By Joe Borders,

Marriage and Family Therapist

In Roseville and Sacramento

April 8, 2019

Misophonia: When Certain Sounds Drive You Crazy

Do certain sounds drive you crazy? Have you ever heard of Misophonia? This is an updated version of a post I originally wrote on my private practice website in 2016. As I write this, it’s winter time in 2019 and misophonia has been coming up a lot in session. I’ll tell you why further into this post.

This week, as I was driving in my car, listening to my baby crying for half an hour, I was inspired to write about something that has come up in therapy several times over the years: misophonia.

What is Misophonia?

Misophonia, literally, the hatred of sound, is a condition which causes sufferers to experience strong emotional and/or physical responses to particular sounds. Common trigger sounds include the sound of chewing, swallowing, coughing, crinkling, and other, primarily bodily sounds. People with misophonia can have reactions to these sounds that range from annoyance to outright rage. Most people I have talked with who have misophonia have described it as being a horrible, overwhelming sense of annoyance….like there’s something someone is intentionally doing to bother them and they’re trying not to snap.

In a sense, misophonia is like the opposite of ASMR. (Read my blog post about ASMR here)

I personally have a strong aversion to my wife’s coughing. I don’t know if this qualifies me for a diagnosis of misophonia, but I have had a few times in our relationship where I became so enraged by her coughing that I have seriously considered spending several days at my parents’ house to get away from it. Most people have certain sounds that annoy them, but misophonia is different in that sufferers typically experience strong reactions that are very difficult to control. In general I am a very friendly, even tempered person, but when my wife gets coughing I feel like I want to scream and break things.

This post feels like it has quickly transformed into a rant about my wife’s coughing, but it feels like a good comparison, and the way I am able to relate to people who have misophonia. I want to be ok with this sound, and I want to ignore it, but I just can’t. That’s what distinguishes misophonia from simply disliking certain sounds; the way the sound and paired reactions become all-consuming and unavoidable.

In session I often demonstrate this by tapping repeatedly on my table while talking about it. Most people can deal with hearing that sound for a while, but eventually its going to get on their nerves. Partially because I drew their attention to it. In misophonia, people have specific triggers that cue off that same kind of attention that leaves a person thinking something along the lines of “Oh god, I can’t stand that noise any longer, when is it going to stop, its never going to stop! OMG!”.

What Causes Misophonia?

Misophonia is a relatively new thing and hasn’t yet gotten a lot of attention and research, so the truth, as I understand it at this point, is that we don’t honestly know what causes misophonia. My own personal theory is that it’s the result of  a person feeling insignificant, rejected, dismissed, or belittled in their past. Every person I’ve ever known who had misophonia had some kind of situation in their past where something difficult was going on and they felt like they had to suppress their reaction for the benefit of others. Some kind of experience that leaves the person internalizing the idea that they don’t matter, other people don’t care, and/or they should “suck it up” when they’re bothered.

Essentially, when it comes  down to it, the experience that a person with misophonia has when they’re triggered is similar to how anyone would feel if someone important, like, say their boss, was doing something really annoying and they couldn’t say anything about it. In therapy I always tie it back to this. There was someone in your life who held a role like that. Someone who hurt you in some way, poked fun at you, or shamed you. At a vulnerable point in your life you were made to feel that you couldn’t say anything to this person when they hurt you. In this sense, I almost think of misophonia as being similar to a conversion disorder; where a person develops physical symptoms to deal with difficult mental issues. Essentially, the person ends up taking all of this inner sense of taking crap from someone else and not being able to say anything about it, and projecting it onto something in the world that can feel equally inescapable.

How To Treat Misophonia

This last part leads us into talking about how to treat misophonia. Again, because misophonia is relatively new and has gotten relatively little attention, we don’t have a lot of interventions specifically tailored to treating misophonia. In reading about misophonia you will mostly hear people talking about interventions like using sound machines to cope with trigger sounds and various forms of therapy to reduce negative associations paired with trigger sounds. Some people even suggest exposure therapy where you work on relaxation exercises and then slowly expose yourself to your trigger sounds while practicing relaxing.

Since I wrote my original blog post about misophonia I have gotten one or two people contacting me each year asking for help with it. I always give people the disclaimer up front that I haven’t received any formal training in working with misophonia, but people always respond by saying that they researched the issue themselves and couldn’t find anyone else who was familiar with, or had worked with it. So because of writing this blog post several years ago, I’ve ended up working with several misophonia clients. In my time working with them, this is what I’ve learned:

Misophonia Gets Better When You Feel Heard and Validated

Everyone I’ve worked with who had misophonia experienced an ebb and flow of their symptoms, but when they were in a good place in life, their symptoms got better. As a therapist, I’ve noticed more specifically, that their symptoms got better when they were in a place of feeling heard and validated by those close to them. Most people I’ve worked with who had misophonia talked about experiencing an inner sense of being wrong, shameful, embarrassing, etc., something that makes them feel like other people don’t care. In my experience, misophonia is really tied to self-esteem issues. In therapy I have helped people in the past by supporting them as they sort through core issues in their past and helping them to work on being more assertive and communicate their needs to those who are close to them.

Why Is Misophonia Such A Problem In The Winter?

So I’m writing about this now because it’s winter time, and everyone is experiencing a relapse in misophonia. Why in the winter? Because everyone is  stuck inside and either sniffing or coughing! If you have misophonia or think you have misophonia, be kind to yourself during these winter months. Things might be hard right now, but they will get better!

Some Specific Things That Can Help

Depending on your triggers and the situations you find yourself in, there can sometimes be specific things you can do to help yourself cope with misophonia. Some things I’ve talked with people about are:

• Headphones
• Earplugs
• Ambient noise machines like I keep in my office
• Fans
• Finding a fidget toy that works for you. Having some sort of fidget can help you get through those tough times when you’re truly stuck and can’t get away from your trigger(s).
• Breathing and relaxation exercises. Just as in working with anger and anxiety, it can really help to practice breathing and relaxation exercises, so that when you get triggered you’re more able to calm yourself.
• Playing Tetris! Or any kind of game/thing that you can get fully involved in. This will take your mind off of your triggers.
• Plan ahead! If you know you’re going into a situation where you might have trouble, plan ahead for ways you will cope with triggers that might arise. So if you’re planning on taking a flight somewhere, bring those headphones and anything else that helps you self sooth.

How You Can Support Someone Struggling With Misophonia

Sometimes I get people in therapy who know someone who struggles with misophonia. People often ask me how they can care for and help the people they know who have misophonia. The most important thing you can do is to communicate to them that you hear them and care about what they’re going through. One of the most common struggles I hear people with misophonia talk about is the fear of telling people about it. Lots of people worry that people either won’t care, will think its stupid, or, as is often sadly the case, will respond by imitating trigger sounds and saying something like “what!? you mean like THIS!?”

If you know someone who has misophonia, just be there for them. They may need your support when trying to navigate difficult social situations. You may be one of the few people who know about their misophonia, and it can really help them to have you to talk to about it.

I’ve had a couple of people in therapy voice anxiety around accidentally triggering someone they care for who has misophonia. This is likely going to happen and is pretty unavoidable. The important thing to hold onto in these situations is that if you’re open and supportive, and your loved one trusts you and talks with you about their misophonia, then you get to be someone who can actually help them heal and cope with their symptoms. Through having you around as support, they can practice talking with you when they get triggered by something you’re doing. This can help them to grow in their assertiveness and reduce some fears/insecurities they might have about their misophonia.

For more on misophonia check out “The Misophonia Institute” at misophoniainstitute.org

Also, the website www.allergictosound.com/ , which has a blog and support forum for those suffering with misophonia.

Lastly, check out the trailer for this full length documentary in production: Quiet Please: A Documentary On Misophonia.

If you or someone you love is struggling with misophonia, you might benefit from coming to therapy. Check out some of the therapists listed on SacWellness.com. SacWellness is home to over 190 therapists located within the greater Sacramento area. This includes the areas between Davis and El Dorado Hills and between Elk Grove and Auburn.

About the Author

Joe Borders is a marriage and family therapist located in Roseville and Sacramento. He is primarily a sex positive gender therapist, but also specializes in working with couples, teens, addiction, and the LGBTQ community. Joe is also the owner and founder of SacWellness. You can find out more about him by visiting his sacwellness listing or by visiting his website: therapy and counseling in Roseville and Sacramento