Does the sound of someone slurping up cereal or chomping on popcorn send you into a rage or make you want to hide under your bed? Then you may have a condition called misophonia – which literally means hatred of sound.
People who suffer from misophonia, and who often diagnose themselves, go into a fight-or-flight state when they hear common sounds, such as chewing, yawning or breathing – or the hum of an overhead fluorescent light – noises that don't normally bother others. Misophonia sufferers may become irritable or even irate, lashing out at the person making the sound. Or they may react with anxiety or disgust.
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Misophonia is not listed in the most current edition of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5-TR. Nonetheless, the condition can negatively impact a person's quality of life and relationships, sometimes in a major way.
Misophonia is attracting more researchers and probably should be recognized by the mental health community as a psychiatric disorder, according to psychologist Jennifer Jo Brout, who estimates that about 70 million Americans may suffer from the condition. Misophonia affects approximately 1 in 5 people, according to a study conducted in the United Kingdom.
Brout helped found Duke University's Sensory Processing and Emotion Regulation Program and has written extensively about the subject. She also directs the International Misophonia Research Network, which actively recruits people who think they might have the condition for studies. She also suffers from misophonia herself – as does Philadelphia-area psychologist Chris Owens, who started looking into the condition once he realized he had a problem.
"One night, we were going to have breakfast for dinner, and I thought of eggs and bacon," Owens said. "My wife and daughter pulled out a box of cereal, and I thought I was absolutely going to lose it."
The solution for Owens was simple. He learned to stay away from his wife and daughter when they are eating cornflakes.
But for others who have an extreme form of misophonia, the condition can cause more pronounced distress and impairment.
"If the sound is something that that person is frequently exposed to and they cannot escape from their psychological response to it, they might lash out" or they "might white knuckle it," Owens said.
But either way, it causes a high degree of emotional upset, said Owens, who eventually compiled his essays on the subject into a self-published book aptly titled, "Stop Crunching the Cereal!"
Brout helps families learn to cope with their children's misophonia through classes. She guides parents to "explain that it is your child's brain making them feel out of control;" to tell "your child that it was the noise that upset their brain, not the person who made the sound;" and to reassure your child that "over time she will gain control over her over-responsivity and that you will help her."
Simone Sims-Riley, a postdoctoral fellow who sees patients in the Media and Lower Gwynedd Township offices of the CBT Center For Anxiety, has successfully treated one patient for misophonia and is currently working with another who suffers from the condition.
Sims-Riley said part of misophonia can be a "fear of consequence."
"That means there is a fear of experiencing an emotional state or a thought process that will never change and that you will have to live with that for the rest of your life," Sims-Riley said. "Someone with misophonia may fear that they will not be able to have a social life" because they cannot stand the sound of people eating and cannot go out to lunch or dinner with friends, for instance.
People who suffer from misophonia also may alienate those around them by becoming angry when people are eating or by leaving the room.
"When you're having those reactions it can cause you to damage your relationships by the things you say and the things you do," Owens said.
Something people who suffer from misophonia need to realize and accept is that the other person doesn't have "... bad table manners," Owens added. "It's my sensitivity. They're just living their lives."
How to cope with misophonia
One way people sometimes cope with misophonia is by using noise-canceling headphones wherever they are exposed to their sound triggers, Sims-Riley said. Several kinds of headphones now have adjustable sound levels, so that people can reduce the level of some noises but potentially still hear conversations, for instance.
Another way to help misophonia sufferers is by teaching them to compete with the sounds that cause them distress. For instance, if someone in the office is clicking a pen and that triggers you, you can try mimicking the noise by making it with your mouth, Sims-Riley said.
"Now the brain is fully focused on you versus fully focusing on the (discomfort)," she said. Making a competing sound may also drown out the annoying noise.
Exposure and Response Prevention Therapy can be effective for those with misophonia by slowly introducing the sounds that trigger them for progressively longer periods.
"It's trying to get you to learn that even when you're exposed to the thing that causes you distress, it doesn't last that long – and you can handle it," Sims-Riley said.
"A lot of the major work here is about the ways we are saying to ourselves," she added. "What are you telling yourself when you start hearing that sound?… Are you telling yourself, 'OK. I'm eating this meal. It's going to take maybe 30 minutes. I want to enjoy this meal with friends?"
Teaching people how to challenge their negative assumptions and thought patterns when they start to hear noise triggers and to talk to themselves differently helps find out "what's important to you and how can we get you closer to living according to your values," Sims-Riley said.
Many people who suffer from misophonia and from other psychological issues fear that they don't have control over their conditions, Sims-Riley said. "Yes, there are some things that we don't have control over, but there are a lot of things we can control."
Practicing deep breathing, progressive muscle relaxation and other techniques for stress and anxiety relief can help misophonia sufferers when they start to feel triggered.
"Emotions are energy in motion," Sims-Riley said. "Whenever you feel an emotion – if it doesn't move through the body it gets stuck. That's why we have a lot of mental illnesses. It has to come out some way," leading to anxiety, depression, PTSD and other disorders.
Although the mental health community does not categorize misophonia as a psychological disorder, Sims-Riley and Owens believe that it may be listed in the next update of the DSM as a condition for further study – which would attract more research into the condition
"Everyone to some degree has an annoying noise," Owens said. "It is what level of distress does it cause."