What's the Deal With Misophonia?

If you’ve ever been told to stop chewing with your mouth open when you weren’t, or gotten angry because a friend was drinking water too loudly, or watched a friend leave the room when you were scraping the last few bits of food out of a bowl, you might have come across a case of misophonia.

Although it may sound like a mental health diagnosis, it isn’t one; it is, however, a condition of heightened sensitivity to particular sounds, or types of sounds, and it’s sometimes referred to as Selective Sound Sensitivity Syndrome.

Misophonia sufferers have elevated or extreme emotional reactions to particular sounds that other people would consider harmless, such as humming, chewing, or even breathing. Other common sounds that trigger those with misophonia are the clicking of pens or the ticking of clocks, typing sounds, or the scrape of silverware against china. If you, yourself, suffer from this kind of heightened sensitivity, then please take heart: your condition is just beginning to be better understood.

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The study of sound has a long history, but even so, as explained on the 20,000 Hertz podcast, we know almost nothing about the way our brains uniquely and idiosyncratically process the sounds that each person hears. Consider the example of synesthesia, the phenomenon of cross-sensory experience—or, better said, the ability to “hear colors” or “smell music.” It may be possible to measure the wavelengths of the sounds that enter a brain through a person’s ears, but when the sounds are processed into electrical impulses, our understanding of that person’s subjective experience of those impulses is quite limited.

Recent experiments have given us a new, more neurological perspective on misophonia, providing scientific evidence that different brains really do react to sounds in very different ways. In one experiment, as reported on the Harvard Health Blog, people with misophonia listened to their “trigger sounds” while having an fMRI scan. It turned out that a part of the brain known as the anterior insular cortex—which is associated with correlating outside input with internal, physiological reactions—showed elevated activity while trigger sounds were being played. This part of the brain is also implicated in retrieval of long-term memories, and in the generation of certain strong emotions, like fear and anger. Briefly, trigger sounds were shown to jump-start the anterior insular cortex and other, associated parts of the brain.

People with misophonia then experienced unmistakable, physiological signs of stress, such as sweating and an increased heart rate. Outwardly, the reactions triggered by these heightened neurological reactions can range from anxiety, disgust, or mild discomfort to rage, panic, fear, or a strong urge to flee. This kind of emotional distress is sometimes referred to as the fight-or-flight response.

Misophonia shows a higher incidence among girls and women, may have an age of onset of somewhere between 9 and 13 years old and is said to develop quickly. But as someone with misophonia gets older, they are likely to experience relational problems caused by the condition. Just by carrying out normal activities, other people in the life of a misophonia sufferer are very likely to generate sounds that result in a strong or otherwise inexplicable emotional reaction. In some extreme cases, marriages may break up because of heightened misophonia responses; other people will have trouble at school or work because they cannot stand the sonic environment in which they have been working.

Couples whose relationships are affected by misophonia may be unable to eat out in public places, because a restaurant’s soundscape may be excruciating for one partner to experience. Alternately, one member of a couple may consistently blame his or her partner for creating trigger sounds, and the partner in question may feel alienated or excessively criticized. Lastly, quite often, parents with misophonia can be triggered by their children—because, as any parent or caregiver knows, children are not very good at masking the unpleasant sounds they can make.

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If you have had experiences like these, what can you do about it? Many sources recommend finding coping strategies that might limit the problem, like carrying earplugs that you can use if you’re triggered in a public place. You may also want to learn relaxation techniques, like visualization or deep breathing. Mindfulness meditation has been said to help with learning to tolerate discomfort, according to GoodTherapy.org.

In some cases, you may want to remove yourself from a situation that is triggering you (as suggested on 20,000 Hertz), or even gently ask someone near you to change their behavior—although admittedly, this isn’t always as easy as it seems, and can cause its own self-conscious discomfort.

To initiate a change, it will first be important to identify your misophonia triggers—the more specific, the better. When you know exactly which sounds bother you the most, start by brainstorming some ways to distract yourself when you’re in situations that produce those sounds. Push yourself away, internally, from the aspect of the situation that is difficult for you. You might even recruit others in helping you do this, if you’ve already trusted them by letting them know what you’re going through.

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And in general, you should strive toward good communication about your misophonia. If you become anxious or irritable when your partner is eating, try to verbalize your feelings in a way that isn’t critical or blaming. This point is an important one, because it may be easy for your partner to feel criticized attention is called to his or her sounds. Instead of blaming, point out the sounds themselves and explain your reaction as something that arises spontaneously within you. (You might use this formulation: When I hear sounds like these, I feel ____.) Be clear about which specific sounds are hard for you to listen to, and about your reactions to each of them.

If it’s your partner who experiences strong reactions to various sounds, you’ll need to take his, her or their misophonia seriously. Try to empathize with their sound-based discomfort; after all, according to the Harvard Health Blog, their reactions are hard-wired into their brains. Make an effort to separate your partner’s strong reactions from your own behavior; remind yourself that you are not at fault for triggering him or her, even if the sounds you make happen to be the focal point of the conflict. Work to find reasonable ways to accommodate your partner’s concerns (while recognizing, as stated above, that your partner’s feelings about these sounds are different from his or her feelings about you). Try to find ways to communicate openly about these issues without blame; if necessary, consider couples therapy.

In the especially challenging circumstances when you’re unable to work through the stress of misophonia alone, or with your partner, you may consider seeking professional assistance. There are a number of clinics oriented toward treating misophonia (and other sensory processing concerns) throughout the United States. Cognitive-behavioral therapy has also been used to treat misophonia, as has exposure-based therapy (for reactions that include intense fear and anxiety). Also, auditory distraction treatments (in which other noises are employed to distract the misophonia sufferer from trigger noises). Lastly, you may benefit from couples therapy, in which you can learn to improve your empathy for each other, to generate ideas to mitigate your conflicts, and to communicate better about this potentially divisive issue.