Misophonia: When Specific Sounds Trigger a Whole-Body Stress Response

Misophonia is a condition characterised by intense, disproportionate emotional and physiological reactions to specific, typically pattern-based sounds. The most commonly reported triggers include the sounds of chewing, swallowing, breathing, lip-smacking, keyboard clicking, pen clicking and repetitive sniffing. For most people, these sounds are mildly irritating at most. For people with misophonia, they can trigger responses that include rage, panic, disgust and a powerful drive to escape, accompanied by significant physiological activation.

Misophonia is distinct from general noise sensitivity (hyperacusis) in that the response is specific to certain sounds rather than to loudness per se. A person with misophonia may be unbothered by loud music but find a family member chewing at the dinner table intolerable. This selectivity is one of the features that points toward an emotional processing pathway rather than a purely auditory one.

What Is Happening in the Brain

Research published in Current Biology in 2017 by Sukhbinder Kumar and colleagues used neuroimaging to examine brain activity in people with misophonia during exposure to trigger sounds. They found abnormal functional connectivity between the anterior insular cortex, which processes emotional significance and interoceptive awareness, and the areas processing the trigger sound. Trigger sounds also produced activation of the autonomic nervous system and motor preparation circuits, consistent with the physical tension and urge to flee or act that people with misophonia describe.

A 2021 study in the journal PLOS ONE found that people with misophonia showed greater mirror neuron activation in response to trigger sounds when they were watching another person make the sound, compared to hearing the sound alone. This suggests that the visual context of the source, seeing someone chew rather than simply hearing chewing, may amplify the response.

Importantly, misophonia is not considered an anxiety disorder or a personality problem. It is a neurologically distinct response pattern that, once established, appears to be involuntary and highly resistant to conscious override even in people who understand the irrationality of the response perfectly well.

The Physical Consequences

The physiological response to misophonia triggers involves the full activation of the sympathetic nervous system: muscle tension, particularly in the neck, jaw and upper back; accelerated heart rate; altered breathing; and in severe cases, trembling or nausea. Where a person is exposed to triggers frequently, as in a family or workplace environment they cannot avoid, the cumulative physical cost is significant.

Many people with misophonia develop sustained cervical and trapezius tension as a result of the chronic repeated startle and bracing responses that trigger sounds produce. Jaw clenching and bruxism are also very common, contributing to temporomandibular dysfunction and headache patterns.

Chiropractic Support for Misophonia

There is no chiropractic treatment for misophonia as a neurological condition. But the musculoskeletal consequences of living with misophonia, the sustained muscle tension, restricted cervical mobility, headaches and the chronic low-grade sympathetic state that characterises the lives of many people with misophonia, are the territory in which chiropractic care operates effectively.

For patients with misophonia at Clifton Chiro in Bristol, the treatment environment is deliberately designed to minimise unpredictable or aversive auditory input. Clear communication about what will happen during each appointment reduces the possibility of unexpected sounds. And the parasympathetic promoting effects of chiropractic care, particularly Network Spinal, provide a physiological counterbalance to the chronically elevated sympathetic state that misophonia creates.

References

1. Kumar S, Tansley-Hancock O, Sedley W et al. The brain basis for misophonia. Current Biology. 2017;27(4):527-533.

2. Schroeder SE et al. Misophonia: a scoping review of research. Journal of Clinical Psychology. 2021.

3. Brout JJ et al. Investigating misophonia: a review of the empirical literature, clinical implications, and a research agenda. Frontiers in Neuroscience. 2018.

About the Author

Tim Scott is the Principal Chiropractor at Clifton Chiro, with over 26 years of experience in healthcare.

Ready to feel better? Book your initial consultation at Clifton Chiro. Book Now