This episode was written & produced by Carolyn McCulley.

The way our brains process sound affects the way we respond to sound. This episode is about why that happens in those who suffer from misophonia, the hatred of certain sounds. Featuring researcher Dr. Phillip Gander, psychologist Dr. Ali Mattu, and misophonics Meredith Rosol and Josh Furnas.


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Fury (instrumental) by Prague
Wait for It by Dustin Lau
Wake Up by Lael (Instrumental)
Every Season by Hidden Tapes
Red Dot by Watermark High

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View Transcript ▶︎

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You’re listening to Twenty Thousand Hertz. I’m Dallas Taylor.

This is an episode may never be heard by one of the guests we tried to record an audio interview with. Josh Furnas can’t tolerate the sound of someone speaking into a studio microphone. He feels threatened, like someone is literally talking right next to his ear. Even normal mouth noises can trigger a traumatic reaction.

Josh has a condition called misophonia, which means the hatred of sound. Not all sound, though--just certain sounds that trigger a sense of alarm. What does it feel like? And how is it that two people’s brains can have such a drastically different response to the same sound? In order to figure this out we'll be using sound examples throughout this episode. This may cause discomfort for someone with triggers, but I think it’s important to attempt to recreate the sensation for those without misophonia. I’m hoping that those who don’t suffer from it to have more sympathy for those who do.

So, If you have Misophonia, proceed with caution. We’ll be playing possible trigger sounds for the rest of the episode.

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Meredith: It feels like a bear is chasing you [SFX: Bear chase]. You freeze. Whatever you're doing, you're not able to focus on anymore. Your heart races, [SFX: heartbeat] you feel tense, you feel irritable, I just freeze and close my eyes or cover my ears until it stops.

That’s Meredith Rosol. Her misophonia started at age six.

Meredith: I was sitting on the couch in the living room with my mom, and I could see and hear her shaking her foot. It gave me this feeling of panic.

[SFX: foot shaking]

Meredith: The hardest part was listening to my parents chew, [SFX: food chewing] so at the dinner table I would cry, and my mom would not know what was wrong. I remember she would teach my sister and I table manners, so she said, "You have to keep your hands in your lap," but I would just want to cover my ear with it. That would frustrate her, so at dinner time was the hardest.

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It might be hard to understand the distress of listening to someone chew. But Dr. Ali Mattu, a clinical psychologist at Columbia University, describes it this way.

Ali: you're experiencing it as if someone is chewing [SFX: loud chewing] right in your face to the point where maybe there's spit or some of their food are just flying all over you. So maybe it is tapping into this basic aversion that we all have.

As a cognitive behavioral therapist, Dr. Mattu says misophonia is a new term, one without a clear psychiatric definition.

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Ali: It's a part of a set of sensory experiences we're beginning to better understand like ASMR, like synesthesia. We're beginning to understand that our senses are more complicated and there's more diversity to how we experience our senses than we knew before. And I think part of the reason we're beginning to understand this is the Internet. We've heard from communities that weren't really formed before about how people were sharing a similar type of experience and now researchers are beginning to catch up and we're seeing this more in clinical environments

Meredith: My triggers are eating [sfx], gum popping [sfx], slurping [sfx], feet shuffling [sfx], the sight of leg shaking and also the sound if it makes a sound [sfx], bass coming from cars and apartments [sfx], keyboard typing [sfx]. Newer ones are whistling [sfx], and humming [sfx].

Ali: There's a lot of unique ones that people have. One of my roommates in grad school hated it when I was eating ice cream and I would get to the very bottom of my bowl and try to scrape [SFX: spoon scraping] the last little bits of melted ice cream out of my bowl using my spoon. Just that scraping sound of the spoon on the bowl infuriated him. Did he have misophonia? I don't know but that was a really unique sound that bothered him and doesn't bother me.

Over email Josh Furnas said that he’s tried a bunch of different things to try and reduce his reaction to triggers. A newly sick or allergic [SFX: coughing] colleague can flatline him. And anyone eating in a meeting can render him useless. And even Mac laptop keyboards [SFX: keyboard typing] are unbearable.

Ali: Some of the things that people tend to share with me are anger at hearing everyday sounds. Sometimes anxiety related to those sounds, and sometimes disgust. But it sometimes can be heightened with close loved ones.

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Phil: We think that what's going on, is that the brain is monitoring these sounds, or having a disorder in the way that it's monitoring these sounds, and interpreting them.

That’s Phillip Gander, an assistant research scientist from the University of Iowa.

Phil: I work in the departments of neurosurgery and otolaryngology and I work as an auditory neuroscientist researching questions on auditory cognition, on how we interpret and understand sound.

Normally what we do is we study perception; our experience of the external world, but interoception is just the opposite, it's our experience of our internal world. There are increasing number of studies in which people are pointing out that we can modulate our cognitive responses, or performance on tasks, based on our heartbeat [SFX: heartbeat], and our heartbeat based on our breathing pattern [SFX: heart beating and breathing].

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Phil: In the case of misophonia, what we think is going on is this is a disorder that really gets at people’s experiences of their internal world are severely disturbed, When they hear a regular sound, like someone eating some food, then they have an interpretation of that sound that leads them to have a really extreme response. Either they need to get out of the space where that sound is occurring, or they need to stop that sound from occurring.

Phillip was part of an international team of researchers that studied misophonia. Using MRI scans and physiological measurements, they showed that misophonic subjects legitimately have a strong reaction in both the brain and body.

Phil: we found evidence for changes in the brain response. in the group suffering from misophonia, to the misophonic sound, or trigger sounds specifically. Not to the control sounds, and not to other unpleasant sounds. What we found was an overreaction, in areas of the brain that are involved in interpreting sound.

Phillip Gander’s study shows that there is clear evidence that the brains of misophonia sufferers respond very differently to certain sounds.

Phil: That's extremely clear in the case of misophonia, in which we have people who hear the exact same sound, and have a regular, what we'll call, a regular response. In which, it doesn't bother them, it doesn't make them want to get away from that sound, and stop it. Whereas other people are having an extreme reaction, [SFX: water dripping] in which they want to do exactly that. This clearly has to do with something related to their response to the sound, their reaction to the sound. That's information that's being fed up from the auditory system, to our perceptual systems, and our emotional systems that are interpreting and putting meaning to the sound.

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But for those who suffer from misophonia, identifying the cause is not as important as finding a treatment. Navigating a world where ordinary sounds can be distressing is exhausting and sometimes isolating. It also has an impact on close relationships. While the research is developing, is there anything that can be done now? More on that in a moment.

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Over email, Josh Furnas said that he’s tried a bunch of different things to try and reduce his reaction to triggers. One study he participated in was a disaster. He said it was so traumatic that it made a few of his triggers even worse. However, another technique--called mindfulness based stress reduction--seems to reduce the effect of his triggers by about 20 percent.

Meredith Rosol has her own techniques as well.

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Meredith: I've seen a psychologist for cognitive behavioral therapy for certain situational anxiety, like medical situation anxiety separate from this, so I think I unknowingly adopted the CBT techniques towards misophonia. I wasn't very cognizant of it, but if I'm sitting there experiencing a trigger, I'll know that that person's not doing it to harm me. They're not doing it deliberately. If it's a friend that I told to stop and they're doing it again, they simply forgot. I know that, okay I have options I can get out of this.

[SFX: bus breaking, foot taping]

Meredith: If I'm sitting on the bus and someone is tapping their foot next I'm sitting on the bus and someone is tapping their foot next to me. When I was younger I'd be nervous to move because I was paranoid of what people would think of me. But now that I'm an adult, I don't care. I could move to three different seats on the bus as long as I'm comfortable. No one's watching me. No one cares.

Dr. Ali Mattu says a lot of people who experience misophonia don’t always have other types of impairments, so they’ll still go through their day like everyone else.

Ali: They might still go to school. They might still go to work, but they all tend to have a high degree of distress. Inside they are so strongly reacting to these sounds. I'm looking at those two things, how impairing is it? And how distressing is it? That's where I usually find people who are really having a hard time is internally it is so turbulent. It is so difficult. [SFX: Storm] It is like a storm inside that no one on the outside can see. So the first thing I tell people is it's okay to avoid sounds that trigger you and that might not be a message they've received before.

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Meredith: I usually get myself out of the situation or mask it. No, there's probably been two times I've asked somebody to stop, which sounds terrible because you think I would be so, "Oh, I'm going to advocate for myself," but I always think, "Well, what if that person has to do it to focus?" It's very difficult to ask a stranger.

It’s funny, I'll meet up with a friend who also has misophonia and we'll go to a bar [SFX: restaurant ambience] or a restaurant. Before we sit down, we say, "Okay, wait. Where do you want to sit? Okay, wait. Is there any leg-shaking over there? No. Okay. What do you want to eat? No don't ... No one will get the chips." It's so funny to talk to someone and negotiate, and make sure we don't trigger each other. Also some people are triggered by silverware too, so in that case you're like, "Okay, I'm going to ...Now, wait. Cover your ears. I'm going to cut this. Okay, I'm done."

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Ali: The main thing I want to help people to do is learn how to tolerate that distress. How to manage that emotion in a better way.

Finding activities that distract you from sounds. Contributing to other people to distract. Contributing to other people to get you focused on someone else instead of what's going on in your mind. Making a comparison to a different time. Making a comparison to yourself in a different time when you were coping better with the situation or comparing yourself to someone else who might be struggling more. Creating emotions that undo anger. Temporarily pushing yourself away from the situation that is difficult for you.

Meredith is grateful that her reactions are more moderate.

Meredith: A lot of people have aggressive reactions, so their gut instinct will be to punch the wall or break something. It puts a lot of strain on relationships. Plenty of people have had divorces. I never want it to prohibit me from doing what I like to do in my life I'll just try to set myself up for success, and do what I can.

It’s mind blowing how little we know about how our brains interpret sound, and misophonia yet another example of how the same sounds can produce totally different results in people. Sound can soothe us or sound can disturb us… and there’s an infinite number of possibilities in between Eventually we will gain a greater scientific understanding. but, for now, the current research validates that those with misophonia. They truly do respond differently and that alone is a relief to those who suffer from it. For the rest of us, it’s important to be empathetic and patient. All in all this is yet another reason why it’s so important to make our world a better sounding place.

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Twenty Thousand Hertz is lovingly crafted out of the studios at Defacto Sound, a sound team that supports advertising agencies, television networks, filmmakers, and really, anyone who needs amazing sound design for anything visual. Check out our recent work at defactosound dot com.

This episode was written and produced by Carolyn McCulley. And me, Dallas Taylor. With help from Sam Schneble. It was edited, sound designed and mixed by Jai Berger. Thanks to our guests–Dr. Phillip Gander, Dr. Ali Mattu, Meredith Rosol and Josh Furnas.

You can read more about Dr. Gander’s research by searching online for The Brain Basis for Misophonia. You check out Dr. Ali Mattu’s YouTube channel, The Psych Show. ...and you can tweet at Josh Furnas @j-o-s-h-f-u-r-n-a-s.

The music in this episode is from our friends at Musicbed. Musicbed wants to make sure you find the perfect song for your project. Not only do they have incredible browse and search tools, but they also have people on staff who are dedicated to helping you find the perfect song. At no extra charge they’ll send you suggestions based on what you’re looking for. Consider them another member of your team. Find them at musicbed.com.

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