs are, on the whole, very observant of their environment, and the circumstances of their surroundings are often processed in great detail. Sometimes this leads to dysfunction, as HSPs tend to become more easily overwhelmed in highly stimulating or chaotic environments (Aron, 2016). This overwhelm, in turn, can negatively impact a person’s energy levels and performance – a fact which has implications in school, in the workplace, and in the home. On the bright side, though, the same sensitivity that leads to overwhelm can also lend itself to moving demonstrations of creative and artistic talent. Noticing the environment so keenly allows HSPs to uncover the beauty of, say, a landscape, or a quiet room, or the unspoken mysteries of the human heart. It is through this exchange of information – the environment provides input, then a person digests that input and processes it – that sensitivity expresses itself. As to the question of onset, it is important to note that adverse events in early childhood may lead to the development of heightened sensitivity later in life, especially among people who have a stronger genetic predisposition to sensitivity (Boyce & Ellis, 2005). Cultural and systemic attitudes toward sensitivity, along with personal experiences of struggling or thriving with the trait, can also impact how sensitivity manifests from person to person – whether it is embraced or rejected, understood or misunderstood. It is impossible to completely isolate oneself from one’s surroundings – and this is particularly true for the HSP. Therefore, we can see that sensitivity and environment are in constant, mutually informative dialogue.
Special Considerations for Different Abilities
Sensitivity, as mentioned earlier, exists on a continuum. Some researchers propose a classification system consisting of three sensitivity levels: low (representing 30% of the population), medium (40% of the population), and high (30% of the population) (Lionetti et al., 2018). It is important to keep this variability in mind when thinking about mental health conditions, especially because people at extreme ends of the sensitivity spectrum may be more vulnerable to psychological problems.
At one end, high sensitivity may be linked to an increased risk of anxiety and depression (Aron, 2016). The hypothesis is that, because HSPs have a highly reactive nervous system, they experience many moments of short-term arousal. This temporary response is normal and appropriate, but if an HSP grows up in an insecure environment, or lacks effective coping strategies, repeated short-term arousal can lead to long-term overarousal. Such prolonged overstimulation can increase cortisol levels and deplete the body’s store of certain key neurotransmitters (like serotonin). It is important to note that this phenomenon only appears among HSPs with a history of unprocessed adverse experiences; vulnerability to disorders like depression and anxiety is not inherent in the trait.
At the other end, very low sensitivity may be linked to conditions like conduct disorder and psychopathy, presumably because such conditions tend to suggest low empathy, shallow affect, and emotional processing deficiencies (Patterson, 1990). However, this connection has been proposed only in theory, and has not been borne out in any conclusive empirical studies.
Another important consideration regarding the sensitivity spectrum is physical in nature. Because of their sensitive nervous systems, many HSPs may be unusually reactive to the physiological effects of medications and supplements (Aron, 2016). As a result, they may require lower-than-normal (even “subclinical”) doses of these substances to derive therapeutic benefit while avoiding undesirable side effects. Gentler forms of exercise like walking and swimming (as opposed to high-intensity forms of training) may also be favored when putting together an HSP-friendly wellness plan.
Thoughtful Interventions
High sensitivity can mean that difficult experiences are felt more intensely, with more impact on overall functioning. But the good news is that HSPs – children and adults alike – have been found to benefit more than usual from psychotherapeutic interventions (Greven et al., 2019). So counselors can proceed with a sense of optimism when working with highly sensitive clients. Here are a few suggestions to guide the process.
First, counselors should consider incorporating some sort of arts-based therapy, like writing, painting, acting, drawing, or music-making, into their work with HSPs. High sensitivity appears to be connected to creativity (Bridges & Schendan, 2019), so HSPs will likely respond well to processing emotions through a variety of creative outlets. Interventions that highlight the healing power of nature and of animals may also be powerful (Setti et al., 2022).
Second, counselors should educate clients on the “best practices” for people with their trait, explaining how it can be helpful to modify the environment to limit feelings of overwhelm. Many HSPs benefit from taking frequent breaks, working in quiet spaces with soft lighting, and setting firm boundaries in both their personal and professional lives. Counselors may wish to do additional work with HSPs who are struggling with vocational questions, helping them to identify meaningful careers which align comfortably with their more sensitive dispositions.
Third, counselors should be encouraged to help clients rewrite their “life narratives” in light of their high sensitivity. Many HSPs will feel relieved to look at their childhoods and past wounds with the knowledge that, rather than being “too weak” or “too delicate” (as they might have been told), they were actually facing the challenges of life under the demands of a highly sensitive nervous system. A strength-based perspective can be tremendously empowering for HSPs.
Thriving Across the Lifespan
To promote optimal functioning across the lifespan, counselors must turn their attention to the role of sensitivity at distinct stages of development. Understanding how high sensitivity manifests differently at different ages, and in different contexts, will inform the strategies professionals employ to foster healing, growth, and, ultimately, human flourishing.
Differences in sensitivity can be observed as early as infancy – or even before. Indeed, research in the field of prenatal development has indicated that some fetuses are more responsive to sounds and maternal stress than others (Pluess & Belsky, 2011). After birth, these highly sensitive babies may seem more reactive, cry more often, express more fear around strangers, and become overstimulated more quickly than less sensitive babies (Slagt, 2017). Later, as highly sensitive children, these same individuals may appear choosy with the foods they eat, exhibit perfectionistic tendencies, show signs of hyperactivity, and be more prone to emotional extremes. If counselors begin to educate new parents on sensitivity, and the role it plays in the lives of their young children, they can promote healthy attachment patterns from the very beginning – effectively setting the foundation for optimal development. Resources that support good parenting and teaching practices across temperament types may prove invaluable.
Gender differences in sensitivity are also apparent, though not yet fully understood. Women are not necessarily hardwired to be more sensitive than men, but research suggests that they do tend to self-report heightened levels of sensitivity (Aron & Aron, 1997). The role of socialization in shaping responses to sensitivity is unclear, but it is likely to have some bearing. By advocating for broader interpretations of gender roles and creating a culture where sensitivity is a valued quality irrespective of gender, counselors can give naturally sensitive boys and men the support they need to express their trait in fulfilling and adaptive ways.
Future Directions
Sensitivity is still an unfamiliar concept to many clinicians. The simple act of raising awareness of this trait will, I think, significantly improve the therapeutic process – not only for clients, but also for counselors (many of whom are probably HSPs themselves and who could benefit from practicing HSP-specific self-care strategies).
As awareness grows, so, too, I hope will the body of relevant empirical research. Our understanding of sensitivity will benefit from a deeper exploration of the following questions: the genetic underpinnings and physiological markers of sensitivity (which could yield insights into medication management for HSPs receiving pharmacological treatment); gender differences in sensitivity (especially in relation to country and culture); the evolution of sensitivity over the course of a person’s life (which could provide clues toward fostering long-term resilience); and the differentiation of high sensitivity from neurodevelopmental disorders like autism and ADHD (with which HSPs are sometimes misdiagnosed). A more robust collection of studies will refine our scientific and clinical understanding of an important human trait.
Additional Resources
Counselors wishing to educate themselves further on high sensitivity will benefit from two websites in particular. The first is Elaine Aron’s website “The Highly Sensitive Person” (https://hsperson.com/), which is full of articles, self-assessments, reading lists, and helpful descriptions of the impact of high sensitivity on the various domains of life (including work, love, and parenting). The second is “Sensitivity Research” (https://sensitivityresearch.com/), authored by a team of researchers interested in the burgeoning study of sensitivity; it offers a clear summary of current findings, as well as a list of opportunities for research participation. Both websites are all-around excellent educational resources. For those wanting additional reading, I suggest the book The Highly Sensitive Person by Elaine Aron (2016), a classic text which serves as an approachable introduction to the topic for the clinician and the layperson alike.
References
Acevedo, B. P. (Ed.). (2020). The highly sensitive brain: Research, assessment, and treatment of sensory processing sensitivity. Academic Press.
Aron, E. N. (2016). The highly sensitive person: How to thrive when the world overwhelms you (Updated ed.). Harmony Books.
Aron, E. N., & Aron, A. (1997). Sensory-processing sensitivity and its relation to introversion and emotionality. Journal of Personality and Social Psychology, 73(2), 345-368. https://doi.org/10.1037/0022-3514.73.2.345
Aron, E. N., Aron, A., & Jagiellowicz, J. (2012). Sensory processing sensitivity: A Review in the light of the evolution of biological responsivity. Personality and Social Psychology Review, 16(3), 262-282. https://doi.org/10.1177/1088868311434213
Aron, E. N., Aron, A., Nardone, N., & Zhou, S. (2019). Sensory processing sensitivity and the subjective experience of parenting: An exploratory study. Family Relations: An Interdisciplinary Journal of Applied Family Studies, 68(4), 420-435. https://doi.org/10.1111/fare.12370
Belsky, J., Jonassaint, C., Pluess, M., Stanton, M., Brummett, B., & Williams, R. (2009). Vulnerability genes or plasticity genes? Molecular Psychiatry, 14(8), 746-754. https://doi.org/10.1038/mp.2009.44
Belsky, J., & Pluess, M. (2009). Beyond diathesis stress: Differential susceptibility to environmental influences. Psychological Bulletin, 135(6), 885-908. https://doi.org/10.1037/a0017376
Boyce, W. T., & Ellis, B. J. (2005). Biological sensitivity to context: I. An evolutionary-developmental theory of the origins and functions of stress reactivity. Development and Psychopathology, 17(2), 271-301. https://doi.org/10.1111/j.1467-8721.2008.00571.x
Branjerdporn, G., Meredith, P., Strong, J., & Green, M. (2019). Sensory sensitivity and its relationship with adult attachment and parenting styles. PLoS One, 14(1). https://doi.org/10.1371/journal.pone.0209555
Bridges, D., & Schendan, H. E. (2019). The sensitive, open creator. Personality and Individual Differences, 142, 179-185. https://doi.org/10.1016/j.paid.2018.09.016
Goldberg, A. & Scharf, M. (2020). How do highly sensitive persons parents their adolescent children? The role of sensory processing sensitivity in parenting practices. Journal of Social and Personal Relationships, 37(6), 1825-1842. https://doi.org/10.1177/0265407520911101
Greven, C. U., Lionetti, F., Booth, C., Aron, E. N., Fox, E., Schendan, H. E., & Homberg, J. (2019). Sensory processing sensitivity in the context of environmental sensitivity: A critical review and development of research agenda. Neuroscience and Biobehavioral Reviews, 98, 287-305. https://doi.org/10.1016/j.neubiorev.2019.01.009
Lionetti, F., Aron, A., Aron, E. N., Burns, G. L., Jagiellowicz, J., & Pluess, M. (2018). Dandelions, tulips, and orchids: Evidence for the existence of low-sensitive, medium-sensitive, and high-sensitive individuals. Translational Psychiatry, 8(24). https://doi.org/10.1038/s41398-017-0090-6
Lionetti, F., Klein, D. N., Aron, A., Aron, E. N., & Pluess, M. (2019). Observer-rated environmental sensitivity moderates children’s response to parenting quality in early childhood. Developmental Psychology, 55(11), 2389-2402. https://doi.org/10.1037/dev0000795
Patterson, C. M. (1990). Emotion and interpersonal sensitivity in psychopaths (Publication No. 9101552) [Doctoral dissertation, University of Wisconsin-Madison]. ProQuest Dissertations Publishing.
Pluess, M., & Belsky, J. (2011). Prenatal programming of postnatal plasticity. Development and Psychopathology, 23(1), 29-38. https://doi.org/10.1017/S0954579410000623
Setti, A., Lionetti, F., Kagari, R. L., Motherway, L., & Pluess, M. (2022). The temperament trait of environmental sensitivity is associated with connectedness to nature and affinity to animals. Heliyon, 8(7). https://doi.org/10.1016/j.heliyon.2022.e09861
Slagt, M., Semon Dubas, J., Aken, M., Ellis, B., & Deković, M. (2017). Sensory processing sensitivity as a marker of differential susceptibility to parenting. Developmental Psychology, 54(3), 543-558. https://doi.org/10.1037/dev0000431