Management:
Good management is important for a misophonia sufferer. Experiencing triggers in the typical environment often causes the trigger response to become more severe. But trying to prevent all triggers is equally as bad. Adding sound to the enviornment can be a big help in reducing the awareness of triggers and the severity of the trigger response.
The most commonly used “treatment” 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 an iPod or other device. These devices can be purchased through some audiologists. The cost can range from $2.000 to $4,000 for a pair.
An iPod 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 or Simply Noise. These apps, 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 an open-ear headphone, such as regular AirPods. These headphones do not plug the ear, as does an earbud headphone. 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.
Treatments
Sequent Repatterning Therapy: This is a hypnotherapy treatment developed by Chris Pearson and provide by trained and certified hypntherapists. It is a great treatment and can be accessed by telehealth. See https://sequent-repatterning.co.uk/
Relaxation and Counterconditioning Therapy (RCT): This treatment was developed by Tom Dozier with the help of Dr. Nate Mitchell. This treatment can also be provided by telehealth. It includes training on the fundamental principles of reflexes that causes misophonia, evaluation of the individual reflexes of the person, and then relaxation training and counterconditioning activities. This can simple or complex, depending on the misophonia reflexes and individual characteristics. It starts with good management to reduce misophonia distress and enable a positive response to treatment. The treatment usually includes intensive Progressive Muscle Relaxation training using the Misophonia Muscle Relaxation app. It also includes specific relaxation techniques when exposed to weak triggers. This allows the brain to rewire (repattern) itself. It may include what has been described as the Neural Repatterning Technique (old term) using the Misophonia Trigger Tamer app or by having specific, fun, engaging activities. Tom usually provides this treatment by telehealth. Dr. Mitchell (psychologist) provides version of this treatment which he calls Cognitive Behavioral Therapy – Misophonia, or CBT-M. As a licensed psychologist, he also addresses comorbid conditions such as OCD, anxiety, trauma, etc. He provides this in-person at his Louisville, KY office. Patients of both Tom and Dr. Mitchell typically have significant positive response from their treatment.
Cognitive Behaviora Therapy: There are many therapists who provide their own version of therapy for misophonia. There are many successful cases. If you are looking for a CBT therapist, make sure you find someone who understands misophonia and has a track record of success with misophonia patients. Most CBT therapists do not understand the unique features of misophonia.
Other Treatments: There have also been some reports of benefit from generic 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.
For more information on treatment, see the other pages of this website or https://misophoniatreatment.com/