Misophonia, Phonophobia, and Hyperacusis: Auditory Sensitivity and Mental Health

Thanks to Dr. Lindsey Tubaugh for teaching me about treatment for sound sensitivities, you can find her online program here: https://littleheroeshearingclinic.com/

There are at least three different types of sound sensitivities, and this matters because sound sensitivities sometimes co-occur with other mental health conditions like OCD, Autism, Anxiety, Trauma and Sensory Processing Disorders. If you get really angry about certain noises, that’s misophonia, if you get really anxious or scared around certain sounds, that’s phonophobia, and if everyday normal sounds are painfully loud, that’s hyperacusis.
So let’s start with hyperacusis. Hyperacusis is when you perceive sounds as being louder than they objectively are. Everyday sounds seem louder than they should. 47% of people with hyperacusis also have anxiety.
Auditory sensitivity can occur on a spectrum, where hyperacuity may be on the more severe end of the spectrum, and a dislike of loud noises can be on the less severe side of the spectrum. Auditory sensitivity can also be associated with sensory differences with autism, and it can stand alone- it can just be that you have really sensitive ears.
Now, let’s talk about Misophonia, misophonia is when specific sounds trigger an intense reaction- usually anger but it can also be irritation, rage, anxiety and disgust. The most common triggers are repetitive sounds like chewing, breathing, lip smacking or tapping. Essentially these sounds are triggering the nervous system reaction of Fight in FFF and this can lead people to react with hostility or avoidance.
Like hyperacusis, Misophonia is not a recognized disorder in the DSM 5, and research is just beginning to understand the causes and treatment. There are some early studies indicating that there are brain differences in people with misophonia and there’s heightened response to sounds in the brain. Misophonia commonly occurs with other disorders including Anxiety, OCPD, ASD, and Sensory Processing Disorder. There’s also a higher incidence in people with tinnitus and hyperacusis.
Phonophobia is an intense fear reaction to certain sounds. Like other phobias, it can be connected to anxiety disorders or a history of trauma, but it can also stand alone.

https://health.clevelandclinic.....org/5-ways-to-cope-
https://pubmed.ncbi.nlm.nih.gov/8339063/
https://www.ncbi.nlm.nih.gov/p....mc/articles/PMC32161
https://www.sciencedirect.com/....science/article/abs/
https://academic.oup.com/book/....34432/chapter-abstra
https://youtu.be/Ls34Jk7AXu0
https://www.youtube.com/watch?v=rUWAwkpDhWI

00:00 - Intro to sound sensitivity and noise sensitivity
2:27 - Hyperacusis
3:49 - Misophonia
5:01 - Phonophobia
6:43 - Treatment options

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Therapy in a Nutshell and the information provided by Emma McAdam are solely intended for informational and entertainment purposes and are not a substitute for advice, diagnosis, or treatment regarding medical or mental health conditions. Although Emma McAdam is a licensed marriage and family therapist, the views expressed on this site or any related content should not be taken for medical or psychiatric advice. Always consult your physician before making any decisions related to your physical or mental health.
In therapy I use a combination of Acceptance and Commitment Therapy, Systems Theory, positive psychology, and a bio-psycho-social approach to treating mental illness and other challenges we all face in life. The ideas from my videos are frequently adapted from multiple sources. Many of them come from Acceptance and Commitment Therapy, especially the work of Steven Hayes, Jason Luoma, and Russ Harris. The sections on stress and the mind-body connection derive from the work of Stephen Porges (the Polyvagal theory), Peter Levine (Somatic Experiencing) Francine Shapiro (EMDR), and Bessel Van Der Kolk. I also rely heavily on the work of the Arbinger institute for my overall understanding of our ability to choose our life's direction.
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