Misophonia triggers can spread in a way that resembles an infectious process—not because they are contagious between people, but because one trigger can become associated with another. When a person with misophonia is exposed to a trigger sound and, at the same time, encounters a repeating non-trigger sound or visual stimulus, the new stimulus can become a trigger through classical conditioning.

For example, someone may already be triggered by crunching sounds. While experiencing that distress at the dinner table, they might begin noticing the clicking of forks against plates. Over time, the clicking can become an additional trigger. Similarly, a person may initially react only to one individual’s crunching, but while distressed, they begin to notice other people’s eating sounds. This can broaden the trigger from one person to all people in that environment, and eventually to eating sounds in general.

Non-trigger sounds occurring during or immediately after a triggering event can become associated with the misophonic reflex. The same process applies to visual triggers. Misophonia often begins with an auditory trigger, but repeated visual cues present during distress can also become conditioned. For instance, someone who reacts to the popping sound of gum may also begin reacting to the jaw movement associated with gum chewing. Over time, the jaw movement becomes an independent trigger, even in the absence of sound—such as noticing someone chewing gum silently in another car.

Brent’s Story

Brent, a middle-aged man, experienced several visual triggers. His physical response involved a constriction in his intestines. During early trials with the Visual Trigger Tamer app, he used music as the positive stimulus, and a chime was played shortly before the trigger video to signal when to look at the screen. He was advised to keep the trigger extremely brief so the physiological response would remain mild and short-lived, as stronger reactions tended to prolong the intestinal contraction.

Brent later increased the trigger intensity in an attempt to speed progress. As a result, the chime itself became associated with the intestinal constriction, creating a new trigger. The treatment was stopped. Since then, the app has been redesigned to use 10 different chimes and a longer delay to help prevent such pairing. This incident clearly illustrated how a neutral sound can become a misophonic trigger through classical conditioning.

Minimize Your Response

Avoiding triggers is important. Staying in a triggering situation increases the likelihood of developing new triggers. When avoidance is not possible, reducing the strength of the reflexive response may help limit the spread of triggers.

Background noise—such as a box fan, noise machine, headphones, or behind-the-ear sound generators—can reduce the misophonic reflex. With a lower reflex intensity, individuals are less distressed and therefore less likely to form new associations with nearby sounds.

Emotional responses can also be minimized by reframing the trigger as an automatic physical reflex rather than a personal threat. Viewing the reaction as a neurological reflex rather than attributing intention to others may help reduce emotional escalation. Case reports from cognitive behavioral therapy show that individuals can learn to remain calm during triggers and continue functioning, even when the sounds are still unpleasant.

Muscle relaxation can also be effective. Quickly relaxing the muscles immediately after a trigger can reduce the anger or rage that often follows the reflex.

Strategies for Managing Triggers

When a trigger occurs, the first option is to allow oneself to leave the situation. Parents of children with misophonia, for example, can help by allowing the child to step away from the dinner table without criticism. If a child is met with frustration or disapproval, they may not feel truly free to escape the trigger.

Avoidance and escape are essential early tools. Remaining in the presence of a trigger often intensifies misophonia over time. Tools such as Bose noise-canceling headphones (QC20/20i or QC25) can block single-occurrence sounds effectively, especially when paired with white noise or other steady background sound.

Overall wellness also plays a role. Adequate sleep, balanced nutrition, regular exercise, and muscle-relaxation practice support emotional stability and resilience, reducing the impact of misophonia and helping prevent new triggers from forming.

How New Triggers Form

New triggers can develop in two main ways:

  1. By pairing distress with a repeating sound, similar to how the original trigger developed.

  2. By pairing a non-trigger sound or visual cue with an existing trigger during distress.

Reframing mildly irritating sounds as environmental noise rather than personal offenses may reduce the emotional distress that contributes to conditioning. For example, a person once found the sound of a partner’s electric toothbrush highly irritating. The situation involved both emotional frustration and physiological tension—conditions that could easily have led to a new misophonic trigger. However, by consciously interpreting the sound as ordinary and benign, the emotional reaction dissipated, and no trigger formed.

Placing a positive or neutral interpretation on environmental sounds can help the brain let them go. The same sound that distresses one person may bring comfort or normalcy to someone else. Strategies such as distraction, focusing on another sensory activity, gentle self-talk, and muscle relaxation can interrupt the buildup of distress. When these strategies are ineffective, escaping the sound remains essential, because distress plus a repeating sound increases the risk of developing new triggers.

Developing Multiple Reflexes

Most people with misophonia develop one primary reflex response, which then spreads to additional triggers through pairing. However, some individuals develop more than one distinct misophonic reflex. For example, one person might clench their jaw in response to eating sounds, while their shoulders tighten in response to keyboard typing. This suggests two separate conditioned reflexes formed at different times. Although uncommon, this highlights why minimizing distress during triggers is so important.

Conclusion

Protecting oneself from triggers, reducing distress, and avoiding prolonged exposure are key to preventing new triggers from forming. Individuals are encouraged to take charge of their sensory environment, use tools that help block or soften trigger sounds, and avoid situations that reinforce the misophonic reflex. Misophonia can worsen when a person forces themselves to tolerate triggers; stepping away, reframing the response, practicing relaxation, and caring for overall wellness can significantly reduce the risk of acquiring new triggers.