Getting Through Thanksgiving with Misophonia

This post is written for people with misophonia, a condition in which a person has an automatic, sometimes intensely unpleasant internal reaction to specific sounds.  Sounds that lead to this reaction are typically sounds from everyday life, such as others’ chewing food/gum, sniffling, or heavy breathing. For people with misophonia who struggle with eating-related sounds, holidays such as Thanksgiving can be a real challenge.  In addition to sit-down dinners, many people tend to “graze” between meals, so the chewing can be almost constant.  This can be really difficult. Many people with misophonia cope with the distress of being triggered by the sound of eating by leaving the situation or avoiding eating with others entirely. However, during the holidays this means that we are isolated from gatherings of friends and family that are commonplace.

In light of this, I thought I’d share a few “tips” on surviving the upcoming holiday season when living with misophonia:

Things do to before you spend time with family:

  • Identify your values. Make a list of the family members with which you are most likely to see and/or those that you’ve been triggered by in the past.  Think about what is important to you about how you treat each person and write a sentence next to each name for how you’d like to act toward them. For instance, as a person with misophonia, my step-dad tends to trigger me when we share a meal together.  I know that what is important to me is treating him with respect, understanding, and kindness; when I do this I am being the daughter that I want to be.  It’s helpful to know that ahead of time so that when I feel triggered by him, I can consider how I want to respond rather than making angry comments. Remembering my value of being understanding allows me to respond in a way that is more accepting and gentle rather than judging him or assuming that he doesn’t care.
  • Practice acceptance. It’s very likely you will be triggered. Some people with misophonia have pretty constant anticipatory anxiety, meaning that they are anxiously scanning the environment while waiting for a trigger to happen.  This anticipatory anxiety can mean that we suffer more – since we suffer in waiting for the trigger and once the trigger has occurred.  Rather than scanning the environment for trigger sounds, accept that you will be triggered and know that you have control over how you respond.  Practice being in the present moment, rather than off in a future that hasn’t happened yet. For example, if you notice yourself anticipating that someone will start chewing again, you might label it as a thought, and bring your attention to things that are happening in the present, such as the sound of people talking around you, the faint sounds of music in the background, or the smell of pies baking in the oven.
  • Be mindful. Practice mindful breathing as a means of centering and grounding yourself.  The wonderful secondary effect one can get from mindfulness in general is a sense of calm and relaxation.  Your breath is a powerful tool that you carry around with you each day; it only needs you to engage it to begin to affect change in the moment.  The more we practice being mindful, the more skilled we are at focusing our attention on that which we choose.
  • Retire the “manners police.” A colleague of mine talks about how people with misophonia can sometimes slip into being the “manners police”.  Generally, once we are triggered we have judgmental thoughts about the person making the noise (for example, “Do they have to eat like that?” or “Didn’t anybody teach you to chew with your mouth closed?”); sometimes we verbalize these thoughts and sometimes not.  However, buying into those thoughts reinforces the idea that we are right and the other is wrong rather than it being about preference or opinion.  What I find helpful is to reframe the judgment into a statement of facts and consequences (“My opinion is that others should chew with their mouths closed.  This person is not closing their mouth when they chew and as a result I feel disturbed.”)  This tends to help me focus on what I can do vs. what they should do.

Things to do while spending time with family:

  • Practice mindful breathing.  Expand your mindfulness to that which is happening around you.  Notice sounds, smells, tastes, sights, and that which you can touch.  The nice thing about the holidays is that there are usually many sights, sounds, and tastes to behold.
  • Take a break. If you notice being triggered consider stepping outside and mindfully noticing the environment around you.  See if you can just observe the different ways your senses are being stimulated.
  • Do something that does not involve eating. Engage in an activity that does not require eating or around which eating would be difficult (e.g., board games, charades, knitting, coloring, etc.) and invite others to join you.  If needed, retreat to a more quiet area to engage in the activity.
  • Shift your attention. Offer to help with something that requires attention and focus and allows you a temporary break from trigger noises (e.g., help out with washing dishes-provided clanking dishes is not a trigger, take the dog for a walk, help with cooking).  It can be helpful to pour our energy into an activity and being of service, for some, can elicit positive emotion.
  • Stimulate your parasympathetic nervous system. When feeling particularly triggered, take a moment to go to the bathroom and splash very cold water on your face and if possible, hold a cold compress (wet washcloth with cold water, ice pack or bag of peas from the freezer, for example) over your eyes for about 15-20 seconds.  This helps to activate the parasympathetic nervous system, which in turn, creates a sense of calm in the body.  The effect is increased by standing up and bending over (as you might do at a sink) and holding your breath.  If you are using a cold compress, try standing, bending over, and holding your breath for 15-20 seconds.  I know this sounds weird, but it works! The effect of this strategy only lasts a short time, so once you feel calmer, it may help to use some of the other strategies listed above.
  • Practice self-compassion. Last, but not least:  practice being self-compassionate, especially for any internal experiences, such as feelings of rage or anxiety and judgment thoughts about others.  These are highly uncomfortable and normal responses to trigger sounds.  Remember, while you don’t get to choose how you feel inside once triggered, you do get to choose how you respond.  And if you happen to react in a way that doesn’t sit well with you, it’s even more important to be kind to yourself.  At times, I still react poorly to being triggered, and that provides me an opportunity to be understanding and validating of myself.

Misophonia: what the heck is it and what’s a trigger?

Misophonia is a condition in which a person has an automatic, unpleasant internal reaction to specific sounds.  This reaction can vary from frustration to panic and even rage, and can be quite an intense experience for the sufferer.  Sounds that lead to this reaction are typically sounds from everyday life, such as others’ chewing food/gum, sniffling, or heavy breathing.  People with misophonia will often refer to “triggers”; a trigger, for someone with misophonia, refers to any sounds that produces the intense internal reaction.

Many people who have misophonia experience a lot of shame before they come to understand that this is a condition experienced by many others and that they are not alone in their struggles.  They can experience a lot of shame about both the intensity of the internal reaction and their response to those who have made a sound that is triggering.  I was one of those folks.

How I learned about my misophonia:

I learned about misophonia about 5 years ago.  I was talking with a colleague about my internal responses to certain noises and she noted that one of her clients had very similar experiences and told her that it was called misophonia.  I remember the first time I googled misophonia and found a video on YouTube, in which a man with misophonia was talking about his internal experiences of it.  After getting over the oddity of hearing this man talk about things I had never heard anyone else talk about, I began to feel so much more understood, by both myself and this larger community.  As I met others with misophonia, I discovered a community who could provide the sort of support that was difficult to garner from those who did not have misophonia.

Discovery and recovery:

Since discovering that I have misophonia, I have engaged with the misophonia community on a few different levels.  Given that I am a psychotherapist, I became interested in helping myself, and others with misophonia, learn to live with the condition and have relationships with others that thrive. I currently specialize in working with people with misophonia and am actively working on developing treatments that can help them to learn better ways to cope with the condition. I feel like being involved in the misophonia community and learning about the experiences of others has given me a lot of insight into the condition that I can share with others who are struggling. I feel grateful to have found this community and am thankful I get to pass on what I have learned to others.

Misophonia Treatment at Portland Psychotherapy