It's a Disorder Called Misophonia

Lip smacking. Chewing. Sniffing. These noises might be considered objectively annoying, but for some people, they are intolerable. 

“If I zone in on the sound, within 30 seconds my upper torso starts tensing,” said Andrew Stevens, a videographer at PBS North Carolina. “My jaw tightens. I have to fight the urge to jump across the table, because I just want it to stop.” 

This sound phobia is called misophonia. It’s a relatively new term, and it indicates an extreme intolerance to certain repetitive sounds, most often ones that come from the nose, throat or mouth—chewing, coughing, sniffling or lip smacking. 

For some people, even anticipating these sounds can trigger a cascade of physiological and emotional responses—a racing heartbeat, a clenched jaw, even rage. 

“Sometimes it’s the sound itself, but often it’s the context behind the sound that triggers people,” said Dr. Zachary Rosenthal, a clinical psychologist at the Duke Center for Misophonia and Emotion Regulation. 

For example, say you’re on a bus and someone pulls out a bag of chips. The bus engine may mask the chewing noises, but just watching the person eat can be enough to provoke a reaction. 

“It’s often an emotional reaction—anger, irritation, even moral outrage, like, ‘they shouldn’t be doing this, they ought to not do this,’” said Rosenthal. “We all have to process so much sensory information all the time, and some people are more sensitive.” 

The Research on Misophonia Is in Early Stages 

 There isn’t a known cause or cure for misophonia. The research is still in the early stages, and most misophonia studies are less than ten years old. But for many sufferers, having a name for the disorder can be a relief. 

“For so many years I thought it was a weird quirk,” said Stevens. “Finding out that there are other people out there experiencing the same thing helps me not be so hard on myself.” 

Depending on how severe a person’s condition is, misophonia can be debilitating. It can cause sufferers to socially isolate, heighten stress in public settings and strain relationships. Imagine if the way your spouse eats cereal triggers a conflict every morning. 

Some people experience misophonia in conjunction with a psychiatric disorder like post-traumatic stress disorder (PTSD) or anxiety, but some people don’t. Misophonia is not a symptom of another disorder, but rather its own unique, if relatively unexplored condition. 

The “Wild West” of Treatments 

According to Rosenthal, the treatment landscape for misophonia is “like the wild west, with lots of snake oil treatments.” 

“If you’re a family member trying to help your loved one with misophonia, and you start Googling you might find yourself on a ranch in Wyoming with a chiropractor,” he said. “What we don’t want is for people to do more harm as they seek treatment.” 

Understanding misophonia’s origins and how to treat it will require more funding and research. But the few clinics that specialize in misophonia, like Duke’s, offer a multidisciplinary approach, with input from audiologists, occupational therapists and psychiatrists. 

The treatment can be an array of interventions, from ear inserts that act as noise-canceling devices to cognitive behavioral therapy (CBT) for strategizing and coping with triggers. 

“But we don’t totally have our hands on what it is and isn’t,” said Rosenthal. “What we really need is more awareness, advocacy and funding to get the answers that people are looking for.” 

In the meantime, Rosenthal recommends misophonia advocacy organizations like soQuiet for education resources and coping tips. For Stevens, one coping mechanism that’s helped is focusing on his own noises while he eats. 

“I’ve sort of trained myself to tune others out, because I don’t want to be a burden,” he said. “But it’s involuntary, and in the end it’s a disorder I have to live with.” 

PBS North Carolina and Sci NC appreciate the support of the NC Department of Natural and Cultural Resources.