Dr. Porges suggests that when we hear high-pitch sounds we become on alert, this could contribute to the brain’s defense system and be what causes misophonia. When Dr. Stephen Porges talks about misophonia and the state of fight/flight and immobilization he notes, “The irony of all this is that the anticipation of all this may be much worse than actually re-experiencing it”. Because of this, the calmness of misophonia sufferers isn’t necessarily enough to help misophonia.
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With it, the body becomes vulnerable. In his work, Dr. Porges has studied why some sounds cause harm and why other sounds are pleasing.
“It amazes me how we talk to each other, and how intuitively correct we are when we talk to our pets”.
Dr. Porges explains that our nervous system has embedded triggers that promote safety. Composers such as mozart started with lullabies, and once the they are comfortable with the noise, the expansion of pitch becomes less abrasive to listeners. Dr. Porges explains that humans have developed our voices to communicate distress with other mammals, and offers singing as a reassuring behaviour that can be calming, especially through ‘lullaby’. Sharon, a suffer of misophonia, recently wrote a piece on how singing helps her cope with misophonia.
While singing has been intuitively used throughout human history to calm, he asserts there is neurophysiology working behind the scenes that accounts for this phenomenon. This idea also includes listening to music. Music, or calming sounds help increase the vagal influence, and is calming for persons.
The polyvagal theory suggests that sounds that trigger misophonia are “uniquely different than music and different than other biological sounds”, they are also different than “most bodily sounds”. Dr. Porges, in his work, is revere-engineering sounds that are displeasing to misophonia sufferers. By creating a disruptive sound, they will be able to understand it more.
While the polyvagal theory is still a theory, it offers interesting discussion for misophonia causes.
Dr. Brout, who has been on the forefront of auditory over-responsivity research for 20 years and has the disorder, notes, “We’re not talking about different sounds. Most people are complaining about similar sounds, and the same sounds”.
Through acoustic anaylsis, Dr. Porges can isolate sounds that bother misophonia and reconstruct the sounds and find the core disruptive signal, in order to understand the misophonic reaction.
“I think misophonia may be very very specific. Very specific sounds that the body reacts to when you’re in a certain state… If you are in a very calm psychological state, then certain sounds will literally be bouncing off your ear drums and not penetrating”.
With this theory, either repetition or the anxiety of a sound causes an upsetting state for misophonic individuals.
Because the nervous system treats ‘triggers’ with ‘high valence’ they have become important.Once sounds have been interpreted as noxious, they can no longer be “background noises”. Through this model, the polyvagal theory sheds understanding on the capability of misophonics to “learn new triggers”.
“We tend to think we are safe when there is no threat, but our nervous system may not be safe when there is no threat.”
According to Dr. Porges, for misophonia intervention, the physiological state must be shifted. Lowering arousal is not enough, you must also retain a feeling of safety. It is both the psychological state, and the emotional connection. Safety allows us to remain calm and regulate our emotional response, however, this is not possible in a ‘chronic fight/flight state’. We may appear calm in a fight/flight state, but that does not mean that we are not defensive. Sufferers of misophonia are living in a constant state of fear. Even when we seem calm, our nervous systems, like a computer with a stuck “shift” key, is essentially screaming, just like the ever-dreaded ALL CAPS.
“The nervous system is very smart, but when it gets stuck in certain states it is smart for that state of defending but the ability to engage and to calm and to calm another is really off the table. The system can’t do it.”
Dr. Porges goes on to say that this state is not only disruptive for fight flight, but it disrupts over-all health. When we’re safe, our body is ready to ‘optimize our health’. We feel tired all the time, get sick more, and we are “not being rejuvenated through our interactions with others, instead they are being exhausted by it”. Living in a state of fear, particularly in a desocialized world, is beyond anger or anxiety, it physically hurts. Dr. Porges suggests that kindness to others, and “learning to be generous and welcoming” can be great for our neurological health. He goes on to suggest that, “even if there are enough resources, even just to think that there aren’t is enough to make people defensive”.
Interestingly, like Occupational Therapists have in the past focused on, Dr. Porges believes that even play can have a positive impact on our neurological state of defensiveness. Susan Nesbit, OT, discusses play and its use of regulation by occupational therapists, particularly with a sensory diet.
Dr. Porges concludes that many people, even outside the extremities of misophonia, will probably be on a spectrum with cues from the defensive state. He believes there is sensitivity among many persons that have yet to acknowledge their condition. This number, in his view is close to 20% of the population, that are explaining away the condition from other factors.
What is The Polyvagal Theory?
In contrast to this empirical approach, the Polyvagal Theory makes predictions based on acoustic properties, and a reaction that causes misophonia. The Polyvagal Theory proposes that subjective responses to sounds are initially (before associative learning) based on two features of the acoustic signal: pitch and variation in pitch. The theory articulates that for mammals there is a frequency band of perceptual advantage in which social communication occurs. It is within this frequency band that acoustic “safety” cues are conveyed.
Consistent with the theory, safety is signaled when the pitch of the acoustic signal is modulated within this band. Thus, a monotone within this band is not sufficient to signal safety. Moreover, the theory proposes that low frequency monotone sounds (e.g., dog’s bark, lion’s roar, large truck, and thunder) are inherent signals of predator and high frequency monotone sounds are inherent signals of pain and danger (e.g., shrill cries of babies or someone who is being injured).
Dr. Porges is currently a Distinguished University Scientist at Indiana University Bloomington and Professor of Psychiatry at the University of North Carolina at Chapel Hill.