For HSPs: 6 Reasons Therapy Isn’t Working And What To Do About It

If you’re a Highly Sensitive Person, simple changes can go a long way to maximize your therapy experience

As a Highly Sensitive Person (HSP), therapy can be an incredible tool for self-exploration, personal growth, healing past wounds, or bettering your relationships.

You can learn the basic traits of being an HSP.  You can learn to finally speak up for yourself.  You can learn what to do when you just can’t stop thinking and ruminating about the past.  You can learn how being a sensitive child has influenced you today.

Unfortunately, there are times when you’re not getting everything you hoped from therapy.  

This isn’t necessarily your fault.  Nor your therapist’s.  With some deeper conversations with your therapist, you can put yourself into the right mindset to change your perspective and get the most out of therapy.   From there, you can make an informed decision about the best move forward.

IMPORTANT: The rest of this article assumes that you feel an initial good fit with your therapist, but just aren’t getting what you need. 

Before you start searching for a new therapist or blame yourself, I want to offer you a few perspective shifts to help you see how honoring your sensitivity and speaking up to your therapist can help you get the most from your sessions.

1) You don’t have realistic expectations for yourself, your therapist, or the therapy process

If you’ve never been in therapy before, you probably don’t know what therapy is like.  You might see examples of therapists on TV – either them snobbily nodding and taking notes, or doing egregious (not to mention illegal) things – like stalking their clients or coming drunk to session.

It’s normal to have unrealistic expectations of therapy. Especially when you’re really hurting and ready for change.  Yet, healing requires you to open up yourself and look at what you’ve been avoiding or been afraid to admit.   It’s no surprise once you start therapy – you might feel worse before you start to feel better.

If you’ve been numbing your emotions with food, dating apps, or mindless Netflix shows, and now your therapist is teaching you skills to name and identify your feelings, stuff is gonna come up! You’re gonna feel overwhelmed.  It might make you question if this whole therapy thing is a good idea.

Sometimes we (unconsciously) expect our therapist to read our minds.  Or be perfect.  Or say the right thing every time.  Therapists are humans, too.  We forget things.  We mess up.  We double-book appointments.  We try one approach and, in doing so, learn we should have taken a different route in helping you. (FYI: This does not mean it’s okay for your therapist to be rude, condescending, unprofessional, or make you feel unsafe.)

The key is for you and your therapist to have open and honest communication so that they have all the information they need to support you, and so you can feel respected and understood.  

Most importantly, therapy will not take away the basic traits that make you an HSP – your depth of processing, your intense emotions, your unfaltering empathy, or your sensitivity to sensory challenges.  You will, however, learn skills and mindset shifts so that being an HSP feels less like a curse and more manageable. You’ll learn how to advocate for yourself and how to say ‘no’ so that you don’t get as overwhelmed with others’ expectations.

  • Consider educating yourself on what therapy is actually supposed to look, feel, and be like.  Don’t rely on mainstream media to tell you.  (Seriously, just don’t.)
  • Talk to other people in therapy to learn what it’s like for them.  You’ll hear a variety of experiences since every therapist works differently.
  • Talk to your therapist about your hopes and goals for therapy.  Your therapist will be able to help you understand what is a realistic timeframe to achieve these goals. Don’t be afraid to check in and talk about your progress.

2) You haven’t had enough time to “settle” into therapy

Non-sensitive folks might feel comfortable with a new therapist within a few minutes or a few sessions.  However, Highly Sensitive People need more time to feel comfortable with a new person  It could take months before you finally feel fully comfortable with your new therapist – and that’s totally normal for an HSP!  If you experienced abuse or neglect as a child or adult, it’s not uncommon for it to take even longer to feel comfortable.

Let’s not forget the sensory aspect of being in therapy.  New smells. New sights.  You may have a therapist whose office is dimly lit and soothing (yes!) or the office may have bright lights or be on a busy street.

It may take you a good 4-5 sessions before you stop observing every detail of the room and can focus on being present in therapy.

If that’s the case for you, that’s perfectly okay.  As long as you feel like therapy is helpful,  and you’re building a good connection, it’s okay for it to take time to deepen into therapy.

This shows up for my clients as well.  I’m in such awe of the subtle differences they catch!  If I so much as move a plant or a piece of art, they will notice.   If I seem a little tired, they will notice.  If there are sounds outside the window that isn’t familiar, even a bird, traffic, or voices, they will noticeWithout fail.  And I love it.  It’s a beautiful reminder of the highly attuned, sensitive brain. 

  • Tell your therapist you’re sensitive to sounds, smells, and textures. Identify and ask what adjustments could help you feel more comfortable. This might entail dimming the lights, closing the windows, or having a soft blanket handy.
  • Schedule therapy at the same time for each session. The routine will help minimize overwhelm and help you adjust to sensory stimuli.
  • Plan therapy for when you’ll be the least overstimulated.  It will help you settle into the newness of therapy.
  • Have this be an ongoing conversation with your therapist.  Tell them you’re very observant of your surroundings and it will take you some time and what they can do to help you feel settled.
  • Keep going.  Especially if you’ve only gone for a handful of sessions.

3) You avoid talking about what is *actually* troubling you

Most highly sensitive people, especially those who grew up in an unaccepting or challenging family, are used to hiding how they feel.  They are used to people not understanding them, thinking they are ‘too much’ or that they need to just ‘get over it’.

It’s hard to break this pattern, even if you’re in a space where you’re *supposed* to say what’s on your mind.  

Let me tell you a story to demonstrate this.

I was seeing a therapist in my early 20s.  Even though the sessions were helpful, I had spent many months dancing around a particular topic that I was ashamed of sharing with her.  I had been dropping ‘hints’ but never giving enough detail for her to actually help me.  (Funny how that works, right?)

Stubbornness (and perhaps a little desperation) won.  I knew that I had to share this experience with her to make any more progress in therapy.  So I shared “it” with her.  I still remember how it felt to sit on that couch. Traffic was rushing by the window.  Dusk outside and the office lights were dim. The therapy dog, Tao, curled up at my feet. The reassurance of his wire-haired coat on my bare ankles helped.

As I shared my shameful secret with my therapist, I expected lava to flow from the earth, the sky to darken, and life to end as I knew it.

It didn’t. She just nodded. Completely unphased. She just held the silence with care and compassion.  After that, I feel like I finally started to understand what therapy was all about. 

Therapy isn’t a space for us to pretend everything is okay.  It’s a space for us to fall apart and know that we will have someone help us pick up the pieces–or at least show us how.

  • If you have a good connection with your therapist, trust that they can hold whatever shame, secret, or emotion you have. Trust that they want to hear it.
  • Instead of sharing the shameful topic, memory, or thoughts with your therapist, you can talk to them about how you’re afraid to share it.  Tell them your fears.  This is different than ‘talking around it’ since you’re directly saying there is something on your mind that is shameful and you’re not ready to share it.
  • If you feel like you’re being clear or straightforward but aren’t getting the response you want, ask your therapist for feedback.  It’s very possible that you have been using vague or abstract language that makes it hard for your therapist to fully understand what’s happening for you.

4) Your therapist doesn’t know about Highly Sensitive People

Even though many HSPs are in therapy, not many therapists know about HSPs.  Even though research dates back to the 90s, some may think being an HSP is a disorder or confuse it with other mental health issues.

Being an HSP is not a mental health disorder or diagnosis.  However, you can be an HSP AND have a mental health challenge or diagnosis.  If you are an HSP, you don’t *have* to have a therapist who is an HSP specialist.  But it can certainly help.

Let’s say that you’re going to therapy to process your recent divorce.  Your therapist is an expert in divorce recovery but has never heard of HSPs.  Does this mean you need to change therapists? Not at all.

However, some therapists may also assume that your high sensitivity is due to experiencing abuse as a child, having been in an abusive relationship, or some other kind of unresolved trauma.  While Highly Sensitive People are not immune to experiencing abuse, it is crucial that both you and your therapist understand that trauma is not the “reason” someone is a Highly Sensitive Person.

The interplay between trauma and high sensitivity is a complex topic that can’t fully be addressed here.  If you are an HSP and have experienced any type of trauma, abuse, or neglect, it may be helpful for your therapist to consult with an HSP specialist to help understand the intersection of trauma and high sensitivity for HSPs.

  • If your therapist isn’t familiar with HSPs, you don’t have to change therapists, just bring up the topic. This article, by Emma Cameron, is my go-to for explaining the HSP trait to newbies.
  • Direct your therapist to resources about HSPs.  They can start with this list of recommended reading, this article I wrote JUST for therapists, or get a consultation from an HSP specialist.
  • Pay attention to how willing your therapist is to learn about HSPs.  Give them an opportunity to learn with you.  Therapists are not immune to myths and misconceptions about HSPs and they will need time to educate themselves.
  • If you have an awesome connection with your therapist, but they aren’t understanding the HSP side of you, consider getting some time-limited consultation or coaching from an HSP specialist to supplement the work you’re doing in therapy.

5) You need to adjust your frequency, with longer sessions, group support, or increasing to weekly

Because HSP brains are constantly processing and taking in their environment, they need more time than other folks to make sense of their emotions, their experiences, and their needs.  They need ample time to settle into the room, process all their emotions, and calm themselves before heading back into the world.

Due to insurance constraints, most therapy sessions last about 50-mins.  For most HSPs, 50 minutes isn’t enough time for you to fully unpack your thoughts and feelings.  You might leave the session still feeling open, and raw, or with this nagging feeling that things feel incomplete.  If this happens consistently, you may benefit from sessions that are longer than the standard 50-min therapy hour.

This is why I offer 60-minute and 90-minute sessions for my HSP clients.  It allows them the safety to really go deep into their experience and inner world, without worrying they won’t have time to feel a sense of resolution.  I find that we can get to the root of the issue faster, and then also have time to try some tools or exercises that can bring relief – before the session is even close to being over.

In addition to individual support, you will benefit from being in a group with other HSPs.  After hearing from my clients how alone and different they felt, I created a therapy group just for HSPs.  Knowing other HSPs, and being in a sacred space with them, will only lead to your growth and self-understanding. Not to mention, it could be just what you need to uplevel the work you’re doing in individual therapy.

  • Talk to your therapist about session length and frequency.  Depending on your therapist’s schedule, or if you are using your insurance for sessions, changes may not be possible. Yet, you might be surprised what your therapist is willing to accommodate to support you. Consider coming weekly for the best results in therapy.
  • Consider joining a group or meetup just for Highly Sensitive People.  If you’re willing to poke around on Google, you’ll find there are many supportive spaces just for HSPs.  (Psssst: If you’re in the Denver area, check out this group for Sensitives, Empaths, and Deep-feelers.)
  • If you’re in a rural or remote area, consider exploring online support groups with other HSPs.

6) You’re not going at the right time of day

For HSP, you have to consider your natural rhythm when going to therapy.  How might you feel if you see your therapist on a Tuesday morning, after a restful weekend?  Will you be able to open up more because you’re less overwhelmed? Or will you be better at putting on the ‘everything’s fine’ mask?

What about on a Friday afternoon when all you want is to put on your sweats, eat Oreos, and watch reruns of The Office? (oh, that’s just me?) Will therapy push your system past the limit or will you be more open because you’re too tired to pretend you’re okay?

Consider what’s happening before and after your appointment.  I have found that HSPs generally do well when they get to be “off” after therapy. You’ll have the space to process what you learned in therapy, as opposed to rushing off to the next thing.  If you do have to go back to work (or life), consider giving yourself at least an hour to process and integrate the session before returning to work.

If you live in a metropolis (Hello, Denver!), traffic is a huge consideration.  Trying to get to a 5pm therapy appointment in Denver traffic is a nightmare. But going to therapy at 10am? Much less traffic and often you’ll feel more grounded heading into the session.

  • Take some time to reflect on the ideal time of day for you to attend therapy. Consider your natural rhythm and when you’ll be the most emotionally open and unrushed.  Or, if you have a hard time opening up, pick a time when you’re more likely to be vulnerable.
  • Talk to your therapist about your scheduling needs.  Consider shifting your work schedule, leaving early, or working from home on days that you have therapy.
  • Explore virtual therapy as a way to minimize overwhelm that can come with traveling to an appointment.
  • Continue to experiment with different days and times to find the best fit.  You might shift the date/time with the seasonal changes as well.

If you’ve tried all the above options, and therapy still isn’t what you want…

While I encourage you to talk to your therapist and explore all other avenues, sometimes it’s just not a good fit.  

Before you change therapists, bring it up to them that you’re not feeling like it’s the best fit.  Tell them if there is anything they could do differently.  I know this might be hard, and it’s great practice for speaking up for yourself in your everyday life.

If you do decide to switch therapists, do it intentionally.  Consider starting your search with an HSP-knowledgeable therapist. This directory is a great place to start.  Consider having your current therapist talk to your new one so you don’t feel like you have to start completely over.

It’s possible to make peace with being sensitive, so you can fill your life with fulfillment, meaning, and love.

Whatever path you take, know that you are in complete control of your treatment.

As a Highly Sensitive Person, you were made to do this tough internal work.  I know that, with time and the right support, you will emerge on the other side feeling wholeness, renewal, and purpose.

Looking for a therapist who specializes in Highly Sensitive People?

For a free consultation, please call/text (720) 772-7413 or email 


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