BY CJ GIBSON
Fort Hays State University, like many other universities across the nation, allows accommodations for students with disabilities, given that the student provides appropriate documentation.
But what about a disorder that isn’t diagnosable? A mental disorder that, while it deeply affects the lives of those who suffer from it, isn’t listed in the official Diagnostic and Statistical Manual of Mental Disorders (DSM-5)? A mental disorder that, while research has proven it exists, most of the world has never heard of?
The disorder I’m referring to is called “misophonia.” And it’s not as rare as you may think.
As the university and the world move forward from the pandemic, misophonia research and awareness are also moving forward. The post-shutdown era is an opportune time to talk about how we can best help those who are at their best at a distance.
The first, and perhaps most important, step in being a misophonia ally is to understand what misophonia is.
For someone with misophonia, explaining why they can’t handle a sound isn’t easy.
After all, gum chewing, sniffling, heavy breathing, and other “trigger” sounds are everyday noises that neurotypical people can easily ignore.
Most people who know they have misophonia develop their own brief elevator speech to explain why they have to blast white noise through their headphones or leave the room when you pop open a bag of Doritos.
One misophonia nonprofit, soQuiet, sends out cards that do the explaining for them:
“Misophonia is a neurological disability which causes me pain when I hear certain noises …. I would be so grateful if you would not create these sounds while I am around.”
And while the definition of misophonia isn’t as simple as being a sound-induced migraine, this explanation is better than the typical alternative: not saying anything at all.
If you have heard of misophonia before, you may be familiar with the most basic of definitions that come from the word miso-phon-ia itself: “hatred of sound.” In news articles introducing the disorder, it’s often portrayed by a picture of a person screaming their head off and plugging their ears. While most people with misophonia are only so expressive at their worst, that photo does provide a glimpse of the intense internal reaction someone with misophonia feels when they hear a distressing sound.
It’s not surprising that children are taught to chew with their mouths closed. (Though social eating is encouraged in many cultures, most people don’t enjoy hearing their dinner dates smacking and slurping.) It’s hard to ignore a noisy eater, and sitting across from one could understandably make you a little salty, misophonia or not.
But misophonia isn’t as simple as being a little annoyed when your cousin talks with their mouth full at Thanksgiving dinner. While “triggers,” or the sounds that cause that emotional response, tend to be human noises, they can be anything: think of the sound of nails on a chalkboard or those clicky pens.
Each person has their own unique trigger sounds, formed by an unconscious connection between stress and a sound.
Kids These Days and Their Evolutionary Maladaptive Brains
The “lizard brain” is a common theme used in the misophonia community to describe the psychology behind misophonia.
The lizard brain represents the primal survival intentions of misophonia. After all, while someone with misophonia in the 21st century may seem defective for having to leave a lunch meeting, misophonia is an evolutionary survival mechanism.
Knowledge of misophonia in the psychological and audiological fields may have developed primarily in the past two decades, but misophonia is not a new disorder.
Charles Darwin, Franz Kafka, and Michel de Montaigne showed some symptoms of misophonia, which would mean that misophonia has been around for at least a few hundred years.
And as an evolutionary trait, automatic association between certain sounds and deadly situations would have helped our ancestors. Human brains can’t come pre-programmed with a list of dangerous sounds for this complex and changing world (though that would be nice). Ages ago, an instant, involuntary reaction to an auditory cue from a rattlesnake or saber-toothed tiger could have meant the difference between life and death.
In a modern office environment, this skill is more likely to cause death than prevent it. Nevertheless, our lizard brains are meant to help.
Wait, It Gets Worse
Imagine that every time you heard a bell ring, you received an electric shock. Once you’ve been zapped enough times, the sound of that bell ringing at any volume would cause you to anticipate that shock.
For someone with misophonia, this fight or flight reaction builds on itself over the years. They develop more and more triggers as their brain connects that stress response from one sound to more sounds and even repetitive movements.
This is why exposure therapy doesn’t work for someone with misophonia. Suffering through triggering situations in an attempt to desensitize oneself is counterintuitive: the more exposure someone with misophonia has to their triggers, the stronger the stress response becomes. People with misophonia should avoid triggering situations as much as possible to protect their present and future well-being.
A person with misophonia can’t “just get over it” and shouldn’t try.
Accommodations Are for Disabilities
In order to receive accommodations from FHSU, a student must have a documented disability.
While misophonia is not yet diagnosable, according to the ADA, it fits the legal definition for a disability:
“The ADA defines a person with a disability as a person who has a physical or mental impairment that substantially limits one or more major life [sic] activity.”
Severe cases of misophonia can seriously impact the working and social lives of those who suffer from it. Some people with misophonia experience such extreme anxiety from their triggers that they totally isolate themselves or even resort to suicide. But even in less extreme cases, misophonia can make it difficult to focus in class or communicate with others because the trigger sounds can be so distracting.
As with most mental disorders, misophonia has no cure. Treatment options are limited, but many of them involve reducing general stress and limiting exposure to triggers. Depending on each individual’s needs, FHSU could make accommodations that would help with this treatment.
Quiet is Relative
As I’m sure many students would agree, college is conducive to stress. But outside of deadlines and a practical IV-drip of Starbucks, classroom environments can create undue stress for someone with misophonia, depending on their triggers.
Places typically associated with quiet, such as libraries, offices, and classrooms can cause the most severe misophonic reactions. When there is little background noise, the few existing sounds are harder to fade out. For example, a pen dropped in a quiet theater would be more noticeable than at a rowdy football game. In general, crowded, noisy environments are ideal for people with misophonia, as there is more to distract from the triggers.
Playing music or white noise can provide a similar distracting effect. Perhaps the most recognizable accessories of a misophone are their earplugs, earbuds, and headphones that they carry around like security blankets. Since a trigger at any volume can create the fight or flight response in someone with misophonia, earplugs alone aren’t always effective because they can’t block out all of the noise.
It can be more helpful to add a layer of neutral noise, like rain or fan sounds, that could overpower soft trigger sounds. Someone with misophonia might request that they be an exception to professors’ “no earbuds” rules or at least be allowed to wear earplugs in class.
Some people with misophonia also have visual triggers, a condition that is called “misokinesia.” These can be derived from an auditory trigger, like seeing someone’s jaw move when they chew gum, or they can be unrelated, like leg jiggling. These can be even more difficult to avoid in a classroom full of students.
Sitting at the front of the class can help put these visual triggers out of sight. In the front row, fidgeting can still be visible in a person’s peripheral vision. Adding partitions to block the view of other students could allow someone with misokinesia to focus on the lecture rather than bouncing legs.
Exams and quizzes can be some of the most anxiety-provoking parts of school. The added stress amplifies a person with misophonia’s reaction to triggers, causing potential panic attacks and providing a poor measurement of how much that person actually understands the material. A separate, distraction-reduced environment would allow a person with misophonia to focus on their test and earn a more accurate score.
In a cruel irony, the people with whom someone with misophonia spends the most time, such as family members or close friends, can be their most severe triggers. This is because the person with misophonia has had ample exposure to the noises that their family and friends make. Their lizard brain picks up on the intricacies of triggers these people make, causing stronger reactions.
A roommate can not only prevent the person with misophonia from having a place to escape triggers at the end of the day, but the roommate might become one of these severe triggers. Already on edge from the triggers in a lecture, a student with misophonia might return to their dorm, only to share a space with a roommate making the same noises. Their lizard brain would never have the opportunity to calm down, and this perpetual panic would lead to the development of more triggers. Offering priority single dorm rooms for students with misophonia would provide them with the solitude they need.
The Pandemic’s Unintentional Accommodations
As FHSU and the rest of the world search for a post-pandemic normal, certain unintentional accommodations will be missed. The COVID-19 shutdown provided valuable lessons regarding the advantages and disadvantages of accepted social isolation for someone with misophonia.
For some people suffering from misophonia, the pandemic was a safe haven. It feels kind of morbid to be at your best because people are dying, but socially accepted social distancing was a silver lining. Avoidance, or leaving the triggering environment, was more easily excused if the person with misophonia claimed they were limiting their exposure to COVID-19.
While masks didn’t stop people from chewing gum, they made it harder to pick up on that common visual trigger. Unfortunately, masks are a misokinesia-friendly trend that isn’t likely to stick around.
Virtual school adapted the typical classroom learning environment to a more misophonia-friendly one, reducing time spent in lectures and limiting added sounds from classmates. Removing a visual trigger was as simple as placing a sticky note over that section of the screen. Virtual options still need improvement, as tuition for online FHSU is higher than in-person and scholarship opportunities are more limited. By forcing the world to take advantage of online software, the pandemic showcased virtual education capabilities and promoted further development that could be helpful to students with misophonia.
Making Some Noise
Misophonia research and awareness have developed considerably over the past few years, creating communities where people can discuss this unspoken disorder. The Misophonia Podcast has had almost a hundred different guest speakers, each giving detailed testimony about how the disorder has affected their lives. MisoMatch provides a social platform that brings together hundreds of people worldwide who have been influenced by misophonia. An annual convention hosts discussions from the leading experts on misophonia. And on top of these resources, research is being done every day that will hopefully earn misophonia a place in the DSM-6.
Misophonia isn’t yet diagnosable. But it can definitely be a disability. With what we’ve learned and continue to learn past the pandemic, I have high hopes that there will come a day when people with misophonia don’t have to suffer in silence.