Surviving Therapy as a Highly Sensitive Person
How to get the most out of therapy as a HSP
As a Highly Sensitive Person (HSP) you have unique gifts and needs. There are barriers to getting these needs met and your gifts seen by others. Although more likely to be seen for who you are in therapy, this barrier does still exist. Unless a therapist is a HSP themself, has studied the trait in-depth, or is in a close relationship with a HSP, they likely don't get the nuances who you are.
The good news is, there are lots of therapists out there who are also a HSP. This field tends to draw the HSP crowd. And the down side is there are plenty who are not and do not have a practice that accommodates HSPs.
So how do you find one of these HSP therapists?
Maybe like me, they have it posted on their website and are seeking to work with other HSPs. I haven't found this to be common practice, so here's what you can do:
You could ask your current or potential therapist directly if they are HSP or if they know about this trait.
You could type into your internet search engine, "therapist for the Highly Sensitive Person."
You could look at this directory of HSP knowledgable therapists on Dr. Elaine Aron's website: hsperson.com .
Now, what if you can't find a HSP therapist?
Or maybe you already have a therapist who isn't a HSP, but you really like them? It can still work, and here are some tips to help your experience feel HSP approved.
You can search for a therapist who meets the qualities below.
You can give this list to your therapist so they know how to make the experience more fulfilling for you.
(Not everything on this list will be for you. Look it over and find the ones that are important and meaningful for your unique needs, gifts, and sensitivities.)
HSPs are sensitive to their environment. This means they are picking up on the energy of the environment, the cleanliness, the lighting, the comfort, the aesthetics, anything out of place, and plenty more.
The ideal environment for me is soft lamp lighting, calming art work, clean and no-cluttered space, plants, and a window.
The ideal environment for you may consist of some of the above, or may have some changes. You might even decide your environment is the best and so telehealth is the way to go. Whatever it is, you will feel comfortable and the stimulation from the environment will be low.
HSPs have a greater depth of processing. They think deeply and have a very involved inner world. This shows up a couple of ways in therapy.
1) It takes HSPs longer to process their emotions and new information coming in. During a session, there may need to be longer pauses as a HSP thinks something through. They may also need to come back to a topic the next session, giving more space for processing between sessions.
2) Once a HSP has processed something, it is deep and meaningful. This means they may start to progress quickly.
There are a couple of points here. 1) HSPs are often over or misdiagnosed, with their sensitivities being pathologized. 2) HSPs are more at risk of developing depression, anxiety, substance use, being traumatized, and other mental health concerns.
1) What I've noticed is that when HSPs are chronically overstimulated and stretched thin anxiety, depression, mood swings, sleep problems, and many other symptoms do get worse. Once a HSP starts to find balance and care for their sensitivities these symptoms decrease significantly or go away completely. Be aware that if your therapist is not knowledgable of the HSP trait and only sees these symptoms as a mental health disorder, you may walk away with a list of diagnoses. Let me assure you, BEING HIGHLY SENSITIVE IS NOT A DISORDER!
2) The other side to this is that HSPs are actually at greater risk for developing mental health problems. This is because HSPs are greatly effected by their environments. So, if your environment is poor and invalidating to your sensitivities you will be affected more deeply and more negatively than non-HSPs. This can cause anxiety, depression, substance use problems, and trauma related symptoms to emerge. And FYI, this also means if your environment is positive and nurturing to you and your sensitivities, you will thrive in the opposite way.
Boundaries can be difficult for HSPs to have. Given a HSPs nature to be more empathetic and conscientious, they are likely to focus more on others' needs and less on their own. HSPs may also have a history of being told they are too sensitive or overreacting, so it becomes difficult to listen to and trust themselves. This means HSPs may not even recognize their boundaries, so therefore cannot enforce them.
Here's how this becomes a problem in therapy. HSPs may want to please and make sure others are comfortable, ie-their therapist. If this is your dynamic with your therapist, this is a problem. You are suppose to be the focus of therapy and your needs and comfort are the most important. You may need a therapist who realizes this and will not accept your efforts at making things easier for them, but instead will help you make things easier for yourself. Examples of this could be related to meeting your needs around scheduling, the lighting or other environmental factors, the content of the session, being able to give feedback, etc.
I find this one to be one of the most important. In my experience, a huge part of healing as a HSP is feeling understood by others. Often, HSPs go through life feeling different and misunderstood, like they are too much or not enough, that something is wrong with them. Feeling like something is wrong with you is such a deep, painful experience. Having a therapist who gets it, is understanding, and is validating of your HSP nature.... this is big! Find a therapist who will help you feel accepted and confident in your HSP nature, not worse about it or as if you have to change yourself.
HSPs have deep internal processing and seek depth in most areas of their life. This is true for relationships. HSPs crave depth in their relationships and the conversations within the relationships. The struggle can sometimes lie in the space of anxiety or being slow to warm up. Social anxiety, "shyness," and timidness can all get in the way of opening up, being vulnerable, and going deep with others. At the core, we're talking about HSPs being slow to warm up to their environments and to others. It won't last forever, but HSPs really need to soak everything in, process it all, and develop some comfort before moving closer and deeper.
In therapy, you don't want a therapist who will keep you in this place. Having a therapist who gently moves you deeper and deeper can be helpful. There are specific tools a therapist will have to help facilitate this. Not every therapist will have these skills or will practice in this way.
Small talk is often not interesting and is draining for HSPs. Find a therapist who moves past the small talk and the surface material and takes you into your inner emotional world.
To tie all of the above together, there are certain therapeutic modalities that may be a better fit for HSPs than others. This is not an exclusive list and the most helpful or relevant modality for you may change at different points throughout your healing journey. Here are some of the types of therapy or therapeutic perspectives that HSPs often relate to.
Internal Family Systems (IFS)
Emotion Focused Therapy (EFT)
Eye Movement Desensitization and Reprocessing (EMDR)
Sensory focused skills
Distress Tolerance, Emotion Regulation, and Relationship skills
In general, the more emotionally focused, somatic focused, acceptance and mindfulness based, and processing therapies tend to be high on the list.
Being highly sensitive is not a disorder. Find a therapist who knows and supports this.
To learn more about my practice and how I work with the Highly Sensitive Person, take a look around my website or reach out to talk.