Stuff You Should Know - Misophonia: More Than an Annoyance

Episode Date: May 7, 2024

Misophonia is a condition in which certain sounds trigger people in very negative ways that can really disrupt someone's life. Listen in today to learn all about this fairly recently recognized condition.See omnystudio.com/listener for privacy information.

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Hey everybody, we are coming to a town ostensibly near you, so putatively see us. That's right, May 29th we'll be in Boston, really Medford, Massachusetts. The next night we're gonna go down to Washington DC and then scooch back up to New York City at Town Hall on May 31st. Yeah and if you're one of those people who likes to plan way far in advance then you can go ahead and get tickets for our shows in August. We're gonna start out where Chuck? We're gonna be in Chicago August 7th,

Minneapolis August 8th, then Indianapolis for the very first time on August 9th, and then we're going to wrap it up in Durham, North Carolina, and right here in Atlanta on September 5th and September 7th. Yep, so you can get all the info you need and all the ticket links you need by going to StuffYouShouldKnow.com and hitting that tour button, or you can also go to Linktree slash SYSK Live. We'll see you guys this year. Welcome to Stuff You Should Know, a production of iHeartRadio. Hey and welcome to the podcast. I'm Josh and there's Chuck and Jerry's here too.

It's the trio, the Tom and Jerry and Jerry of podcasting. Okay, I like that. Well, now how about Tom and Jerry and Jerry's little like nephew who's always getting in trouble, but he's super cute. So he's like a baby. Was that a character? Yeah.

I'm not sure if I remember that. He was a little gray kid in diapers. Very, very cute. Even Tom wanted to take care of him sometimes. It feels like so many shows and cartoons felt the need to bring on like a little cute edition every now and then, whether it was Cousin Oliver. I was gonna say him.

On the Brady Bunch or Godzuki. Who? Godzilla and Godzuki. Mm-mm. Yeah, it's a little cute baby Godzilla. Oh, that's great. Way to go, Godzilla. You really slipped one past the goalie. Or whoever this one.

Who's this one? What's his name? Uh... The nephew? I don't know. Okay. Jerry. That's why I said Tom and Jerry and Jerry.

I gotcha. There's also, don't forget, Captain Caveman and Son. Jerry. That's why I said Tom and Jerry and Jerry. I gotcha. There's also, don't forget, Captain Caveman and Son. Yeah. Pretty straightforward stuff. But that's not at all what we're talking about, Chuck. Let's just get serious here. Let's get down to brass tacks.

Let's get down to the facts, in other words, as our cockney friends say. We're talking about misophonia. Uh, and there was an O in there somewhere, but my voice hitched. Misophonia. And it's possible I just accidentally set some people off because when I said it that second time, I articulated it clearly, the O.

And vocal articulation or speech articulation, where you're really pronouncing a phoneme, can trigger misophonia, which we should say means hatred of sound, and is essentially a outraged nervous reaction to sounds that make the other, the average person doesn't even notice. Yeah, and we'll get into like all of the stuff here with me, Soponia, but

It's it seems to be more like Generally more like sounds people make like you often hear about like chewing food or lip smacking or chewing gum Just sort of like body sounds that people make, yawning sometimes. Yeah, particularly or- or-o-facial, like the stuff you do with your mouth and stuff. Yeah, or nose, yeah. So that's typically it. I mean, you know, there's a range of stuff, but I thought maybe we could chat very briefly just about sounds that you hate, like if you have any triggering sounds at all. that you hate, like if you have any triggering sounds at all. I, trigger is probably a strong word because I don't like fly into rage. I don't necessarily feel disgust.

Like the closest would be someone using a leaf blower. I just think those are the worst people on the planet. I forgot about that. Your long running feud with the. I can't stand them Chuck. The blowers. I know, I forgot about that. You're a long-running fugue with the... I can't stand them, Chuck. The blowers. I know. I'm with you.

So I have a couple of things, but similarly to you, similarly, uh-oh, here we go. It's like a noise thing, like an ambulance crossing close by. Like I plugged my ears like a five-year-old. I can't take it. How about these new ambulance sirens that are like, woo! Have you heard those? I don't know if I've heard those. They're bonkers.

But if I'm on a street and there's like a rush of emergency services, I have to plug my ears. When I'm using an airplane toilet, I have to plug my ears for that succubus flush sound. Mm-hmm. Cannot hear it. Mm-hmm. But those, I think, are just like loud noises, which as we'll see isn't the same as misophonia. No.

The closest I can come with misophonia as far as like an emotional thing that really feels like it's connected to my brain is hearing two kinds of music at the same time. When Ruby was growing up, it's a big thing when we'd be playing music, and she would come into the room with some dumb kid toy that plays music. It makes me crazy and angry very fast, and it's clear it's not just like,

oh, that annoys me. it's like a real thing. You're like, I'm trying to listen to pavement. Yeah, but it triggers me in such a way that I'm like, oh, I think I understand that neuro-connective annoyance, which is not the same as just like, I don't like that sound. So, Yubi has mesophonia. She's never been clinically diagnosed,

but she very much has it. Yeah. Oh yeah. For sure. Uh, it's like the oral facial stuff, like chewing that kind of stuff. And you're just not telling me. She's, I know it's just fun to sit back and observe when you guys are all in the same room together.

Right. Um, so she has. Like, I would say maybe middling, middling, um, misophonia. Okay. She can control it. But I think if there's like, if she's having a bad enough day, um, or she's stressed or something like that and it's triggered, she'd be more likely to be like, can you chew any louder or something like that, right?

But normally she can like, just kind kinda just chill and like deal with it. But now that I've done the research, I'm like, man, I feel for her more than I ever had before as far as that stuff is concerned. And it's not like this is news to me. Like I knew she had misophonia, I understand it. But it just the degree that it affects people. She just plays it really cool.

And knowing now that what's going on inside of her while she's playing it cool makes me never want to eat around her again, just out of, out of, um, support. Yeah. Well, that's A, that's sweet. Uh, B, playing it cool is the Yumi way. So that doesn't surprise me. And C, you know, you mentioned her, if she's already anxious or something about something else, like as we'll see, there are comorbidities

that can definitely make it worse. And I imagine just being in an anxious state, like with anything else, something annoying could push you over the edge. Exactly, you're already right there. And yes, it's an emotional reaction, a profound emotional reaction. And you said something else too,

that I think is worth, worth really kind of digging into for a second. Like you don't like ambulances. Nobody likes the sound of ambulance. The ambulance siren is designed to, to annoy you, to basically get you out of the way to catch your attention, right? But not in a good way. They don't want you standing around like jamming out to the siren or something.

Right. So that makes sense. Someone chewing, the sound of someone chewing doesn't send the average person into a state of like anger or in severe cases, like rage, you know, where you're yelling at the other person because they're chewing like a normal person. That's really where misophonia begins, where just a sound that wouldn't really upset anybody else really affects you. Yeah, absolutely.

And we heard from the reason, I mean, we're getting to it kind of late, but when we did our ASMR episode, we heard from a lot of people with misophonia that were like, hey, a lot of this episode triggered me, and like, it's a real thing. And I think we might have even poked fun at it a little bit, and we're like even doing like smacking sounds and things, because we were oblivious at the time to what a real thing it is. So we're doing this to make up for that in a way,

and we're not going to make up for that in a way, and we're not gonna give examples of sounds because we do know that it's a serious thing. It's not something to be made fun of or laughed at, it's to be taken seriously. And that is part of the history of mesophonia and continuing history as clinicians, basically being like, I don't know what this is, but you learn to deal with it if you don't know what this is, but you

learn to deal with it if you don't like the way your husband choose. Yeah, let's talk about history. One of the reasons why people who finally go in to get diagnosed and treated for mesophonia, one of the reasons they run into that kind of thing, their doctor might tell them just wear earplugs or get a hold of yourself or something like that. Yeah. Or their psychologist might be like, you clearly have other issues. This is just some symptom of it.

Misophonia is like a very new thing. It has no clinical definition anywhere. Apparently there was a committee that got together as recently as like, I think 2014, 15, 16? Pretty, pretty, very recently. I don't know. 2022 was when the expert committee got together. Okay.

Yeah. So, so during COVID, that's how recent this was. They finally said, exactly. They're like, I guess we'll get around to it. But they finally said, okay, we have time now. Exactly. They're like, I guess we'll get around to it. But they finally said, okay, this is a thing. This is what this thing is, it consists of, and this is how we think maybe you could conceivably treat it. It's that new.

It was only back in 2001 that it was first described. 2001, the 21st century. It's like a brand new disorder. Yeah. In 2001, that was when a couple that is going to figure pretty heavily in this one, cause they were sort of the OGs, uh, Powell and Margaret, uh, Jastraboff. They were from Poland, uh, the married couple. They were professors of, uh, otolaryngology.

Laryngology. Laryngology. Yeah. Geez, I had it right. It sounds funny. That's an ENT study basically. They were here at Emory, I guess, in Atlanta. And Powell was studying

tinnitus, TRT specifically, tinnitus retraining therapy. And Margaret, she was studying cancer research, but was like, I'm also involved in this tinnitus thing, and we're both going all in.

It's 2001 on, what do they call the grouping? Over-sensitive hearing? Well, decreased sound tolerance conditions, DST conditions, which at the time included hyper acusis, phonophobia with a B and then mesophonia with an N. Yeah. That's a lot of info. It is a lot of info.

And by the way, I can just hear you saying like, I had a bout of tinnitus while I was getting a tattoo. I'm going with tinnitus. All right. I'm also going with Pavel because they're from Poland, so I think his name tinnitus. All right. I'm also going with Pawel. They tattoo. Because they're from Poland, so I think his name's Pawel. Oh, is it W-A-A?

I think so. Yeah, you're probably right. I think they actually spell vodka with a W over there. It's just off the wall. What a time to be alive. Right. So at first they were saying like, okay, there's all these things that are kind of lumped together. Like you said, the DSTs, decreased sound tolerance, and they can kind of present in different

ways. Hyperacusis is definitely its own thing. They think that maybe something happened to your ear, you damaged it, there's a facial muscle that controls it, that controls like how much your ear intensifies or amplifies the sound. And if that muscle's damaged, that sound is gonna just come raging through your brain. So if you hear somebody typing on a keyboard,

you might have to crawl under your desk and wanna die. It's like Batman. Because it seems like really loud though, not annoying. Exactly. I mean, I'm sure it's annoying, but it's the decibel level is the issue. Yeah, it seems to have more of a, produce more of a physical reaction than just an emotional reaction.

And if it is an emotional reaction, it seems to be more like suffering than rage. Yeah. Phonophobia, they were like, okay, that's a separate thing too, for now. Um, and that is a fear of loud sounds. And the reason that it's a phobia is because you're afraid of loud sounds that can't actually hurt you, like the sound of traffic or the sound of emergency services. An ambulance.

Yeah, an ambulance or something like that. Or a toilet and a plane. So if you felt fear while you were plugging your ears and maybe even ran away, you would probably have phonophobia. No, it doesn't reach those levels. It's just, it bothers me and I'm not afraid to look like a five-year-old in public.

Okay. Man, I wanna see that so bad. Well. I'm surprised. No, surely I've done that in front of you. Maybe not. I have not seen it. I would definitely remember that.

I mean, I know one thing. We've never been in an airplane bathroom together. Did you know what I'm going to, that's true. You know what I'm going to do is next time we're on tour and we're hanging out backstage, I'm gonna start start a fire and sit around and wait for the show. That's a great idea. Okay. And then there's Misophonia too, which is the topic of this episode. Yeah. And I think they went on, you know, kind of studying that stuff for about a dozen

years. And then in 2014 is when they said, and this is the couple, the Jastorboffs, yeah? Jastorboffs. Or is this probably Jastorboff, huh? Pavel Jastorboff is what I'm going with. That sounds so much better than Pavel Jastorboff. Jastorboff. Jastorboff. Anyway, they got together in 2014 and said, Dear, I think we should reorganize the stuff.

And Margaret said, don't call me dear. We're in a professional environment. Also, could you chew any louder? Could you chew any louder? And they said, let's just reorganize our taxonomy here. And I believe what they did was they tucked the phobia under, phonophobia under mesophonia, and basically said there's pretty much two things,

hyperacusis or mesophonia with phonophobia underneath phonia. Yeah, you kinda touched on the distinction between them two. Hyperacusis is some sort of mechanical issue, they think. It's not in the brain. It's just like the sound itself is being delivered to your brain way louder than it is to other people for some reason. But with mesophony and phonophobia, the research seems to strongly suggest that not only does it have a neurobiological, a brain basis.

Yeah. It also may even have a genetic basis as well they're starting to figure out. So it is definitely something going on with your neurology. And again, just in 2022, they finally created a diagnostic definition of mesophonia. So we have no idea what actually causes mesophonia. But the studies that are out are pretty interesting and they seem to point to something that I will,

I'll point it out when we get to it. But I think it's the smoking gun. It's the reason for misophonia, if you ask me. Ooh, well that sounds like a fun cliffhanger. Oh, I agree. All right, well, you know what they say, if you introduce a smoking gun in Act One, you have to fire it in Act Three.

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What is going on with me? The Yastrobuffs were doing their work. It started to become just a more known thing on the internet. In 2011, there was a New York Times article by Joyce Cohen that sort of got it out there in a more public way. The growth of internet forums and Reddit and stuff like that, all of a sudden people are getting online and saying in the 2010s and saying like, hey, wait a minute, like, I've been living with this my whole life, no one's ever

taken me seriously. And that's kind of one of the, can be one of the great things about the internet is bringing people together for a common ailment that had not previously been taken seriously. Yeah, for sure. That Joyce Cohen New York Times article from 2011, by the way, is called when a chomp or a slurp is a trigger for outrage. And it, like you said, it really helped a lot of people, right? So, um, flash forward to 2022, we've got the, the diagnostic kind of definition of it. And what they figured out is that when you have a, um, a bout of misophonia, when you're triggered, the sound

triggers you, not only do you have like an emotional reaction, typically it's anger, anxiety, disgust. And again, like this is a pronounced emotional reaction. It's not like you're just kind of a little annoyed, like you're disgusted. There was, uh, Olivia helps us with this and

she turned up, I think, on a Reddit board that, um, somebody who, if you heard the sound of somebody clipping their toenails, you'd be so disgusted that you would not be able to like drink coffee even 20 minutes later. Yeah. Just stuff like that. I don't like that one. So that's, that's disgust, but I think the kind of the classic emotion is, is rage or anger usually associated with it.

So in addition to the emotional component, there's also a physical component too. And like it's been documented, these things happen to your body when you're suffering about a misophonia. Yeah, and they sort of smack of, sorry, I don't even know if these words trigger like a chomp and smack. Yeah, probably. So I didn't mean to say that, but, you know, like anxiety, it sort of mirrors anxiety. Your blood pressure might go up, you might start sweating, you might get tightness in the chest, goosebumps, I think I said heart rate,

and it's not necessarily, you know, it kind of depends on the person as to whether or not there's a single trigger that affects you or whether you have a lot of them. It's not always the same in everybody. And there's also behavior responses. Like you said, if maybe Yumi was having a particularly bad day, she might be glaring at you

from across the dinner table. And you're like, you know, stop with the fork in your mouth. And you're like, what? What? I've got like a chunk of spaghetti hanging out of the side of my mouth. Now you know what? Yes.

And I knew what before, but again, like I just did not, I hadn't done the research. I hadn't been around it long enough. I've never met anybody with it before. So yes, I was. Gosh, man, I guess I wasn't a very good husband for a little while there. No, you were fine. You just didn't know. We're all better people now than we were when we got together.

That's true. That's true. I like to think that too, Chuck. But it can lead to, like you said, ragey episodes and it's pretty rare, but it can lead to actual like violence, suicidal feelings, self harm. I think they've documented that that's almost always isolated to cases where people have, you know, some other mental condition that is comorbid with, like it may be a last straw kind of thing. But it can, you know, it's again, just more than an annoyance. And I think that's probably the name of this episode. I think you're right the name of this episode.

I think you're right. You hit upon it. There's also some other things that studies have turned up. They found that people with mesophonia don't respond to loud noises any different typically than other people. So somebody with mesophonia probably wouldn't respond with a mesophonia response

to those ambulance sirens, right? It's more usually kind of softer, probably wet or something like that sounds. I'm sorry, I'm really trying not to, but it would make sense why the ASMR episode set so many people off, because it's exactly those kind of like soft sounds, chewing. Like that's why if somebody's like, can you chew any louder? You're like, I'm, I'm not doing anything unusual, but it's, it's a, you're making a soft sound and that is what they hone in on.

So there's no difference between someone with misophonia and someone without it. As far as loud sounds go, it's where the softer sounds are. And then other sounds that upset most people, again, this ambulance siren well is still very deep, I'm gonna go back to it again. But also like a baby crying or something like that. Who wants to hear that? Nobody.

And that includes people with misophonia, but that doesn't necessarily trigger rage in them or misophonia. Yeah, and in cases of babies crying, even if you in them or misophonia. Yeah, and you know, in cases of babies crying, even if you don't have misophonia, a lot of times that is coupled with lack of sleep from new parents, and it can get pretty severe. I mean, we were lucky with the sleep situation,

but I've heard horror stories of new parents who are getting, you know, three hours of sleep a night, and a colicky baby is just, it's terrible. You know, I feel so much, I have so much empathy for those situations. But back to Misophonia, I guess I was just sympathizing for a minute. If we're going to talk about how many people have this, the Yastra's did a, I guess just sort of a round guess of 3.2% in 2014, but they based that on people who came in seeking treatment that also usually had tinnitus and obviously, you know, we've said this before about lots of

things, you can't really base a number like that on people who seek help because so many people don't, especially when it's something like this that's under diagnosed and treated. Right. So other people who've studied it are saying, no, it's more like 20% of the entire population, which is, that's a lot of people who have misophonia.

They also think that, um, women are, uh, overrepresented among people with misophonia as much as 83% of peace people with misophonia might be women. Um, and then there's one other very important thing that we need to point out. Um, people with misophonia do not have better or more acute hearing than anybody else. That's not the problem. Yeah.

That's not it. It's, it's, it's a difference in the way their brain is connected is what it seems like. Yeah. Well, we should, I mean, that's a good setup for getting into the brain. Thank you. I've been doing this for years now. If, if you're wondering if they ever stuck somebody into a wonder machine and smacked some oatmeal in their ears, then the answer is yes, of course they have. They have done

experiments, but as we'll see there haven't been a ton of them because it is so new and probably underfunded, but they did put people in an fMRI machine, the wonder machine, and they found that the interior insular cortex, the AIC, which, and this makes total sense, it helps integrate sensory data from like organs and stuff like that, but it's also associated with the parts of the brain that are responsible for like emotion, fear, long-term memory, and stuff like that. Yes, here's, this is where I think the smoking gun is,

the AIC. Act two, we're a little early. Because, well, I haven't fired it yet. Okay. I'm about to though. The anterior insular cortex is also a major component of what's called the salience network, which is the region or the network of your brain that takes stimuli from the

environment, like you said, from even down to your internal organs and sorts through all of it and says, not important, not important, not important. Oh, that's important. And amplifies it up the chain and it keeps getting amplified and passing through more and more filters until it becomes the brain's awareness or attention becomes focused on it. Right?

So that salience network is like, that's important. We need to let the brain's consciousness like in on this thing. And now all of a sudden you're paying attention to that stimulus. What they think, what I think in particular is that there's a hyperactivity and or hyperconnectivity within the AIC that takes things that other people

are able to filter out and turns them into a sound that can trigger you emotionally. And it's because your salience network is basically supercharged. So that would actually back up what they did with the studies with the MRI scans, not the fMRI, correct? Yeah, where they turned up the medial frontal cortex. Yeah, well what they found was what you just said, the medial frontal cortices, if you

have mesophonia, they have more myelin, which we've talked about before. Uh, it's a fatty substance that insulates the nerve cells, but they're saying that, uh, the excess of myelin kind of backs up the idea of that hyper connectivity with the, uh, the anterior insular cortex. Boom. The gun has just been fired and is now smoking bright red, white and blue smoke. Yeah. It's a Nerf gun, of course, people were, you know. Yeah, for sure. There's one other thing that seems to be a bit of a boondoggle in

misophonia research, and that is that there's a theory or I guess a school of thought that it's actually triggered by overactive mirror neurons in somebody. Oh, our old friends. I guess a school of thought that it's actually triggered by overactive mirror neurons in somebody. Oh, our old friends. And in particular, the motor cortex that has to do, again, with orofacial movements, that those mirror neurons are hyperactive. And that when you see somebody or hear somebody chewing, it triggers those mirror neurons and it creates a reaction, a response in you that you can't control because your mirror neurons have taken over.

That seems to be untrue. Okay, well, even so, we did an episode about mirror neurons many, many, many years ago that it's still super interesting to me and just the quickest sort of summation is the idea of mirror neurons or like when you see someone in a football game on TV like break their leg in a painful way and you literally feel that in your own leg. Yeah. I mean that's the dumbed down version but that's what we're talking about. No I mean that's a great example. When I watch sports like I find myself like leaning like if the guy's trying to avoid a tackle, I'll like turn as well.

It doesn't help the guy at all, but it, it, I can't, I can't stop myself. I noticed it because I'll be on the treadmill watching like basketball or something. And all of a sudden I'm like off, off balance a little bit, cause I'm moving along with the guy who's like doing the layup. I've seen people do that when they're gaming, like firstperson games. That's the exact same thing I think yeah. Moving their body around in weird ways. It's

pretty interesting like if you train a camera on somebody gaming. Yeah. You did mention genetics. It may have a genetic component. I think they did just an analysis on what's called a GWAS, a genome-wide association study about just rage-related mesophonia, and they found that it does cluster with PTSD, anxiety, and depression, which indicates it could, you know, have a genetic component, right? Yes, which makes sense for sure.

I didn't see the gene that they targeted it to, but. I didn't either. It does seem to be related genetically. There's also, there's a researcher from Oxford named Jane Gregory, who also suffers from mesophonia. And she posits that mesophonia could be like a relic, like an evolutionary relic, from back when it was advantageous for a group to have a few people who responded to sound, like, way more than other people,

because they essentially served as, like, alarms for the rest of the group. All right. Makes sense. I mean, this is the place that we're at in Miso-phonia research. You can just toss stuff out like that and be like, yeah, probably. Yeah, it's also can be comorbid with misokinesia. And that is when you have a misophonia like response to someone's fidgety motions. Yeah. So I think someone clicking a pin can be a misophonia trigger, but that's also sort of a fidgety thing. So that kind of makes sense, I think. Yeah, if you want to empathize with people

who have Mesophonia and Mesokinesia, go onto Reddit. Actually, any condition that could be debilitating, go onto Reddit and look at the Reddit board for that condition and your heart will just go out to people. And I looked at the Miso Kinesia Reddit board and just the first few posts are like the language they use, like, like want to die. It can't live like this. They're not, they're not, they're not talking about self harm.

They're saying like, it's so like, like this is just bonkers out of control. And they're talking about being in class and everyone's just kind of bouncing their knee and they like they're just so overwhelmed by that and unable to not pay attention to it that they just feel like they're losing their minds in just the worst way. It's really awful. And I'm not overstating the way that they describe it at all. Oh, I'm sure. One thing I did notice though, on the Miso Kinesia board is one poster said, or sorry, one OP said that they counteracted the experience by, I guess, kind of like mirroring what the person was doing.

So somebody's bouncing their knee, they use their hand to just kind of keep time with the person's knee and it it somehow counteracted or short-circuited the mesokinesia in them right then. Well, I mean, they've said the same thing with mesophonia, is that sometimes people will make that sound themselves to counteract it, and that can help. Yes. So if you're ever clicking a pen and your coworker stands up and just shouts, click, click, click, click, click, click, they probably are having a misophonic episode right then. Yeah, for sure.

And you should stop clicking your pen. It can, you know, it can affect obviously the workplace in negative ways, but it can also affect your relationships and your, your family. It can, it has been described as contagious in a way. Because if you're, let's say, in a close relationship maybe like married to somebody or coupled up with someone, or living with someone with mesophonia, you might become very attuned to their trigger sounds.

It's not the same as having mesophonia, but it is contagious in a way in that all of a sudden, like if you then were just really on the lookout for the sound of people chewing their food because of being married to Yumi, that obviously it's not as bad for you, but it can get into your brain and sort of take over in a way.

Yeah, and I don't think it's like it could trigger misophony in somebody else. I don't buy that. What I think is is you've just become hypervigilant on behalf of your spouse because you care about them. So you could conceivably get angry at somebody daring to chew around them because you know what it's doing to them.

That's what I take that as. No, no, no, absolutely. But I think that they say it can be worse with people that are close to you than like out in a restaurant with a random stranger, you might get more bothered by your family members or your coupled person. Yes. If you have misophonia, usually it's the people who are closest to you that can set you off

the easiest. Right. With you, with your spaghetti hanging out of your mouth. I've not figured out exactly why. My guess would be that they know that you know what they're going through and you're still doing it. Maybe you seem very thoughtless or careless. Yeah, right then.

That would be, that would be mine. Um, my guess, but there's a huge component of this that I think really kind of supports that salience network hypothesis of mine. Let's hear it. Um, and that is that the sounds seem to have also like a personal emotional component to them. Like the Yastrobov's, their theory is that like the limbic system is very

much involved, which would explain why emotions there. So if you combine the limbic system with the salience network, the emotions you're feeling are like personal, like it feels personal to you, hence why you would feel something like outrage or profound disgust or something like that. You feel like you're being personally attacked right then. Oh yeah, that makes sense. Yeah, like your brain has told you,

this is a very, very important stimulus and you need to respond to it in kind. That's the salience hypothesis. I like it. Can we call it the Josh Clark salience hypothesis? I've been hoping you would say that all episode. The J-C-S-H, it almost spells Josh. It does.

Can we rework that? Sure. Yeah, can you turn that scene into an O? Well, sure. Can you turn my last scene into an O? I wasn't sure if you knew what you were saying, so I was just giving you a my last name into a no? I wasn't sure if you knew what you were saying, so I was just giving you a back door. No, no, I knew it. Josh O'Clarke. I just did it for you.

Hey, you may have been at one point. You never know. All right, so we'll, let's take a break now and we'll come back and talk about what you probably think is coming, which are myriad forms of CBT behavioral therapies right after this. Learning stuff from Joshua and Charles, stuff you should know. Hey, girlfriends. It's me, Carol Fisher. I'm so excited to tell you about

the brand new series of The Girlfriends. I'm so excited to tell you about the brand new series of The Girlfriends. In season one, we told you about the murder of Gail Katz at the hands of my ex-boyfriend, Bob. At one point, a woman's torso washed up on Staten Island and was misidentified as Gail. She spent nine years in Gail's grave, and then she just disappeared.

It's almost like it's become this moral obligation to find her. And that's what we're going to do, find this missing girlfriend and tell her story. With the help of some of your favorite girlfriends from season one, like my producer, Anna. Oh my God. My friend, Dr. Mindy Shapiro.

Hi, it's Dr. Shapiro and I'd like to speak with the deputy medical examiner. And of course, Gail's sister Elaine Katz. Having no closure, it kills you. Join us as we try to solve a 35-year-old cold case. It's not going to be easy, but it's going to be one hell of a ride. What? I can't believe this. Listen to season two of The Girlfriends, our lost sister on the iHeartRadio app, Apple podcasts, or wherever you get your podcasts.

Get emotional with me, Radhita Vlukya, in my new podcast, A Really Good Cry. We're going to talk about and go through all the things that are sometimes difficult to process alone. We're going to go over how to regulate your emotions, diving deep into holistic personal development and just building your mindset to have a happier, healthier life. We're going to be talking with some of my best friends. I didn't know we were going to go there, aren't we? I mean, don't let me go this way. People that I admire.

When we say listen to your body, really tune in to what's going on. Authors of books that have changed my life. Now you're talking about sympathy, which is different than empathy, right? And basically have conversations that can help us get through this crazy thing we call life. I already believe in myself.

I already see myself. And so when people give me an opportunity, I'm just like, oh great, you see me too. We'll laugh together, we'll cry together, and find a way through all of our emotions. Never forget, it's okay to cry as long as you make it a really good one. Listen to A Really Good Cry with Rady Dvlukia

on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Bring a little optimism into your life with The Bright Side, a new kind of daily podcast from Hello Sunshine, hosted by me, Danielle Robay and me, Simone Boyce. Every weekday, we're bringing you conversations about culture, the latest trends, inspiration, and so much more. Thank you for taking the light and you're going to shine it all over the world and it

makes me really happy. I never imagined that I would get the chance to carry this honor and help be a part of this legacy. Listen to The Bright Side on America's number one podcast network, iHeart. Open your free iHeart app and search the Bright Side. So one of the saddest things about Mesophonia and mesokinesia, um, aside from the fact that people suffer from it is that they're like the treatment landscape is so hit or miss.

There's so little widespread information out there among clinicians that you very well might go to see an ENT or a psychologist or a psychiatrist or, um, even like a neurologist that's particularly uninformed who might basically say this is your problem. or a psychologist or a psychiatrist or even like a neurologist that's particularly uninformed who might basically say this is your problem, wear earplugs, like just relax, go do mindfulness or something like that. And some of that stuff can help but if that's all you're being met with like

that's not, that's no treatment whatsoever. So fortunately there are people who have really started to study how to treat it. And one of the things that they've discovered is that good old cognitive behavioral therapy, CBT, seems to work for it. At least as far as any decent study has shown, it definitely has some effect compared to control groups.

Yeah, there was a trial in 2020, a randomized clinical trial that found that there was significant improvement in 37% of the group that completed CBT versus 0% for the control group and that a year later those 37% seemed to be holding, which is great. Yeah, that's what they call statistically significant. I would say so. Um, we also should mention as we're going through these, uh, various treatments, there are good people doing a lot of great work. Uh, but there are also, you know, just be wary. There are also people online that are, uh, just lining up to take your money, uh,

to help you with this that may be quacky. Yes. to help you with this that may be quacky. Yes, so like if somebody has earplugs that the description almost makes seem magical, you should steer clear of that. Yeah. Or if somebody says this supplement or this crystal or this tarot deck is going to help you, it's not. So just don't.

Go seek out a neurologist, a neuropsychologist or neuropsychiatrist I should say, and they should be able to help you. Do research yourself and say, hey, I want CBT or I wanna try something called unified protocol, which is called transdiagnostic therapy, meaning that you can use it for all sorts of different things that stir up strong emotions.

It basically, like CBT, it gives you tools to identify what triggers your emotional reactions, what you feel like when you're having that emotional reaction, how to deal when you're having that emotional reaction, and then also, if you're lucky, how to distance yourself from the emotional reaction and the trigger that causes it. Yeah, I think there are lots of, I feel like all of these are sort of just a reskinned version of the same kind of thing which is, which are those therapies. Identifying, mindfulness, recognizing behaviors, learning, you know, one thing called cognitive flexibility, like kind of retraining your brain.

The one that's a little different, I think, is the tinnitus retraining therapy. The TRT they've been using for mesophonia, it seems like with some pretty good results. It's basically sound therapy, where you have a wearable device that plays like a very low level, like white noise or pink noise, whatever your noise of,

whatever color noise you prefer, I guess. But just below the volume threshold of that trigger sound, and the Yastrobov's say that 80% of the patients that have tried that have had pretty good success. Yeah, the key is you want to gradually increase like the volume of that trigger sound against the background of that pink noise. Right. So that you can, you're basically, it's a type of exposure therapy. Yeah. Which is very controversial with mesophonia.

Yeah, for sure. Um, a lot of people say, do not try exposure therapy. That does not work. And actually it makes it worse because what you're doing is enraging yourself and all you're doing is strengthening that neural pathway that triggers that rage in the first place. So it's not only not helpful, it's actually counterproductive. Other people say, no, no, no, you can do certain types of exposure therapy, like the

Yastraboth's TRT with the pink noise. Um, but if you do start to have an emotional response, stop. Like anybody who has any understanding as a healthcare provider of mesophonia will tell you that if you have an emotional response to mesophonia while you're trying to, while you're undergoing treatment, stop the treatment.

Get away from the sound. That's the, that's like best practices. If somebody's trying to force you to just hang in there through it during exposure therapy, you're being treated by a quack and you need to find somebody else to help you because they don't understand mesophonia. Yeah. There's this one I don't fully understand. This is Jane Gregory again from Oxford.

She has worked on a situation where, or I guess a therapy where she tries to create a different association with that sound. She did this in one case at least by riding one of those amusement park an amusement park like Disney World I guess like a dizzy ride like a spinning teacup ride while listening to what was it in this case? Her husband's slurping tea. Yeah, Josh eating spaghetti. Right. Which makes sense in a way but then like wouldn't that just make you dizzy? Wouldn't you want to choose something that's? Not also awful. I think that what she would she just love those rides

She must love those rides and also I think she was after making the whole thing silly So like when she heard her husband's slurpee She would think about spinning around in a teacup and and that might kind of disarm her rage or something Okay, I guess I hear that and I'm like those are the worst rides because it just makes Me sick to my stomach. So I'm totally with you. Maybe the Yeah, I get it. But yeah, so that is a weird weird example But what the basis of that therapy is is that you're you're you're listening to the trigger sound while also doing something else or learning? To associate it with something else. that's not that horrible emotional reaction.

Yeah. Okay. Well, that makes sense. And then also, Chuck, there's self-treatment for misophonia that people have discovered along the way, like wearing noise-canceling headphones, wearing headphones where you're listening to pink noise or some kind of noise or music, like just putting a barrier between you and any sound headphones where you're listening to pink noise or some kind of noise or music. Like just putting a barrier between you and any sound that might trigger you.

And then there's other techniques too, but they're very sad, like not eating with your family. Yeah. Because you are probably going to get triggered and it's sad, but that's a really effective intervention for Misafonia. Yeah, there's a woman named Shailen Hayes Raymond who is a co-founder of a Misafonia International and her whole jam is like self-advocacy. So, you know, don't just you know, it's okay to tell your family that It's okay to tell your family that, hey, can you try and avoid these triggering sounds?

Can you be aware of what I'm going through? Can you understand if I have to leave the room during a big family meal? Can you go scan the subreddit on Misophonia? Yeah, sort of. But to advocate for yourself, also in things like noise canceling headphones like you mentioned, or just like getting out of there, like you said, like leaving the room, because from

what I've seen, it calms down pretty quickly. If you can remove yourself from the sound, you don't stay in that state for hours generally from what I've seen. Is that right? Yes. Yeah. It can pass fairly quickly. So that's the? Yes. Yeah. It can, it can pass fairly quickly.

So that's the good news. Yeah. And then also the good news is that there are smart people who have begun to study this in addition to the YastroBoths who are making some headway. So hopefully there will be some sort of like verifiable cure or treatment for it in the not too distant future. Yeah. I mean, if we're talking about a thing that's just been seriously looked at in the last 20 years,

you'd imagine that there'll be a lot of headway made. Yeah. I think just getting like an episode out here for people that maybe have been like poking fun at someone in their life, not taking it as seriously like, hopefully this will help that. Yeah, we're the Joyce Coens of podcasting.

Did you get that? I did. I mean, that was, uh, I don't know. I'm sorry. I thought you were talking about the self-advocate. Who's Joyce Cohen? She's the woman who wrote the 2011 New York Times article that told everybody who was talking from Misophonia that it was a real thing.

It was the other person, I got it. I thought you were saying Joyce Brothers. Who won on, oh what was that show? Quiz? That was Network Stars? No, it was like quiz show. Remember she won like big time on a game show and like you had to pick what topic you wanted to be deeply quizzed on and she chose boxing and just wiped the floor

with her opponent. Oh, wow. Yep, that was on our game show episode. Really, I don't remember that. For some reason, that always stuck out to me. Joyce Brothers and boxing, it's like kind of cognitive dissonance that just stuck with me. Yeah, totally.

You got anything else on Misophonia? Nope. Well, our heart goes out to all of you out there listening to us who have Misophonia. We hope we didn't trigger you. We hope we've never triggered you. And sorry again about that time with the ASMR. And since I said that, it's time for Listener Mail.

I'm going to call this is very interesting Irish Famine Connection. Hey guys, listen every day. I'm going to drive to work in rural Ireland. Luckily an episode is just right linked for my 40 mile trip. On the Selects episode, this is about an old one from famines in 2017, you did a nice job describing the nature of the Irish famine, but rather than bemoan the terrible response of the British rulers, I wanted to celebrate the amazing gesture of the Choctaw Nation of Americans, of sorry, Native Americans, who upon hearing of the plight of the Irish people during the famine, gathered up $170 at the time, which was, you know, fairly significant money, to send over for help.

This incredible act of generosity came from people who had only recently themselves suffered terribly during the infamous Trail of Tears, showing the true nature of them as a people. This kindness had never been forgotten, has never been forgotten, and thankfully now that Ireland is a country of significant wealth, we have been able to give back. There's been a spectacular monument erected in honor of the Choctaw Irish Connection and also a university scholarship program in, and that's a program with two M's and an E. In Cork, where members of the Chalk Doll Nation can avail of a fully paid BED or master's degree, I guess BED is an undergrad, and living expenses paid also.

This is something I teach my students in geography classes on migration at a high school level, as I think it is so important to recognize the incredible human acts that take place in these terrible moments. Really enjoy the variety of things you cover, and thanks for looking beyond the potato in Irish history. And that is from Bob Grace in County Carlo. That's awesome. Thanks a lot, Bob.

Super cool. Yeah, that's wonderful. I had no idea about the scholarship, did you? I feel like we mentioned that in another episode. I don't remember which one. Maybe Trail of Tears. Oh, really? I don't remember because, yeah, it does sound familiar, but I definitely don't remember

the college scholarship thing. So way to go, Bob. Well, you know me. I've forgotten anyway, so I'm happy to relearn it. It's awesome. I wish I were you. You could just watch movies over and over again. I'm like that guy Memento.

Yeah, Guy Pearce. Yeah. If you want to get in touch with us like Bob Grace did with a great story, we want to hear it. You can send it off via email to stuffpodcastatihartradio.com. Stuff you should know is a production of iHeartRadio. For more podcasts, my heart radio, visit the iHeartRadio app, Apple podcasts, or wherever you listen to your favorite shows. Get emotional with me, Radhita Vlukya, in my new podcast, A Really Good Cry.

We're going to be talking with some of my best friends. I didn't know we were going to go there, Amir. People that I admire. When we say listen to your body, really tune in to what's going on. Authors of books that have changed my life. Now you're talking about sympathy, which is different than empathy, right? Never forget, it's okay to cry

as long as you make it a really good one. Listen to A Really Good Cry with Rali Devlukia on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Welcome to season nine of Next Question with me, Katie Couric. I've got some big news to share with you in our season premiere featuring the one and only Chris Jenner. Oh, my gosh.

Congratulations. That is very, very exciting. And that's just the beginning. We'll also be joined by podcast host Jay Shetty, Hillary Clinton, Renee Flemming, Liz Cheney and many more. So come on in, take a break from the incessant negativity for a weekly dose of fascinating conversations. Some of them, I promise, will actually put you in a good mood. Listen to Next Question with me, Katie Couric, on the iHeart Radio app, Apple Podcasts, or wherever you get your podcasts.

Bring a little optimism into your life with The Bright Side, a new kind of daily podcast from Hello Sunshine, hosted by me, Danielle Robay. And me, Simone Boyce. Every weekday, we're bringing you conversations about culture, the latest trends, inspiration, and so much more. I am so excited about this podcast, The Bright Side. You guys are giving people a chance to shine a light on their lives, shine a light on a little advice that they want to share.

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