Misophonia, a newly described condition, is receiving a lot of press. It is often inaccurately characterized as “chewing rage,” as “sound rage” and even as an “eating disorder.” Misophonia is not any of these things!
Misophonia research is in its infancy, and very little is known about it. Yet doctors, researchers, and reporters continue to create ill-conceived, incorrect and exponentially replicating memes. This misinformation harms sufferers (and their loved ones) in a multitude of ways as they sift through the confusing clutter trying to parse out the facts from the fiction.
“The assumption that “body noises” are the only issue in misophonia dominates much of the popular press, medical websites and even some of the academic literature. However, like many of the misophonia myths and memes, this is untrue.”
Here are the misophonia facts in one paragraph or less. Pawel and Margaret Jastreboff of Emory University originally described misophonia in 2001 as a disorder in which repetitive and pattern-based sounds trigger autonomic nervous system arousal. Some examples of these noises include other people chewing or clearing their throat, finger tapping, foot shuffling, keyboard tapping, and pen clicking (Cavanna & Seri, 2015; Edelstein, 2013; Jastreboff & Jastreboff, 2001; Jastreboff & Jastreboff, 2013; Wu et al., 2014).
You many have noticed that many of these noises cluster around sounds emanating from others (e.g., chewing, coughing, sneezing, etc.). Thus, the assumption that “body noises” are the only issue in misophonia dominates much of the popular press, medical websites and even some of the academic literature. However, like many of the misophonia myths and memes, this is untrue.
“One thing that can be said with confidence is that misophonia is NOT restricted to 'chewing sounds,' and we should not be calling it 'chewing rage.'”
People with misophonia report responsivity to many non-body (or people-generated) noises such as birds chirping, windshield wipers, fans blowing, etc. In reality, the acoustic features of the sounds have never been studied, and researchers have little idea what qualities of these or any other sounds cause the “misophonia reaction.” Scientists are early in the hypothesis testing stage, and very little can be said with certainty. Adding to the confusion are numerous reports by individuals with misophonia who experience the same extreme response to specific visual stimuli. One thing that can be said with confidence is that misophonia is NOT restricted to “chewing sounds,” and we should not be calling it “chewing rage.”
While we are at it, let’s revisit the idea of rage. Preliminary research (summarized here in one paragraph or less) suggests that the “misophonic response” is a reaction in which the brain essentially misinterprets particular noises as dangerous or otherwise harmful. For reasons not yet understood, particular auditory stimuli send the brain a message that an individual is in harm’s way. This kicks off the sympathetic nervous system, which readies us for fight or flight (Cavanna & Seri, 2015; Kisley et. al. 2004; Lane & Thacker, 2010; LeDoux, 2015;Kumar et. al. 2012; San Gorgi, 2015; Schroder, et. al, 2014).
“Must medical and mental health clinicians and researchers continually repeat the mistakes of the past in which we label something 'emotional' or 'psychiatric' simply because we don’t yet know what it is?”
There are a number of potential brain regions and processes specific to this reaction. However, both typical and atypical brain processing (and the physiological and behavioral associations) are extraordinarily complex. Science is just beginning to unravel this mystery. Yet we see reference after reference to misophonia as an “emotional” or “psychiatric” disorder rather than a neurophysiological one. Of course there are identifiable emotional and behavioral responses related to the underlying brain mechanisms of misophonia. But must medical and mental health clinicians and researchers continually repeat the mistakes of the past in which we label something “emotional” or “psychiatric” simply because we don’t yet know what it is?
None of this is to suggest that misophonia is not real… quite to the contrary! More support for a biological basis for this disorder is revealed as the research develops. Unfortunately, mythical memes become viral and harmful.
I can understand the press making some errors regarding misophonia. It is a newly termed and complex disorder. Yet when doctors and researchers do so, it is unconscionable.
If information is a right, then misinformation is an injustice.
References:
Cavanna, A. E., & Seri, S. (2015). Misophonia: current perspectives.Neuropsychiatric disease and treatment, 11, 2117.
Edelstein, M., Brang, D., Rouw, R., Ramachandran, V.S. (June 2013). Misophonia: physiological investigations and case descriptions. Frontiers in Human Neuroscience. Vol. 7.
Jastreboff, P J. and Jastreboff, M.M. ( 2001). Components of Decreased Sound Tolerance: hyperacusis, misophonia, phonophobia. Institute of Translational Health Sciences.
Jastreboff, P J. and Jastreboff, M.M. (2013). Using TRT to Treat Hyperacusis, Misophonia and Phonophobia. ENT & Audiology News. Vol 21 (6), 86-90.
Kisley, M. A., Noecker, T. L., & Guinther, P. M. (2004). Comparison of sensory gating to mismatch negativity and self‐reported perceptual phenomena in healthy adults. Psychophysiology, 41(4), 604-612.
Kumar, K., Kriegstein, K., Friston, K., and Griffiths T.D. (October 2012). Features versus Feelings: Dissociable Representations of the Acoustic Features and Valence of Aversive Sounds. Journal of Neuroscience. Vol. 32 (41), 14184 –14192.
Lane, S. J., Reynolds, S., & Thacker, L. (2010). Sensory over-responsivity and ADHD: Differentiating using electrodermal responses, cortisol, and anxiety. Frontiers in integrative neuroscience, 4, 8.
LeDoux, J. (2015). Anxious: Using the brain to understand and treat fear and anxiety. Penguin.
San Giorgi, R. (2015) Hyperactivity in amygdala and auditory cortex in misophonia: preliminary results of a functional magnetic resonance imaging study.
Schröder, A., 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 Patients. Frontiers in Behavioral Neuroscience. Vol. 8 (123), 1-6. doi: 10.3389/fnbeh.2014.00123.
Jennifer Jo Brout is a New York State Certified School Psychologist, a Connecticut Professional Licensed Counselor, and she also holds a Doctorate in School/Clinical-Child Psychology. She graduated from New York University, Columbia University, and Ferkauf School of Psychology (at Albert Einstein School of Medicine) respectively. Dr. Brout is the founder of the International Misophonia Research Network and is the Research Director of the magazine Misophonia International.
