How to treat misophonia
In this video, I'm going to tell you about 5 techniques that individuals use to help with misophonia.
You hear the sound of somebody eating. you instantly get enraged. Someone around you just yawned and you want nothing more than to leave the room and scream. You avoid restaurants because you can't stand the sound. When people talk and make the S sound, you immediately have a fight or flight reaction. If this sounds like you, you may have what is called Misophonia.
Misophonia is not just an ordinary annoyance with sound. This is so much more. We all get annoyed from time to time. I absolutely cannot handle it when somebody is chewing their food. But there are times when I don't notice it. But this wouldn't be considered misophonia. Instead, I have a case of normal annoyance.
Individuals who have misophonia are affected emotionally by common sounds. What time they are sounds that most people don't ever pay attention to. Some examples may be breathing, yawning, certain letters that people say. It could be the rustling of paper, someone chewing gum. Someone sniffing. Really it could be any noise. These simple noises cause a fight or flight response. This response tells the body to RUN. Get out of there. It can cause anxiety, distress, and anger.
Whenever I talk about this usually response to get from somebody is, "Oh I totally have that" I hate when people click their pen or hearing the pants shuffle. - But likely, it's not misophonia. Here is one big indicator to look for:
Misophonia seriously compromises functioning, socializing, and ultimately mental health. So if you hear a sound you don't like, does it cause you to not function. For those who struggle with this, it can take over their life.
You may think....well, get over it. It's just sound. But not to do those who experience this. It can be torture.
There is not much research that is done for those who struggle with misophonia, however, researchers have found that whos who have misophonia have higher amounts of myelination. This fatty substance wraps around nerve cells in the brain to bo provide electrical insulation. Right now, we don't know if that extra myelin plays a part, but it goes to show us that individuals are not just making it up. This is a real disorder.
Anger is a biiiiiiiig response to these noises. Individuals will often feel betrayed that someone will make this noise around them and snap. "you know I don't like when you tap your fork on the plate." Isolation seems to be the only fix.
There is some debate on what therapy strategies you should use with misophonia and realistically, each person may be different. Here are 5 methods that could be used for misophonia.
#1 - Distress tolerance techniques - Exposure and response prevention with the idea to habituate does not seem to be helpful. We've learned that these sensitive to sound don't just "simply go away" Instead, we teach to tolerate the sounds. To have a distressing emotion AND still be able to move forward with life. Continue watching the movie, continue eating at the table, continue talking to friends. This idea for some is to on purpose be exposed to a sound and respond differently to it. Not expecting it to go away, but to connect with valued activities while hearing the sounds. Acceptance seems to be the key here. I've excepted that these sounds will trigger a negative response, but am sitting with this and will continue forward instead. Simply put, some may hear a sound over and over and over again, while doing an activity that they enjoy. Teaching their brain that they can still talk with family members AND hear that sound. Both can be in existence in the same bubble.
#2 - Manage the environment - This one is tricky and really designed to manage symptoms. Not treat them. What this means is simply to accommodate! Yikes, did you ever think I'd say that? It feels weird for me to say, but in a lot of cases, misophonia can be so distressing that individuals can change the environment to minimize the chance of a sound happening. If I'm triggered by metal spoons touching the bowl, the family may eat with plastic spoons. I may use headphones at the dinner table while we're eating. I change things around knowing I may still be triggered, but the chances are slimmer. It can be tough because you cannot control each situation or environment. But acceptance also helps to know, if the sound is heard, then it's heard. In other words, accommodations (headphones, white noise, noise cancellation) alone, without cognitive-behavioral strategies is not recommended as a sole treatment strategy.
#3 - Self-compassion - since anger is a big component of misophonia, individuals can often get angry at others or themselves. When someone practices self-compassion, it has been shown to increase treatment outcomes and reduce overall emotions. Keep an open mind that you may hear a sound you don't like. Be kind to yourself if you do. You may use phrases like, yep, there is that sound and I am an awesome person. Or, my uniqueness makes me special. Self-compassion may me that you're continuing to live life despite the idea that you may hear a noise.
#4 - Emotion regulation techniques - Individuals who practice emotional regulation tend to cope better with life's stressors and are more resilient. Ultimately, this may help a level of 10 out of 10 of anger to lower. Emotional regulation can look like this for kid and even adults. Name the feeling. Instead of feeling frustrated or anger, name it. I feel angry when I hear that noise. I feel distress when I hear that sound. It can help take a step back and label what's happening. Notice your body, the sensations that are happening. Practicing self-awareness. My heart is beating fast, my head feels hot, my hands are shaking. We can notice without putting judgement. Not saying, it's bad that my heart is beating fast. It just simply is beating fast. Another emotional regulation technique is to "pause" - don't immediately run at any sound heard. Take a moment to pause. Notice the sensations, feelings, emotions and then reevaluate your choice.
#5 - Self-soothing - Because we know that sound is sensory. To help calm emotions and feelings, some choose various self-soothing techniques. Meditation, yoga, breathing. Some find it helpful to use fidgets or other self-soothing tools when emotions are high. It can be take a few deep breaths. Engaging in positive self-talk. Place your hand over your heart and notice the beats. Sit with your pet. Color something. List positive things about yourself. Use your 5 senses to enjoy the work around you.
Ultimately, here's the thing. Misophonia isn't just about being sensitive to sound. It's on a whole another level. Be patient with those who have it. Be patient with yourself. Do you or something you know struggle with misophonia?
What to do when I hate sounds
What is misophonia
Nathan Peterson specializes in working with OCD and Anxiety related disorders and has done so for the past 7+ years.