The Highly Sensitive Person in Therapy

Last week I posted a book review of The Highly Sensitive Person: ?How to Thrive When the World Overwhelms You by Elaine N. Aron, Ph.D.

In this post, I’ll explore what taking part in therapy may look like for a highly sensitive person (HSP).

A Fictional Story

Jenny (age 23) had recently graduated, ?with a certificate?in Business Administration, from a small community college in her hometown . ?Due to financial restrictions, she had chosen to live at home throughout her coursework. ?After graduation, job prospects where she lived were in short supply, so?she happily accepted a receptionist position at a busy company in a large city three hours away. ?Jenny was looking forward to moving to ‘the big city’, making new friends and starting her ‘grown up’ life.

Jenny arrived in the?city a few days before she was due to start her job. ?She moved in with a young woman that?she had found on Kijiji who was?looking for a roommate. ?The apartment was small, but she told herself that wouldn’t matter as she had her own room. Plus, her?roommates was going to become a?new friend.

Jenny’s first day at work was a whirlwind. ?The subway ride from her apartment to the office was hot and crowded. ?The reception area where she sat was in a busy lobby that echoed with the sound?of hundreds of people rushing?through the space. ?If the phone wasn’t ringing, there was someone waiting to meet?another employee?or a courier asking her to sign for packages.

By the time Jenny ‘fought’ the subway to get home, she was exhausted and overwhelmed. She was looking forward to spending a quiet evening at home getting to know her roommate. However, when she arrived she was greeted by deafening noise! ?Her roommate had invited work colleagues to the apartment for their usual “Thank Goodness Monday is Over” party. ?They invited Jenny to join them, but she was so tired that she declined, promising to join them another time.

Jenny’s first day turned out to be the pattern for most work days–busy days, followed by some sort of social gathering taking place in her apartment at night. ?Weekends were somewhat quieter as the office was closed, but her ‘home’?became pre-party central both Friday and Saturday nights as her roommate and her friends warmed up for their evening adventures. Jenny often spent her time at the apartment, curled up in her bed with her head under her pillow. ?Jenny started to feel lonely and miserable.

After six months of living this ‘grown up’ life, Jenny was struggling to cope. On?the advice of a friend from home, she decided to find a therapist.

The Therapy Experience

By the time individuals like Jenny start to meet with a therapist, they are often overwhelmed and doubting their abilities. ?Many HSP’s think that they are failing at life and that there is something wrong with them.

As a therapist, once a client and I have talked about what is bringing them into therapy, if I suspect that the individual may be highly sensitive, I will talk to them about the concept of HSP’s. ?We will explore the characteristics of high sensitivity–looking at past and present behaviours, situations and experiences.

I often suggest homework to my clients, and at this point will ask that they read The Highly Sensitive Person, not only as a way to gain more information, but?also to discover some tools and coping strategies.

If the idea of high sensitivity rings true for them, this concept?can provide a new lens for the client to look at their way of being in the world. ?For the therapist, being aware that they are working with a client who is highly sensitive can help them to adjust their way of working with that client and the types of interventions they may recommend.

HSP’s and Types of Therapies

When working with clients, it’s helpful if a therapist has different ‘tools in their toolbox’ to help them. ?The art of therapy involves matching specific therapeutic tools, from different types of therapies, to particular clients. ?What are some common therapies and how can they be adapted to be the most beneficial with working with someone who is highly sensitive?

Cognitive Behaviour Therapy (CBT):?
CBT helps to relieve specific symptoms by exploring how our thoughts and beliefs?affect our behaviour. ?It’s fact-based, and involves keeping track of thoughts and behaviours. This type of therapy tends not to focus on feelings or motivations for actions.

When working with HSP’s, I like to use CBT not only as a way to explore symptoms (monitoring the thoughts and behaviours in the same way that we would a?science experiment), but also as a way to gauge if the coping strategies learned in the Highly Sensitive Person are proving to be useful.

One of the skills possessed by highly sensitive people is an ability to focus on details. ?This is very helpful when observing/tracking symptoms in CBT.

Dialectical Behaviour Therapy (DBT):
DBT takes Cognitive Behaviour Therapy ?further by looking at the emotions that are not explored in CBT.

I find that there are two benefits of using DBT with highly sensitive people: ?the first is that DBT teaches calming and distraction skills that can help HSP’s to cope with the sense of overwhelm they can feel in specific circumstances. ?The second–DBT encourages acceptance of current situations, while at the same time realizing that there needs to be positive change. ?This acceptance allows HSP’s to begin to feel comfortable with their way of being in the world, while?learning new skills and making changes.

Narrative Therapies:
We usually equate therapy with talking, and talking is at the heart of the narrative group of therapies where feelings and motivations are explored. ?HSP’s can feel very comfortable?with?this type of therapy as they tend to?have a rich inner life and are sensitive not only to their relationships with others, but are intuitive regarding interpersonal dynamics. Their attention to detail and awareness help them to recognize patterns in behaviour and circumstances.

As a psychotherapist, I don’t prescribe medications, though I sometimes suggest that a client consult with their doctor to explore if medications could be a useful addition to therapy.

For many highly sensitive people, their sensitivity includes their physical self. ?They may have noticed that they are more sensitive to physical stimulation such as sounds, light, touch. ?They may have discovered that they are more sensitive to alcohol, caffeine and over-the-counter medications. ?They may react to prescription medications.

It’s important for people who feel that they are highly sensitive to let their health care providers know. ?For many prescription medications, compounding pharmacists can create?specific dosages?for individuals that can be slowly increased?over time–eventually arriving at the ideal dosage while minimizing side-effects.

The End of the Story

When Jenny learned about the possibility that she may be highly sensitive, she felt that a big piece of her personal puzzle fell into place.

With her therapist, Jenny explored her negative beliefs about her feelings of failure and that there was something wrong with her. ?She looked at how her current living and working situations were affecting her health. ?Jenny thought about whether she?wanted to continue her current?lifestyle ?(using her new coping strategies and tools) or if she wanted to try something else. ?Jenny gave herself permission to dream about what a new lifestyle could look like and used her therapist as an accountability partner as she planned for a change and set these plans in place.

By the end of therapy, Jenny had decided to fine-tune her lifestyle. ?Using what she learned in therapy along with her past experiences, she decided look for a?new job at a smaller company. ?She updated?her resume to help her obtain a?specific position that didn’t involve working with the public in an open space. ?She decided that she liked living in the big city, but wanted to do so on her terms. She found a?bachelor apartment that?allowed her to live alone at a rent she could afford.

Jenny ?used the HSP coping strategies to travel to work on the subway and organize her social calendar. ?Jenny found that when looking at her life though the HSP lens she was able to take care of herself and do so?without embarrassment.

Let’s Take a Break

Now, for all of us who would like to take a break from the business and noise of life; here are two clips. ?They both feature the famous cellist, Yo Yo Ma. ?The first ?is a clip of his 2015?concert at the?Royal Albert Hall in London, England. ?The second is of a seven-year old Yo Yo Ma (accompanied by his sister) at the his American debut performance at the Kennedy Center for the Performing Arts. ?Enjoy!


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