HSP or Autism? Navigating High Sensitivity and Neurodivergence
NEURODIVERSITY, SELF-TRUST
Am I Austistic or HSP?
I have struggled with the distinction between non-stereotypical autism and high sensitivity, personally and clinically. I've known I'm more sensitive than your average bear for a long time. However, it took a while before I felt confident in my autism self-diagnosis. The lines between the two are blurry, and this confusion reflects a broader challenge in understanding neurodivergent experiences that don't fit traditional diagnostic criteria.
The Historical Context and Controversy
Elaine Aron, the creator of the term Highly Sensitive Person, believed the two were different. However, from my understanding, she believed the two were different primarily because autism was featured in the DSM and high sensitivity wasn't. Aron saw autism as being a disability while supporting high sensitivity as a "gift." This distinction has created significant tension within neurodivergent communities.
Aron was so disparaging towards autism in her books that the autistic community often asks that the term HSP not be used at all in order to not elevate those remarks. I generally refer to high sensitivity rather than HSP for this reason. The controversy runs deep - many in the autism community believe the ongoing insistence that the HSP concept is a separate thing is harmful to autistic people, particularly those who don't fit stereotypical presentations.
Learn more about Elaine Aron's research on high sensitivity
The Autism Community's Perspective
Some autistics think there is no such thing as a Highly Sensitive Person, that Aron was referring to non-stereotypical autism without realizing it. Critics note that men tend to score lower on the HSP threshold than women do, mirroring the gender gap in autism diagnoses, suggesting these patterns might reflect undiagnosed autism rather than a separate trait.
Others think there might be a difference, but ask that the term HSP not be used so as to not denigrate autistics unintentionally. This perspective acknowledges that the debate itself may be less important than ensuring all neurodivergent people receive understanding and support.
The Research Gap and Current Understanding
There is no clear researched answer to the question whether autism and high sensitivity are the same thing or not. Research on Sensory-Processing Sensitivity (the scientific term for high sensitivity) began in 1991 and continues today, but definitive comparative studies with autism remain limited.
What we do know is that both experiences involve:
Heightened sensory processing
Deeper emotional processing
Increased awareness of subtle environmental changes
A tendency toward overstimulation
Rich inner lives and intense experiences
My Personal and Clinical Perspective
From my research and experience, my take on it is that: the two may be different, but similar neurotypes, both falling under the camp of neurodiversity. This perspective allows for complexity rather than forcing binary distinctions.
I have a few reasons for this position:
1. Honoring Self-Diagnosis and Personal Journey
One, I want to honor the self-diagnosis of HSPs as highly sensitive. Whether or not they are autistic is not even the first question. If they are autistic, the process of figuring that out can be a long one. Learning about non-stereotypical autism and doing lots of research and starting to wonder if they might be autistic too tends to be a long journey, not a leap. And that journey often starts by identifying their high sensitivity.
For many people, particularly women and non-binary individuals, recognizing high sensitivity can be the first step toward understanding their neurodivergence. The path to autism understanding often involves layers of self-discovery, and invalidating someone's initial recognition of their sensitivity can be counterproductive to their broader journey of self-understanding.
Am I Masking My Autism? Signs, Effects, and Getting Diagnosed
2. The Possibility of Co-occurrence
Two, as I've been researching this, I'm starting to wonder if you can have both high sensitivity and non-stereotypical autism. Personally, I meet criteria for both highly sensitive person and non-stereotypical autism. And yet, they have some varying traits. Which leads me to conclude that they are separate, but overlapping neurodivergences.
A Framework for Understanding
Here is a Venn Diagram I crafted to begin exploring the similarities and differences. I'd love any thoughts or feedback you have about it. I will continue to adjust it as more information comes in.
Another way of putting this…
Shared Characteristics:
(the shared characteristics may sometimes be for the same underlying reason and sometimes be for different underlying reasons)
Sensory processing differences
Emotional intensity
Need for processing time
Environmental sensitivity
Deep thinking and reflection
Need for recovery time after social/sensory stimulation
Prefer deep conversations to surface topics
Seek meaning & purpose
Things can feel highly personal (a comment can still feel personal, even when it is understood that its not meant in a personal way)
High Sensitivity Specific:
Primarily sensory and emotional processing
More responsive to environmental modifications
Strong aesthetic appreciation
Emotional contagion from others
Enjoy indirect communication - “It’s like communicating in poetry (subtle, symbolic language), and there’s special delight when the other person can “get the memo” and disappointment when they don’t (because how much they read between the lines)” —Joanne B. Kim, LMFT
Autism Specific:
Social communication differences (prefer direct communication)
Repetitive behaviors and interests (unless AuDHD, then seek novelty)
Desire for predictability and routine
Distinct cognitive processing patterns
Tend to be literal and direct, and prefer that style of communication
Look at details first, then create coherent framework/picture from there
When have Rejection Sensitive Dysphoria subtype, can be sensitive to criticism as perceived rejection
Stimming (which is frequently internal, but sometimes external)
Moving Forward: A Both/And Approach
Rather than getting caught in either/or thinking, perhaps the most helpful approach is recognizing that:
Neurodivergence is a spectrum - People can have multiple, overlapping neurotypes
Self-identification matters - How someone understands their own experience is valid and important
Support needs vary - Different aspects of someone's neurodivergence may require different approaches
Community belonging - People may find home in multiple neurodivergent communities
Internal Link: [Building inclusive spaces for all types of neurodivergence]
Clinical Implications
From a therapeutic standpoint, this nuanced understanding suggests:
Avoiding rigid diagnostic categories when supporting clients
Recognizing that someone might benefit from strategies developed for both highly sensitive people and autistic individuals
Understanding that the journey of self-discovery is often non-linear
Focusing on what support someone needs rather than which label fits best
External Link: Resources for neurodivergent-affirming therapy approaches
Conclusion: Embracing Complexity
The relationship between high sensitivity and non-stereotypical autism remains complex and under-researched. Rather than insisting on clear boundaries, perhaps our energy is better spent ensuring that all neurodivergent people - whether they identify as highly sensitive, autistic, both, or something else entirely - receive understanding, validation, and appropriate support.
What matters most is not whether we can definitively separate these experiences, but whether we can create a world where neurodivergent people of all types can thrive. The ongoing conversation itself reflects our growing understanding that human neurodiversity is rich, complex, and deserving of nuanced recognition.
What are your thoughts on this perspective? I'd love to hear about your own experiences navigating these overlapping identities, and how this framework does or doesn't resonate with your understanding of neurodivergence.
Resources and Additional Learning
References consulted for this piece:
Understanding the differences between autism and high sensitivity (FYI, this piece does not appear to be updated on all the research on autism)
