Gifted children and adults: When is therapy helpful?

As a gifted adult or the parent of a gifted child, you may have wondered if either you or your child would benefit from therapy.

You also might have questioned whether it was really necessary. Am I overreacting and being an alarmist? Will it help? And when is it worth the cost?

Although education, mental health and health care professionals have been known to misdiagnose and mislabel gifted thinking and behaviors as a sign of disturbance, it is just as important to not overlook problems when they arise.

And gifted people often possess traits that make life more complicated!

While depression, anxiety and self-defeating behaviors are universal, giftedness poses specific challenges that bring with it several risk factors for emotional distress. Gifted children and adults are not more prone to psychological problems; rather, emotional distress among gifted individuals may be precipitated, heightened or modified by these gifted traits:

• Overthinking - Due to their active minds, many gifted individuals have a tendency to obsess, ruminate, worry, hyperfocus, or spend an excessive amount of time deconstructing a simple concept. While sometimes this might be entertaining, like solving an interesting puzzle, when the focus is on something distressing that is not easily resolved, it can become overwhelming.

• Perfectionism - While perfectionism is not necessarily more common among the gifted than anyone else, some gifted people feel compelled to strive for perfection. They hold exceptionally high standards for themselves, avoid taking risks, and feel devastated if they fall short of their goals. This can contribute to anxiety, panic attacks, depression, and, ironically, procrastination, which allows them to avoid tackling the dreaded task.

• Isolation - Given the fact that gifted (and especially highly gifted) individuals are in the minority, many feel isolated and misunderstood. Some have difficulty finding a close group of peers or developing meaningful friendships or relationships. Isolation and loneliness can contribute to low self-esteem, depression and delays in social maturation.

• Underachievement - Some gifted children and adolescents either "dumb themselves down" to fit in at school (or sometimes merely to survive and avoid bullying) or become so disenchanted with the lack of intellectual challenge that they perform well below their potential. Not only does this cause stress within the family, but it can ultimately contribute to low self-esteem (as the child may start to believe the persona he or she has created) along with feelings of hopelessness and depression.

• Impostor syndrome - Gifted individuals, especially women, sometimes doubt the validity of their accomplishments. They believe they have fooled everyone, that the truth will be discovered (i.e., that they are not smart and are undeserving of any accomplishments), and that any success is due to luck rather than their abilities. 

• Asynchronous development - Social/emotional and intellectual development are often out of sync for gifted children, and some definitions of giftedness even claim asynchrony is its defining characteristic. When intellectually advanced children lag socially, they may struggle to fit in and experience rejection and criticism from peers. They may feel isolated and misunderstood, and respond by withdrawing, becoming depressed, or occasionally, retaliating.

• Oversensitivity and emotional overexcitability - Gifted people often experience heightened emotional reactivity and sensitivity.  This can create a tendency to be easily hurt, respond intensively to emotionally charged situations, and feel deep empathy for the pain others suffer. Too much emotional reactivity can contribute to depression and anxiety. Many also feel misunderstood when less sensitive people label them as "too sensitive" and criticize their emotional reactivity.

• Existential depression - Some gifted individuals grapple with a perception that life is meaningless, and become disillusioned and depressed. Their intellect and emotional depth allow them to ponder the meaning of life with great intensity, and they may feel lost and alienated until they can reconstruct a new sense of meaning and purpose. 

Many gifted people have managed to adjust to these traits with success, but others suffer and would benefit from the guidance of a psychotherapist who can offer support and help them develop  perspective and coping skills.

And parents of gifted children often struggle with anxiety and frustration when trying to help their child, whether attempting to challenge underachievement and procrastination or helping them weather the storm of heightened emotional reactivity and oversensitivities. Parents benefit from the feedback and support of a psychotherapist or family therapist who can help them manage their child's emotional or behavioral problems along with their own personal reactions.

Here are some brief facts about psychotherapy:

1. Therapy provides a safe, supportive and challenging environment where you, your family or your child can develop tools for change. Through exploration of thoughts, feelings, or long-standing patterns, a greater understanding of how to relieve distress and change problem behaviors can be accomplished. Therapy with adults and adolescents typically range from here-and-now techniques that address current thoughts and behaviors to in-depth exploration of past family patterns and how they relate to current problems. Additional approaches include family, couples and group therapy, parent guidance, and play therapy. (For more on psychotherapy, see: Understanding psychotherapy and how it works.)

2. Searching for a licensed mental health professional can be a challenge at first. Experience, training and skill certainly count, but finding a a therapist with specific expertise in your areas of concern, and where you truly feel understood is also essential. Good referral sources can include close friends, your family physician, school counselors, or professional organizations, such as state psychological or social work organizations.

3. Don't wait to get help. Symptoms that warrant an immediate evaluation by a licensed mental health professional include any threats of harm to self or another person, or a loss of contact with reality. Also, therapy is indicated if symptoms of distress or self-destructive behaviors interfere with school, family, work or relationships, and/or if they create unhappiness that is unrelieved by alternative attempts to address the problem.  Common symptoms can include (but are not limited to) the following:

• Depression (persistent sadness, mood swings, frequent crying, hopelessness, loss of interest in activities, sleep and appetite disturbance, suicidal thoughts)

• Anxiety (panic attacks, obsessive thoughts, compulsive rituals, generalized anxiety)

• Anger (difficulty managing anger, frequent tantrums or hitting in children)

• Self-destructive and acting out behaviors (cutting, eating disorders, school refusal, running away from home, drug or alcohol abuse)

• Persistent and unresolved problems (low self-esteem, body image concerns, parenting problems, marital or family conflict)

In addition to psychotherapy, gifted children and adolescents benefit from other sources of professional help and support, depending on their specific needs. These can include:

Psychoeducational testing - It might seem obvious that gifted identification would require an evaluation, but many schools only use broad, generic screening tools. As a result, many gifted children are not identified, and even when they are, useful information about learning differences and even possible learning disabilities are missed. Testing must be conducted by a licensed psychologist or school psychologist. If testing is not available through the schools, check with your pediatrician for referrals. Don't wait to get your child tested.

Occupational therapy - Some gifted children may have fine motor skill deficits that affect their handwriting and interfere with their ability to function in school. Others may have sensory processing issues, such as an oversensitivity to touch (e.g., cannot tolerate labels from clothing touching them). Occupational therapy can help children with these difficultlies. Again, your school or pediatrician may be a good source for referrals.

Educational consultation services - Sometimes psychotherapy is not necessary, but coaching or guidance related to your child's or your own personal goals may be what you need. Consultation, or coaching, is much more direct and goal-oriented than psychotherapy and is not intended to resolve psychological problems or emotional distress. When researching a consultant or coach, look for someone with training and certification as a psychotherapist, education specialist or life coach.

College planners - Many families are caught off-guard when planning for college. They might assume that the schools will advise them or that their child's smarts will land a merit scholarship. Families often discover much too late that their child's school may offer little guidance, and admissions opportunities may be lost. College planning consultants can help, for example, with strategically planning for college, prepping for the SATs, or reviewing college essays. But it is important to get good recommendations for whomever you work with to ensure that they are experienced and can truly help your child.


While not a substitute for communicating with family or friends, therapy or other support services can provide a unique opportunity for exploring concerns in greater depth and for receiving useful, direct feedback. Whether it is for your child, your marital relationship, or for yourself, therapy can help.


This blog is part of the Hoagie's Gifted Education Page Blog Hop on Asking for Help. To read more blogs in the hop, click on the following link: http://www.hoagiesgifted.org/blog_hop_asking_for_help.htm