An HSP Therapist Explains How DBT Can Help You Embrace Emotional Sensitivity
By: Dr. Mary Kate Roohan
Do you experience big emotions? Me too! If you identify as someone who feels a lot, you may be a highly sensitive person (HSP). HSPs experience life in a highly defined manner due to heightened processing (Aron, 1996) and often find it overwhelming to handle intense feelings, navigate interpersonal conflicts, and maintain emotional balance.
Highly Sensitive People and Emotional Sensitivity
My experience as a Highly Sensitive Person therapist has taught me that many HSPs possess a trait called emotional sensitivity, or the tendency to feel more frequently, intensely, and for longer durations.
This term was coined by Dr. Marsha Linehan, the psychologist who developed dialectical behavior therapy (DBT), which is a form of treatment that helps folks regulate their emotions and improve their relationships.
Sensitivity and Invalidation: Am I Wrong?
Many people view their emotional sensitivity as a strength. People who are feelers tend to be more socially motivated, empathetic, and compassionate. This trait, however, can be experienced as a nuisance when there is an environmental mismatch between a person’s sensitive temperament and their environment. For example, a chronic pattern of dismissive reactions to how a sensitive person experiences reality can hurt that person. Consistent invalidation can lead the HSP to believe that they are “wrong” or “too much,” perpetuating feelings of shame and self-doubt.
Does it really sting when someone calls you “too sensitive?”
If you are an HSP, you probably feel it really hard when you are invalidated (even if you aren’t fully aware that the invalidation is happening). HSPs, like emotionally sensitive people, have heightened sensitivity during interpersonal interactions; as a result, comments that could be experienced as nonthreatening by someone who is not an HSP can be magnified and experienced as attacking by someone who has a sensitive temperament.
What Invalidation Looks Like
Invalidation can be explicit (“your feelings are wrong”) or subtle (“don’t worry about it”). My experience has taught me that invalidation often masquerades as positivity and concern. I call this “sneaky invalidation.”
Even patterns of perceived invalidation experienced in subtle ways can significantly impact an HSP. Let me give you an example:
You are in 8th grade. You are struggling to focus on and complete your math assignment because you are overwhelmed by the other students talking (they’re already done), the bright lights in the room, and the medley of smells coming from the lunch boxes in the cubbies lined up against the classroom wall. You are the only student who has not completed the worksheet, and, as soon as you realize this, your anxiety skyrockets. Your teacher, who knows that you are very intelligent and capable, comes over to your desk and makes a seemingly benign statement: “This is easy, honey, don’t overthink it.”
Woof. To a sensitive person, this comment is brutal! At that moment, the teacher communicated that your reality (it’s hard to finish this task) is not the “correct” reality (the task is simple and easy to complete). When these experiences happen repeatedly across environments, such as in school, at home, or work, it can take a serious toll.
The current understanding of HSP prevalence is that 20-30% of people are highly sensitive. This means that as an HSP, your unique experience may have been quite different from most people (70-80%) with whom you interacted regularly throughout your early developmental years. When parents, siblings, teachers, or friends do not possess the quality of sensitivity, it can be extremely difficult for them to attune to the experience of an HSP.
Most people are not sensitive.
This means that you have had many interactions with people who do not understand your sensitivity.
The experience of interacting with people who do not “get it” can be exhausting and isolating.
Emotional Sensitivity and HSPs
The dominant perspective is that emotional sensitivity, or “super feeling,” is a component of an individual’s temperament. When an individual possesses this trait and is met with chronic invalidation, they can develop “symptoms” such as:
difficulty identifying needs
putting the needs of others before their own needs (people pleasing)
low self-esteem
challenges with setting boundaries
barriers to regulating emotions effectively regulating emotions
tendency to take on the emotions of others and feel overwhelmed
Can you relate to any of those challenges? If so, you might be emotionally sensitive!
My clinical experience has taught me that it is quite helpful to use biosocial theory, the model from DBT that explains the interaction between emotional sensitivity and invalidation, to help HSPs better understand some of the challenges they experience.
The Solution: How DBT Can Help HSPs
As an HSP therapist, I work with clients who frequently describe their emotional experiences as intense. Clients tend to have extensive histories of invalidation and chronic misattunement. When clients come to my office, they may not even realize some of the misattuned they have experienced due to their heightened sensory processing.
If you are an HSP who experiences intense emotions, Dialectical Behavior Therapy (DBT) can teach you how to better navigate your emotions and improve relationships.
While the practice of standard outpatient DBT is quite comprehensive (and not always accessible), this form of treatment has been adapted to support individuals unable to meet the client's specific needs.
DBT Skills Training includes four modules: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Each module teaches numerous skills that can be applied directly to clients’ individual lived experiences so that they can better manage emotions, tolerate distress and overwhelm, and navigate interpersonal relationships.
Here is a breakdown of the modules:
Mindfulness - Staying in the Now
As an HSP, you are well aware of the fact that you have a rich inner life. While this may help you to be creative and empathic, it can also lead to difficulty staying in the present moment. Mindfulness, the foundational module in DBT, helps you develop skills to keep you in the here and now.
Distress Tolerance - How to Keep Cool When Everything's on Fire
You may experience distressing emotions due to heightened processing of your environment. DBT's distress tolerance module equips you with skills to cope effectively during moments of crisis. It will also help you understand the concept of radical acceptance, which is a challenging skill to integrate; however, utilizing this concept will help you live a full life filled with purpose.
Emotion Regulation - Riding the Emotional Roller Coaster
As an HSP, you will likely benefit greatly from learning emotional regulation skills. DBT's emotion regulation module provides tools to identify and understand emotions and modify emotional responses.
Interpersonal Effectiveness - Using Skills To Make Relationships Easier
A reality is that, as an HSP, you may face challenges in your relationships due to your heightened sensitivity to emotional cues and a propensity to become overwhelmed by stimuli, especially in social settings. DBT's interpersonal effectiveness module can help you to set boundaries and improve your communication skills.
DBT for HSPs: Another Tool for the Toolbox
Sensitivity is not a flaw. In fact, sensitive people are frequently considered good friends and attentive listeners, known for their compassion, humor, and creativity. At the same time, most HSPs benefit from learning strategies to help them better manage their emotions and communicate their needs in relationships. With the right tools and techniques, such as those provided by DBT, sensitive people can learn to navigate their world more effectively.
A friendly reminder to all my sensitive people out there: being an HSP is a part of who you are, and with the right tools, you can turn your emotional sensitivity into a strength.
After all, we know that the world needs more people who feel deeply, care profoundly, and love generously.
About the Author
I'm Dr. Mary Kate Roohan (she/her), a Licensed Clinical Psychologist and Registered Drama Therapist who can help you break out of a cycle where your feelings and sensitivities are dictating your life. I use a blend of DBT, Acceptance and Commitment Therapy (ACT), Eye -Movement Desensitization Reprocessing (EMDR), and drama therapy techniques to change the way you relate to your internal experiences (thoughts, feelings, physical sensations, memories, urges, traumas). I’m passionate about working with folks who identify as emotionally sensitive and love providing therapy for comedians, improvisers, and queer folks.
References
Aron, E. N. (1996). The highly sensitive person: How to thrive when the world overwhelms you. Kensington Publishing Corporation.
Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.
Linehan, M. M. (2015). DBT Skills Training Manual. Guilford Publications.
