What Misophonia Is & How I Can Help

For many families the hardest part of misophonia is the time spent not knowing it exists. This blog post explains what misophonia is and suggests where to turn next.

Children and teens with misophonia have strong emotional reactions to particular patterns of sound, often tied to specific situations, places, or people. Common examples include chewing or slurping at meals, pen clicking in the classroom, the crinkling of plastic or paper, the sound of someone breathing, or the drone of a lawn mower or vacuum cleaner. Many children are also distressed by the sight of certain repetitive motions, such as someone chewing, bouncing their knee, or tapping their foot. This phenomenon is known as misokinesia.

Misophonia is not listed in the DSM-5, the manual clinicians use to diagnose mental health conditions. The Duke Center for Misophonia and Emotion Regulation explains that this is partly a matter of timing and classification. According to the Center, a scientific consensus definition of misophonia was only published in 2022, nearly a decade after the DSM-5 came out, and researchers are still debating how to categorize a condition that spans several fields, from psychology to audiology. None of this makes misophonia any less real. Children and teens with the condition often face considerable discomfort, heightened anxiety, and disruption of everyday life at school and at home. Anxiety and depression can accompany misophonia as well.

There are two established organizations that offer a starting point for families impacted by misophonia. soQuiet is a nonprofit that supports people living with misophonia through free resources, peer support groups, and updates on clinical research. This organization hosts World Misophonia Awareness Day every July 9th. The Duke Center for Misophonia and Emotion Regulation conducts research on the condition, publishes accessible information for families, and holds CARE for Misophonia Day, a yearly gathering that welcomes both clinicians and people living with misophonia.

Research on misophonia is ongoing. No therapy has yet been scientifically proven to treat or cure it, but early research suggests that approaches drawn from cognitive behavioral therapies may be helpful. In my work with children and teens, I use adaptations of Dialectical Behavior Therapy (DBT) and the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A), both of which have a strong research track record of effectiveness with the emotional difficulties that so often accompany misophonia.

When a family comes to me, my first task is to understand in detail what misophonia looks like for their child or teen. Together with my clients, I focus on which sounds and sights set off the reaction, where and with whom they tend to occur, and how they impact the child or teen and their family. From that picture, the family and I map out a therapy plan shaped around what this particular child or teen needs. Much of our work centers on skills that calm the body’s alarm response when a trigger hits and that help my clients put words to what is happening, speak up about their needs, and get through hard moments in the school cafeteria, the car, or the living room. Since misophonia spans several disciplines, I may refer my clients to audiologists, occupational therapists, and other specialists when it is helpful, and I stay in close contact with everyone involved in a child’s care. I also partner with schools, helping families put supports in place such as 504 plans.