Misophonia

 
 “I think there’s something strangely musical about noise.– Trent Reznor
Misophonia, a rare but very disturbing disorder, literally means the “hatred of sound”.  It is the experience of extreme and immediate negative emotions such as hatred, disgust, irritation, panic, anger or even rage (including possible physical violence) in response to specific, often commonplace and ambient, sounds.  Trigger sounds may include such common things as yawning, chewing gum, drinking, coughing, laughing, clicking a pen, snoring, or even just breathing.  Unrelated to the volume of sounds, ”misophonia”, also known as “selective sound sensitivity syndrome”, was first coined by two neuroscientists, Margaret and Pawel Jastreboff.  The disorder encompasses a distinctive array of symptoms, most likely attributable to neurologically based causes not related to problems with hearing.   This condition can often be confused with a more common disorder known as hyperacusis in which sound is experienced as being abnormally loud and, in many cases, physically painful.  Many patients suffering from misophonia have suffered with it for literally decades, but it has actually been recognized as a true medical condition for only the past twenty or so years.

 

Although the onset of symptoms of misophonia usually first appear later in childhood, they can have their onset at any age.  It typically begins with one or two particular sounds triggering the extreme negative emotions, and over time additional sounds are often added to the list of “triggers”.  The intense negative emotions, particularly that of anxiety, can lead to significant disruptions in activities of daily living with increasing avoidant behaviors, and a resultant diminishing of socialization.  People suffering with misophonia can often feel misunderstood and estranged from their family and friends as they are often thought of as being overly sensitive or hysterical.  While some will attempt to mask the trigger sounds with other noise such as music, others will simply do what they can to avoid them.  Depending on the actual trigger sounds and their severity, attempting to avoid them can have profound consequences on a wide range of relationships.

 

A 2013 review of the most up to date neurological studies relative to misophonia strongly suggests it is an abnormal appraisal of nerve impulses in the central areas of the brain known as the insular cortex and anterior cingulated cortex that lead to the inappropriate response to particular trigger sounds.  It is of interest to note that it is these same areas of the brain that are involved in Tourette Syndrome, and are the cortices of the brain involved in processing pain, anger, and sensory information.

 

For many years the therapeutic interventions known as Cognitive Behavioral Therapy (CBT) and Tinnitus Retraining Therapy (TRT) have been the recommended treatments for misophonia.  Although neither of these help diminish the disorder, they both can help the sufferer learn how to cope.

Just last year a treatment called Psychosomatic Remediation Technique (PRT) was developed by Dr. Scott Sessions.  He had used this treatment modality for quite some time in treating other emotional issues, but it was not until just last year that he applied this technique to the treatment of misophonia.   Based on the principles of acupuncture, PRT utilizes pressure and light rather than needles on the meridian (acupuncture) points.  To be clear, PRT does not treat psychological or emotional problems, it instead uses acupressure and light to try and repair the dysfunctional neuronal pathways involved in causing misophonia.  The goal of this intervention is the restoration of the proper physiologic functional response to stimuli, in this case specific trigger sounds.  It does not actually cure the patient, but rather helps facilitate the body’s natural reparation process.

To be certain, the application of PRT in the treatment of misophonia is, by the truest sense of the word, new.  As of last month only six patients had been treated with PRT for the disorder.  However, the fact that it is reported that four of the six experienced completer, or almost complete, resolution of the triggering stimuli shows definite promise in its application.  Because the treatment intervention is so new the jury is still out as to whether or not the positive changes seen with PRT are in fact permanent.  To learn more about PRT go to misophoniatreatment.com, contact Dr. Session’s associate, Tom Dozier at tom@misophoniatreatment.com, or call 925-371-1576.

For those suffering with misophonia it is important to know that you are not alone and that research is underway to search for a cure.  In fact, there is an entire support group which has over five-thousand members, and continues to grow.  The group can be found at groups.yahoo.com/neo/groups/Soundsensitivity/info.  This website provides resources to learn more about misophonia, ways to deal with the disorder, and information on how to reduce symptoms.  The website contains both public and private support sections, as well as sections for family members and friends.

 

gven

 

Glenn E. Miller, M.D. is a Board Certified Psychiatrist.  Educated as a pharmacist, physician and psychiatrist Dr. Miller has been in private practice in Santa Barbara for more than twenty years.  Dr. Miller is co-author of Ancient Herbs, Modern Medicine: Improving Your Health by Combining Chinese Herbal Medicine and Western MedicineHealthy Mind – Healthy Future runs on Saturdays.  Opinions in the column are Dr. Miller’s and not necessarily those of this newspaper.  Send questions or topics you would like covered to glenn@healthymindhealthyfuture.com