According to research by Dr. Elaine Aron, High Sensitivity, otherwise known by its research term of Sensory Processing Sensitivity (SPS), is an innate trait dispersed equally among all gender identities. It is a variation found in 15-20% of the human population (and in some animals) that allows the nervous system and brain to process subtleties and details that most miss.
An initial indicator that your client is Highly Sensitive is that they are eager to do the work and very conscientious. You may notice that they rarely miss a session, are mindful of your time and pay promptly. Highly Sensitive clients may also take longer to feel comfortable with you, but once they do are deeply and outwardly appreciative.
Although there is no definitive criteria to determine whether a client is Highly Sensitive, a good starting point is to look for the following core characteristics along with reviewing the adult self-test or child self-test developed by Dr. Elaine Aron. Since Sensory Processing Sensitivity is an innate temperament variation, these core characteristics will be present from birth and apparent in some form across the lifespan.
D - Depth of Processing
The Highly Sensitive brain has a more active insula, the part of the brain that helps enhance perception and increase self-awareness. HSPs are also wired to pause and reflect before engaging. Therefore, HSPs are always taking in a lot of information around them and thinking deeply about it. This may result in slower decision making and more transition time between tasks.
O - Overstimulation
Since HSPs notice more subtle details in their environments and are more emotionally impacted by social stimulation, it makes sense that they are more likely to get overstimulated and exhausted by high levels of input.
E - Emotional Responsiveness/Empathy
Brain scans have shown that HSPs have more active mirror neurons which are responsible for feelings of empathy for others and more activity in areas that are involved with emotional responses. HSPs feel both positive and negative emotions more intensely than non-HSPs.
S - Sensitive to Subtleties/Sensory Stimuli
HSPs notice subtle details that others miss such as non-verbal cues and small changes in their environment. They are also more impacted by strong sensory input such as bright lights, loud noises, strong smells or rough textures.
When Highly Sensitive People are living a lifestyle suitable for their temperament which includes adequate downtime, meaningful connections and time to integrate experiences, they are able to access many of the gifts that their highly perceptive brains and heightened emotional capacity afford.
Many of the struggles of being Highly Sensitive are due to being overstimulated and emotionally exhausted. These challenges are easily remedied with more downtime and access to regulation tools.
Below are a few ideas of what could be helpful, but you can apply any modality or therapeutic orientation to your work with Highly Sensitive clients. Most important is helping HSPs understand their trait, normalize the difficulties and create a supportive lifestyle so their Sensitive Strengths can shine through.
The characteristics of Sensory Processing Sensitivity are often misinterpreted as a mental health disorder instead of being recognized as a temperament variation. For instance, when the client is suffering from overstimulation it can easily look like anxiety or ADHD, but with adequate self-care these symptoms generally dissipate with ease. Of course, a client can be Highly Sensitive and still meet the criteria for a diagnosis, but the characteristics of the trait are not synonymous with any disorder. Therefore, HSPs may experience the effects of a mental health disorder differently than a non-HSP. Below are a few common misdiagnoses to be aware of when working with Highly Sensitive clients.
For a full list, see Appendix B of Dr. Elaine Aron’s Book, Psychotherapy and the Highly Sensitive Person.