Highly Sensitive Trait and Pressing Affect
During the Spring Festival, back in my hometown, I came into contact with two young children in the toddler stage. Their shared trait was that they were more emotional than average children, easily falling into irritability or brooding, and showing strong aggression toward the outside. I know the upbringing environment of both children; in fact, their families treat them very well, no one has harmed them, and they have suffered no major trauma. Yet they seem innately more sensitive than other children; the same event produces much stronger emotional reactions in them than in normal children.
I know the elders in the direct line of these two children, and there are indeed highly emotional members among the older generation. Their stronger emotionality seems to have little to do with the upbringing environment and is more likely due to biological inheritance. They must have inherited some genes not yet well understood that make them respond to environmental stimuli differently from ordinary children.
I cannot be sure whether these children's emotions will stabilize as they grow older, but this observation made me realize that the textbook view that the 0–6 year upbringing environment determines a person's personality is not entirely tenable. Both children have sisters who grew up in the same environment, yet those sisters behave differently.
A portion of the population is born with a highly sensitive trait: their reaction intensity to environmental stimuli far exceeds that of ordinary people, making it hard for them to adapt to a society made up mostly of ordinary people. In the long run, this affects their romantic relationships, employment, and future family and parent-child relationships. I could see that these two children often fell into pressing affect—sometimes in a state of extreme sadness, sometimes anxious and depressed, and frequently outwardly angry.
Their emotions caused frequent conflicts with those around them, putting both themselves and their close family in a tense state; their relationships were hard to maintain well. These children grew up feeling tense and confused about relationships. Others could not understand their feelings, and they could not understand others' feelings, so inwardly they were actually lonely.
Because of my own interest in psychiatry, social media often pushes me reports about people with abnormal cognition and behavior. During the Spring Festival I also saw the life stories of other people; some of them were given up for adoption at birth, untouched by their biological parents, raised with much love by adoptive families, yet in the end their behavior closely resembled that of their biological parents, not their adoptive parents at all. This phenomenon suggests that genes may determine a person's extreme character more than postnatal upbringing.
For example, there is a girl whose biological father (a very extreme man) committed suicide many years ago; she was given up for adoption shortly after birth, and as an adult her various behaviors closely resembled her father's. Her adoptive parents loved her dearly, but in the end this girl killed her adoptive parents' whole family and then committed suicide herself.
I have also seen on some emotional channels that some elderly people with obvious personality disorders or affective disorders spend their whole lives in a state of emotional and affective dysregulation; their relationships and marriages repeatedly end in breakup, and in old age they are lonely and helpless, with rough fate.
In fact, people with the highly sensitive trait mostly go on to develop depression, anxiety disorders, phobias, bipolar disorder, and various personality disorders; their reactions to external stimuli far exceed the appropriate intensity. Some highly sensitive people realize at a certain age that they have problems, while others may never realize it in their whole lives; in their view, their conflicts with the outside world are caused by others, not by themselves.
Highly sensitive people are especially hard for ordinary people in society to understand, but if ordinary people truly want to understand them, it is not actually difficult. We can imagine what it would be like if all our own feelings and emotional reactions were magnified several times over; then we can understand what highly sensitive people feel. Ordinary people's joys and sorrows are under control; highly sensitive people's joys and sorrows, being too intense, are often out of control.
Ordinary people also experience emotional loss of control—for example, when a close relative dies or when we suffer a romantic breakup, our grief can be very deep; or when we face criminal prosecution and possible imprisonment, we can be very anxious. Highly sensitive people live in such trauma and stress states all the time, so their lives are very hard. In fact, highly sensitive people are also much more likely than ordinary people to be imprisoned; most impulsive crimes are committed by highly sensitive people.
Most of us can hardly imagine what it would feel like to spend our whole life immersed in the pain of bereavement, romantic heartbreak, or the threat of imprisonment. For some highly sensitive people, most of their life is sunk in such suffering, so they live long-term under pressing emotions such as depression, anxiety, and fear.
In the past, psychology generally believed that these highly sensitive people were the product of childhood abuse, even attributing the cause of mental illness to the harm done to them by their family of origin. A popular saying now goes: some people's childhood can heal a lifetime, while others need a whole lifetime to heal their childhood.
But if we carefully observe the people around us, we can hardly fully agree with this view. Although the exact proportion of highly sensitive people with pressing affect in the population has not been established, it is certainly no less than 15%. So if we pay attention, nearly all of us can observe many such highly sensitive, pressing-affect people around us; we usually just dismiss them as having a "bad temper" without trying to understand their inner world. Many of them grew up in environments not very different from most of us; the root of their "bad temper" may lie in the special genes they inherited.
A female psychiatric patient with the highly sensitive trait I came into contact with has a twin sister; the two grew up in the same family, with equal parental love, yet their personalities are utterly different. The older sister has been tormented by pressing affect her whole life, while the younger sister is especially optimistic and cheerful. This patient herself realized that her problems had nothing to do with her family of origin; from the time she could remember, she was hard to please and easier to provoke, often brooding and throwing tantrums from childhood. Her sensitivity was entirely innate. She was very troubled by it but could not escape this instinctive reaction.
Another view holds that improved family finances and reduced life stress can ease the pressing affect of these highly sensitive people; this does not fully match what I have observed. Some highly sensitive people from well-off families actually have more severe pressing affect. Some women easily dwell on fear and anxiety that their husband will abandon them; when their husbands' careers flourish, this fear not only fails to lessen but grows worse, because they feel less and less able to match their husbands.
Some highly sensitive people's pressing affect lessens with age, but a considerable number remain anxious, depressed, manic, and fearful regardless of age. Not long ago I met the 74-year-old husband of an elderly depressed patient; he had accompanied his wife his whole life, and in old age she was still so affected by pressing affect that she needed psychiatric hospitalization. She frequently flew into rages, uncontrollably taunting and attacking the husband who had accompanied and cared for her all her life. This elderly family member was tormented terribly by his wife; during our conversation he broke down in tears several times.
Under pressing affect, highly sensitive people often involuntarily vent their negative emotions on family members, causing them great harm. Most highly sensitive people are aware of this, so after venting they fall into extreme shame and self-reproach, but they dare not express it because they have alexithymia and are poor at open communication.
Are all highly sensitive people born that way? The answer is also no. In this wave of COVID-19, many people's personalities changed greatly after infection; some formerly cheerful and optimistic people became sensitive, suspicious, pessimistic, and negative because the virus attacked their nervous system. In addition, many stroke patients who were rescued also underwent major personality changes, becoming especially sensitive and sinking into pressing affect. In fact, for such patients, antipsychotic medication can improve not only depression and anxiety but also their somatic symptoms.
Major life upheavals can also turn an originally emotionally stable person into an oversensitive, neurotic one. For example, some veterans who have witnessed large amounts of real bloodshed on the battlefield develop trauma syndromes; they are highly sensitive and neurotic, lose trust in those close to them, and are aggressive in daily life. People who have experienced earthquakes, tsunamis, terrorist attacks, rape, or the accidental death of multiple close relatives (by gas poisoning, traffic accidents, or criminal cases) also become more sensitive and fragile than before, and their descendants may inherit this highly sensitive trait.
This gives us reason to speculate that the ancestors of those born with highly sensitive genes most likely suffered great misfortune that caused epigenetic changes, which they then passed on to their descendants.
To date, humanity's achievements in psychiatry are still modest; treatment outcomes for most mental illnesses are not good. People with the highly sensitive trait who are often affected by pressing affect can hardly escape their suffering completely through medicine—but there are many drugs and psychotherapies that can reduce it. Training their capacity to tolerate suffering is the key to improving their quality of life; promoting deeper sympathy and understanding from all sectors of society (especially their families) can also improve it. Dialectical behavior therapy (mindfulness-based therapy) is currently popular and moderately effective; its sources lie in certain practices and concepts of Buddhist Zen.
I have met many such highly sensitive people and increasingly realize that the earlier their suffering-tolerance skills are trained, the better for their whole life. Unfortunately, there are very few therapists who master these skills and can effectively train patients. The life of the highly sensitive sufferer is fated not to go as smoothly as that of normal people; their pain is always deeper than others', and their feelings for those they love are far more intense than most people's, so they urgently hope for equally intense love in return—but often end in disappointment, because such love is too excessive for ordinary people. When they feel empty, their boredom is also far stronger than the occasional listlessness of ordinary people; so most lack a sense of meaning and often feel no joy in life.
They usually love and hate people intensely, and are prone to black-and-white cognition driven by their emotions. Once pressing affect makes them lose control, they easily become hysterical. This makes it hard for them to maintain good relationships, so from childhood onward they may constantly feel rejected and disliked, which leaves them without firm confidence in any relationship.
Promoting such patients' self-awareness, training their suffering-tolerance skills, and improving their capacity to bear pain, while promoting society's tolerance, acceptance, and care for such patients, is very helpful for improving the lives of both them and their families.