Chronic Anxiety and the Highly Sensitive Person (HSP)

As a therapist, not all the people I see with chronic anxiety are highly sensitive, but all of the HSPs I’ve worked with have also dealt with anxiety– especially if they learned about the trait later in life. The HSP’s nervous system is more likely to experience overstimulation and anxiety.

In my therapy practice, I have found that ‘anxiety’ is a word commonly used for unidentifiable discomfort; it can feel random and mysterious. Being able to identify what we are feeling and why is a step toward shifting the way we relate to anxiety. 

Being an HSP and not knowing contributes to chronic anxiety. Psychologist Elaine Aron began studying the trait of high sensitivity or ‘sensory processing sensitivity’ in 1991. In her excellent book The Highly Sensitive Person, she emphasized that the trait wasn't a new discovery, rather misunderstood and mislabeled as shyness or introversion. Since then, there have been studies to support the existence of the trait in an estimated 15-20% of the population of humans as well as 100 other species.

A quick way to get a sense of what it means to be a Highly Sensitive Person is using the acronym DOES, created by Elaine Aron, which stands for:

D- Depth of Processing

O- Overstimulation

E- Emotional Reactivity/ Empathy

S- Sensing Subtleties

All four of the above can end up feeling like constant background anxiety. 

  • Depth of Processing 

    HSPs are thinking and feeling a lot a lot of the time. They typically enjoy deep conversations (with a trusted person) and they have rich inner lives. They take their time to make decisions and tend to be cautious.

    Elaine Aron notes, “Research by Bianca Acevedo and her associates has shown more brain activation in HSPs than others in an area called the insula, a part of the brain that integrates moment to moment knowledge of inner states and emotions, bodily position, and outer events. Some have called it the seat of consciousness. If we are more aware of what is going around inside and outside, this would be exactly the result one would expect.”

    Without knowledge of their trait, depth of processing can make HSPs vulnerable to analysis paralysis or circular thinking, both of which contribute to anxiety. 

  • Overstimulation

    Because HSPs are taking in more subtleties in their surroundings and processing more detail than non-HSPs, they are prone to overstimulation. Overstimulation can physically feel like an increased heart rate, a sense of shutting down, a desire to escape; these experiences will sound familiar to anyone who has dealt with anxiety.

    Learning what situations are likely to be over-stimulating and becoming familiar with the physical warning signs that you are approaching over-stimulation is a very helpful skill for HSPs. With that awareness, you can have a ready list of actions to help yourself to regulate, take a break, or set a boundary.

    Think of a set of scales. If your scale is tipping into over-stimulation, you can add soothing regulation strategies to the other side such as the butterfly hug, box breathing, aromatherapy (rollerball essential oils), and other grounding exercises. All of these bring you back into your physical body and can disrupt the intensity of your brain’s overstimulation.

  • Emotional Reactivity & Empathy

    Too often HSPs are reduced to just this piece, the emotional reactivity. Research shows that HSP brains react more to both positive and negative stimuli. As kids, most HSPs heard things like ‘you’re too sensitive’, ‘you’re a crybaby’, ‘stop crying or I’ll give you something to cry about’. And they probably experienced parents and friends not quite understanding them when they attempted to open up and share their feelings. 

    HSPs received the message that feeling deeply and crying are bad somehow– out of control, embarrassing, weak, and to be avoided. When an innate part of us is labeled as ‘bad’, we feel shame. We can never fully relax and be ourselves because that would be to reveal this flawed part of ourselves. The more acceptance HSPs learn to bring to their emotional natures, the more at ease and less anxious they will feel. 

    As with emotional reactivity, HSPs experience more brain activity in response to others’ emotions. Empathy is a gift both to the HSP and to their loved ones who are on the receiving end of their attunement and caring. However, HSPs greatly benefit from having more control around their experience of empathy.

    They can learn how to feel empathy and not take on others’ feelings in a number of ways. Emotions are said to be contagious, especially anxiety. So an HSP is primed to soak in more emotion that isn’t theirs including and resulting in anxiety.

  • Sensing Subtleties

    HSPs excel at sensing subtleties. Elaine Aron explains that It’s not that HSPs have better senses than non-HSPs, but that the brain activity is higher when sensing, indicating taking in and processing more information.

    Light, noise, temperature, fabric, clutter, texture– HSPs each have their own unique relationship sensory input and benefit from knowing specifically what affects them and how. 

    Learning about your specific sensory sensitivities and allowing yourself to accommodate those is a kind and loving act toward yourself. HSPs can benefit from having things on hand to limit sensory stimulation (headphones, noise machines, eye masks). 

As an HSP, knowing about your trait can help you prepare for what you encounter in the world. I frequently work with clients who carry shame around sensitivity, emotions, and especially crying.

When HSPs can start to accept the emotional part of themselves, it is a real turning point.  HSPs might cry out of over-stimulation sometimes– crying releases stress hormones, helping the body process and release emotions. Crying in therapy and having all of these aspects of ‘DOES’ normalized is deeply healing.

If you think you might be an HSP check out some resources; Elaine Aron’s self-test, books, and website are great resources. When HSPs learn about and start to accept themselves, shame can ebb away, their relationship to anxiety shifts, and confidence can start to grow.

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