Sensory Processing and Mental Health: An Introduction: Dr. Sarah Anderson

Our senses shape how we experience the world—the sights we see, the sounds we hear, the textures we touch, the flavors we taste, and the scents we smell. While many people find everyday sensory experiences manageable or even enjoyable, others may find certain stimuli overwhelming or insufficient, creating challenges in their daily lives. By deepening our understanding of sensory processing and its link to mental health, we can foster greater well-being and support more effective paths to recovery.

What Is Sensory Processing?
Sensory processing refers to how your body and brain receive, recognize, and interpret sensory information (Brown et al., 2019). This process begins when your nervous system detects sensory stimuli through various receptors, leading to a behavioral response. For example, imagine hearing a loud alarm while working at your desk. You recognize the sound as a fire alarm, observe others moving toward safety, and are prompted to follow them. This highlights how sensory processing helps you respond adaptively to your environment.

There is variability in sensitivity to sensory stimuli based on individual thresholds (Brown et al., 2019). A high threshold indicates that a person needs a stronger stimulus to notice it, whereas a low threshold means even minimal stimuli can become overwhelming. For instance, while most people would quickly respond to a loud fire alarm, individuals who are hyper-responsive to auditory stimuli may find such sounds painful, causing long-lasting dysregulation. On the other hand, those who are hyposensitive may require a stronger stimulus for recognition.

While many people are familiar with the five traditional senses—sight, sound, touch, taste, and smell—three lesser-known senses are also critical for understanding sensory processing: proprioception (awareness of body position), vestibular (balance and movement), and interoception (awareness of internal body states) (Brown et al., 2019). In individuals with typical sensory processing, the brain effectively organizes and integrates sensory information, allowing appropriate responses to stimuli. For example, a person might walk along a crowded street, effectively filtering out distractions like billboards and other pedestrians, or engage in a conversation in a busy café without becoming overwhelmed by the surrounding noise and activity. Those with atypical sensory processing may struggle to take in stimuli and modulate their responses, leading to feelings of overwhelm or anxiety. 

A Model for Understanding Sensory Processing 

As a mental health occupational therapist, I use a specific framework to understand my clients’ sensory processing patterns—Dunn’s Sensory Processing Model. This model categorizes sensory processing into four quadrants (or patterns), each representing different ways individuals respond to sensory input (Brown et al., 2019):

Sensation Seeking

These individuals actively pursue intense sensory experiences and are often drawn to environments that provide heightened stimulation. They tend to crave loud environments, bright colors, and high levels of movement. Sensation seekers often thrive in situations that involve excitement and novelty. 

For example, they may enjoy engaging in contact sports such as football or rugby, where the physicality and intensity provide both sensory input and an adrenaline rush. Similarly, thrilling amusement park rides, like roller coasters, offer the fast movement and sensory overload they enjoy. Additionally, these individuals may find pleasure in activities such as dancing at loud clubs, racing motorcycles, or participating in extreme sports like skydiving or rock climbing, where the combination of physical exertion and sensory excitement is high. Sensation seekers are often drawn to high-energy, sensory-rich environments because they help satisfy their need for stimulation.

Sensation Avoiding

People with sensation avoiding patterns feel uncomfortable with strong sensory stimuli and actively limit their exposure to prevent stress or overwhelm. These individuals are particularly sensitive to intense or overstimulating environments, and they often seek out quiet, calm spaces to feel more in control and at ease. The key characteristic of sensation avoiders is that they make a conscious effort to avoid situations that may lead to sensory overload. 

For instance, they may prefer online shopping over visiting crowded stores because the noise, bright lights, and large crowds can cause distress. Similarly, they may choose to eat and converse at home rather than going to noisy restaurants, where the sounds, smells, and social interactions can be overwhelming. In other contexts, sensation avoiders might prefer a peaceful walk in nature over attending a crowded event or concert. They may also avoid certain types of music or films that feature loud noises or flashing lights due to their heightened sensitivity. By actively limiting sensory exposure, sensation avoiders can maintain a sense of comfort and reduce anxiety caused by overstimulation.

Sensory Sensitivity

Sensory-sensitive individuals, like sensation avoiders, are highly attuned to sensory stimuli and can become overwhelmed or anxious when exposed to certain sounds, sights, or other sensations. They are particularly responsive to environmental inputs, such as bright lights, strong odors, or loud noises. However, the key distinction between sensory sensitivity and sensation avoidance lies in their reaction to these stimuli. While sensation avoiders actively work to limit their exposure to sensory triggers, sensory-sensitive individuals do not necessarily avoid them. Instead, they confront and endure these sensory experiences, often feeling the full intensity of the distressing sensations. 

For example, a sensory-sensitive individual might attend a concert despite being sensitive to loud music, or they might work in a busy office environment even though the noise and activity create discomfort. The difference here is that, rather than avoiding these situations, they are exposed to them and may struggle to manage their heightened sensitivity, leading to feelings of overwhelm, irritability, or anxiety.

Low Registration

Individuals in this category may not notice sensory input readily, requiring stronger or more intense stimuli to respond. This can make them appear inattentive or uninterested in their surroundings, as they may not pick up on subtle sensory cues that others might notice immediately. For example, they may not be aware of a ringing phone, a colleague speaking to them, or even a change in the temperature of the room until the sensory input becomes more intense or disruptive. Because of this, people with low registration might be perceived as daydreaming, disengaged, or disinterested, but in reality, they are simply less responsive to sensory input.

These individuals often need support systems built into their environment to help them stay on track and become more aware of important stimuli. For example, they might benefit from the use of alarms to signal tasks or appointments, sticky notes as reminders for daily responsibilities, or bright, noticeable signs to highlight important information. These external cues help trigger their attention and provide necessary prompts to remain engaged with their environment.

In some cases, individuals with low registration may not respond to social cues or environmental changes unless they are more extreme. For example, they may not notice a subtle shift in tone when someone is upset with them, but if the person becomes visibly angry or vocal, they are more likely to react. Similarly, they might not notice a decrease in room temperature until it becomes very cold or uncomfortable. The challenge lies in their ability to process and respond to sensory stimuli only when the input reaches a certain threshold of intensity. While this pattern of sensory processing may not necessarily cause distress or anxiety for these individuals, it can lead to difficulties in social or work environments, where a heightened awareness of sensory details and a more timely response are often necessary.

It is important to know sensory processing is not always uniform across all sensory modalities, and people may display different patterns depending on the type of sensory input they encounter. For example, while someone might avoid certain auditory stimuli, they may actively seek out specific tactile or oral sensory experiences. This complexity emphasizes the importance of tailoring sensory interventions to the unique needs of each individual, ensuring that therapeutic approaches are both comprehensive and personalized. 

The Relevance of Sensory Processing in Mental Health
Many individuals with mental health conditions, including anxiety disorders, depression, ADHD, OCD, and post-traumatic stress disorder (PTSD), exhibit sensory processing differences (Brown et al., 2019). For those with anxiety, sensory overload can exacerbate symptoms, leading to panic and avoidance behaviors. An individual with sensory avoidance patterns may steer clear of crowded social events, often resulting in isolation and increased feelings of loneliness.

Additionally, a study by Jerome and Liss (2005) explored the relationship between sensory processing patterns and attachment types. The authors found that sensory sensitivity correlates with relationship anxiety, while sensory avoidance relates to relationship avoidance; low registration is associated with both forms of relationship discomfort, and sensory seeking is linked to secure attachment.

Sensory processing can also play a key role in building resilience and supporting recovery. Engaging in positive sensory experiences promotes overall well-being and helps individuals feel grounded during times of distress. Interventions that include sensory-based strategies, such as mindfulness practices and grounding exercises, have been shown to support nervous system regulation (Miller et al., 2007). For example, practicing deep breathing while focusing on tactile sensations like a soft blanket or stress ball can induce relaxation in overwhelming situations. Weighted blankets, in particular, offer deep pressure stimulation that activates calming sensory pathways, reduces anxiety, and boosts melatonin production, fostering a sense of safety and relaxation (Yu et al., 2024). Additionally, introducing a noxious stimulus, such as a sour taste, during a panic attack can help redirect attention. This interrupts the cycle of distress and engages neural pathways that regulate emotional responses (Rainville, 2013).

Practical Strategies for Engaging with Sensory Processing Differences
Understanding one’s sensory processing patterns can lead to effective coping strategies that enhance engagement in daily life. Here are specific strategies tailored to each processing category:

• For Sensation Seekers: Structured physical activities such as rock climbing or martial arts provide the significant sensory input that sensory seekers benefit from, promoting physical and emotional regulation through intense engagement. Similarly, practices like yoga or tai chi enhance grounding and body awareness through controlled movement. For those craving excitement, adventure activities such as zip-lining offer stimulating sensory experiences while fostering a sense of community and connection with others.
• For Sensation Avoiders: Gradual exposure to challenging environments, like shopping during off-peak hours, allows sensory avoiders to build tolerance without overwhelming their senses. Comfort tools such as noise-canceling headphones or sunglasses provide instant relief in overstimulating situations. Additionally, calmer venues with softer lighting create a sensory-friendly atmosphere for social interactions, contributing to more positive experiences.
• For Sensory Sensitivity: Designating a safe space at home equipped with weighted blankets and sensory-friendly items can provide a calming refuge for sensory-sensitive individuals. Mindfulness techniques such as deep breathing and gentle stretching focus on regulation, reducing the effects of sensory overload. Engaging with nature through activities like gardening or hiking can also help mitigate sensory overwhelm by offering grounding sensory input in a peaceful environment.
• For Low Registration: Individuals with low registration often miss sensory cues, making tools like alarms, sticky notes, or digital reminders valuable in fostering engagement and awareness. For example, placing a sticky note on a desk as a visual cue and pairing it with a timed phone alarm can help reinforce tasks that might otherwise go unnoticed. Incorporating tactile or flavorful experiences into routines, such as savoring meals or exploring varied textures, can further enhance sensory awareness and promote meaningful interaction with one’s environment.

Additional Considerations in Recovery
It’s crucial for centers and programs to have formal sensory assessments such as the Adolescent/adult Sensory Profile, as this helps to understand the unique sensory profiles of the individuals in their care. A formal assessment provides valuable insight into how sensory processing may be affecting their clients’ daily functioning, helping programs identify when sensory processing is a barrier. This enables them to implement targeted interventions and accommodations, ensuring that sensory needs are met. Furthermore, understanding the sensory profiles of individuals allows providers to offer personalized support strategies and create environments that foster greater comfort and engagement. Sensory processing is a foundational aspect of how we navigate the world, and understanding its complexities enables us to support individuals in overcoming challenges so that they can thrive in their daily lives.