Recognizing Highly Sensitive Person Traits in Clinical Practice: What Every Clinician Should Know

Had I known of Aron’s seminal work, or even heard of the term, “highly sensitive person,” I wonder if that might've helped me avoid a whole lot of pain and anguish. The reality, at least in my experience, is that there’s not much wondering happening in survival. And at the time, I was in survival mode, even if I didn’t know it yet.

I was a sensitive little bean from day one, and not just in the emotional way. My mom would tell me that she would have to, quite frequently, hose me down in the backyard because my diaper refused to hold what my chronically upset tummy had to offer.

(There’s fascinating research² that explores this relationship between highly sensitive people—or folks with sensory-processing sensitivity—and irritable bowel syndrome. I’ve had a sensitive stomach most of my life.)

I’ve always been emotionally sensitive, too, which never pairs well with a father whose rage and control seemed bountiful and unceasing, and a mother who tried to protect us and ultimately failed.

I lived in a house that was fueled by my father’s emotional peaks and valleys. In moments, he could be sweet and loving, and then a flip would switch so swiftly none of us would see it coming, like the time he threw a stray cat from our balcony like a football because he was angry that my younger brother and I, both six and nine years old respectively, brought the malnourished feline inside the house to care for it. My dad was allergic after all.

* * *

I never felt fully safe growing up, and as a result I learned to protect myself by shutting down. On any given day, this could look like me being quiet, or even shy—though I have a feeling the shyness was more like a symptom of my environment than anything else). It also could look like me being disengaged when my siblings were fighting or yelling.

That quiet detachment is the stuff that was on the surface. Underneath, I was writhing with shame, anxiety, guilt, fear, sadness, a tense stomach, a heaviness in my chest. All of which I tried to hide, and for a while I was pretty stellar at hiding. The after-school, one-person wine parties helped with that.

Drinking was something that I could control in an environment that often felt very out of control. It felt good. I felt relief. I felt, if only for a moment in time, some distance from the hyper-vigilance of living with such a soft, sensitive heart.

Yet, soon I’d learn that while my shutting down served as a form of protection, it also served as a form of destruction.

After my sister went off to college, I became my parents’ mediator. Not in any official way, of course, just in the way that naturally occurs when you have two very dysfunctional parents and one very emotionally dysregulated but deeply empathetic kid.

I have vivid memories of my mother crying on my shoulder, telling me about how awful my father was. Then, later that day, I’d listen to my dad scream about my mother. I was caught in between two broken creatures, and my heart couldn’t take the weight. So I learned to escape.

I escaped with the aforementioned booze, a brief bout of self-harm, and spending as much time away from home as I could with early bike rides to school and after-school skate sessions until my shins were scabbed over.

But my favorite way to escape was to read. I read voraciously, immersing myself in stories that were unlike my own. I’d take journeys to magical worlds with dragons and faeries. I’d yearn to be seated around a campfire with Jack London and his wolf-dog³. I imagined myself romping around the Ozarks with Old Dan, Little Ann, and young Billy Coleman⁴. Some of my fondest memories were the weekly trip to the library with my mom and my siblings. It was a little respite from home, surrounded by books, those little portals to empathy.

When high school rolled around, all of the love I had for reading was overshadowed by the crippling anxiety I might be called on for my perspective on, for instance, what Orwell had to say about the evils of totalitarianism. I was not only fearful of any criticism or feedback my teacher might give me, I was also terrified of what my peers would think of what the quiet little boy might say.

I lacked self-confidence, and it showed. I suspect it’s why I had a bully. The bullying mostly consisted of mean words and evil eyes, but on occasion he’d get in my face, try to intimidate me, and provoke me into a fight. Being highly sensitive, I did everything in my power to avoid him like the plague, but on the occasion he’d track me down, I’d muster up the will to ask him, “why are you doing this?” He never had an answer, which of course inspired me to retreat back into my own head to wonder what the hell I was doing wrong to be a target of a guy with a flattop.

After high school, around nineteen, I ran head first into an eating disorder. I basically stopped eating, more or less (mostly less), for about a decade until a Welsh doctor told me my heart would stop if I continued down the path I was heading. Even if I didn’t know it then, I wasn’t ready to let my heart die before I could open it for the first time.

Over the next ten years, slowly and steadily, I learned to let a little light in. It was all at once beautiful and painful, full of both loneliness and connection. I tried therapy, ghosted a therapist or two, then eventually found a therapist who I felt comfortable with. I was diagnosed with major depressive disorder, which was one of the most relieving and validating moments of my life. I found some medication that helped me avoid, for the most part, being a relentless Eeyore. I eventually quit drinking.

And, most of all, I discovered what safety means in the form of a human named Jessica. She saw me before I saw me: a highly sensitive person unanchored by any real sense of identity, purpose or meaning. Just a little sensitive bean adrift in a sea of repression. She saved my life, and I’m forever grateful.

As I look back on my childhood and the experiences I’ve had, I grieve what could have been, and at the same time I’m a middle-aged dude who used to think he’d never live past his teens. The truth is that I wouldn’t be here without the safety that people like Jessica provided me, and also I wouldn’t be here without the immeasurable privilege I lived with as a white cis-het guy who had the access and means to seek healthcare, therapy, and support.

I once thought being highly sensitive was a burden. I see it now as a superpower, one that requires curiosity, an open heart, clear boundaries, feedback, emotional awareness, an examination of assumptions and biases, and the safety to wield it.

There’s not a highly sensitive person diagnosis, and there doesn’t have to be. If you are reading this right now and you feel like it resonates with you, I’m grateful for you. The question now is, “what are you going to do with that great superpower of yours?”

References:
1. The Highly Sensitive Person by Elaine N. Aron, PhD
2. https://jpcp.uswr.ac.ir/article-1-538-en.html
3. Where the Red Fern Grows by Wilson Rawls
4. Animal Farm by George Orwell