Wired for more: Reflections from an FP on hypersensitivity, head injury and the healing power of presence

As a family physician with over three decades of clinical experience, I’ve come to recognize a unique challenge in patients who, after head trauma, become overwhelmed by the very fabric of daily life: sound, light, touch, thought. These individuals are often neurodivergent or constitutionally sensitive to begin with. Post-injury, their nervous systems seem to become over-tuned, leaving them navigating a world that feels too much. What I’ve observedclinically—and come to believe deeply—is that the way forward is not through sedation or avoidance, but through presence. This article explores those lived observations, personal reflections, and emerging scientific support for the Presence-Based model of healing.The world too loud, too brightI recently sat with a patient who’d been hit on the head during a recreational soccer game. A couple of weeks later, she found herself retreating into dark rooms, avoiding restaurants and grocery stores, and wearing sunglasses indoors along with noise-cancelling headphones just to survive a conversation. “Everything is too much,” she said. “The light, the sounds, even people’s voices—I can’t think straight.” She’s not alone. I’ve now met many patients like her, often bright, sensitive, high-performing people who, after injury, feel like their nervous systems have gone into overdrive.The hypersensitive nervous system: a clinical pattern emerges Over the years, I began to see a pattern. A subset of patients who had experienced mild traumatic brain injuries, vascular events or even psychological trauma would go on to develop a persistent form of hypersensitivity—especially to sound (hyperacusis), light (photophobia) and often emotional or cognitive overload.What struck me was not only the intensity of their symptoms, but the chronicity. Long after any measurable injury had healed, their nervous systems remained reactive. Their lives had become a negotiation with the environment. Sunglasses indoors. Earplugs in crowded places. Cancelled plans. Social withdrawal. Hypervigilance. Many of these patients, I noticed, were already highly sensitive before their injury—empaths, deep feelers, or individuals diagnosed with ADHD, PTSD or migraine-prone nervous systems. And they suffered longer. Recovery seemed elusive.The role of avoidance: when relief backfiresOut of necessity, these patients often develop patterns of avoidance. And while avoidance provides short-term relief, my clinical suspicion—and now supported by research1, 2—is that it contributes to long-term sensitization.Avoiding sound by wearing earplugs constantly can lead to auditory deconditioning. Over time, even moderate noise feels painful. Similarly, dark adaptation from chronic sunglasses use indoors increases photophobia. This is the paradox: the very strategies people adopt to cope may be amplifying their suffering.A shift in perspective: what is experience, really?I started asking myself: what is it that makes a sensation become suffering?I’ve come to understand that experience is not just the raw sensory input. It is the product of three interdependent variables:Sensation—the actual stimulus: light, sound, heat, emotion.Attention—how much awareness is being focused on the sensation.Judgment—the mental interpretation of the sensation. Is it dangerous? Is it welcome? Is it a threat?To explain this, I often use a simple example: Imagine putting hot pepper on your tongue. That’s a sensation. If you’re paying attention, you’ll likely experience it more vividly. But if you’re deeply distracted—say, watching an intense film or caught in conversation—you may barely register the spice unless it’s extremely strong. Attentionamplifies or dulls the experience.But attention alone isn’t enough. The final layer is judgment—and that’s where things get personal. If you enjoy hot food, the heat of the pepper might feel exciting or pleasurable. If you dislike it, it might feel irritating or painful. The same sensory input, with the same level of attention, yields a completely different experience.That’s because judgment is cultural, conditioned, and often unconscious. And yet it powerfully shapes our relationship with discomfort.Pain as information, not enemyThis understanding has reframed how I support my patients. I often explain: “Pain isn’t the problem—it’s the messenger.” If we respond to pain with fear and suppression, we lose the opportunity to learn from it. But if we can meet pain with presence, we can begin to listen. To distinguish signal from noise.This doesn’t mean spiritual bypassing or denial. It means becoming attuned to the experience without collapsing into it. Not flinching away, but gently noticing.Presence therapy: a pathway to re-inhabiting the bodyOut of these insights, I began developing a practice I now call Presence Therapy. I hesitate to call it therapy, because there’s nothing to fix. It’s a way of inviting people back to the here and now, into an honest relationship with what is arising.Presence Therapy blends:Ear acupuncture (NADA protocol), an evidence-based approach supported by acudetox.com,Subtle sensation awareness training to uncover equanimity at the sensory level,Group integration to learn from shared experiential insight and restore a felt sense of safety in community.The work is not about changing the content of experience, but changing our relationship to it.Conclusion: invitation into the unknownI believe many of the patients suffering from post-injury hypersensitivity are not broken—they are simply more tuned. And this tuning can become a strength when met with compassion, structure, and presence. We are not done learning. This is a living inquiry, and I invite others—clinicians, patients, and curious minds—to join in the exploration.If you’re interested in learning more or participating in Presence Therapy, feel free to reach out. I currently offer an experiential course for physicians and wellness professionals who want to understand this approach firsthand. Sometimes the path forward begins not with more effort, but with stillness.Dr. Carlos Chi-Shih Yu is a family physician in Ajax, Ont., assistant professor at Queen’s University, and founder of Presence Therapy. He can be reached at info@inwardexpeditions.ca | www.PresenceTherapy.caReferences:Faulkner JW et al., 2021. Fear-avoidance and noise intolerance after mild TBI. Journal of Psychosomatic Research.Formby C et al., 2003. Auditory plasticity and earplug-induced attenuation. Journal of the Acoustical Society of America.Winstone-Weide LK, Gettig K, Austin CA. 2024. Postconcussive symptom severity, risk factors for prolonged recovery, and mental health history. Annals of the Child Neurology Society.

Wired for more: Reflections from an FP on hypersensitivity, head injury and the healing power of presence

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