Misophonia – Hatred of Sound Triggers Intense Emotional Reaction

By Jack Surguy

Selective sound sensitivity

In 2001, Margaret M. Jastreboff and Pawel J. Jastreboff coined the term misophonia (hatred of sound) to describe a disorder in which varying sounds triggered intense emotional responses in people. The disorder has also been termed “selective sound sensitivity.” Overall, researchers consider the disorder to fall under the umbrella term Decreased Sound Tolerance (DST) disorder, which includes other disorders such as hyperacusis and phonophobia. Typically, misophonia is more often associated with specific sounds and intense emotional responses such as anger and rage. The disorder is not currently classified in the DSM-5 or ICD-10, which are the official psychological/psychiatric diagnostic manuals. However, growing research indicates that the most frequent emotional responses in those with misophonia are anger, flight, hatred, and disgust. Along with these intense emotional responses, sufferers may also experience such physical symptoms as sweating, muscle tension, and an increased heartbeat.

Misophonia is considered a rare disorder, even though some estimates suggest that around 10 to 20 percent of the population has either experienced this reaction at some point in their life, or suffer from it on a regular basis. Currently, there are a few theories that try to explain this puzzling disorder. In 2013, a review of the most recent neurological and fMRI studies of the brain, as it relates to the disorder, suggested that abnormal or dysfunctional coding of neural signals occurs in certain sections of the brain. The specific areas affected are the primary areas responsible for processing anger, pain, and other sensory information. In other words, it appears that auditory stimuli are processed in the brain in such a way that a stress response, or the fight-flight-freeze response, is more easily triggered within the brain of someone with misophonia. Research also indicates that those with misophonia tend to experience very unpleasant bodily sensations along with their intense emotional responses. What researchers are trying to determine is if this condition is genetic, meaning people are basically born with it, or whether it’s developed in a way similar to other phobias; for example, a person may develop a phobia of dogs if they are attacked by a dog.

One interesting research study was completed by Dutch researchers Schroder, Vulink, and Denys (2013). In this study, the researchers examined 42 patients with misophonia to try and discover if any suffered from what used to be referred to as Axis I disorders. These disorders include depression, anxiety, and stress-related disorders such as post-traumatic stress disorder (PTSD). People with Axis I disorders frequently seek help because they know that they don’t feel as they usually do. The researchers didn’t find any particular Axis I disorder that was statistically significant. However, there are also disorders called Axis II disorders, which consist of “personality disorders.” These disorders are considered more a part of a person’s personality and therefore more difficult to treat. Also, those with personality disorders often don’t believe they have an issue; it’s often at someone else’s insistence that they seek treatment. Some of the disorders in Axis II are Borderline Personality Disorder, Avoidant Personality Disorder, and Dependent Personality Disorder. What the researchers discovered was that more than 50 percent of the patients being studied met the diagnostic criteria for Obsessive-Compulsive Personality Disorder (OCPD).

Now, OCPD is different from what many know as Obsessive-Compulsive Disorder (OCD), which is an Axis I disorder. OCPD is a personality disorder characterized by a preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency. Individuals with OCPD are prone to become upset and angry in situations in which they’re not able to maintain control of their physical or interpersonal environment, although their anger is rarely expressed directly, but rather indirectly, in a passive-aggressive manner. Those with OCPD may have difficulty being comfortable around emotionally expressive people, and often are considered very emotionally restricted. Their everyday relationships have a formal and serious quality, and they may often appear rather stiff or uneasy in social situations. They tend to be overly focused on performance and are highly stressed when perfection is not achieved. Lastly, individuals with OCPD also tend to be overly preoccupied with logic and intellect, due to their difficulties in processing emotions. Now, everyone has tendencies or behaviours that are found in at least one of the personality disorders listed in the DSM-5. What usually leads to a person receiving a psychological diagnosis occurs when their behaviours are so severe that they experience significant disruptions in their public and personal life.

Though the studies thus far on misophonia are very limited, they do suggest a couple of possibilities that need to be further studied and explored. First, if the brain exams are accurate, they suggest that the brain of a person with misophonia is wired in such a way that auditory sounds can trigger an autonomic response, similar to the flight-fight-freeze response, that is largely out of a person’s control. When a person with misophonia is triggered by a sound, they may instantaneously be filled with anger, rage, aggression, or an overwhelming need to leave the area. These experiences are oftentimes accompanied by intense bodily sensations that are often not recognized due to the intense flood of emotion. Those with misophonia are often very disturbed by the experiences because they don’t make sense, and the overwhelming deluge of emotion can be terrifying. Second, the Dutch study referenced above suggests a possible connection between people who are hyper-focused on control and perfectionism and misophonia as well. This suggests that a psychological or emotional connection to the triggering sound may, in fact, be present.

So, yes, the experience you described may in fact have a visceral component to it; it is technically a natural response, as far as your body is responding as it would to a perceived threat; and there are many other people who have these experiences as well.

Aggression and anger

If someone were to seek my assistance in therapy with the information you provided, the first step I’d likely take would be to explore the person’s history to try and discover any possible experiences the sound could be associated with. In doing this, I wouldn’t focus just on the sound itself, but would also explore the sources of the noise as well. Was there anything about the car, the sound system, or even the person playing the music loudly that seems familiar? Does that type of music remind you of anything?

Since you stated that you’ve thought and thought about this and can’t remember anything or connect anything to any of the factors I mentioned above, I would probably not spend a great deal of time on such a direct approach. Instead, I’d try and explore the tendencies to try and avoid confrontations at all costs. What is it about confrontations that are so uncomfortable or disagreeable for you? What would be the worst-case scenario of a confrontation gone wrong? I’d also want to explore the fact that you never become aggressive—never, as well as your belief that anger means a loss of control. Aggression can be a very potent, powerful tool if used in a healthy, appropriate manner. Most people believe that aggression must include acts of violence or threats of violence. This is not necessarily the case. So I would explore if it’s your belief that violence has to be a part of aggression that makes you completely avoid it, or if you choose to avoid taking any offensive action at all. I’d also explore the idea that anger means losing control. I would agree that people who go into a rage are likely out of control, but anger? Anger is a natural part of human existence. Even the Dalai Lama himself admits that he continues to deal with anger at times. Before I would have you begin a meditative practice, I’d want to explore if being in control at all costs is indeed an issue for you. If it is, trying to explore the reasons for that could prove beneficial and be included in the interventions I’d suggest.

“One does not become enlightened by imagining figures of light, but by making the darkness conscious” – Carl Jung

“The shadow is the greatest teacher for how to come to the light” – Ram Dass

Carl Jung stated the following in his 1912 essay “New Paths in Psychology,”

We know that the wildest and most moving dramas are played not in the theatre but in the hearts of ordinary men and women who pass by without exciting attention, and who betray to the world nothing of the conflicts that rage within them except possibly by a nervous breakdown. What is so difficult for the layman to grasp is the fact that in most cases the patients themselves have no suspicion whatever of the internecine war raging in their unconscious. If we remember that there are many people who understand nothing at all about themselves, we shall be less surprised at the realization that there are also people who are utterly unaware of their actual conflicts. (p. 425)

Woman facing own shadow - Psychological & spiritual therapy: misophonia

I believe another very beneficial approach would be in exploring the full impact the experience has had on you. I can only imagine what it must have felt like for a person who considers themselves a “complete ‘peacenik’ and pacifist” to suddenly have extreme feelings of rage and violent aggression pulsing throughout their entire body. When emotions hit us with such tremendous force, it’s not uncommon to have very violent fantasies flash through our minds, allowing us to imagine all the violent acts we’d enjoy doing in that moment. This can be a very disturbing and troubling experience. Regardless of the cause of the experience, the fact is, you came face to face with your shadow side. “It is a frightening thought that man also has a shadow side to him, consisting not just of little weaknesses- and foibles, but of a positively demonic dynamism. … there emerges a raging monster; and each individual is only one tiny cell in the monster’s body, so that for better or worse he must accompany it on its bloody rampages and even assist it to the utmost.” (Jung 1912, p. 35)

From the description in your question, it’s obvious that coming face to face with your shadow side has had a tremendous emotional and psychological impact on you. My guess is that you may have worked very hard in trying to eradicate such thoughts and feelings within yourself and may have been shocked that those kinds of impulses were still within you.

Feeding your demons 

If you’re like most of us, I’d guess that your first desire is to find a way to eliminate or remove that side of you to ensure that you never have that type of experience again. As tempting as that may sound, I don’t believe it’s either a realistic goal or a healthy one. The fact is, as humans, we have a shadow side that is capable of all kinds of horrible behaviours. I have a picture that I keep hung up in my office. It’s a drawing of a young girl confronting a big aggressive demon, yet the young girl is smiling. Without fail, people always ask why I would have such a picture on display. I explain that that the picture basically explains my approach to therapy. I believe that a person has to approach the shadow just as this girl does in the picture: in a warm, welcoming, accepting, and trusting manner. When we’re able to do this, the shadow within us can actually make each of us a more compassionate, loving person. How do we do this? Again, I believe meditation and loving-kindness are at the heart of the answer.

Tsultrim Allione developed a very powerful meditation practice called “feeding your demons.” This practice is based upon a Tibetan meditation practice called Chod that was developed in the 11th century by Tibetan nun Machig Labdron. This practice doesn’t require adherence to any one particular faith or any faith at all. As the title of the practice suggests, the aim of this practice is to feed our shadow side—which is our fear, hate, anger, greed—all the things we work to repress and keep under control. Paradoxically, “feeding” our shadow side does not make it stronger; ironically, starving it can. Feeding the shadow side can actually free up the energy that’s being used to bind it. In this way, powerful emotions that have been bottled up by inner conflict are transformed into loving-kindness and compassion. When we try to fight against or repress the disowned parts of ourselves, they actually gain power and develop resistance. In feeding our shadows, we’re not only rendering them harmless; we’re also, by addressing them instead of running away from them, nurturing the shadow parts of ourselves so that the energy caught in the struggle transforms into a positive protective force.

The following is an outline of the practice:

  • When you sit down in meditation, and after you have centred yourself through mindful breathing, think back to that day and try to remember where in your body you felt the emotions hit strongest. Gently allow yourself to begin to feel how those emotions felt, what the sensations felt like in your body. Do not try to understand why; just remain mindful of where in your body the sensations feel strongest.
  • In the second step, allow the energy that you feel to take a personified form in front of you. Do not try to control the personification, but allow it to take whatever shape it chooses. In fact, when I do this practice, I actually set up another meditation cushion for the shadow to sit on so it feels more welcome.
  • In the third step, we try to discover what the shadow needs. However, we don’t do this by asking it what it needs; rather, we discover what the shadow needs by putting ourselves in its place, by essentially becoming the shadow. In my own practice, I’ve even changed meditation cushions, and in this step, I sit on the cushion I placed for the shadow side.
  • In the fourth step, imagine yourself dissolving your own body into nectar of whatever it is the shadow needs, and allow this to flow to the shadow side. You can even do this if you didn’t get a clear idea of what the shadow side needs. Sometimes it takes a few sessions before we’re comfortable enough to fully allow ourselves to become the shadow. During these times, I imagine myself dissolving into loving-kindness and allow it to flow to the shadow.
  • In the fifth step, after you finish feeding the shadow side, generate an attitude of compassion for the shadow and allow it to dissolve back into emptiness. Stay relaxed and focused on your breath until you end the session.

I’ve found this to be a very powerful practice not only for myself, but for those with whom I’ve worked. One woman in particular felt that she was totally transformed after doing this practice a few times. Again, the main underlying principle of this practice is to confront those fear-provoking aspects of ourselves while in a state of calm mindfulness. As we become more adept at doing this, the energy and sensations that we’ve tried to avoid or control become less and less frightening because we no longer fear losing control. As a side note, the one woman who felt totally transformed by this practice was suddenly able to remember experiences that were associated with the reasons she sought help.

I believe the experience you had may, in fact, be a tremendous opportunity for remarkable growth. I suspect that if you practiced this on a regular basis, the tendency to avoid confrontation at all costs would become less and less prominent.

Closing thoughts

Many of the treatments for the disorder are based upon the underlying principles of the meditative practice I described above. To feel overwhelmed with extremely powerful emotions that threaten our ability to control ourselves is not a pleasant experience. I encourage you to use the knowledge of how that feels the next time you see someone consumed with emotions. My guess is that you’ll likely feel compassion for that person, since you truly know what it’s like.