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Sensory dysregulation is a central feature of PTSD, not simply a secondary consequence.

PTSD can impair auditory filtering, making irrelevant sounds difficult to suppress.

Trauma can alter how sounds are assigned threat, salience, and emotional meaning.

Auditory processing in PTSD can shift from sensory hyperreactivity to sensory shutdown.

Post-traumatic stress disorder (PTSD) is usually conceptualized in terms of its psychological impact. But Van der Kolk and McFarlane recently reminded us that beneath this affective/cognitive layer is a fundamental disruption in how the brain processes the sensory world.

In their article, they note that "little attention has been paid to the central role of sensory processing", that "critical elements of the phenomenology and neurobiology of traumatic stress" have been ignored, and that "somatic symptoms and lack of sensory regulation are central, not peripheral, to the clinical presentation of PTSD" [1].

With this in mind, we decided to ask the somewhat peculiar question: What does PTSD sound like?

To find out, we examined over 200 first-person accounts of sound and hearing from public PTSD communities. From these, we identified four canonical features that can be tethered to specific findings from auditory neuroscience in PTSD populations.

Auditory Disinhibition

"Background noise never becomes background. I hear all of it."*

“I hear everything, all at once, and my brain doesn't decide what I don't need to hear.”

"Every little sound gets my attention. Nothing seems to get filtered out."

Normally, the brain performs a remarkable audiological task — not hearing.

Repetitive, irrelevant sounds are suppressed so attention can be directed toward what matters — a process called sensory gating. In PTSD, this system can become less effective, leaving far more of the auditory environment competing for attention. This is not simply heightened sensitivity to sound, but a collapse of the distinction between what should be heard and what should be filtered.

Perhaps the most striking finding across the literature is the consistency of subjective sensory gating deficits, despite considerable heterogeneity in where the processing failure occurs. Across electrophysiological studies, PTSD is associated with weaker filtering of repetitive or irrelevant sounds, heightened automatic attention to unexpected........

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