Highly sensitive adolescents in psychotherapeutic practice

Julia Lichte

The importance of apparently small things

Highly sensitive people often react to all kinds of stimuli such as light, noise, smells, materials and moods much more strongly and intensely than a person with ordinary sensitivity. Anna (16), a former patient, tells how she is “very porous for all kinds of impressions”, everything rushes in on her. This means that the therapeutic setting is particularly important. My practice room is furnished “minimalistically” in Anna’s opinion. Also important is the appropriate spacing of the chairs and the angle at which I sit facing the patient. Anna: “Therapy was the first time I was given the opportunity to determine my distance to another person myself. That felt incredibly good ...” The subject of distancing is of therapeutic value, particularly for this adolescent who often experiences her space as being invaded in contact with others.

The air in the room is also important. Thorough ventilation is essential since many highly sensitive people are very receptive for the moods and energy of others. Anna: “I sense how another person is feeling and automatically take in if they are stressed or depressed. It flows as if by itself through my boundaries, over my skin, into me. Since I find it incredibly difficult to distance myself in any life situation, I mostly cannot protect myself against it. My skin begins to itch, I want to shake off what pulsates in the other person – mostly without success.”

Creating security

Is an understanding and empathetic attitude enough? Particularly with regard to highly sensitive adolescents, I consider it important that they should feel themselves profoundly understood. Many highly sensitive people report that throughout their lives they felt misunderstood and as a consequence experienced themselves as alien and cut off. That can lead to deep insecurity, anxieties and limited self-confidence.

Another important element is how we look at one another: it is often uncomfortable for highly sensitive adolescents to make or maintain eye contact. They experience it as exhausting. A direct look can be experienced as invasive, demanding and irritating, thus making it more difficult to maintain themselves inwardly. I have trained myself to use a broad and soft look and ask whether my interlocutor is comfortable with that.

The same applies with regard to body contact: is it appropriate or sensible to shake a highly sensitive adolescent’s hand on meeting? I have become cautious, although it is something I like to do. It gives me additional diagnostic information when I can have a sense of what a hand feels like; but I ask first: “How shall we greet one another?” In that way I can find out what is felt to be comfortable or uncomfortable. Highly sensitive people mostly experience this as liberating and an invitation to take themselves seriously in the way they perceive themselves and take account of their own boundaries.

Even brief, accidental contact can leave a strong impression in highly sensitive people. Anna: “I experience touch particularly intensively. When people brush past me or deliberately tap me, that costs me a lot of strength and robs me of energy.” Physical contact therefore has to take place very mindfully and consciously.

“I’m OK” – Jan’s way

Jan, a fifteen-year-old pupil, came to me years ago because of anxiety about school.

In the initial therapy sessions I get to know a polite, very quiet boy with delicate features who can talk in a differentiated way about himself. I ask him whether there is something in his life that means a lot to him. “I love reptiles,” he says. He has several terrariums and withdraws to spend time with his animals when – I suspect – he wants to restore calm to his frequently over-stimulated nerves again, but also to recover his inner strength. School was a big subject. I feel the pressure on him. As early as in primary school, teachers had taken advantage of him because he kept to the rules. As he speaks, the old anxiety rises again: “It floods back.” I focus his attention on something stabilising: “Jan, what helps you in such moments?” He tells me how it helps him to take a step back to withdraw into the world of his reptiles. So I invite him to sit down with his animals in his imagination and he calms down.

I decide to continue working with him on a resource-based and in a stabilising way and to discuss with him what makes him feel good and gives him security: “How are your geckos doing, Jan?” Unexpectedly and with surprise he responds that one gecko has become more trusting recently. But if there are any changes in the terrarium he withdraws immediately and might even enter a state of shock. This description offers me a wonderful entry point: “How do you deal with something new?” I learn that change is difficult for him too. It leads him to occupy an observer position at the periphery, above all in group situations. That gives him security. Being in the middle of a group, in contrast, triggers massive stress reactions and the impulse to escape.

Jan’s reactions are widespread among highly sensitive people. I reinforce that it is good that he is aware of them and can take account of them. I am curious to know how he survived the crowds of people at the Christmas bazaar in the school. He answers: “I was the parking attendant!” We both laugh. At the end of the hour, Jan responds to my question what he would take away from the session: “I’m OK.” Once trust has grown, I ask him whether he could imagine coming to therapy by bus instead of being driven by his parents. He investigates it and succeeds in coming to the therapy session by himself. I am able to start confronting him with things and don’t have to treat him with kid gloves.

In a lineup of his class with selected teachers he places himself at the periphery but nevertheless in the middle of his peer group. He distinguishes between teachers who see him and can thereby rouse his interest for a subject and those who neglect him and therefore make him feel hurt. It is important for Jan whether he feels seen or not. He himself sees people in a detailed and precise way – one of his strengths. In response to the question whether there was anyone in his class who was like him, he names a male and a female friend. He can describe the commonalities and differences between them in great detail. I affirm that it is important to know about these two people. Jan is very surprised that he has many more similarities with them than he thought. He notices that he is not alone – with evident relief.

Being different

I ask Jan whether he has a feeling of “being different” – a key point among highly sensitive people. He talks about the past: “I felt myself as not belonging. I perceived things differently, above all joyful and stressful things. I often felt alone, as if cut off, isolated, sometimes lonely. I wondered whether my perception was correct.” These doubts made him insecure and he experienced himself as being less close to people. Then he adds: “There’s also something good about not being the centre of attention. I always have to remain a bit outside.”

How is it today with contact with other people, I ask Jan, and learn that he is well able to perceive whether they give or deprive him of energy. I encourage him to act with that in mind – in other words to avoid or distance himself from the latter. Jan is surprised, having so far felt he should put up with it.

That Jan’s focus is now shifting to the nature of relationships is confirmed when he tells me that during the holidays he consciously experienced and enjoyed the warmth and openness in his family.

A health problem arises which is familiar to Jan from the past. It is associated with bad memories, anxieties and the feeling of helplessness. How does he deal with it today? I am surprised by his clear voice: “I am much more confident today. I can judge and understand things much better.” He had greater control over his anxieties and his fear of school was receding. Previously, the anxieties had destroyed and drowned everything like a flood. Today it was just a wave that arrived and, before he knew it, had passed – no longer everything under water. And he noticed that today he tended to be angry with the teachers who had made him feel hurt rather than sinking into depression.

Spontaneously he calls out: “What the hell are they doing with their pupils?” I ask him there and then to stand up and repeat that sentence standing up. He does so several times and each time I encourage him to express this old anger ever more powerfully and with the whole of his body. And he does something that a few minutes earlier still seemed unthinkable. It is as if he were shedding shells of shame and embarrassment and finding his strength. Jan says: “Now I no longer feel at their mercy.”

I build on his physical and mental strength and suggest that he should start doing a group sport again which challenges him physically, makes him sweat, in which he has a sense of himself but in which he can also show his abilities. Jan fends that off, he had already tried a number of things. He suggests that he could meditate again. I protest: “No, Jan, this is not about inner contemplation but about communal activity.” Jan smiles. After a bit of thought he suggests laser tag – a sport which alongside speed, physical strength and agility also requires the voice. That is well suited for him! In the next few weeks, he manages with friends to put this idea into practice.

Curse or gift

It has been clear to me for a long time that Jan is highly sensitive. Is he aware of it?

I set up a selection of various toy animals – a giraffe, swan, deer, leopard, seal, wolf, fox, tortoise, frog, ray, eagle – and ask Jan to imagine as what animal he was born. He promptly answers: “As a tortoise!” I learn that Jan has an incredible amount of knowledge about tortoises. Another resource! They were peaceful animals about which not that much was known; they had enough time for everything they wanted to do since they grew very old. They were animals without enemies, liked to live in groups because otherwise they could become depressed. They could withdraw into themselves at any time and their shell offered strong protection. On the one hand they were slow, but they could also flit. If they had a goal in view, they would not let any obstacle put them off! Now I stand up and clear all animals from the board so that only the tortoise is left sitting there. Jan looks at it and is visibly moved. He feels a connection and murmurs: “What a comfort.” Without having to say anything it is clear to both of us how many characteristics of the tortoise also apply to him. This identification will further strengthen Jan in what he is.

It turns out that Jan is well aware of what highly sensitive means: “I simply perceive more. Just because we don’t like to approach you and don’t say a great deal doesn’t mean that we aren’t interested in you. We simply need more quiet and therefore sometimes react by holding back. But highly sensitive can mean a lot of things. One person might have a greater perception of the vibes and atmosphere in a room, another of smells and sounds ... I feel highly sensitive in contact with people and animals. I perceive whether the cat I am stroking is feeling well, what it is feeling. That is a gift. With regard to people that sensitivity tends to be a curse rather than a gift. I perceive crude people and subtle passive-aggressive remarks particularly strongly ...”

Jan was able to reduce his school phobia to a considerable degree in therapy. He became less self-conscious in his contact with other people. The conscious way he deals with his high sensitivity gives him greater security in life.

If their complex perceptions are dealt with in a mindful way, highly sensitive adolescents can open up a way to their inner treasures in psychotherapy which can be like a release. For me as a therapist, it is moving and enriching to accompany them on this path.

About the author: Julia Lichte is a body therapist using depth psychology (HAKOMI®) and trauma therapist in Lübeck. She has many years of experience accompanying highly sensitive people. www.julia-lichte.de