Misophonia- Bringing an obscure condition into light

What is Misophonia versus sensitivity to sounds? Determining the correct diagnosis. 

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The term Misophonia comes from two Greek words- Miso meaning “hate” and phonia meaning “sounds”. This gives us the translation: the hatred of sounds. Prior to researchers coining the term Misophonia, the symptoms were also labeled as soft sound sensitivity, select sound sensitivity syndrome, decreased sound tolerance, and sound-rage. It is quite normal for human beings to feel a dislike for sounds, especially a loud or repetitive sound such as  a fire alarm going off, a baby crying on an airplane, or a car alarm beeping at 10pm. In fact, I’d be concerned about someone who doesn’t find those sounds irritating or disruptive. For misophonia sufferers, however, their brains are producing extreme emotional responses such as rage, hatred, and disgust to specific sounds that are found in everyday life. Symptoms of Misophonia are commonly mistaken for a child being “stubborn or difficult”, paranoia, a symptom of Sensory processing disorder or Autism spectrum disorder, Oppositional defiant disorder, Generalized anxiety disorder, Bipolar disorder, and other mood disorders. 

When I assess for Misophonia, I am looking for very immediate, angry or disgusted responses to a sound or visual cue that exists in everyday life. A child or adult with Misophonia will cover their ears, have automatic negative thoughts towards the trigger, ask the person who made the sound to stop, yell, and sometimes get physically aggressive. If an individual is describing the emotional reactions only occurring in situations that involve a lot of sensory overload (eg. only in a noisy restaurant), sounds that are very loud (a fire alarm) or commonly regarded as irritating (nails on a chalkboard), then there is less likelihood that we are working with Misophonia. Misophonia triggers can exist in as little as one setting (eg. Grandma stirring her tea with a silver spoon from her set of blue teacups) but it will be regardless of volume.

Some common misophonia trigger sounds can include chewing/eating noises, keyboard clicking, noises from someone speaking, pen clicking, paper shuffling, etc. Very often clients will feel triggered by sounds created by only one or a few specific people. They can also become triggered by the sight (a family member shaking their foot despite not making a noise) or the anticipation of the trigger- eg. a sibling arriving home from school, or hearing a parent move in a different room. Over time, individuals and their loved ones learn avoidance strategies to avoid the triggers. For example, many of my clients with chewing/ eating triggers will eat meals alone in their bedrooms- they miss out on interaction with their families and opportunities for communication and bonding. Understandably, these avoidance behaviors are intended to reduce the number of unwanted conflicts or outbursts. But over time, avoidance can lead to an increase in overall distress at the anticipation of the triggers, changes in mood, and isolation. 

 All of the clients I have worked with who suffer from Misophonia struggle with some levels of shame, embarrassment, and distancing themselves because their misophonic reactions are completely opposite of how they want to treat their loved ones. If you or a family member is struggling with symptoms of Misophonia please know that the misophonic responses are NOT a choice (they are not your fault!) and are experienced as involuntary. In fact, you or the loved one are experiencing a physical reflex where the emotional reaction is being automatically jerked out of you. With the proper treatment, you or your loved one can learn the strategies to manage the distress, thoughts, and behaviors that come with the triggers and the anticipation of the triggers. 

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Misophonia has been thought to be untreatable- Is it possible to treat Misophonia? 

Yes! There is hope. Fortunately, over the years awareness and treatment for Misophonia has grown. At CalmOCD our therapists are trained to provide full assessments for Misophonia and identify unique goals for each client we serve that will help them live their fullest lives. We utilize a combination of Acceptance and Commitment therapy (ACT), Dialectical Behavior therapy (DBT), and Cognitive Behavior therapy (CBT) to equip clients with the distress tolerance, stress reduction, and cognitive skills they will need to respond differently to their anticipatory anxiety and sound & visual triggers. Exposure therapy can be added into Misophonia work, but it is not done right away, nor does it need to be a strong emphasis of treatment. For the majority of clients with Misophonia, exposure is not necessary because they are already receiving plenty of exposure opportunities being around their loved ones. Therefore, the primary goal of treating Misophonia is to help the client show up in their lives as they want to through skills usage, despite the negative internal sensations. 

At the start of treatment, our clients with Misophonia started out eating meals in different rooms, wearing noise canceling headphones at school and other places, avoiding school altogether, taking tests in different rooms, avoiding spending time with their family/friends, and experiencing tension within their relationships. At the end of Misophonia treatment, our clients can successfully return to important activities such as: eating at the dinner table, attending school again, spending less time avoiding sounds, enjoying more time being present in conversations, and experiencing more quality time with their significant other or family members. Recovery is possible! 

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