Someone nearby is chewing, slurping, sniffing or tapping a pen, and within seconds you feel a wave of anger, disgust or panic. You know it’s “just a sound”, but your body reacts as if it’s an emergency. If that sounds familiar, you may have misophonia.
What is misophonia?
Misophonia means “hatred of sound”. It’s a strong emotional and physical reaction to specific everyday sounds, usually sounds made by other people. In 2022 an international expert panel agreed a consensus definition, describing misophonia as decreased tolerance to specific sounds or the things linked to them.
Common trigger sounds include:
- chewing, crunching, slurping and swallowing
- breathing, sniffing and throat clearing
- tapping, clicking pens and keyboard sounds
- sometimes the sight linked to a sound, such as watching someone chew.
Reactions can include irritation, anger, disgust, anxiety, a racing heart, muscle tension and a strong urge to escape. Many people then feel guilty or embarrassed about how strongly they reacted.
Misophonia often starts in late childhood or the early teenage years, and the people closest to you, such as family members, are often the hardest to be around.
Is it a real condition?
Yes. It isn’t yet listed as a separate diagnosis in the main diagnostic manuals, but researchers and clinicians recognise it, and it can seriously affect family life, study and work. It’s different from hyperacusis (sounds feeling physically too loud) and tinnitus (ringing in the ears), although some people have more than one.
Why does it happen?
The causes aren’t fully understood. Research suggests the brain’s threat and emotion systems become very sensitive to particular sounds. Each time a trigger leads to distress and then escape, the link can grow stronger. It’s not a sign that you’re a difficult or intolerant person.
Practical ways to cope
- Use background sound strategically, such as music, a fan or white noise, in situations where triggers are likely, like family meals. Avoid wearing earplugs all the time, which can make you more sensitive to sound.
- Talk to the people you live with at a calm time, not in the moment. Explain that it’s a reaction you don’t choose, and agree on a few small adjustments.
- Plan escape routes kindly: “I need five minutes” rather than snapping.
- Lower your overall stress and tiredness. Like most reactions, misophonia is worse when you’re already on edge.
- Notice the first signs in your body, such as tension or heat, and use a calming skill early.
Does treatment help?
Research is still growing, but Cognitive Behaviour Therapy (CBT) currently has the strongest evidence. In a randomised trial in Amsterdam, 37% of people who had 3 months of group CBT improved significantly, compared with none on the waiting list.
Therapy for misophonia usually includes:
- understanding your reaction, and reducing guilt and shame
- skills to lower physical arousal and shift attention
- gradually changing how you respond to trigger sounds, at your own pace
- Acceptance and Commitment Therapy (ACT) skills for living with discomfort without it running your life
- for teenagers, working with parents on family routines and responses.
If you also notice ringing in your ears or everyday sounds seeming too loud, an audiologist can check for related conditions.
Misophonia treatment at MindBox Psychology
Our clinical psychologists in St Leonards help adults and teenagers with misophonia using CBT and ACT. Sessions are face-to-face or through online counselling anywhere in Australia. You don’t need a referral to book. Medicare rebates may be available with a referral and Mental Health Treatment Plan from your GP. Private health funds and self-managed NDIS may also cover some costs.
