What is misophonia?

Misophonia is an extreme emotional reaction to certain everyday sounds that most people would find relatively easy to ignore. The three main types of sounds that disturb individuals with misophonia are eating, nose and throat sounds, and repetitive environmental sounds like keyboard tapping and rustling paper.

Isn’t everyone irritated by certain sounds?

Whilst many people find these noises annoying, individuals with misophonia describe an intense feeling of disgust, anger, distress, or panic that escalates while the sound is still present. This can happen even when the sound is at a very low volume. They report physical sensations similar to a fight or flight response, including racing heart, shortness of breath, tension, feeling hot, and sometimes an unwanted groinal response. They often describe a sense of feeling trapped, helpless, and out of control when they can’t get away from these sounds.

When is misophonia a serious problem?

An individual can be considered to have significant misophonia when it causes frequent distress and has an impact on daily living, work, study and/or relationships. This might include anxious anticipation of sounds before they happen, replaying sounds after the event, feeling guilty or embarrassed about one's own reactions, thinking a lot about the person making the sound, verbal outbursts, and avoidance of things one would otherwise like to do (for fear of encountering sounds). They might report low mood, anxiety, sleep problems, family tensions, inability to relax in the home, and trouble focusing.

At the more severe level, individuals may be unable to work or attend school, have trouble maintaining relationships, feel near constant distress, and may even contemplate ending their life. Because misophonia is not well known, people often feel isolated and struggle to get support from family, friends, and health professionals.

Can CBT help?

CBT can be helpful for people with misophonia. It is thought that at the core of misophonia is a variation in sensory processing, which includes heightened attention to certain sounds that could be a sign of potential contamination (e.g., illness from breathing through a blocked nose, spreading illness through spit when eating with an open mouth) or a potential predator (e.g., footsteps, tapping and rustling sounds). This part of the problem might not be directly changed with therapy to the extent of eliminating this sensitivity altogether.

However, therapy may be helpful for people whose reaction feels like a flight or fight type feeling, or if they feel trapped, panicked, angry, or helpless around sounds. Therapy can also help if the impact of the sound exists even when the sound is not present (e.g., taking a long time to wind down from a reaction, worrying about sounds in advance, or having lasting impacts on work or relationships). Want to know more? Feel free to get in touch.