(Part One: Getting the right physical care for you)

Google, ‘Self-Care,’ and you’ll be met with over 51 million search results (!) and article headings with everything from, “7 Steps to Exquisite Self-Care” blog entries to vulnerable personal narratives (“My painful and terrifying tell-all about what happened when I neglected self-care, grew two heads, and then exploded!”).

We’ve gotten better at thinking about what it means to care for ourselves, and what that might look like at any given time, for a variety of issues and personality types. Putting the slight sarcasm from the previous paragraph aside, I actually think this is, generally speaking, a good thing.

What’s harder to find are resources on how to be cared for.

As a massage therapist and bodyworker working with people experiencing pain and stress, my views have evolved. Over six years and nearly 2,000 sessions ago, I had the somewhat naive thought that people just naturally knew how to seek the appropriate care, at the appropriate time, and to communicate with physical care providers in such a way that they’d receive what they needed and have their comforts met.

Not necessarily so.

Learning to be an adept recipient of physical care is much more nuanced and complex than I originally thought.

The topic seems to have a specific complexity for Highly Sensitive People (HSP). Though information about the HSP trait has grown and become considerably more available in the last decade or so, there are still many care providers who are, through no real fault of their own, unfamiliar with the matter and its implications for treatment.

On the flip side, it can be challenging to clearly communicate needs or preferences related to your highly sensitive nature (never mind communicate them on-the-spot during a session), especially if you are in the midst of learning about it.

What can often ensue are awkward or frustrating misunderstandings between client and practitioner.

There’s no need! That’s why I decided to begin compiling and sharing my thoughts on what it means to be cared for, specifically for Highly Sensitive People.

A little HSP primer: According to the pioneering work of Dr. Elaine Aron, people with the genetic trait of high sensitivity make up 15–20% of the population. Being highly sensitive is not a genetic defect or disorder. The trait’s scientific term is Sensory-Processing Sensitivity (SPS). The acronym, D.O.E.S., is used to summarize the main aspects of high sensitivity (Depth of Processing, Overstimulation, Emotional Reactivity/Empathy, and Sensitive to Subtleties). For more information and a self-quiz, www.hsperson.com is a great in-depth resource.

If you’re an HSP reading this, I hope the following talking points letter helps you more clearly and confidently articulate your needs and receive the care you deserve. It may even give you insight into the types of care or types of practitioners to seek. Feel free to print this out and hand it off, or draw inspiration and put these concepts into your own words.

If you’re a physical care provider reading this, I hope this helps you feel more confident in your abilities and successful in your work.

Please note: These talking points are specifically geared towards working with massage therapists and bodyworkers, physical therapists, chiropractors, and anyone using touch or movement to help promote pain relief, strengthening, movement reeducation and/or relaxation.

Letter for Your Care Provider

Dear Care Provider,

Here are a few important facts and ideas to consider when working with someone who identifies as being a Highly Sensitive Person (HSP).

A quick primer: According to the pioneering work of Dr. Elaine Aron, people with the genetic trait of high sensitivity make up 15–20% of the population. Being highly sensitive is not a genetic defect or disorder. The trait’s scientific term is Sensory-Processing Sensitivity (SPS). The acronym, D.O.E.S., is used to summarize the main aspects of high sensitivity (Depth of Processing, Overstimulation, Emotional Reactivity/Empathy, and Sensitive to Subtleties). For more information, www.hsperson.com is a great in-depth resource.

1. Less Is Often More:

HSPs often need less sensory input to experience deep results within the nervous system. In a physical or manual therapy setting, they may benefit from fewer repetitions of an exercise or soft tissue technique, less intense or pointed pressure, and more pauses to integrate the effects of treatment. Depending on treatment goals, degree of client self-awareness, overall health, and capacity/resiliency of their nervous system, shorter sessions may actually be more beneficial so as to not overwhelm the nervous system with novel stimulus.

Nervous system overwhelm makes it very difficult to impossible for learning and positive change in behavior or soft tissue to occur, so it is best to work within a zone where the client is exposed to input at a speed and in amounts that encourage learning and integration. This lays the foundation for success and longer-lasting change, and creates a higher likelihood that your client will continue their work with you.

2. Sensitivity to the Five Senses:

Special consideration with regard to treatment environment and products used (such as lotions, oils, sprays, or detergents) should also be paid. Skin sensitivities seem to be more common among HSPs, as well as sensitivity to scents, ambient noise, music, lighting, temperature, and fabrics. Including questions on intake forms about sensitivities or during intake conversations can be particularly helpful in avoiding confusion or unintentional missteps.

3. Build Trust and Rapport:

Beginning any movement or touch therapy client/practitioner relationship with the invitation to provide honest verbal feedback (e.g. ask to slow down, pause or stop treatment at any time, ask to change pressure or intensity, provide personal insight into the process) is also advised. Offering this invitation at other times, either at the beginning or during a treatment, can also be helpful in creating trust, rapport, and a richer experience.

That said, it will not always be easy for a client to provide this feedback of their own volition, especially towards the beginning of working together (and especially if this client is new to receiving professional physical care), so making a point to check-in periodically about pressure, touch quality, physical comfort, treatment goals, etc. is a good idea. (This is, of course, a basic rule-of-thumb with any client, but I think bares special emphasis for HSPs.)

4. Sensitivity ≠ Weakness:

It can be easy to assume that HSP clients are weaker and will always require a “kid-glove” approach to treatment. This is an incorrect assessment of the situation. While it is true that HSPs have a more sensitive and receptive nervous system than their hardier counterparts, they are often quite strong, intelligent, perceptive, creative, self-aware, resilient, and capable of deep change in a relatively short period of time with guidance that honors, supports and gently challenges them along the way.

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P.S. Did you find this article interesting or helpful? Please share it with your HSP buddies or clients, or with physical care providers (e.g. massage therapists, PTs, chiropractors, personal trainers) working with HSPs. Let’s help open the gates of communication! Thank you.

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