{"componentChunkName":"component---src-templates-article-tsx","path":"/sabrinawhensoundshurt","result":{"data":{"primeArticle":{"slug":"sabrina.whensoundshurt","excerpt":"For those struggling with misophonia, public areas, like classrooms and libraries, can be excruciating.","headline":"When Sounds Hurt","author":"Sabrina Huang","authorbio":"","authoremail":"","authortwitter":"","coverimg":"https://assets.dailybruin.com/images/whensoundshurt/COVERARTmisaphonia-b68bf5c6a9c1f04a037edb3d38d67e5b.jpg","covercred":"Bridgette Baron","coveralt":"An illustration of a person being surrounded by common sound triggers for those with misophonia, such as chewing.","articleType":"article","updated":null,"content":[{"type":"text","value":"Natalie Finander was 10 years old when she realized there was something wrong with the way she reacted to chewing sounds."},{"type":"text","value":"For one, she felt uncontrollably angry. Feelings of rage permeated her consciousness and an uncomfortable pulsing began between her legs."},{"type":"text","value":"Finander was at a loss for words. She didn’t understand why she felt this way."},{"type":"text","value":"At first, she thought it was because people chewed with their mouths open. But when she tried ignoring the sounds, she found it was impossible."},{"type":"text","value":"Over the next six years, public areas, like classrooms and libraries, became excruciating. Finander found it hard to concentrate in class after lunch when kids were finishing their food. When her mom would ask her how her day was, she would list all of the times she heard something triggering, because it was all she could remember."},{"type":"text","value":"She tried telling people about it – but when she did, no one believed her. Some would go out of their way to exacerbate her symptoms. Once, in dance class, Finander, a third-year English student, said she asked a classmate to move to a different location to eat. This individual not only refused to stop but began to chew even more loudly."},{"type":"text","value":"When she told her family, they didn’t believe her. They didn’t seem to care."},{"type":"text","value":"After all, how could a sound as unremarkable as chewing cause that much pain?"},{"type":"text","value":"In 2001, former Emory University researchers Margaret and Pawel Jastreboff attempted to answer this very question from patients who reported feeling a disproportionately strong aversion to sound."},{"type":"text","value":"No established medical conditions seemed to encapsulate the symptoms these individuals described. So, the Jastreboffs decided to coin a new term for this mysterious condition that transcended the once-indestructible barriers between the auditory and psychological – misophonia."},{"type":"text","value":"Derived from the Greek words “misos,” hatred, and “phon,” sound, misophonia translates literally into “hatred of sound.” Some have come to refer to misophonia as selective sound sensitivity syndrome, but for those who have it, “sensitivity” cannot always fully describe the unexplainable, and at times, uncontrollable, emotional reaction a particular sound may elicit."},{"type":"text","value":"These noises, referred to as “triggers” or “misophonic sounds,” can range anywhere from the sound of chewing to the tapping of a pen. While trigger sounds vary depending on the individual and the environment they are in, previous case reports have shown a large percentage of these sounds are those generated by other people, particularly with their mouths. These include sounds such as chewing, smacking lips, slurping, coughing and, in some cases, breathing."},{"type":"text","value":"Although common responses to these sounds include feelings of anger, irritability, disgust and general anxiety, Finander said reactions are not limited to general feelings of aversion or hatred."},{"type":"text","value":"“When I hear a trigger, the first thing that happens is my whole body kind of jolts, like my muscles all tense up at once,” Finander said. “Immediately following that is feelings of rage. My chest tightens up, I can't breathe (and), if the trigger sound continues or if it takes me a long time to be able to protect myself from it, I’ll have images of violence against the person just to make them stop.”"},{"type":"text","value":"People with misophonia can also develop a strong reaction to visual stimuli, such as fidgeting or shaking legs. Finander, for example, said she experiences feelings of sexual arousal if she sees someone crossing their legs. The sight of someone’s jaws moving up and down can also be as triggering as the sound of chewing."},{"type":"pull","value":"{\"caption\":\"When I hear a trigger, the first thing that happens is my whole body kind of jolts, like my muscles all tense up at once. - Natalie Finander\"}"},{"type":"text","value":"But Finander would have to wait six years before receiving an official diagnosis for misophonia at the age of 16. Her therapist, whom she had been seeing for anxiety, formally diagnosed her with misophonia. Finander had never even heard of the condition before, a perhaps unsurprising fact considering misophonia is categorized as a rare condition by the Mayo Clinic."},{"type":"text","value":"The long wait for a viable explanation of symptoms and ensuing feelings of confusion in the meantime appear to be common struggles for those who have misophonia."},{"type":"text","value":"As someone who has the neurological condition myself, it took me five years to discover that the reactions I experienced to the sounds of chewing, swallowing and smacking lips were not a byproduct of puberty or a hormone-addled mind."},{"type":"text","value":"For myself and Finander, knowing the name of the demon that planted itself in our brains and claimed stake over our sanity did not help. Despite the official diagnosis, Finander’s parents still had trouble believing these symptoms were legitimate. A name simply did not translate into a solution."},{"type":"text","value":"“I think they didn’t want to believe that something they had been doing had been causing me so much pain,” Finander said."},{"type":"text","value":"No matter where people with misophonia go, a trigger is only minutes away. That’s exactly what makes misophonia so challenging to deal with."},{"type":"text","value":"Researchers do not know why particular stimuli become triggers. However, brain imagery has provided some insight into how misophonia impacts the underlying neurological and psychophysiological mechanisms of patients who have the condition."},{"type":"text","value":"A group of researchers used functional magnetic resonance imaging, or fMRI, which measures levels of blood oxygenation and flow in the brain, to study the brains of people with misophonia in 2017."},{"type":"text","value":"The researchers discovered increased activity in the bilateral anterior insular cortex in subjects with the condition after exposure to a trigger sound, while the brain activity of subjects who did not have the condition was largely unchanged."},{"type":"text","value":"This led researchers to believe those with misophonia may be biologically predisposed to pay greater attention to sounds they consider triggering, one of the first insights into how misophonia works."},{"type":"pull","value":"{\"caption\":\"No matter where people with misophonia go, a trigger is only minutes away. That’s exactly what makes misophonia so challenging to deal with.\"}"},{"type":"text","value":"Researchers also found that neurons in certain regions of brains of those with misophonia have a greater degree of myelin – a layer of fat and protein surrounding nerve cells – that aids in the efficient transmission of signals throughout the nervous system. As misophonic reactions are involuntary, this finding may explain why researchers observed an abnormal degree of functional connectivity between the anterior insular cortex of people with misophonia and the part of the brain responsible for memory."},{"type":"text","value":"Ultimately, researchers still don’t know exactly what causes misophonia."},{"type":"text","value":"Researchers prefer to think of misophonia as the product of a confluence of factors. Monica Wu, a clinical researcher in the Division of Child and Adolescent Psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior, said these factors can include a genetic predisposition to the condition or the presence of existing psychiatric disorders."},{"type":"text","value":"Wu, who also works with the Child OCD, Anxiety, and Tic Disorders Program Clinic at UCLA, conducted her own research on misophonia when she was a doctoral student in clinical psychology."},{"type":"text","value":"In her first experiment, which studied undergraduate students, Wu found a strong association between misophonia symptoms and those of general sensory sensitivities."},{"type":"text","value":"Most strikingly, however, Wu also found that misophonia symptoms were moderately associated with symptoms exhibited by patients who have obsessive compulsive disorder, anxiety or depression. Anxiety, specifically, may play an important role in inducing anger outbursts among subjects with misophonia."},{"type":"image","value":"{\"alt\":\"Illustrations by Baron depicting characters struggling with misophonia and receiving comfort from others.\",\"url\":\"https://assets.dailybruin.com/images/whensoundshurt/dbmisav2-1d42d3c16886c4302f4f4cfc571dd819.png\",\"credit\":\"Bridgette Baron\",\"caption\":\"\"}"},{"type":"text","value":"But little research has been done on misophonia. Few studies have examined the relationship between the condition and psychiatric disorders, and Wu said misophonia can coexist with a variety of mental disorders, such as post-traumatic stress disorder, OCD and anxiety."},{"type":"text","value":"However, it is still not known if those who have misophonia are more likely to have a preexisting mental condition. But for Finander, her anxiety is deeply tied to her misophonia. If she is feeling particularly anxious, she said her reactions tend to be more severe."},{"type":"text","value":"The coexistence of misophonia and other recognized psychiatric disorders has prompted researchers to consider classifying misophonia – which currently does not have an official medical classification – under the umbrella of obsessive- and compulsive-related disorders in the fifth edition of the “Diagnostic and Statistical Manual of Mental Disorders.” Some, however, believe misophonia should be classified as its own psychiatric disorder."},{"type":"text","value":"To make the situation even more complicated, there are people who do not believe misophonia is a mental disorder. Instead, they claim it is a form of synesthesia, a condition in which stimuli perceived by one sense simultaneously affect other senses."},{"type":"text","value":"At the moment, misophonia has no standardized classification. While this may not seem like a big deal, the lack of consensus on how to understand misophonia presents problems for medical professionals who seek to provide treatment for patients with the condition. Without a set library of information on misophonia, doctors may have difficulty recognizing and diagnosing patients who have it."},{"type":"text","value":"Wu said a formal classification of misophonia may also help patients feel more comfortable with their daily realities. Misophonia is a condition few people, including medical professionals, have heard."},{"type":"text","value":"My parents, for example, who have both practiced medicine for more than 20 years now, did not know the condition even existed until I brought it to their attention three years ago. This lack of knowledge, while characteristic of recently recognized conditions, can suggest to people with misophonia the emotions they experience are not valid – that is, their experiences are not legitimate enough to be recognized or acknowledged by the greater medical community."},{"type":"text","value":"“I think that (formally classifying misophonia would) really validate people with misophonia (because) you have a formal diagnosis (and) a formal set of criteria,” Wu said."},{"type":"text","value":"But at the end of the day, classification is only one piece of the puzzle."},{"type":"text","value":"Even with a formal classification, living with misophonia can be an endless cycle of unanswerable questions, unexplainable rage and self-loathing."},{"type":"text","value":"“You start to hate yourself for the reaction that you’re having,” Finander said. “We are not blind to the fact that this is weird.”"},{"type":"text","value":"For people with misophonia, coping strategies are essential to remain in public spaces, where trigger sounds and sights are not just widely anticipated but expected."},{"type":"text","value":"Whenever I hear the crinkle of wrappers or the opening of a water bottle, I quickly stick my fingers in my ears to prevent the sound from reaching my ears. And when I cannot prepare myself beforehand, I typically imitate the sound I hear. For some reason, in my delirious mind, this helps to ward off feelings of rage by allowing me the ability to reclaim power over my sanity. But this coping strategy is painful and largely ineffective."},{"type":"pull","value":"{\"caption\":\"You start to hate yourself for the reaction that you’re having. We are not blind to the fact that this is weird. - Finander\"}"},{"type":"text","value":"Finander, who has learned to develop preventative and coping measures to better handle her misophonia, always has a pair of noise-canceling headphones draped around her neck. She also has a jacket, which she calls her “horse-blinder jacket” because of its large hood, that can help to block out visual stimuli."},{"type":"text","value":"In lecture halls, she always sits in the front to block out the noises of people eating and the sight of moving jaws. For smaller classroom settings, Finander, who is registered at the Center for Accessible Education for her misophonia, often asks the instructor to establish a no-eating policy."},{"type":"text","value":"When that doesn’t work, she will ask people if they can stop eating. But Finander said she will try to avoid this at all costs because it makes people uncomfortable."},{"type":"text","value":"When I asked her why she believes this, Finander said her mom, who has since come around to accepting her misophonia, thinks it’s equivalent to insulting their manners."},{"type":"text","value":"“(It) makes them feel like a child, and they don’t like that,” Finander said. “Also, eating is normal. All the things that they’re doing that are causing me pain are normal human things, accepted things, things that people have to do.”"},{"type":"text","value":"Treatments do exist to help patients who have misophonia. However, because the condition lacks an official classification, people with misophonia receive different forms of treatment based on what kind of medical professional they see."},{"type":"text","value":"Wu, a psychologist, offers cognitive behavioral therapy to her patients with misophonia. Additionally, audiologists can prescribe sound therapy, in which patients are presented with a trigger sound, mixed in with another sound like background noise, but are given control over its volume."},{"type":"text","value":"Finander has also sought treatments, but she said they have not been very successful. Shortly after receiving an official diagnosis, her therapist attempted to treat her misophonia with exposure therapy. During therapy sessions, Finander’s therapist would chew almonds in what she described as a “very quiet” room and attempt to engage in conversation. It wasn’t long before Finander said she broke down and decided to stop the treatment."},{"type":"text","value":"Finander also tried sequent repatterning therapy in the summer after her first year at UCLA. As part of the treatment, she was put to sleep for 40 minutes at a time by a hypnotherapist in England. Although her mom noticed a difference in her symptoms, Finander said she did not find it to be effective."},{"type":"pull","value":"{\"caption\":\"Finander’s therapist would chew almonds in what she described as a “very quiet” room and attempt to engage in conversation. It wasn’t long before Finander said she broke down and decided to stop the treatment.\"}"},{"type":"text","value":"The Misophonia Institute, the nonprofit that connected Finander to her hypnotherapist, disseminates information on effective symptom-management techniques and treatment options for patients who have misophonia. In addition, it promotes research into the condition."},{"type":"text","value":"Tom Dozier, a behavior analyst and president of the Misophonia Institute, also owns the Misophonia Treatment Institute. Dozier, who has been studying misophonia since 2012, considers the condition to be both an emotional and physical reflex. Common treatments provided by his organization include the neural repatterning technique, which Dozier himself developed, and progressive muscle relaxation."},{"type":"text","value":"The Misophonia Treatment Institute offers services both virtually and in person. While its website contains testimonials from patients who say treatments have been effective, a 50-minute session alone can cost $100."},{"type":"text","value":"One unlikely source of comfort for people with misophonia is the internet. From numerous support groups on Facebook to websites that aim to increase awareness of the condition, people with misophonia are working to forge their own communities in a world they do not feel they belong in."},{"type":"image","value":"{\"alt\":\"Illustrations by Baron depicting a character using headphones to avoid triggers. Other illustrations include doctors conversing and a character chatting with a friend.\",\"url\":\"https://assets.dailybruin.com/images/whensoundshurt/dbmisapt2-0426f133490d90422176084ed316dcaa.png\",\"credit\":\"Bridgette Baron\",\"caption\":\"\"}"},{"type":"text","value":"And Finander is one of them. She created Misophonia Support and Awareness at UCLA a little over a year ago. A support group for students who have misophonia, MSA provides a safe, trigger-free space for people with misophonia to share their experiences with people who understand their condition."},{"type":"text","value":"“Finding someone else with misophonia is really incredible because I’m not scared that you’re going to yell at me when I explain,” Finander said. “I wanted a place for people to be able to complain (and) not be ashamed of having it.”"},{"type":"text","value":"Finander currently leads MSA alongside third-year English student Cami Miceli and third-year microbiology, immunology and molecular genetics student Izabel Comandante. Before meeting Finander, both Miceli and Comandante had never heard of misophonia."},{"type":"text","value":"“I didn’t really understand it at first, but then once I did, it wasn’t a big deal,” Miceli said. “It didn't change my opinion of (Finander). It just sort of changed the way that I had to accommodate her when we were together, and that was really early on in our friendship.”"},{"type":"text","value":"Accommodating Finander’s misophonia wasn’t difficult, they said. Miceli and Comandante have learned to cover their mouths when they eat with Finander. Both have a tendency to fidget – another visual trigger for Finander – and have also learned to play with toys or hairbands instead. In addition, they typically ask for permission before eating or doing something in Finander’s presence."},{"type":"text","value":"MSA also aims to increase public awareness of misophonia. Finander, Miceli and Comandante have tabled at events, such the Enormous Activities Fair and Bruin Day. In addition, the three regularly make misophonia-related memes for MSA’s official Instagram page. Finander showed me some of the memes she thought were especially relevant to her experiences in handling triggers. One was an image of a cartoon character sweating over whether to “Leave a trigger situation and make a scene” or “Explain your misophonia and make a scene.” Another had images of a human brain and a popped kernel with the question of “Who would win?” emblazoned at the top."},{"type":"text","value":"Public attention has been growing around misophonia. A quick internet search will yield numerous news articles published by NPR, The Washington Post and The Wall Street Journal on misophonia."},{"type":"text","value":"But the lack of research on misophonia is a problem clinical researchers are still grappling with. Wu, for instance, is currently applying for a research grant to conduct a study on the brain activity of adolescents and college-aged people with misophonia. Using neuroimaging, she and a colleague at the Semel Institute hope to study potential similarities and differences in the neurological and psychophysiological processes of individuals who have misophonia and those who exhibit sensory over responsivity."},{"type":"text","value":"In the meantime, the only thing people with misophonia can do is wait. After years of waiting for our initial diagnoses, it’s something we’ve grown accustomed to do."},{"type":"text","value":"Finander has accepted that her daily reality will be difficult, that living with misophonia, as she describes, sucks. But for her and myself, misophonia is more than the suffocating and, at times, cruelly comical wave of fear we experience when the sound of crinkling food wrappers reaches our ears. It is more than the triggers we see or hear. And it is more than the anger we feel at the world and ourselves."},{"type":"text","value":"It is the ironically deafening beat to which we reluctantly, but compliantly, march. It is the canvas upon which the contours of our lives are painted, and it is a fact we need to grapple with every minute of every day, whether we like it or not."},{"type":"text","value":"Finander, perhaps, explains it best."},{"type":"text","value":"“Misophonia means hatred of sound, but it's not really about those things,” she said. “It's about being lonely.”"}]}},"pageContext":{"term":"spring20","slug":"sabrina.whensoundshurt"}},"staticQueryHashes":[]}