Misophonia Was on Criminal Minds?

Who are we to blame?

Posted May 01, 2018

I have been a Criminal Minds fan since the show’s inception in 2005. Beyond the compelling entertainment value, I am fascinated by human nature, at its best and at its worst. For those who are not fans, here’s the premise of the show: A group of think-outside-the-box profilers work for the Behavioral Analysis Unit of the FBI, utilizing their unique skills to solve serial murders.

On Wednesday, April 18, I was very tired, having spent most of the day driving back from a visit with my son at college. As I lay in bed watching the episode “Mixed Signals”, fading in and out of sleep  suddenly I heard the words, “auditory cortex”.  Auditory cortex? Now I’m wide-awake. I say to my fiancé, “This is it…this is when misophonia is going to be on Criminal Minds.”

You see, for years I’ve been deeply disturbed by the way the disorder has been represented, and half-joking/half terrified I have often said that it was a matter of time before misophonia ended up on Criminal Minds.

And it did.

Here is a quick set-up of the episode: The team travels to the desert town of Taos, New Mexico, to investigate a string of murders in which the killer drills into his victim’s auditory cortex  Major ewwy. The auditory cortex is a part of the brain that processes auditory information, and the agents hypothesize about how this horrific act might explain something about the suspect. They learn of a strange phenomenon commonly reported in Taos called “The Hum.” The Hum is a low-frequency rumbling sound that a significant number of people report hearing persistently in certain geographical locations.

Courtesy of Pexels
Source: Courtesy of Pexels

As the team begins to discuss the Hum, and its possible connection to the murders, Spencer Reid (played by Matthew Gray Gubler) says the following:

There is a medical condition, called Misophonia, which causes its sufferers to react with panic or even extreme rage at everyday sounds, like chewing, humming, even breathing. Not everyone who hears the sound is going to react violently. But, given the right set of preconditions, violence is absolutely possible.”                                 

Violence is absolutely possible? Slow down. Reid, you did not say that!

Whenever misophonia is mentioned publicly, it’s usually a double-edged sword.  I welcome the visibility, while condemning the inaccuracy. Many in the misophonia community feel the same way, and these comments from misophonia advocate Kelly Bruno were indicative of the rather wide and rapid response to the Criminal Minds name-drop:

 “ [The condition] should not be represented in such a way that it could lead people unfamiliar with the disorder to believe that they have reason to fear someone that suffers with it… This is not the type of media that our community needs. The price of sensationalized entertainment tonight is costing a whole community of people part of their upward gain in accurate knowledge and awareness, and replacing it with a misleading, and stigmatizing stereotype.”

Similarly, Shaylynn Hayes, a published misophonia advocate and writer, states:

I think it’s important that we reflect on the important nature that fiction plays in our lives.“Fiction can impact how we see the world. It is a way to experience new things. Criminal Minds is more than just a show. For many it is the first introduction they have ever had to misophonia. For sufferers, it’s scary because we worry that people will associate our very real pain with criminals. While there might be anger and frustration, for the most part, we are individuals that are hurting. We want to be heard, and we want our experiences to be shown accurately.

This isn’t the first time the community has been upset by a public portrayal of misophonia, and advocates have made great efforts to contact producers, journalists, etc. I don’t think there has been one time that any of us have received a response. However, yesterday I spoke with a very apologetic Breen Fraizer, a writer and executive producer for Criminal Minds who cared enough to take my call. I asked Mr. Frazier how the writers derive ideas and how they follow up with research. He explained to me that writing the show is a collaborative process, and that ideas often flow from real-life and personal experiences of the writers and actors. Someone may casually mention a psychological or psychiatric disorder that a relative or friend suffers from, and the writers’ job is to explain how this particular disorder (or sometimes traumatic event) might lead to serial murder. Mr. Frazier, again somewhat ruefully, adds that as a writer, he does have to imagine the extremes of the spectrum of human nature and that he often worries about the affect this might have on sufferers of various disorders. Mr. Frazier certainly convinced me that he and his staff take great care to represent the psychiatric disorders referenced in the show sensitively.

Here lies the problem. Misophonia is not a psychiatric disorder, and there certainly aren’t any scientific studies that equate misophonia with violence.

As many of you may know, Emory University otolaryngology professor [emeritus] Pawel Jastreboff, and his wife and colleague (Margaret) first described misophonia as a disorder related to a decreased tolerance for sound. How did a disorder that was termed by an OTOLARYNGOLOGY professor become PSYCHIATRIC? In a short email exchange today, Pawel Jastreboff confirmed for me what he has said all along, and what he has said over and over, again and again, in countless interviews:

"There is no basis for the classification of misophonia as a mental disorder. The problem with misophonia classification arose because a group of psychiatrists did a study on psychiatric patients from their clinic, some of whom also had misophonia.”  In the Slate article, Jastreboff said: It’s an “extreme, inaccurate, and improper approach to treat misophonia as a psychiatric disorder.” Jastreboff adds that [they] have seen hundreds of misophonia patients and that very, very few had any sort of psychiatric condition.

We can’t blame the show writers. They write an entertaining television show involving multiple plot points based on fact, fiction, science, theory, and rumor. However, we can hold accountable the researchers who jumped the gun on this disorder, and without much thought blithely associate it with violence in their papers, without any scientific backing (or explanation).

Many misophonia researchers have not taken care enough to explain that simply because someone feels “rage” that doesn’t mean that they act on it. Instead, misophonia has been sensationalized right from the source. Notably, it doesn’t help that some people with misophonia post memes on the internet – these will sometimes feature an image with text that says something like, “Stop chewing or I will kill you,” or suchlike hyperbole. We know we don’t mean it, but we can’t expect the press or the writers of television shows to know this. Yet, the researchers and doctors who put the cart before the horse with misophonia (who are obligated to “do no harm”), have in fact done harm.

We don’t even have a working description of what misophonia is or a way to measure who has it and who does not. Yes…people with misophonia report feelings of rage, and aggressive thoughts. Yet, there are numerous disorders for which one could say the same. In fact we could easily say this of the human condition. My daughter, a creative writer, who also has misophonia, says in jest “any sensorial being has the propensity for violence. Haven’t you ever swatted away a bee?”

One does not like to think of psychiatry/psychology (or any) researchers as sensationalizing. However, they are no less vulnerable to this than are press outlets. I leave you with a better conceptualization of the disorder that is scientifically based and does not serve to perpetuate the inaccurate representation of misophonia:

Misophonia is a complex neurophysiological and behavioral syndrome characterized by heightened physiological responsivity and a high magnitude of emotional reactivity resulting from intolerance to specific auditory stimuli. Originally described by Jastreboff and Jastreboff, individuals with misophonia are believed to demonstrate increased sympathetic nervous system arousal, accompanied by emotional distress in response to specific pattern-based sounds, irrespective of decibel level. Examples of these sounds include other people chewing, throat clearing, slurping, finger tapping, foot shuffling, keyboard tapping, and pen clicking. The acoustic pattern of these sounds and their elicited response vary across individuals. Both sounds and reactions appear to take on idiosyncratic forms, suggesting that individual differences, learning and context may play a role in aversive responding." (see link at end for literature review).

One last caveat for the road: Statistics reveal that 88.6 % of serial murderers are male (11. 4 %  are female). Preliminary research states that up to 80% of misophonics are female.  Dare I say, "do the math"? 

For a comprehensive literature review  about misophonia misophonia https://www.frontiersin.org/articles/10.3389/fnins.2018.00036/full

For more information and misophonia advocacy https://www.misophoniainternational.com/

Citations upon request

* Thank you to Maddy Appelbaum for helping write this!