Misophonia is a neuropsychological condition which has yet to be classified in a diagnostic manual, however, experts have agreed in a consensus definition in 2022 that it is an existing condition which impacts the lives of sufferers. The brain basis of misophonia has been explored by Dr. Suhkbinder Kumar in his 2017 study, and research is slowly trickling, yet picking up speed in the last decade.
Misophonia can make everyday relationships and activities much harder than they should be. For example, going to movie theatres or to restaurants is challenging for those who are triggered by the sound of chewing. Classrooms and workplaces are difficult due to what’s been named misokinesia, or visual triggers such as leg shaking, leg tapping, and auditory triggers like sniffling, whistling, gum chewing, and pen clicking.
Misophonia sufferers and researchers refer to sounds and visuals that cause a fight-flight-freeze reaction as “triggers.” Common triggers include whistling, chewing, sneezing, sniffling, clicking sounds, pens, keyboards, mice, clacking, scraping, licking, suckling, barking, chirping, etc. This is not an exhaustive list, merely a way to give you an overview of some of the triggers which cause distress.
Unfortunately, there is no treatment for misophonia that has been verified, but this does not mean there is no hope for sufferers of the disorder. As of 2023, there were only 33 studies on misophonia treatment—a very limited number considering the distress expressed by sufferers of the condition. Utilizing CBT, sensory, and self-regulation skills to help manage misophonia has been promoted by psychologist Jennifer Jo Brout in her book on misophonia. Exposure therapy is not considered appropriate for misophonia and has been discredited both by misophonia community members and a 2022 study by Andrea Guetta at Duke University. Another way to deal with misophonia is through personal advocacy, accommodation, and limiting exposure to triggering moments. This can help in various situations, including personal relationships.
Perhaps one of the hardest parts of misophonia is deciding which triggers should or should not be accommodated by another person. In practice, this is a constant negotiation. The example below assumes that it is a romantic couple negotiating, and offers potential accommodations for the relationship.
Reasonable Requests
Unreasonable Requests
Since there is no official treatment for misophonia, it is important for sufferers and clinicians alike to have eclectic approaches to coping that considers an ever-changing research situation, as well as the meaningful efforts of clinicians who are helping clients cope with misophonia in the meantime. For example, CBT has been shown to helpful to increase quality of life in persons with misophonia and I have personally used CBT in my own life and with therapy clients. Whatever the answer to misophonia may be, an eclectic approach that considers each individual's needs is a useful first step to coping skills.
References
Swedo, S. E., Baguley, D. M., Denys, D., Dixon, L. J., Erfanian, M., Fioretti, A., Jastreboff, P. J., Kumar, S., Rosenthal, M. Z., Rouw, R., Schiller, D., Simner, J., Storch, E. A., Taylor, S., Werff, K. R. V., Altimus, C. M., & Raver, S. M. (2022). "Consensus Definition of Misophonia: A Delphi Study". Frontiers in Neuroscience, 16, 1–16. https://doi.org/10.3389/fnins.2022.841816
Brout, Jennifer. (January 13, 2022). "Misokinesia, Misophonia, and Mirror Neurons". Psychology Today. https://www.psychologytoday.com/ca/blog/noises/202201/misokinesia-misophonia-and-mirror-neurons.
Brout, J. (2021). A Clinician’s Guide to Understanding and Managing Misophonia from a Self-Regulation Perspective: Regulate, Reason, Reassure. The International Misophonia Foundation. https://amzn.to/3Q3wk4O
Mattson, S. A., D'Souza, J., Wojcik, K. D., Guzick, A. G., Goodman, W. K., & Storch, E. A. (2023). "A Systematic Review of Treatments for Misophonia". Personalized Medicine in Psychiatry, 39-40, 100104. https://doi.org/10.1016/j.pmip.2023.100104
Schröder, A.E., Vulink, N.C., van Loon, A.J., Denys, D.A., (2017.) "Cognitive Behavioral Therapy is Effective in Misophonia: An Open Trial". Journal of Affective Disorders. https://doi.org/10.1016/j.jad.2017.04.017.
Shanker, Stuart (2017). Self-Reg: How To Help Your Child (And You) Break the Stress Cycle and Successfully Engage with Life. Penguin Books. 9780143110415.
Guetta, R. E., Cassiello-Robbins, C., Trumbull, J., Anand, D., & Rosenthal, M. Z. (2022). “Examining Emotional Functioning in Misophonia: The Role of Affective Instability and Difficulties With Emotion Regulation”. PloS One, 17(2), e0263230. https://doi.org/10.1371/journal.pone.0263230
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