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September 10, 2021
by Tina Arnoldi

CBT May Help Treat Misophonia

September 10, 2021 08:15 by Tina Arnoldi  [About the Author]

Misophonia is a neurological disorder characterized by negative emotional reactions to ordinary sounds, like chewing, eating, and breathing.  People with misophonia experience strong feelings of anxiety, disgust, or anger towards these harmless noises. They have a strong urge to avoid the sounds and can even become physically aggressive when exposed to them. These symptoms are often associated with more general problems, including difficulties with attention, anger management, or depression.

 A 2021 study in the journal of Depression and Anxiety found cognitive-behavioral therapy (CBT) can be an effective treatment for misophonia for some. In an academic outpatient clinic, a clinical trial was conducted with misophonia patients randomly assigned to 3 months of weekly group-CBT or a waiting list and tested at baseline, 3 months (following CBT or waiting list), 6 months (after crossover), and 15/18 months (1-year follow-up). The techniques used during sessions with therapists as part of the group-CBT included task concentration, which worked on developing coping strategies to decrease negative emotions when faced with triggers; arousal reduction, which helped calm down the patient by using routines like deep breathing exercises; positive affect labeling, which involved recognizing emotions associated with strong negative feelings before expressing them verbally.

 The research included 54 out of 71 patients, with 46 (85%) of them completing it. CBT resulted in statistically fewer misophonia symptoms in the short-term in the randomized phase. Clinical improvement was observed in 37% of the CBT group, compared to 0% in the waiting list group. The impact of CBT on primary and secondary outcomes was sustained after a year of follow-up.

According to the results of this first randomized control trial, CBT was proven effective for misophonia in both the short and long term. To further validate the findings of the study, we asked mental health providers treating clients suffering from misophonia if they have ever used CBT or any other method.

Author Girish Shukla notes that CBT is one of the possible treatments that mental health professionals and doctors are exploring to treat this newly discovered phenomenon. He goes on to explain that CBT may help change the way a person thinks of their trigger noises. CBT looks at how our reactions to these triggers are created and what we can do in response to alleviate some distress. “CBT has proven effective against misophonia which is the reason it is at the forefront of all the different treatment methods for misophonia,” he adds.

Ramona Lehadus, a nutritionist at Elevate Delta 8, says there’s no standard treatment or protocol to turn to for relief from the disorder's symptoms.She believes it can be hard for those who suffer from this condition not to become isolated without alternative treatments. “Observational data shows CBD interacts with addiction pathways and influences the anxiety, anger, and pain receptors by stimulating the release of serotonin, hence providing a calming effect,” she notes.

 “Avoidance is the key to anxiety. It’s counterintuitive, but every time we avoid anxiety, we reinforce it,” explains Tom Parsons, a therapist at Optimism Counseling. He explains that anguish characterizes misophonia caused by a sound, followed by an attempt to avoid the suffering, and finally alleviation from the distress. As a result, the mind learns the sound was unpleasant and that avoiding it was He adds that short-term avoidance can help, but it surely backfires in the long run, as pleasurable. The cycle is perpetuated, since the reward for avoiding is relief.

Avoiding can never resolve the issue in the first place. “By using CBT skills like emotion regulation, distress tolerance, or cognitive reframing, relief is created without avoidance. Building these skills over time breaks the cycle by teaching the mind that the noise isn’t distressing,” added Parsons. 


About the Author

Tina Arnoldi

Tina Arnoldi, MA is a marketing consultant and freelance writer in Charleston SC. Learn more about her and connect at

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