Miller shared Aron’s estimate that this trait makes up 20% of the general population, and around 50% of therapy clients. Given that most therapists are also clients, many of us therapists are likely carry this trait as well! This was demonstrated in the group of us, with most of us nodding our heads along, throwing “me!” in the chat box, and considering other diagnoses we’ve been given and how they might relate to masking this trait, or wondering how much conditioning has played a part in the experience of mental illness. What if these traits were valued instead?

For a general overview of the traits, Miller recommends a handy-dandy acronym (don’t we love those in this field!?)

D.O.E.S

D-Depth of processing-slow to make decisions, deep thinking and feeling, commonly perfectionistic tendencies

O-Overstimulation/Over-Arousability-overstimulated by sensory input, but also novelty, sudden change, complexity, transitions, potentially easily overwhelmed by having many things to process

E-Emotional Reactivity-a strong reaction to positive and negative experiences, easily impacted by the emotions of others, may cry easily

S-Sensitive to Subtle Stimuli-ability to notice subtle differences or changes through their sensory fields.

André Solo (2023) outlines 4 Scientific Theories Behind this trait, noting that these are currently the dominant theories and models presented:

1. Sensory Processing Sensitivity: This is Elaine Aron’s theory, and the most widely known. Aron proposes that sensitivity is a trait, and that sensitive people are processing information differently at the level of the brain, which has not been fully proven. She theorizes that this sensitivity leads to traits like empathy, sensitivity to subtle sensation, and overstimulation. According to Solo, researchers estimate this trait is more proposed to be around 30% of the population, not 20%.
2. Differential Susceptibility-J. Belsky’s theory was organized around the question of why some had these traits and others didn’t. He points toward the evolutionary advantage and describes those with this trait as more shaped by how they are nurtured than non-sensitive people, who remain somewhat fixed. This is nature’s adaptation for the best opportunity for survival. He theorizes the sensitivity trait will propel children along who grow up in nurtured, safe environments, and keep those who have had less than nurturing environments alive and surviving, due to their ability to adapt.
3. Biological Sensitivity to Context-Similar to Differential Susceptibility, this theory, proposed by W. Thomas Boyce and Bruce J. Ellis, focuses on child development. Instead of proposing that those with the trait are born this way, they proposed that their environments shaped them to be more sensitive.
4. Diathesis-Stress vs. Vantage Sensitivity-These models are combined into a theory about advantages and disadvantages of the sensitive. On the one hand, sensitive people have a more difficult time under stressful circumstances, but they also benefit more from positive ones than the average person.

Miller shared with us some gems I’d like to share with you here (and thus hopefully remember them myself!)

We talk a lot about safety in therapy. Our brains scan for safety 4 times a minute and there are 3 layers of it:

1. Interoceptive Safety (what are we feeling in our bodies?)
2. The environment
3. Interpersonal: relating with the other, specifically their nervous system

In the therapeutic relationship, all are important! But the most pronounced is the relationship itself. Miller differentiated between two types of self-disclosure: a hot topic for therapists, and the theme of many hilarious therapist reels and memes. See below:

image from @cloud09therapy

The classical way we tend to think of self-disclosure is one where we share personal information. But the other, particularly important as highly sensitive people working with other highly sensitive people is something she refers to as “Therapist’s self-involving (TSI) interventions, utilizing the nervous system and emergence in the field of the therapy as an intervention, i.e. “I noticed something shifting when you said that. What are you feeling now?”

Sound like something you’re interested in engaging with? We’ve got you. Reach out now to inquire about our therapists that specialize in working with Highly Sensitive populations and other neurodivergent traits.

References

Sólo, A. (2023, November 22). The 4 wildly different theories researchers use to explain highly sensitive people. Sensitive Refuge. https://highlysensitiverefuge.com/four-theories-of-sensitivity-highly-sensitive-people/

Miller, Katherine. (2026, March 5) Self-Disclosure, Felt Safety, and the Highly Sensitive              Person. Tucson Counseling Associates