Woman blocking ears with fingers Photograph: Jamie Grill/Getty Images/Tetra Images RF
Sent into apoplexy by whistling noses? Can’t bear the sound of people eating? You could be one of the many people affected by this potentially debilitating condition. As a teenager, I remember being moved almost to tears by the sound of a family member chewing muesli. A friend eating dumplings once forced me to flee the room.
The noises one former housemate makes when chomping popcorn mean I have declined their invitations to the cinema for nearly 20 years. I am not proud of myself for reacting like this – in fact, I am pretty embarrassed – but my responses feel unavoidable. It is probable that I have misophonia. According to a scientific paper published last year, so do 18% of people in the UK.
Otherwise known as “sound rage”, misophonia is “a decreased tolerance to certain sounds” says Jane Gregory, a clinical psychologist at the University of Oxford who co-authored the paper and counts herself among the 18%. Sound triggers are usually repetitive, she says. It is not about “the volume of the sound or necessarily the acoustic pattern”, but what it means to the observer.
Eating sounds are most commonly reported, closely followed by so-called throat sounds. (Gregory is driven spare by the sound of pigeons.) “Chewing, crunching, snorting, sniffing, throat clearing, nose whistling, heavy breathing,” rattles off Dr Zach Rosenthal, who runs the Centre for Misophonia and Emotion Regulation at Duke university in Durham, North Carolina. “These are all relatively ordinary everyday things that people need to do, but in people with misophonia they are experienced as highly aversive.”
That “aversive reaction” can take the form of physical changes such as increased muscle tension or heart rate, or emotional responses such as irritability, shame and anxiety. It brings on a fight, flight or even a freeze response where, according to Gregory, “you get a really strong adrenaline reaction and it tells you that you’re either in danger or you’re being violated”.
Only about 14% of the UK population are aware of misophonia, according to Gregory’s paper, a collaboration with King’s College London. Perhaps one of the reasons, she suggests, is simply that it is hard to talk about. “You are essentially telling someone: ‘The sound of you eating and breathing – the sounds of you keeping yourself alive – are repulsing me.’ It’s really hard to find a polite way to say that.”
Maybe the movie Tár will help: its protagonist, played by Cate Blanchett, has an extreme reaction to the sound of a metronome. Theories about how misophonia develops are exactly that. “A lot of people say they had always been a little bit sensitive to sound, but then they remember a certain time when it suddenly got a lot worse,” says Gregory. Rosenthal says it typically presents itself in late childhood or early teens and is often associated with family members.
“People ask me all the time: ‘Why my family? Why my parents?’” The explanation feels comfortingly logical: “You’re not blaming, you’re not judging – you were probably just around them the most.” You might have clocked a sibling eating baked beans, say, then once you have noticed it your brain begins to look out for it.
Rosenthal describes the whirlpool: “It starts to be aversive and then I pay more attention to it, and then the more attention I pay to it the more I notice it, and then the more I notice it the more aversive it becomes …”
The impact can be severe. Gregory knows of relationships that have ended over misophonia; she has encountered people who have moved several times to escape triggering neighbours. Others must pick careers based on where they can work without being bothered by sounds. “If you don’t get any respite from it, you can get desperate,” she says.
You get a really strong adrenaline reaction and it tells you that you’re either in danger or you’re being violated…Jane Gregory
Strategies might help, however, such as introducing background noise when eating. Gregory’s husband, who knows better than to eat Monster Munch at home, can tell if she is bothered by a sound, because she will suddenly call out: “Siri, play Taylor Swift!”
Sometimes the best option is to walk away. Gregory suggests then “slowing down your breathing, or just giving your mind a little job to do”, such as playing a game for a minute. By the time you re-enter the room, the sound might be gone, or you might feel better equipped, “because you know what’s coming”.
She also recommends “opposite action – this idea that sometimes the more we avoid something or block it out, the more harmful it feels to us. In CBT [cognitive behavioral therapy], we do the opposite of what you feel like doing.” In this vein, she tries to fight her instinct to glare at her husband, gazing adoringly at him instead: “It’s a way of tripping up your brain and saying: remember that you love this person, remember that you’re not actually in danger.”
I make a note to try this the next time I hear someone eating scrambled eggs.
.
Related contents:
“Familial misophonia or selective sound sensitivity syndrome : evidence for autosomal dominant inheritance?”. Brazilian Journal of Otorhinolaryngology. 84 (5): 553–559. doi:10.1016/j.bjorl.2017.06.014. PMC 9452240. PMID 28823694.Cavanna AE, Seri S (August 2015). “
Misophonia: current perspectives”. Neuropsychiatric Disease and Treatment. 11: 2117–23. doi:10.2147/NDT.S81438. PMC 4547634. PMID 26316758.Swedo S, Baguley DM, Denys D, Dixon LJ, Erfanian M, Fioretti A, Jastreboff PJ, Kumar S, Rosenthal MZ, Rouw R, Schiller D (2021).
A Consensus Definition of Misophonia: Using a Delphi Process to Reach Expert Agreement”. medRxiv. doi:10.1101/2021.04.05.21254951. S2CID 233152520. Retrieved 11 April 2021.Brout JJ, Edelstein M, Erfanian M, Mannino M, Miller LJ, Rouw R, et al. (2018).
“Investigating Misophonia: A Review of the Empirical Literature, Clinical Implications, and a Research Agenda”. Frontiers in Neuroscience. 12: 36. doi:10.3389/fnins.2018.00036. PMC 5808324. PMID 29467604.
“Misophonia”. Tinnitus & Hyperacusis Center. Retrieved 8 October 2022.Freytas-Tamura, Kimiko de (3 February 2017).
“Misophonia Sufferers: Scientists May Have Found the Root of Your Pain”. The New York Times. Retrieved 6 October 2022.Jastreboff, Margaret M. Jastreboff,Pawel J.
“Hyperacusis”. AudiologyOnline. Retrieved 8 October 2022.Jastreboff MM, Jastreboff PJ (2001). “
Components of decreased sound tolerance : hyperacusis, misophonia, phonophobia” (PDF).Jastreboff, Margaret M.; Jastreboff, Pawel J. (1 November 2002).
“Decreased Sound Tolerance and Tinnitus Retraining Therapy (TRT)”. Australian and New Zealand Journal of Audiology. 24 (2): 74–84. doi:10.1375/audi.24.2.74.31105.Jastreboff MM, Jastreboff PJ (2001). “
Components of decreased sound tolerance : hyperacusis, misophonia, phonophobia” (PDF).Tunç, Serhat; Başbuğ, Hamit Serdar (2 October 2017). “
An extreme physical reaction in misophonia: stop smacking your mouth!”. Psychiatry and Clinical Psychopharmacology. 27 (4): 416–418. doi:10.1080/24750573.2017.1354656. ISSN 2475-0573. S2CID 148603011.Kumar S, Tansley-Hancock O, Sedley W, Winston JS, Callaghan MF, Allen M, et al. (February 2017). “
The Brain Basis for Misophonia”. Current Biology. 27 (4): 527–533. doi:10.1016/j.cub.2016.12.048. PMC 5321671. PMID 28162895.Cartreine J (21 April 2017).
“Misophonia: When sounds really do make you “crazy””. Harvard Health Blog.Kumar S, Dheerendra P, Erfanian M, Benzaquén E, Sedley W, Gander PE, et al. (May 2021).
“The Motor Basis for Misophonia”. Journal of Neuroscience. 41 (26): 5762–5770. doi:10.1523/JNEUROSCI.0261-21.2021. PMC 8244967. PMID 34021042.Schröder A, Vulink N, Denys D (23 January 2013).
“Misophonia: diagnostic criteria for a new psychiatric disorder”. PLOS ONE. 8 (1): e54706. Bibcode:2013PLoSO…854706S. doi:10.1371/journal.pone.0054706. PMC 3553052. PMID 23372758.Rouw R, Erfanian M (March 2018).
“A Large-Scale Study of Misophonia”. Journal of Clinical Psychology. 74 (3): 453–479. doi:10.1002/jclp.22500. hdl:11245.1/c9c45e84-3c70-407e-aa2f-782ccdb79791. PMID 28561277.
“ASMR and Misophonia: Sounds-Crazy!”. Science in our world: certainty and controversy. Pennsylvania State University. 16 September 2015.Higa K (11 June 2015). “
Technicalities of the Tingles: The science of sounds that feel good. #ASMR”. Neuwrite. Retrieved 20 January 2016.Cohen J (5 September 2011).
“When a Chomp or a Slurp is a Trigger for Outrage”. The New York Times. Retrieved 5 February 2012.Jeffries A (17 June 2016).
“There’s a New Film About Misophonia, Where People Get Enraged by Certain Sounds”. Motherboard. Retrieved 18 September 2020.“Past Ig Winners”. improbable.com. 1 August 2006.Lerner BH (2 March 2015).
“Please Stop Making That Noise”. Well. New York Times. Retrieved 18 October 2016.Bisley A (10 March 2015).
“Melanie Lynskey on Togetherness, realism and ‘radical’ nudity”. The Guardian. ISSN 0261-3077. Retrieved 30 June 2017.
Misophonia: Kelly Ripa Has Rare Disorder. 20/20. ABC News. 18 May 2012. Retrieved 18 October 2016.
Marketing Programs You May Like: