Are Highly Sensitive People (HSPs) More Likely to Have Trauma?

Jun 21

This seems like a logical assumption. Since HSPs are more empathetic, attuned, and sensitive to their environments, it makes sense that disruptions, stresses, and traumatic events would affect HSPs more deeply. But we can’t take assumptions at face value. Let’s dive into the literature and see what the research says.

Many therapists who have written on this topic take it as a given fact that HSPs are more likely to have trauma reactions to a wider range of events. I wanted to explore what research has to say on the topic. We do know that therapists often have a skewed view of HSPs simply because HSPs make up the majority of therapy clients overall, not just for trauma therapy. So therapists thinking about this question by looking at their clients might assume that HSPs are more likely to experience trauma or other mental health issues because HSPs are more likely to go to therapy.

Citations will appear at the end of each section and again in order at the end of the article.

Psychotherapy and the highly sensitive person; improving outcomes for that minority of people who are the majority of clients. (2010). SciTech Book News.

Highly Sensitive People Process Differently

On a neurobiological level, HSPs have what we call “Sensory Processing Sensitivity” (SPS). The theory holds that HSPs are not only more sensitive to external stimuli but also transmit and process sensory information differently. We know that disruptions in memory processing are a primary neurobiological cause of trauma, so it’s possible that SPS would make HSPs more likely to have traumatic reactions to environmental factors.

Sensory processing sensitivity is defined by having a low neurological threshold to stimuli. People with a high threshold (non-HSPs) can be categorized as low registration, which has a passive response to stimuli; and sensation seeking, which has an active response to stimuli. People with a low threshold (HSPs) can be divided into sensory avoiders (active) and sensory accepters/sensory sensitives (passive).

This processing difference is not only related to external sensory stimuli. Further research shows that SPS also affects the way in which HSPs experience physical pain differently from others. The theory holds that high sensitivity combined with passive responses to stimuli lead to less effective coping strategies to manage pain compared to people with a more active response.

People with low registration, sensory avoidance, and sensory sensitivity tend to use the passive coping strategy referred to as “pain catastrophizing” which leads to an exaggerated negative pain response, a stronger pain experience, and more negative pain outcomes. So in terms of physical pain, HSPs are less likely to use effective coping strategies to navigate the experience.

Meredith, P. J., Rappel, G., Strong, J., & Bailey, K. J. (2015). Sensory sensitivity and strategies for coping with pain. AJOT: American Journal of Occupational Therapy, 69(4).

Highly Sensitive People Have More Attachment Anxiety

Another study found a strong correlation between attachment anxiety and high scores on the Highly Sensitive Person Scale (HSPS), the instrument currently used to measure sensory processing sensitivity and identify the HSP trait.

[T]he following significant positive relationships were identified: sensory sensitivity and attachment anxiety, sensory avoidance and both attachment anxiety and avoidance, and low registration and anxious attachment. In addition, sensory seeking was negatively correlated with attachment avoidance, lending more confidence to associations between sensory seeking and secure attachment.

This is important because strong, secure attachments are protective factors that help people who go through traumatic events to stay resilient and recover quickly from any mental, physical, and spiritual disruptions from the trauma. The study concluded that insecure anxious and avoidant attachment patterns are correlated with high sensory sensitivity. Of course, we can’t assume a causal relationship in either direction, and other studies have suggested that it is high anxiety and stress that causes a child to develop high sensory sensitivity rather than the other way around.

Attachment issues also affect our experience of physical symptoms in people with sensory processing sensitivity. Anxious attachment shows up as a stronger experience of distress and avoidant attachment shows up as a suppressed expression of distress. This is important because we still don’t know when we develop SPS during childhood. Many of the factors that play into SPS are still a mystery. But we do have quite a bit of research on how and why we develop insecure attachments, so the correlation may help us learn how sensory processing sensitivities come to be.

Meredith, P. J., Bailey, K. J., Strong, J., & Rappel, G. (2016). Adult attachment, sensory processing, and distress in healthy adults. AJOT: American Journal of Occupational Therapy, 70(1).

Le, T. L., Geist, R., Hunter, J., & Maunder, R. G. (2020). Relationship between insecure attachment and physical symptom severity is mediated by sensory sensitivity. Brain and Behavior, 10(8), NA.

Outcomes for HSPs are Highly Dependent on Childhood

This may seem logical, but it’s nice to have a study to confirm that sensory processing sensitivity is indeed correlated with negative outcomes like anxiety, depression, and shyness in people who had a difficult childhood. In people with high SPS and a good childhood, there was no correlation at all with negative outcomes. So we see here that environmental factors are key in determining whether or not HSPs will grow up to experience the strengths of their sensitivity. This study in particular looked at parenting quality as the determining factor, though of course there are many possible reasons to have a “difficult” childhood.

The researchers chose parenting quality as the determining factor because “[t]hrough high-quality parenting, children learn emotional regulation of overarousal for both positive and negative stimuli.”

Other research goes beyond only parenting factors. Childhood trauma in general is highly associated with adult psychopathology with sensory processing sensitivity as a mediating factor. In research, mediation analysis quantifies the extent to which one variable affects another in a causal relationship. This means that people with childhood traumatic events who have sensory processing sensitivity are more likely to have mental health issues as adults.

Putting it All Together

The research seems to point to a confirmation of the popular theory that HSPs are more likely to have ongoing trauma symptoms continuing into adulthood from childhood traumatic environments. And that HSPs are more likely to use passive coping methods to deal with current pain, be overwhelmed by external stimuli, and have less secure attachment than non-HSPs.

So HSPs who experienced childhood trauma are more likely to have mental health issues as adults and HSP adults are less likely to have positive resilience factors like good coping skills and strong attachments. With this in mind, therapy is an effective way to help HSPs improve coping skills, heal broken attachments, recover from trauma, and learn how to manage overwhelm.

High sensitivity is a trait that can be a wonderful strength, but it also comes with some challenges. If you’re an HSP who has experienced childhood trauma, anxiety, depression, chronic stress, or chronic pain, this research is hopeful that you can develop good resilience and healing.

HSP Aware Therapy Can Help

To learn more about me and how I work with HSPs and others who have experienced trauma, learn more about me here, about EMDR here, and how I specifically tailor both talk therapy and EMDR to HSPs here. Contact me today for a free consultation to get an individualized picture of how I can help you meet your unique needs.

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Cited Research

Psychotherapy and the highly sensitive person; improving outcomes for that minority of people who are the majority of clients. (2010). SciTech Book News. https://link-gale-com.proxy.santacruzpl.org/apps/doc/A243379401/AONE?u=scruzpl&sid=bookmark-AONE&xid=33e206d1

Roth, M., Gubler, D. A., Janelt, T., Kolioutsis, B., & Troche, S. J. (2023). On the feeling of being different-an interview study with people who define themselves as highly sensitive. PLoS ONE, 18(3), e0283311. https://link-gale-com.proxy.santacruzpl.org/apps/doc/A741765769/AONE?u=scruzpl&sid=bookmark-AONE&xid=be405e58

Meredith, P. J., Bailey, K. J., Strong, J., & Rappel, G. (2016). Adult attachment, sensory processing, and distress in healthy adults. AJOT: American Journal of Occupational Therapy, 70(1). https://link-gale-com.proxy.santacruzpl.org/apps/doc/A439634334/AONE?u=scruzpl&sid=bookmark-AONE&xid=cdf40edc

Jagiellowicz, J., Aron, A., & Aron, E. N. (2016). Relationship between the temperament trait of sensory processing sensitivity and emotional reactivity. Social Behavior and Personality: An International Journal, 44(2), 185+. https://link-gale-com.proxy.santacruzpl.org/apps/doc/A452158403/AONE?u=scruzpl&sid=bookmark-AONE&xid=753bf7d5

Meredith, P. J., Rappel, G., Strong, J., & Bailey, K. J. (2015). Sensory sensitivity and strategies for coping with pain. AJOT: American Journal of Occupational Therapy, 69(4). https://link-gale-com.proxy.santacruzpl.org/apps/doc/A421213919/AONE?u=scruzpl&sid=bookmark-AONE&xid=e32a7352

Le, T. L., Geist, R., Hunter, J., & Maunder, R. G. (2020). Relationship between insecure attachment and physical symptom severity is mediated by sensory sensitivity. Brain and Behavior, 10(8), NA. https://link-gale-com.proxy.santacruzpl.org/apps/doc/A710483538/AONE?u=scruzpl&sid=bookmark-AONE&xid=a9827cb9

Karaca Dinç, P., Oktay, S., & Durak Batigün, A. (2021). Mediation role of alexithymia, sensory processing sensitivity and emotional-mental processes between childhood trauma and adult psychopathology: a self-report study. BMC Psychiatry, 21(1), NA. https://link-gale-com.proxy.santacruzpl.org/apps/doc/A681631783/AONE?u=scruzpl&sid=bookmark-AONE&xid=e34ac4bc

trauma therapyhsphighly sensitive personsensory processing sensitivity

Jessica Brohmer