What Does Misophonia Treatment Really Mean?

What is a Cure? What is Treatment?

Misophonia is a highly unique disorder. As the Consensus Definition suggests, misophonia doesn’t belong soley in psychiatry, audiology, or neurology. It is not thought of as a mental illness, and it is not yet studied in medicine (although it is being studied by neuroscientists). Misophonia is a disorder that transcends disciplines and is not easily comparable to any other disorders identified in an allied health or mental health field.

Misophonia is not related to a particular trauma but the memory associations act like trauma memories. It is not an auditory disorder, but certainly includes the auditory sense and auditory brain pathways. Neuroscience research even supports that motor pathways in the brain light up when a person is triggered by sounds. It is not an easy disorder to understand, and it is not like any other disorder one might think of. We have no idea how or why it starts, and who is most vulnerable to getting it.

Yet, more and more we see claims for cures and treatments for misophonia across disciplines that may or may not ultimately have a place in misophonia. Therefore, I think it is important to clarify what is meant by a cure and what is meant by a treatment. As you are out there searching for help for you or for a family member, think about these distinctions. Let’s consider what exactly “cure” and “treatment" mean in regard to you and misophonia.

According to the Nemours Hospital, a treatment is something that health care providers do for their patients to control a health problem or lessen its symptoms. Treatments can include medicine, therapy, surgery, or other approaches. The term cure means that, after medical treatment, the patient no longer has that condition anymore.

To me, this distinction is highly important. It goes without saying that we all want a cure for misophonia. As we wait for a cure, we of course consider various treatments. Currently, most treatments we see for misophonia are based in psychology, with some in audiology. Let’s review a bit about how psychology and audiology describe treatment paradigms.

According to the American Psychological Association, "various forms of treatment … including psychotherapy and behavior modification are aimed at increasing an individual’s adaptive and independent mental and behavioral functioning."

This means that psychological treatment, in general, strives to increase the individual’s ability to adapt to the disorder, by helping to change behavior and thinking. Note, that this is not a cure. A psychologist may strive to answer the following questions. How can I help a person learn to tolerate triggers better? How can I help a person be less afraid of their own responses?

Psychologists might also want to treat this disorder with support, as is done with chronic illness and pain. A more middle-ground alternative in psychology is a coping skill approach, which considers both changes that can be made in the environment (such as the school, workplace, and family) as well as ways to help the individual understand and manage misophonia. Coping skills approaches can be multi-disciplinary; for example, a psychologist or counselor might work alongside an audiologist. Some say this is simply semantics but I think it is important distinction.

An audiologist may help those with misophonia with assistive technology to change or inhibit trigger sounds. They may also advise on sound layering and other acoustic methods to assist in dampening sounds. They may even try to help the individual associate new experiences with the sounds that make them uncomfortable. Audiologists, however, do not address the visual triggers that often accompany misophonia and will mostly refer to a psychologist for further support. Here we see a combination of treatment and coping skills. That is, the audiologist uses technology so that the individual may better adapt to the environment, while also supporting changes in the environment. However, we don’t see a cure.

When a disorder spans different disciplines and is still poorly misunderstood, we must be careful not to fall into traps. Thinking about the distinctions between cures and treatments, as well as how coping skills approaches differ will help you to distinguish amongst the various cross disciplinary interventions for misophonia. Ultimately, you must decide for yourself who can help you most with misophonia. I hope that being mindful of these issues will help you to find a path that is right for you or your family member.