About Misophonia

FAQs: frequently asked questions

Misophonia  is a predisposition that gives sufferers an intense hatred of certain sounds. So everyday sounds like chewing, sniffing, and breathing can cause extreme negative emotions such as anger, rage, fear or disgust. Two similar traits are: hyperacusis, when sounds (often loud sounds) cause pain through the ears, and phonophobia, when certain sounds cause fear (making phonophobia perhaps sometimes a sub-classification of misophonia). Although misophonia is largely associated with a hatred of sounds, there can be visual triggers also, especially watching repetitive movements such as leg-fidgeting or pen-tapping. Sounds that trigger misophonia often seems fairly mundane to other people, meaning misophonia can sometimes be a lonely experience. Here we answer some of the questions we are asked most frequently.

1. How common is misophonia?
2. How many different types of misophonia are there?
3. What is the most common type of misophonia?
4. What kinds of emotions are felt by people with misophonia?
5. Is it possible for a misohponic to have only one trigger?
6. Is it misophonia if the source of my anxiety doesn't make a sound?
7. Does it have a biological (e.g. genetic) cause?
8. What are the disadvantages to having misophonia?
9. Are the brains of people with misophonia different?
10. Does misophonia run in families?
11. Are women more likely to have misophonia than men?
12. Is misophonia related to ASMR or synaesthesia?
13. Can you develop misophonia overnight?
14. Where does the word 'misophonia' come from?
15. At what age does misophonia arise?
16. Can misophonia be treated?
17. My ears hurt from loud sounds. Is this misophonia?
18. Is misophonia related to the volume of the sound?
19. I am afraid of sounds (they scare me). Is this misophonia?
20. Which famous people have misophonia?
21. How can I manage my misophonia in the Covid-19 crisis?

 

 

 

1. How common is misophonia?

Misophonia is relatively unknown, but this doesn't mean it is rare. Studies show that as many as 20% of the population may report symptoms resembling clinically significant misophonia (Wu, 2014). But one problem is that it's difficult to draw a line between everyday disliking, and the extreme disliking found in misophonia. Many people dislike the sound of someone slurping messily and noisily, and indeed, as many as 37% of the population may have the very mildest aversions (Naylor et al., 2020). But only clinically significant misophonics will feel the extreme rage and disgust that makes living with the sound almost impossible. Scientists must work together to carefully decide where to draw the line, by listening to the reports of people with misophonia and designing questionniares that ask exactly the right questions.  ^

 

 

2. How many different trigger sounds are there for  misophonia?

Different people experience misophonia from different trigger sounds. Triggers fall into categories such as: eating or mouth sounds (e.g., chewing, breathing, voices), repetitive sounds (e.g., pen tapping), and even visual triggers (e.g., fidgeting foot). Our recent study found at least 39 different triggers in 165 adults with misophonia. These were their sound-triggers ranked from most to least common (98.2% of people with misophonia had a trigger within the top 36, and 99.4% had a trigger within the top 39):- Chewing, Lip smacking, Wet mouth sounds, Throat clearing, Slurping, Sniffing, Crunchy foods, Crispy snacks, Swallowing, Foot tapping / foot on floor, Pen tapping, Pen clicking, Coughing, Some voices, Finger tapping, Snoring, Breathing, Leg rocking, Humming, Whistling, Plastic rustling, Dog barking, Burping, Clock ticking, Paper rustling, Foot shuffling, Typing, Letters, Accents, Consonants, Hiccupping, Sneezing, Snorting, Other eating sounds, Other throat sounds, Car, Other back-ground noises, Fridge, Other voice sounds. This is not an exhaustive list: 1 in 165 people with misophonia had none of these triggers ^

 

 

3. What is the most common type of misophonia?

Eating sounds appear to be most commonly described by misophonics. Some people with misophonia dislike crunching while others dislike 'wet' sounds such as eating yoghurt. But these are simply some of the most common as described to scientists. It could be that other types of triggers (e.g., repetitive sounds) are more common overall but less impactful, so turn up less often in reports.  ^

 

 

4. What kinds of emotions are felt by people with misophonia?

Some people with misophonia feel anger or rage. They may have to resist the urge to physically hurt the person at the source of the sound. They may engage in, or want to engage in actual violence (reactive behaviour), or -- more commonly -- they may leave the room to avoid the urge (avoidant behaviour). Other people with misophonia feel intense disgust, a type of over-riding nauseau at having to hear the sound. They may go out of their way to avoid being anywhere near the person, just in case he or she starts to make a sound they find offensive. Equally, some people with misophonia may feel actual fear or anxiety. All these represent manifestations of misophonia.  ^

 

 

5. Is it possible for a misophonic to have only one trigger?

Yes - some people only hate one sound, while others hate very many indeed. What matters is the intensity of the emotional response: if it is anger, disgust or fear, beyond anything experienced by the average person, then it is misophonia.  ^

 

 

6. Is it misophonia if the source of my anxiety doesn't make a sound?

Yes and no. It is certainly true that people with misophonia sometimes have exactly the same negative responses from certain visual events. e.g., someone flicking their foot back and forth, or chewing their nails. These aversive movements often involve hands and feet, and are often repetitive. This type of aversion is relatively common in people with misophonia, although it does not fit the verbatim etymology of the word (aversion to sounds). For this reason is it sometimes called misokinesia (aversion to movements). Sometimes this is bundled together within "misophonia" itself. But what's clear is that people for whom sounds are aversive are also often sensitive to visual movements. ^

 

 

7. Does it have a biological (e.g., genetic) cause?

There are certainly biological differences found in people with misophonia. For example, people with misophonia have differences in their brains compared to the average person (see below). But whether these are causes or consequences is something that modern science has difficulty answering. A useful step would be systematic studies looking at the genes of people with misophonia.   ^

 

 

8. What are the disadvantages to having misophonia?

Misophonia can have a profound negative effect on well-being. It clearly causes anxiety and negative emotions in those who experience it, and can lead to significant impacts on every day life. People with misophonia may find the actions of other people intolerable, even loved ones. This can lead to considerable strains on relationships and drive wedges between friends and family members. And family members themselves may feel hurt and confused that something so mild to them can cause distress. This lack of understanding between those who do have misophonia, and those who do not, is at the heart of why life can be difficult for misophonics.  ^

 

 

9. Are the brains of misophonics different?

Yes. Studies have shown that the brains of people with misophonia are subtly different from the average person. For example, people with misophonia have more connections in some regions of the brain, and this seems to be part of their normal development. White matter, which connects different regions together, in the brains of people with misophonia is organised differently, and there is more grey matter in some regions of the brain relating to threat and emotion. Most theories of misophonia talk about "re-wiring" or "extra-connections" in the brain.  ^

 

 

10. Does misophonia run in families?

One recent study shows that 22% of people with misophonia reported having family members with similar symptoms but we do not know if this is meaningfully high. But even if misophonia is 'familial' (shared in families) whether this is genetic or not remains unclear. ^

 

 

11. Are women more likely to have misophonia than men?

It's not entirely clear. In one recent study of 300 misohpnics, the test-subjects were found to be predominantly female. But women are more willing to volunteer information, even if their experiences exist equally across the sexes. This can make it look like there is a sex bias when there is, in fact, no bias at all. In that same study, people with misophonia also reported more female misophonics in their family... "more often mother (N=48) than father (N=19), more often sister (N=37) than brother (N=10), more often daughter (N=29) than son (N= 17)." The authors point out this may mean misophonia is more common in females, but it could also mean test-subjects (mostly women) are closer with female relatives, or indeed that female relatives are again more willing to volunteer information, even to their family.  ^

 

 

12. Is misophonia related to ASMR or synaesthesia?

ASMR stands for Autonomous Sensory Meridian Response, in which certain sounds (e.g., whispering) cause a euphoric feeling of relaxiation, often phyisical sensations such as head tingles. Synesthesia is another unusual trait in which certain activities (e.g., reading, listening to music) evoke unrelated sensations such as colours or shapes (Simner, 2019; Ward, 2008). All three traits (ASRM, synaesthesia, misophonia) involve unusual responses to incoming signals, often things heard or seen. But are they biologically related? We do not know. One recent study of over 300 people with misophonia found that half of them reported ASMR which is higher than we might expect from other studies of ASMR. But the authors of that study said more work is needed to be sure. There might equally be no link at all: perhaps someone with both ASMR and misophonia might simply be more likely to want to fill out a questionnaire about unusual experiences. And the authors pointed out there were no controls in that study, so we don't know whether there might have been similar responding in a group of people without misophonia.  ^

 

 

13. Can you develop misophonia overnight?

It's not know whether someone can suddenly develop misophonia -- for example after a disease or brain injury. But this type of misophonia would be  extremely rare and potentially different from lifelong misophonia. This question has no scientific answer yet.  ^

 

 

14. Where does the word 'misophonia' come from?

"Misophonia" comes from the Greek words μίσος (IPA: /'misɔs/), meaning "hate", and φωνή (IPA: /fɔˈni/), meaning "voice", loosely translating to "hatred of sound". Jastreboff and Jastreboff coined the term 'misophonia' in an article in 2001. They noted that some people have an aversion to certain sounds, even if they can tolerate other sounds that are much louder. They elaborated on this condition in a subsequent article that same year.  ^

 

 

15. At what age does misophonia arise?

In a survey of 300 people with misophonia (Rouw & Erfanian, 2018) most people reported it started in childhood or early teenage years. The earliest possible age of onset is not yet clear. But other people report their misophonia started as adults, and we know that misophonia can get either stronger or weaker over time.  ^

 

 

16. Can misophonia be treated?

Current treatments for misophonia include cognitive behavioral therapy (Bernstein, Angell, & Dehle, 2013; McGuire, Wu, & Storch, 2015; Schröder, Vulink, van Loon, & Denys, 2017), tinnitus retraining therapy (Jastreboff & Jastreboff, 2014), and counter conditioning (Dozier, 2015a). These approaches aim to re-conceptualise the individual's relationship with sound, or re-pairing unplesant sounds with something pleasant. They can also combine therapy with gentle exposure to troublesome sounds. However, more studies are needed to examine the effectiveness of these treatments (Jastreboff & Jastreboff, 2014; Cavanna & Seri, 2015; Cavanna, 2014).  ^

  

 

17. My hears hurt from loud sounds. Is this misophonia?

No. Unusual pain from (often loud) sounds is called hyperacusis. The distinction between hyperacusis and misophonia has been helpfully described by Dr Jennifer Brout in an article for Psychology Today. She says "Unlike..patients with hyperacusis (a disorder in which individuals feel pain in response to loud sounds), individiuals with misophonia... report rising stress levels (such as elevated heart beat, muscle tension and sweating) along with strong negative emotions. This is different from ... hyperacusis."  ^

 

 

18. Is misophonia related to the volume of the sound?

No. Unlike hyperacusis (pain from sound), misophonia is not triggered largely by loud sounds in particular. It appears to be the type of sound (i.e., its quality rather than volume) that determines whether a noise will be a trigger for misophonia. ^

 

 

19. I am afraid of sounds (they scare me). Is this misophonia?

Yes and No. Fear of sounds is actually called phonophonia. Phonophobia is sometimes considered to be a sub-category of misophonia, because it fits the defintion of being an unusual, intense negative emotion triggered by sound. Importantly, phonophobia is sometimes also related to another condition, hyperacusis -- when  loud sounds cause pain through the ears. For people with hyperacusis, sounds literally hurt the ears; so naturally this can cause a fear of sounds over time.  In summary, people can have a fear of sounds (phonophobia) either because sounds hurt (linked to hyperacusis), or even if sounds don't hurt. And in either case we might consider phonophobia ("triggering fear") to be a sub-classification of misphonia ("triggering intense emotions").  ^

 

 

20. Which famous people have misophonia?

There are a number of contemporary celebrities who have described their misophonia, and you can read about some of them here. ^

 

 

21. How can I manage my misophonia in the Covid-19 crisis?

Coronavirus and its related illness Covid-19 has placed great strain on people around the world. Many people are in lockdown at home or mixing with only a small group of people. This can have added significance for people with misophonia. You may be in lockdown with someone who makes noises causing you great anxiety, anger or fear. You may not be able to easily remove yourself from their presence, and removing yourself may bring the added feeling of isolation. So what can you do? First of all, try to remember that this time will pass. There will be an end to these restrictions and you will be able to go outside and mix with other prople more freely again. Until then, use coping strategies you know work well. Block irritating noises with earplugs, or earphones. Allow yourself whatever space you have to move away if you need to. Open a window and breath in fresh air. Go for a walk or look at the scene outside your window, especially if you can look out on nature which is good for well-being. Try to focus on the things you can control, such as your own behaviour. Being in control of your own actions will help you to feel happier. Try to keep things in perspective: it is almost certain that nobody is trying to irritate you. Remember that the sound of breathing, eating, and talking are all natural, normal things; even though you find them difficult, they are mundane to others. So most importantly, try to talk to the people around you. Try to calmly ask for help. Tell people specifically what will help you (e.g., closing their mouth to eat) and ask them to be especially thoughtful in this difficult time. Finally, be kind to yourself and to others. You are good people in a difficult time. ^

 

 

References

Bernstein, R. E.Angell, K. L., & Dehle, C. M. (2013). A brief course of cognitive behavioural therapy for the treatment of misophonia: A case exampleThe Cognitive Behaviour Therapist6e10https://doi.org/10.1017/S1754470X1300

Brout, J.J. (2016). What was the original theory of misophonia. In Psychology Today, posted August 29th 2016. https://www.psychologytoday.com/intl/blog/noises/201608/what-was-the-ori...  

Cavanna, A. E. (2014). What is misophonia and how can we treat itExpert review of neurotherapeutics14(4), 357359https://doi.org/10.1586/14737175.2014.892418.

Cavanna, A. E., & Seri, S. (2015). Misophonia: Current perspectivesNeuropsychiatric Disease and Treatment2117https://doi.org/10.2147/NDT.S81438

Dozier, T. H. (2015). Treating the initial physical reflex of misophonia with the neural repatterning technique: A counterconditioning procedurePsychological Thought8(2), 189210https://doi.org/10.1073/pnas.94.8.4119

Jastreboff, M.M. & Jastreboff, P.J. (2001). Hyperacusis. Audiology Online. Published June 18, 2001. https://www.audiologyonline.com/articles/hyperacusis-1223 

Jastreboff, M.M., & Jastreboff, P.J. (2001). Component of decreased sound tolerance: Hyperacusis, misophonia, phonophobia. ITHS News Letter, 2, 5-7.

Jastreboff, P., & Jastreboff, M. (2014). Treatments for decreased sound tolerance (hyperacusis and misophonia)Seminars in Hearing35(02), 105120https://doi.org/10.1055/s-0034-1372527

McGuire, J. F.Wu, M. S., & Storch, E. A. (2015). Cognitive‐behavioral therapy for 2 youths with misophoniaThe Journal of Clinical Psychiatry,76(5), 1478https://doi.org/10.4088/JCP.14cr09343

Rouw, R., & Erfanian, M. (2018, preprint 2017). A large-scale study of misophonia. Journal of Clinical Psychology,  74(3), 453-479.

Schröder, A.van Diepen, R.Mazaheri, A.Petropoulos‐Petalas, D.Soto de Amesti, V.Vulink, N., & Denys, D. (2014). Diminished N1 auditory evoked potentials to oddball stimuli in misophonia patientsFrontiers in Behavioral Neuroscience8(123), 16https://doi.org/10.3389/fnbeh.2014.00123

Wu, M. A. (2014). Misophonia: Incidence, Phenomenology, and Clinical Correlates in an Undergraduate Student Sample. Journal Of Clinical Psychology, 70(10), 994-1007.

 

NOTE: These FAQs were created by Prof. J Simner. They represent the views of the author of this website but include relevant evidence and citations where appropriate.