What is Misophonia? Simply put, misophonia is a hatred of sound.
After the definition nothing is simple.
Diagnosis or Symptom?
Just why is dealing with it so perplexing?
Misophonia is largely diagnosed based on a behavioral subjective symptom, the angry outburst. Diagnoses are based on quantifiable (physiological) objective measures called signs. A quantifiable measure would be a marker in a bodily function. Some examples include a brain scan marker, a sonogram measure, a blood marker, a genetic marker, or an objective measure on an auditory test.
For misophonia, such a marker would need to be one that all those with misophonia have, which is unique to misophonia and not due to another condition. Since this term is fairly new, the research is rather sparce and no such marker(s) have been identified yet.
This means that currently the label “misophonia” reflects a behavior, and not a diagnostically viable measure. For that reason there is no diagnostic code in the DSM 5 for misophonia. Although there is discussion as to whether it should be under mental health or auditory category.
No Diagnosis! Now What?!?
This is an unbearable situation.
The person who is getting angry from the triggering sound(s) is suffering.
The people around him are suffering from his angry outbursts.
But without a treatable diagnosis, relief is limited.
It is challenging to classify, or create a test for, something that has such a varied presentation.
For example, at the time of this writing we are dealing with the challenge of an onslaught of viruses. On a personal level I want to know exactly which virus I have so that I can get relief from my suffering.
Do I have the flu?
If so I would like a script to tamiflu.
Do I have strep?
Then I want a script for antibiotics.
Do I have Corona? If so, is it the Delta or Omicron variant? As different treatments are best suited for the different variants.
What I don’t want to hear from my doctor is, “you have a virus”. That isn’t helpful.
The Difficulty in the Differentiation
Dealing with misophonia may leave you feeling like you are at a salad bar, make your own mix of whatever you’d like and we will call all the different results “salad”.
Which of these best describe your misophonia experience?
– A laundry list of different sounds that trigger /only a couple of trigger sounds
– The sound is triggering from only one particular family member / any family member / anyone
– Rhythmic sounds / a mix of rhythmic and non-rhythmic / only non-rhythmic sounds
– Triggered by loud sounds / exceedingly soft sounds such as whispers / a mix of volumes
And so it goes with no discernible pattern.
“Misophonia” is used to refer to any of these, despite their dissimilarities, because of the behavioral reaction to the sound.
This is as helpful as saying you have a virus.
So What Can Be Done: Treatment Considerations
So, is misophonia simply a behavior?
Then behavior modification would easily treat this.
Or perhaps it is psychosomatic?
Dr. Sarno discovered that much of back pain was due to an underlying unresolved emotional conflict. Perhaps, similarly, we need to think of misophonia as an auditory manifestation of emotional conflict and treat using the Sarno method?
Perhaps misophonia is related to a nutritional deficiency?
B vitamin deficiencies contribute to anxiety. This can be due to insufficient ingestion or malabsorption of what is ingested.
Perhaps misophonia is an auditory issue?
A poorly functioning acoustic reflex would ineffectively dampen loud sounds.
The acoustic reflex test is an objective measurable sign of an auditory function.
This would result in loud sounds actually being louder for such people than they are for people whose reflex is functioning properly.
Perhaps misophonia is related to hyper-arousal?
This could be due to a retained moro reflex or a trauma response.
Or it may be a mix of the above.
Different people having different contributing factors would explain the wide spread of differing presentations we are seeing.
At Hearing Kids we specialize in differential diagnosis.
Misophonia is no exception.
By identifying which underlying cause(s) are contributing to your misophonia we can provide targeted treatment that work.
Knowing what you are dealing with brings relief because it directs you in how to best deal with it.
You can schedule your misophonia assessment here
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