New Misoponia Treatment Developed – Sequent Repatterning Hypnotherapy
Sequent Repatterning is a therapy which has been designed and developed specifically to treat those having misophonia. It recognises that misophonia is a neurological condition and approaches its treatment through a methodology underpinned by solid neuroscience.
The therapeutic framework was developed by Chris Pearson working in UK. It was implemented during 2014 the therapy has now become more widely available to those with misophonia since early 2015. A huge benefit of this therapy is its effectiveness when provided remotely, online. Usually the secure telemedicine platform VSee is chosen for this purpose, having the appropriate features and durability in practical use.
Those properly trained in Sequent Repatterning are required to demonstrate their skills and present a case study before being listed as a properly certified practitioner. Training is restricted to those suitable qualified and experienced in the application of clinical hypnosis along with at least time-line therapies, integrative parts work and NLP technqiues. Those practising sequent repatterning are listed on the Misophonia Treatment Institute web site: here. Working closely with Tom Dozier and the Misophonia Treatment Institute (MTI) we are now providing therapy to clients world-wide. Our team includes four therapists based in UK, one in Canada and another in The Netherlands.
There is a web site, sequent-repatterning.co.uk, providing more information on this therapy.
Other Treatments
Historically, the most commonly used management technique for misophonia is sound. This is a primary component of the Misophonia Management Protocol (MMP) developed by Dr. Marsha Johnson. Filling the auditory channel with sound (such as waterfall sound) reduces the strength of the reflex reaction to the misophonic trigger sound. This does not eliminate the trigger or the reaction to the trigger, but it reduces the reaction so it is not so upsetting. The sound can be provided best with a behind-the-ear sound generator. The device is virtually invisible. Many devices have a remote control and can even be connected by bluetooth to a smartphone or other device. Sound generators can be purchased through some audiologists. The cost can range from $2.000 to $5,000 for a pair.
A phone and headphones can be used to provide the same effect, but is far more visible and can cause difficulties in public (especially for children or in the workplace). A smartphone or iPod Touch can run a sound app, such as White Noise by TMSOFT (blue icon). This app, costing only $0.99, can provide a variety of different sounds that will reduce the strength of the misophonic response. It is best to use open-ear headphones. See Misophonia Treatment Helpful Products. These headphones do not plug the ear, as does 0earbud headphones. So a person can still hear conversation and set the noise level to block the trigger sounds.
Filling the home with sound is also an option, using devices such as a box fan or white noise machines. The more background noise there is, the less problematic the trigger sounds.
Along with the sound generator, the MMP treatment recommends 6 to 12 weeks of Cognitive Behavioral Therapy (CBT) or similar therapy focused on the area of misophonia. (A recent study on using CBT alone to treat misophonia showed a significant reduction in the impact of the misophonia on the person’s life). The MMP treatment should be very compatible with the NRT treatment (see below), which works to reduce the strength of the reflex to the trigger sound.
Pawel and Magaret Jastreboff provide a treatment which they say uses the Tinnitus Retraining Therapy. This technique uses the sound generator as one of the components, and also works to reduce the strength of the misophonic reaction through controlled exposure to the trigger stimulus. The published article on TRT for misophonia indicated a high percentage of patients benefit from this therapy, but the criteria for “benefit” was a 2 point improvement on a 10-point scale. Data on the average benefit or distribution of amount of benefit was not provided.
More Work on New Treatments Methods
Progressive Muscle Relaxation (PMR) has also shown to be very beneficial in both reducing the anger/rage after a trigger and the strength of the trigger. PMR also has many other health and well-being benefits. It should be practiced daily. The app, Misophonia Muscle Relaxation (Training) provides PMR sessions specifically focused on misophonia. For iOS, see https://apps.apple.com/us/app/misophonia-muscle-relaxation/id1533315873
Nerual Repatterning Technique (NRT) and Relaxation and Counterconditioning Therapy (RCT)
The neural “repattering” technique (NRT) developed by Tom Dozier has been effective when a person has specific triggers, such as sounds from one or two people. Qrecently, this is been incorporated into a treatment called Relaxation and Counterconditioning Therapy (RCT) which includes relaxation training using Progressive Muscle Relaxation and counterconditioning using NRT and other methods. RCT also includes good misophonia management techniques. Tom Dozier regularly provides this treatment by telehealth video-chat. For more information and a video describing this treatment (and how it works) click here.
Psychosomatic Remediation Tecchnique (PRT)
Dr. Scott Sessions developed a treatment called PRT (Psychosomatic Remediation Tecchnique) that he uses for emotional issues. Until Dr. Session and Tom Dozier got together on October 21, 2013, this treatment had never been applied to misophonia. Well, what happened was almost unbelievable. The first 2 individuals treated for misophonia had a complete elimination of symptoms. The next person, who had/has extremely severe misophonia, had no effect. Recently, 2 more individuals were treated with PRT, and both had a complete elimination of misophonia symptoms. A 6th person, treated on 1/4/14, had moderate improvement from the treatment. In April 2014, we treated 31 people. about half show a reduction in symptoms, but is seems that the treatment effect is not lasting. Dr. Sessions is continuing to work on this treatment and as of 2021, he reports consistent positive response from many patients. See https://misophoniainstitute.org/psychosomatic-remediation-technique-prt/
Cognitive Behavioral Therapy (CBT)
CBT incudes many components, and what is provide under this name by one therapist with training in misophonia may be very different when provided by someone who does not have expertise in misophonia. Dr. Nate Mitchell provides CBT-Misophonia treatment, and has a good success rate. He even provides a 1-week intensive misoponia treatment program. See misophoniatreatment.com for more information on this program.
There have been 2 research studies that reported success treatment misophonia using CBT. It is important to understand what a therapist means by CBT. Specifically, what techniques will be used? As of 2021, there are very few CBT therapists that understand misophonia, so be careful.
Other Treatments
Dialectical Behavior Therapy (DBT) is provided by Dr. Jaelline Jaffe in southern California. There are others providing DBT for misophonia. The most important factor is to find someone with training and expertise in misophonia.
There have also been some reports of benefit from traditional hypnotherapy (mostly short term), neurofeedback, biofeedback, and muscle relaxation. Some have benefited greatly from neurofeedback, and even had a complete elimination of triggering. Neurofeedback takes 10, 20, 80 (or more) sessions. There have also been many who have reported it helped in other areas, but had not effect on their misophonia.