Why Highly Sensitive People Need Energy, Health and Support: An Evolutionary Perspective

Over recent years, my clinical research-based interests have increasingly converged around a fascinating question: What happens when a nervous system designed for deep processing is required to function in a society that rarely slows down?

As a Physiotherapist specialising in Pain and Fatigue Management, I have long been interested in the relationship between stress, health, fatigue and persistent pain. More recently, my work has led me to explore how these issues intersect with the trait of high sensitivity, also known as Sensory Processing Sensitivity (SPS).

This journey recently took me to Somerset (UK), where I attended a retreat for Highly Sensitive People (HSPs) organised by Barbara Allen, an international consultant and speaker on high sensitivity. The retreat brought together a remarkable community of individuals seeking a deeper understanding of their sensitivity and how to work with it rather than against it towards their own maturity.

I was also invited to deliver a presentation on high sensitivity, pain and fatigue management. It was incredibly encouraging to see the level of interest, engagement and thoughtful discussion generated by the topic. The conversations that followed reinforced something I frequently observe in clinical practice: many highly sensitive individuals are struggling with pain or fatigue and searching for practical ways to care for their health while honouring the way they are naturally wired.

The Evolutionary Role of Highly Sensitive People

Research suggests that approximately 20–30% of the population possesses the trait of high sensitivity. As described by Dr Elaine Aron, who first identified and reaserched the trait, highly sensitive individuals tend to process information more deeply, notice subtle details, respond strongly to emotional cues and carefully consider consequences before making decisions. They are often the people who "pause and check" while others move forward (1).

Therefore, far from being a disorder or a weakness, SPS is a naturally occurring temperament trait that has been observed across many species.

From an evolutionary perspective, diversity within a population creates resilience.

Some individuals are predisposed to act quickly, take risks and respond rapidly to changing circumstances. Others are inclined to pause, observe, gather information and process experiences more deeply before taking action.

Both strategies have value.

The highly sensitive individual tends to belong to the second group.

Rather than rushing forward, they are often the ones who notice what others overlook. They detect subtle changes, think carefully, integrate information deeply and often bring empathy, creativity and intuition to complex situations.

Dr Elaine Aron has described highly sensitive people as the equivalent of the "royal advisors" in human societies — those whose role is not necessarily to lead the charge, but to help ensure that decisions are wise, balanced and sustainable (2).

Similarly, during the Somerset retreat, Dr Andrew May, a researcher in the field of high sensitivity, spoke about the concept of an evolutionary trade-off which I really liked: energy invested in deeper processing, awareness and thoughtful decision-making cannot simultaneously be invested in speed and rapid action. This means that highly sensitive individuals are not designed to be constantly rushing from one task to the next. Their strengths lie in reflection, insight and careful evaluation.

In many ways, due to their depth of processing, highly sensitive people perform an essential societal function. They are often found among teachers, therapists, healthcare professionals, coaches, researchers, writers, artists and caregivers — roles that require reflection, insight, empathy and an awareness of nuance.

The Cost of Deep Processing

However, as explained by Dr Andrew May during the retreat, the same nervous system that enables deeper processing also requires more energy.

Highly sensitive individuals tend to process sensory, emotional and social information more thoroughly than average. Their brains are continually integrating, analysing and making meaning of the world around them.

This depth of processing is one of the defining characteristics of high sensitivity. For this reason highly sensitive individuals naturally require more quiet time with low stimulation during the day. Yet it is also one of the reasons why they may often experience periods of overstimulation, mental fatigue and exhaustion (3).

In my own work, I often explain it this way: if your brain is constantly running more detailed analyses of what is happening around and within you, it is likely to consume more resources. The challenge is not that highly sensitive people are weak. The challenge is that deep processing is energetically demanding.

When recovery is insufficient or stimulation is ongoing for long periods of time, the nervous system can remain in a state of heightened activation. Over time, this may contribute to chronic stress, burnout, sleep difficulties, fatigue and reduced wellbeing.

Research increasingly supports these observations, demonstrating associations between sensory processing sensitivity, stress, sleep quality and health outcomes (including mental health) (4).

High Sensitivity, Pain and Fatigue

This has particular relevance when we consider persistent pain and fatigue.

The emerging research suggests that highly sensitive people do not necessarily have a lower physical pain threshold. Rather, their experience and processing of pain may be amplified through the central nervous system (5).

At the same time, many of the factors associated with high sensitivity — including prolonged stress, anxiety, depression, sleep disruption are important risk factors for the development and maintenance of persistent pain (6-8).

Clinically, this raises an important question:

Could highly sensitive individuals benefit from pain and fatigue management approaches specifically tailored to their nervous systems?

I believe the answer is yes.

Many highly sensitive people spend years trying to adapt themselves to environments, expectations and lifestyles that are not aligned with their natural processing style. They may push through exhaustion, ignore signs of overwhelm and feel guilty for needing more recovery time than others.

Yet when we view high sensitivity through an evolutionary lens, a different perspective emerges.

Perhaps the goal is not to become less sensitive.

Perhaps the goal is to learn how to support a highly sensitive nervous system so that it can function at its best and thrive in the world.

Supporting the People Who Help Society Pause and Reflect

One of the most meaningful insights I took away from the Somerset retreat was the recognition that supporting the health of highly sensitive people is about more than individual wellbeing.

Highly sensitive individuals often fulfil an important role within families, workplaces and communities. They are frequently the people who notice emerging problems, ask thoughtful questions, identify risks, generate creative solutions and care deeply about the wellbeing of others.

They help society pause and check.

But they can only fulfil this role effectively when they have sufficient energy, resilience and health. If highly sensitive people are constantly exhausted, overwhelmed or living with persistent pain, many of their natural strengths become more difficult to access.

Supporting their wellbeing therefore benefits not only the individual, but also the communities around them.

Looking Ahead

This understanding has become a key motivation behind the next stage of my work.

From this autumn, I will be running small-group programmes specifically designed for highly sensitive individuals living with persistent pain, or fatigue and energy issues.

The programmes will combine evidence-based approaches to pain and fatigue management with education about the highly sensitive nervous system and practical strategies for living in greater alignment with one's sensitivity (please find more info here for the ENERGY Management Programme and here for the PAIN Management Programme).

I am also delighted that these groups will be delivered with the support of a psychotherapist with an expertise in working with HSP (Cindy Gale, UK), allowing us to address both the physical and psychological aspects of health in a compassionate, evidence-informed and collaborative way.

My hope is that these programmes will help highly sensitive people move beyond simply coping or pushing through, and towards a deeper understanding of how to work with their sensitivity as a strength.

Because when highly sensitive individuals have the health, energy and support they need, they are able to contribute some of their greatest gifts to the world: insight, empathy, creativity, wisdom and care.

FIND OUT ABOUT THE ENERGY MANAGEMENT PROGRAMME

REFERENCES:

1. Aron EN. Psychotherapy and the highly sensitive person: Improving outcomes for that minority of people who are the majority of clients. Routledge; 2011 Apr 27.

2. Aron EN. The highly sensitive person. Kensington Publishing Corp; 2026 Jan 27.

3. Golonka K, Gulla B. Individual differences and susceptibility to burnout syndrome: Sensory processing sensitivity and its relation to exhaustion and disengagement. Frontiers in psychology. 2021 Nov 23;12:751350.

4. Costa-López B, Ruiz-Robledillo N, Moreno O, Albaladejo-Blázquez N, Hernandez C, Baryła-Matejczuk M, Ferrer-Cascales R. Sensory processing sensitivity as a predictor of health-related quality of life outcomes via stress and sleep quality. Scientific Reports. 2024 Sep 30;14(1):22707.

5. Gubler DA, Ertl M, Janelt T, Roth M, Troche SJ. Sensory processing sensitivity (SPS) is not a sensory ability: Examining the relationship of SPS with objectively and subjectively measured sensory sensitivity. Journal of Research in Personality. 2026 May 15:104730.

6. Edwards RR, Dworkin RH, Sullivan MD, Turk DC, Wasan AD. The role of psychosocial processes in the development and maintenance of chronic pain. The journal of pain. 2016 Sep 1;17(9):T70-92.

7. Buscemi V, Chang WJ, Liston MB, McAuley JH, Schabrun SM. The role of perceived stress and life stressors in the development of chronic musculoskeletal pain disorders: A systematic review. The Journal of Pain. 2019 Oct 1;20(10):1127-39.

8. Runge N, Ahmed I, Saueressig T, Perea J, Labie C, Mairesse O, Nijs J, Malfliet A, Verschueren S, Van Assche D, de Vlam K. The bidirectional relationship between sleep problems and chronic musculoskeletal pain: a systematic review with meta-analysis. Pain. 2024 Nov 1;165(11):2455-67.