With the coming of the new year, I have spent a fair amount of time reflecting about my practice as a new decade begins.
As of now my practice is beyond its infancy, and shepherding that process along has been a hell of an experience. Over the course of past several years I have made multiple mistakes: been fired and ghosted by clients, gone down tangential research rabbit holes, attempted and failed to be a disciplined writer, and pissed off a few fellow clinicians while I tried my hand at presenting for continuing education programs. I was presenting my own material. Needless to say the practical knowledge I've gained is indispensable and taught me a lot about what not to do in the future. Learning from error is something I've done well over these past many years.
On the positive side, I've really taken notice of whom I do some of my best work with and a good bit more about how those positive working relationships (therapeutic alliances) occur. And it's not what I really ever thought it would be; not with a specific disorder or condition, and not by use of a specific treatment or mode of therapy. It's more about the who, the population that get's how I work and connects with me in that alliance. It's the creatives, the artists, and the gifted. Don't get me wrong, I do good work with a range of clients, only my best appears to comes out with this group of individuals and couples. Oh, and it's not all happy rainbows of feeling, therapeutic "aha's!", and consistency with appointments.
Well some of that, but not all that often.
Therapy can be messy because of the nature of the work. All those emotions, coming up, past stuff, relationships, family, yeah I get it. When you have a more nuanced or expressive way of showing it, like creatives, artists, and the gifted do, therapy can become more dynamic and at times confusing.
So I went and did some digging about the gifted and talented. What I learned about working with them, in particular the adults, is that they present a very different set of challenges than one would normally think in regards to their mental and emotional health.
And, yeah, I know: "go on Mr. Therapist, tell me about another first world problem you have to manage for somebody". I get it. After all, since the term "gifted" is often conflated with intelligence and intelligence has been correlated with all kinds of positive outcomes for adults, why would being smart and talented create issues? Well, it does when that intellect remains hidden, or ignored, or is misunderstood. And our "intellect" is more than just the ability to do math, read, and write. Intellect has its creative components like problem solving skills and artist expression, along with the awareness and function of our feelings and emotions.
So, it's actually a rather complex question with more research behind it from the school counseling/education side of things than from clinical psychological study. However, starting in the 1920's and ending in the 1960's under this guy named Terman, a longitudinal look at the progress of "gifted" children into adulthood over that forty year period was conducted (Oden, 1968). That work was done in effort to better identify and validate a more accurate picture of what it means to be gifted.
Today, partly due to Terman's work, our public schools are set up to "catch" that group of young people that show an aptitude for creative thinking and expression that deserves another level of attention. Just as accommodations can be made for those individuals with special needs in the classroom, students that are identified as "gifted" qualify for additional services throughout their educational career in the public school system. Around where I live and work, the program for the gifted is called GATE and testing for identification starts for everybody in the second grade.
So beyond the grades and test scores and after school activities, the other thing that is big in gifted education literature that is supposed to help identify those kids that deserve that extra level of attention has to do with certain behaviors exhibited. A good number of these kids (and adults) act and think in ways that could be viewed anywhere from beneficial and advantageous, to quirky, to problematic, to
diagnosable as something entirely different. Regardless of the range of the expression, those individuals stand out. What I'm referring to here is known in educational circles as overexcitablities (Dabrowski, 1964).
Overexcitabilities are exactly like they sound. They are areas of richness and intensity of "feeling, vividness of imagination, moral and emotional sensitivity" that result in enhanced interactions with the world (Ackerman, 1997). There are five and they include: psychomotor, sensual, imaginational, intellectual, and emotional . These excitabilities have been historically used as a means to better determine a student's potential for "giftedness", in particular the imaginational, intellectual, and emotional aspects (1997).
So, it should be easy to see that if you are overly excitable and it comes out as kinetic energy, wanting or having to be active and on the move, you could get labeled as something very different than gifted. If you are strongly drawn to "feeling" your world out around you and you show it, or your time is spent less than focused on tasks at hand and more often daydreaming, or you look for the fairness/justice in every situation to a fault, you get labeled and not necessarily just by your friends and peers around you. It's possible, because of this, some students prefer to go unnoticed, and they hide or minimize their talents.
The social scientist in me knows that there are many pressures in our school system that send messages to stay in your lane, be a part of the mainstream, and work to fit the norm. From very early ages, the expectations of how to behave and what action is acceptable, when and where, is drilled into us all. At the same time (if we're lucky), we are also given messages that encourage us to explore and experiment, try new things out, and make mistakes. However, if you feel your world more acutely than others, or if you see and experience your world in more intense ways, life can hurt and feel overwhelming.
Simply because a person finds themselves more sensitive or more high strung does not mean that they need therapy. It is worth noting however, that as adults, the issues that show up most frequently in counseling for the gifted include: addressing past school and childhood experiences, coping with high emotional sensitivities, depression, issues with perfectionism, relationship difficulties, and suicidal ideations (Rinn and Bishop, 2015). Label them with an "overexcitability" or not, gifted folks still experience mental and emotional challenges like everyone else. They are just as susceptible or prone to anxiety and depression, along with interpersonal challenges like communicating with partners or feeling disconnected from the people around them.
Yet, because of the intensity of the emotions felt, the tendencies to be overly self critical, and often the need to be and do "right", the possibility to be gifted and misdiagnosed is a strong possibility. It seems obvious that it would be one or the other. Occasionally it's both. Regardless, the notion that giftedness is more rare or uncommon may also be a fallacy that deserves its own attention.
Because of all of this, working with the gifted requires a different set of clinical lenses to recognize behaviors for what they are, along with an equally creative set of interventions to help address the actual needs. In particular for adults, those same overexciteabilities from the educational perspective translate well to the personality traits of divergent thinking, excitability, sensitivity, and perspetivity and can have both postive and negative impacts on social, professional, and/or romantic partnerships (Lovecky, 1986).
Divergent thinkers are often adept at creative problem solving and show preferences for original and sometimes unusual thinking (Lovecky, 1986). That can get in the way of building consensus or knowing when and how to comprise in order to reach goals at work or effectively communicate with a partner.
Excitability (easy guess here) is associated with high energy, however does not necessarily mean hyperactivity (Lovecky, 1986). Taking risks and embracing challenge are positives associated with this trait, along with spontaneity and energetic enthusiasm. Yet, excitability can also lead to difficulty with emotional and self regulation along with the biggest issue of having to learn to deal productively with boredom (1986).
For those that possess sensitivity, they tend to "think with their feelings" (Lovecky, 1986). That affords them the ability to feel and experience emotional connections in ways most others simply do not. They operate with deep concerns for the wellbeing and rights of others. Because of this, the tendency to overreact is often present, and due to the openness of their emotional being. The vulnerabilities they carry are less guarded and more easily wounded as a result(1986).
Lastly, perceptivity is an ability to envision multiple possibilities simultaneously for situations, to quickly recognize motivations, and to apply meaning of their's and others' actions (Lovesky, 1986). It's an amazing talent, yet can unnerve and feel threatening to others because they can't understand how or why the gifted person makes those connections and sees patterns where they seen none (1986).
There are other issues that need and deserve attention. Here,
I've just outlined a few of them, all in effort to demonstrate what can very easily be misdiagnosed as something that it may not be. To be able to assist those that feel different, either because of an overactive imagination, intense feelings and challenges with emotional regulation, or because they are driven by perfectionism, understanding where the problems arise and a possible cause can be the key to successful time spent doing therapy.
So if this possibly sounds like you or somebody you know, consider counseling as a means to help. If even for short period of time, taking action can be the ticket to better way of living.
Just remember, mental health matters.
References:
Ackerman, C.M. (1997), Identifying Gifted Adolescents using Personality Characteristics: Dabrowski's Overexcitabilities. Roeper Review, June/233.
https://www.researchgate.net/profile/Cheryl_Ackerman/publication/247528278_Identifying_gifted_adolescents_using_personality_characteristics_Dabrowski's_overexcitabilities/links
Heylighen, F. (2000) Gifted People and Their Problems, http://pespmc1.vub.ac.be/Papers/GiftedProblems.pdf
Lovecky, D.V. (1986) Can You Hear the Flowers Singing? Issues for Gifted Adults. Journal of Counseling Development, May, vol 64. http://www.positivedisintegration.com/Lovecky1986.pdf
Oden, M. L. (1968). "The fulfillment of promise: 40-year follow-up of the Terman gifted group" (PDF). Genetic Psychology Monographs. 77 (1): 3–93. PMID 5640199.
Rinn, A., Bishop, J. (2015). Gifted Adults: A systematic review and analysis of the literature. Gifted Child Quarterly, vol 59(4) 213-235.