Imagine sitting next to a bored stranger fidgeting with a pen. The room is silent, except for that pen. Quiet amplifies—it makes everything sound louder. Yet for people who suffer from misophonia, every tap of that pen is louder than a chisel removing tile. The man on the train breathes with more force than a motorcycle. And that co-worker chews gum as if she were a cow in front of a microphone.
Misophonia—an emotional, decreased tolerance to sound—can make some situations feel uncomfortable, or even unbearable: anger, disgust, anxiety, avoidance. But the first trial for the condition, published recently in the Journal of Affective Disorders, claims to have found an effective treatment: cognitive behavioral therapy (CBT).
“Despite the high burden of this condition, to date there is no evidence-based treatment available,” first author Arjan Schröder wrote in the abstract. Schröder and a team of Dutch researchers treated 90 patients with CBT for eight group sessions, every other week, and found that CBT was effective for half of the patients. What’s more, patients who had more severe symptoms were more likely to respond to treatment.
“We started this project because hardly anything was known about [misophonia], yet the patients we talked to suffered significantly. So together with the first patients, we decided to investigate it… and tried to figure out if and how it could be treated,” Schröder said. The results of the experimental therapy they decided to implement—combining four techniques individualized to what worked best for each patient—were strong early on, he added. “We know patients who, after successful treatment, noticed at the end of a meeting the core of an apple lying on the table,” Schröder said. “Someone had been eating an apple during the meeting, and they hadn’t noticed it!
“So they had managed to focus on the presentation or questions, not having been distracted or anxious.”
The trial used a set of clinical interview questions called the Amsterdam Misophonia Scale (PDF), according to specific diagnostic criteria and five symptoms. However, misophonia isn’t recognized by the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Various peer-reviewed studies suggest that misophonia could arguably be categorized as a disorder, a syndrome, a symptom, or even a physiological state. It’s associated with many neuropsychiatric disorders and conditions, including autism, OCD, Tourette’s Syndrome, ADHD, and tinnitus.