Guest post by Tom Dozier, M.S., BCBA, misophonia researcher and therapist

Misophonia – a little known word for a common condition, affecting more than 10% of adults in the United States.  Do certain soft sounds, such as chewing, sniffing, or breathing seem intolerable?  Maybe the sight of someone shaking their leg or chewing gum fills you with anger, rage, disgust, or anxiety.  This would be misophonia.  Misophonia is a condition where subtle stimuli cause an extreme reaction.

“Misophonia” comes from “miso” meaning dislike and “phonia” meaning sound.  When a person hears a misophonia trigger, they experience extreme emotions, usually including anger/rage, disgust, anxiety, and a desire to get away or make the trigger stop.  If the trigger cannot be stopped or escaped, the person endures physiological distress.  Some people recover quickly from experiencing a trigger and some take hours after a bad trigger situation.

For information on misophonia, see misophonia.org or misophoniatreatment.com.

Triggers for many also include visual images such as leg shaking, hair twirling, or hand movements.  Vibrations from loud bass or a desk bump caused by the person of the other side of the partition (curse those open offices).  There are also instances of odors and tactile stimuli triggers, but these are far less common.  Virtually any repeating sight or sound or other stimulus can become a misophonia trigger.  

Misophonia is a conditioned (learned) response.  If you have misophonia, your response to trigger stimuli is something your brain accidentally learned.  Unfortunately, once a the misophonia reflex develops, it strengthens and expands with experience.  In most cases, it starts with a family member or close friend, and then expands to other people, sounds, sights, and places.  In a large survey I conducted, 96% of people had triggers to eating/mouth sounds, so although misophonia is known as a condition where the sound of others chewing fills you with rage, there are those that are not triggered by mouth sounds.  Visual triggers are also common, and 92% in the survey had at least one visual trigger.  

The misophonia reflexes:  There are several reflexes in misophonia.  First, there is an initial physical reflex.  This is the “cause” of misophonia.  This is usually a muscle flinch, that goes unnoticed because the second reflex is extreme emotions that dwarf the muscle flinch.  Following the emotions, there are physiological distress reflexes of sweating, increased heart rate, general muscle tension, and fight-or-flight.  I don’t have misophonia and so have never been triggered.  I tell my patients, “I don’t know what you experience when you are triggered, but I know it is horrible.”

So, what can you do?  Simply enduring triggers makes you miserable and makes your misophonia worse.  Trying to avoid all triggers doesn’t work either.  First, you can reduce the severity of auditory triggers by adding background sound.  When it is quiet, the triggers are experienced as louder and are more noticeable.  Turn on a sound machine or a box fan (very loud fan), or a noise app on your phone and earbuds.  As you increase the background sound, the severity of your trigger response will decrease.  Earplugs should not be used except for short periods of time because they can increase your hearing sensitivity (and noise works better anyway).

You Must Relax. This was the title of Dr. Jacobson’s book on progressive muscle relaxation (PMR). PMR exercises develop neural connections that allow you to relax your muscles on demand. This can only be learned with practice. It takes practice, practice, and more practice, but it is worth it. I made an app for this. Misophonia Muscle Relaxation Training is a PMR app focused on how to use PMR as a treatment for misophonia. If you relax when you are tense, your triggers will be less severe. If you can relax after a trigger, it can shorten your anger response. But if you relax before and through a trigger, it can cause your muscle reflex to decay, and as the physical reflex decays, so does your anger reflex because it is triggered by the physical reflex.

What doesn’t work:  Traditional hypnotherapy rarely provides lasting results, and the biggest no-no is exposure and response prevention (ERP).  ERP is great for OCD, but it is horrible for a miso-patient and usually makes misophonia worse.  

There is hope for misophonia sufferers.  There are good management techniques that help and there is treatment for misophonia.  To find a therapist that can help you with misophonia, see the treatment provider directory on misophoniatreatment.com.

One more note.  If you like to read, there is a book on misophonia, Understanding and Overcoming Misophonia, A Conditioned Aversive Reflex Disorder.

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Julie Bjelland is a Psychotherapist, host of The HSP Podcast, and Founder of the Sensitive Empowerment Community, whose mission is to create a paradigm shift where sensitivity is embraced, valued, and honored. Register for free Masterclasses, get a free guide to calm your brain, a letter to give your medical and mental health practitioners about high sensitivity and take the Sensitivity Quiz at JulieBjelland.com ❤️🌈❤️ (she/her)