When sounds are unbearable: Understanding misophonia, with Heather Hansen, PhD
37 min
•Nov 19, 20258 months agoSummary
Dr. Heather Hansen discusses misophonia, a condition where certain sounds trigger intense emotional reactions like anxiety and rage. The episode explores the neurological basis of misophonia, its prevalence (approximately 5% of adults), how it differs from normal sound sensitivity, and evidence-based coping strategies including cognitive behavioral therapy and visual reframing techniques.
Insights
- Misophonia affects approximately 5% of the population globally and is more common than previously believed, but lacks a universal diagnostic tool, leading to inconsistent prevalence estimates across research
- Misophonia is distinct from other conditions and should be recognized as its own disorder rather than a symptom of anxiety, OCD, or autism, though co-occurrence exists in some individuals
- The condition involves complex brain connectivity between auditory processing regions and emotional regulation centers (insula), indicating it's not purely sensory but involves cognitive interpretation and emotional response
- Trigger sounds vary significantly between individuals and are not limited to mouth/nose sounds; they can include typing, pen-clicking, and water dripping, suggesting the disorder is more nuanced than previously theorized
- Visual context dramatically influences how people perceive triggering sounds, opening therapeutic possibilities through cognitive reframing and visual association techniques
Trends
Growing recognition of misophonia as a distinct neurological condition rather than behavioral sensitivity, driving increased research funding and clinical attentionShift toward personalized, data-driven approaches in misophonia research that account for individual differences in trigger sounds rather than universal categorizationEmerging therapeutic focus on cognitive reframing and visual perception manipulation as alternatives to avoidance-based coping strategiesIncreased workplace and academic accommodations for misophonia (quiet testing spaces, remote work options), reflecting broader acceptance of sensory processing differencesInterdisciplinary research expansion connecting misophonia to autism spectrum sensory processing and investigating potential genetic and environmental etiological factorsGrowing online community advocacy and self-reporting through platforms like Reddit, driving clinical awareness and patient-centered research prioritiesInvestigation of overlap between misophonia, misokinesia (movement-triggered aversion), and ASMR (pleasant sensory response), suggesting shared neurological mechanisms across opposite emotional valences
Topics
Misophonia diagnosis and assessment challengesNeuroimaging findings in misophonia (insula activation, brain connectivity)Trigger sound characteristics and individual differencesCognitive behavioral therapy for misophoniaVisual reframing and McGurk effect therapeutic applicationsMisophonia prevalence and epidemiologyMisophonia vs. anxiety, OCD, and autism spectrum overlapMisokinesia and movement-triggered aversionASMR and opposite sensory responses to identical soundsWorkplace and academic accommodations for misophoniaSocial judgment bias in people with misophoniaGenetic and environmental factors in misophonia onsetEarly adolescence onset patternsRelationship and partnership impacts of misophoniaMisophonia Research Network and interdisciplinary collaboration
Companies
American Psychological Association
Producer and publisher of the Speaking of Psychology podcast series
College of William & Mary
Institution where Dr. Heather Hansen is an assistant professor of psychology
UC San Diego
Research group that studied synesthesia and early misophonia presentations
UC Santa Cruz
Institution conducting research on visual representation effects on sound perception (McGurk effect)
People
Heather Hansen
Expert researcher on misophonia using neuroimaging and behavioral methods; director of Misophonia Research Network
Kim Mills
Host of Speaking of Psychology podcast conducting interview with Dr. Hansen
Quotes
"With misophonia, it is causing significant impairment to your daily life. It's making you need to leave the room. It's making you reduce or making your social interactions worse."
Heather Hansen•Early in episode
"Misophonia is more than just a condition to chewing an aversion to chewing or breathing. It is the most common by all means, but it's not exclusive."
Heather Hansen•Mid-episode
"It's not just pure acoustics that bothersome to you, because otherwise you would respond the same to the same acoustic information. It's demonstrating that how you feel, what you think the sound is, how you identify it, where you think it's coming from, your associations with that sound that are actually controlling how much you react to it."
Heather Hansen•Treatment discussion
"This exact sound that I had to plug my ears to is one that you enjoy. And so it's fascinating to me to know why that same sound might lead to completely opposite reactions in different people."
Heather Hansen•ASMR discussion
"My biggest advice is just to communicate. If someone with misophonia feels like they can't speak up or that they have to kind of suffer in silence, it's going to be a lot worse for them."
Heather Hansen•Support strategies section
Full Transcript
Have you ever been sitting in a quiet room when someone starts chewing gum, and suddenly that sound is all you can hear? For most of us, it's mildly annoying. But for people with misophonia, certain sounds like chewing, coughing, or pen-clicking can trigger an intense emotional response that feels completely out of proportion to the stimulus. We're talking anxiety, disgust, rage, even panic. For a long time, misophonia was dismissed as just being overly sensitive or irritable. But researchers are now recognizing it as a genuine condition with neurological underpinnings. They're using brain imaging and other methods to understand why certain sounds provoke such extreme reactions in some people, and are working to educate the public and develop tools to help people cope. So how common is misophonia? What exactly is happening in the brain when someone hears a triggering sound? Why do some sounds bother people with misophonia while others sounds don't? Is misophonia related to such conditions as anxiety or obsessive-compulsive disorder? And what can people do if they're living with misophonia or living with someone who has it? Welcome to Speaking of Psychology, the flagship podcast of the American Psychological Association that examines the links between psychological science and everyday life. I'm Kim Mills. My guest today is Dr. Heather Hansen, an assistant professor of psychology at the College of William & Mary. Dr. Hansen uses behavioral, physiological, and neuroimaging methods to study misophonia. She's explored the types of sounds that can act as triggers, what's happening in the brains of people who are triggered, and how misophonia affects people's cognitive and social judgments. Dr. Hansen is also the director of the Misophonia Research Network, an interdisciplinary international network of scientists and clinicians that aims to advance misophonia research. Dr. Hansen, thank you for joining me today. Thank you so much for having me. Let's start with the basics. How is misophonia different from merely finding certain sounds annoying? Yeah, great question. We all find certain sounds annoying, right? I think the key difference to me is that with misophonia, it is causing significant impairment to your daily life. So it's doing something different that makes you change your behavior. It's making you need to leave the room. It's making you reduce or making your social interactions worse. It's impairing your ability to hold down a job, for instance. It's doing a lot more than just, man, that's annoying, that person's rude. It's like, oh no, I've got to change what I am doing because of it. When did researchers start recognizing misophonia as a distinct condition? I think the earliest research has come from around like 2001. So this is still relatively new compared to a lot of other disorders. And it came from different patients presenting to folks with audiology. So an audiologist who studies sound and hearing, I think the original was from the Jastrov office back in 2001, where a participant was like, hey, I've got this weird thing where I'm having trouble. Like I have a reduced tolerance for certain sounds, but not all sounds like help me out. And that's when people were like, hey, this is a little bit different than other sound disorders I've heard. It's a little bit different than like tinnitus or hyperacusis or some of the other audiological kind of conditions. There seems to be something different going on here. And so kind of in conjunction throughout the early 2010s, similar things were happening. So similar patients with misophonia were presenting to UCC and Diego, a group who studies synesthesia, which is when you kind of link two different sensory systems together. And they were like, hey, I'm having this really averse negative reaction to certain sounds. Is that a normal sensory connection? Like what is this? And so those researchers also put together, hey, this is a little bit different than what we study. What is this condition? And so it originally got the name misophonia back in 2001. And since then we have better understood it. We have more of a consensus definition now. We have acknowledged that it's a different thing than other conditions. And it is getting a lot more attention now than it was 20 years ago, which is nice. We did an episode on synesthesia a couple of years ago. So is there a link between the two? Is like misophonia the ugly side of synesthesia? I think the research is still out there. Personally, I would say they're a little bit different because I think I typically think of synesthesia as involving multiple senses per se. So like your vision and audition or color and music or whatever that looks like. To me, I think misophonia is a little bit more of a social context kind of thing than it is pure sensory intake. And so I think it's maybe there's some commonalities, but I think it's a little different to me. How common is misophonia? And is it really rare or does it affect a significant portion of the population? More than you think. So early research landed on about like 20% of the population. Some more recent research though that does a little bit more like random sampling from the population has landed closer to about 5%. So there was a study recently that came out in the US that about 5% of adults from a representative sample have clinical or really impairing misophonia symptoms. And similar groups, I think a matching study in Germany and there was a couple in Turkey that found really similar numbers. So it seems to be something pretty consistent across the world, which is cool. The short answer is it is more common than you think in the 5% range, but I will caveat a little bit. And that is that we still don't have a great way of diagnosing it yet. So a lot of groups have created their own scales to try to figure out this issue. So we have created their own assessments to be like, here's how I am going to assess misophonia in my participants. But the downside of that is that we're all kind of leading to slightly different numbers in our own research. So until we have like a universal accepted way of assessing misophonia, we're going to get slightly different numbers throughout our research. So if somebody came to you and said, I think I have it, what would you do? How would you test them? What would be the things that they would have to go through to determine whether, you know, I'm just a little bit irritable. Or I really have this disorder. Yeah. So I, because there's not like a diagnostic tool per se and also a disclaimer, I'm not a clinical psychologist, so I don't have the training to diagnose myself. But what I'd be interested in is to know exactly what happens to your physiological reaction to your behavior. When you're hearing a sound you claim you don't like. So some people are like, man, I hate chewing. That person's super annoying. But then maybe if you measure their skin conductance, how much they're sweating when they hear chewing, it's just like a normal amount compared to other people. So I would like to know if you're hearing a sound that you claim you do not like or a sound that triggers you. I would like to know whether that actually gives you a body reaction. If that actually makes you need to leave the room. If that impairs things about your ability to pay attention or to study a paragraph and be able to, you know, recall information from it, things like that. So I test more of the cognitive effects of misophonia to figure out if it's actually causing you impairment. Instead of just like, yeah, I think I have a kind of situation. What kinds of sounds typically trigger misophonic responses? And is there something that these sounds have in common or do they vary from person to person? This is the million dollar question. This is what started my research program. So commonly, if you, you know, Google misophonia, you'll see that misophonia is an aversion to chewing, to breathing, to sniffling, to sounds that are typically from the mouth of the nose. So some researchers really early on were like, maybe this is like a health discussed kind of reaction. Maybe people with misophonia have that normal aversion to sniffling means, you know, sickness. I don't want to get sick. I don't want to be near someone who is, you know, spittles coming out of their mouth as they're chewing. So maybe it's that kind of, maybe that's the disorder. Maybe that's the feeling. But I, so myself, I have misophonia and I knew that I am bothered by more than just chewing sounds. I'm bothered by things like a clock ticking or water dripping or typing or a pen clicking or the list goes on. But my experience of it is more than just mouth or nose. And I was like, the idea of it being a health discussed thing doesn't quite track why I would hate the sound of typing or mouse clicking, for instance. So I came on the scene as a graduate student and I was like, I want to experimentally test. Am I abnormal or is this a universal experience? And others do have triggers that are not just mouth or nose. So one of my first studies I did is I tested a variety of different sounds. So I started with mouth or nose sounds produced by a human. So I did, I gave participants clips of sounds like the chewing, the breathing, et cetera. And I contrasted that in two ways. One, I contrasted that with sounds also produced by a human being, but not from the mouth or nose. So these are things like tapping your fingers or typing or kicking your feet, walking, those types of things. And I did that because I wanted to remove that sort of health, discussed sort of component. But I wanted to keep a person in the picture because one another theory with misophonia is maybe it's a man, that person is so rude. I need someone to blame for a sound. And so I wanted to keep a person that you could blame, for instance. But then I contrasted those two with a category that didn't have any humans in it all. So this is either animals, which a lot of people will report like they're so cute. They can't help it if they're eating like that, for instance. And so animals were important to me, but also the nature sounds. So like a wind chime or water dripping or things that kind of naturally occurring that you can't really blame someone on. And I wanted to know if misophonia is just an oral or nasal sort of human produced condition, if it's this discussed health sort of response, then I should only see differences between someone with misophonia and someone who doesn't have misophonia for that first condition, the condition that has that, you know, mouth, nose kind of category. But in my results, I found that all three of those showed a significant difference between people with misophonia and controls. And so it signaled to me that misophonia is more than just a condition to chewing an aversion to chewing or breathing. It is the most common by all means, but it's not exclusive. And so some of my more recent research has really taken advantage of that and noticed that people have wide array of differences in what they're bothered by. And so as I tried to make an experiment that puts like here is my category of trigger sounds and I'm trying to make it as broad as possible. I'm realizing that my participants with misophonia aren't equally bothered by all of those sounds. And so I've started to kind of employ more of a data driven approach, if you will, where I say, all right, y'all here are all my sounds that I have, you tell me what you're most bothered by, and then I'll use those in my experiment, for instance. And so I'm finding it is it is a different, a difficult disorder to try to study in that way. But there are definitely individual differences in how many sounds, the types of sounds, all of that type of thing. And so the other part of your question real quick was like if there's any commonality between them. And at least in my own work, I have not found anything on like the acoustic scale. So things like frequency and whatnot are often different. They tend to come from sort of a repetitive nature or things like, you know, the chewing that the water dripping where there's a repetitive drip. But it the jury is out on whether that repetition is more bothersome if it's predictable and and the same between each instance, or whether it's unpredictable. So there's still so much to go on as far as whether it's the sound that's important or the interpretation of the sound. There's a lot that's going on. Wow. Now you've done neuro imaging research on misophonia. What's happening in the brain when somebody hears a triggering sound and that person has misophonia? Yeah. And I'll start this by saying first, a lot of the work I've done have has looked at general connections in the brain rather than activation of what's happening. So I'm going to share with you some results that have come from a few other labs that have addressed that question more specifically. So, for instance, if someone is lying in an MRI scanner, and they're listening to a sound that they don't like a triggering sound, researchers have shown that there's an area of the brain is called the insula. It's an area that's kind of beneath your temporal cortex and it does a lot of higher level cognitive functions. So it'll do things like helping you pay attention and ignore things that are irrelevant. It'll help you regulate your emotions. It also processes some disgust. It does a lot of different things. And so researchers have found that this particular region, specifically the anterior insula portion of it, is really active in people with misophonia when they hear a triggering sound. More so than when controls hear this triggering sound or more so when you're hearing just generally aversive voices. So there's something particular about this insula. So I swooped into it and I was like, I wonder what's going on in the brain with connectivity from this insula. And so I do this partially because neuroimaging is expensive. Not everyone has access to being able to scan participants on their own. So I've kind of taken advantage of some open access databases and things where I can look at neuroimaging through data that already exists. So one of the things I'll do is I gave participants assessment scales of misophonia and I looked at what's going on in their brain even when they're not listening to sounds. What we call that at rest. When they're just at rest, how is their brain connected? And it turns out that folks with misophonia, higher misophonia, tend to have more connections from that insula to some key regions. So things for instance like higher level auditory cortex, the part of the brain that is processing what these sounds are, the complex nature of its noises is more connected to this insula. That is telling you that this is an emotional thing and I need to either pay attention to it or not. I've also found just general insulas connected to things in the motor cortex, which is another group has similarly found and it's kind of a baffling, wondering if people are mimicking the sound they're not liking as a potential coping mechanism or whether there's more in the motor cortex that might be leading to why people are having reactions to these particular sounds. Because they're not all sounds that involve human movement, so I'm kind of baffled myself. There are more things that I'm exploring with them. Is there a connection between misophonia and other mental health conditions? I'm thinking for example anxiety disorders, obsessive compulsive disorder, or even some way autism spectrum disorder for example. The short answer is there's a lot of co-occurrence between those. A lot of folks who have misophonia will similarly express things like anxiety. They'll be like, yes, I also experience or I've also been diagnosed with anxiety for instance. Originally a lot of the researchers who studied misophonia were researchers in the OCD field. Some folks were like, maybe misophonia is under the umbrella of OCD. Maybe that's kind of where it best fits. But I think the short answer is different groups have sort of probed that question, being like is there co-morbidity? Is there any co-occurrence between folks who have misophonia and any of these other conditions? And what they have found is that while there is some overlap in some people, there is not one universal condition that it best relates to. So misophonia is not characteristic of one particular thing. And so it's kind of been argued in the field that misophonia should be its own distinct disorder. It doesn't best fit under any of these other ones. And it's really fascinating to you mentioning autism at the end. And that's something that's recently been getting some research because there are a lot of similarities with folks with autism experienced in that sort of sensory difficulty. Maybe things like sounds might be bothersome to them or they might not notice them as much. Or there's a lot of kind of sensory difficulty that might overlap misophonia. And some researchers are looking into that specifically to note if it's a similar mechanism, if it's a different thing that's going on. And so I think there's a lot of future research that will be really cool to tease that apart. But as of now, we can't confidently say that it's most similar to one of these things. You've also looked at how these sounds affect people's cognitive and social judgments. So what have you found in your research? Yeah, it's a lot of interesting things. So I've studied cognitive and social judgments partially because I get a lot of self-report from folks that are like anecdotally, man, that version is so rude. That person is a caveman in the way they chew, like giving me judgments about a person just anecdotally. And so I was like, I wonder if this is a universal thing. And so I put this to the test. And so I designed an experiment where I had participants study faces of people paired with sounds in the environment. So I said, all right, pretend this person is making this sound, for instance. And I give them a variety of sounds, triggers, non-triggers, et cetera. And ask them to do a variety of things. I ask them, you know, follow up to tell me if they had seen that face before on a memory task that they weren't aware of. So I'm inadvertently getting measures of their memory, their reaction time performance. I have a variety of different metrics in this study. But the key thing that I find interesting in it is that when folks are able to correctly remember what sound was paired with a face they saw. So if I showed you, for instance, a person's face and it was paired with the sound of chewing, and you don't like chewing, chewing is one of your trigger sounds, and you remembered that that face was paired with chewing when you first saw it, you do significantly rate that person as less likable when you're shown them again later. Only if you have misophonia, though. So that is not a universal experience, which I find very fascinating, that only folks with misophonia apply that social judgment to folks. And so it is kind of permeating our experiences with people, which I think is also another interesting facet to explore further. We're going to take a short break. When we return, we'll talk about a related condition called misokinesia, a reaction to other people's movements and about the effects that misophonia can have on people's work, relationships, and daily lives. Now, as I was researching this podcast, I read about a condition called misokinesia, which is a reaction to other people's movements rather than sounds. Is this an active area of research as well, and is it as common as misophonia? Also a recently active area, for sure. So there's kind of a couple camps of ideas there, because again, there's so little work on it that I don't think we confidently know for sure. So some groups think that misokinesia is kind of under the umbrella of misophonia. It's this aversion to certain repetitive sights or sounds, any sort of environmental thing that most people don't respond to. So maybe that's from misokinesia, maybe that's something like someone shaking or swinging their leg, for instance. And that doesn't have a sound associated with it necessarily. But maybe that repetitive kind of sight similarly hits the same negative emotional response that sound that is repetitive in that nature. So some folks think it might share a similar mechanism, even though it's a different sensory vision versus sound. A lot of folks too acknowledge that misophonia does include some visual input. So as defined recently, there is a 2022 consensus definition of misophonia, and it specifically acknowledges misophonia as an aversion to sounds or sights associated with those sounds. And so it's a little bit bizarre, but something for instance, I keep using chewing as my example just because it's easiest. But if you don't like the sound of someone chewing, even if that sound is taken away, so for instance, what if you're looking through a restaurant window where you can't hear chewing, but you can still see that person's jaw move, like you can see that repetitive movement associated with chewing, that will similarly trigger that same sort of reaction. And so it's an idea that misophonia does kind of involve some visual component as well. And so misokinesia might be tapping into similar things. It might be a little bit different because there's no sound included. So things like auditory cortex doesn't really apply as much. And so I've only seen some recent articles in the last few years studying misokinesia or any overlap. It seems that there are folks with misokinesia that also experience misophonia and vice versa. But again, in most of our research, not a one-to-one correspondence. So it doesn't seem to be like everyone who has condition A has condition B. Let's change gears for a minute and talk about the impact that misophonia can have on people's lives. What do you hear from people about how misophonia affects their relationships, their work, their daily functioning? And since you also have it, how has it affected you? Yeah, so in a variety of ways. And everyone experiences it kind of different to different extremes. One, if you're ever curious, if anyone needs to justify that misophonia is real, I encourage them to go online to like a Reddit and just read the posts of people with misophonia being like, help me, I need to leave this environment. How do I deal with my boss? My partner is making all these noises. There's just like various venting kind of mechanisms to get a sense of how much this actually interferes. But I think it does tend to anecdotally, I hear people talk about, man, yeah, I can't, I had to leave my partner. My partner made chewing noises that I couldn't deal with. And I talked to him about it and it just, it was not a thing that could change. And so that's, I can't do that. Can't do that for me. Maybe that's a I work in an office job and I sit in an open space cubicle where everyone's typing around me. And I'm wearing, you know, headphones, but they don't block it out completely. I literally can't be in this job. I can't do my job effectively if I'm sitting in this environment. And so ironically, the work from home system that that era was good for a lot of folks with misophonia because it took them out of that space. So it's folks looking for different jobs that are more compatible. It definitely affects academic functioning as well. That's something that I experienced growing up and that's something that a lot of advocates are working towards. It's like accommodations for students with misophonia, because if you've ever been, you know, in a silent testing room as you're all seniors taking that, you know, SAT test or whatever, and people are scribbling with their pencil on the paper or maybe they're clicking their ballpoint pen or whatever it looks like. It is so distracting that folks with misophonia will literally disengage and not be able to focus on what they're doing. And so it's one of those where now, at least, you know, as a college professor, I'm seeing folks with accommodations that say, all right, this student is going to take their test in a separate quiet sound booth. This person is going to not have any auditory distraction when they take their test. And so it's at least getting a little more recognition as far as that is concerned. And it's at least something that is interfering with many aspects of life, whether it be that relationship, the work, the school, etc. Other than separating students, let's say, as they're taking tests so that they don't have to hear the triggering sounds, what are some other options or treatments that are available for people who have misophonia? And what is the research show about what really works? So a lot of researchers looked into this in sort of kind of case studies or smaller sample sizes to be like, all right, is there a treatment that it seems to be effective? And so different clinical psychologists have done things like cognitive behavioral therapy or CBT that helps people to kind of reframe their cognitive interpretation of the sound. So I've mentioned a few times, you know, people think this person is super rude in the way that they're chewing. But maybe if you try to convince your brain, man, this person is just they just got jaw surgery and they have to chew that way. Like that's not their fault. Like they just need to. That's the way that they have to consume food right now. Like if you help to rephrase the way that you are thinking about the sound, you might reduce your emotional response to it. So there is some help that seems to occur if you go to a psychiatrist who can help you with CBT kind of practices. One of my favorite though coping skills that I am really excited about as someone who research is kind of the sensation or perception of these sounds. There is a study down at UC Santa Cruz showing that a visual representation of like a scene can alter how you hear the underlying sound. So there's a common phenomenon called the McGurk effect, which is the idea that if you have visual and auditory input, your visual input kind of tends to win over a little bit in what you're interpreting. So to give you a concrete example, the researchers have shown that if you're for instance, seeing a video of someone slurping through a straw, their cup, and you're hearing that slurping sound, you're going to, with me, Syponia, you're going to find that really aversive. You're seeing a visual of a trigger you don't like and you're hearing a trigger you don't like. However, if you pair that same exact sound, that slurping sound, but instead of a person slurping through a straw, if you show them for instance, like a babbling brook, like a nice calming kind of sound. But line it up so it looks like it could potentially be producing the sound you're hearing, you actually have a reduced response to it. So it's an interesting phenomenon to demonstrate that it's not just pure acoustics that bothersome to you, because otherwise you would respond the same to the same acoustic information. It's demonstrating that how you feel, what you think the sound is, how you identify it, where you think it's coming from, your associations with that sound that are actually controlling how much you react to it. So it's a fun kind of insight that could lead to some therapeutic approaches if maybe you convince yourselves, either with a visual image or in your mind, that that sound is coming from a different source than it actually is, could reduce your response. I want to ask about something that's different, but possibly related. It's called ASMR or Autonomous Sensory Meridian Response. There's a lot about this on the internet and I've heard it described almost as the opposite of misophonia. It's a pleasant sensory response to certain sounds or visual stimuli like a brain tingle. Do you think these two situations are related and could studying one tell us something important about the other? Also a hot button question and one that I think very genuinely could be a related thing. I've similarly heard that, you know, they're opposite ends of the same spectrum. And as you might notice with different sounds that lead to ASMR, a lot of them overlap the sounds that are bothersome to someone with misophonia. So one of my classic ways I love to introduce presentations when I give a talk on misophonia is I show an ASMR video from YouTube. So you'll find tons of them of folks, for instance, eating into their microphone and making all of those chewing noises. And I will play that video, mind you, with my ears plugged because it's a verset to me. But I'll pull my audience and I'll be like, how many of you guys enjoyed that or found that, you know, tingling. And without fail, no matter what group I'm in, a good fifth of them at least will raise their hand and be like, yeah, that was great. You could keep playing that. And it's a really cool demonstration to be like this exact sound that I had to plug my ears to is one that you enjoy. And so it's fascinating to me to know why that same sound might lead to completely opposite reactions in different people. And it's one that, again, all of these conditions we've talked about today, whether it was a misophonia, ASMR, misoconisia are so new in what their names are that they haven't gotten a ton of quality research behind them to be able to fully disentangle, you know, how much should they overlap? Why do they share these common patterns, for instance? So I think you'll see more work on that moving forward. There's been some survey responses, folks with misophonia report also having ASMR to different sounds, and it's interesting that they would experience the same reaction, but obviously not to the same stimulus. But again, not a one to one kind of correspondence. So stay tuned for more research on that. I'm curious to know if that is something that turns out to be an effective comparison group. Well, given that this is all fairly recent in terms of scientific research, do we know when misophonia typically develops in people? Are they born with it? Does it emerge at a certain age? Is there any genetic link? Yeah, this is something I'd love to dig more into. So most of what we know here is a little bit anecdotal. So when surveys have asked people with misophonia, when do you kind of remember the onset occurring? Most people, this seems to be a pretty common response that early adolescence is when people first start to experience this. So you'll often see in like the 10 to 12 year old range of when people will express their onset of misophonia. And there's some fascinating, maybe social reasons for this. You're starting to go through puberty, you're starting to maybe go through the I hate my parents stage or like I am annoyed at being here. And one thing that I find particularly interesting about misophonia is it does seem to affect the people who are closest to you the most people making sounds that are like your family members are going to bother you more than strangers making that same sound. And so it is one thing where for instance, if you're a 12 year old and you're stuck in your parents house, you can't move out your in an environment where you can't control it. And now that sound from your parents or your siblings is going to really irritate you more than for instance someone who's an adult who can be like I have the ability to leave this apartment I am in for instance. Or if you're able to remove yourself from the situation and have more control, it the sound is a little bit easier. So there's like maybe some speculation to why onset in early adolescence might be interesting. But as far as I'm aware there haven't been really any longitudinal studies or studies across time where they've been able to say, All right, I am looking at a brain scan or survey from a child, you know, pre 10 to 12 to know whether or not in which children it tends to develop. I would love to do a study where I look at younger kids, and I get surveys of anxiety or depression or autism or whatever it looks like. Maybe we do brain scans, for instance, and I invite them back every couple years to be like, All right, can I predict which of you will end up experiencing this misophonia condition. And so using some of your earlier symptoms if we can predict it ahead of time, then likely we can be able to reduce the effects of it. And so that's something that I think future research will definitely dig into when there's more funding to be able to do those types of long studies. The other thing that you asked about was genetics and I think that's an interesting concept to because a lot of folks with misophonia will report like oh yeah my dad also has it, or like my aunt expresses this too. And so, again, you can take that a couple different ways. Maybe there is a nature component, there's something in your genes that is leading to this feeling, or it could be that you were raised in a house where people were really sensitive to noises and so you started to attune yourself and also be sensitive to noises. So it could be a nurture on an environmental factor as well, as with all things in psychology. More research is needed to fully tease those apart, but I think that they're interesting avenues to go down, that there very well could be a genetic component, there could be an environmental component. Man, a twin study would be awesome to be able to test and to use these apart. If I hypothetically could find twins raised in different areas where one of them had misophonia, one of them didn't, that is ideal research study. For our listeners who might be living or working with people who have misophonia, what can they do to be supportive and help the people around them? Yeah, I love this. My biggest advice is just to communicate. So like for instance, I have a very loving partner who is able, I'm able to say like hey, I'm feeling this emotion right now or I'm having trouble with this sound. And it's like great, we're going to turn on some music, we're going to, I'm going to stop eating this food, I am going to move to a different location. Like a very open communication is one of the best things you can do in a non-judgmental way. Because if someone with misophonia feels like they can't speak up or that they have to kind of suffer in silence, it's going to be a lot worse for them. And so I think if you are around someone with misophonia, I think both asking them like what kind of things bother you just so I know that I'm not doing it. If someone's bothered by eating chips, don't pull out a bag of chips in front of them, just like some obvious stuff like that. But I think in general, asking, talking to them, validating that it's a thing that they're actually experiencing and not just them being moody and not wanting to be around people or something. Like talking it up to validating that it's a thing, they're a real thing. I think it's super helpful. You talked a little bit about things that you would like to study, but just to wrap up, do you have any ongoing studies right now? What are you looking at? Yeah, so right now since I'm super new, we're going a little basic. So one of the things I'm currently looking at is expanding the types of sounds that are bothersome to people with misophonia in a sound bank. So one of the things with research is it's helpful to present sounds, but as I've said, everyone's bothered by different sounds. So one of the things I've got a group of students doing is aggregating a variety of sounds from different sources, multiple examples of all those sounds. So I could get a better idea and better use it in experiments to get a sense of why certain sounds are bothersome, why people like certain sounds and not others. So right now I'm just expanding sound banks that can be used in future research, but more things on the horizon. Well, Dr. Hansen, this has been really interesting. I want to thank you for joining me today. Yeah, thank you so much for having me. It's been fun. You can find previous episodes of Speaking of Psychology on our website at Speakingofpsychology.org, or on Apple, YouTube, Spotify, or wherever you get your podcasts. And if you like what you've heard, please follow us and leave a review. If you have comments or ideas for future episodes, you can email us at Speakingofpsychology.org. Speaking of Psychology is produced by Lee Weinerman. Thank you for listening for the American Psychological Association. I'm Kim Mills. Thank you.