What is it?

Misophonia is a marked intolerance of specific sounds that invokes a strong negative reaction such as extreme rage, hate, anger, anxiety, frustration, disgust, and harm ideation. First termed selective sounds sensitivity syndrome (SSSS or 4S), it has a biological impact on a person’s autonomic and limbic systems, that causes an emotional response, and, long term, significant psychological impact. Sounds which trigger misophonia causes an overwhelming fight or flight response, with an intense need to escape or violent urges directed at the individual making the noise. Over time, misophonia causes a person to avoid situations and people where they may be triggered, alienating them from friends, family, and colleagues, leading to relationship dissolutions, unemployment, and social isolation.

What are the signs and symptoms?

People with misophonia are triggered by an overwhelming emotional response (e.g., rage) to a particular sound, followed by an extreme need to make the sound stop or to escape from the sound somehow. Sounds which are most common to misophonia are those associated with oral functions such as breathing, eating, chewing, yawning, sniffing, and swallowing. It can also include sounds such as typing, pencils scaping, trickling water, or crunching paper.

For some people with misophonia, triggers can go beyond auditory sounds and include physical sensations such as clammy hands, moist lips, warm skin, and body fluids such as sweat.

How do we treat Misophonia?

Misophonia can be treated using Cognitive Behavioural Therapy (CBT) and Exposure with Response Prevention (ERP). Together, this can help you identify your triggers and the unhelpful, irrational, and negative thoughts that these sounds invoke. Techniques are developed which challenge these thoughts, with alternative strategies to managing emotional reactions identified. ERP helps you confront your triggers in a safe and supportive environment with a trained professional. By developing a list of sounds and sensations you have identified as triggering, you can gradually desensitize your urge to avoid sounds, people, and places. This allows you to regain control of your reactions, developing helpful coping strategies, and replace your old reactions with new positive, rational thoughts, feelings, and behaviours.


Retrieved from: Bernstein, R. E., Angell, K. L., & Dehle, C. M. (2013). A brief course of cognitive behavioural therapy for the treatment of misophonia: A case example. The Cognitive Behaviour Therapist, 6(10). 1-13. https://doil.org/10.1017/S1754470X13000172
Retrieved from: https://misophoniainstitute.org/what-is-misophonia/
Retrieved from: https://www.health.harvard.edu/blog/misophonia-sounds-really-make-crazy-2017042111534

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