Ask Tom Dozier

Let’s Not Confuse Misophonia and Sensory Processing Disorder – Part 1
August 2, 2016

Ask Tom Dozier

Please submit your question to Tom Dozier using the comment field on this page.  He will answer your question here.

Question: Is it a form of Misophonia where hearing the “s” sound from some of my kids, but not all, causes the reactions you speak about? I hate that it makes me feel like a bad parent.
Answer: Yes.  This IS misophonia.  Generally a trigger starts with a single source (one child) and then grows to include other children and other sounds.  Misophonia is a neurological condition that causes an involuntary reflex to the sound.  You are not choosing to have those horrible feelings toward specific children.  It is your Lizard Brain doing this to you.  So I give you permission to REGRET the situation but please don’t feel guilty.  Your ugly misophonic feelings are beyond your control.  I hope you find the information on this website helpful.

Question:  One of the most common questions is, “Is there a misophonia treatment provider in my area?”
Answer:  There are treatment providers listed on the Treatment Providers page (http://misophoniatreatment.com/treatment-providers)
– Tom Dozier works with individuals around the world by video-chat, so this treatment is available to you regardless of where you live.

Question:  Is misophonia caused by the genes I inherit or by life experiences.
Answer:  Misophonia influenced by both our genes and our life experiences, our environment.  A person who is genetically inclined to be anxious or stressed is more likely to develop misophonia than a person who is very calm and easy going.  But it still takes life events to develop misophonia.  These life events do not need to be traumatic or the result of a bad home environment.  Often children who are anxious or stressed can be upset over seemingly small things.  People have to develop the misophonia triggers, which is technically a form of learning of the Autonomic Nervous System (our Lizard Brain), but this does not require anyone to “teach” the child this.  Just as a child learns to walk, without help, a child can develop misophonia without anyone teaching it to him or her.

Question:  Hello Tom ! I would like to ask you about PRT , have you found something new in curing misophonia with this method?
Answer:  PRT was a great hope of ours for treatment a year ago, but it still needs work for wide use.  My daughter and granddaughter were cured of their misophonia with this treatment.  Currently, about half of the people treated show a positive response to the treatment, and half have no effect.  The problem is that most of those who respond positively regress.  Their misophonia comes back.  It did not come back for my daughter and granddaughter.  They are still trigger free after 13 months.  Right now, we only promote the PRT treatment for individuals who can travel to Thayne, Wyoming to be treated at least once every 3 months.  Dr. Sessions needs more practical experience with this treatment, and we are soliciting people in the Thayne area for help so PRT can become an effective, predictable treatment for misophonia.

54 Comments

  1. Adam A. says:

    Hi Tom, I am writing a paper for school about Misophonia and had a few questions about it.
    1. is it misophonia if you get triggered by a sound, but only if it’s from a certain person?
    2. do all triggers have to be organic, or can it come from something like and alarm clock. was wondering about this one because I hate the sound of alarm clocks to the point where I have to turn down the volume or mute the T.V. When I hear one on it.
    3. can you develop new triggers as time goes on, or are a person’s triggers set in stone
    4. Are there other forms of treatment other than playing the sound to get used to it?
    5. this ones vague, but are there any advancements in the understanding of misophonia

    • Tom Dozier says:

      1. Yes. Misophonia is a condition were specific stimuli (sometimes in specific settings) triggers an immediate response. See this conference presentation, Misophonia Phenomenology, Diagnostic Criteria, and Comorbidity https://www.researchgate.net/publication/316822210_Misophonia_Phenomenology_Diagnostic_Criteria_and_Comorbidity
      2. A trigger can be any stimulus. Chewing and breathing sounds are the most common, but there are visual triggers, olfactory triggers (smells) and vibration of the body triggers (like base through a wall that shakes you slightly, or someone bumping your desk). It can be sounds made by people, animals, machines — anything.
      3. Most people do develop new triggers. Triggers develop through experience. They appear to be conditioned stimuli which elicit a conditioned response.
      4. Yes. There are other forms of treatment, but most involve some contact with the trigger stimulus (but it can be through imagining or a greatly modified version of the trigger).
      5. I think we developing a good understanding of misophonia. See the recent presentation at the Sound Sensitivity Conference, https://www.researchgate.net/publication/316822210_Misophonia_Phenomenology_Diagnostic_Criteria_and_Comorbidity

  2. Emma says:

    Hello,

    Thank you so much for all of your research and efforts in understanding and treating misophonia. I have many triggers – whistling, gum popping, knuckle cracking, etc. It’s not just from one person, so it would seem that I wouldn’t benefit from Trigger Taming. My question is, I have a new trigger that I’m actually not certain is misophonia related and would be interested to hear your perspective. We moved to a house by a busy street (unknowingly at the time), and now I cannot tolerate the sound of cars going by – mostly louder trucks and motorcycles. I do have a fight or flight response to it and am miserable since I’m home a lot and it’s pretty constant. Moving is not an option at this time and I’ve tried almost everything to reduce the noise (loud white noise machines, window treatments, etc). Do you think this is misophonia related, and if so, is there a particular treatment that you think would be most beneficial?

    Thank you,
    Emma

    • Tom Dozier says:

      The short answer is that it can be misophonia. If you are reacting to the sound because it IS annoying, then it may not be misophonia. See A-d and A-e in the proposed criteria for misophonia below.

      The Misophonia Institute recommends the following criteria for misophonia derived from Misophonia: Diagnostic Criteria for a New Psychiatric by Arjan Schroder, Nienke Vulink, and Damiaan Denys (2013).

      A. The presence or anticipation of a specific stimulus such as a sound, sight, or other stimulus (e.g. eating sounds, breathing sounds, machine sounds, hand movement, vibration), provokes an impulsive, aversive physical and emotional response which typically begins with irritation or disgust that quickly becomes anger. [ sources for different sensory modality triggers: 1,2,3,4,5,6,7,8,9,10,11]
      a. Although auditory and visual stimuli are the most common, the stimulus can be any sensory modality [4,6,7,8 plus clinical experience]
      b. The stimulus is a conditioned stimulus, which excludes responses in which the stimulus is unconditioned, eliciting an unconditioned physiological response (i.e. sensory over-responsiveness or sensory processing disorder) [2,3,4,6,12,13]
      c. Where a single occurrence or a small number of stimulus instances cause the default response [clarification that the stimulus elicits the response and this is not a response to persistent annoying stimuli]
      d. Where a minimal intensity instance of the stimulus will elicit the default response (e.g. low volume baby crying or quiet breathing). If a high intensity instance of the stimulus is necessary to elicit the response, then it does not support the diagnosis of misophonia, especially if the stimulus is uncomfortably loud or startling. [6,11 This is the distinction between SPD and misophonia]
      e. But not including stimuli that do not cause this response unless they signal other distressing stimuli (e.g. airplane noise indicating the noise will occur for the rest of the day) [6 and clinical experience. This is rare.]
      B. The stimulus elicits an immediate physical reflex response (skeletal or internal muscle action, sexual response, warmth, pain, or other physical sensation). Note the physical response cannot always be identified, but the presence of an immediate physical response may be used to more clearly identify the condition as misophonia. [2 This is a new item, not in Schroder]
      C. A moderate duration of the stimulus (e.g. 15 seconds) elicits general physiological arousal (e.g. sweating, increased heart rate, muscle tension) [1,15 this is a new itme]
      D. Dysregulation of thoughts and emotions with rare but potentially aggressive outbursts. Aggressive outbursts may be frequent in children. [1,6,12,16,17, Schroder item B, plus]
      E. The primary negative emotion is later recognized as excessive, unreasonable, or disproportionate to the circumstances or the provoking stressor [16, rewording Schroder item C. It may be better to say, “The negative emotions” because it could also cover multiple emotions]
      F. The individual tends to avoid the misophonic situation, or if he/she does not avoid it, endures the misophonic stimulus situation with discomfort or distress [slight wording change for Schroder D].
      G. The individual’s emotional and physical experience, avoidance, and efforts to avoid cause significant distress or significant interference in the person’s day-to-day life. For example, it is difficult for the person to perform tasks at work, attend classes, participate in routine activities, or interact with specific individuals [slight rewording of Schroder E]
      H. The person’s response to specific stimuli are not better explained by another disorder, such as obsessive-compulsive disorder (e.g. disgust in someone with an obsession about contamination) or post-traumatic stress disorder (e.g. avoidance of stimuli associated with a trauma related to threatened death, serious injury or threat to the physical integrity of self or others) [slight rewording to Schroder F]

      References
      1. Edelstein, M., Brang, D., Rouw, R., & Ramachandran, V.S. (2013). Misophonia: Physiological investigations and case descriptions. Frontiers in Human Neuroscience, 7(296), 1-11. doi: 10.3389/fnhum.2013.00296
      2. Dozier, T. H., & Morrison, K. L. (in-press). Phenomenology of misophonia: Initial physical and emotional responses. American Journal of Psychology.
      3. Dozier, T. H. (2015). Counterconditioning treatment for misophonia. Clinical Case Studies. Published online before print January 20, 2015. doi: 10.1177/1534650114566924
      4. Dozier, T. H. (2015). Etiology, composition, development and maintenance of misophonia: A conditioned aversive reflex disorder. Psychological Thought, 8(1), 114–129, doi:10.5964/psyct.v8i1.132
      5. Dozier, T. H. (2015). Treating the initial physical reflex of misophonia with the neural repatterning technique: A counterconditioning procedure. Psychological Thought.
      6. Dozier, T. H. (2017). Understanding and overcoming misophonia: A conditioned aversive reflex disorder, 2nd Ed. Livermore, CA: Misophonia Treatment Institute.
      7. Dozier, T. H., (2017). What is misophonia, 2017. Presentation at the annual conference of the Misophonia Association, Las Vegas, NV.
      8. Dozier, T. H., (2017). Misophonia phenomenology and comorbidity. Presentation at the Sound Sensitivity Conference of the Tinnitus Practitioners Association, Dallas, TX.
      9. Johnson, P. L., Webber, T. A., Wu, M. S., Lewin, A. B., Murphy, T. K., & Storch, E. A. (2013). When selective audiovisual stimuli become unbearable: A case series on pediatric misophonia. Neuropsychiatry, 3(6), 569-575.
      10. Bernstein, R. E., Angell, K. L., & Dehle, C. M. (2013). A brief course of cognitive behavioural therapy for the treatment of misophonia: A case example. The Cognitive Behaviour Therapist, 6(10), 1-13. doi:10.1017/S1754470X13000172
      11. Claiborn, J. M., Dozier, T. D., Hart, S. L., & Jaehoon L. (in-review). Misophonia phenomenology, impact, and clinical correlates.
      12. Jastreboff, M. M., & Jastreboff, P. J. (2002). Decreased sound tolerance and tinnitus retraining therapy (TRT). Australian and New Zealand Journal of Audiology, 24(2), 74-84. doi:10.1375/audi.24.2.74.3110
      13. Jastreboff, M.M., & Jastreboff, P.J. (2014). Treatments for decreased sound tolerance (hyperacusis and misophonia). Seminars in Hearing 35(2), 105-120. doi: 10.1055/s-0034-1372527
      14. Kumar, S., (2015). Neurobiological bases of misophonia. Presentation at the annual conference of the Misophonia Association, Chicago, IL.
      15. Kumar, S., Hancock, O., Cope, T., Sedley, W., Winston, J., & Griffiths, T. D. (2014). Misophonia: A disorder of emotion processing of sounds. Journal of Neurology, Neurosurgery, and Psychiatry, 85(8), e3. doi: 10.1136/jnnp-2014-308883.38
      16. Schröder, A., Vulink, N., & Denys, S. (2013). Misophonia: Diagnostic criteria for a new psychiatric disorder. PLoS ONE 8, e54706. doi: 10.1371/journal.pone.0054706
      17. Wu, M. S., Lewin, A. B., Murphy, T. K. & Storch, E. A. (2014). Misophonia: Incidence, phenomenology, and clinical correlates in an undergraduate student sample. Journal of Clinical Psychology, 70(10),1-14. doi: 10.1002/jclp.22098

  3. Paul Brennan says:

    Tom, as a psychologist I’m a bit perplexed by “don’t try exposure therapy”. It sounds like you mean “don’t try the type of exposure therapy that involves full intensity”. But this is only one type of exposure (and is more usually called “flooding”). I would do exposure with very low volume or even imaginary sounds, or even just words that describe the sounds. Note that CBT, mindfulness, relaxation all involve exposure to your own thoughts, feelings and body response so strictly speaking there is no therapy without some kind of exposure. Apart from that, great site!

    • Tom Dozier says:

      Paul, you are absolutely correct. I corrected this in 2nd edition of Understanding and Overcoming Misophonia, which was released on March 16th, 2017. It seems that the problem has occurred where therapists produce real, full-strength triggers, and expect the person to habituate to the stimulus. There is something about real-world, full-strength triggers that generally increases the severity of the misophonic response. Most of the content of this site are the chapters of the first edition of Understanding and Overcoming Misophonia. Your post has motivated me to change that page of this website right away. If you look at the Neural Repatterning Technique, it is a form of exposure, but with a highly reduced trigger stimulus.

  4. Mary says:

    My son is 13 years old. Onset was 12. I am his only trigger. Could he have miso if I am the only trigger that causes severe reactions?

    • Tom Dozier says:

      Absolutely! Your son can have misophonia. Misophonia usually starts with one specific trigger and then other triggers are added. If your son is having severe reactions to your voice, breathing, or eating (or other sound), but only when you make it, it is probably misophonia. The Neural Repatterning Technique can be used for triggers that are only caused by one source (person). The quicker you take action, the more likely you are to make significant improvement, including the possibility of completely eliminating his misophonic reactions.

  5. Carol McCarron says:

    Dear Tom
    My name is Carol and i have suffered with this horrible condition since I was 8 years old. It started where I could not eat in the same room as my mom. Im 51 years old now and the condition just keeps getting worse. I have alienated myself from so many people over the years. Its the sound of chewing, breathing ,snoring and muffled noises that affect me. Also certain movements from other people. Like petting a dog or rubbing ones feet together. I have been married for 29 years and have never slept in the same room as my husband. It has within the past 5 years affect me at my job. My father suffered from it. My daughter and my niece suffer from it. I cant eat with anyone. I have to eat in a room by myself. I cant sit in the living room with anyone. My husband resents the fact that I have this condition. He wants a divorce. He claims this has gotten so out of hand that he refuses to live like this anymore. I am becoming more and more isolated from the world.The stress, rage and anger I feel evertime I hear or see a trigger is unbeerable. Sometimes it gets so bad that I think about hurting the offender. I would really appreciate any help or suggestions you can offer. I live in South Eastern Pennsylvania and can not find a doctor who can help me with Misophonia. Thank you

    • Tom Dozier says:

      Misophonia is a horrible condition that can be very debilitating (as you have experienced). MisophoniaTreatment.com has more of a focus on treatment options and providers. On average, treatment will reduce misophonia severity by 50% (or more). We can work with you by internet video-chat. If you are interested in seeking treatment, email tom@misophoniatreatment.com for more information.

      The first session with Tom Dozier covers assessment/management/treatment-options. It costs $150, but there is also a hardship rate. Follow-on treatment may be with Tom or another treatment provider based on the treatment you choose. Sequent Repatterning hypnotherapy has promising results and can also be provided by video-chat.

  6. Reanna J. says:

    Dear Tom,
    I am 17 years old and just recently figured out that I have Misophonia. It’s really bad. It’s gotten to the point where it’s effecting my family and friends. I do not act out aggressively, but do get upset when I hear chewing or repetitive noises.I have very sensitive ears and I don’t know why. I have Googled different kinds of therapies and ways to help, but don’t really know….please help..

    • Tom Dozier says:

      Hi Reanna. Misophonia is a difficult condition. We have a team who provide treatment for misophonia. You can email tom@misophoniatreatment. We provide treatment for misophonia by internet video-chat. The treatments do not eliminate misophonia, but we generally expect a 50% reduction in misophonia severity, along with ways to manage the condition to minimize the risk of new triggers and worsening of existing ones.

  7. Esther Schwartz says:

    Hi. Can I download the trigger tamer to a regular windows laptop and use it on the laptop? We don’t own a smart phone. Thank you!

  8. Amy says:

    Hi Mr. Dozier,

    Is there any chance that the Sequent Repatterning Hypnotherapy could be used on a very bright 8 year old?

    • Tom Dozier says:

      It is possible. You and your daughter should meet with a Sequent Repatterning hypnotherapist and see if she has the emotional maturity and focus needed for this treatment.

  9. Esther Schwartz says:

    Thank you for your very well written and organized website! My eleven year old daughter fits the description of a sufferer of this disorder! My question is: how can I explain it to her in terms understandable to her. I don’t want her to feel that there is something wrong with her (she already struggles in school with learning issues and is self conscious about her weight). Also, which treatment do you recommend? Right now her only trigger is my breathing and chewing, and her sisters’ breathing. School does not seem to be a problem (yet).

    • Tom Dozier says:

      I suggest you read the “Taking about Misophonia” page and “What Is Misophonia?” page to explain to your daughter.

      It depends on your daughter’s initial physical response, as to how you should proceed with treatment. This will be the easiest time to reduce or eliminate these triggers. Sequent Repatterning hypnotherapy may be very helpful. Because she only has 3 triggers (your breathing and chewing, and sisters breathing), the Neural Repatterning Technique (Trigger Tamer) might work very well. Both are explained on this website. Those would be my top 2 treatment choices, but I cannot be sure without and assessment.

      We are here to help.

  10. Julia says:

    Hello Tom, I have a question about the trigger tamer app. How often per day do you recommend listening to the app and for how long? And is it correct that while listening to the app the trigger is supposed to be so quick that I don’t get triggered (don’t feel the anger)?

    • Tom Dozier says:

      You are correct that you should not feel anger when you are using the Trigger Tamer app. The trigger should cause an instant, tiny jolt to your body. You should notice it, but as soon as the trigger is over, it should go away. You may feel a tiny bit of irritation or disgust, but nothing like you experience with a real trigger.

      I generally recommend using the Trigger Tamer 30 minutes a day, but you can use it more if it is not irritating. One of the first people to use the app would listen to music at work with the app, with triggers interspersed. He would listen for several hours at work. If you do this, you probably want the trigger to occur every 2 or 3 minutes. This is just an expert guess, as we have no data on this. Look at the words on the top of the treatment screen. It says, “Happy Time” which is a requirement for the app to be effective at reducing your misophonic response.

      • Julia says:

        Thanks for your reply. For some reason when I listened to the app I didn’t really feel anything bad (not even a tiny jolt) when I heard the trigger (in real life I still get triggered though) but maybe I haven’t recorded the trigger sound well enough, I will check u pon that. Do you know how long (weeks, months, years) it took some of the people who used this app to feel less triggered? I am highly motivated to use this app. Unfortunately I sometimes lack discipline to really listen to it every day.

  11. Kristie Jordan says:

    I have not read the book or all of these comments, but has any research been done on the incidence of miso being tied to the mother using anti-depressants during pregnancy? I think some research is now coming out that indicates a link to antidepressant use during pregnancy and autism…although miso is not autism, it is similar in the fact that some peeps with autism have certain sensitivities. Just curious since I took an anti depressant during pregnancy before any of the negative stuff about it was out. Although I have another daughter I took anti depressants with and she does not have any sound sensitivity issues….nor any other obvious issues.

  12. jerome says:

    Hi, I think to have Misophonia becouse when I hear snorting sound I get really angry and so I have few questions.
    Do I have Misophonia?
    Can I treat it with trigger tamer app, and if not are there other ways to heal from Misophonia?
    Please answer me becouse this is really destroying my life.

    • Tom Dozier says:

      This sounds like misophonia. The Trigger Tamer app may be appropriate, especially if you only have 1 trigger person.

  13. Lauren says:

    I’m a mental health provider working with a patient to have school accommodations met at a university. The example one on your website was very helpful but it designed for K-12. Do you have any example ones for college accommodations or advice about working with a university for a student’s accommodations for misophonia? I already submitted a report with suggested accommodations similar to the example here, but the university did not include most of my recommendations in the approved accommodations for this student, such as having a trigger free testing environment with no eating/gum chewing. The university feels this is too difficult to accommodate since they have other students that must eat during testing for their medical accommodations and they want to test all of the accommodated students in the same room. They do not feel these are reasonable accommodations to request. Any suggestions for helping this student?

  14. Nina says:

    Hi Tom, My 10 year old son has misophonia, he is particularly triggered by chewing noises which cause rage and upset. It began with his sister´s and father´s chewing noises but now it appears he cannot tolerate any noisy eaters. We watched a film the other day with a giant that ate noisily and he found this very hard and had to block his ears and look away. He did not leave the cinema though and did manage it better than he would have done hearing eating noises at home. He also manages to sit through lunch in the school canteen without incident, he claims he doesn´t sit next to noisy eaters there. I think he is now becoming triggered visually as well. I am wondering if we should purchase the Trigger Tamer App or whether you think his trigger is too general and the app would therefore not work. He was so delighted when I said there was an app that might help him but having read more I´m worried that it wouldn´t have any effect. Would it be worth a try? Can you please advise me?

    • Tom Dozier says:

      I think his triggers are too general for the Trigger Tamer app. There are other treatments, such as Sequent Repatterning or Cognitive Behavioral Therapy. But you need to work with someone who has experience and is willing to share their success rate with their method of treatment.

  15. Magdalena says:

    Hi! I’m pretty sure I have Misophonia, but I am not 100% positive. I go to a place called Theraplay to help with my sound sensitivities (I think I’m a type 2 but my daddy says I’m a type three). Many sounds bother me, including typing, chewing, peeling vegetables, chopping, people doing the dishes, cats licking, showering and many other sounds. At my theraplay, my therapist has me work on core strength, but sometimes she has me listen to the sounds that I don’t like (my parents will record sounds of them chewing, doing the dishes ect.). I briefly read through the comments, and I noticed that you said a couple of times that if the person listen to the sounds they don’t like, the Misophonia will get worse. I already have one visual trigger, cats licking. I’m wondering if this is because my Therapist made me listen to a lot of cat licking sounds? She says, that if I listen to the sounds while doing a cognitive task that I like, my brain will retrain itself to not flip when I hear those sounds. Is she wrong? Even though I think I have Misophonia, why I’m hesitating to full out say that I have Misophonia, is because I can contain myself when I’m not with my parents. I’ll be at my friends how, and we’ll have dinner, and I’ll still not like the sounds, but I don’t yell and scoot my chair farther away from them. When I’m just with my friend somewhere I’ll tell them to stop smacking their gum, but that’s about it. My point is that I only react at home, but the sounds still bug me. It’s really hard to be a twelve-year-old with Misophonia. I’ve had it for a couple of years, and it’s made me very miserable. I have a teacher who types during silent reading, and it sounds just like my moms (I hate the sound of my mom typing). It makes me cover my ears during reading, and even if I cover them, my hands get tired and I can’t focus. Do you have any suggestions on how to cope with her typing during reading? Should my therapist keep making me listen to those sounds, or is she making it worse?

  16. Faith says:

    hello!! im fifteen years old and have suffered with misophonia for many years now. it’s become such a problem for me. i’ve grown a hatred towards school because of all of the gum chewing going on. i need help, but i dont know where to start.

    • Tom Dozier says:

      I suggest you talk to your parents and together watch the video, Misophonia, What Is It? You are entitled to a 504 plan. You can use headphones in school and a number of other things to make school bearable.

      You are not alone. If your parents do not listen, talk to the counselor at school. Keep talking until you get the help you need.

  17. Lisa says:

    How is it that people with misophonia can stand the sound of their own chewing when they eat, yet can’t sit at a dinner table for fear they might hear normal chewing noises during a meal?

    • Tom Dozier says:

      Misophonia is a reflex response. Some things others do trigger us, but it is different when we do it. For example, most people can not tickle their self. From a reflex standpoint, it would be expected that the sound of one’s own chewing would not be a trigger.

  18. Joss Glenn says:

    Are there any research facilities where can volunteer myself as a research subject?

    • Tom Dozier says:

      There are various research studies, but you usually need to replay to an announcement of the study to be admitted. You could try contacting individuals who have published journal articles on misophonia and see if they have any open studies. We have one which is in the IRB approval process at this time. We will post the announcement and request for participants on this website, and on the Facebook groups such as Misophonia Treatment and Management.

  19. CS says:

    On the ‘What is Misophonia’ page the following is mentioned: “There are reports of individuals with stomach, intestine, or esophagus constriction, urge to urinate, or a sexual sensation.” But I could not find any further information regarding that last physical reflex issue of ‘a sexual sensation’. For many years I have experienced a sensation similar to insects crawling over my genitals when I felt threatened by the presence of people who I felt exhibited predatory sexual behaviors (intentionally or not) toward myself or others. The only explanation I have had for this is that a perhaps it is a strong emotion manifesting itself as a physical sensation. Could this actually be linked to misophonia? The audio or visual cue of seeing/hearing such persons has been linked by my lizard brain to a need for a freeze, fight, or flight response. Please let me know where I can find more information about this, if it’s available, and thank you for your time.

    • Tom Dozier says:

      I cannot point you to any research on this, but it seems very similar to a visual misophonia trigger. My research indicates misophonia is a conditioned physical reflex – a Pavlovian reflex response to a common stimulus. In your case, you probably have some history with sexual predators. The sensation is likely a natural response which occurred at one of those times. It isn’t related to freeze, fight, or flight, because these are unlearned (innate) responses. This is likely a learned response that will not extinguish.

      Do you have strong emotions from these experiences (anger or disgust)? If so, it meets my definition for misophonia — a common stimulus causes a physical reflex response which causes anger/disgust emotions.

  20. Sheila Naderhoff says:

    Hi Tom, in doing research I think I have Miso and Hyperacusus. Dr’s have never heard of my triggers before. When I am around loud music for extended period of time I end up with what the Urgent care Dr called Seizure TYPE symptoms. I’m not having seizures had MRI, MRA …. 2 yr of tests. I lose concentration, walk like I’m drunk, get very aggregated, I have to leave or it gets worse. Bass from cars, Kids screaming, a bunch of people talking at the same time, plus some of the common triggers. Do you think I am right in my diagnosis and have you found any foods to be triggers?

    • Tom Dozier says:

      I do not know any cases where foods are misophonic triggers. But I have seen all sorts of physical reflexes from misophonia. I met one person who had a burning sensation as his physical reflex. It may be possible that your body is producing a little bit of some hormone each time you are triggered, and the accumulation of the hormone cause the “drunk” behavior. How long does the effect last once you leave the trigger situation? Who long are you agitated after you leave? If you have misophonia, it is a unique manifestation of the condition. I cannot say if you do or do not have misophonia. Hyperacusis causes pain in the ears when exposed to loud noises, and it can be accurately diagnosed by an audiologist.

      • Sheila Naderhoff says:

        Thank you Tom for responding. It can take a day or two for the “drunk” behavior to stop. If I can’t get out of the situation and I go into a full blown episode it takes 3 days.

  21. Rhanda Frangie says:

    Tom,

    My 13 year old son has so many triggers, it is stressful to be around him and he often chooses to stay home alone instead of joining in family outings. His triggers sound typical (smacking, all eating noises, the “s” leftover when singing or whispering, any singing (except his favorite bands), whistling, and oddly, when I twirl my hair around my finger as I drive in the car, he’ll quickly bring to my attention that I need to stop, or, I’ll hear stomping noises from him in the back seat taking his frustrations out on the car floor. THE QUESTIONS IS: how much should his triggers be avoided and accommodated? When anyone oppresses his company with extreme requests to NOT do many of the simple joys in life, it does feel like I am setting a bad precedence of intolerance for anyone in his future, let alone his issues in classrooms and other public places. Those in his ear shot (or even visual field) are on edge trying not to set him off. My side of the family has a few members (myself included) who show signs of misophonia, but none as pronounced as his). He is a witty, intelligent and sensitive young man, but is calling all the rules with social situations, forcing me to warn people of his many triggers, making tense situations of simple gatherings.

    • Tom Dozier says:

      In general, forcing a person to endure triggers strengthens the emotional and initial physical reflex, so in the future, his response will be worse. Secondly, forcing a person to endure triggers can cause other sounds and sights present to become new triggers. So forcing him to endure triggers will make his miso-response worse and increase the number of triggers. I suggest you provide a way for him to not experience triggers, such as noise cancelling or noise isolating headphones. Visual triggers are harder to manage.

  22. Rathernot Say says:

    Tom Dozier thank you for studying this. I’m an extreme sufferer of misophonia. My sister has been helping me research the issue. She thinks that I underwent some type of extreme trauma in my childhood and that I have suppressed memories. She thinks that hypnotherapy would really help me. Is misophonia acquired through trauma? Does hypnotherapy help? How often do you encounter suppressed memories with your patients? I have so many blanks in my past that I think this is possible for me.

    • Tom Dozier says:

      Misophonia is acquired through pairing of sounds (which become triggers) and stress. Usually there is no trauma. Regular hypnotherapy usually provides short term improvement, but only very short term. There is a treatment developed specifically for misophonia called Sequent Repatterning Hypnotherapy. It is an 8-week sequential treatment. It reduces misophonia approximately by 50% (on average) and the reduction in misophonia is about the same 6 months later. See http://misophoniainstitute.org/hypnotherapy-srt/

  23. Dear Doctor Dozier

    I needed help with this one. I suffer from Misophonia symptoms all day everyday such as tapping, chewing, eating, people breathing, computer keys and lots more and this keeps making my toes cringe in a way and my neck jerks without me wanting it to and I my question is do I have Misophonia or the symptoms or is that just normal in a sense. I’ve asked for help with it with NHS but they said to me it’s a phase but it doesn’t feel like that, it makes me think hateful things about friends, family and just others, lash out, throw things and cry sometimes. But what I wanted to ask you was what do you think, is it a phase or something else

    George S

    • Tom Dozier says:

      First… I am not a doctor. I am an applied behavior scientist. What you describe is misophonia. Misophonic triggers cause a physical reflex. In your case, you are perceptive and recognize the physical reflex to triggers. Your lizard brain hears a trigger and contracts the muscles (toes, neck, or both). It is like you are getting zapped with a mini taser, but it is your Lizard Brain that is doing it. This is explained in more detail on page http://misophoniainstitute.org/hidden-truth-misophonia/

      Progressive muscle relaxation (see misophoniatreatment.com/pmr) can be helpful if you do it every day. You need to learn to relax your muscles. It takes lots of work, but is worth it. Do PMR every day for a month and see how it helps you. It is the best free treatment for misophonia.

  24. Monica Hoffmann says:

    Dear Doctor Dozier, My Grandson, Tyler, is now 23years old and has HF Autism, He did well in school and wanted to go to County College and continue his studies. His exposure to another disabled student
    that screamed at Tyler and others caused his sound sensitivity to become worse. He cannot tolerate screaming children and babies. He had been doing well at county college but when encountering crying and screaming child he would run away blindly “fright and flight”. He becomes very aggressive. and has to be restrained He has been housebound for over a year and is very depressed. He has other noises he cannot tolerate. His Mother tells him, he has to control the noise. I have taken care of Tyler for three years and he lived with me most of the time. He misses school and I don’t know how to help him. Mom is a single Mom and has another son, Jordan, he has ADHD. I am hoping you can help Tyler, his young life is passing him by. Best Regards, Monica Hoffmann

    • Tom Dozier says:

      First… I am not a doctor. I am an applied behavior scientist who has worked on misophonia for 4 years.

      I think you should consider Sequent Repatterning hypnotherapy for misophonia. It is discussed under the “Treatment” tab. Sequent Repatterning hypnotherapy can be provided by internet video chat. This is similar to another case where the individual with ASD had a very strong response to triggers.

  25. Gary Lake says:

    Hi Tom
    I know I’ve had misophonia for about 18 years now. I can almost pinpoint the series of events that made me painfully aware.

    I have two major triggers, sniffling and repeated (over loud) throat clearing.
    I’ve actually requested to be moved at work because a hearing impaired co-worker does this open mouth throat clearing thing I can’t even describe (haaaa….ahhhhhhhkkkkkk)…andhe has no idea how loud it is. His allergies has me considering other jobs.

    On a somewhat contrary note, do suffers ever report triggers that are exceedingly pleasurable?
    For instance the sound someone turning pages of a newspaper (or book with crispy pages) makes me almost euphoric.
    Likewise a man’s low melodic whistling of a tune is entrancing to me. It’s in complete opposition to the negative triggers.

    • Tom Dozier says:

      The positive responses to triggers that you describe are called autonomous sensory meridian response (ASMR). I don’t think it is related to misophonia.

  26. Rob Stark says:

    My daughter has misophonia and is working very hard to keep it under control but at 15, it is tough. She uses her headphones while we eat and it seems to help. I’m looking into getting her to see an audiologist and hope it provides relief for her. My question is this, at what age can misophonia start? She never slept well as a baby and cried often, driving her mother and I crazy during the nights because, obviously, we didn’t get a lot of sleep either. She eventually stopped crying so much and started sleeping better but maybe she learned to sooth herself. I wonder if she had it as a baby and that was what was causing the lack of sleep and sheer anger in her?

    • Tom Dozier says:

      From my research and working with patients, misophonia is a conditioned response to specific sounds. That means that it develops through experience. A new sound would not be a trigger, but if the person hears the sound under the right conditions (and these conditions include what is happening in the person’s body) then that sound can become a trigger.

      It seems highly unlikely to me that the problem of sleeping through the night was related to misophonia in any way. In her room, she was not being exposed to trigger sounds, so even if she did develop misophonia at an early age (say 3-6 months), it is very likely that she was not being triggered in her room. But her natural sensitivities, distress, lack of self-soothing could have let to the development of misophonia at a later age.

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