Your Triggers, Your Remedies

misophonia no right cure

What works for you to get relief from a headache? Some people take Tylenol, others insist on Advil or Aleve, while some swear by Goody’s or BC Powder. Deep breathing, exercise, darkness, and even orgasm have been used amongst the myriad approaches to relieving this common, millennia old problem.

What about getting rid of the hiccups? Holding your breath, being scared, pinching your nose while gargling with salt water, eating a spoonful of sugar, and laughing loudly are just a handful of options that can work. (I even have a friend that insists on being punched – hard – square in the gut.) There are literally hundreds of home remedies and a few medical procedures purported to deal with this diaphragmatic annoyance.

 

You have your way. I have my way. As for the right way, the correct way, and the only way, it does not exist.— Friedrich Nietzsche

Perhaps as you read the previous few sentences, you thought of your own methods for managing headaches and hiccups. Maybe you’ve settled on one specific approach that works for you; or perhaps what works for you varies across place and time. Or you’ve realized that someone else’s method simply doesn’t work for you, and others think you’re crazy for getting punched in the abdomen. The bottom line is, the world don’t move to the beat of just one drum; what might be right for you, may not be right for some. (Wait…isn’t that the theme from “Diff’rent Strokes”? Nevertheless, the point is valid – there’s more than one way to deal with a problem.)

Hiccups and headaches have been a part of human experience and medical knowledge for thousands of years, and are mostly well understood issues. Even with this sound knowledge base, there are countless “treatments” that may or may not be helpful. And Misophonia? Ooof. That’s a new kid on the block, and we don’t know him very well yet, nor do we have many good ideas as to how effectively deal with this little jerk exasperating kid.

Just because there aren’t scientifically validated methods to prevent, treat, or cure it yet, there are indeed ways that people manage their Misophonia. So, how do people deal with their triggers? Think of all of the different approaches that you’ve come across – apps, hypnosis, exposure, avoidance, headphones, competing thoughts, distraction, herbs, meds, etc. There are a lot of possible strategies, and some of them may sound really kooky to you. But you know what? Some people HAVE been successful with these approaches for auditory aggravations. But, I’d be willing to bet that more people have failed with those tactics than have succeeded. So far, the literature indicates that none of these options consistently work.

In an ideal world, we’d have one cure or treatment for each disorder. But we live in the real world. We are each unique individuals with specific strengths, weaknesses, skills, resources, situations, goals, and biology – that define who we are, and therefore how we will respond to various methods of dealing with life’s problems. Since we’re all different entities, there’s no right or wrong way that applies to each of us, yet we can get discouraged when our attempts to cope fail, especially if others have found success with our chosen plans. Our self-esteem – and even our very sanity – can take a hit when we try really hard at something and aren’t successful. People with Misophonia are frustrated while grasping at straws, desperate to find anything that can provide some relief, to restore any semblance of control over their lives.

Here’s an example of a common straw that Misophonics are sometimes told to grasp at – exposure therapy. This type of intervention basically introduces a trigger to the person, and tries to teach him or her to better cope with being exposed. Now, exposure therapy is a gold standard for dealing with anxiety and phobias, and I’ve used variations of it with many clients in the past. For many different reasons, it works well for some, not at all for others. As applied to Misophonics, I’m certain that some folks have indeed found improvement with exposure-based interventions. However, I can tell you unequivocally that there’s no way in H-E-Double-Hockey-Sticks that this would ever work for me and my (admittedly quite mild) Misophonia. What if I was engaged in a gradual exposure intervention in which I must endure my primary trigger noise – crunching cereal? Here’s what would happen: I’d have more time for the anxiety and anger to build, sitting there powerless, and I’d begin to think about implementing payback options that I could take towards the person making those sounds. (Can you actually stab someone with a spoon? How many inches of milk need to be in the bowl before you can drown your friend in it?) Once I hear the noise, I HAVE to leave; there is no way I can tolerate being around it without temporarily sacrificing my sanity and relationship with the offending person. Even if this exposure was done disconnected from another human being via a neutral app or headphones, my emotions would still get out of whack. Television commercials demonstrate this exposure effect on many of us – you know the products you’ll never buy again because their commercials involve your trigger sounds? It’s because those emotions have to be directed outward somewhere. (I’m looking at you Nature Valley Granola Bars.) Oh, and as a reminder – I am a proponent of exposure therapy, as I have used it professionally and personally countless times in my life. I’ve tried it informally at home for cereal crunching, and there’s not even a remote chance that it would work for me with this issue.

However, that’s me. For you? Perhaps exposure therapy sounds like something you’d be willing to give a go. And that’s another huge piece of the puzzle when it comes to dealing with any sort of problem – what are you willing to do to deal with it? If you’re reading this article, you’ve no doubt found some level of difficulty dealing with some sort of external stimuli that you find – at minimum – annoying. You’ve also no doubt read all sorts of approaches on support forums, news articles, web searches, etc., so you have a decent variety of options to investigate further. Gather them all up, examine them fully, and think about how they might apply to your unique situation. Which of the pathways make the most sense to you, for you? Additionally, one of the ways we learn is through trial and error. Think about coping changes you’ve tried to make in the past (lose weight, quit smoking etc.); did you get it right on the first try? Of course not! It takes time to find what works. Dealing with Misophonia remedies will be no different, especially at this infancy period of our understanding. Expect – and accept – that some of the approaches simply will not work for you. It may be because they don’t fit you well as a person, or it may be that the approach is total garbage, and may do more harm than good. (But that’s another article for another day.)

Another important question is what are you NOT willing to do? After you have gathered up a list of options, there are likely some that you can immediately cross right off the list. In my case, my sound triggers are usually avoidable and infrequently occurring; therefore, I’m not willing to walk around with headphones on all day to drown out the outside world. It’s just not necessary in my case. But it may be for you – pick and choose what you are willing to try – or not try!

As our understanding of Misophonia moves forward, hopefully we’ll gain a more universally accepted definition of what it is (and isn’t). From there, more effective treatment options can be developed. Until then – unfortunately – most Misophonics are on their own. There are indeed a variety of snake oil claims out there – but since we’re grasping at straws here – if the snake oil sounds like something that’s worth a shot, I say go for it – if the risk of harm is low. Still other approaches might be genuinely ineffective or neutral, but they can be useful due to the placebo effect – if we think something will work, often it will. We just don’t have enough of a solid evidence base yet to discard – or include – anything as a universally valid or invalid remedy.

Just like a brand-spanking new migraine pill hitting the market, even if a wonderful new treatment for Misophonia arrives on the scene, it doesn’t mean it will work for everyone. Besides, that approach could be decades away, so it’s on you to find a better way to manage your life today and tomorrow. It’s not fair, but that’s the real world in which you live. So to the sufferers of the capital M-i-s-o, keep reading, keep learning, keep experimenting, keep networking. Use your supports, find what can bring you some level of relief, and in those dark days, remember that there’s a light out there somewhere. Don’t give up – you just have to find your light.

Chris Owens MA, LPC
Chris Owens, MA, LPC is currently a faculty member for Drexel University’s Department of Psychiatry, Division of Behavioral Healthcare Education in Philadelphia, PA. His primary duties involve developing and delivering continuing education workshops to other mental health professionals throughout Pennsylvania. Chris also has twenty years of experience as an educator, practitioner, supervisor, or director in the behavioral healthcare field in various settings, including family therapy, substance use treatment, and health education. He is also the author of an upcoming, creative weight loss book, “I LOVE HOT WINGS! Lose Weight, Your Way.”