Misophonia

Misophonia is a condition in which certain sounds trigger emotional or physiological responses that to some, may be perceived as unreasonable. Individuals with misophonia may describe it as a sound that “drives them crazy.” Their reactions can range from anger, fight-or-flight response, annoyance, isolation, or anxiety. It may impact aspects of quality of life such as: relationships with family and friends, jobs, school, hobbies, and mental health.

What are triggers?

We define triggers as an automated response someone with misophonia has when they hear one of their trigger sounds. Trigger sound examples are the noise someone makes when they eat, breathe, or chew. Other sounds include keyboard or finger tapping. They may also respond intensely to repetitive motions such as pen clicking or someone fidgeting or wiggling their foot. Most triggers are considered soft sounds. Similarly, individuals with misophonia say they often react to visual stimuli that accompanies the sounds.

What causes it?

Nobody knows exactly what causes misophonia. Researchers believe that those with misophonia acquired the problems when they were young. It is not an innate reaction. Life changing events may initiate misophonia, or it may be genetic.

How is Misophonia treated?

There is no cure yet. Treatment should involve a multidisciplinary approach combining sound retraining therapy by audiologists and supportive counseling, in which coping strategies are emphasized. However, many counselors and psychologists in Washington state have never heard of or dealt with individuals with misophonia.

Some have tried psychotherapeutic interventions such as cognitive behavioral therapy (CBT), exposure therapy, acceptance, and commitment therapy (ACT), dialectical behavior therapy (DBT), and eye movement desensitization and reprocessing (EMDR). Some take medication to manage their mood or anxiety.

How is Misophonia treated at PAC Audiology?

Dr. Mamiya is the only audiologist in the state of Washington helping to diagnose and treat misophonia patients for the past 10 years. Her expertise, empathy and treatment options have helped many patients take control of their misophonia.

Many patients who proactively work on Dr. Mamiya’s treatment plan notice they do not have an intense automated trigger response as they did before starting treatment. They no longer go to fight-or-flight, anger, anxiety, or isolation. Their reactions are lower in intensity.  Their trigger sounds become more of an annoyance. For example, the sound of fingernails on a chalkboard. An unpleasant sound, but they can identify it as an annoying sound and move on without experiencing heightened automated responses.

Our sound retraining therapy consists of acoustic therapy with a pair of devices, counseling, education, and homework assignments. Counseling and education are designed to help patients track their progress throughout the treatment process. They will see how well they can tolerate their triggers and compare their progress from the first time they started treatment. They will notice significant changes in how well they can tolerate their triggers.

We encourage our patients to receive professional counseling from experts simultaneously to improve their mental health. Encouragingly, many patients on this treatment program receive some degree of relief within a few weeks unless they have some known neurological condition. In our experience, some patients who wear the devices and do their homework thoroughly may reach a point where they no longer need to rely on the devices within 1 to 3 years. We may use special earplugs instead of devices, but the outcome is unknown.

Our goal is to reconnect those suffering with misophonia back to conversations, family, friends, and life.

Unfortunately, we cannot work with people who cannot physically come to our clinic for each visit. Our treatment uses devices that need to be fit, adjusted, and followed up with in person. We cannot work remotely. Individuals with misophonia frequently get triggered by listening to other people’s mouth sounds through remote communication (Skype, Zoom) and choose to mute voice and sound.

Where can I find more information?

• Go to the Misophonia Association website for more information.
• Go to the Misophonia Treatment Institute website for more information.