Misophonia: The Google consensus for the definition of misophonia seems to be an intense emotional reaction to specific sounds. While technically accurate, this definition doesn’t really do the experience of misophonia the justice it truly deserves.
Most people may be able to relate to the physically uncomfortable sensation that results from the sound of dragging nails on a chalkboard. Most people can identify with the auditory agony that scratching incompatible surfaces against each other can produce. Misophonia is something very different.
I can’t remember how it started. I distinctly remember being in a car with my mother shortly after I got my driver’s license. It’s probably safe to admit that we were both nervous at the idea of me driving. I was giving the task my full attention, until it was interrupted at unpredictable intervals by the sound of a hard candy bouncing off my mom’s teeth and slowly disintegrating into a frothy mulch that grated abrasively against her tongue. To me, it was the auditory equivalent of decomposing flesh.
The sound made my skin crawl. I felt my grip on the steering wheel tighten, my breathing changed. I felt my vision narrow, my situational awareness disappeared. My mood almost instantly changed from pleasant and jovial to intensely angry. I wrestled with a powerful urge to stand on the accelerator and point the car away from the road.
This was a very different reaction to the socially common nails-on-a-chalkboard full body groan-in-agony. What I was experiencing was an intense and uncharacteristic rage in response to extreme disgust – the result of a sound that most people find pretty easy to ignore.
In addition to the shame and guilt I felt for the irrational rage and disgust I experienced, I felt very alone. I had never heard of misophonia and I did not know how to explain these feelings to anyone else. I chose to avoid social gatherings where food would be consumed – movie theatres especially. I find the sound of crunching popcorn is deafeningly vile.
What helped my experience with misophonia?
There isn’t a lot of information on misophonia. Small scale pilot studies and case reports discuss the following strategies:
- Behaviour therapy to become less aware of the sound
- Strategies to compete with the sound so it’s more predictable
- Devices to cancel out the sound
I discovered that being able to make the noise that triggers my misophonia brings me much relief. The sounds of other people eating don’t bother me if I’m eating too. When my mom knocked a peppermint around in her mouth, I had one as well.
The key takeaway here is that these strategies work for me… I cannot (and would not dare to) state that my experience with misophonia is equivalent to anyone else’s.
What do professionals need to know about misophonia?
There are currently no diagnostic tests for misophonia. (Kumar, 2017)
The condition can occur with or without other physical and mental health conditions. (Jastreboff, 2015)
Common responses are irritability, anger, and disgust (Edelstein, 2013) (Jager, 2020) (Webber, 2015)
Interestingly, misophonia is rarely self-induced; the triggering sound is almost always produced by another individual. (Yilmaz, 2021)
There are currently no pharmacological treatments. (Yilmaz, 2021)
While case studies suggest that CBT may reduce the severity of symptoms in some patients, (Schröder AE, 2017) there are no large-scale randomized-controlled studies that might elucidate a more comprehensive understanding of misophonia. (Yilmaz, 2021)
This absence of clinical evidence makes the condition difficult to discuss with healthcare professionals (Sanchez, 2018).
Still, there are ways to be supportive:
- Listen without judgment. The person with misophonia is aware that their emotional response is excessive, unreasonable, or disproportionate to the circumstances or stimulus. It is really helpful to know that other people have similar experiences.
- Misophonia is a reaction to specific triggering sounds. Unlike hyperacusis, it is the sound, not the volume of it that causes distress.
- The description of the intense emotional response is not an exaggeration, and may even be toned down so the experience can be shared.
- Encourage open communication – loved ones tend to appreciate knowing how they can help and that they are not the reason for the emotional outburst
Skye Van Zetten (lived-experience advisor)
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Edelstein, M. B. (2013). Misophonia: Physiological investigations and case descriptions. Frontiers in Human Neuroscience, , 7, 296. https://doi.org/10.3389/ fnhum.2013.00296.
Jager, I. d. (2020). Misophonia: Phenomenology, comorbidity and demographics in a large sample. PLOS ONE, , 15(4), e0231390. https://doi. org/10.1371/journal.pone.0231390.
Jastreboff, P. J. (2015). Decreased sound tolerance: hyperacusis, misophonia, diplacousis, and polyacousis. . Handbook of Clinical Neurology , 129, 375–387. https://doi. org/10.1016/B978-0-444-62630-1.00021-4.
Kumar, S. T.-H. (2017). The brain basis for misophonia. Current Biology, , 27(4), 527–533. https://doi.org/ 10.1016/j.cub.
Sanchez, T. G. (2018). Familial misophonia or selective sound sensitivity syndrome: Evidence for autosomal dominant inheritance. . Brazilian Journal of Otorhinolaryngology , 84(5), 553–559. https://doi.org/10.1016/j.bjorl.2017. 06.014.
Schröder A, V. N. (2013). Misophonia: diagnostic criteria for a new psychiatric disorder. . PLoS One, , 8:e54706.
Schröder AE, V. N. (2017). Cognitive behavioral therapy is effective in misophonia: An open trial. . J Affect Disord, , 217:289-294.
Webber, T. A. (2015). Toward a theoretical model of misophonia. . General Hospital Psychiatry, , 37(4), 369–370. https://doi.org/10.1016/j.genhosppsych.2015.03.019.
Yilmaz, Y. A. (2021). Misophonia: A review. Current Approaches in Psychiatry / Psikiyatride Guncel Yaklasimlar , 13(2):383-393 doi: 10.18863/pgy.857018.