Wednesday, May 8, 2024

What your therapist needs to know about giftedness

What does your therapist need to know about giftedness? And why should this matter?

Most therapists are not trained to consider how giftedness can affect you or your child. Cognitive complexity, emotional sensitivities, asynchronous development, twice-exceptional conditions, and outlier status with peers may be misconstrued or misdiagnosed. Many are unfamiliar with the distress children feel when bored at school, or how perfectionism, high expectations, and existential angst create barriers to reaching potential. 

Of course, this does not mean that you must find a giftedness-informed therapist. Given the wealth of information available now, it is not that difficult for a skilled therapist with extensive training and experience to learn more. 

For Mental Health Awareness Month, and with permission, I am sharing part of my article, Intellectual Giftedness Imparts Challenges That Affect Gifted Clients Throughout the Lifespan* written for a special issue on disabilities for the Pennsylvania Psychologist.

It is written as a brief research-oriented review, so less "chatty" than most blog posts. But hopefully you (or your therapist or your child's therapist) might find it helpful.

Giftedness has an impact across the lifespan 

At first glance, including gifted intellectual ability in a conversation about disabilities might seem odd. Although not a disability in a traditional sense, exceptional cognitive ability associated with an IQ of 130 or higher – two or more standard deviations above the mean – imparts distinct differences that, at times, create a disadvantage for gifted individuals and contribute to a range of deficits. 

Gifted children learn at a faster pace and with greater depth and complexity than their classmates and often endure boredom in classrooms ill-equipped to accommodate their academic needs. They sense how much they differ from same-age peers and may struggle to engage in normative social activities. Many struggle with heightened feelings of sensitivity and emotional reactivity, along with asynchronous development, where social/emotional maturity lags behind intellectual strengths. This sense of “differentness,” – this outlier status – can contribute to social, emotional, motivational, and academic challenges that hamper their development, affect peer relations, and create inner turmoil. (Webb, et al., 2007).

Most conceptualizations of giftedness presuppose an IQ of 130 or higher; however, additional criteria have been proposed, including exceptional creativity, motivation, task commitment, expertise, environmental impacts that can either thwart or enhance capabilities, and asynchronous development (e.g., Worrell, et al., 2019). 

Despite these expanded views of giftedness, many children remain unidentified because they do not “look gifted” to educators. Gifted under-identification often occurs when gifted children underachieve or mask their giftedness to fit in with peers or when they present with a twice-exceptional condition (such as ADHD or a learning disability) that obscures their strengths. Gifted under-identification is especially common among students who are English Language Learners, persons of color, or who reside in impoverished home environments, creating an “excellence gap” where those most in need of enrichment remain underserved (NAGC, 2019). 

The dearth of appropriate educational services, stereotypical assumptions about giftedness, and the widespread misconception that gifted children will “do just fine” regardless of their education deprives these children of much-needed academic services. Gifted education is legally mandated in public schools in PA; however, many school districts are non-compliant. Universal pre-screening for cognitive abilities, referrals for cognitive testing, and implementation of research-backed strategies, such as acceleration or ability grouping, are frequently absent. 

Children who are chronically bored and under-stimulated may become depressed, apathetic, oppositional, disruptive in the classroom, and fail to develop executive functioning skills.

Why this matters

Psychologists must be alert to the cognitive and social/emotional impact of giftedness in assessment and treatment, and in consultation with educators or prescribing medical professionals. Giftedness may contribute to or amplify social, emotional, academic, motivational, and vocational struggles. Gifted children can be misdiagnosed with ADHD, OCD, ASD, or an anxiety disorder, when in fact, their symptoms are more consistent with the emotional intensity, sensitivity, heightened energy, rigidity, asynchronous development, or overthinking so prevalent among the gifted (Webb, et al., 2005). 

A child’s emotional or behavioral difficulties also may be fueled by peer rejection, social isolation, apathy associated with boredom at school, or internalized pressure to succeed. Widely diverse symptoms and behaviors – ranging from selective mutism to oppositionality to substance abuse – can be understood as compensatory mechanisms used to quell intense emotions or offset disengagement from school or peers.

Are gifted children more prone to psychological problems?

Questions have been raised regarding whether gifted children are more prone to psychological problems than their neurotypical peers. Some researchers and theorists view gifted intellectual strengths (including critical thinking skills, internal locus of control, and openness to experience) as buffering mechanisms that enhance resilience (e.g., Kronborg, et al, 2017); others propose that their emotional reactivity and tendency toward overthinking leaves them psychologically vulnerable (e.g., Karpinski, et al, 2018). 

Reviews of the research (Neihart & Yeo, 2018) support both perspectives and suggest a mixed presentation that includes both exceptional strengths and disabling weaknesses. Szymanski (2021), for example, proposed a harmony/disharmony hypothesis to describe how giftedness affects all aspects of a child’s life: 

“The harmony hypothesis supposes that high IQ allows individuals access to better problem-solving abilities, greater frequency of ideas, and abstract thinking, which serve as buffers to reduce some negative social and emotional issues faced in development. Conversely, the disharmony hypothesis posits that feelings of being different, increased awareness, and pressure to perform may contribute to a more negative developmental experience for gifted children than for nongifted” (p. 417).

As psychologists, we must consider the impact of giftedness in assessment and in educational or treatment planning (NAGC, 2019). We can utilize our skills to consult with educators and prescribing medical professionals, and advocate for changes in how these children’s needs are addressed within the schools. Parents of the gifted also benefit from support since normative parenting advice may not always apply (Post, 2022).

What about gifted adults?

Giftedness does not disappear after childhood; its impact is seen throughout the lifespan. In fact, many gifted adults who show up in our psychotherapy offices describe a long-standing history of emotional distress, social rejection, and the use of compensatory behaviors to cope with their emotions. Vocational problems may stem from boredom, impatience, perfectionism, an absence of executive functioning skills, or multipotentiality. 

Older gifted adults may feel despair upon retirement if their sense of purpose is lost, and gifted elders may become depressed if like-minded peers do not reside within their retirement communities. In short, gifted individuals experience the same psychological conditions as their neurotypical peers; however, giftedness infuses an added layer of cognitive complexity, introspection, and sensitivity that may trigger or intensify emotional distress,

What psychologists must consider in their work with gifted individuals

In our clinical work, we are called upon to provide therapeutic support for gifted children, adolescents, and adults as they navigate a world not quite built for them. Regardless of our therapeutic orientation, providing a warm, supportive presence is essential – one where their differentness, quirks, and social struggles are understood; where overthinking, heightened emotional reactivity, and self-regulation or executive functioning deficits can be addressed; and where they feel comfortable exploring their emotions and existential concerns related to life’s complexities.

*Post, G. (2024) Intellectual giftedness imparts challenges that affect gifted clients throughout the lifespan. Pennsylvania Psychologist, 84(2), 23-24.

The photo above is courtesy of Unsplash/Tim Gouw

** For insights about parenting gifted children, please see my book, The Gifted Parenting Journey. Available through the publisher and the usual bookseller sites, this book addresses a previously neglected topic in the literature: the needs and emotional life of parents of gifted children. 

**Continuing education for therapists:

Information in my book is also relevant for psychotherapists. It can be used to meet APA-approved Continuing Education requirements through an online course offered through SENG, a non-profit organization dedicated to the needs of the gifted.