What is Misophonia?
Misophonia may be described as a ‘hatred’ of certain sounds. It’s a sound sensitivity disorder in which specific sounds trigger emotional and physiological responses such as irritation, anger, rage, and disgust, which most people would perceive as irrational.
The triggers for the majority of people with the disorder are the noises made by others as they eat, drink, and breathe, such as chewing, slurping, and swallowing. But these can vary; the noise produced by a distant train or an airplane, as well as sounds made by animals, can all potentially result in misophonic reactions in affected individuals. More than 50% also develop visual triggers known as Misokinesia; a ‘hatred’ of small, repetitive movements involving other people’s hands, face, or both, such as scratching, hair twirling, or pencil tapping.
On hearing or seeing, (or sometimes just anticipating) a trigger, the sufferer experiences an overwhelming fight-or-flight response, causing them to instinctively lash out at, or to get away from the person or situation as quickly as possible. Embarrassed by their reactions, people with Misophonia generally try to hide the disorder, avoiding settings where they know triggers are likely to be present, such as in cafés and restaurants.
For a more detailed explanation of Misophonia, see here:
When do symptoms develop?
Misophonia generally develops between the ages of 9 and 13, and is more common in girls than boys. An accurate diagnosis at the time of onset is rare, not only because of the obscure nature of the condition, but also because, at such a young age, it may be difficult for the child to acknowledge or vocalise their feelings.
Is it a physical or mental disorder?
There’s currently no consensus with regard to the classification of Misophonia. The ears and hearing of sufferers are normal. It appears to occur on its own, and also alongside other health, developmental, and psychiatric problems, including autism spectrum disorders, obsessive-compulsive disorder (OCD), mood disorder, attention-deficit hyperactivity disorder (ADHD), Tourette syndrome, and obsessive-compulsive personality disorder (OCPD). Considerably more research is required in order to be able to identify it as either a primary diagnosis, or a symptom of other underlying or comorbid conditions.
Key research
The term Misophonia was coined by American neuroscientists Pawel and Margaret Jastreboff in 2001, after 10 years of working with patients with tinnitus. They proposed that misophonic reactions could be induced in any person by the creation and reinforcement of a negative association with any type of sound; the physical characteristics of the sound being secondary. Reactions to the sound depended on the person’s past history and on non-auditory factors like their evaluation of the sound, their psychological profile, and the context. For example, where the eating sounds made around the dinner table at home would evoke a negative reaction, and yet the same sounds at a friend's house would not.
In the UK, research led by Dr Sukhbinder Kumar has used magnetic resonance imaging (MRI) to investigate whether there are any structural or processing differences in the brains of people with Misophonia. In 2017 his team identified a disruption in the connectivity in parts of the brain that process both sound stimulation and the fight-or-flight response. More recently, they found an abnormal 'supersensitised connection' between the auditory and motor brain regions. Both of these studies demonstrate a difference in brain structure and functionality in sufferers. See the latest report here:
Living with Misophonia
As the majority of people with the disorder go undiagnosed, the most used coping strategies are avoidance, walking away, or using music, headsets, or earplugs to mask the sounds. Sadly, these behaviours may lead others to label them overly-sensitive or hysterical, which can have a significant impact on the sufferer’s ability to form relationships and enjoy a normal school, work, family, and social life.
In addition, the closer they are emotionally to the ‘trigger’ person, the more offensive the sound tends to be. So in order to avoid conflict, it’s quite common for those with Misophonia to eat separately from their spouse, family, or roommates. In severe cases, they may spend most of their time alone in their room.
Treatment
Although there isn’t a cure for Misophonia, it can be managed successfully with the right treatment.
Treatment often involves a multidisciplinary approach that could include sound therapy by an audiologist, a psychological evaluation, cognitive behavioural therapy (CBT), dialectical behaviour therapy (DBT), pharmaceuticals, mindfulness, hypnosis, or supportive counselling in which coping strategies are emphasized.
The Jastreboff’s have continued with their research, and in 2015 reported a success rate of 83% in a treatment study of 184 patients using tinnitus retraining therapy (TRT) principles, together with four specific protocols for Misophonia. Find the report here:
Lifestyle
Eating healthily, taking regular exercise, and getting a good night’s sleep are especially important for people who face the challenge of living with a disorder such as Misophonia.
Having a quiet spot in the home that they can call their own is also vital, and will help people with the disorder relax.
Maintaining good relationships with family and friends is key to preventing isolation, and participating in activities that don’t revolve around food and drink, such as team sports, bike riding, bowling, hiking, and swimming, can be a good way to stay connected.
Further information and resources
For anyone who thinks they may have the condition, or knows someone who has, the following websites contain a comprehensive range of information and support for Misophonia sufferers and their families, as well as resources for doctors and researchers:
https://misophonia-association.org/
https://misophoniainstitute.org/
https://misophonia-research.com/