Highly Sensitive People and EMDR Therapy

Tell us a little bit about you, your experience becoming an EMDR therapist, and your experience working with highly sensitive persons (HSP).

I became an EMDR therapist shortly after going into private practice. I was shocked at how effective it was, so I quickly incorporated EMDR therapy into my practice. Soon, EMDR became my main modality because it helped my clients so much more than other treatments. However, standard EMDR protocol wasn’t that effective for me. I have been extremely sensitive my entire life to smells, fabric, chemicals, foods, sounds, and bright lights. There were aspects of the way I was taught EMDR that did not work for me. So, I developed a secondary practice, specifically geared toward sensitive people.

Can you help us understand more about HSPs?

First, the definition of a highly sensitive person (which is not a diagnosis in the DSM, but rather a personality trait) is self-evident by its name. People who are highly sensitive react much more strongly to stimuli in their environment than those who are “normies” (neurotypical individuals). The psychologist Elaine Aron championed the term HSP (https://hsperson.com/), but most people I know with this condition are already quite aware they are “different.” They often see this high sensitivity negatively, as evidence of being neurotic, a “head case,” “high maintenance,” deeply flawed, weak, needy, and/or overreactive. As children, they may have been called whiny, “cry babies,” or too sensitive. For them, finding out that as much as 10% of the general population also identifies as HSP, that there is nothing wrong with them, and that there are techniques they can be taught to cope with sensitivity, is very relieving.

When you are highly sensitive, you react to the world in complex ways. For example, subtle expressions or comments, sounds, textures, smells, and tones of voice can be more triggering than for neurotypical people. In my clinical opinion, as a result of this sensitivity, HSPs are more likely to experience higher levels of trauma in life. Situations that may have been somewhat bothersome for siblings, for example, can be highly traumatic for an HSP. Relationships can be fraught with difficulty, as neurotypical partners may become impatient or irritated with the HSP’s reactivity, perhaps to the point of believing their HSP mate is making up symptoms or has become a hypochondriac. Using EMDR to work through their traumatic issues in general, as well as those related to being HSP, normalizes their experiences, empowers them, and provides tools to help them cope

How can EMDR therapy help HSPs? What successes have you seen?

I believe EMDR therapy is probably the best means of helping people with HSP, because EMDR depends upon the client revealing and leading the way. It is a quiet, subtle therapy. In addition, EMDR reprocessing works extremely well with highly emotive individuals, such as HSPs. Ideally, HSP’s can also choose how to best process the information, whether with eye movement devices, hand buzzers, earphones, or alternate tapping. This allows them to focus on the best means of stimulating their body, as well as controlling the intensity and the frequency. For most of my HSP clients, I have found that simple tapping on the thighs or hand buzzers work best. The eye movement devices can create eye strain, and the earphones may be too distracting.

To provide an example of how EMDR can be very helpful, I can share my experience. I have had a few HSP clients with severe mast cell disorder (https://www.aaaai.org/conditions-treatments/related-conditions/mcas). In my clinical experience, it is common for HSP clients to have health problems because their systems are so sensitive. As clinicians, we are understanding more and more that all of the systems, physiologically and psychologically, work together as one unit. So when someone is able to create calm, positivity, and healing within the brain as a result of reprocessing trauma, this is reflected in a decrease in inflammation not only in the brain, but in cortisol levels, and throughout the rest of the body. And the more I read, the more I realize that inflammation is at the root of almost all disease. In the case of my HSP clients with mast cell disorder, they greatly benefited from not only reprocessing and releasing the psychological traumatic experiences, but also the physical trauma from suffering with the disease. In addition, their physical as well as psychological symptoms decreased dramatically.

Are there cautionary measures you would like to mention regarding the use of EMDR therapy and HSPs?

Many of my HSP clients have been pathologized by their past therapists. They were diagnosed as borderline or narcissistic, perhaps because the therapists saw the clients as easily triggered and very self-involved. However, if you are extremely sensitive, that is part and parcel of the course of your life. You are constantly trying to figure out how to fit in, how to make yourself less reactive, and how to deal with all of the assaults on your senses, while remaining “normal” to the outside world. It can be exhausting. Once you have a road map for understanding that it has to do with being HSP and neurodivergent, you can look for EMDR clinicians who know how to work specifically with HSP issues. Honestly, once somebody knows they are HSP, and they are able to one by one resolve their trauma through EMDR therapy, they are good to go. Most of the anxiety, depression, and other symptoms dissipate and decrease.

Are there any myths you’d like to bust about using EMDR therapy with clients who have high sensitivity?

Perhaps that it will take a lot longer to help them because they’re so sensitive. I have often found the opposite to be true. When I work with these types of highly sensitive people, who almost always have keenly intelligent minds, they understand and get things very quickly and often process at tremendous speed.

What multicultural considerations might EMDR therapists need to keep in mind regarding EMDR therapy and high sensitivity?

Every characteristic about someone that makes them “different” will impact their level of trauma. That may be the color of their skin, their culture, their religion, their sexuality, their gender non-conformity, or their class. When you add HSP into the mix, it means that the trauma levels are even higher. I strongly recommend, not just for HSP clients, but for all clients, to always start with the lowest subjective units of disturbances (SUDS) first. I rate all disturbances right in the initial assessment. This helps me create a SUDS roadmap, moving forward, having found some lower disturbances to start with. If you try to begin your work with a SUDS above five, it may well trigger the brain into resisting, or even increase symptoms temporarily. The problem is, most clients won’t tell you which disturbances are lower, because they are so focused on trying to get rid of the things that are bothering them the most. My best practice suggestion is to rate all of their issues from birth forward, to find the lower level SUDS.

Do you have any favorite free EMDR related resource that you would suggest to EMDR therapists interested in learning more about using EMDR with HSP or high sensitivity?

Check out Elaine Aron’s website to learn more about high sensitivity (https://hsperson.com/). There is a free test there where people can explore high sensitivity if interested. I know there are other online tests as well.

There is also an awesome book, called Divergent Mind by Jenara Nerenberg, that I highly recommend. As a female, she provides a very different explanation for atypical and neurodivergent behavior that is extremely helpful, in contrast to most of the research and books that focus on CIS male neurodivergence.

What would you like people outside the EMDR community to know about EMDR therapy and HSPs?

There are probably far more clients who are HSP than clinicians realize. In phase one of EMDR history taking, EMDR therapists can ask simple questions about sensitivity to sounds, smells, touch, and sight that can help determine high sensitivity. If they are interested, encourage the client to explore more by using one of the online tests. As is always the case with someone who is presenting with a characteristic or way of being that you’re not sure about, ask them what works for them.

Jennifer Holt, Ph.D. (she/her) has been a practicing therapist for nearly 30 years, with EMDR a primary modality for 20 years. In addition to HSP’s, Dr. Holt enjoys working with diversity in all its varied forms, specializing in trauma and forgiveness. For her next career, she is looking forward to working internationally with victims of war.

Resources

American Academy of Allergy Asthma and Immunology. (2025). Mast cell activation syndrome (MCAS). Webpage. https://www.aaaai.org/conditions-treatments/related-conditions/mcas

Aron, E. (2025). The highly sensitive person. Website. https://hsperson.com/

Nerenberg, J. (2020). Divergent Mind: Thriving in a world that wasn’t designed for you. Harper Collins.

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