Question: My teenage daughter can't stand the sound of people eating and chewing. When we try to have a family dinner, she becomes really irritable and gives out, and says we are chewing too loudly (when we are all eating normally).
She often gets so frustrated by it that she eats on her own or if we insist she eats with us, then she will wear earphones. It’s awful for her that she feels this way and, of course, is bad for our family dinners. It also causes issues when we are out socially as a family or travelling together when we have to eat out.
Otherwise, she is a happy and content teenager.
What should we do to help her? Should she see a professional?
Answer: Many people have a hypersensitivity to certain sounds which causes them to become irritated or distressed. Common trigger sounds include other people chewing, lip smacking or sniffing and also repetitive sounds such as tapping or dripping.
The condition is called misophonia which literally means a “hatred of sounds”. The condition can range from being quite mild to very severe and disabling. Many of us can probably identify a sound that irritates us or keeps us up at night such as a leaky tap or a creaky window. No matter how you try not to listen, the sound continually plays on your mind and you can’t sleep. In severe cases, misophonia can trigger a very distressed reaction, where the person becomes intensely irritated and can’t bear the noise at all. Misophonia is thought to be a neurological condition, whereby certain noises trigger a physiological “fight or flight” reaction. While there is no cure for misophonia, there are lots of different ways that you can help your daughter as well as many strategies she can use to help herself.
Be understanding
Most people think people with misophonia are reacting unreasonably and can become critical in response – “what is the matter with you, I am only eating, why are you freaking out?”. We can easily think that they should be able to control their reactions and that they are somehow “crazy” by getting annoyed over something trivial. Seeing it as a real condition that they can’t control is very important as this helps you respond in a more empathic way.
Help your daughter be understanding
It is also important to help your daughter be understanding of other people. They aren’t choosing to annoy her by chewing etc, and they don’t share her sensitivity to the noise. Helping your daughter frame the problem like this will help her respond more appropriately. Rather than reacting angrily and saying “stop that disgusting noise” (and getting into an angry exchange), she can learn to communicate more appropriately like “sorry but I am getting bothered by that noise”. Often an agreed signal or non-verbal communication can work when you are out in public. For example, your daughter might point to her ears as a signal that she is getting agitated and needs to withdraw and take a break for a minute.
Understanding as a family
Often the biggest problem associated with misophonia is blame and conflict. Your daughter might think family members are making the noises on purpose to annoy her and those around her think she is crazy by the way she is reacting. Helping your daughter and her siblings be more understanding and talk differently about the problem can certainly reduce conflict. In short, the key is to stop thinking about the person with misophonia as the problem and start thinking about the misophonia as the problem that you are all tackling together.
Help your daughter discover strategies to manage
Your daughter has already discovered some strategies that work for her such as wearing earphones and leaving the room for a minute and there may be more. For example, instead of wearing earphones (which is a bit anti-social) it might help to have some background music at dinner time. Also, your daughter might be able to learn strategies to calm her body and reduce her physical reaction by using visualisation, mindfulness or meditation. She can also try to change her thinking which might reduce her distress. For example, rather than thinking “his chewing is disgusting”, she might use soothing self talk: “it is only a noise, I am learning to relax”, etc.
Learning to tolerate sounds step by step
It may be possible for your daughter to learn to tolerate the “trigger sounds” step by step. This might mean she creates a list of all the sounds that trigger her reaction, rate them in order of difficulty and identify the easiest one to tackle first. Then she would identify a set of strategies she could use to help her tolerate this sound, such as relaxation, self-coaching, engaging in conversation etc and practise this for a short time. The trick is to pick an easy situation to start with so she can be successful and get a sense of progress. It can be hard to set up a plan like this alone, so gaining the support of a professional therapist to assist might be useful.
Seek professional support
There is no one proven treatment for misophonia, though research is still at an early stage for this relatively newly identified condition and there are some promising treatments (see misophonia-research.com). Some audiologists are exploring using sound therapy as a form of treatment and even suggesting people wear a hearing aid (that might play a background relaxing sound) in more severe situations.
In addition, cognitive behavioural therapy may be useful in identifying triggers, learning coping strategies and helping your daughter establish a step by step tolerance plan (see above). There are also a growing number of helpful websites and well as many online support groups which can be an excellent source of information and mutual support. See misophoniainternational.com, tinnitus.org.uk as starting points.
John Sharry is founder of the Parents Plus charity and an adjunct professor at the UCD School of Psychology. He will be delivering Positive Parenting workshops in Galway on February 16th and in Dublin on March 7th, 8th and 28th. See solutiontalk.ie for details.