Misophony: Noises can trigger aggression - bildderfrau.de
- By sennenqshop/li>
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- 14/03/2023
Everyone is acoustically annoyed by their fellow human beings, be it teenagers with extra loud music on the train or colleagues who seem to be beating up their keyboards... This is normal, after all we are exposed to countless noise stimuli every day, that strain our hearing. However, there are people for whom some noises are almost unbearable, trigger disgust and blind rage, and in extreme cases even aggressive attacks on the polluter. An unknown disease could be behind this: misophonia.
Misophonia: When noises trigger aggression
Most likely, this is due to misophonia, a disorder many believe to be a hearing problem. The Duisburg ENT doctor and tinnitus specialist Dr. Uso Walter regularly deals with people affected by misophonia: "For example, patients often come to the ENT practice who complain that their neighbor showers for hours every night when they want to sleep. The noise drives them crazy and they think about it even moving because of it. Of course, viewed soberly, a complete overreaction. There are also known cases in which people cannot bear the chewing and swallowing noises of their relatives and therefore avoid eating with them. What that means for family peace is good imaginable. Such patients really need to be helped quickly so that their lives don't get out of hand."
Dr. Walter in his book "Too much to do - how stress changes hearing" (Ecowin Verlag). More info can be found here.
Noise hatred or sensitivity to noise? This is misophonia
The term misophonia comes from ancient Greek and is made up of misos = hate and phone = noise, meaning hatred of noises. This is not a disease of the ears, nor is it an independent medical diagnosis. Misophonia was only scientifically described as a phenomenon in 2001. However, it is undisputed that misophonia exists and sometimes severely restricts the lives of those affected. There are certain noises - individually different for each person affected - that trigger a strong emotional reaction with aggression and / or disgust, especially towards those who caused it. In general, all noises can be a trigger, but mostly those that come from people. According to the "German Misophonia Aid", particularly typical trigger noises caused by eating, breathing and nasal noises and keyboard typing or the clicking of a pen.
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Misophonia is often confused with other hearing disorders in which people also react strongly to noises, such as hyperacusis and phonophobia . While hyperacusis is an oversensitivity to all sounds, which is often also caused organically, for example by diseases of the inner ear such as sudden hearing loss, patients with phonophobia and misophonia only react to certain sounds. With phonophobia (Greek: fear of noises), the anxious avoidance of the feared noises is in the foreground. In misophonia, the aggressive response is dominant. Ultimately, in both cases it is a strong emotional stress reaction that activates the fight / flight mode, i.e. in which the body is automatically put into fight or flight mode. Phonophobia corresponds to the flight reaction, misophonia to the fight reaction.
Differences to other mental disorders
Because of the extreme emotional reaction, misophonia is also more often associated with mental illnesses, such as phobias, obsessive-compulsive disorder or post-traumatic stress disorder - these 3 symptoms are typical for this. The Dutch psychiatrist Damiaan Denys from the Free University of Amsterdam treats people with misophonia and was able to identify the following differences:
Where does misophonia come from?
It is not the sounds themselves, but their (subconscious) evaluation that determines whether misophonia occurs. "There are often negative attitudes, bad experiences or situations of being overwhelmed. Linking negatively rated situations with certain noises leads to classic conditioning in the long term," says Dr. Walter. He points to the famous example of "Pavlov's dog", an experiment by the Russian researcher Ivan Petrovich Pavlov, who used it to demonstrate how classical conditioning works and was awarded the Nobel Prize for it. Dogs were only fed when a bell rang at the same time. If, after a few feedings, you only let the bell ring without giving any food, it turned out that the dogs still reacted as they had learned. Their salivation increased in preparation for eating even though there was no food in front of them at all. So your brain automatically linked the acoustic stimulus to a specific experience. This is how misophonia works.
Dr. Walter's example: "For example, a sports teacher who has difficulties with a particularly loud class can develop a real aversion to the noise in the sports hall. The stress caused by the teaching situation is subconsciously linked to the aversion to the noise, which is perceived as increasingly loud. Reinforced The whole thing is made worse by the feeling of being powerless in this situation. After all, she has to teach. In individual cases, this can go so far that she no longer feels able to work as a teacher."
Wrong shortcut? Misophonia shows up in the brain
In fact, the stress response of misophonia patients also shows up in brain imaging. The neuroscientist Sukhbinder Kumar from the British University of Newcastle examined the brain activity of 20 affected people using functional magnetic resonance imaging (fMRI). Their respective trigger sounds were played to them and the reactions in the different brain areas were observed. Among other things, it was shown that the anterior insular cortex in the brain is activated in misophonia patients. This region acts as a kind of switching station that links sensory impressions with emotions. The insular cortex showed connections to the amygdala – an area for processing emotions – and to the posterior cingulate gyrus – a brain region that is linked to memory. Also involved was the hippocampus, an area of the brain that decides what content should and shouldn't be stored as memories. In misophonia, the brain centers for emotions and memories are particularly active and interconnected. Research leader Kumar even thinks it is possible that the brains of those affected are also organically altered. However, this cannot be seen with MRI or other imaging methods.
What's particularly tricky about misophonia is that the emotional reaction to a noise is burned into your memory and reinforces itself. The activated insular cortex in the brain also evaluates signals such as the heartbeat, which emanate from the body itself. Such an increased self-awareness was also evident in the misophonia patients. If the strong physical reaction is in turn perceived by the brain itself, it stores the trigger as particularly important. As a result, the noise is amplified in auditory processing and is perceived as even louder and more present – a vicious circle.
Help with misophonia: psychotherapy and auditory training
The ENT expert recommends a combination of auditory training, stress reduction and behavioral therapy to treat misophonia. The problem is not the hearing, but the psychological processing of what is heard. Those affected must recognize the actual stress factors and reflect on their own negative inner attitudes. "The prerequisite for this, however, is that the person concerned is aware of the problem. He has to realize that the problem is not the neighbor showering or the wife eating, but himself. These discussions are not that easy in practice. Patients often lack insight into the illness. For it's the sound that's the problem and not your inner attitude," says Dr. Walter's experience.
A psychology explains: when is psychotherapy useful? In addition to psychotherapeutic treatment, misophonia in the ENT area can be alleviated through auditory training. It's all about down-regulating the exaggerated sensitivity to that particular noise, i.e. achieving a tolerance. In the example of the sports teacher, this could mean that she listens to the sounds of a loud sports hall at home in a relaxed environment and initially very quietly as a sound file. "Due to the absence of the class, the low volume and the possibility of being able to turn off the sound at any time, significantly fewer stress reactions develop. In the further course, she could then increase the volume and then gradually expose herself to real situations, for example in a other sports hall where you don't have to teach yourself," explains Dr. Walter a possible course of action. With this type of auditory training, the processing of the stress-triggering noise is gradually decoupled from the stress system in the brain.
Am I just clairaudient or do I have misophonia? There are these tests
Most people have special "hate noises", some squeaking is almost physically painful, others find it hard to endure rustling - however, this does not automatically mean illness. Whether a disorder such as misophonia is present depends a lot on how severe the suffering is in those affected and how much the noise hatred and avoidance strategies limit them in everyday life. There are still few standard tests to diagnose misophonia, but it is becoming more and more researched. The "German Misophonia Aid" refers to these scientific (English language) questionnaires to determine the extent of misophonia:
As a self-help association, the "German Misophonia Aid" offers the opportunity to network and exchange ideas with other affected people.
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