Do you ever get upset when you hear a sound?
This happens to me when I’m in a movie theater
and the person next to me is breathing heavily.
I can’t get their breathing out of my head.
It sounds like Darth Vader, with the volume
turned up, to MAX.
I can’t get used to hearing their breathing,
it takes me out of the movie, and makes me
want to force choke.
It’s not just the person next to me making
the sounds that bugs me, but everyone else
nearby who seems to be just fine with it.
It makes me want to scream out, “isn't someone
going to do something about this person breathing,
it’s ruining the movie for all of us!!!“
This type of problem, intensely experience
certain sounds, followed by powerful emotions
and distracting thoughts is called misophonia.
We’re just now beginning to understand misophonia
as a unique neuropsychological condition and
my friend Vanessa Hill over at BrainCraft
has a great overview of how it works.
Here’s the bad news - misophonia is such
a new idea in the mental health community
doesn’t have a clear definition for what
it is.
There’s a big debate about what emotions
are involved in misophonia.
That’s why we don’t have a diagnosis for
it yet and why there’s zero research on
how to treat it.
This is a problem because misophonia limits
the lives of people who experience it.
Misophonia can turn everyday activities like
dinner with your family, interacting with
coworkers, and even watching online videos
into torture.
People who experience misophonia need relief
now, not 10 years in the future when research
is available.
Here’s the good news.
We can draw on decades of cognitive behavioral
therapy research to identify some ways treatment
might work.
The first thing I want you to know is it's
okay to avoid triggering sounds and to block
them out.
Remember misophonia is a biologically based
problem and sometimes the best way to deal
with it is just to avoid situations that might
trigger it.
That means using earplugs, creating white
noise, listening to music all in situations
where you know misophonia is going to happen.
For patients who are students I also write
accommodation letters so they can take tests
and complete assignments in environments where
they're less likely to experience misophonia
triggers.
But it's impossible to avoid or block out
misophonia triggers all together.
That's where you need to understand the function
of your distress.
What do you exactly experience when you're
hearing triggering sounds?
What is the feeling that comes up?
Is it anxiety, anger, disgust, or something
else?
Different treatments work for different emotions.
If the sound makes you anxious, then exposure
therapy might help.
In exposure you intentionally experience the
thing that makes you anxious until your body
gets used to it.
You start with easy exposures, get bored of
them, and then move up in difficulty.
It’s the exact same process I showed you
in my bee phobia video.
If I wanted to do exposure with breathing,
I could get a recording of it, play it on
low volume far away from myself, and keep
listening to it until my anxiety goes down
on it’s own.
Then, I turn up the volume and move the sound
closer to me.
But in my experience treating misophonia,
people rarely feel anxiety in response to
sounds.
They might get anxious about being in situations
where they’re likely to hear distressing
sounds, like being on guard at a dinner table,
but when they hear a sound they’re more
likely to get disgusted or angry.
Exposure takes a lot longer for disgust and
it doesn’t work well for anger.
In fact, exposure in these situations might
make misophonia worse.
For these emotions, counter conditioning might
help.
It’s a small variation on exposure therapy.
In counter conditioning, we use something
that feels good to reduce to impact of the
sound that feels bad.
You could practice doing deep breathing, the
kind I show you in this video, have a relaxing
cup of tea, or watch one of your favorite
shows.
Then, every 30 seconds play a short clip of
distressing sound.
Through practice, this could help you to build
up a tolerance for the sound.
So far we’ve talked about ways of making
people less vulnerable to sounds.
But there’s a lot you can do to cope with
the powerful emotions that misophonia can
trigger.
Distress tolerance skills can especially be
helpful if you’re dealing with anger.
The myth about anger is you want to take it
out on something, like punching a pillow.
But that doesn’t work, it just revs you
up and gets you more mad.
The best ways to tolerate distressing emotions
like anger involve distraction.
Doing things that temporarily take you away
from whatever is making you mad, reducing
your chances of doing something you might
regret, and then helping you to return to
the situation.
Just remember the acronym Accepts.
Find activities that can take your mind off
the anger.
Organizing my desk always helps me, because
it’s always messy.
Contribute to others.
Texting something nice to a friend helps me
to take my mind off myself.
Comparisons to someone else or another time
in your life can make this situation feel
a bit more tolerable.
Remembering that I am so much better at tolerating
the intense sounds of New York City’s subways
now than when I moved here does make me feel
a little bit better.
Engage opposite emotions.
Listening to a soothing song, watching a funny
YouTube video, or looking at a cute photo
of Mwaji quickly undo my anger.
Temporarily push away the the situation.
Either push away the thoughts in your head
or actually get up and remove yourself from
the situation.
In a movie theater, I could have gotten up
and picked a new seat or get a refund and
watch the movie at another time.
Create different thoughts.
Sometimes paying attention to something else
in the environment, like counting the number
of seats in a row of the movie theater can
be enough to reduce anger.
Create new sensation.
Chew some gum, hold an ice cube, smell a candle,
splash some water on your face - anything
that shakes your nervous system into feeling
something different.
The last, and what seems to be the most important
thing about treating misophonia seems to be
finding ways of getting unstuck with your
thoughts.
Misophonia creates very strong intense thoughts.
Ideas that people are doing this on purpose
to harm you or there's something wrong with
you and that's just not the case.
Yes this is your problem but it's a biologically
based problem.
It's not your fault that you're experiencing
this.
And if everyone heard sounds as intensely
as you did they would also get upset.
When I've talked to people about this they
also tell me that it's likely the person breathing
doesn't realize how loud they're doing it
or that it's impacting you in this way.
To learn more about misophonia check out Vanessa
Hill's awesome video.
It's really really good and I'm in the very
tail end.
We talk about misophonia in a little bit more
detail.
Also be sure to check out some of the resources
in the description below and I want to hear
from you.
How do you cope with distressing sounds?
Let me know in the comments below!
