This is the third time I have tried this—beginning with a report of some of the latest research, and then in the second part exploring something “Spiritual.” Here are the five studies I selected for Part I. There were others—more and more research is being published on HSPs. But I thought readers would gain the most from these.

CLARIFYING SPS, AUTISM, AND ADHD–AND MUCH MORE

Damatac, C. G., ter Avest, M. J., Wilderjans, T. F., De Gucht, V., Woestenburg, D. H., Landeweerd, L., … & Greven, C. U. (2025). Exploring sensory processing sensitivity: Relationships with mental and somatic health, interactions with positive and negative environments, and evidence for differential susceptibility.  Current Research in Behavioral Sciences ,  8 , 100165.

We are often asked about the relationship between Autism Spectrum Disorders (ASD) and SPS as well as its relation to Attention Deficit Disorder (ADHD). This complicated, ambitious study looked at both these issues as well as differential susceptibility to mental and physical health and life satisfaction. In case you get mired down in the details, here is what you probably most want to know: This study did not find that overall the measures they used for autism, ADHD, and SPS were measuring something similar. However, factors within the measures overlap. That is, there is an overlap in some areas but not all. Some of the same people answer yes to items on two or three of the measures.

The participants were 252 adults from the Netherlands’ Healthy Brain Study, which includes 1000 persons selected to be a good representation of the larger population, except all are aged 30–39 years (in the midst of life, past thresholds like marriage, first child, and first job). They filled out several measures, but most important for us, they took De Gucht’s measure of SPS, involving six factors. These are similar to the HSP-R’s six factors, except the De Gucht measure (the Sensory Processing Questionnaire or SPSQ) does not include depth of processing. To make sense of the rest of the study, you need to know what these six are:  Sensory Sensitivity to Subtle Internal and External Stimuli, Emotional and Physiological Reactivity, Sensory Discomfort, Sensory Comfort/Pleasure, Social-Affective Sensitivity, and Esthetic Sensitivity. (Clearly this is very similar to the revised HSP Scale, the HSP-R.)

Importantly, there was no statistically significant association between De Gucht’s overall measure of SPS and the six-item ADHD measure or the longer measure of ASD. That is, this study does not support the idea that SPS is simply either ASD or ADHD. There were however associations between SPS, ASD, and ADHD on some SPS factors: “Sensory sensitivities” and “emotional and physiological reactivity” from the new measure and “ease of overstimulation” from the old HSP Scale are features that high SPS, ASD, and ADHD have in common. That is, these specific traits or experiences are common for all three to some degree, which is why they can seem to be the same trait if one only looks at being easily overstimulated. 

As for ASD in particular, among the subscales of the ASD measure (which were attention to detail, childhood behavior onset, limited imagination, limited social skills, and rigidity), “limited imagination” was especially not associated with SPS and among the SPS factors, “sensory comfort” and “social affective sensitivity” were not associated with ADS. That is, these are ways SPS is not like ASD. Regarding ADHD, only the “inattention” aspect of that measure had small associations with subscales of SPS, mainly, again, “higher emotional and physiological reactivity.”

The study also tried to look at both positive and negative environments, in childhood and in the present, in order to continue to understand differential susceptibility, the tendency for HSPs to be more affected than others by both good and bad environments.  As expected, HSPs with positive histories and present situations reported more life satisfaction than those without the trait, while those with negative histories and present situations were more likely to have autistic traits (that is, they answered yes to more items on the ASD measure).

An odd result was that HSPs who had more of what were called “uplifting” events during a given week were more likely to exhibit autistic traits!  But most of these uplifting events were very stimulating: Relating well with your spouse or lover; relating well with friends; completing a task; eating out; visiting, phoning, or writing someone; or spending time with family.  These all could be a source of overstimulation and increase emotional and physiological reactivity, an SPSQ subscale correlated with autistic traits. My guess is that by the time an HSP has been “uplifted” by some of these, they will want to withdraw, as measured by items on the autism scale such as “not liking parties” or “not liking having your daily routine disturbed.” I think the point is that it can be difficult to find the right measures of positive outcomes for HSPs—what is “uplifting” for others may not be for us.

The authors also looked at health, and found that higher SPS related to more burnout, anxiety, depression, stress, health complaints, and nonprescription medication use, even after controlling for neuroticism.  However, other studies I have cited [link to that blog https://hsperson.com/are-highly-sensi... ]indicate that stress may be the main underlying cause of health complaints in HSPs, but this study did not separate out stress. 

This is a complicated study, and I am sure I have not done it justice.  But it is a fine example of what is to come in research with SPS—for example, more teasing out of the differences among ASD, ADHD, and SPS, and more detailed studies of differential susceptibility.

Bottom Line:  Again, this study did not find that overall measures of autism, attention deficit disorder, and SPS were correlated.  That is, SPS did not appear to be the same as either trait.  However, factors within the measures did correlate with SPS.  That is, there is an overlap in some areas but not all.  And if an HSP had a negative history, or too many “uplifting” experiences in a week, they scored higher on some aspects of the measure of ASD. (And remember, it is possible to be an HSP AND in addition to having ASD or ADHD.)  But they are not one, single trait or condition.

HIGHLY SENSITIVE ADOLESCENTS FEEL MORE PHYSICAL PAIN THAN OTHERS

Hochreuter, J., Wehrli, S., Locher, C., Lionetti, F., Kossowsky, J., Pluess, M., & Koechlin, H. (2025). Painfully Sensitive: How Sensory Processing Sensitivity Affects Healthy Adolescents’ Perception of Pain.  Journal of Pain Research , 719-733.

A hundred healthy adolescents, aged 16 to 19, completed questionnaires and participated in an experimental heat pain paradigm.  As a direct measure of pain, participants were asked to raise the intensity of the heat on their hand until it became “painful.” How high that level was and how  long it took to reach that level was the direct measure of pain.  This was done three times, and after each time all participants were asked to report how painful it had been, from zero to ten.  Highly sensitive adolescents were more sensitive to pain than others as measured during the procedure itself,  However, they did not report experiencing more pain than others.  

In another part of the experiment, all participants were shown photos intended to make them happy, sad, or neutral, to see if this affected their experience of the pain, but these had little impact on any participants (the authors realized the photos they used were so dated—puppies, birthday cakes, snakes, auto accidents), they were not likely to affect any modern adolescent!).  Finally, the authors used questionnaires to look at the quality of parenting these teenagers were receiving, their social support, and their emotional regulation.  None of this had very much effect on any participants’ experience of pain, even HSCs. That is, regardless of other factors, HSCs  simply physically felt more pain.  

Bottom Line:  I repeat, HSPs, at least in adolescence, seem to be more sensitive physically to pain, even if they do not report it.  (This makes me think of the many HSPs who have told me that they know they are more sensitive to pain than others are, but are not very inclined to admit to it—that is, complain about it. How many times have we been told “Don’t be so sensitive?  It’s nothing.  It’s all in your head!”)

HARDLY “BREAKING NEWS”: GOING TO THE DENTIST IS MORE STRESSFUL FOR HSPS

Golonka, K., Gulla, B., Kościelniak, D., Darczuk, D., Cienkosz-Stepanczak, B., Bystrowska, B., … & Krzyściak, W. (2025). Sensory processing sensitivity in adult dental patients and its relation to perceived stress, cortisol, and serotonin secretion.  Scientific Reports ,  15 (1), 1-14.

This study looked at adult dental patients (N = 157) on the day of a routine dental visit. Patients took the HSP Scale, a measure of feeling stressed, and one of positive and negative emotions, plus various biochemical tests. The higher the patient’s score on the HSP Scale, the more they reported feeling stressed and having negative emotions, plus they had higher levels of cortisol (a sign of stress) accumulated over the last few months as measured by hair samples. The authors saw various reasons why this would be so and suggested some effort could be made to help HSPs during dental appointments. 

Okay, I will make this personal.  Thank goodness and amen.  For me, going to the dentist has always involved stress, how much depends on what is being done and the kindness of the dentist.  To keep the stress from ruining my life for weeks in advance of the appointment, I learned not to think about it until the day I was going.  And I have always taken crazy care of my teeth to avoid anything difficult. But just getting my teeth cleaned is painful.  (It is not painful for my non-HSP husband, who falls asleep during teeth cleaning).  The last time I had my teeth cleaned I took two acetaminophen beforehand and it actually helped.  I’m not saying you should. It was probably just a placebo effect.  But the big point is, if going to the dentist bothers you, it’s probably your sensitivity—to pain, to anxiety about the condition of your teeth, to fear of criticism for not taking proper care of your teeth, and all the rest.  Once again, high sensitivity explains us to ourselves.

Bottom Line:  Especially given that HSPs are usually physically more sensitive to pain (see above), it might not be surprising that going to the dentist makes them nervous.

HSPS MAY BE ABLE TO ACHIEVE A BETTER QUALITY OF LIFE THAN OTHERS WHEN DEALING WITH CHRONIC ILLNESS

Bakhshayesh Eghbali, B., Hosseini-Nejad, M., Saadat, S., Babaee, M., Eyvani, K., Kohandel, K., & Shabani Chobe, M. (2025). The Role of Sensory Processing Sensitivity and Self-management on Quality of Life in Multiple Sclerosis.  Caspian Journal of Neurological Sciences ,  11 (1), 67-76.

This study provides a sense of how being highly sensitive can actually help a person living with a serious illness.  Multiple sclerosis (MS) symptoms lead to all sorts of impairments that predict limitations, unemployment, and withdrawal from social and leisure activities.  This study used questionnaires to measure health related quality of life, SPS. and “self-management.”  These were given to 320 “relapsing-remitting” MS patients registered in the nationwide MS registry of Iran.  

I found self-management an interesting concept.  It refers to how much a person actively copes with a chronic illness through, for example, adherence to treatment and medication, participation in medical decisions, self-care, maintaining social relationships, and keeping one’s emotional balance.  That is, it is learning and using the skills necessary for an active life and a satisfactory mental state while living with a chronic disease.  The measure tapped five areas of self-management, including communication with health care providers, treatment adherence, knowledge of MS, and overall health maintenance behavior.  

The findings showed that the quality of life in people with MS was higher if they were both highly sensitive and if they scored high on self-management.  They did not report the correlation between the two, but I would guess it is high.  They studied SPS because they thought people who are more aware of sensations in their bodies might manage their illness better, and if being overstimulated bothers them, that they might be better at reducing it and thus improving their well-being.  But we know HSPs would also process everything about the illness more deeply, which would certainly lead to better self-management.  I hope someone repeats this research looking at other long-term illnesses, to see if being an HSP improves outcome.

Bottom Line:  This opens a new avenue of research, into whether and how HSPs might be better patients, by paying more attention to their bodies, to professional advice, to details about any illness they are dealing with, and to their own individual needs.

ONCE AGAIN—HSPS BENEFIT MORE THAN OTHERS FROM BEING CONNECTED WITH NATURE

Wigley, I. C. M., Nazzari, S., Pastore, M., Provenzi, L., & Barello, S. (2025). The contribution of environmental sensitivity and connectedness to nature to mental health: Does nature view count?.  Journal of Environmental Psychology ,  102 , 102541.

This is yet one more study about HSPs benefiting from being in nature—in this case, living with a view of nature (trees, a garden, or a park)).  In a sample of 807 Italian citizens, it was found that those high on the measure of SPS were more at risk of reporting symptoms of stress, anxiety, and depression, but feeling connected with nature reduced this risk.  Being connected with nature was of course associated with exposure to nature, so this study tested whether, particularly for HSPs, having a view of nature would have this same positive effect on connectedness with nature and on mental health, and it did. That is, visual exposure to nature appeared to enhance the feeling of connection to nature, particularly among HSPs, thereby mitigating the risk of psychological distress. 

Bottom Line:  Most HSPs know this very well, but the research continues to show it:  Feeling connected to nature really helps us, and just being able to see it in our daily lives can do that.  So try to make it a priority to live or work, preferably both, where you have a view of nature.  And while they did not study it, having plants in your house or pets, even goldfish, may help too!

Part II

The Container and the Contained

Have you ever thought (at any age)  that you are getting older but something in you is not?  That you are really the same person you have always been? 

Have you ever felt like you were witnessing yourself in a situation?  That you were not the “doer”? 

Who is that person that does not change, and the one that can witness without participating?  This is a huge subject, but let’s take on a piece of it.

In the second half of recent newsletter blogs I have been addressing “spiritual” topics, I guess in the classical sense of spiritual as opposed to material, since I began by writing about the possibility of experiencing two aspects to life, the relative and the absolute or transcendent.  In the second blog, I simplified matters by talking about expansion and contraction.  Even forgetting about anything absolute, we all know that there are expanded and contracted mental states. There is nothing wrong with contracted states.  We contract or constrict our awareness when we focus.  If you want to speak more philosophically (HSPs usually like to), ultimately, everything in the relative, material world is contracted in the sense it is one aspect of the whole.  Being expanded is when we relax those constrictions and see the bigger picture or enjoy some rest.

In this blog post I want to talk about these two aspects of life in a different way, the container and what it contains.  

The Contained?  What’s That?

As always, I hope to be both factual and practical. “By the container”, I mean our body, but we can extend that to everything else in the relative that “belongs to us”–our name, history, education, career, family.  All that is ours.  But the body is so central, because it at least seems that without a body, especially without a brain, everything else goes. We may forget, ignore, or deny our physical vulnerability until we get seriously sick or are caused to notice that we are aging.  (I secretly think there’s something mean about those birthday cards that make jokes of our adding another year.)

I am sure all of you view death and what does or does not remain after death in very different ways.  Some of you are already yawning–you totally believe in an afterlife.  Maybe reincarnation.  But others of you are already annoyed, that I would even bring it up.  When we die, everything goes. How is it factual or practical even to discuss it?

The Factual

True, it seems that just as most people only know about the relative and not the absolute field of life, most people only know about the relative container, the body, and completely identify with that. Yet the fact is that a vast number of people think they have a soul or spirit that lives on after death. Some people feel they have experienced it during a near-death experience.  The research on these experiences is quite solid and substantial (e.g., the work of Bruce Greyson).  Many say they have experienced visitations by a loved one who had died and was able to come back to speak to them or show them some sign of their presence. Further, every single religion (even Judaism) has some idea of the soul or spirit living on, reincarnating into a new body or eternally living in a place where the soul goes after death. 

Those are the facts of countless human experiences, and it can be hard to believe that so many are simply wrong–except you and me.  I’m saying “you and me” because I’ve never been sure what I believe about all of this.  (A friend who is certain about reincarnation teased me that it was my karma to be born with the burden of not believing I would be reincarnated.)  One practical part of the container plus contained perspective is that it really does change how you live your life if you are certain that death does not end it. 

But forgetting about the question of whether something survives death, some people I really respect have no doubt that the body is the container of something more. Indeed it seems to me that all spiritual teachers and writers have discussed it. For example, I like Thomas Merton on the subject of the “individual,” which our culture relentlessly encourages us to develop, to “self-actualize,” and the “person” God means for us to be, which we can only know when we let go of the outer trappings of ourselves and our lives and seek to do God’s will and to know God’s love.  

Then there is Ram Dass, that jolly, charming author of Be Here Now, who had a stroke in his sixties and then wrote Still Here to explore for us the issue of aging and death, using his personal experience.

The Practical

While I am not sure about life after death, like Ram Dass I know about life now.  After fifty years of consistent meditation practice and eighty years of living in my body, I have the clear experience of my body being the container of something else, a witness to it all, or the Soul as Ram Dass calls it.  This is not a belief, but an experience, and it is extremely practical. The experience can be overwhelmed for a time by something like being in chronic pain, a new scary diagnosis of something, or losing another activity that I once enjoyed. But that “this-is-it” feeling does not last. Without much of an effort, the transcendent–the Soul, the Great Whatever–prevails.  I just feel this equanimity return.  It is something big, boundless.  And I can tell that it is due to my not identifying with my body or its changes very much.  I am something else.  Again, it is not a belief or attitude. I experienced that. And it certainly makes aging and illness less difficult, so far.

Here’s another practical story:  I turned to Ram Dass after reading the transcript of an interview with Riyas Motan on “Buddha at the Gas Pump” (one of my favorite podcasts). Riyas was born in Kenya, of Indian ancestry, and while working as a psychotherapist, privately pursued a spiritual path until he had a permanent “awakening.”  This eventually led to his being given “dharma transmission” by one of his spiritual teachers, Adyashanti.  This meant he was considered evolved enough to teach others, so in a way it was the pinnacle of his life.  But four months later, this very health-conscious, spiritual man learned he had fourth stage, probably terminal lung cancer, and was plunged into the treatment for that. 

Adjusting to this extreme change in his life demanded that he use his spiritual life as never before to come to a place of not just acceptance, but growth.  After much inner work he says he is actually grateful for the cancer, saying that it “happened not to him, but for him.”  

That line really caught my attention.  He was quoting Ram Dass, who felt the same about his stroke, which left this dynamic man in a wheelchair and able to speak only very slowly.  How does one get to that place of feeling this is the best thing that could have happened to me?  Not easily, when you live in a culture that focuses entirely on the body and its health, as if that is all you are.  But Ram Dass has a lot to say about undoing that perspective in his Still Here.  And it comes down to finding a way to get to know the difference between the container and what it contains.  Of course the container, the body, is important. The contained must have a container.  But how many of us really know the contained?  Really can identify with it?  

How to get there is another subject, so complex that it led me to spend five years researching and writing a book about it, Spirituality Through a Highly Sensitive Lens. It will be published next spring, but in the meantime I hope these blogs will give you some ideas. It is always, in the end, a very personal journey to reach a place like that of Thomas Merton, Riyas Motan, or Ram Das.  But I wanted to make it clear that it can be done. By anyone.