The Highly Sensitive Child: Helping our children thrive when the world overwhelms them

For the first two months of life Emilio had been crying every night at the same time, right on schedule, and was obviously miserable. Then his parents bought a playpen. From then on he was happy in it and nowhere else. He ate there, slept there, played there. If his mother took him out, he howled, and as soon as he was old enough, he crawled right back to it. He had no interest in exploring the cupboards or closets. He wanted his playpen!

Neighbors and relatives felt sorry for him, and told Emilio’s mother she had to get rid of that baby prison and stunter of exploration—a perfect example of that familiar, well-meaning advice that implies something is wrong with either the child or the parents.

But Emilio’s mother could not bear to separate her infant from his playpen. It made him too happy. The playpen was in the living room, so he was included in most family life, and to Prince Emilio it seemed to be more like a castle than a dungeon. So his mother decided to stop making an issue of it—as long as the floor of it did not break under her chubby son’s bouncing! She knew he would not be there when he was twenty. And in fact, at two and a half, when his younger brother needed it, he gave it up, not wanting to seem like a baby.

Another Source of Variation—Two Competing Systems

Another reason for the variations in the behavior of HSCs is suggested by one of the scientific models for the cause of sensitivity, which is that sensitive persons have a very active “behavioral inhibition system.” All brains have this system, but in the highly sensitive it is thought to be especially strong or active. For example, this system is associated with an active right hemisphere of the thinking part of the brain (the frontal cortex), and babies with more electrical activity and blood flow on the right side of the brain are more likely to be HSCs.

I prefer to call this system in the brain the “pause-to-check system” because that is what it really does. It is designed to look at the situation you are in and see if it is similar to any past situations stored in your memory. So it only causes “inhibition” for a moment—unless, of course, the prior similar situation was threatening. Otherwise, after a brief pause to check, one could just as easily decide to rush ahead.

For the highly sensitive, the pause-to-check urge is probably strong because they have so much input to process from every situation. Consider the two deer pausing at the edge of the meadow. The highly sensitive deer is noticing subtle scents, shadows, shades of color, tiny movements caused by the wind—or perhaps not caused by wind but by a predator. The less sensitive deer is not noticing all of this so has less to process, less reason to pause.

What the less sensitive deer has is a stronger “behavioral activation system”—it sees some good grass in the meadow and after a very brief check, it heads for it. This system, which I will call the “go-for-it system,” causes us to be eager to explore, succeed, and pursue the good things in life. It makes us want new experiences, try new things, all in the interest of knowing, acquiring, thriving.

Again, everyone has both systems, and these two systems are controlled by separate genes. Thus one can have a very strong inhibition system or a strong activation system, or both, or neither. HSCs who are high on both are like Ann or Chuck—always exploring, trying new things, climbing higher. But being HSCs, too, they do it carefully, usually without taking big risks. They know their limits.

So, another major source of variation among HSCs is the relative strength of these two systems. I will discuss this more in Chapter 3 (#u81717e4b-cea1-5683-9c12-891f9e778533).

Now It Really Gets Complicated—So Many Other Traits

Yet another source of variation besides different genes for different kinds of sensitivity and the relative balance of the aforementioned two systems are your child’s other inherited traits. Those who study temperament have come up with several different lists. (I think of them as different ways to slice the same pie.) The best-known list is of nine traits, arising from the work of Alexander Thomas and Stella Chess. As you seek to better understand your HSC, it is important to know something about these other temperament traits. So let’s consider each, in the light of high sensitivity (the definitions are from Jan Kristal’s The Temperament Perspective).

1. Low sensory threshold. On this list from Thomas and Chess, low sensory threshold is the equivalent of high sensitivity, although their term seems to imply that the five senses are the main source of the trait and does not emphasize the deeper processing of experiences, including imagined or remembered experiences, with all their emotional implications.

2. Activity or energy level. Active children have a great zest for life. They are independent and approach everything with their entire mind and body on. They are usually well coordinated, quick to walk and talk, eager to learn, but exhausting to parent. Less active children are calm, seldom fidgety or restless, better at fine motor skills than gross ones, and in no hurry. HSCs can vary on this as much as other children (it is probably affected more by the go-for-it system). Being high in activity can help an HSC move out into the world. But when considering activity level, I like to think about both inner and outer activity. Some children, HSCs in particular, may be outwardly quiet but their minds are buzzing.

3. Intensity of emotional response. Intense children put considerable energy into their emotional expression. They seem dramatic and loud; you do not have to guess what they are feeling. Low-intensity children are subdued, showing their displeasure with little fuss, never a tantrum. Most HSCs have intense responses, but many would be considered low on this trait because they do not express their reactions outwardly, in dramatics, so much as inwardly, with stomachaches or anxiousness. It is usually not hard to see their intense response if you are paying attention. And HSCs who are outwardly intense—there are some—at least grow up with the advantage that they let the world know when they are overwhelmed.

3. Rhythmicity. Children with this trait are very predictable. You know what time they will be hungry, sleepy, or have bowel movements. When older, they are creatures of habit, keep their rooms orderly, eat regular meals and snacks, and get their work done on time. Most HSCs are fairly predictable, probably because they thrive on order, and this can be a great advantage to you and your child. But your HSC may also be quite unpredictable.

5. Adaptability. Children who are very adaptable go with the flow; they can handle changes, transitions, and interruptions; they make good travelers. Slow-adapting children need to know what to expect and when to expect it, and don’t like change that happens suddenly. They want to control situations when they don’t know what to expect. A simple statement like “Time to eat” may be met with stalling or a complete tantrum. Most HSCs seem to be poor adapters, but in reality they are being asked to adapt to too much. They are overwhelmed, or afraid of being overwhelmed, by all the new stimulation that must be processed before they can relax. On the other hand, HSCs can see the consequences if they do not adapt, both for themselves and those around them, and will try their best to be flexible. What is frustrating for parents is that these children often keep it together when away from the family, then when they come home, they “lose it” when asked to make a small transition. For the sake of being socially appropriate, they have overtaxed their ability to handle change. At home they feel free to let go.

6. Initial Reaction or approach/withdrawal. One child rushes into things, another is slow to warm up. Most HSCs pause to check, but if the HSC also has a strong go-for-it system, she might be fairly quick to engage with new people and things if it feels safe.

7. Persistence. Some children stick to a task no matter what. They like to finish what they start; they will practice something until they master it. We say they have a long attention span, until it becomes a problem, then we call it stubbornness. Other children stay with an activity briefly, then move on. It may be that they are easily frustrated and give up more easily. This is a separate trait from sensitivity, but sensitivity affects it. For example, since HSCs process things so deeply, they tend to be persistent. But their vision of how to do something perfectly can make them frustrated when they cannot achieve it, which leads to overarousal and a sense of failure, and then they want to quit and are not persistent. Or some will drop everything—not persist—if they see that someone needs or desires them to do something different.

8. Distractibility. This refers to how easily a child can be taken “off task” or shifts on his own from one activity to another. How does this differ from low persistence? A distractible child will look up from reading if someone walks by; if he is also persistent, the child will return to reading. A less persistent child keeps watching. A less distractible child would not even notice the person walking by. If he’s also not persistent, he will not read for long either, but not necessarily because of any distraction. HSCs are fairly distractible, since they notice so much, but their deep processing usually overrides their distractibility—that is, in a quiet place with no inner worries they have deep concentration.

9. Predominate Mood. Some children are said to be naturally cheerful, some irritable, some pessimistic. Many temperament counselors no longer use these labels, because they recognize that a child’s mood is deeply affected by her environment and experiences. I do not see any one mood predominating in HSCs, although I do see their moods affected more by life experiences than non-HSCs.

CLEARING UP AGAIN THOSE OLD MISCONCEPTIONS

As we come to the end of our introduction to highly sensitive children, it is equally helpful to pinpoint what your child is not. People have probably labeled your HSC in various ways that sound so true you may find it difficult to ignore those labels. So let’s consider some of these and whether they have any real merit.

First, is your child “fussy”? Yes, HSCs are definitely bothered more by “little” discomforts, changes, or oddities. But “little” is in the eyes of the beholder. What seems neat, clean, comfortable, or scent-free to one person is dirty, miserable, and reeking to another. If it is the same macaroni to you whether it’s shell-shaped or elbow-shaped, it is not to your tearful child. Respecting the reality of your HSC’s experience is basic to getting along with her. It’s okay if you do not like your child’s reactions—you each have likes and dislikes—but you each have to be respectful. You can allow your child not to like the macaroni’s shape, and she should be polite about it. Chapter 7 (#litres_trial_promo) has advice on handling your child’s discomforts. But we will not call this type of response “fussy.”

Second, your child is not inherently timid or fearful. Again, I doubt any individual—animal or human—is born highly afraid of everything. Except for a few specific fears, such as the fear of falling, we learn what to fear from experience. It is actually rather easy to tell the difference between fear due to past bad experiences and sensitivity—people who like to pet dogs or cats know what I mean. Both the “shy” and the sensitive animals may hang back and watch you rather than rush forward. But the sensitive ones are alert, curious, and come forward eventually, deciding about you and then sticking to that decision the next time you meet. The frightened ones can barely look at you, are tense, distracted, and miserable, and may never come forward, or if they do, you have to go through it again the next time around.

It is also true that once HSCs have had bad experiences or feel unsupported, then when they do pause to check they cannot compare the new situation to old ones and assume all is well, so they truly are fearful. But to think of these children only as fearful is to miss their essence and especially their assets. When we see a lovely fair-skinned person with blond hair and blue eyes, we don’t say, “Oh, look at that skin cancer – prone person.” So why focus on the greater potential for fear in HSCs? It is important to regard every personality trait as having a purpose and to focus on the situations in which it is adaptive as well as the times when it is not.

In the same vein, HSCs are not born “shy.” I doubt anyone is born shy in the sense of fearing the negative opinions of others and being seen as not good enough. Of course, the word shy is loosely tossed around, especially about those who hang back for any reason. “Shy” is even used with animals—people will say that one in every litter is born “shy.” But when it is used in this loose way to describe any kind of hesitance, again, you are probably inaccurately labeling a child who is actually an HSC.

I was present on the first day of preschool for both my son and, fifteen years later, my nephew. Both boys, both HSCs, stood at the back of the room, just stunned by all the kids, toys, and activity. I could tell they were not afraid. They were just watching, fascinated. Both times a teacher came up and asked them if they were “shy” or “afraid.” The labeling had already begun for them.

Third, introverted HSCs do not “dislike people.” Introverts simply prefer being with one or two close friends rather than in large groups or meeting strangers. Another way to think of introverts is that they prefer to step back and reflect on what they encounter; extroverts prefer to rush forward. Introverts value the inner, subjective experience of what they encounter; extroverts value the outer, “actual” objective experience.

As I said earlier, when I began my research, I thought sensitivity might be the same as introversion, and by the last definition, it is. But most people think of introversion and extroversion as a description of how sociable one is. And by that definition, as I’ve said, about 70 percent of HSCs are introverts, but not all; some are extroverts. And not all social introverts are highly sensitive. Are introversion and extroversion inherited differences? We do not know for sure. What matters is that you know your child’s preferred, most comfortable style.

Fourth, your child is not even “overly sensitive.” Professionals with a medical background tend to think of sensitivity as a disorder, a problem of being “too sensitive” and unable to filter or coordinate the information they take in. For example, occupational therapists who use Sensory Integration Therapy to treat real problems include “oversensitivity” as a problem, as if it can be cured.

I do not wish to be critical of Sensory Integration, however. Certainly, sensitive children, like all children, may have a sensory integration problem. These show up as difficulty with balance, awkwardness or stiffness of motion, lack of coordination, and so forth. Many parents have told me that they found Sensory Integration very helpful for their HSCs, although it takes time. But I do not think being sensitive as I have defined it is a problem to be treated, much less cured. (Whenever anyone says an HSC is “overly” sensitive or taking in “irrelevant” information, I think of Sherlock Holmes, who found everything relevant.)

Finally, HSCs are not mentally ill and will not become mentally ill unless put under unusual stress. As Jerome Kagan of Harvard said about “highly reactive infants,” 90 percent do not become consistently inhibited or anxious as adults. Studies of adolescent anxiety finds it unrelated to shyness in early childhood, except in rare cases in which the families already had members with anxiety disorders. Finally, there is my own research, which indicates that those HSCs with reasonably normal childhoods were no more prone to anxiety, depression, or shyness than non-HSCs.

Furthermore, two studies have found that “reactive” children (HSCs) with good childhoods are actually less likely to have physical illnesses or injuries than non-HSCs (suggesting they are emotionally healthier as well).

STILL UNSURE IF YOUR CHILD IS AN HSC?

At the start of the chapter I said that a good way to know if your child is an HSC is simply to read this chapter and see if it fits. To help you draw your conclusion I need to make a few more comments.

First, your child is probably not an HSC if he is sensitive about only one thing, or only about something that would be expected for his age. For example, most children develop a fear of strangers in the second half of the first year, and become fussy about how things are done when they are two. Most young children are bothered by very loud noises and separations from their parents. They almost all have some nightmares.

Your child is also probably not an HSC if there was no sensitivity or fearful reactions until a big stress or change in the child’s life—a new sibling, move, divorce, or change of caregivers, for example. If your child’s personality has undergone a sudden, persistent, disturbing change—such as becoming withdrawn, refusing to eat, developing obsessive fears, picking fights constantly, or developing a sudden, very negative self-image or sense of hopelessness—that needs to be checked by a professional team, which usually includes at least a child psychologist, child psychiatrist, and pediatrician. An HSC’s reactions are fairly consistent from birth, not a sudden change, and not purely negative.

HSCs have responses that are more pronounced than those of a non-HSC, but they are within the normal range for HSCs, and the normal range on most other behaviors. They start to talk and walk at about normal times, although slight delays are common in toilet training or giving up a pacifier. They are responsive to people as well as to their environment, and eager to communicate with those they know well. And while young HSCs may refuse to talk at school at first, they should be talking at home and with close friends—that is, they should be relaxed in familiar surroundings.

HSCs and ADD

I am always asked about the relationship between the trait of sensitivity and attention deficit disorder (ADD). On the surface, there are similarities, and some professionals think many HSCs are misdiagnosed as having ADD. And, I suppose, it is possible for HSCs to have ADD. But the two are not the same at all, and in some ways are, in fact, opposites. For example, there is more blood flow to the right side of the brain in most HSCs, more to the left in those with ADD. Children with ADD probably have very active go-for-it systems and relatively inactive pause-to-check systems.

Why are the two confused? Like children with ADD, HSCs can be easily distracted because they notice so much (although at times they are so deep in thought they notice very little). But ADD is a disorder because it indicates a general lack of adequate “executive functions,” such as decision making, focusing, and reflecting on outcomes. HSCs are usually good at all of this, at least when they are in a calm, familiar environment. For whatever reason (the cause is not known), children with ADD find it very difficult to learn to prioritize, to return their attention to what they are doing once they have glanced outside or know the teacher is not talking to them personally.

Again, HSCs can generally tune out distractions when they want to or must, at least for a while. But it requires mental energy. Thus another reason HSCs can be misdiagnosed as having ADD is because, if the distractions are numerous or prolonged, or they are emotionally upset and thus overstimulated already from within, they may very well become overwhelmed by outer distractions and behave as if agitated or “spacey.” They may tire midway through a long, noisy school day because they have to make a greater effort than others to screen out distractions. Also, if they fear they will perform worse in a given situation because of overarousal and distractions—for example, during an important exam—they very often do become overaroused and therefore notice some distraction they could ordinarily tune out.

Teachers may suggest that an HSC has ADD because there is usually money for treating ADD, so the student who is thus diagnosed will receive special help—as discussed, high sensitivity is a less familiar explanation for unusual behavior. (There is also considerable controversy among those who study temperament about whether much of ADD is simply normal temperament variation that is, like sensitivity, misunderstood. For an interesting cultural discussion of ADD, with much to say to highly sensitive people as well, take a look at Ritalin Nation by Richard DeGrandpre.)

Autism and Asperger’s Syndrome

Usually, when a child has a serious problem, such as autism or Asperger’s disorder, the parents or pediatrician have spotted it early on. Autistic infants do not smile, imitate facial expressions, follow a pointing finger with their eyes, or mouth the syllables of language. At two or three they have little interest in others or responses to others’ needs and feelings. They apparently do not wish to communicate and do not engage in imaginary play, as far as we know. This is all very different from the behavior of an HSC, who is eager to communicate except when very overstimulated. High sensitivity is found in about 20 percent of the population; autism affects two to four children in ten thousand, and three quarters of them are boys. One is a normal variation, the other is a true disorder.

Asperger’s syndrome affects about one in five hundred children and is five times more common in boys. Such children often exhibit motor problems, such as strange postures, gestures not matching their speed, awkwardness, poor rhythm, and unreadable handwriting. An HSC during the stress of an examination might show poor coordination but not the other symptoms. Children with Asperger’s do seem to wish to communicate, but do so very poorly because they apparently lack an intuitive understanding of how to listen and when to talk. They cannot take hints, understand irony, keep secrets, or decipher facial expressions. They often talk monotonously on a subject no one else is interested in. None of this is true of a normal HSC.

The reason there is sometimes confusion here is that children with autism or Asperger’s are usually very highly sensitive to sensory input. But again, they are not sensitive to social input, or at least not in an adaptive way, which makes them very, very different from HSCs. I do not believe that HSCs are on some normal end of an “autistic spectrum,” although that argument has been made. A better description of children on the more normal end of the autistic spectrum would be those who are socially “odd”—eccentric, pedantic, or emotionally remote.

Again, normal children, HSCs included, are born ready and eager to relate; they are programmed for it. As we will see in Chapter 6 (#litres_trial_promo), they are probably already emotionally responsive to their mother even in the womb; children with these other disorders are not.

What to Do If You Are Not Sure