Originally published in Comfort Zone Newsletter: November 2013
Many of you will see a psychotherapist at some point in your life or have already. Whether this is because you are in enormous distress, want to further explore the meaning of your life, or are merely curious, your choice of therapist will impact your life enormously.
I have written about how to select a therapist in The Highly Sensitive Person, The Highly Sensitive Person’s Workbook, and on this blog. For you, however, an issue deserving special attention is how to discuss your sensitivity with therapists. This is important when choosing a therapist, and especially so if you are already seeing someone you like but are not sure how to bring it up. Actually, your therapy may not involve long discussions of high sensitivity–you already know about it. But whether your therapist is highly sensitive (nice but not necessary) or not, being informed about it allows him or her to keep it in mind, bring it up when it seems appropriate, and adapt the work to better fit your trait.
The Easy Way
An easy way for a therapist to be more knowledgeable about sensory processing sensitivity (SPS, the research term for it) is by reading the book or DVD on therapy with HSPs. (Indeed, starting this spring, interested therapists can be listed on HSperson.com as being well informed about conducting therapy with HSPs after completing a test on either the book or DVD.) However, broaching the subject can be tricky. Hence this article.
Of course not mentioning your sensitivity is even easier. It depends on how important it is for you, relative to your other goals. You might be struggling with recovering from sexual abuse or alcoholism, and if you can see an expert in that, you might not care how he or she views your trait of high sensitivity. Further, it is difficult to know whether a particular reaction you have had is due to sensitivity or the persistent effect of past personal experiences, so you do not want a therapist to explain everything as sensitivity.
Ideally, however, you will find someone who is smart, able to keep both your sensitivity and your personal history in mind as well as how the two could interact, and ask the right questions, neither attributing everything to history nor trying to undo something that in fact is better explained by your innate sensitivity. With your sensitivity in the background as a fact, you can both turn attention to helping you find ways to cope with rather than to eliminate the reaction.
When to Bring Up Your Sensitivity When Choosing a Therapist
I would do so as early as possible in the process of selection. It should help the therapist understand you, and also give you some additional insights about him or her. Some will talk to you a little on the phone before meeting with you, so that they can refer you to someone else if the two of you are not suitable. This is good for you as well, since it gives you a chance to eliminate a therapist before meeting. Let the therapist ask most of the questions at the outside, probably about what your main problem is, a very brief description of your past, any medications you take, past psychotherapy you have had, and anything else pertinent. During this conversation you can mention being highly sensitive and listen for the reaction (see below).
Other therapists will not want to talk on the phone with you at all except to tell you their fee and where to come for your first, trial session. So then it will be in this first session that you bring it up.
What You Might Say
Here’s a possible dialogue that you could even print out and have in front of you if you speak first by the phone. These will not be your first words, of course, but you eventually say, “Have you heard of something called high sensitivity? It is a somewhat new idea [you don’t want to make the person defensive by suggesting he or she is not up to date] but there’s research on it already and quite well done, I think. I really identify with this trait and think it will be important for our work, although not everything by any means” [you don’t want the therapist to feel you will explain everything in terms of your sensitivity and resist other explanations].
We hope the therapist asks more, but if not, you could close the topic by referring the person to www.hsperson.com, the research tab. Otherwise you could go on like this: “Maybe you’ve seen The Highly Sensitive Person, which is all about it. There’s even a book on doing psychotherapy with highly sensitive people, I believe published by Routledge. [The therapist may recognize this publisher as very solid.] The subtitle is even Doing psychotherapy with the 20% of the population who may be 50% of clients.” [Hopefully this will provide further professional curiosity or incentive to read the book.]
You could continue: “If there really are that many patients with the trait, you probably have some idea about people like me already–aware of subtle things, liking to think deeply, more emotional, easily overwhelmed, slow at decisions–stuff like that. But I guess the idea of the therapy book is that even if you have an intuitive sense of it, being conscious of its ins and outs can help.”
If the therapist offers to learn more about it before you meet again, even just by reading a little on the website, you don’t have to do any more explaining. Just be certain at that next meeting–if you decide to have one–that he or she did the homework. If not, you could try again, by providing more details–see below–but you can also think about why you received this rebuff, which could be explained in the next section (even though it is about talking to a therapist you already know).
When Bringing up Your Trait with Your Ongoing Therapist
Talking with a therapist you are already working with about your new-found interest in being an HSP is much like talking about it with someone with whom you have a close relationship. Indeed, hopefully your therapist falls into that category. Remember that you are suddenly announcing that you think you are not the person they thought you were. Depending on the people on the receiving end, this could imply many things, even if you don’t mean them at all:
- That you will now be telling them about you, almost as if their opinion is outmoded and even ignorant or harmful.
- That from now on you want different treatment, even are demanding it as based on indisputable fact.
- That you are less interested in past and future explanations for your behavior that are not based on your sensitivity.
- That you have taken control, telling them what they must know in order to be a competent member of this relationship.
- That they are not adequately “sensitive.” The problem here is the two meanings of “sensitive.” Sensitivity in the sense of empathy, caring, and insight can be very strong in non-HSPS.
In short, in any therapist new to the subject, you are almost sure to trigger a complex, whether you can detect it or not. So be sensitive in both senses of the word.
Now Watch Their Reaction
Therapists are legally required to be able to work with people from other cultures and to know the issues that can impact a person who is African-American, Asian-American, Hispanic-American, gay, lesbian, or whatever. They are also obliged to be familiar with a topic, like sexuality or learning disabilities, before they try to deal with it. They are also supposed to be aware of and have worked through their own prejudices around an issue. In that light, it is perfectly right that you should expect your therapist to become an objective, friendly expert on high sensitivity if he or she is going to work with you. You are the consumer–you should receive what you need.
Given the above, you have a right and obligation to yourself not only to inform your therapist about your trait, but then to note the reaction of your therapist to your disclosure. A poor initial reaction does not mean you should stop seeing this therapist if you are otherwise gaining from the therapy. It does, however, become an issue you must discuss further. Whatever comes up in your discussion, you are going to learn from going through it. Just use two of the big rules for any potential conflict with someone who matters to you: (a) stick to your opinion as long as you feel you are right–don’t cave in, submit, or give up with the intention of just enduring a bad situation; and (b) listen attentively to the other person–see it from the other’s point of view so that you can better understand what is going wrong between you. Finally, allow time for the issue to evolve, for the unconscious to do its work. The two of you may disagree today and one of you may wake up tomorrow with an entirely different view of it.
As you work it through, either your therapist will begin to see it your way, the two of you will agree to disagree in a way that is fruitful for your individuation, or you will discover some issues between the two of you that may suggest your work together is coming to an end. As an HSP you might prefer to drop it, but don’t. How honest you are in therapy is a direct determinant of how much you receive from it. If you can’t be honest–if you feel some subjects are landmines–be honest about that with your therapist. Figure out how much the distrust is due to something in your past and how much due to your distrust of the other based on experience with him or her. Both are hot topics sure to pay off.
Simply appreciate, again, that it can be awkward for any professional (e.g., doctor, psychiatrist, nurse, teacher) to have someone inquire as to whether they are properly up-to-date. But any professional should also be gracious about it. The ability to be open-minded is especially important in a therapist, since the therapist’s personality will have such an impact on you.
A bad response is one that stays defensive and dismissing–something like, “These self-help books–every year it’s something new.” Or, “Yes, but that’s really pretty irrelevant in your case.” Or, “So why are you telling me this? What does it mean that you feel you have to tell me about this?” That might be a fair question if raised in a kind way. Looking at the unconscious meaning of your bringing it up might be useful, but he or she should not use this to evade or detract from discussing the actual subject.
Then there are the therapists who will say, “Oh, yes, I know all about that,” without any interest in how you describe it. If they start talking, listen for whether they mislabel the trait or imply it to be an innate tendency to timidity, shyness, introversion, neuroticism, depression, or anxiety. Do they offer to rid you of it through insight, training, or medications to “correct the chemical imbalance”? You may well need treatment for depression, anxiety, or social difficulties. But the goal should not be to “cure” you of your trait, which would mean overlooking all the good that comes with it as well as not accepting that it is innate.
The best therapists will be gracious about hearing new information–eager to be informed, interested in you, and glad to understand you better. They will say things like, “I hear how important this is to you. Please, tell me more.” Or, “Tell me how I can learn more about this. This is very interesting.” And best of all, some really will know all about it!
If You Want a Sample Dialogue for Speaking with your Ongoing Therapist
Just say something like, “I’ve just read this book on being highly sensitive. I feel excited by it. I believe I’ve come across something important to us, so I thought we might explore it as another aspect of me. The research says this is an innate trait, found in about 15 to 20% of the population, we can’t really change it, but there are ways to adapt better to it. It’s not really a new discovery, but a new name for something that has been misunderstood as shyness or introversion. In fact, it’s not either of these, although sensitive people can be shy or introverted too.”
You can remember how to explain it by using the acronym DOES:
- D for Depth of processing. “Mainly, people who have this trait tend to process information more deeply, reflect before deciding.”
- O for Overstimulating. “They also get more easily overwhelmed, overstimulated.”
- E for Emotional responsiveness and Empathy. “They are deeply affected by distressing experiences, but positive ones too, and they have more empathy than others.”
- S for aware of Subtle Stimuli. “They also are aware of subtle things that others don’t notice.”
“We’ve talked about some of this, and given how these things made me feel different, flawed, this might help us understand some of my…” [depression, anxiety, shyness, low self-esteem]. Something like that.
If saying it seems difficult, I would not hesitate to photocopy from the book or print from the website something about it, especially the self-test, and give it to your therapist, or loan them your book. The self-test gives a good sense of the trait, and might bring up whether your therapist is or is not highly sensitive too.
Your Own Task
Many people come to me wanting to hear that their only problem is their sensitivity, which I tell them is not a problem, of course. Then they want to hear that they are just fine. But in fact I can see much more that needs attention. So be willing to listen and admit to your other problems. In particular, remember and perhaps explain my key mental health finding about the trait: Those who are HSPs and have had a troubled childhood are more prone to depression, anxiety, and shyness–things that therapy can treat–than non-HSPs with the same bad childhoods. (But HSPs with an adequate childhood are NOT more prone to these problems.) I am sure the same holds true for HSPs who have had a stressful adult life or a recent trauma.
Some of What You Both Should Keep in Mind
Certain things are normal for HSPs, even if not found in the other 80% of the population. HSPs…
- Need more down time than others.
- Do not do well working long hours or at a job that is not meaningful to them.
- May have to change jobs or professions often before they find the right one. On the other hand, they may stay too long in a job that’s bad for them because of professional insecurities.
- Are unusually good parents, but parenting is also more stressful for them and they need even more time off than other parents.
- Perform worse when being observed and evaluated, often giving them a long history of underachievement and seeming failures.
- Have a deep sense of being flawed because of having been raised in a culture that does not value the trait, and because they have always felt secretly different without any explanation for it. This is especially true for men.
- Differ in some of their sexual feelings. (See The Highly Sensitive Person in Love.)
- May have problems in their relationships at home or at work that could be easily solved with a better understanding of their trait.
Many more points about HSPs and relationships, shyness, depression, and the like are found in the books and newsletters you have.
Should your Therapist be Highly Sensitive?
It’s a tough question–whether to seek out a therapist who is actually highly sensitive, rather than one who is merely knowledgeable or willing to become knowledgeable about the trait. In general, I would find the best therapist you possibly can and see how quickly that person can grasp the concept. If he or she can appreciate it, then it probably does not matter. It is very, very nice to be with another HSP, however, and I hope that anyone seeking long-term personal development through depth psychotherapy or analysis can find a highly sensitive therapist. (They are not as easy to find as you might think because, while HSPs make excellent therapists, the training and the inevitable crises can be tough, and HSPs must limit the hours they work, also limiting their income.)
I see this issue in the same way as whether a non-sensitive parent can raise a sensitive child as well as a sensitive parent can. Of course so, and there might even be some advantages. All the research says what matters is that parents (and teachers) provide a “goodness of fit” between the child’s temperament–any temperament–and his or her environment, so that the child can thrive and the strengths of that trait can be brought out. It does not mean the parent and child have the same temperament. Rather, it means the parent is responsive to the needs of the child, including those dictated by temperament. For some parents, this knowing will come spontaneously from sharing the child’s temperament, and others will need a little training.
It’s the same for a therapist. A responsive, empathic, caring therapist may just naturally understand your sensitivity. Otherwise, he or she will certainly do everything to learn about it. When a person who does not have your trait wants very much to learn about it and you, that in itself can be very healing. Further, you and your therapist may have other characteristics in common that are even more important. Again, what matters most is the “goodness of fit”–the sense of it feeling right, overall, when you are with this therapist.