Wendy Aron

Sounds Awful

On the Misophonic’s Bookshelf: Sound-Rage

A new author’s interesting insights on a rare disorder

Posted Jul 31, 2013

I must admit that when author Judith T. Krauthamer sent me a review copy of her new book about misophonia called, Sound-Rage: A Primer of the Neurobiology and Psychology of a Little Known Anger Disorder, I was a little skeptical. Ms. Krauthamer does not have a formal educational background in neuroscience, plus the book was self-published.

But I found the work, for the most part, to be well-written, thoroughly researched and compelling. Here are excerpts from Ms. Krauthamer’s responses to some of the questions I had after reading “Sound-Rage”:

A lot of people say they want to write a book. How did you find the motivation to do this one?

 I don’t know if it was motivation as much as a call to service. Writing the book was where my gift for doing research intersected with the world's need to reduce people's suffering. Having the disorder added an important element -- deep, unconditional compassion for the pain of others in the misophonia community. I know the depth of anger, the sadness of separateness, and the longing for answers.

 I did have an epiphany when writing the book. While researching the relationship(s) between cognition and neurology, and thoughts and physiological reactions, it became exceedingly clear how much of our sound-rage lives require the need to control. When I completed the book, I decided, quite consciously, to give up control and to find a way to create a larger story that I could live with, at the same time allowing the world to take its course. Giving up control has been liberating.

 You have a bachelor’s in psychology and a master’s in ecological modeling (systems analysis), with a specialization in shrimp fisheries, as well as a graduate certificate in social change and transformative leadership. How did this background help or hinder you in terms of writing about neuroscience?

This training was instrumental in understanding how systems work in general. As I progressed in my career, I used the skills and tools from graduate school to apply detective work determination in understanding many different areas of science. In addition to work in the field of fisheries, I have worked as a consultant to review projects in other areas, such as transportation, parks and recreation, and energy managers. I took a year off from work and studied [misophonia]. I had maps of the brain posted all around my office. I read articles, journals and books on a daily basis, until the language (scientific vernacular) became second nature. It was like being in graduate school again! Fortunately, I had many top notch professionals to clarify things for me.

You draw some interesting parallels between misophonia and Tourette syndrome. How did you discover this syndrome’s similarity to misophonia?

I am vice chair of the Board of Directors of the Tourette Syndrome Association of Greater Washington, so I knew a bit of the history and literature. It is one of the few neurological disorders that manifests in childhood, so I thought it might prove to have other correlates as well. Also, there was a tiny bit of data suggesting that a certain percentage of people with Tourette have “misophonia” so I thought I would look deeper into the literature.

Your basic theory is that it is affective, (emotional) pain, as opposed to physical pain, which causes the anger without aggression that is the hallmark of misophonia. What led you down this path?

I spent a great deal of time trying to figure out the connection between all the hallmark symptoms. I made all sorts of venn diagrams, wrote out questions. It was a very interesting process. Coming upon the connector of pain wasn’t quite an epiphany, although once I reached that conclusion, I was really excited by it. I shared the insight with the cognitive behavior therapist who I worked with, and he concurred that it seemed to be the lynchpin.

You talk about multi-sensory integration with regard to triggers (i.e. the sight of someone chewing can turn into a trigger from the original auditory trigger). How do you account for the fact that some auditory and visual triggers are completely distinct and unrelated (i.e. mouth sounds and the sight of someone playing with her hair)?

 I can’t account for it; there are still many mysteries. I contend that there must be connected circuitry; motion, particularly repetitive motion, can lead to the same physiological response. We do know that visual and auditory stimuli overlap in processing (this information comes with the advances in fMRI technology, where we can literally see the signals firing).

Which healthcare profession do you ultimately see diagnosing and treating misophonia?

I think it will take a team of practitioners. In the Tourette world, a person might have a neurologist (for the physical tics), psychiatrist (for the co-morbid disorders like OCD), and psychologist (for CBIT—or tic retraining). Similarly, with this disorder, it might take a team comprising a psychologist (for cognitive behavior therapy or similar therapy focusing on reducing the impact of triggers), a counselor (to deal with the insidious social issues that arise through time, such as a need for personal space, perhaps a general lack of trust or intimacy issues etc), and psychiatrist (if hypervigilance or anxiety arise and reduce a general quality of life). An audiologist might also be part of the team, to provide blocking mechanisms.