- Misophonia is a highly distinct disorder.
- It is important to think about what you are looking for as you seek help.
- Considering differences in medical and psychological paradigms can help you to find the right practitioner.
As many of you know, my experience of misophonia is based upon having the disorder myself, having an adult child with it, and working to help other children (and their families) live better lives with this disorder as they develop ways to cope. I have spent the greater part of my life learning about the underlying mechanisms of misophonia and how to help others who suffer with it, and therefore it is a relief to me that misophonia research is finally off and running, after decades of so little work. When I think back to the 1990s when I was seeking treatment for my [then] young child and myself for a disorder that didn’t even have a name yet, I am amazed at how far misophonia has come. Yet, we still don’t have a validated treatment that has been replicated that includes cross-cultural variables, and that is as multi-disciplinary and unique as misophonia is.
And that upsets me. I have a feeling I am not alone, and that I why I am writing about this topic.
Misophonia is a highly unique disorder. As the Consensus Definition suggests, misophonia doesn’t belong solely in psychiatry, audiology, or neurology. It is not thought of as a mental illness, yet it is not yet studied in medicine — although it is being studied by neuroscientists, which is very important. Misophonia is a disorder that transcends disciplines and is not easily comparable to any other disorders identified in an allied health or mental health field.
For example, misophonia is not related to a particular trauma, but the memory associations act like trauma memories. It is not an auditory disorder, but certainly includes the auditory sense and auditory brain pathways. Recent work even suggests that motor pathways in the brain light up when a person is triggered by sounds. It is not an easy disorder to understand, and it is not like any other disorder one might think of. We have no idea how or why it starts, and who is most vulnerable to getting it.
Yet, more and more we now see claims for cures and treatments for misophonia across disciplines that may or may not ultimately have a place in misophonia. We see these claims on the internet, in books, and touted by various kinds of practitioners. Because of this, I think it is important to clarify what is meant by a cure and what is meant by a treatment. As you are out there searching for help for you or for a family member, think about these distinctions. This helps you to ask questions to any practitioners you may consider. So rather than detail or question the so-called treatments themselves, let’s consider what exactly “cure” and “treatment" mean in regard to you and misophonia.
According to the Nemours Hospital, a treatment is something that health care providers do for their patients to control a health problem or lessen its symptoms. Treatments can include medicine, therapy, surgery, or other approaches. The term cure means that, after medical treatment, the patient no longer has that condition anymore.
To me, this distinction is highly important. It goes without saying that we all want a cure for misophonia. We want research to parse out what this idiosyncratic disorder is so that we may never experience its symptoms again. Yet, for now we must settle for treatment, and most treatments we see for misophonia are based in psychology and audiology. Let’s review a bit about how psychology and audiology describe treatment paradigms.
According to the American Psychological Association, "various forms of treatment … including psychotherapy [CBT] and behavior modification, among others—[are] aimed at increasing an individual’s adaptive and independent mental and behavioral functioning."
This means that psychological treatment, in general, strives to increase the misophonic's ability to adapt to the disorder, possibly by learning how to change their behavior and how they think about their own functioning. Note that this is not a cure, and we must wonder to what extent psychology can change a neurological response, particularly one that is not very well understood. Could different forms of psychology lessen symptoms of misophonia? Yes. However, the symptoms most misophonia treatment research focuses on is the individual’s behavior. That is, how can I help the misophonic to think differently about trigger sounds (and visuals)? How can I help a person learn to tolerate triggers better? How can I help a person be less afraid of their own responses? How can I help the individual with misophonia tolerate triggers with more fortitude? Here, as is true of many psychological interventions, the disordered person is being treated but the disorder is not. Let me explain a bit more.
Imagine a time before there was an understanding of what a migraine was. Imagine a sufferer exclaiming that they were seeing "cracks" in their vision or "tunnel vision," or that they couldn’t "bear any noise or any light." That which cannot be explained by medicine often falls into psychology. I can almost hear it now: "The sufferer is hallucinating and has taken to the bed as they cannot stand daylight … perhaps rest and talking to someone might relieve her nervous tension."
We know misophonia is neurological, and this might help us to define psychology’s goals. Psychologists might want to treat this disorder with support, as is done with chronic illness and pain. A more middle-ground alternative in psychology is coping skills approaches, which consider both changes that can be made in the environment (such as the school, workplace, and family) as well as ways to help the individual understand and manage misophonia better. Coping skills approaches can be multi-disciplinary; for example, a psychologist or counselor might work alongside an audiologist.
According to the American Speech-Language-Hearing Association, audiologists can treat disorders related to hearing and balance. Audiologists may use assistive devices to help those with hearing difficulty. Conversely, an audiologist may help those with misophonia with assistive technology to change or inhibit trigger sounds. They may also advise on sound layering and other acoustic methods to assist in dampening sounds. They may even try to help the individual associate new experiences with the sounds that make them uncomfortable. Audiologists, however, do not treat the visual triggers that often accompany misophonia and will mostly refer to a psychologist for further treatment.
When a disorder spans different disciplines, when a disorder is still poorly misunderstood, we must be careful to know the focus of the treatment. Is the treatment going to put the burden of change on me or my child? Can I change? Will those changes within me help me to bear the burden of this disorder? I would like to see the disorder being treated, not the disordered person. Ultimately, you must decide for yourself who can help you most with misophonia. I hope that being mindful of these issues will help you to find a practitioner that is right for you or your family member.
To find a therapist, please visit the Psychology Today Therapy Directory.