Highly Sensitive People
Have you ever been told that you are too sensitive or that you were too shy or difficult when you were a child? Do you recognize yourself as feeling emotions very deeply or needing more time to process things than others?
If this resonates with you, you can do a self-test here to find out if you are a Highly Sensitive Person (or HSP): https://hsperson.com/test/highly-sensitive-test/.
Sensory Processing Sensitivity is the scientific term for high sensitivity and it is defined as an innate neutral trait that you are born with, found in around 15-20% of the population worldwide and in more than 100 other species. The highly sensitive trait has an evolutionary meaning, as a minority of the human species has an innate capacity to observe and process everything more thoroughly than others before acting (to avoid danger and protect their own species).
This trait has been widely validated through research studies and its public awareness is slowly increasing. Dr. Elaine Aron is the researcher that first identified this trait through her extensive work published for the first time in 1997 (1).
Highly sensitive people have in common 4 characteristics that can be remembered through the acronym DOES:
D = Depth of processing, preference to process information more thoroughly, with a tendency to think or reflect more deeply about the meaning of things (e.g. the meaning of life, environmental issues).
O = Overstimulation that if prolonged can cause overarousal, overwhelming feelings, and stress. Examples of overstimulation are loud noises, crowds, work pressure, deadlines.
E = Emotional Intensity and Empathy. Tendency to feel strong emotions, both positive and negative and to be moved or touched by other peoples’ emotions more easily than others.
S = Sensory Sensitivity. Strong awareness about subtle stimuli, capacity to notice and appreciate more easily than others fine details in the environment.
According to Dr. Elaine Aron’s research, HSP are more sensitive or responsive to stimuli. Therefore, they seem more sensitive to caffeine, beautiful music, violence in the media, and even physical pain (1).
HSP and Pain
Being HSP on itself does not mean being vulnerable to developing persistent pain. However, due to the combination of deep processing of the nervous system and the overstimulating world in which we all are immersed, HSP tends to become more easily stressed and prone to chronic over-arousal, which in turn can lead to chronic illnesses, including persistent pain (2, 3).
Although sensitivity to pain has been identified as a recurrent feature in Dr. Aron’s research based on interviews, this has not been fully studied via physiological measures (e.g. Quantitative Sensory Testing) and research in this field is still in its infancy (see below some recent studies on sensitivity trait and persistent low back pain (4, 5)).
Highly sensitive people, due to the continuous high processing in their nervous system, can experience persistent pain as overwhelming and difficult to navigate or manage. For this reason, I believe it is important to take into account this trait when working around managing persistent pain and/or stress-related conditions.
Aron EN, Aron A. Sensory-processing sensitivity and its relation to introversion and emotionality. J Pers Soc Psychol. 1997 Aug;73(2):345-68. doi: 10.1037//0022-3518.104.22.1685. PubMed PMID: 9248053.
Listou Grimen H, Diseth A. Sensory Processing Sensitivity: Factors of the Highly Sensitive Person Scale and Their relationships to Personality and Subjective Health Complaints. Percept Mot Skills. 2016 Dec;123(3):637-653.
Benham G. The highly sensitive person: Stress and physical symptom reports. Personality and individual differences. 2006;40(7):1433-1440.
Clark JR, Nijs J, Yeowell G, et al. Trait Sensitivity, Anxiety, and Personality Are Predictive of Central Sensitization Symptoms in Patients with Chronic Low Back Pain. Pain Pract. 2019 Nov;19(8):800-810.
Clark JR, Goodwin PC, Yeowell G. Exploring the pre-morbid contexts in which central sensitisation developed in individuals with non-specific chronic low back pain. A qualitative study. Brazilian journal of physical therapy. 2019;23(6):516-526.