The Hidden Truth of Misophonia

Misophonia is characterized by an extreme involuntary anger/disgust emotional response to a typically occurring sound (or visual stimuli).  This is the trigger sound or a visual trigger.  The most common trigger sounds are eating and breathing sounds, but any repeating sound can be a trigger.

1-step-misophoniaWith this basic definition, misophonia has a single cause (the trigger) and a single response (extreme emotion).  This figure shows the way misophonia is experienced by virtually everyone who suffers from this condition. (The word, “elicits” means that the response is drawn out by the stimulus – the response happens automatically in response to the stimulus.)  But this is actually a very deceptive experience.  The emotion is so strong and overpowering that it masks what is actually happening in the person’s body.

2-step-misophoniaFrom Tom Dozier’s work with many individuals with misophonia, he finds that there is a hidden physical reflex.  The trigger stimulus actually elicits the physical reflex.  The physical reflex is why you actually “feel” a misophonia trigger.  You perceived the stimulus (auditory or visual) and your Lizard Brain (your ANS) pulses the neurons for your particular misophonic muscle reflex.  You feel the reflex just like an electrical shock.  Essentially you are being “tazered” at that part of your body.  That instant jolt from your Lizard Brain is very aversive.  Think of it as someone sneaking up behind you and thumping your ear.  It is irritating.  If the person keeps doing it, it becomes upsetting.  If he thumps your ear over and over and over again, it becomes intolerable.  Then, all he needs to do is thump your ear one time, and you want to strangle the person.  This is the way misophonia works.Watch the video; Misophonic Reflex ResponseYou do not recognize the physical reflex because the emotions are so overpowering (and come instantly). these emotions are also a conditioned reflex – a Conditioned Emotional Response (CER).  Your experience is the Traditional View of Misophonia, but in reality, you are having this quick, physical reflex before you get angry.  To identify your physical reflex, you need to get a VERY tiny trigger — a trigger that happens one time and is mild enough to not cause an emotional response (or only a weak emotional response).  This needs to be done in a controlled setting, where you know you will only get one trigger.  It also works well if you can test your reflex with a recorded trigger.  That way, you can turn down the volume until you are not triggering at all.  You want it so low that you can not tell what it is.  Then, slowly turn up the volume, playing the trigger each time.  At some point, you will start to have a very small reflex response.  Pay attention to what you feel.  Wherever you feel the twinge, that is your misophonic physical reflex.

NRT Treatment for MisophoniaWe developed an app for iPhones and Android phones to help you identify your physical reflex.  It is called the Misophonia Reflex Finder (purple head icon).  It is available free on iTunes and Google Play.  You can use a voice recorder or the Misophonia Reflex Finder and even edit the trigger so it starts with your trigger.  Then carefully test yourself for your initial physical reflex.

Some treatments reduce the emotional response, without affecting the physical reflex.  Other treatments reduce the physical reflex.  Normally, when the physical reflex does not occur, the emotional reflex does not occur, or when the physical reflex is greatly reduced, the emotional response is greatly reduced.