What Is Misophonia?

Even the thought of a fingernail scratching across a blackboard is enough to make most of us cringe. Now imagine if that fingernail just kept going and the sound got louder and louder – how discomfited, annoyed, or even angry would you be? That taken to an extreme degree is what people with misophonia go through.

Misophonia Is Extreme Negative Reaction To Certain Sounds

Misophonia or selective sound sensitivity syndrome is a chronic condition in which a person experiences an involuntary and extremely negative reaction to commonplace everyday sounds like lip smacking, chewing, gum popping, grunting, or the clicking of pens. Misophonics may feel panic, anxiety, and rage when they hear a specific trigger sound – this involuntary reaction is considered similar to the one we feel in an extreme “fight or flight” situation.1

A rare condition, misophonia is, incidentally, not yet considered a discrete disorder by the Diagnostic and Statistical Manual of Mental Disorders (used by the medical community to diagnose and classify disorders)

– prompting many to question whether it even exists. On the other side, studies are afoot to better understand the condition, categorize it, and create diagnostic criteria.2

Misophonics Don’t Process Sound Normally

The reasons for misophonia are not entirely clear. However, it is assumed the brain doesn’t process sound information normally in misophonics. This is why people with misophonia experience an extreme version of the reaction that most people normally feel when they hear certain sounds, for instance, the fingernails scraping the board.3 According to researchers, misophonia has two aspects: an obsessional aspect with a focus on a specific sound and an impulsive aspect which tends toward aggression or uncontrollable rage.4

Another possibility is that misophonia is an abnormal reaction involving the limbic system

(which is involved in emotions) and the autonomic system (which is associated with the body’s involuntary functions like controlling heart rate and body temperature); it is thought to occur because of a deeper connection between the auditory and limbic systems than is normal.5 Many people with misophonia also show symptoms of other disorders like depression, anxiety, or obsessive-compulsive personality disorder (OCPD).6

Misophonia Triggers Have Physical And Psychological Effects

People who suffer from misophonia are aware that their reaction is unreasonable and they try to avoid situations where they could come across their trigger sound. This can have a really adverse effect on their social lives and generally reduce their quality of life.

Man-made sounds are triggers: The trigger sounds are usually produced by people. Sounds produced by animals or other sounds don’t usually cause this reaction.7

Visual elements may also set misophonics off: Though the trigger may be a sound initially, it can expand to include a visual. For instance, someone who is averse to the sound of eating can also be agitated by the sight of someone eating.8

Extreme negative reaction evoked: The trigger produces an immediate negative reaction such as irritation or disgust that instantly turns to anger. This can sometimes even lead to verbally or physically aggressive behavior.9

Physical effects are also produced: Misophonics may also experience physical effects such as clenched and tense muscles, pressure in the arms or chest, rising temperature and blood pressure, or sweaty palms when they hear their trigger sound.10

Triggers may be relative: The response to a trigger sound appears to be influenced by social context too, and not just driven by the physical characteristics of sound. For instance, some misophonics say that eating sound triggers don’t bother them so much when babies make them. The knowledge that babies don’t have much control over the sounds they make may mitigate the severity of the reaction. A trigger sound will also not evoke a strong reaction when the misophonics themselves produce the sound.11

Tackle Misophonia With Mimicking And Coping Strategies, CBT, Tinnitus Retraining Therapy

There are a number of coping strategies used by people with misophonia. They may distract themselves, listen to music, and use headphones or ear plugs. Mimicking techniques, where they copy the trigger sound, are also common. This helps them blot out the sound or becomes a means for retaliating (placidly) against the person making the sound, thus providing an outlet for their anger.12

Medically, there is no effective cure or comprehensive treatment for misophonia yet. Most practitioners treat other accompanying conditions like anxiety and rely on coping mechanisms. For instance, tinnitus retraining therapy (TRT) involves training misophonics so their tolerance of a noise improves. Cognitive behavioral therapy (CBT) focuses on changing the way they think about the distressing sounds. Associating the trigger sound with a pleasant situation and systematically exposing the misophonic person to gradually increasing levels of sound can be helpful in reducing the severity of the reaction.13