Sensory processing difficulties — counselling and support for adults

Sensory processing refers to the brain’s ability to receive, organise, and respond to information from the senses — sight, sound, touch, taste, smell, and also proprioception (the sense of body position) and interoception (awareness of internal bodily states). When this processing works differently, the result can be either heightened sensitivity (hypersensitivity — where stimuli feel more intense, more overwhelming, or more painful than they do for most people) or reduced sensitivity (hyposensitivity — where stimuli are under-registered, prompting sensory-seeking behaviour). Many people experience a mixture of both, sometimes in the same environment on the same day.

Sensory Processing Disorder (SPD) is not currently a standalone diagnosis in the clinical manuals used in the UK — it does not appear in DSM-5 or ICD-11 as an independent condition. Sensory differences are, however, formally recognised as a core feature of autism and are also highly prevalent in ADHD. Many adults experience significant sensory sensitivities without any formal diagnosis — they simply know that certain environments and stimuli are reliably and genuinely difficult.

The brief note on diagnosis is important here: a clinical label is not required to access counselling support, and the absence of a formal SPD diagnosis does not mean the difficulty is not real. The experience is the starting point.

How sensory difficulties present in adults

• Noise: difficulty filtering background sound; certain frequencies painful or impossible to ignore; conversation in noisy environments significantly impaired
• Light: fluorescent or flickering lights produce headaches, distress, or visual overwhelm; screens at certain brightness levels cause fatigue
• Touch and texture: clothing labels, seams, certain fabrics; unexpected or non-consensual touch; physical pain from light contact that others do not register
• Smell: hypersensitivity to scents that others find unremarkable; nausea, distress, or inability to concentrate in environments with strong or mixed smells
• Crowds and public spaces: cumulative sensory overload in environments with multiple simultaneous sensory demands; difficulty functioning in open-plan offices, transport, or shopping centres
• Recovery time: needing significant time and quiet after high-stimulation environments; the ‘social hangover’ that others do not seem to need

Sensory difficulties are particularly prevalent in autistic and ADHD adults — see our pages on autism and ADHD for more on these neurotypes. Sensory sensitivities also occur independently, and in people with no neurodevelopmental diagnosis.

Counselling does not change how the nervous system processes sensory input — that is the domain of occupational therapy, and where sensory integration work is appropriate, we will say so. What counselling can work with is the emotional layer: the anxiety that has built up around sensory situations, the avoidance that has narrowed daily life, the shame around responses that feel outside your control, the exhaustion of sustained management, and the identity questions that arise around a brain and body that work differently.

Person-centred counselling provides a genuinely non-judgemental space — and for sensory reasons, online sessions can be particularly well-suited to this work, removing the potential sensory load of travelling to an unfamiliar environment. Sessions can be conducted by video or phone, in your own sensory environment, with any adjustments you need.

CBT addresses the anxiety and avoidance that develop around sensory difficulties. It works with the thought patterns that accompany high-stimulation environments — the anticipatory anxiety, the catastrophising about what a situation will feel like, the avoidance cycle that makes environments feel increasingly threatening. CBT also works with the behavioural side: carefully, collaboratively, exploring what might be possible to expand without pushing beyond genuine limits.

For adults whose sensory history has included significant adverse experiences — bullying, workplace dismissal, relational breakdown around sensory responses — EMDR may be used by some of our therapists to process specific difficult memories.

A note on occupational therapy: where sensory difficulties are significantly affecting daily functioning, an OT assessment can be valuable alongside or before counselling. OTs can assess sensory profiles, advise on sensory diets and environmental modifications, and provide a framework for understanding the sensory experience itself. Counselling and OT are complementary, not competing, approaches. If you are uncertain which is the right starting point, your GP or the free consultation with us is a reasonable first step.

Sessions are confidential. There are limited circumstances where this may need to change — for example, if there is a serious risk of harm to you or others — and your therapist will explain these clearly before sessions begin.