Smack! Go the lips that simultaneously smack one’s patience down in the auditory boxing ring.
Hem! Goes the throat as it clears its passageways while one struggles to clear their head.
Tick! Goes the clock as it ticks down the time left before the dam of unspoken emotions breaks entirely.
Although no harm is meant by these noises, it can quickly become unbearable to those with misophonia — a lesser-known, neurological disorder defined by a decreased tolerance to specific, repetitive and often human-based sensory inputs.
It’s so unheard of that as I write these words, the term has been underlined in that red, jagged line indicating that what I’ve typed out needs to be rewritten — an “error” that should be easily corrected. But its impact runs much deeper than a simple behavioral correction, and affects many more than one may believe at first glance.
An Overlooked Disorder: The Spectrum of Sensitivity
Similar to other disorders, misophonia exists on a spectrum — with tools such as the Amsterdam Misophonia Scale (A-MISO-S) and the Duke Misophonia Questionnaire having been created to pinpoint various levels of severity.
Ranging from the subclinical to the severe, these evaluations often measure both levels of distress caused as well as the subsequent behavioral and cognitive impact on daily life. Said symptoms can be broken up into three different categories:
- Emotional — Elicited emotions can range from irritation, to disgust, to anxiety and fear depending on an individual’s severity level.
- Bodily — Automatic, physical responses that may include sweating, increases in heart rate and blood pressure, or goosebumps.
- Behavioral –Actions taken to reduce stress that range from active avoidance of potential triggers, verbal confrontations, or direct interventions.
Just as how an individual’s symptoms are extremely diverse, so are the triggers that accompany them. Despite this, they can typically be broken down into some common categories:
- Eating/Drinking — e.g. chewing, crunching, slurping
- Breathing — e.g. snoring, yawning, sniffling
- Mouth/Throat — e.g. kissing, coughing, flossing
- Activity/Movement — e.g. pen clicking, typing, tapping fingers
Of course, this is nowhere near close to being an exhaustive list, but you may have noticed that all of the aforementioned categories are all people-related. However, other noises not produced by people can also trigger symptoms such as animal sounds, ringing from bells or phones, and plumbing-related noises such as water dripping.
Furthermore, misophonia can overlap with misokinesia — replacing the repetitive auditory triggers with visual ones (e.g. hair twirling, leg bouncing, etc.) instead. While this may seem nonsensical to many, one-third of the population is estimated to have misokinesia and around one-fifth of people develop misophonia across their lifetime — usually around one’s early teens.
Which begs the question: If it’s so common, what exactly causes it in the first place?
A Permanent Prognosis?
Unfortunately, experts are uncertain of its exact causes and as such there is no existing cure at this time. Furthermore, there is no agreed-upon official criteria for diagnosis by professionals in spite of the assessment tools listed above — facilitating the invalidation and judgment often faced by those who identify with the above.
Although this may seem like a gloomy outlook at first, there are multiple hypotheses as to why it develops — with variations in genetics and brain structure being some of the more prominent theories.
The Mirror Neuron Theory
One study discussed on Psychology Today suggests that the premotor cortex — responsible for orofacial movements of one’s mouth and nose and is full of mirror neurons — activates in response to an auditory or visual trigger. Essentially, the firing of these neurons allows for mirroring of others’ actions and function “as though the observer was performing the action.”
In other words, the constant, unintentional firing of said neurons may lead one to feel intruded upon and experience a lack of control over what should be their own body — as oftentimes mimicking the other person can act as a temporary coping strategy.
Additionally, aside from overlapping with misokinesia, it also has links to neurodivergent conditions (e.g. ADHD, autism spectrum disorder), mental health conditions such as OCD and PTSD, as well as hearing-related conditions like tinnitus and hyperacusis. Oddly enough, it also has connections to ASMR — which in contrast, involves positive, calming reactions in response to specific visual or auditory triggers.
Thus, if this mysterious disorder has so many connections to well-known, documented conditions, another question naturally arises: Just what exactly are the best coping strategies?
Managing Misophonia
Considering the exhaustion that comes from navigating the daily minefield of triggers combined with the lack of acknowledgement from both professionals and those around oneself, it’s incredibly easy to feel isolated and on your own. Despite this, there are still actions one can take to reduce its impact on everyday life such as:
- Physically removing yourself from the distressing situation
- Utilizing noise blockers such as noise-canceling headphones or earplugs
- Engaging your senses with other stimuli
- Mentally distract yourself by counting backwards, reciting quotes/lyrics, etc.
Also, although diagnosis may not be possible, audiologists, psychiatrists, and psychotherapists do recognize it — offering potential aid with accommodations for school or work.
Even if you don’t have it yourself, you can still support those around you by practicing self-awareness of one’s own behavior, respecting boundaries, and remaining open-minded and empathetic to others’ struggles.
Nevertheless, although change may seem impossible at first, more research is being conducted as recognition of its existence starts to enter the public eye — no longer unseen and unheard. Additionally, there are communities out there who are actively turning their experiences into works of art that can be read by all — bridging the gap between those with and without the disorder.
Relief is possible. All it takes is a listening ear.