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High Sensitivity Creates Chronic Fatigue and Anxiety

What is high sensitivity? It’s a personality predisposition or trait that at least 20% of people have that is caused by changes in how their brains process sensory information. It is NOT a condition or illness!

Sensitivity as a trait is not evenly distributed in the population. Instead, sensory processing sensitivity (SPS as it is properly called) is more like a group of 3 different peaks across the spectrum of the population (a mountain range rather than the mountain). If we plot sensitivity (x axis) to the number of people with that score we would see this:

Highly sensitive people show much more of a response to stressful events, even when young.

Common problems like fussy eating, difficulties tolerating change, loud noises or bright lights are likely due to SPS.


It is characterised by four main features captured by the mnemonic DOES:

· Depth of processing – we take longer to process information and things are thought about very deeply.

· Overstimulated/aroused – this is very commonly seen in both child and adult HSPs as a need for quiet, non-stimulating environments.

· Emotionally reactive/empathic – this is seen as feeling not only your own feelings deeply but feeling others as well!

· Sensitive to Subtle Stimuli – sounds, smells and textures are perceived by us much more than the average person. Stone in your shoe? Scratchy clothing? You can’t ignore it.

It’s usually present from birth (and there’s some evidence it even begins in the womb), but it certainly becomes apparent in children aged one to in their play, the way that they interact with other people and so it's very clearly not developmental like autism or ADHD. As a trait it can be positive or negative depending on the quality of childhood support which matters more for highly sensitive people than for neurotypical children. This is called Differential Susceptibility. See the graph below and notice for HSPs if the environment is stressful they do much worse than neurotypical children. But if the environment is supportive they do way better!

This allows for HS children to thrive if given more emotional support. But that takes emotionally attuned parents (some of whom may be SPS themselves and possibly struggling with their own emotional regulation from childhood experiences!). We are seeing an epidemic of anxiety in children currently as trauma perpetuates down the generations and society heaps so much stress on them from an early age.

Interestingly, it is not the same as shyness or introversion (some HSPs are extraverts), it is more about how their brain processes sensory information. The person that first discovered this was research psychologist Elaine Aaron when she began to measure reactivity to different stimuli. She found that there as a distinct group of people who show high heightened reactivity that was consistent across cultures. So, it's not something you're making up or something you're using to get attention, it actually translates biologically to the way you process your senses is different. Hence, we now prefer to call this sensory processing sensitivity SPS or more simply environmental sensitivity because that more or less describes the adaptation rather than the person themselves as HSP did).

Following on from Elaine’s work there has been fantastic research by Thomas W Boyce that categorized children now in in this high group as ‘Orchid children’ because these children need to be hothoused more than other children. Regular kids are called Dandelion because they will thrive more adaptively anywhere[1] (and a middle group of Tulips has recently been added).

Gender differences

Are women more sensitive than men?

No! It turns out that the research shows us that 50% of Highly Sensitives are men and boys but the difficulty is that they often don't self-report - they wouldn't recognise it as culturally they are taught to repress their emotions and have a ‘stiff upper lip’ and believe that ‘big boys don’t cry’. So, this cultural bias keeps men in the dark really about their own sensitivity and indeed it crushes it so that the body then has to express it for them in various ways like heart disease, anxiety and chronic pain.

Girls tend to model themselves more on others and minimize their own needs - it therefore can mask the fact that they aren’t coping under the surface until it burst out in strange ways like eating disorders, cutting or sudden onset gender dysphoria.[2] It masks the issue about what they're really feeling underneath and indeed some of these strategies do help to calm the nervous system temporarily!

SPS and Longterm Health

I sometimes term it ‘Outsider syndrome’ because you just feel outside of things, but it's quite a sizable minority - 20 to 35 percent and it’s interesting that it also occurs in other animals: dogs, cats, horses etc that have a higher sensitivity than the majority. But as a minority state it's often misunderstood by a mainstream world, it's pilloried or ignored and it leaves children and the adults they become feeling that they don’t belong anywhere.

Dr Gabor Mate wrote a beautiful book recently called The Myth of Normal which describes how our culture is pretty dysfunctional and it ignores it ignores our needs both emotional and physical and we're supposed to accept that. For HSPs that has even larger consequences than averagely sensitive people. In adult life they tend to fill the doctor’s surgeries with their various symptoms that come and go and then settle into chronic pain or fatigue syndromes.

This usually starts with a virus, difficult emotional experience or some other trigger which simply doesn’t resolve. You find all your strategies to recover, move on, etc are failing. Particularly when illness strikes it creates a downward spiral because basically you've already felt like you were wrong and to blame for things that happened to you and now this thing has come along and taken away your health which generates a huge amount of anxiety. You wonder ‘Is it me is it me, what have I done to deserve this?’ and then you feel really displaced, like you've lost your meaning and your identity because you're no longer maybe working or perhaps you can't maintain your social life anymore, you lose your friends and so on. It’s a downward spiral from which many people never recover.

So how can we thrive as a HSP with SPS?

So given it's innate and intrinsic to a person and not something you can wish away, how can we embrace our sensitivity and make a life worth living? Here is Elaine Aron’s Five to Thrive:

· Understand the trait is real

· Design a life that is compatible

· Reframe the past in light of that understanding

· Heal from past trauma

· Know and be supported by other sensitive people

These five points are the basis of how you can transform what has maybe been your Achilles heel into your ‘superpower’.

I’ll be talking more about this next time.

[1] Do see his wonderful TED talk and catch the research by Michael Ploess from Queen Mary University London and Dr Bianca Acevedo who's in the Neuroscience Research Institute in California. [2] Here I’m not talking about children who know from an early age that they are the wrong gender. I’m talking about girls who decide (or are persuaded by well meaning experts or online influencers) as they hit puberty that they are in the wrong body because of body shame. Puberty is always harder for girls than boys as it introduces a vulnerability (periods) and visible difference (breast enlargement) that simply doesn’t happen for boys that may cause girls to disown their female bodies by binding breasts or asking for puberty blockers. This is a highly controversial area that is currently the subject of legal and social battles and likely a swing back away from simple affirmation to more of a protective stance is likely. But undoubtedly it is largely an adolescent female problem (about 70%).


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