This is a type of therapy that changes one’s emotional response to a trigger. It aims to replace a negative feeling, like anger or anxiety, with a positive or even neutral one.
As a misophonia treatment, then, counterconditioning therapy gets the person with misophonia to listen to a triggering sound and learn to reduce their reaction to it through something that elicits positive emotions. For example, the noise of someone chewing might be paired with a photo of a loved one, with the intention that – over time – the negative feelings associated with that sound will subside, and be replaced by positive ones.
One investigation used counterconditioning therapy as a treatment for a middle-aged woman who was disabled by severe misophonia. After a 13-week course of treatment, the patient reported 82.1% recovery, and 93.1% recovery at a follow-up one year after the end of treatment.
Cognitive behavioral therapy, or CBT, is a talking therapy which can help you to manage your emotions, feelings, and responses to certain situations by changing the way you think.
It’s based around the premise that your thoughts, feelings, physical sensations and actions are all connected. That means that if you have negative thoughts and feelings, you can be trapped in a negative cycle that’s hard to get out of. CBT helps you to change these negative thought patterns to change your response to triggering sounds, and helps you regulate the emotional responses you feel.
It does this by:
- Helping individuals to understand the thoughts and behaviors that are associated with their sound triggers
- Examining these thoughts and behaviors to understand whether they are helpful or unhelpful
- Changing those thought patterns from unhelpful to helpful, and modifying behaviors associated with triggering sounds
Let’s say you’re someone who is triggered by the sound of a colleague clicking their pen during a meeting. You might think “They’re doing this on purpose to annoy me! They don’t care about me at all! Now I’m going to have to get up and leave the room, and I’m going to look like I don’t care about this meeting!”. You might actually get up and leave the room, missing part of the meeting.
CBT would retrain you to think in a different way. Perhaps you might instead think something like “They’re not doing it on purpose. They probably don’t even realize that they’re doing it. I’ll have to focus on what the speaker is saying so I don’t miss any important information.” Instead of leaving the room, you might lean forward and listen to what’s being said more intently. Rather than the feelings of anger that are associated with the first set of thoughts, you should instead feel calmer and more in control of the situation.
One research study found that after eight sessions of CBT, 48% of participants experienced an improvement in their misophonia. As a misophonia therapy, then, CBT can be quite effective. You should speak to your healthcare provider in the first instance about accessing therapy, or you can go directly to a private clinic.