Experiments in ‘trigger taming’ and new Misophonia triggers

It has been several months since I started working on an experimental treatment to tackle my Misophonia. The treatment has been hit-and-miss, with my reaction to some trigger noises diminishing. For other trigger noises, the treatment has not been effective so far.

Last fall, I was contacted by behavioral scientist Tom Dozier, who offered me the treatment free of charge, assuming I would chronicle my journey on this blog. I told him I would be giving an honest account of how the treatment worked.

Dozier developed a smart phone app called the Trigger Tamer that allows patients to record the sounds that trigger them, and then expose themselves to just a few seconds of the sound at a time, as to only trigger themselves a small amount. After experiencing the minor Misophonia reaction, they work to immediately calm themselves.

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The premise of the app is that the reaction people with Misophonia have is actually an unwanted reflex that has somehow been programmed in a primal part of our brain, the medulla oblongata. This treatment method also assumes that people with Misophonia experience a physical reaction to trigger sounds in addition to the emotional response. This physical response could be a jerking of the shoulders, a tightening of the chest, a clenching of other muscles, or any other physical reaction.

For the Trigger Tamer app to work effectively, a patient must identify their physical responses to Misophonia sounds, then find a way to extinguish those physical responses in a matter of a couple of seconds. If the physical response is a tightening of shoulder muscles, for example, then the patient could have someone massage their shoulders immediately after they are triggered by a noise, or they could use muscle relaxation techniques to relax their shoulders by themselves.

That’s how this treatment works. A patient listens to a snippet of their trigger sound on the app until they experience a mild amount of that physical trigger, then they immediately perform the act (such as muscle relaxation) that will wipe out that physical reaction.This process retrains the brain to stop reacting negatively to trigger sounds, according to Dozier.

Dozier has estimated that patients using this method for about 30 minutes a day can see their triggers diminish in a matter of weeks. The app isn’t a huge investment (about $40), but Dozier prefers patients using the app schedule regular check-in appointments with him.

Did this treatment work for me? Yes and no.

One of the biggest challenges for me is that my physical reaction to sounds is sexual arousal, and not in a good way. Hearing a trigger sound doesn’t make me want to have sex; it makes me feel sexually aroused and angry at the same time. It’s very confusing and upsetting.

I had to experiment a lot to find something that could make my sexual arousal go away quickly. I tried making myself sad, muscle tightening and muscle relaxation, but those didn’t work. I tried having a partner tickle me aggressively. That seemed to work, but it wasn’t very practical, or enjoyable. I tried yoga stretches, and some of them worked, particularly stretching out my hips (half-lotus and head-of-knee poses).

A couple times a week, I began using hip stretches while listening to the Trigger Tamer.

The first trigger sound I tried to tackle was the sound of a spoon clanking on a bowl. I listened to one particular sound and over time, I stopped triggering to that one specific sound of a spoon hitting a bowl. But, it only helped me slightly out in the real world. I think that’s because there are several different types of clanking and scraping noises that trigger me when I hear someone eat out of a bowl, and for this treatment to truly work, I would have to record each of those many sounds and work with them one at a time with the app.

I gave up on that for a while and decided to take on the sound of typing, which was really starting to eat at me while I was at work. I had serious concerns that I would have to quit my job because I’m surrounded at work by people typing constantly. This is a trigger I developed just in the past year or two, and I wanted to nip it in the bud. I worked with a 10-second recording of a person typing aggressively. At first I listened to a second or two at a time, but eventually was able to listen to the whole 10 seconds without triggering. It wasn’t long before I could listen to the recording for a half hour without triggering.

The typing sounds at work are now manageable. I can go days and weeks without being triggered, and if the Misophonia reaction begins to crop up again, I do a quick stretch at my desk to eliminate the trigger feeling as fast as I can. That seems to send my Misophonia reaction into dormancy for a while longer.

snoring1During the past few months, I have developed two new triggers: the sound of snoring, and feeling my partner breathing when we are lying in bed. This means we no longer sleep in the same bed, and I have to sleep in another room while listening to pink noise, because my partner’s snoring sounds reverberate throughout our home.

I’ve been working with my partner to have him tickle me while we are lying down to fight the reaction I have to feeling my partner breathe. That remains a work in progress.

I recorded the snoring sounds and am now able to listen to the recording without being triggered, but for some reason that hasn’t made it any easier for me when I hear the actual sounds of my partner snoring. Dozier suggested that when I use the Trigger Tamer I try to make the recording seem more real, by lying down while listening to the recording and really imagining my partner snoring. That should trigger me more and allow me to fight that Misophonia reaction more effectively.

It’s a time-consuming treatment and can be difficult to stick to, especially if you need another person to help you wipe out your trigger responses while using the Trigger Tamer app.

Since first writing about this treatment, I’ve heard a couple of concerns from readers of this blog. They include:

Don’t you know exposure therapy doesn’t work?

Yes, traditional exposure therapy hasn’t worked to combat my Misophonia. In this case, though, trigger taming “exposes” patients to a mild trigger and allows them to kill a small physical reaction to the trigger before they become too distressed. With traditional exposure therapy, the goal is to distress the patient and allow them to get used to those feelings of distress until their anxiety eventually diminishes and they get used to the object they are being exposed to. That type of traditional exposure therapy has not been shown to help Misophonia patients whatsoever, and can actually be a very horrible experience.

There’s no good evidence that the Misophonia treatments out there work, and we should be cautious of so-called experts trying to sell us things to fight Misophonia.

I completely agree with this statement. Because Misophonia research is still in its infancy, it’s impossible to have reliable, hard data the prove which treatments work. It’s also possible that something could work for one Misophonia sufferer but not another. We’re still very much in an experimental phase, and everyone should proceed with caution.

The bottom line: Only you can decide when trying an experimental treatment for your Misophonia is worth it.

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18 responses

  1. I am actually a 13 year old myself, and have had misophonia for years, but the sexual arousal thing comes with my chewing sound trigger, or lipsmacking (The noise people make when about to talk or while talking.) I was VERY confused as I had never really noticed this before (I noticed a very long time ago though) and was really worried that there was something wrong. Being an idiot, my brain said “…Turned…On?…” I was disgusted by myself… I only found out today that this is actually a symptom, after reading misophonia levels. I’m level 7, and if possible I leave the room, or bite my hand, feel disgusted and angry and my breathing quickens, I also plug in my ears and try to make a noise myself to distract myself, I also uncontrollably smacked my fist on the table today. I literally had lot control of my arm, I didn’t mean to do it… 😦 I also hate the arousal thing, I don’t think a kid my age should experience that feeling at all D:

  2. You mentioned traditional exposure-response prevention therapy isn’t believed to be helpful in misophonia. Do you have any links to studies or recommendations for books on the subject? I don’t have a doctor who is very familiar with it, so finding information on it is hard.

    1. I would suggest you visit Tom Dozier’s website for more about trigger taming. I believe he has just put out a book on the subject. http://misophoniatreatment.com/

  3. I guess I don’t get it. My worst trigger is the sound of people sniffing. The sound literally makes me boil over with rage, and I have an urge to hurt someone or myself. How will listening to the sound more help? If someone around me has a cold, the sniffling goes on, the worse it gets for me. Maybe I should start with some of my less intense triggers (i.e. loud music/bass, coughing, tapping) Also, I don’t have any physical reations to any of my triggers. Just rage, depression, anxiety…etc. Is the app only for physical responses?

    1. Hi there. It’s not a matter of just listening to trigger sounds, it’s about listening to a very shortened snippet of the sound, stopping the sound and trying to stop your trigger reaction very quickly. Most people do find that they have a physical response to trigger sounds, even if it’s not obvious at first. Try to see if you notice one at all the next time you are triggered. If you absolutely don’t have a physical response, I’ve heard some people have had luck using the trigger tamer while jogging or doing something else that calms them emotionally. Hope that helps!

  4. It was very interesting to find this blog and this post especially as I happened to try something similar a few years ago. It was probably not the same “procedure”. I recorded the triggers and listen to them just a bit and then tried to calm down from the first signs of body responses. It worked to some extend with the recorded sounds but … not with the real ones like the one with snoring you described. There is another element to that in my miso as I tend to trigger a lot more when I have no control over the sounds and much less if I do. I was wondering if that is specific for me or other people can also sea the “control” factor in the triggering severity?

  5. Does anyone experience anger/annoyance/upset at other people who are causing the trigger-sounds, followed by feelings of desolation and isolation? If anyone does, have you had, or tried, treatment for this?

    I often feel I’m the only person who has this anger towards other people causing sounds.

    1. No, you are not alone. There are times that I feel like throat punching someone who triggers it. Before I knew that I had this disorder I would yell at the kids or my husband. After I found out it was a problem with me and not them, I felt bad. I wish there was an easy way to control it. My husband triggers it more than anyone and I can hardly stand to be around him because of it. For me it’s mainly heavy breathing, smacking of lips, and utensils against plates (clanking, scraping,etc). It’s such a hard thing to live with and people who don’t have it look at you like your crazy when you try to explain it to them.

      1. It must be really hard having to live with other people when you’ve got this sound-sensitivity! Mostly, I get by because I (am lucky enough to) live alone.
        And knowing it’s a problem with oneself and not the trigger causers seems to make it more desolating and isolating. Though – in some ways, it should be the trigger causers’ problem too, as they can be causing or making the (often unnecessary) sounds because of lack of consideration for those around them. Though, unfortunately, sounds like breathing and eating cannot be helped. But there are loads more sounds that really don’t need to be made.

  6. I’ve been trying out limited and controlled- that’s the trick that worked for me, having a control over exposure. I worked on eliminating clock ticking sound and managed twice to fall asleep with it. Previously , I would have been triggering wildly while listening to it. I didn’t know of this app, and was essentially doing the same treatment, with the same idea, on my own. I start with the volume down and only 10 or so seconds, and while I’m listening IM trying to think whatever nice thoughts I can, daydream I won the lottery, laughing with friends in a restaurant, hugging my daughter, and I aldo gently caress palms of my hands. Then I have rest and repeat.
    Clock ticking sound is now very tolerable, sometimes even not noticeable. I’ve tried the munching sound recently, but that triggers me almost immediately. That will take more work.
    Do you think it a good strategy to tackle first easier triggers and build confidence in recovery, or would tackling the worst triggers be more beneficial?
    Thanks, Tanja.

    1. Hi Tanja, I’m glad you are seeing some success! As far as the best strategy, I’m not sure there’s a “right” way. For me, I am first trying to isolate the triggers that cause me the most problems in my everyday life. But if you want to work up to really bad ones by working on the lesser triggers, I think that is a smart move too. Good luck and keep me posted!

      1. Have you found any practitioners here is Raleigh,NC that have had success treating Misophonia? My youngest daughter and myself are sufferers and I have been able to manage throughout my life but it seems that my youngest is having a difficult time now with the onset of Misophonia.

  7. The voices of other people and my own voice make me crazy – especially my partner’s voice. I wish I could die. There’s no cure, so what’s the point in living?

    1. Hi John, I’m sorry to hear about your frustrations, and I get where you’re coming from. My hope is that with increased research and awareness into misophonia, a treatment will be possible in the near future. For me, that’s something worth waiting for. I wish you the best.

  8. I too have the sexual arousal response, especially with oral sounds. It has meant that the sounds are pleasant when made by females I find attractive, and so very unpleasant when made by anyone else.
    I guess this is a partial blessing in that sounds made by my significant other are not unpleasant. It would be horrible to be repulsed by the person you spend most of your time with. But with family, especially my mom, I just don’t know what to do with it. So glad to find out there are at least a few others like me I’ve always thought I was just a freak. My ears are definitely wired directly into my sexual arousal mechanism, I’m far more aroused by sexual sounds than visuals, which I guess is very unusual for a man.

  9. Oh wow. I’ve been doing a lot of research on misophonia and, other than myself, you’re the first person I’ve heard of that suffers from the unwanted sexual arousal response to trigger sounds. Thank god I’m not the only one!

  10. Thanks again for another great article (or should I say ‘post’?), and glad this seems to have helped you in some cases.

    It would be good if this apps treatment could help to curb the anger-reflex that I get after a trigger-sound has happened. I also wonder if CBT is really more effective in helping to curb anxiety rather than anger.

    I do also experience a physical-reflex and also enormous anxiety, both in anticipation of a sound happening, and immediately after it’s happened, but it’s the anger-reflex I find the most distressing and alienating, which can lead me into depression.

    As my sound-triggers seem different to most misophonics’ I’d be interested to know if this app can be ‘tailor-made’ for each person’s particular triggers – in my case most impact-type sounds unnecessarily, over-forcefully or heedlessly caused by other people.

  11. Thanks so much for sharing your experiences with this treatment. I’m happy for you that it’s helped at least a little bit!

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