Instant Genius - Misophonia: Why some of us can’t bear the sound of chewing

Episode Date: June 20, 2024

It’s a scene many of us will have experienced: we’re at the cinema, the lights go down, the film begins and then suddenly the person behind us starts rustling a packet of sweets or noisily chomping on popcorn. For most of us this is merely an annoyance and after a while we’re able to tune the sounds out and concentrate on enjoying the cinematic experience. But for some, it can be unbearable and engender feelings of distress, anger and even panic. These people are experiencing misophonia. In this episode, we catch up with Dr Jane Gregory, a clinical psychologist and author of the book Sounds Like Misophonia: How to Stop Small Noises from Causing Extreme Reactions. She tells us what’s going on in our brains when we experience a misophonic reaction, how it can trigger our fight or flight response and why it’s surprisingly common. Learn more about your ad choices. Visit podcastchoices.com/adchoices

You said this place was steps from the water. We just haven't found the steps yet. How much did we save? Enough. Enough to get lost! Or you could book a stay with Hilton. Welcome to your oceanfront room. Just steps from the water.

The Hilton sale is on now. Book on Hilton.com or the Hilton app and save up to 20% to get the stay you expected. When you want savings, not surprises. It matters where you stay. Hilton, for the stay. No one goes to Hank's for his spreadsheets. They go for a darn good pizza.

Lately, though, the shop's been quiet. So Hank decides to bring back the $1 slice. He asks Copilot in Microsoft Excel to look at his sales and costs. To help him see if he can afford it. Co-pilot shows Hank where the money's going and which little extras make the dollar slice work. Now, Hanks has a line out the door. Hank makes the pizza.

Co-Pilot handles the spreadsheets. Learn more at M365Copilot.com slash work. This podcast is sponsored by name, audio and focal. Streaming has made music more accessible than ever, but true listening is about more than ease. It's about quality. British audio experts name audio, alongside French acoustic specialist focal,

combine handcrafted tradition with cutting-edge innovation and high-end materials, delivering digital precision with analogue warmth, so you can experience exceptional sound at home. Music just as the artist intended. Visit name. Hello and welcome to Instant Genius, a bite-sized masterclass in podcast form. Each week you'll hear world-leading scientists and experts talking about the most fascinating ideas in science and technology today.

I'm Jason Goodyear, commissioning editor, a BBC science focus. It's a scene many of us will have experienced. We're at the cinema, the lights go down, the film begins, and then suddenly, the person behind us starts rustling a packet of sweets or noisily chomping on popcorn. For most of us, this is merely an annoyance, and after a while we're able to tune out the sounds and concentrate on enjoying the cinematic experience. But for some, it can be unbearable, and engender feelings of distress, anger, and even panic. These people are experiencing misophonia. In this episode, I catch up with Dr. Jane Gregory, a clinical psychologist and author of the book

sounds like misophonia, how to stop small noises from causing extreme reactions. She tells us what's going on in our brains when we experience a misophonic reaction, how it can trigger our fight or flight response, and why it's surprisingly common. Dr Jane Gregory, welcome to the podcast. Thanks very much for joining us. Thanks for having me. So today we're talking about something called misophonia. So first off, maybe our listeners haven't heard of this.

So what exactly is it? Misophonia is an extreme or persistent reaction to repetitive everyday sounds. And this is not just being annoyed by sounds, but having an extreme reaction to sounds that other people might find mildly annoying or might not even notice. And yet you get stuck on them and have an intense reaction. So how long have we known about its existence sort of scientifically? scientifically not very long. It first appeared in scientific literature early 2000s, but most of the research has happened in the last two or three years. There's been more research published in the last two years than they had ever been published before on Misophonia. So it is very new, scientifically speaking. So this is your field of research. So it's quite interesting. But how did you get into it? I got into it when somebody sent me an article in the New York Times about misophonia with the caption,

This You, and I read it and realized that, yes, it was very much me. It perfectly captured what I had experienced most of my life, which was to get really angry or distressed when I couldn't get away from repetitive sounds. And for me, that was eating was a big one, repetitive sort of throat clearing or sniffing or coughing. I had some pigeons outside my window as a child that used to drive me mad when I was trying to sleep or relax or read. And everywhere I go, I feel like those pigeons have followed me. So when I hear pigeons anywhere, it feels like it is the same pigeons from childhood. And I'm transported back to that moment in my room of just not knowing why I was so upset by

something that no one else seemed bothered by. So having said that, I think a lot of people will relate to this who are listening. So do we know how common it is? We have some research that tells us that it is surprisingly common. And I think it's really good when we're talking about how common it is to sort of distinguish between what's being annoyed by a sound, what's misophonia and what's sort of what we'd call clinical levels of misophonia. So we did some research here in the UK, my colleague Celia Viteratu at King's College led this project where we asked the general population in the UK how they reacted to sounds and also to answer a questionnaire about misophonia. We found that 85% of people had a negative reaction to the sound of loud chewing.

So that's a really, really normal reaction to not like the sound of loud chewing. But we found that nearly one in five people had a more extreme reaction, which is where they felt trapped or helpless or really angry or panicked in response to those kinds of sounds. And so that was nearly one in five had that more extreme reaction. And there's just been a new study out of the US that found that around 4% of people have it at that more what we'd call clinical level where it causes distress on a day-to-day basis or really gets in the way of living your life how you want to live it. So it's surprisingly common that around 4% of people have it to an extreme level where it causes day-to-day problems for them, for something that most people have never heard of.

Yeah, so you mentioned eating noises there. I always find this funny when I read about misophonia because I used to live in Japan, and they have a culture there of ramen noodles, and the apparently correct way to eat them is to slurp them like people do when they're tasting wine. And whenever I read about this, I think that must be an absolute nightmare for people with misophonia. First of all, I was in a conference in South Korea last year and discovered the same cultural difference there. And so I was eating this really delicious food, but having to sit there listening to these sounds

that ordinarily I'd be highly judgmental from my own personal perspective, but you shouldn't eat like that. But looking around, I could see that this was clearly a really normal, culturally appropriate way to eat this delicious food. And I did pop my earplugs in, but there was something about, because of it. it was a culturally acceptable thing to do that it tempered my reaction a little bit. And one of the things that we've discovered from doing lots of work in different cultures is that even though the different types of sounds might cause different reactions,

the pattern of misophonia is really pretty consistent across cultures. There's these sort of five key areas that keep coming up in lots of different cultures, including so we've looked at Mandarin-speaking population in China, German, Polish, Portuguese, a Farsi-speaking population in Iran, and they still get this really similar sort of cluster of symptoms. Symptoms is not quite the right word, but experiences. And that includes this feeling of sort of being trapped or helpless in response to sounds. It includes not doing things that you would otherwise like to do because of the way you react to sounds and either having sort of verbal aggressive outbursts or being afraid that you might say something that you

regret, blaming yourself for the way that you act while also simultaneously blaming the other person for creating the sound. So those five sort of key areas keep coming up across cultures. So it's really interesting that even though the types of sounds might be different across cultures, the way that misophonia is experienced seems to be relatively consistent across cultures. So are there any other sounds that commonly trigger misophilia? There seems to be three main categories of sounds. So one is the very typical eating sounds, and that's usually the one that gets talked about when we talk about misophonia.

The other category is sort of nose and throat sounds. So that can include sniffing, clearing your throat, heavy breathing, which I know heavy breathing probably feels pretty creepy to anyone, but if you can audibly hear somebody breathing, just not being able to tune that out. And then the third category is more repetitive environmental sounds. So that can include typing, the sound of clocks ticking, rustling crisp packets, mobile phone sounds, so things on loudspeaker or just the notification sounds from mobile phones. And one of the things, there seems to be a little bit of a difference in terms of how we react to those different groups of sounds.

So while the eating sounds is more likely to get that really intense immediate, almost fight or flight kind of reaction, the environmental sounds, it can be more of like a slow build. So you might notice it and then think, oh, that's a bit annoying. And then your brain can't tune it out. And so it becomes more and more annoying because it stops you from doing what you want to do. So it's really interesting that the nature of the misophonia can be different depending on the types of sounds. Yeah. So it sounds like it can have a really big impact on people's lives.

So, for example, I really like going to the cinema. I find it incredibly annoying when people are eating crunchy food because I'm trying to concentrate on the movie. but it doesn't sort of shut off my enjoyment of the movie. So how different is it? How extreme can the reaction get? I think that's a really nice description of the difference between finding a sound annoying and having a misophonic reaction. So if you find it annoying, it's like, I don't like that.

It's not going to get in the way of enjoying the film or it's not going to stop me from being able to concentrate. Whereas for somebody with misophonia, they can't tune it out. They don't habituate to it. They don't get used to it. And so it's like they're hearing it for the first time every time they hear it. So it keeps being as annoying as the first time you hear it. I also love going to the cinema, but I will go on a Tuesday afternoon, middle of the day,

after the film's been out for a while so that I can be fairly confident I can sit in relative silence. And if I hear somebody eating loud foods, I'll probably move. Or if I hear somebody talk like that sort of hushed whispering gets really annoying, I can't tune that out either. I was literally nine months pregnant. It was the day I ended up going into labor at the cinema and there were two people talking at the back of the cinema and my ears just would not let it go. And so it's the only time I've confronted someone in the cinema. I waddled up with my giant pregnant belly and I just said, I can hear you from the front row and I usually sit at the front because there's usually no one there. Can you please stop talking?

And that was one of those examples where I just couldn't tune it out, even though they were talking really quietly, my ears just would not let it go. So having said that, do people who have these misophonic reactions, do they have any sort of personality traits in common? That's still very new in the research. So there's some research that suggests that maybe sort of perfectionist kind of traits might be associated with it. And also the way we process information, so people who maybe have a bit more attention to detail might be more predisposed to have misophonia. But that's still very, very new research, and there's so many different things that, like, there could be something that causes both of those things to exist rather than the sort of personality necessarily causing

the misophonia. But what we do know is that it's not just about the properties of the sounds. It's not just the sound itself, because there's been lots of really cool studies recently that they might play the sound, but put a video of something else that could be creating the same sound. So, for example, like someone's sort of smacking their lips as they eat and someone like splashing, in a muddy puddle. And so both of those things could create that audio. And people in this subpoena, when they see it paired with somebody eating, they're much more likely to have an intense reaction compared to if they think it is

somebody splashing in a puddle. And if we misidentify what the sound is, if we think it's someone sculpting in a puddle and it's actually somebody eating, we're also going to have a much less intense reaction. So there's something about knowing what the sound is, maybe knowing who's making it. So if it's what appears to be a fully functioning adult choosing to make this sound in a quiet train carriage, for example, we might get a much more intense reaction. But if we turn around and see that it's actually a little kid who hasn't quite learned the mechanics of eating yet, we're likely to have a much less intense reaction to that. So we know that the context of the sound is also extremely important. So having said that, is there any sort of crossover with people that have other sensitivities like to,

say you hear of these people that are called super-tasters that taste flavors very strongly, more strongly than the rest of us. Is there any sort of overlap between these types of things? I think it's similar in terms of its natural variation in the way that we hear in process sounds. But across the research, there doesn't seem to be any difference in how well somebody hears. It's not that people are detecting these sounds more effectively than people without dysophonia. But for some reason, they're not able to unhear them. So they don't tune them out.

They don't habituate to them. So it might be more about how long you hear the sound for rather than necessarily being able to hear better. Some people say that they do hear things that other people don't hear. And yet, when we do research on this, what we find is that when you ask somebody to listen out for a sound, there's no difference between people with and without misophonia. So it's probably more that people with misdiphania. their brain is just instinctively more attentive to sound.

So they're listening out for sounds in case there's a sound, and therefore they're more likely to hear it, but it's not that their hearing is necessarily better. So you mentioned there this idea of attention, and we've said it's relatively common. So is there any sort of evolutionary reason that it exists? It's all very theoretical at this stage. I personally have been doing a lot of reading about meerkats,

and there was something when I was watching the meerkats at the zoo, and I thought, just seeing those little meerkats at the top of the hill whose job it is to look out for danger while the other meerkats get on with their business, I immediately connected with that experience. And so I looked into it and it turns out that meerkats, within a group of meerkats, there are these superguards who are the ones that spend the most time on the top of the hill looking out for danger. And they are the ones that the other meerkats trust more when they signal that there's danger happening. So if we think about a sort of natural variation in meerkats, there are some meerkats who for some reason are better

at detecting potential signs of danger, but also staying aware of that possible danger and not signaling too early that it's a threat. So they'll wait and keep watching the rustle in the grass and stay very tuned into that and not ignore that in case it's a snake, for example. I think that that's what people with misphonia, that's what our brains are doing, is that it's trying to stay tuned into possible signs of danger. And that could be literal danger. So if you think about when we're living in caves, that the person who stayed tuning into a rustle outside the cave might have survived because if there was a lion outside the cave, then they would be the ones that would be protected from that sound. But also sort of social threat. Like if we've all

agreed that we should eat with our mouth closed. And it makes sense that some people would be more tuned into signs of sort of social transgressions as well. So sort of an in-group, out-group thing. Yes, exactly. It sort of connects us as a group and helps us to connect with other people. So how about genetics? Do we know if that plays any role in this? Again, it's so early in the research. There is a question in 23 and me genetic testing. There is a question, that something like, do you experience rage at the sound of chewing? And what they found is that around 20% of people say yes to that question, which is really close to our one in five statistic on people who do have an extreme reaction

to these sounds. And there was some genetic testing that was done on that. And what we found is there's a potential marker that might be associated with saying yes to that question. But we don't really know what that marker is. It's probably not a misophonia gene per se, but maybe something that predisposes people to tune into these sounds or react more to sounds. Are there any things that any sort of situations where it's more likely to occur?

So one that I was thinking of is if you're hungry or, you know, hungry, as people say, does that make it worse? Well, there are a few situations. So one is related to how well you can regulate your emotions, how well you can sort of tune out irrelevant information. And we know that when we're tired, when we're stressed, it's much harder to deal with strong emotions, it's much harder to tune out irrelevant information. So you will most likely experience a worse reaction when you're tired or hungry or hungry.

And if you're hungry and someone else is eating and you don't have any food yet, I can understand that that would also cause a more intense reaction. But the other time where it causes more intense reaction is where there's some kind of rule being broken, some kind of social rule. So for me, I would be much more angry if I'm on the other. the quiet carriage of the train and someone is making a loud noise or typing loudly or watching a video on their phone than if I was in a busy, noisy carriage, even though it's the same sounds, there's different rules and they're being broken, and so that's going to cause more

of a sort of anger response. So what do we know about what's going in our brains when this happens to us? Do we have any studies that have looked into that? There are now lots of really interesting studies related to the brain, and so what they've found is that there are different. patterns happening in the brain between people with and without misophonia. And that even when they're not listening to sounds, the brain looks a little bit different. There are some sort of heightened connections between the areas where we process sounds and where we process information, where we process meaning of events and experiences and where we process emotions. So there seems to be a heightened connection between those two regions of the brain, which might explain why we have this more

intense reaction to sounds, or it could be because we have this more intense reaction to sounds that has created this stronger connection between those two areas. So that's the biggest problem with the brain studies is that it's all cross-sectional, which just means it's one snapshot in time. So we don't know if that's showing what causes misophonia or if that's showing what changes in the brain as a result of misophonia. But it's really exciting. And I think it was really validating for people with misophonia to see that something different. is happening in their brains, not just different from people without misophonia, but different between sounds that are universally annoying, sounds like sirens and screaming, like things that

we're not supposed to ignore, that have acoustic properties that are hard to ignore, compared to sounds that are more typical misophonia sounds like eating and sniffing and coughing. So there's different things happening in the brain depending on the sound and depending on whether you do or don't I have misophonia. Ambition comes in all shapes and sizes. At First Citizens Bank, we roll with your goals because we're built for what you're building. Fit for your ambition for Citizens Bank.

It's peak pollination season, and my business is scaling fast. To keep the nectar flowing, I need a phone plan with top priority data speed. That's why I chose GoogleFi wireless. My connections stay strong even when the hive is buzzing. Plus, unlimited plans started 33,000. $5 a month. Now that's a deal that doesn't stay.

Explore GoogleFi Wireless plans today. Plus taxes and government fees. GoogleFi Wireless is not subject to data traffic deprioritization during times of high network usage. This podcast is sponsored by Name, Audio and Focal. With over 100 years of combined expertise, Name and Focal have been bringing music to listeners just as the artist intended. Since day one, this mantra has shaped every innovation in Hi-Fi. design, technology and acoustic engineering, balancing craftsmanship and tradition with pioneering thinking.

Name Audio pushes cutting-edge technology to ensure digital precision whilst sustaining Pratt, pace, rhythm and timing, the elusive quality that makes music feel alive and gives it emotional texture. Today, in partnership with French acoustic specialist's focal, name audio creates systems that deliver exceptional sound, and unforgettable, listening experiences at home. Try it for yourself at a focal powered by name boutique. Visit focal powered by name.com for more information. So let's have a look at the bulk of your book then,

which is sort of ways of coping with misophonia if you do, can I say suffer from it? I'm sure plenty of people would say that they suffer from it. I've done a lot of work to try and change how I feel about the problem, how I react to sounds. And so I am now at the point where I feel like I don't suffer anymore, but there are definitely times in my life where I would have suffered, and I know there are a lot of people who are suffering to a really extreme level.

The main strategies are actually related to how do you increase your functioning, even though you have these reactions to sounds. So that can be being selective about when you use earplugs or headphones. For example, if you need to concentrate and you know that this sound is going to continue to distract you, then it's not a problem to just pop your ear. plugs in or put headphones on. Another area that I think is really important is understanding the problem because what we discovered through the research is that the experience of misophonia as a whole includes feeling bad about yourself for the way that you react to sounds, feeling worried that

because you're having these really angry, aggressive thoughts towards somebody that you really love and care about, it makes you feel like a bad person. So another part of dampening down the response is actually learning more about misophonia, discovering that you're not the only one that reacts this way, talking to people about the problem and seeing whether you can come to any agreements together about how we manage sounds in the home, for example. And part of that is also getting a better understanding of other people and why they make the sounds that they do and allowing other people to have some sort of agency over the sounds that they make. So it's not just about we have to, as a family, agree that no one's going to eat loudly. It's, well, this person eats loudly,

this person has misophonia, how are we going to manage that in the home instead of sort of enforcing particular rules? And then the third part, which is the bit that I find most interesting as a clinical psychologist, is how can we sort of retrain the brain to learn that these sounds are no more harmful, no more dangerous than any other annoying sound? And the idea is that for some reason our brain has associated these sounds with danger or harm. And so we get this really intense fight-to-flat reaction as if there is danger or harm happening or about to happen. And so we need to somehow relearn that these sounds are annoying but not harmful. And the way we do that is by creating new experiences with these sounds.

And these experiences can be anything that is sort of novel, new, silly, funny, anything that you're in control of as you listen to the sound can help to create these new associations with sounds. So one of my favorite ones for this is what I call the director exercise. So this is basically imagining that you're a director in a film and the person making the sound is a character in the film that you're directing. And you have to come up with a really good backstory for why they have to make this sound that they make. And so it's a way of sort of empathizing with the other person, considering the idea that there are lots of different reasons why people make the sounds that they make

and not all are intended to harm you. But it's also a way of interacting with. the sound in a non-threatening way. So it's a little bit playful and it's a new way of interacting with the sound and it makes you feel a little bit more in control because you're the director. You're the one that's making this sound happen in a way. And another one that we do is by pairing the sound with a visual that could also be creating the sound. So for example, if you get really bothered by the sound of sniffing, you might think, well, what else sounds like a sniff. So someone that I worked with said that the sound of a zipper going up and down sounded a bit

like a sniff or the sound of a broom going across the stage. And so if you can watch a video or even just imagine that that's what's creating the sound whilst intentionally listening to the sound, it can help your brain to discover that it might still be annoying, but it's not harmful. And you start to create new experiences with the sound. So as we mentioned earlier, this is your specialist area of research. So sort of by way of closing, what's your sort of hit list of things that you'd like to discover next? I'm really interested in, there's two areas that I want to go down and I haven't quite decided which it's going to be. So one is, what are the things that are different for people with misophonia in the moment that they're hearing

the sounds compared to people without misophonia? And what are the things that are different across the board. So for example, emotion regulation is one that's come up a little bit. So how well we handle our own emotions, how accepting we are of them, how intense they are, and how well we can sort of calm down. We know that people with misophonia in the moment have this really intense emotional reaction and it's really hard to bring it back down again. But what we don't know is whether that is a general problem, is that something that they find difficult in all areas of their life or is it something that is just a problem in the context of sounds? So that's one. area that I'm really interested in. And the other is about coping strategies and behaviors,

because we know that in anxiety disorders, for example, and in obsessive-compulsive disorder, the things that we do can make the problem worse. And in fact, there's research where, for example, if they get people to clean their hands a lot and clean door handles and think a lot about all the germs that could be harming them, if they do that for a week, they predict more that they will be contaminated by these germs. So the things that you do can change how threatening things feel. But no research has been done on that in misophonia. And I think from a therapist's perspective, a lot of us instinctively think, yeah, behavior is a part of the problem because we see that in other disorders. But we don't know with misophonia. And so what we might be going in saying,

well, you need to stop avoiding these sounds and maybe that will help you to feel differently about the sounds, but we might be unintentionally making people do something that just makes them feel worse. And so this really needs to be tested in research so that we can work out, are behaviors helping the person to function and live their life, or are behaviors serving to sort of maintain the problem, or which behaviors are doing one and which behaviors are doing the other. And so one of the things that I'm really interested in is like, for example, the way you interact with other people. So if you glare at another person when they make the sound, that, for example, might be an example of an unhelpful behavior because it might intensify the hostility between you

when the other person, it might make you feel more angry towards the other person because you're treating it as if they are doing something intentionally harmful. But something like headphones or earplugs where putting your headphones in helps you to focus and helps you to communicate and connect with other people, that might be an example of a helpful behavior. So I'd like to explore that on a really broad scale and try to understand those relationships better. Thank you for listening to this episode of Instant Genius. brought to you from the team behind BBC Science Focus.

That was Dr Jane Gregory. To read more about the topics we've just discussed, check out her book, Sounds Like Misophonia, How to Stop Small Noises from Causing Extreme Reactions. If you liked what you just heard, please do consider subscribing to Instant Genius on your podcast platform of choice.

The current issue of BBC Science Focus is out now. Pick up a copy wherever you buy your favourite magazines or downloaders on your preferred app store. You can also find us online at sciencefocus.com. This podcast is sponsored by Name, Audio and Focal. The texture and emotional depth of music can be lost through digital sources or poor signal. Name Audio believes you can have digital precision with analogue warmth. Alongside French acoustic specialist focal,

name creates high-end audio systems combining innovation with craftsmanship, so you can listen to music, just as the artist intended. Discover more at name audio.com.