The Five Senses and Beyond: The Encyclopedia of Perception - Jennifer L. Hellier 2017


One of the least beneficial forms of synesthesia is misophonia or the “hatred of sound.” This condition is extremely rare and results in strong, specific, negative adverse emotions in response to the specific sounds of other people breathing and eating. Repetitive sounds typically produced by other people like chewing, pen clicking, or tapping trigger misophonia. During a trigger event, the person may become defensive or offensive, agitated, and possibly act out and express anger or rage at the offending sound’s source in an actual fight-or-flight reflex. The reaction to these sounds makes the misophone (person with misophonia) avoid situations where these sounds may be produced and limits the misophone’s ability to interact professionally and socially.

Causes and Symptoms

Misophonia, also referred to as selective sound sensitivity syndrome, may be caused by faulty or hyperconnectivity between the limbic system and the auditory cortex. This condition may be hereditary with at least one family relative suffering from it. There are some similarities between misophonia and tinnitus (persistent ringing in the ears when no actual sound is present). The difference between tinnitus and misophonia is primarily in terms of where the sound is located. Misophonia is sound produced by other people while tinnitus is internally perceived sound. Neuroimaging findings may provide hypotheses on the neural basis of misophonia including linking in relevant sensory regions or an actual increase of anatomical connectivity. Pathological distortions between limbic structures and the auditory cortex could be a cause of misophonia. Misophonia may be exaggerated mechanisms already present in the general population—many of the common aversive stimuli are also deemed socially inappropriate in Western society.

Particular sounds made by other people provoke particular reactions: the worst trigger sounds tend to be chewing, pen clicking, crunching, and clock ticking. Other common trigger sounds include clicking, typing, and whistling. The person with misophonia will have a range of negative emotions, thoughts, and even physical reactions that are triggered by these sounds. Trigger sounds are felt as intrusive or disgusting and evoke anger, extreme irritation, intense anxiety, and strong feelings of being violated for the individual with misophonia. Physical symptoms include pressure on the chest, sweaty palms, tense and tightened muscles, difficulty breathing, and an increase in blood pressure and body temperature. These reactions and endless discomfort can have a serious impact on the misophone’s daily life. Interactions within personal and work relationships can be affected and the potential for social isolation exists, especially if the misophone is trying to avoid problematic situations. Pharmacological agents affect misophonia. For most persons with misophonia, caffeine will intensify their reactions to the offending sound while alcohol decreases the adverse response. Self-induced trigger sounds will not evoke as much of an adverse reaction and neither will the sounds produced by animals or babies. This implies an underlying social component to misophonia.

Misophones commonly describe the onset of misophonia in childhood with responses evoked by trigger sounds modulated by context, sound source, and prior knowledge. Many times, it is the people who are the closest to the misophone or the people they are exposed to frequently who elicit the worst triggers, which can make personal relationships stressful and difficult. School settings and workplaces can also become an issue, especially if the misophone has little input in shaping that environment. Sometimes, the sound environment can make keeping a job intolerable with supervisory or teaching staff not really understanding the issue. Misophones describe themselves as being hyperfocused on background noise.


Mimicking trigger sounds is an effective coping strategy. It appears to “overwrite” the disturbing sound and sometimes functions as a way to retaliate against the offending individual producing the sound. Some of the current treatments for misophonia are Neurofeedback (NFB), Cognitive Behavioral Therapy (CBT), psycho-therapeutic hypnotherapy, Tinnitus Retraining Therapy (TRT), and Neural Repatterning Technique/Trigger Tamer. The use of ear plugs, sound masking, and sound machines is often effective and helpful.

Carolyn Johnson Atwater

See also: Auditory Processing Disorder; Auditory System; Auditory-Tactile Synesthesia; Synesthesia

Further Reading

Cavanna, Andrea E., & Stefano Seri. (2015). Misophonia: Current perspectives. Neuropsychiatric Disease and Treatment, 11, 2117—2123. http://dx.doi.org/10.2147/NDT.S81438

Ro, Tony, Timothy M. Ellmore, & Michael S. Beauchamp. (2013). A neural link between feeling and hearing. Cerebral Cortex, 23, 1724—1730.