Chewing, crunching, sniffing, breathing… These sounds can get under anyone’s skin. But for those with misophonia, the intense distress experienced when hearing these sounds is unbearable.

Many people go through life deeply distressed by these ordinary everyday sounds, often believing they are the only one or that they are ‘broken’. As a therapist with misophonia, I write from personal experience.

What is misophonia?

Misophonia is an extreme reaction to specific trigger sounds; typically mouth, throat and nose sounds such as chewing, swallowing or sniffing. These are perceived by the brain as a threat and trigger the fight, flight or freeze response; the sufferer feels that they’re either in danger or being violated. It is a highly distressing and uncontrollable response which impedes daily functioning, and has severely damaging effects on family and intimate relationships, job prospects, and social capacity. Many sufferers experience significant anxiety and depression, and can develop panic disorders as a result of living with the condition.

As the key trigger sounds are so common, sufferers tend to be traumatised again and again. They can become conditioned to associate other things with the distress: for example, many have strong physiological responses to visual cues such as the sight of someone eating, or other sounds such as the clink of a spoon on a bowl.

What causes misophonia?

Unfortunately, we don’t yet know. Current research indicates that misophonia is associated with abnormal activation, functional connectivity, and structural changes in the brain, and heightened autonomic responses of the body. However, the underlying cause and/or mechanisms of the condition are still to be identified.

Can misophonia be treated?

This is the big question! Some psychologists suggest that cognitive behavioural therapy (CBT) can help, however, CBT relies on high order thinking, and people with misophonia start to experience a physiological reaction before they’re even aware that they’re hearing the trigger sound.

“It’s like a tsunami of negative responses… It’s instant. It’s huge.
It takes over most of (the sufferer’s) cognitive functioning.” Johnson

Misophonia is also not a phobia. It is important to realise that treatments like exposure therapy do not work, and can excacerbate the condition.

I have tried a wide range of interventions over the years: counselling, hypnosis, CBT, exposure therapy, intense meditation training, even EMDR. None of these approaches worked for me, and in many cases the therapists were not able to create a space which felt truly ‘sound safe’ during treatment. Many of the experiences were stressful, exhausting and expensive.

What helps people with misophonia?

While a cure for misophonia itself is still elusive, there are ways in which the right therapist can effectively support sufferers and minimise the negative impact of having the condition. These include:

• Identifying and understanding physiological responses

• Processing associated feelings of guilt and shame

• Explore underlying beliefs and fears

• Developing self-awareness and self-actualisation

It is critical that any therapist working with a client with misophonia has deep understanding and awareness of the condition so as to avoid triggers occurring in the therapeutic space. Empathy and non-judgement are also key: research consistently finds that the best predictor of therapy’s success is the quality of the relationship between therapist and client.

How can loved ones help sufferers of misophonia?

For many years, I suffered not only from the physiological distress that comes with misophonia, but also incredible shame. I avoided family mealtimes, social events and holidays, and have had to walk out of interviews, meetings and exams. If I had been armed with knowledge of the condition, there are many ways in which my loved ones could have supported me. If you love someone with misophonia, I encourage you to do the following:

• Learn about the condition (see links below)

• Talk about it! Secrecy breeds shame

• Encourage the sufferer to identify and communicate their needs

• Ask what helps them, and support them to access these strategies (e.g. background music at dinner, wearing headphones in the car)

• Develop a code word or signal the sufferer can use to indicate they are triggered

• Try not to take it personally

If you’d like further information or support, please get in touch.
Remember, this is a real and debilitating condition, and you are not alone!

Further Reading

Living with Misophonia: “I Love You, but I Hate the Noises You Make” Reframing Autism

The neurobiology of misophonia and implications for novel, neuroscience-driven interventions Frontiers in Neuroscience

Misophonia: how ‘sound rage’ destroys relationships and forces people to move home The Guardian Australia

Understanding Misophonia: When Everyday Sounds Cause Distress Healthline

Misophonia: When chewing, sniffing, tapping sounds are more than just annoying ABC health & Wellbeing

Facebook Support Groups

Misophonia - Parents of Children with Misophonia

Misophonia Australia/NZ