Therapy for misophonia will be a work in progress

I finally got set up with a therapist to talk about some coping strategies for misophonia. This therapist does not specialize in misophonia; in fact she hadn’t even heard about it until I stepped into her office on the morning of my appointment.

She gave me the same puzzled look my primary care doctor had given me, but being a therapist, she was respectful and willing to learn more. I gave her a list of articles to read up on the topic, the New York Times article in particular (one reason why coverage of misophonia is so important).

During our appointment, she explained cognitive behavioral therapy. Essentially, it’s the idea that situations outside of our control can impact our thoughts and our emotions and ultimately our behaviors. But if we try to recognize negative thoughts and interrupt them, then we can replace bad thoughts with good ones and start to get a grip on our emotions and behaviors that are typically caused by an unpleasant situation. Please understand, this type of therapy is commonly used for anxiety and depression, and it’s use to treat misophonia is experimental only. As far as I know, it hasn’t cured a single person. It’s strictly a way to make it a little bit easier to cope.

This is the typical CBT model. It’s not a perfect match for misophonia, because hearing a trigger seems to cause an emotion (fight or flight) before there’s time to have any thought about the situation. But the hope is that it can still be used to address the negative thoughts that crop up during a trigger situation.

At the end of that initial appointment, my therapist gave me an assignment: write down my thoughts every time I hear a trigger sound. What am I actually thinking? I had never done this before, and I honestly didn’t want to face the reality of it because my thoughts had become so awful. I came up with a system of texting myself my thoughts while I was at work, and recording them one a piece of paper once I got home.

I found brief relief initially. A coworker would pop in a piece of gum for the fifth time that day, and I would become irate, but then I would have to stop. And pay attention to my thoughts. It interrupted my anger for a bit, maybe a few seconds. It didn’t make the problem go away, and eventually my physiological responses to the sound would, nonetheless, cause a wave of panic, disgust and contempt to rise up from within. In the earplugs would go. Or I’d make a trip to the bathroom to give myself a break from the sound.

My thoughts that I recorded made me feel completely ashamed and disappointed with myself. The “C” word used toward a woman I find to be quite pleasant. Complete revulsion. Words like “gross,” “disgusting,” and “sick” would pop into my mind. Feelings of self pity: “Again?” “Of course she’s going to eat that apple now, at the worst possible time.” “Why is this happening to me?!”

I returned several weeks later to the therapist (my health care provider is overloaded with mental health patients, so therapy appointments are hard to come by). I shared my recorded thoughts with her. She said we would need to arm me with an arsenal of strategies I can use every time I encounter a trigger noise. Escaping is working for me with the ear plugs, as well as getting up to leave a situation when I can. Are there ways I could distract myself when I hear a trigger?

If I need to sit at my desk and talk on the phone and a trigger noise begins, are there ways I can adjust to make things at least a little better? Maybe put an ear plug in the ear I’m not using?

Another interesting suggestion the therapist had was to replace the negative thoughts I have in response to a trigger with a positive thought that I know to be true. For example, people use this cognitive behavioral technique if they have problems with road rage. Instead of blowing up when someone displays horrible driving techniques, which might be true, try to replace it with something like: “Everyone does the best they can.” Or: “This too shall pass.” The trick is that it has to be something that is true to you, and also positive.

When I get triggered at work, I’ve been trying to focus on the person and the traits I like about them rather than on the noise they are making. I try to think things like: “So-and-so is a nice person. He is not trying to hurt me. He doesn’t know any better.” I’ve also been trying to use: “This noise cannot harm me. I am not in danger. My body is functioning just fine and I am going to be OK.” I then try to take a mental inventory of the different parts of my body, noting that my arms are OK, my legs are not hurt, my torso is just fine, my head doesn’t hurt, etc.

The therapist also suggested I get familiar with relaxation techniques such as deep breathing and yoga, and do all the other basics such as make sure I’m eating right and getting enough sleep.

Have any of these methods truly helped so far? Not really. It helps a tiny bit in the sense that I feel more empowered against my misophonia. I have named the enemy, and I have some allies who want to help me fight it. But in another sense I remain powerless. I cannot think my way out of getting triggered. I can attempt to rationalize with the fight or flight instinct that has taken control of my brain.

Perhaps these are coping skills that need to be strengthened over time, so I’ll keep at them to see if things get any better, and I’ll try to do a better job of keeping everyone updated. If you’ve come across a good coping strategy, please share it in the comments section below.

My next appointment is in a little more than a week with a new therapist, because unfortunately my other therapist got transferred somewhere else. I imagine that meeting won’t be too productive, because I’ll be explaining misophonia again to someone new.

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24 responses

  1. I went to a counselor today for my problem with misophonia, which is mainly mouth noises like smacking. She hadn’t heard of this phobia before and told me it wasn’t a real phobia. She also told me I was being judgemental of others for making those noises and that I thought they were beneath me…. What??! Trust me, if I knew how to control this, I would. I don’t choose to feel this way. And I don’t believe others are beneath me. 😦 I really don’t know what to think about this because I’ve tried so many things and different coping methods, but the noises instantly trigger feelings of disgust and I get very irritable and angry. I try to deal with the trigger sounds when I’m out in public or at home by breathing steadily and not tensing my muscles, but nothing really seems to work for long. It’s dumb that I can’t even go to a counselor with a PhD who is supposed to help me but ends up judging me instead because she doesn’t understand the phobia. I’m happy to know I’m not the only one with this issue.

  2. Hi there, so good to find this blog. Myself, my two sisters, my mother and now my 15 year old daughter all have misophonia. I am particularly worried about my daughter as her sensitivity is 10 times worse than mine and I am worried about how she lashes out at all those closest to her. I saw you contacted the audiology clinic in Oregon. Have you had your appointment? How did it go?

    1. Hi, yes I did have my appointment in Oregon. Basically, I was diagnosed with misophonia (no surprise there), and we talked about possible ways to help cope with misophonia. I wrote a blog post about the appointment. You can read that here: https://lifewithmisophonia.wordpress.com/2012/04/03/cognitive-behavioral-therapy-white-noise-generators-used-as-defenses-against-misophonia/

  3. I’m so glad I found your blog. I have a new neighbour who’s a great fan of playing video games all afternoon and late into the night. I can hear a deep bass thump through the walls (though he lives about 50 m down the road from us) that my husband doesn’t hear. His “deafness” has really brought home the fact that I’ve been inappropriately, chronically fearful of deep bass noises for nearly 25 years. Reading through misophonia sites has brought home that I am not alone in experiencing these feelings and that’s a great comfort. Thanks.

  4. The thing is- I don’t really understand learning “techniques” to deal with this is the way to go. I understand that your therapist is doing her best to help by dealing with it in what she knows, cognitive therapy. But it is a neurological problem. An audiologist that specializes in misophonia described it as a bee sting- we want to swat it as soon as it happens. I try to explain to my parents once when they suggested I should just try and think of other things….when my sister suffered tremendously as a child from a skin disease, never once did they say, “Don’t scratch. Try to think of something else.” They could see the disease so they understood it. People can’t see misophonia and because they deal with their own pet peeves they assume it is simply an idiosyncrasy.

    Here is what I am beginning to wonder- could misophonia be caused by food we eat or by a spinal injury that we are unaware of? Nutrition is something I am really interested in- going vegan especially. I am wondering if gluten or dairy, or perhaps the hormones and pesticides put into food could be triggering something or perhaps causing a deficiency. I saw a special on TV about misophonia and they believe there is a part of the brain that doesn’t work properly….which leads me to wonder if it’s food or related to the spine? The spine is the center of our nervous system. I don’t have the money right now to be treated by a chiropractor regularly but I have been checked and my spine is severely out of place. Has anyone else considered either of these? I am starting to alter my eating habits.

  5. PLEASE update! I love your blog, it is so helpful. My young daughter and i both suffer from misophonia.

  6. I’d love to hear any updates about your CBT. I am a CBT therapist myself and I’m intrigued to hear whether any of the standard strategies have been effective for you. I had been thinking about some exposure techniques for myself, until today when I discovered that my blind rage over eating noises might be a little more complex than me just being a hypersensitive and judgmental child about such things.

  7. Are you still out there? It looks like there’s been no activity on your blog in a while. Don’t give up, your blog is inspirational for lot’s of people looking to figure out what they’re going through. Thank you for what you’ve done so far and hope to see some new activity soon!

    1. Yes, I’m still around and doing OK! The response to my blog has been inspiring, and I’m glad people are finding it helpful. It has been a busy year for me, and I’ve had trouble finding the time to post. Updating this blog is on the top of my to-do list. Thanks for reading!

  8. Does anyone know of any treatment that has been helpful? Would love to hear about it – I guess we all would.

  9. I’ve been suffering with misophonia since I was seven years old (I’m 23 now, so it’s been a long while.) I never even knew that it was an “actual thing” or that other people could possibly suffer from it as well. Recently I learned that it has a name, and to be honest, just knowing that I’m not alone or insane in my severe reaction to trigger sounds made things a lot easier to cope with. Personally, when I feel myself becoming bombarded with irritating noises, I take a moment to just feel all that anxiety and then realize how silly I am to be reacting so strongly to something that literally can’t hurt me. If you can find a little humor in your condition, it may help you to cope better. Good luck in all you do! 🙂

  10. I just discovered this blog and everything associated. I am hoping to meet with Dr Johnson soon as I am not far from her. I am curious to see how therapy has been going for you. Keep us updated. I have also started a blog to share day to day family life of a person with Misophonia.

  11. Here is a research study: http://www.spdfoundation.net/researchlanding.html
    Please participate so maybe we can find some answers:)

  12. I feel a physical reaction, a crawling sensation, whenever I hear gum chewing myself. I have coped with it in the most bizarre ways so much so that I didn’t even know that I coping back then.

    I don’t know if this is something that can be beat through rationalization. Currently, I continue with my discipline not to look at someone chewing, which I rationally know is a product of my “fight or flight” response. I just move away if I am able to because I know I am not yet strong or healthy enough to tolerate it. If not I deliberately do my best to occupy my thoughts in a productive and healthy way. I keep breathing, I scan my body for any tension, I close my eyes if possible, and I pray (often with much anger). I will sometimes look towards the sky and remember the metaphor my therapist gave me, which is somewhat like “this too shall pass.” I also recall that I am steadily approaching a day where my mind will achieve a healthier level of integration; and as a result I will carry an awareness of all things–even bothersome things–but I will not be overtaken or overwhelmed by them.

    While in therapy, I have also come to realize that these issues are deeply rooted in much of the abuse and traumatic events in my life. Nonetheless, I cannot really pigeonhole everyone who suffers with this as a victim of the same thing. I just mention my personal experience to illustrate my sense that these emotional responses are the products of encoded information and rigid (perhaps even tangled) neuropathways in our brains.

    I think that CBT has the potential to work on the reprogramming of those neurological connections so to speak by weakening the ones that reinforce your irritation (i.e. the angry, despair-filled thoughts) whenever you get triggered.

  13. Thank you all for your responses! I have had misophonia since i was 12. I remember shouting at my brother that if he did not stop smacking I was going to pull out all of his hair! Ouch, right? I hate it! This is torture. My family and friends have learned what my triggers are and try their best to resist the triggers. I’m currently seeking treatment. If you have any idea of where to start please let me know. I have horrible guilt because my husband and kids hear me yell about it all the time! I wish there was an end to this agony. Evening seems to be worse and when I’m tired. I don’t know if anyone else sees that that affects them or not.

  14. I’m happy to find this blog as well. I have lived with this since I was 12, and found all those years dealing with Misophonia before it was “real” and had a name, to be particularly agonizing, especially in school. I feel for all those children out there dealing with this and not knowing why, and all those puzzled teachers and parents not knowing how to help. Awareness of this is just so very important.

    I am a professional comic book artist, and one of my life goals is to create a friendly, informational comic pamphlet to be distributed out to schools to inform more people about this and how to help. I’ll figure out how to make this happen sometime, but I think it’s wonderful that so many people are coming forward to talk about Misophonia.

    @Nena, I too feel terrible for my husband and children. I try to contain my anxiety when sounds happen but sometimes I fail, and then I feel terrible. I especially never ever ever wanted my children to bear the brunt of something that is not their problem. I try extra hard to be a great mom the rest of the time, but I still feel tremendous guilt.

  15. My sister and I both have misophonia. Both of us for as long as I can remember. I’m 36 and she’s 35 and it’s awful. Its really sad because our kids and husbands get the worse end of the situation. Since our kids could eat and understand not to make noises while eating etc.. we have drilled into their heads no smacking or other noises or mommy will flip out. Even our husbands get fussed at for swallowing to loud or eating the wrong way. We have to have some kind of background noise or something while people eat. We both would rather our ears stabbed out, strangle or punch the person making the obscene noises. I know this sounds really awful and we would never go to the extreme but I just hope a cure or some type of treatment will be found. My sister’s two girls both have it too. So far it has not affected my children.

  16. Hello, I was very happy to come across this blog. I’m glad Misophonia has been getting more recognition as a serious condition. I also had gum chewers at my work. I found that my best defense against these people were noise canceling headphones (http://www.amazon.com/gp/product/B0054JJ0QW/ref=as_li_qf_sp_asin_il_tl?ie=UTF8&camp=1789&creative=9325&creativeASIN=B0054JJ0QW&linkCode=as2&tag=softengiintet-20) Although they are quite expensive, I don’t even have to listen to music for these headphones to drown out chewing noises. Best of wishes with your treatment. I hope that I can find a specialist in my area

  17. It makes me feel better that I’m not crazy- I just have misophonia. My mom has misophonia as well, but she copes with it so well and my family tells me to just “ignore” it like she does. It drives me crazy when my dad tells me to “just get over it.” He doesn’t understand that it’s IMPOSSIBLE to “ignore” it or “get over” it. I rationalize in my head and it helps for only a split second, because the next trigger sounds send me into another rage and I want to scream at the person.

  18. I didn’t know anyone else had this until my friend told me about it so I looked it up and it’s crazy. I’ve had this for as long as I can remember; it got so bad that I ate in a different room than the rest of my family. I’m definitely going to look and see if anyone in the area can help me with this! I’ve pushed so many people away.

    1. I also have to go into he other room while my family is eating. I can’t take listening to them eat and talk at the same time.. It makes me nauseous. I wish it would go away. I won’t let my mom eat crunchy things in front of me; she just doesn’t understand. I’ve been like this for years an I’m 17. It probably started around when I was nine. Even someone coughing makes me cringe. I’m glad I’m not the only one like this.

  19. I also suffer from misophonia. Thank you for all these ideas to try! I find it difficult to tell people about my problem and how much it affects my life. Do you think there will ever be a cure. Because i am only 13 and have heard it gets worse with age?

    1. The earlier you start, Cassidy, I think it will be better for you.

  20. I find that nothing really is working too well for me either. Us “Misophonies” need a whole new therapy designed just for us. We also need to be the ones researching because nobody else knows anything about it..I wouldn’t waste my money on therapists unless I already knew they specialized in Misophonia or have overcome it themselves. What I’ve come up with is that misophonia is a fear based disorder that stems from anxiety. I think tackling the anxiety first is the key before jumping into CBT or other techniques. Ive been considering hypnosis? I’ve suffered from this since before I can remember. I find that i tell my partner..”i promise I will stop commenting on the way you swallow..and then the next hour or two ..I flip out about it again and its almost like I have no control..Its almost like I have to say something, so the anxiety subsides for a second. Then it turns into another fight, I wind up letting the other person down, and myself.

    I guess I’ve tried staging scenarios..having the person make the noises over and over again while i sit through it, but then it almost seems like it doesn’t phase me when its on purpose, it has to be unexpected to cause me the rage and fight or flight. Anyways its mostly with loved ones, which is hard because Im driving them away..hope to find out more about it..CANT TAKE IT ANYMORE

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