For a person with misophonia, personal triggers are a central fact of life. A trigger is a sound or sight that causes a misophonic response. It may be a sound someone makes while chewing, a slight pop of the lips when speaking, or a person whistling. For someone with misophonia, a trigger produces an involuntary reaction of irritation, and if the trigger continues, emotions can escalate quickly to extreme anger, rage, hatred, or disgust. Trying to remain calm while being triggered is nearly impossible for those with misophonia.
The immediate negative emotions in response to a trigger are the hallmark of misophonia. Alongside these emotions, physiological and physical responses often occur, including increased muscle tension, elevated heart rate, sweating, and feelings of overwhelming distress. Even after the trigger ceases, emotional upheaval may continue. Many individuals continue to replay the sound or experience in their minds. While extreme distress can occur within minutes of exposure, it can take hours to fully calm down and resume normal activities.
The impact of misophonia varies widely, from minimal disruption to severe impairment. One individual may have only a single trigger, such as the sound of a spoon stirring a glass of iced tea. If no one in their environment produces that sound, their misophonia may have little effect on daily life. In contrast, another individual might have a single trigger—such as the sound of two or more women talking—that significantly disrupts life. For example, a student in a predominantly female discipline might be exposed to this trigger repeatedly at school, creating a highly stressful experience.
Triggers, Triggers, and More Triggers
Misophonia triggers often begin with a familiar person and a familiar sound. In 2013, Tom Dozier, founder of the Misophonia Institute, conducted a survey of individuals with misophonia. The results showed that two-thirds of respondents reported their worst trigger was an eating or chewing sound, and 10 percent said it was a breathing sound. The remaining participants reported a variety of “worst triggers,” including bass through walls, a dog barking, coughing, clicking sounds, whistling, parents talking, sibilance (the sound produced when saying words such as sun or chip), and someone typing on a keyboard. This is not a complete list, as it is virtually impossible to catalog all possible triggers. Less commonly, triggers can also involve touch, smell, or vibrations.
Triggers are typically sounds encountered in everyday life. Eating and dinner table sounds are the most frequent triggers, followed by breathing or nose sounds such as sniffling, heavy breathing, sighing, snoring, or nose whistles. Essentially, any repeating sound can become a trigger.
Triggers do not become aversive because of the sound itself. Instead, they become triggers when a person hears the sound in a specific situation and develops a misophonic response. Triggers often begin with one sound or one person, and over time can spread to similar sounds, other locations, anyone making the offensive sound, and even visual cues associated with those sounds.
Although misophonia usually begins with auditory triggers, it can occasionally start with a visual trigger, though this is very rare. Visual triggers often develop after an auditory trigger has been established. For example, someone triggered by chewing might also become sensitive to seeing someone put food into their mouth, bringing food toward their mouth, or picking up a potato chip. Visual cues occurring with a trigger can also become independent triggers, such as jaw movement during chewing or repetitive movements like leg jiggling or hair twirling. These visual triggers may arise because the movement accompanies a sound or appears repeatedly after being triggered.
Common Misophonic Triggers
Sound (Auditory) Triggers:
- Sounds of people eating – all forms of chewing, crunching, smacking, swallowing, talking with food in mouth
- Sounds made at the table – fork on plate, fork scraping teeth, spoon on bowl, clinking of glasses
- Sounds of people drinking – sipping, slurping, saying “ah” after a drink, swallowing, breathing after a drink
- Other mouth sounds – sucking teeth, lip popping, kissing, flossing, brushing teeth
- Associated sounds – opening chip bags, water bottle crinkling, setting a cup down
- Breathing sounds – sniffling, snorting, nasally breathing, regular breathing, snoring, nose whistle, yawning, coughing, throat clearing, hiccups
- Vocal triggers – consonant sounds (S and P especially), vowel sounds (less common), lip pop, dry mouth voice, gravelly voice, whispering, specific words, muffled talking, several people talking at once, TV through walls, singing, humming, whistling, “uh”
- Home sounds – bass through walls, door slamming, refrigerator running, hair dryers, electric shavers, nail clipping, foot shuffling, flip flops, heavy footsteps, walking of people upstairs, joint cracking, scratching, ticking clocks, pipes knocking, baby crying, toilet flushing
- Work or school sounds – typing, mouse clicks, page flipping, pencil on paper, copier sound, pen clicking, pen tapping, tapping on desk
- Other – farm equipment, pumps, lawnmowers, bouncing balls, back-up beepers, traffic noise, beep of car locking, car door slamming
- Animal sounds – dogs/cat grooming, dogs barking, rooster crowing, birds singing, crickets, frogs, animal scratching, dog whimpering
Sight (Visual) Triggers
- Jaw movement (chewing), hand touching face, scrolling on smartphone, pointing, leg jiggling, hair twirling, putting food into mouth, drumming fingers, blinking eyes
Odor (Olfactory) Triggers
- Certain scents (rare)
Touch (Tactile) Triggers
- Touching a keyboard, touching certain fabrics (rare)
Other Triggers
- Vibration from anything such as bass, bumping desk, kicking chair, heavy footsteps