Misophonia • Treat symptoms & with which therapy?

Some find normal noises such as breathing unbearable. The misophony – the hatred of noises – can go so far that those affected become lonely. Symptoms and what therapy can be used to treat misophonia.

Baby screams, a microphone feedback and vomiting: These are the three worst sounds in the world. At least this is the conclusion reached by acoustics researcher Trevor Cox from the University of Salford in England. However, people who suffer from misophonia also perceive more harmless everyday noises such as chewing or even breathing as acoustic torture.

At a glance:

Overview of relaxation techniques

What is misophony?

Misophony describes the hatred of noise, i.e. a reduced tolerance to noise. The term comes from the Greek: “missein” means hate and “phone” stands for tone, sound or voice.

Every now and then annoyed by your colleague’s smacking or sipping soup? Far from being a misophony. It becomes pathological when everyday noises such as chewing, drinking, drumming fingers, clearing throat, sniffing, whistling, coughing or even breathing are perceived as so unpleasant that those affected have to leave the situation. This can be, for example, a visit to a restaurant that cannot be tolerated because too many chewing and drinking noises fill the room.

In online forums, people affected by misophonia also report that the chewing gum of their classmates makes them insane or that having dinner with the family makes them angry or disgusted. The noises perceived as stressful mostly come from fellow human beings, technical noises such as the hum of an air conditioning system or engine noises are described less often as triggers.

Misophonia is not yet a recognized disease, and it is not to be found in the official ICD-10 and DSM-5 classifications for mental illness. It is currently assigned to neurological disorders.

Causes of Misophony: What’s Behind the Hatred of Noise?

“Some people react very sensitively to noises due to their system,” says Uwe Landwehr, a qualified psychologist with his own practice in Grevenbroich in North Rhine-Westphalia.

“However, behind the misophony there are often psychological reasons such as extreme workload or conflicts in the partnership.” This is the case, for example, when the hatred of the husband’s snoring is actually due to other frustrations, such as his long working hours and the lack of time for the relationship. Misophonia is also more likely in people with obsessive-compulsive disorders than in mentally healthy people.

The phenomenon is not entirely new: the disgust and anger at noises were first described by the American neuroscientists Pawel and Margaret Jastreboff in the 1990s. The Jastreboffs suspect that the misophony is based on a selective noise intolerance that has nothing to do with the sound itself. It should be the individual experiences that have triggered frustration, disgust or anger at some point. These deep-seated feelings are, according to the theory, evoked by certain noises. That could be, for example, the colleague’s throat clearing, which reminds you of your hated aunt.

Parent-child conflicts are assumed by some doctors and scientists as an increased cause. Often those affected are still children when the phenomenon of misophonia is diagnosed. Due to familial accumulation, a genetic component cannot be ruled out either.

Altered brain activity in misophonia

A study published in the journal Current Biology in 2016 gives misophonia greater psychopathological relevance for the first time. The researchers observed via magnetic resonance imaging that emotional control mechanisms in the brain are disturbed in misophonia. Hearing the triggering noises activates, among other things, the anterior insular cortex in the brain, which plays an important role in linking sensory impressions and emotions.

Symptoms of misophonia: anger up to violent fantasies

The misophony can reach extreme proportions. “Especially with my mother or other family members, I can hardly stand it when they eat. I get totally aggressive and at some point I run into my room and start crying” – those affected describe these or similar experiences. The environment often reacts with incomprehension, labeling those affected as too sensitive, overly sensitive or in the worst case as crazy.


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Misophonics have developed different strategies to deal with their problem: Some consciously make noise themselves, for example by singing out loud. If the level of suffering increases, self-harming behavior can occur. Or misophonics get lonely because they no longer dare to socialize with people. Violent fantasies are also possible if the anger at the noise trigger becomes too great. Then at the latest you should see a doctor or psychologist.

Treat misophonia with behavioral therapy

“There are no programs to treat misophonia,” explains psychotherapist Landwehr: “In the context of cognitive behavioral therapy, there is the possibility of counter-conditioning: the noise that is perceived as very unpleasant and the associated negative emotions and experiences should be overwritten with new, positive impressions . ” For example, the person concerned is confronted with his “hate tone” while practicing relaxation techniques.

If it becomes clear in the conversation that the misophony is an expression of a work-related stress reaction or that relationship problems are the actual cause, counter-conditioning is useless. In these cases, the psychotherapist will work with the patient to find solutions on how they can cope with the actual causes, for example through couples therapy.

Differentiate misophonia from other disorders

As a mental disorder, misophonia must be differentiated from the following diseases:

  1. Phonophobia describes the fear of certain sounds. Animals, people, objects or situations can cause fear; in phonophobia it is noises. These can be very different individually. A kindergarten teacher, for example, reacts sensitively to loud children’s voices after a hard day’s work. An office worker, on the other hand, is more likely to develop a phonophobia to the ringing tone of the telephone. As with misophony, it is assumed that the problem is not the tone itself. Rather, phonophobia develops because certain noises are associated with a negative experience. In contrast to phonophobia, those affected with misophonia are not afraid of certain noises, but react aggressively.

  2. Another phenomenon that must be distinguished from misophonia is hyperacusis: an oversensitivity to sounds of all frequencies. Normal ambient noises are experienced as too loud and unpleasant from as little as 50 decibels – this corresponds to normal conversation. Possible causes are hearing damage, neurological diseases or the failure of certain cranial nerves. Hyperacusis is seen in over 40 percent of tinnitus patients.

  3. Like misophony, there is still little research into high sensitivity. It is also not classified as a disease. Highly sensitive people react more to stimuli. Crowds, loud music, but also hunger or pain overwork or disturb them faster than other people.

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Source: Lifeline | Das Gesundheitsportal by www.lifeline.de.

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