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Just as the divide between mind and body is disappearing, so too, clear and fast distinctions between nature and nurture are on the way out.
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Orchids and Dandelions: The Emerging Science of Emotional Sensitivity
Anyone who is highly sensitive must often wonder, Why am I the way I am? Is it nature, nurture, or both? A number of recent scientific findings and popular theories indicate that the answer is undeniably both.
A British study from the University of Essex shows how an important genetic variant makes some people more sensitive than others to their emotional environment—and thus more susceptible to anxiety disorders.1 This research focused on the serotonin transporter gene. Serotonin itself is a neurotransporter, a chemical released into the gap between nerve cells. The serotonin transporter is a protein that plays an important part in that cross-nerve signaling. Once a signal has crossed from one nerve cell to another, the serotonin transporter removes serotonin from the gap and transports it back into the initial nerve cell, where it can be reused for the next signal.
The gene that encodes the serotonin transporter varies across the human population. Some people carry a “short” version of the gene, which means they have fewer copies of the serotonin transporter and therefore higher concentrations of serotonin in the gaps between neurons. Other people have a “long” version of the gene, which leads to more copies of the serotonin transporter and lower levels of serotonin in the cross-neuron gaps. Previous studies found that people with a short version of the gene tend to pay more attention to negative or potentially threatening information. This negative bias is characteristic of many anxiety disorders, such as depression, post-traumatic stress disorder, and irritable bowel syndrome.
Remarkably, the University of Essex team found that people with the short version of the serotonin transporter gene were not only more sensitive to negative information but also to positive information. According to the lead researcher, Dr. Elaine Fox, such people “are likely to be far more reactive to both very negative situations, such as a car crash, and very positive ones, such as a very supportive relationship.” The short version of the gene, Fox says, can be viewed as providing enhanced adaptability as well as greater vulnerability in the first place. In contrast, people with the long version of the gene are likely to be less influenced by negative stimuli but also less able to benefit from a highly positive emotional environment—since their reactivity in the different experimental conditions barely changed.2
Orchids and Dandelions
The serotonin transporter gene—and others like them—can be characterized as an orchid gene, like the flower whose bloom is spectacular but requires great care to cultivate. If the environment is supportive, a person with orchid genes will probably thrive and possibly succeed in spectacular ways. But if neglected or subjected to negative emotional input, such a person may develop any of the anxiety disorders and wilt (to stay with the flower analogy). Those who are more resistant to the vicissitudes of life and aren’t quite so subject to the relative quality of their nurturance are dandelions. They are more numerous and more hardy.
The orchid-dandelion hypothesis has been expressed principally by University of Arizona development psychologist Bruce Ellis and University of British Columbia developmental pediatrician W. Thomas Boyce and has been presented in a more popular vein by author David Dobbs.3 People who are orchids, they point out, have a heightened genetic sensitivity to all experience, but their environment plays an equally important role. They call this biological sensitivity to context. Although orchids are more susceptible to stress and tumult, whether they go on to develop various health conditions ultimately depends upon their emotional environment.
Incidentally, humans aren’t the only species with variations in reactivity among individuals. The same has been found in mice. The ones who seem most vulnerable to stress are also more likely to fall ill.4 This variability may eventually be disclosed as a feature of all mammals.
Just as the divide between mind and body is disappearing—thanks to all manner of discoveries in the field of psychoneuroimmunology (the discipline that studies connections between the nervous, immune, and endocrine systems)—so too, clear and fast distinctions between nature and nurture are on the way out. The latest findings indicate that environmental stimuli can be as deterministic as genes were once believed to be and that the genome can be as malleable as only environments were believed to be. To discriminate between nature and nurture in this way seems as futile as asking which feature of a rectangle—length or width—makes the most important contribution to its area.5
The University of Essex findings are important in many ways. First, we can discern a mechanism behind some people’s pronounced sensitivity. Second, we can see how off base the “nature versus nurture” debate is (or was). Third, there are significant implications for personal health. Quoting Dr. Fox again, the lead researcher: “This opens the door to the idea of personalized treatments for anxiety disorders. Information about the genotype... of a patient could be used to inform decisions about which treatments... are likely to be most effective.”6
The prospects are actually more intriguing and potentially more useful than that. All we need do is consider a particular framework for sizing up this most salient distinction between people—that is, how much “gets” to them and how they handle it. This framework, known as boundaries, opens the door to a whole different way of viewing health care and assessing both individuals’ vulnerabilities and the treatments most likely to help them.
The Boundaries Concept
Because we are bound within our bodies, we are enabled to have distinct minds and personalities. The “boundaries concept,” developed by Ernest Hartmann, MD, of Tufts University, is an especially useful way of looking at personality differences and understanding why one person may develop a chronic illness that is distinctly different from another.
Boundaries are more than a measure of introversion or extroversion, openness or closed-mindedness, agreeableness or hostility, or any other personality trait. Boundaries are a way to assess the characteristic way individuals view themselves and the way they operate in the world based on how they handle the energy of feelings. To what extent are stimuli “let in” or “kept out”? How are a person’s feelings processed internally? Boundaries are a fresh and unique way of evaluating how we function.
According to Hartmann, each of us can be characterized on a spectrum of boundaries from “thick” to “thin.” In his words:
There are people who strike us as very solid and well organized; they keep everything in its place. They are well defended. They seem rigid, even armored; we sometimes speak of them as “thick-skinned.” Such people, in my view, have very thick boundaries. At the other extreme are people who are especially sensitive, open, or vulnerable. In their minds, things are relatively fluid... Such people have particularly thin boundaries... I propose thick and thin boundaries as a broad way of looking at individual differences.7
Hartmann first came to his conception in an interesting way. In the 1980s, he was studying people who have nightmares and noticed that they could also readily recall vivid or colorful dreams that didn’t qualify as nightmares. These people seemed to him especially “sensitive,” “vulnerable,” or “imaginative,” in contrast with other people who came across as more “stolid,” “stoic,” or “persevering.” He suspected real brain and body differences between thin- and thick-boundary people, and he developed a questionnaire to gain more insight.
Since the 1980s, at least five thousand people have taken Hartmann’s Boundary Questionnaire (BQ) and more than one hundred published papers have referenced it. Scores on the BQ are distributed across the spectrum of boundaries in a bell-shaped curve. Women tend to score significantly thinner than men, and older people tend to score somewhat thicker than younger people.8
Thick and Thin Boundaries
The accumulated evidence shows that thin-boundary people are highly sensitive in a variety of ways and from an early age:
- They react more strongly than do other individuals to sensory stimuli and can become agitated by bright lights; loud sounds; particular aromas, tastes, or textures.
- They respond more strongly to physical and emotional pain in themselves as well as in others.
- They can become stressed or fatigued by an overload of sensory or emotional input.
- They are more allergic, and their immune systems are seemingly more reactive.
- They were more deeply affected or recall being more deeply affected by events during childhood.
In a nutshell, highly thin-boundary people are like walking antennae, whose entire bodies and brains seem primed to notice what’s going on in their environment and to understand more precisely what it means.9
Thick-boundary people, on the other hand, are fairly described as stolid, rigid, implacable, or thick-skinned:
- They tend to brush aside emotional upset in favor of simply “handling” the situation and maintaining a calm demeanor.
- In practice, they suppress or deny strong feelings. They may experience an ongoing sense of ennui, of emptiness and detachment.
- Experiments show, however, that thick-boundary people don’t actually feel their feelings any less. Bodily indicators (such as heart rate, blood pressure, blood flow, hand temperature, and muscle tension) betray their considerable agitation despite surface claims of being unruffled.10
In sum, highly thick-boundary people don’t take in nearly as much in their environment and are much slower to recognize what they’re feeling. However, they are affected by what’s happening within them just as much as thin-boundary people.
Several other researchers have traversed similar territory over the last two decades. Psychologist Elaine Aron has illuminated various facets of what she calls the “highly sensitive person” or HSP.11 Harvard professors Jerome Kagan and Nancy Snidman have studied the differences between “high reactive” and “low reactive” individuals.12 Educator Mary Sheedy Kurcinka has profiled what she terms the “spirited child” (one who exhibits high energy as well as sensitivity).13 Researchers Sheryl Wilson and Theodore Barber have profiled the “fantasy prone” person.14 Psychologist Sharon Heller has examined what makes someone “sensory defensive,” and physicians James J. Lynch and Gabor Maté have chronicled “Type C” people, those who seem unwilling or unable to acknowledge their feelings.15
Researcher Susan Cain’s book on introversion has grabbed popular attention. In Quiet: The Power of Introverts in a World That Can’t Stop Talking, she draws an important distinction between shyness and introversion: shyness is the fear of social judgment, whereas introversion is “really a preference for less stimulation.”16 This interpretation is consistent with what Elaine Aron has found, that high sensitivity is not the same thing as shyness. Indeed, approximately 30 percent of highly sensitive people are gregarious. But, as they still tend toward being careful and deep thinkers, highly reactive, and easily overstimulated, they need much more downtime than do extroverts to recover.17
Value of Knowing Your Boundary Type
All of these conceptions are helpful, and all point to the same basic kind of person, the orchid, someone who can thrive or wilt based on the quality of her or his emotional environment. Hartmann’s boundary concept goes to the heart of what actually drives the formation of that particular personality. In a word, it’s stimulation—what kind (positive or negative), how much (not enough, just right, too much), and most important, how the person handles stimulation (acts as if it’s not happening, reacts immediately, stores it away for future rumination). The person’s boundary type—thick or thin or any degree in between—mediates with the outside world and the internal world of feeling.
That flow, that characteristic style of processing emotional stimuli, has a direct bearing on what kind of illnesses a person will experience. At the beginning of this article, we noted that highly sensitive (thin-boundary) people are especially susceptible to anxiety disorders. This class of chronic illnesses can be seen to reflect a “hyper” style of feeling. Similarly, highly thick-boundary people, who aren’t nearly so sensitive to environmental changes, are much slower to recognize what they’re feeling, so it stands to reason that they would manifest different forms of chronic illness. According to our research, ulcer, hypertension, and phantom pain are examples of thick-boundary conditions.18
The implications are quite remarkable. Based on where you fall on the boundary spectrum, you’ll have a sense for what forms of chronic illness you’re most susceptible to. And you don’t need a genetic workup to determine boundary type. All you need is Hartmann’s Boundary Questionnaire—of which there is an 18-question short form. The benefits of knowing your boundary type don’t stop there. Since specific forms of complementary and alternative medicine (CAM) are known to alleviate the symptoms of particular kinds of chronic illness, you could conceivably develop a “menu” of therapies that would be most appropriate for the chronic condition you are susceptible to or have. This brings the concept of “personalized medicine” down to earth, making it more immediately accessible than any genotype assessment could be.
Chronic Illness Is Different from Disease
It’s important to realize that the health conditions mentioned above are distinct from diseases. A disease is an illness (even a run-of-the-mill illness such as a cold) that is not conditioned by personality type and the way a person registers feelings. Anyone can catch a cold, and everyone wants to get rid of it. The most serious diseases—such as AIDS, leukemia, smallpox, malaria, cancer—are something our bodies fight precisely because they are alien and threaten our survival.
In contrast, science is showing that a variety of chronic conditions are more directly related to our thoughts and feelings.19 Rooted in our emotional biology, these types of illness include the following:
- chronic fatigue syndrome
- irritable bowel syndrome
- migraine headache
- post-traumatic stress disorder
- rheumatoid arthritis
- skin conditions (such as eczema and psoriasis)
These conditions—call them the Dozen Discomforts—are far more constitutional than a disease. They affect a person, yes, but they are also of the person. They are rooted in how we handle stimuli, the most important kind being emotional, and they won’t be resolved through standard medical interventions, such as drugs and radiation, for the simple reason that they are not really “alien” to us.
Allopathic medicine, which fundamentally views sickness as originating outside the person, fails in many cases to successfully treat chronic pain and illness. However, CAM can often do so, because complementary and alternative approaches are psychosomatic in the literal (and appropriate) sense of the term.They address the whole person: the emotional/mental (psyche) as well as the physical (soma). Distinct from conventional practices that treat a given symptom or set of symptoms, CAM treatments proceed from a holistic perspective that considers the entire patient—mind and body.
CAM Treatments for You
There are, of course, many CAM therapies, but seven of them stand out by virtue of being well established, safe, and effective. Indeed, based on our analysis of boundary type matched against CAM therapy type (a true first), the relative merits of these seven become clear.20 The Super Seven are
- guided imagery
- relaxation/stress reduction
These therapeutic approaches have been extensively studied over many years. They are not “off the wall” or in an early stage of development. They have helped millions of people already and saved them a substantial amount of money in the process. I am not arguing against conventional medicine, but I am advocating sound, safe, cost-effective treatments that have a reasonable chance of improving your health based on your boundary type.
Progress in Science and Health
Medical science is making huge strides in discerning how closely connected nature and nurture are in shaping individual personality. Likewise, there is more evidence than ever before that mind and body are not separate but more appropriately viewed as two sides of the same coin. Emotion seems to underlie all of this—since, clearly, feelings go on inside of us but are inevitably linked to what goes on outside too (what people say to us, how well or poorly we’re treated, what shifts or changes we’re subjected to).
Science is also coming to realize that everyone is different. Some people are thin-boundary—orchids, high reactors, HSPs, call them what you will. Thick-boundary types, on the other hand, are more staunch and perhaps more resilient, but everyone is affected in her or his own way by emotional ups and downs. Some of us may be more “in touch” with what we’re feeling at any moment, others less, but all of us are feeling something all the time (or we wouldn’t be alive).
Hartmann’s boundary concept provides a truly useful framework to capture this most salient personality difference and relate it to health. Despite the fact that conventional medicine is moving toward a model of personalized medicine that relies on genetic testing, the short-form Boundary Questionnaire (BQ) offers unprecedented insight into who you are and the sorts of illnesses you may be prone to. [Take the BQ here; it typically requires less than ten minutes to complete and score.] Furthermore, a range of cost-effective CAM therapies has now been evaluated against boundary type, so a menu exists that allows you to select the treatments most likely to benefit you.
Information on Jawer and Marc Micozzi’s new book, Your Emotional Type: Key to the Therapies That Will Work for You (Healing Arts Press, 2011), can be found at www.youremotionaltype.com. Information about their previous work together is at www.emotiongateway.com.
1. E. Fox, K. Zougkou, A. Ridgewell, and K. Garner, “The Serotonin Transporter Gene Alters Sensitivity to Attention Bias Modification: Evidence for a Plasticity Gene,” Biological Psychiatry 70, no. 11 (2011): 1049–105, http://www.biologicalpsychiatryjournal.com/article/S0006-3223%2811%2900681-0/abstract).
2. “Scientists Find Link Between Gene and Sensitivity to Emotional Environment,” MedicalXpress, January 13, 2012, http://medicalxpress.com/news/2012-01-scientists-link-gene-sensitivity-emotional.html).
3. Bruce J. Ellis and W. Thomas Boyce, “Biological Sensitivity to Context,” Current Directions in Psychological Science 17, no. 3 (2008): 183–86, www.hsperson.com/pdf/Ellis_and_Boyce_2008_Biological_Sensitivity_to_Context%5B1%5D.pdf). David Dobbs, “The Science of Success,” The Atlantic, December 2009, 51–60, www.theatlantic.com/magazine/archive/2009/12/the-science-of-success/7761/).
4. “Every Mouse Is Different: How Mouse ‘Personality’ Sheds Light on Human Depression,” ScienceDaily, November 14, 2011, www.sciencedaily.com/releases/2011/11/111114093409.htm.
5. Darlene Francis and Daniela Kaufer, “Beyond Nature vs. Nurture,” The Scientist, October 1, 2011, http://the-scientist.com/2011/10/01/beyond-nature-vs-nurture/.
6. “Scientists Find Link between Gene and Sensitivity to Emotional Environment,” Medical Xpress, http://medicalxpress.com/news/2012-01-scientists-link-gene-sensitivity-emotional.html.
7. Ernest Hartmann, Boundaries in the Mind: A New Dimension of Personality (New York: Basic Books, 1991), 4–7.
8. E. Hartmann, R. Harrison, and M. Zboroski, “Boundaries in the Mind: Past Research and Future Directions,” North American Journal of Psychology 3 (June 2001): 347–68.
9. Elaine Aron, The Highly Sensitive Person: How to Thrive When the World Overwhelms You (New York: Carol Publishing Group, 1996), 7.
10. James J. Lynch, The Language of the Heart: The Body’s Response to Human Dialogue (New York: Basic Books, 1985), 209–222.
11. Aron, The Highly Sensitive Person.
12. Jerome Kagan and Nancy Snidman, The Long Shadow of Temperament (Cambridge, Massachusetts: Belknap Press, 2004).
13. Mary Sheedy Kurcinka, Raising Your Spirited Child (New York: Harper, 2006).
14. S. C. Wilson and T. X. Barber, “The Fantasy-Prone Personality: Implications for Understanding Imagery, Hypnosis, and Parapsychological Phenomena,” in Imagery: Current Theory, Research and Application, ed. Anees A.Sheikh (New York: John Wiley & Sons, 1983), 340–87.
15. Sharon Heller, Too Loud, Too Bright, Too Fast, Too Tight: What to Do If You Are Sensory Defensive in an Overstimulating World (New York: HarperCollins, 2002). James J. Lynch, The Language of the Heart: The Body’s Response to Human Dialogue (New York: Basic Books, 1985). Gabor Maté, When the Body Says No: Understanding the Stress-Disease Connection (Hoboken, New Jersey: John Wiley & Sons, 2003).
16. Maia Szalavitz, “‘Mind Reading’: Q&A with Susan Cain on the Power of Introverts,” Healthland.Time.com, January 27, 2012, http://healthland.time.com/2012/01/27/mind-reading-qa-with-susan-cain-on-the-power-of-introverts/.
17. Elaine Aron, “Time Magazine: ‘The Power of (Shyness)’ and High Sensitivity,” February 2, 2012, Psychology Today, www.psychologytoday.com/blog/attending-the-undervalued-self/201202/time-magazine-the-power-shyness-and-high-sensitivity.
18. Michael A. Jawer and Marc S. Micozzi, Your Emotional Type (Rochester, Vermont: Healing Arts Press, 2011).
19. Sharon Begley, “The Depressing News about Antidepressants,” Newsweek, February 8, 2010, www.thedailybeast.com/newsweek/blogs/the-human-condition/2010/02/01/the-limited-power-of-placebo-when-the-strength-of-suggestion-is-not-enough.html.
20. Jawer and Micozzi, Your Emotional Type.