“Don’t Be So Sensitive!” The HSP Throughout History

Source: Mauro Mora, Unsplash

“Kristen… had such a crisis the year she started college. She had attended a low-key private high school and had never been away from home. Suddenly, she was living among strangers, fighting in crowds for courses and books, and always overstimulated... Kristen was on the edge” [1]

“Kristen” was one of psychologist Elaine Aron’s interviewees who would qualify as a “highly sensitive person,” or HSP—a term Aron coined in 1990 as a result of her work on sensitivity. Highly sensitive people are higher in what's known as sensory processing sensitivity, or SPS. (SPS is different from sensory processing disorder (SPD), which is currently conceptualized by some as its own condition.) As neuroscientists and psychotherapists currently understand it, the HSP’s experience involves a “greater sensitivity and responsivity to environmental and social stimuli” and arousal by new or prolonged stimulation than non-HSPs. [2]

Some researchers have described sensory processing sensitivity as a continuum using a flower metaphor: people have either particularly low sensitivity (these are the dandelions), medium sensitivity (the tulips), or high sensitivity (the orchids). [3] Those with high sensitivity (the orchids) are thought to make up roughly 15 to 20 percent of the population. [4] Overall, these HSPs will be sensitive to any or all of the following: sensory stimuli, overstimulation, and/or aesthetic quality of objects or surroundings. [5]

HSP and Hysteria

But the personality trait of “high sensitivity” is not a new or singular one by any means. Over 150 years ago, nerve doctors and alienists (the nineteenth-century term for psychiatrists) depicted “hysteria” as a sensorial-emotional problem, too.

During the Victorian era, women were understood to be biologically prone to environmental, social, and biological stimuli. Despite the many and sometimes conflicting narratives around hysteria, impressionability (susceptibility to sense impressions) and vulnerability through the senses reemerged in semi-revised, yet consistently pathologized, ways in medical texts about hysteria.

What, then, if “hysterics” live among us still? And not only those who have received the DSM diagnoses of conversion disorder and histrionic personality disorder—but also, revised and reconceptualized, the 20 percent of us who qualify as HSPs? Examining our modern understanding of “sensory processing sensitivity” and comparing it with how doctors talked about hysteria in the Victorian era can open up new ways of thinking about how we view people’s sensorial-emotional experiences today.

“Curing” the Hysteric, Then and Now

Our culture tends to think about illness in terms of a familiar medical narrative moving from catalyst to crisis to cure. The catalyst is what triggers or sets off the unwellness in the first place. The crisis is the experience (or representation of the experience) of the unwellness itself. The cure is what will remedy the unwellness.

Nineteenth-century discussions of hysteria and twenty-first-century discussions of sensory processing sensitivity both seemingly follow a similar medical arc from catalyst (trigger) to crisis (unwellness). Sensitivity to emotional and sensorial impressions (catalyst) can make an individual susceptible to crisis (unwellness): a hysterical fit for the hysteric or TMI (transmarginal inhibition) stage for the HSP. But what makes an individual sensitive and vulnerable to the catalyst in the first place? And, on the tail end of the catalyst-crisis-cure narrative, what is the proposed “cure” for the impressionable hysteric or for the HSP?

When I examined texts on hysteria in light of contemporary HSP research, one thing in particular came to the forefront: unlike the hysteric of the mid-1800s, the HSP is beginning to break free from the need to be cured. The research on the HSP implies that, rather than treating the person as psychologically and emotionally abnormal and unhealthy—and therefore “curing” this person—we as a culture need to understand and support their sensitivity. Today, in the psychology texts at least, if not in the broader culture, we are beginning to chip away at the medical narrative that has long stigmatized emotion.

The striking central overlap between the nineteenth-century hysteric and the contemporary highly sensitive person is how the medical and psychological texts narrate the sensorial-emotional experience as one of overarousal and shutdown for both. The HSP’s experience of the so-called “crisis” begins with awareness of subtleties and deeper processing of these environmental subtleties. [6] This processing of stimuli is—as it was for the hysteric—wrapped up in emotion and emotional reactivity. [7] Coupled together, this higher degree of environmental sensitivity and emotional reactivity can cause the HSP to “become overaroused and overwhelmed by sensory inputs, such as strong smells, loud noises, bright lights, and strong tastes” as well as “social cues.” [8] These are the HSP’s catalysts, or triggers.

What this means is that HSPs often get rattled when they have a lot to do in a short period of time; they are often shaken up by changes in life; they frequently find themselves withdrawing during busy days to get privacy and a break from stimulation; they are easily overwhelmed by bright lights, strong smells, coarse fabrics, and/or crowds. [9] This sensitivity to social and environmental stimuli can lead to feeling, Elaine Aron writes, “overwhelmed or exhausted in a total-body, can’t-work, can’t-coordinate, can’t-relax, brain-frazzled way. [The over-aroused HSP] may have a pounding heart; churning stomach; trembling hands; shallow breath; or hot, flushed, damp, or cold skin.” [10] When this over-arousal hits the TMI threshold, the HSP "shuts down." [11]

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Similarly, Victorian medical texts claimed that overwhelming sense impressions could lead to disruptive emotion. Regulating external stimuli was crucial because it was through the shock of sense impressions that a woman (“hysterics” were usually women at that time) experienced disordered emotions and became hysterical. Hysteria was understood fundamentally as a sensorial-emotional malady.

Victorian physicians outlined overlapping theories: if environmental or social conditions caused strong emotion (such as surprise, joy, grief, or fright) in a woman and her physiological regulators were unable to temper the sensorial-emotional shock, [12] her sympathetic nervous system communicated nervous distress to organs throughout her body: her brain, heart, pharynx, or larynx, among others. [13] With multiple organs now under nervous, muscular, and/or circulatory distress, she experienced any or all of these symptoms: dizziness, fainting, paroxysm, nausea, feelings of choking or suffocation, trembling, sweating, etcetera. This was called hysteria. According to physicians, once a woman was physically and mentally in a hysterical state, she lost willpower and there was very little she could do to regain herself. [14]

Though the Victorian hysteric and contemporary highly sensitive person may appear similar in the descriptions of the “catalyst” and the “crisis,” they begin to diverge in their account of the “cause” as to why these individuals are sensitive.

The next part of this series (Part 2) will explore how the topics of gender, genetics, and parenting are essential to this historical divergence and differentiation.