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Counseling Gifted Adults – A Case Study

By Paula Prober.

Gifted children are often identified by their insatiable curiosity, advanced mental ability, intensity, and thought-provoking questions. But what happens when these children become adults? What are they like and do they have any particular mental health needs? This paper uses a case study of one particular gifted adult to explain the typical issues these clients bring into counseling.

Most of us can recognize precocious children by noticing any or all of the following: thought provoking questions, advanced vocabulary, avid reading, unstoppable curiosity, creative thinking, and unusual mental, academic, and/ or musical abilities. (Webb, Amend, Webb, Goerss, Beljan, Olenchak, 2005) If we’ve worked with them in our counseling offices, or raised them, we find other traits, including: advanced empathy, intense emotion, hyper-sensitivities, and perfectionism. (Mendaglio & Peterson, 2007)

But what happens when these children become adults? And if they come to us for therapy, what do they need and how can we help?

The concept of giftedness, especially in adults, is unclear, complicated and controversial. M. Streznewski (1999), in her book Gifted Grownups, says it’s a “…finely tuned and biologically advanced perception system and a mind that works considerably faster than 95% of the population.” Typically, we associate giftedness in adults with high levels of achievement. But it is not that simple. In fact, the gifted person is as likely to be the high school rebel as she is the valedictorian, the CEO, or the Nobel prize winner (Jacobsen, 1999).

In adults, as well as children, giftedness is a whole-person phenomenon. Being gifted affects not only the cognitive and academic aspects of individuals, those qualities that we usually associate with giftedness, but also their emotional, social, and spiritual well-being. It is more a set of traits than a list of achievements; traits that don’t always make life simple or successful. Throughout their lifetimes, these individuals experience both the blessings and burdens of being gifted (Roeper, 1999).

Over my 29 years of working with this population, I have found certain issues come up repeatedly in therapy. The main challenges include: painful schooling experiences, high levels of sensitivity and intensity, existential depression/ advanced empathy, perfectionism, multipotentiality, and difficulties with relationships. (Mendaglio & Perterson, 2007) When a therapist recognizes the characteristics that often accompany advanced development and explains these traits and their effects to the clients, this explanation, in itself, can have a profound impact on the outcome of therapy (Jacobsen, 1999).

Case Background

Susan had known that she was different since she was seven. Her thoughts and feelings had never fit into the box that was comfortable and reassuring for most children. Her appetite for learning was insatiable. Reading was more nourishing than food. Thinking, analyzing, and synthesizing were better than Barbie.

And she worried about everything: poverty, world peace, and the loss of the rain forests. It kept her awake at night. The adults around her said that she was too young to be concerned with such things. That didn’t help. To her classmates, she just seemed weird–certainly not birthday party material. All of these reactions confused and saddened Susan but no one was explaining to her that she was different because she was gifted: She had a mind running deeper and faster than most. No one told her that seven year olds don’t feel responsible for saving the world.

Forty-five years later, at age 52, Susan came to therapy. Raising her teenaged son, John, had forced her to confront herself. John had been identified as gifted in preschool. Susan started reading about gifted children and was quite surprised to find that she was reading about herself.

When Susan first came to see me, I noticed her intensity immediately. Her penetrating hazel eyes were both anxious and skeptical behind her wire-rimmed glasses. At the same time, her affect was energetic and engaging. She wore a burgundy corduroy jumper with a turtleneck sweater and comfortable shoes.

At that first session, Susan told me her reasons for therapy. She needed to understand how, if she was gifted, it affected her work and relationships and to find ways to “handle this better” –to deal with the anxiety and deep loneliness she felt, to find friends who truly understood her, to communicate more effectively, and to keep her marriage from dissolving.

This was unusual. Most gifted clients come to counseling with the typical requests for help with depression, anxiety, relationships, and family dynamics. They do not suspect that they are gifted and even resist the idea, at first. They are often aware that they don’t “fit in,” but they do not know why. (Jacobsen, 1999) Susan’s awareness of giftedness made the issues involved and the approaches to therapy stand out clearly. That is why I decided to make her the subject of this case study. If counselors suspect giftedness and ask clients about it, using the following guidelines, insight can result that will influence and positively affect the outcome of therapy (Silverman, 1993).

I began by talking with Susan about some of the typical traits of gifted adults. Many of the characteristics were obvious: complex analytical mind, rapid speech, advanced empathy, quirky sense of humor, and perfectionism. As she described her early years, it became apparent that she was prone to multiple sensitivities, meticulous attention to detail and precision, and divergent thinking, all gifted traits. (Webb, et al, 2005) I gave her articles to read and a list of resources. Then she told me about her early experiences in school.


Very often, gifted adults have painful memories of their years in the classroom. (Clark, 1997) Susan said she recalled being thrilled about starting school but very quickly feeling deeply disappointed. In second grade, for example, she completed an entire reading workbook in one night. With enthusiasm, she showed her teacher the next day and was reprimanded for working ahead. The teacher told her to sit and color until the rest of the class caught up. This type of experience happened repeatedly over the years. Because Susan was a compliant child, she suffered silently. Occasionally, to her delight, a creative teacher would recognize her intellect and find ways to challenge her, but, on the whole, her experience in school was sadly lacking.

Susan had an unusual ability to remain upbeat and said she got through school by entertaining herself. Many other clients report being quite discouraged and depressed, becoming rebellious, and in some cases, never completing high school. It is important, then, for therapists to hear the stories of the schooling years and validate clients’ feelings: probable grief and anger over lost potential and wasted time, self-doubt about their own intelligence and abilities to achieve academically, and serious disappointment in the system.


In order for Susan to “handle” her giftedness, I let her know that multiple sensitivities are common in this population. Senses are generally more developed; perception is greater. (Silverman, 1993) Susan reported an ability to hear pitches both above and below normal range. Loud noise, certain music, sounds that would be fine for the average person were disturbing for Susan. She also was sensitive to texture, which meant she had to select clothing carefully and usually cut out the tags. Her visual sensitivity made it difficult for her to stay in an environment that was cluttered or chaotic, and was one reason she was meticulous about keeping her home and office in order. When taking medication, she needed to be sure to tell her physician to prescribe the lowest possible dose. It is easy to see how these symptoms could be pathologized and they often are, especially if the clients are so finely tuned that they’re like walking satellite dishes. (Webb, et al., 2005) Everywhere they go, they are bombarded by sounds, colors, smells, even the emotions of other people. Counselors can help clients cope by brainstorming solutions, including leaving places early, using ear plugs, deep breathing, visualization; explaining this phenomenon helps clients feel more relaxed and self-accepting. Discussing the benefits of a more developed sensory awareness is useful as well.

While Susan felt overwhelmed by her environment, her husband and friends were often overwhelmed, by her. There was an intensity in her speech, emotion, and energy. From childhood, people remarked that she was too sensitive, too curious, too dramatic, and too passionate. But this is the normal state for the gifted, and that’s what I told her. (Jacobsen, 1999) She was relieved. We looked at how she might both adapt to the people around her, and also seek friends and situations where she could express herself freely.

On occasion, Susan wondered if her intensity was too much for me. She would watch and check to see if I lost my focus or if I could not keep up with her. I let these clients know if I am confused or feeling ill or out of balance in some way because they are sure to notice and may misinterpret what they perceive.

Existential depression/advanced empathy

Very often, gifted clients will report experiencing mid-life crises of meaning and purpose—at age ten. Susan was no exception. Questions like, “ Why am I here?” “What is my purpose?” “ Why do humans hurt each other?” would rattle around in her brain. This type of existential questioning is common and extends into adulthood. (Neihart, Reis, Robinson, Moon, 2002) Of course, these are questions that most adults ask, and yet, the difference is that with the gifted, the questions are unending, and can turn into serious depression if a child has no one who will listen or the adult has no intellectual peers. Careful listening from a therapist who doesn’t minimize the importance of the questions can be deeply helpful. Counselors can recommend books along with suggestions for book clubs and participation in organizations where complex philosophical thought is welcomed.

Empathy is another quality that develops early. (Kerr & Cohn, 2001) Susan’s childhood interests in poverty, race relations, and the environment, all grew out of her deep caring for humans, animals, and the planet. For many, this empathy can be so strong that clients feel intense somatic symptoms when around others in pain, even tuning into the suffering around the world; it can manifest as strong intuitive abilities as well. It is important for therapists to acknowledge the beauty of such deep empathic responses and to help clients find ways to meet their needs to be of service through volunteering, writing, or specific career activities. Meditation, yoga, breathing techniques and connecting with nature are some of the practices I suggest. Susan found hiking, camping, gardening, and a “fierce advocacy for natural systems” to be soothing. She made her affinity with the natural environment the centerpiece of her spirituality. Finding a spirituality that feeds their souls can ease the intense worry about others and give clients a form for helping that is meaningful and manageable.


Typically, the gifted have extremely high standards and expectations for themselves and others. It is often labeled “perfectionism” and seen as a problem, though it may not be one. (Neihart, et al, 2002) Certainly, expecting others to work at your pace and level may be inappropriate and create serious conflict. But, it is important to note that these clients carry unrealistic expectations of others because they believe that their friends’ and colleagues’ abilities are similar to theirs.

When gifted adults apply these performance ideals to themselves, however, the outcome can be astonishing—a symphony, a problem solved, a work of art, an iMac. Susan compared her striving for perfection to an “extreme sport.” She needed to test the extent of her abilities “to keep life interesting.” Her soul needed to create order and beauty. If therapists understand this and don’t try to get clients to lower their standards but, instead, help them prioritize, so that less important projects can be simplified and more valuable work can be thoroughly and thoughtfully designed and accomplished, this supports clients’ authenticity while providing them with coping strategies (Silverman, 1999).

There is another type of perfectionism that is partly due to early pressure to achieve and excessive praise for accomplishments. It is quite complex and can include a debilitating fear of failure. (Silverman, 1993) This was not an issue for Susan but is very common in this population. It can include procrastination patterns due to fears of disappointing others or not living up to expectations and can seriously undermine success in higher education and in careers. Therapists can address this best through examination of family of origin dynamics, using their usual approaches to family systems work. If they focus on early pressures, expectations of self and others, achievement or underachievement, and connections between identity and accomplishments, they can uncover the root of this problem and find solutions.


Professionally, Susan was a policy analyst in the renewable energy field. She had selected the field because it allowed her to explore many of her interests and abilities, contribute to the betterment of society, and to work at a fast pace with lots of variety and contacts worldwide. Most gifted clients struggle with career choices because of their diverse passions and skills and their perfectionism. (Kerr, 1994) Therapists can help by guiding clients to craft a career, as Susan did, based on values, meaning, interests, and independence. Clients may need to be self-employed or design a career that doesn’t yet exist or change careers multiple times (Webb, et al, 2005).

Susan’s interests ranged from music to European culture to construction design with many others in between. This range and diversity is typical and, for some clients, can make choosing impossible. When therapists show understanding of the weight of this decision-making process, it is a relief for clients who, once they do decide, may need to grieve over career choices they did not make.


Gifted adults have trouble finding friends and partners—people who have similar depth, complexity, sensitivity, and interests. (Webb, et al, 2005) I have seen many clients who were seriously depressed due to a lifetime of loneliness. Susan spent much of her life moderating her intensity and being sensitive to others’ needs, not finding people with whom she could be herself. She was like the craftsman-style multi-storied bungalow with the vegetable garden in the front yard in a neighborhood of well-manicured two-story tract houses; too colorful, out of place, odd. People might have found the dwelling fascinating if they would have taken the time to enter, but few did.

But Susan did have a few friends.. She found the ones most like her through her work. One was in Sweden, one in Malaysia, and one in Minnesota. This is one solution for clients. They need to look for peers everywhere, and be open to less traditional types of relationships where location, age, and gender, for example, are not as important.

Susan had also found a partner. Jim was eleven years her junior. They were married when she was in her mid-thirties. Susan described him as sensitive, well-read and bright. She said there were some differences in style, complexity, and depth that resulted in tension, frustration, and resentment. For example, Susan ran the household. Even though she worked full-time, she handled finances, domestic chores, and all other responsibilities. Jim lacked focus and ability to complete tasks; decision-making was difficult for him. Even though they agreed on child raising matters, Susan was the more active parent. Not surprisingly, Jim felt intimidated and insecure around her sizable competence. Communication was limited and awkward. Susan blamed herself some of the time and other times thought her partner wasn’t trying hard enough or was purposely holding out on her. She didn’t realize he simply wasn’t capable of the same level of functioning. They were at an impasse.

I described for Susan the frustration and loneliness that many gifted individuals feel in partnerships. (Jacobsen, 1999) Like the other issues described above, simply validating her experience and giving her a place to say that being “so smart” wasn’t always a gift, allowed her to relax into the problem and start to generate solutions with me. I suggested couples counseling when I heard more details about their struggles and referred her to someone who both worked with couples and had an understanding of giftedness.

Susan had found a spouse who was willing to examine himself; many clients don’t. They long for partners who dive as deeply as they do, especially emotionally and spiritually. Often, they swim alone. When they get a clearer picture of their giftedness, though, they can start to find satisfying partnerships and friendships, because they know better who they are and what they’re looking for.


At our last session, we reviewed our work together. “There’s a foundation under me now,” she said. She described more comfort with the compromises she had to make with her husband and others and, at the same time, confidence that she could move at top speed and into the depths. Mostly, she said, she learned that she had a right to be herself—to seek complexity, to feel ecstasy and despair, to let her sensitivities be a guide rather than a pathology, to adore learning, and to live a full-on, nonstop, socially conscious, passionate life. She said she no longer felt like she had to try to fit herself into a box or to hide the “vibrant life” inside. Or, perhaps, the box had been transformed. “It feels more like a nest, not a cage…It feels like freedom.”

There are an infinite number of types of clients who seek therapy. One population rarely studied and often misunderstood are the people we assume will be fine because they are “so smart.” These individuals face serious challenges but there are significant, fairly simple ways therapists can assist—by explaining the struggles that can result from being gifted, validating their pain, helping them find ways to cope, and supporting their search for authenticity and meaning (Silverman, 1993).


Clark, B. (1997). Growing up gifted. Upper Saddle River: Prentice Hall. Jacobsen, M. (1999). The gifted adult. New York: Ballantine. Kerr, B. (1994). Smart girls: A New Psychology of Girls, Women, and Giftedness. Scottsdale: Gifted Psychology Press. Kerr, B., Cohn, S. (2001). Smart boys: Talent, manhood, and the search for meaning. Scottsdale: Great Potential Press, Inc. Mendaglio, S., Peterson, J., (2007). Models of counseling gifted children, adolescents and young adults. Waco: Prufrock. Neihart, M., Reis, S., Robinson, N., Moon, S. (2002). The social and emotional development of gifted children. Waco: Prufrock. Piirto, J. (2007). Talented children and adults. Waco: Prufrock. Silverman, L. (1999). Perfectionism: The crucible of giftedness. Advanced Development, 8, 47-61. Silverman, L. (1993). Counseling the gifted & talented. Denver: Love Publishing Co. Streznewski, M. (1999). Gifted Grownups. New York: Wiley and Sons. Webb, J., Amend, E., Webb, N., Goerss, J., Beljan, P., Olenchak, F., (2005). Misdiagnosis and dual diagnosis of gifted children and adults. Scottsdale: Great Potential.


Paula Prober, M.S., M.Ed. is a licensed counselor in private practice in Eugene, Oregon. Over the 30 years she has worked with the gifted, Prober has been a teacher, consultant, adjunct instructor with the University of Oregon, and a guest presenter at Pacific University and Oregon State University. Presently, she is counseling gifted adults and youth and consulting with parents of gifted children. Her blog (Your Rainforest Mind) is about gifted adults. Her book, Your Rainforest Mind: A Guide to the Well-Being of Gifted Adults and Youth will be released by GHF Press in the Spring of 2016.

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If you want to make your studying process much easier you always rely on professionals who will be able to make it this way. I know that study is always hard so i frequently use help, especially when i have question how to write a nursing research paper and other ones. I think that it is important to keep your life as balanced as possible. Not to be very tired from study is omportant, because when you are tired you have lack of motivation and motivation is a really important thing to me


Wow, the part about sensitivity to sound, sensations, and sights, described me perfectly.

The more I read about "Susan", the more I saw me.

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