Misophonia is a condition in which certain soft, repetitive sounds or visual cues trigger strong emotional and physiological reactions. Individuals with misophonia may experience sudden and intense feelings of anger, anxiety, panic, resentment, or physical distress when exposed to specific triggers. Although the reaction may feel personal or intentional in the moment, individuals typically recognize afterward that this interpretation was not accurate.
People with misophonia generally have normal or excellent hearing. Their reaction is not caused by sound volume, but by an automatic reflexive response to particular auditory or visual stimuli. Symptoms often begin with sensitivity to sounds produced by a parent or close family member and can gradually generalize to similar sounds from others.
What Causes Misophonia?
Current research suggests that misophonia is an involuntary reflex reaction involving both emotional and physical components. Trigger sounds appear to directly activate:
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the Autonomic Nervous System (responsible for physiological arousal),
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the Limbic System (responsible for emotion).
This creates a rapid, automatic pathway—similar to flinching when suddenly poked—bypassing conscious thought.
From a behavioral science perspective, this reaction is understood as a respondent or reflex response developed through classical conditioning. When a sound repeatedly occurs during a period of distress (anxiety, stress, conflict, or tension), the brain forms a learned neurological connection. Over time, this connection becomes a misophonic reflex, triggered automatically by the sound.
The Double-Reflex Model
The Misophonia Institute views misophonia as a condition driven by two linked reflex reactions.
Research suggests that misophonia involves two reflexes:
1. Emotional Reflex
A 2017 neuroimaging study—“The Brain Basis of Misophonia” by Dr. Sukhbinder Kumar and colleagues—demonstrates heightened activation in brain regions involved in emotional learning, particularly the ventromedial prefrontal cortex (vmPFC). This provides evidence that misophonia includes a rapid emotional reflex pathway.
2. Physical Reflex
In addition to emotional reactions, many individuals report immediate bodily responses. These may include:
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muscle flinching
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stomach or intestinal tightening
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esophageal constriction
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urge to urinate
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sexual sensations
These findings were documented in Dozier & Morrison (2017), “Phenomenology of Misophonia: Initial Physical and Emotional Responses,” published in the American Journal of Psychology. Their research describes misophonia as involving a “physical startle-like reflex” as well as an emotional surge.
How Misophonia Develops
Misophonia appears more likely to develop in individuals experiencing:
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chronic stress
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elevated anxiety
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compulsive tendencies
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environments where they cannot escape triggering sounds
It often begins in childhood or adolescence and frequently originates with repetitive sounds from close family members during moments of tension (eating, breathing, tapping, throat sounds). Visual triggers, such as body movements, can also initiate the reflex in rare cases.
Once established, the misophonic reflex can generalize to new sounds over time. Without treatment, reactions may intensify, and daily functioning can become increasingly limited.
How the Misophonic Reflex Differs From Typical Sound Responses
In typical sound processing, the brain takes the “high road”: the auditory signal is interpreted consciously, its meaning is evaluated, and the emotional response is shaped by context.
In misophonia, the signal takes the “low road”—a fast, unconscious pathway directly from sensory input to the emotional and physiological centers. This reflex bypasses conscious processing, creating an immediate surge of emotional and physical reactions before the individual has time to interpret the sound.
Outlook and Treatment Options
Although misophonia can significantly affect daily life, there is growing reason for hope. Over the last several years:
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new treatment approaches have been introduced
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existing therapies have been adapted successfully
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more clinicians and researchers have begun focusing on misophonia
At the 1st International Misophonia Research Symposium (Pleasanton, California, 2018), presentations included:
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Sequent Repatterning, a hypnotherapy-based protocol showing promising clinical results
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a Fordham University study led by Dr. Dean McKay using stress-management techniques and structured exposure strategies
These early findings demonstrate that misophonia can respond to targeted, research-informed treatment.
For additional information on available therapies, see the Treatment section of this website.