THE BLOG

Misophonia - Coping With Anger From Noises Other People Make

07/03/2017 15:09 GMT | Updated 07/03/2017 15:09 GMT

You're tired and overworked when the person next to you begins to sniff. Or chews gum. Or taps their pen repeatedly.

Feeling calm? Or do you experience rage? Do you want to scream, flee or even plot a horrible demise to the sniffer?

Scientists have recently discovered the brain pathways that drive anger after hearing certain sounds others make, such as sniffing and eating, yet unhelpfully offering no treatment ideas. Misophonia is a relatively new condition, in which people react to noises with anger and frustration but also sadness, guilt and shame. In some cases, I have worked with patients who had to leave the classroom/workplace, and even those who had isolated themselves entirely.

Misophonia, meaning a 'hatred of sounds', has become quite the click-bait darling e.g. "Want to know why you hate other people chewing?" In fact, many of the referrals I receive are from those who have searched online for their condition and then self-diagnosed. As one of the few Clinical Psychologists to specialise in Misophonia, the truth is that currently there is no simple cure, no magic pill that will remove the rage that boils up at the slightest chomping or whistling.

However, a 'toolbox' of psychological techniques can often work wonders, starting with a comprehensive assessment and then a combination of cognitive-behavioural and systemic (relationship-based) interventions to reduce the distress.

For those who require clinical treatment of Misophonia, a helpful technique is similar to phobia-based graded exposure e.g. moving closer to the spider with each attempt. With Misophonia, however, anger is the keyword rather than fear or anxiety and instead it is important to sandwich the hated sound; by listening to a happy song then a snippet of the sound and straight back to the happy song, there is no time for the anger to erupt. On the next attempt, two seconds, then five seconds... building up tolerance levels over time as the anger begins to extinguish. This can be an anxiety-provoking experience but it's always encouraging when patients report that they've listened to their hated noise for a cumulative number of minutes and not been fazed.

For all of us, there are strategies that can help. First, can you change something in the environment? Families I have worked with have managed mealtimes with the radio on in the background, 'masking' the bothersome noise.

Distraction has also been shown to work: focus on other tasks, play a game on your phone or mindful 'noticing' of things you can see, hear, smell and feel around you to shift your attention elsewhere.

Pre-empting noisy situations by first engaging in relaxing or fun activities can enable a stronger tolerance threshold, for example, having a bath, listening to pleasant music, doing yoga. Relaxation also helps in the presence of the sound, such as mindful breathing or sensory imagery, in which you imagine a safe place and enjoy the serenity that 'going there' brings.

It is also important to consider why the sound bothers you. What underlies the anger? Difficulties in our relationships can increase the likelihood to feel angered by these noises. It's also unsurprising that stress decreases our tolerance levels and that a difficult day is likely to make us more irritable; someone eating nearby may be excusable when you're happily chatting to a friend compared to when you're already fed up. Further, a sniff may be seen as rude, a repeated tapping thoughtless; the transgression of what we deem culturally or socially inappropriate helps to explain why we may feel annoyance rather than fear.

It is vital to remind ourselves that no man is an island and that the world is full of sounds that bother us; the solution to managing Misophonia, clinically severe or not, seems to be through a combination of practices that aid our tolerance to these noises e.g. relaxation, distraction and exposure, as well as working through stress and difficult relationships.

It may not only be the sound alone but the reasons behind our annoyance that we need to consider.