Misophonia, a ‘hatred of sound’ is more common than most people realize, affecting approximately 15% of adults. But where can people go where there isn’t noise? Whether visiting a local restaurant or shopping at the grocery store, there is music playing or poor acoustics so it is not easy to find quiet. I invited mental health and medical professionals to offer their insight on misophonia.
Bart Wolbers, a researcher at Nature Builds Health, points out the continuous stress caused to the human body by noise, noting that “noise is everywhere in modern cities, even approximating 80-90 decibels (dB) in the biggest ones. In nature, noise levels are often closer to 20-30 dB. The dB scale is logarithmic, and every 10dB increase denotes a 10-fold greater loudness level. Sound levels are thus 10,000 - 100,000 times higher in cities than in nature.”
So noise is clearly an issue in our culture, but how can we even define and assess noise sensitivity? Adina Mahalli, MSW, a mental health professional points out that loudness discomfort levels are subjective, which means that there is no universal protocol for assessing misophonia.
Mahalli highlights research that suggests "most patients with Misophonia have a normal hearing sensitivity, but their limbic system is at a heightened excitement level allowing for an abnormal reaction to triggering noises. While there is a reason to believe that our ‘loud’ culture has a role to play in the increased prevalence of Misophonia, the fact that loudness discomfort levels are so subjective also has a role to play in what could potentially have been previous misdiagnosis."
Andre Sólo, a co-founder of Highly Sensitive Refuge, encourages people to consider more than noise and look at the traits of HSPs (Highly Sensitive Persons) since Misophonia is rarely an isolated trait.
Solo points out that "many people who deal with Misophonia are highly sensitive people, which means their nervous systems process all stimuli more deeply than the average person. While 15% of people are affected by Misophonia, research also suggests that 15-20% of the population is highly sensitive. Although these two traits are not exactly the same thing, there is substantial overlap. Many HSPs report being distracted, annoyed, or even 'driven crazy' by repetitive or unpleasant noises. And most find loud noises, like being in a busy restaurant, can quickly become painful or even unbearable."
Barbara Bergin, M.D. is one of those people and recently did a gene analysis through 23 & Me, learning she may have a gene for Misophonia. "This was hugely important", says Bergin, "because now I can discuss it with my family as if it were a disease and not some cranky-old-lady-intolerance thing. Now, everyone eats a little quieter, goes somewhere else to eat, and isn't bothered when I stick my fingers in my ears or get up and leave."
However, avoiding noise is not a strategy that Dr. Marla Deibler recommends. She specializes in anxiety and related disorders and says noise avoidance actually negatively reinforces the problem. Deibler explains, "The elimination of something unpleasant, such as an aversive sound, will unintentionally promote the continued avoidance, limiting the individual’s functioning. There is no evidence that this disorder is increasing in prevalence; however, there does appear to be an increasing awareness of the problem, so people are more likely to be able to identify it as a problem for which there may be help available. Treatment is a specific kind of cognitive behavioral therapy, [known as] exposure therapy. This systematically exposes the individual to the sounds that cause distress to slowly build distress tolerance to the sounds over time as well as reduce any avoidance behaviors so that they may lead a full life."
In the short run, people who have a low threshold for noise can wear earplugs, insulate rooms, and use noise dampening mats. In addition to making physical changes to the environment, Wolbers advocates mindfulness meditation. By meditating, Wilber says it allows people to shift "focus away from ruminating continually about not being able to control the noise, onto the present moment." An additional benefit is the resulting "detachment from stressful feelings and thoughts about the noise. The more you don't want such feelings and thoughts, the more they'll stick around. Letting yourself experience the noise paradoxically increases both control over your experience and your perception of control of that experience."
There are a number of potential coping strategies for Misophonia with no clear-cut treatment plan. While Misophonia meets some criteria for a mental disorder, the nature of it is not entirely clear, and more research is needed. For now, experts recommend patients explore options such as exposure therapy, mindfulness, and adjusting the physical environment to make everyday life more comfortable.