Misophonia is not a disease, but a disorder in which individual noises are perceived as extremely unpleasant and make you angry. The causes have not yet been clearly clarified, but the treatment prospects are good.
What is misophonia?
Misophonia is translated as “hatred of sounds”. Those affected react aggressively when they hear certain noises. This can be eating noises such as smacking, slurping, chewing or other noises such as sneezing, clearing the throat, sniffing. Misophonia was first examined and named by the American neurophysiologists Pawel and Margaret Jastreboff. See ablogtophone for LS which stands for Lichen Sclerosus.
In this context, the term selective noise intolerance is often used today. The selectivity consists in the fact that only certain sounds are experienced as annoying. The fact that extreme negative reactions occur especially when the noises are made by certain people such as the father or the partner is sometimes neglected in the specialist literature.
The reduced tolerance for certain sounds and the resulting anger is to be distinguished from hyperacusis (general hypersensitivity to sounds that other people do not find loud and disturbing) and from phonophobia (fear of specific sounds).
It is suspected that childhood experiences cause misophonia: if there was a problematic father-child relationship and the father slurped the soup at lunch, then similar noises can trigger anger in the current spouse. In addition, sexual abuse can also be responsible for the fact that the heavy breathing of a fellow human being is later perceived as hateful.
Every time the stimulus or the noise is perceived, the negative reaction occurs “as if by itself”. Those people who begin to suffer from misophonia often have a pre-existing OCD. Perfectionists are particularly at risk because they also assume that there is a perfect way of eating, chewing, drinking, coughing, etc. that everyone else should follow.
Selective noise intolerance is not caused by a hearing disorder. According to a study by brain researcher Sukhbinder Kumar from the University of Newcastle, it is based on a brain disorder. However, this theory is controversial.
Symptoms, Ailments & Signs
The literature warns against pathologizing noise-induced discomfort. This is appropriate because many people have unpleasant childhood memories associated with noise, and all urban dwellers have to live with a wide variety of noises. However, when reading the specialist literature, one sometimes gets the impression that misophonia is being trivialized.
Affected people are not taken seriously and labeled as “overly sensitive”. What is decisive is the level of suffering, which can express itself in massive avoidance behavior: There are reports of people who have not eaten together with their families for many years.
Others will make violent scenes or do violence to their partners if they get angry with their noises. The suffering can also be measured objectively: when they hear the noise, the affected person reacts with altered skin conductivity, an increased heart rate, outbreaks of sweat and muscle tension. This is how nervousness, stress and panic arise.
Diagnosis & course of disease
When diagnosing, attention is paid to how people respond to certain sounds: if they feel fear, phonophobia is suspected. If they get angry and the physical symptoms described above are recognizable, then it is a case of misophonia, which can vary in severity.
One can speak of a pathological condition when life is comprehensively redesigned in order not to be at the mercy of any unpleasant situations and noises. Professional difficulties, relationship problems and social withdrawal are the consequences.
As a rule, misophonia leads to psychological problems and limitations. Those affected perceive all noises in the environment as disturbing and can no longer concentrate properly. Especially in children, this complaint can lead to developmental disorders or social problems that significantly reduce the quality of life.
It is not uncommon for the treatment to be delayed because those affected are not taken seriously and therefore do not agree to proper treatment. Furthermore, an aggressive mood or irritability of the patient can also occur, which has a very negative effect on health. Patients also suffer from headaches and sweating or tense muscles.
It also leads to stress and strong nervousness. In some cases, sufferers can also suffer from panic attacks. A direct and causal treatment of misophonia is not possible. Treatment is therefore always symptomatic and aims to limit the symptoms.
However, this does not always lead to a positive course of the disease. Sometimes those affected are dependent on lengthy therapy so that the misophonia can be treated.
When should you go to the doctor?
People who are particularly sensitive to certain environmental sounds should see a doctor. Although misophonia is not a disease in the medical sense, it is still advisable to clarify the symptoms so that organic causes can be ruled out. If there is inner restlessness, behavioral problems or irritability, a doctor is needed. If the auditory perceptions trigger feelings such as aggression, anger or severe despair, a visit to the doctor is advisable. In the event of inner tension, a reduced zest for life or reduced well-being, it is helpful to consult a doctor.
Stress, fear, states of panic or nervousness are signs of an existing health irregularity. A comprehensive medical examination is required to clarify the cause and initiate countermeasures. Loud palpitations, an increase in pulse rate or other cardiac arrhythmias should be checked out by a doctor. When people suffer from the noise due to their sensitivity, a treatment plan is needed to improve the quality of life. If the affected person withdraws from social life, if public places are rarely visited or if there are more conflicts and interpersonal disputes due to the disturbing noises, a visit to the doctor is recommended.
Treatment & Therapy
If misophonia is present, behavioral therapy can be used, in the context of which an attempt is made to break the link between the stimulus or noise and the negative emotion. The method of “counterconditioning” is used here: the people suffering from misophonia are confronted with the noises that they previously found unpleasant in a new context – associated with positive associations – in order to suppress the negative ones with positive reactions.
In her treatment method, the German acoustician Gabriele Lux relies on providing those affected with soothing sounds (the sound of the sea, etc.) via headphones or sound generators worn behind the ear. The aim is to soften the noises that are perceived as annoying and, ideally, to experience them in a new way. Dealing with the specific noise experience that caused the symptoms is helpful in most cases.
This can be done as part of a group or individual therapy with specialized psychologists. Despite all measures, negative reactions will not be absent in the future, but those affected will be able to absorb the noises more calmly in the future. Relaxation techniques ( progressive muscle relaxation according to Jacobson, autogenic training or yoga) are a useful addition.
Outlook & Forecast
The prognosis for misophonia is relatively good. The disorder and the associated aggression can be treated with relaxation therapies, behavioral therapies and psychological support. As part of the therapy, those affected also learn to accept the disease and thus live more relaxed and open. For patients, this often opens up the opportunity for social contacts and relationships.
Early treatment is a prerequisite for a positive course. Patients must have the noise sensitivity treated therapeutically before further mental illnesses manifest themselves. Persistent stress can also cause physical ailments such as high blood pressure or gastrointestinal problems. If physical or psychological complications have already established themselves, this makes it difficult to treat misophonia.
Around 80 percent of all misophonia patients recover from the condition with appropriate therapy. Relapses rarely occur. The prognosis for misophonia is therefore comparatively positive and the prospect of a symptom-free life is given. Life expectancy is not reduced by misophonia. The prognosis depends on the cause and treatment of the misophonia. It is provided by the responsible neurologist with the support of an ear, nose and throat specialist.
If the main cause of misophonia lies in specific noise experiences, then prevention is difficult. The best prevention is to identify and eliminate the root cause of the problem. One way to prevent it is to talk to the person making the annoying noise and find a solution as soon as possible.
This will lead to discrepancies, but it is unavoidable. If pathological perfectionism or compulsion to control are involved in the development of the problem, these compulsive behaviors must be treated.
Since misophonia cannot heal on its own, follow-up care focuses on a healthy and prudent lifestyle. If the effects of the disease have led to mental upsets or depression, therapy with a psychologist can be helpful in processing the symptoms and regaining a positive attitude towards life. The further course of the disease usually depends very much on the exact cause, so that no general prediction can be made. The extent of aftercare depends on this.
You can do that yourself
Those affected who suffer from misophonia should take their suffering seriously and not trivialize it. This is especially true when certain noises provoke severe aggression or the patient is already beginning to make massive lifestyle changes to avoid the hated noises.
As a rule, the family doctor can only serve as the first point of contact. The diagnosis should be left to an expert who also administers or at least monitors the therapy. Since the disease is rather rare, experienced doctors and therapists for this disorder are not easy to find. If the family doctor cannot help, those affected can contact the medical association and their health insurance company. Some professional associations, such as the Deutsche Psychotherapeuten Vereinigung eV, provide tools on the Internet that help in the search for a suitable therapist.
In any case, those affected have to prepare themselves for lengthy behavioral therapy. You can often promote the success of this therapy by learning relaxation techniques such as yoga or autogenic training. The other self-help measures that those affected can take depend on the noises to which they react aggressively. However, earplugs from the pharmacy or an iPod that plays your favorite music can shield you from unpleasant noises in many situations.