Treatments for Noise and Sound Sensitivity Including Misophonia and Hyperacusis
by Erika Slater
This post was updated in March 2020 to reflect new treatments and findings in research around the topic of noise sensitivity.
We’re told we enter the world with two fears – fear of falling and fear of loud noises. Every other fear it’s said is… learned.
However, for many folks they never lose the fear of loud noises. But it’s not the only sensitivity to sound that impacts people throughout their lives.
I suffer from tinnitus and while its not as extreme as some sufferers nonetheless its always present and I can sympathize with anybody who endures over the many forms of noise and sound sensitivity.
This article will explore different classifications of sensitivity and treatments available. I consider myself a practical person and while the medical research fascinates me, many times clinical description leads to a lack of understanding and clarification about what to do next for a lay person.
Disclaimer: I’m not a medical doctor and in order to make this article readable I’ve taken some liberties with conditions and their classification in the scientific community. The fact that even the medical community doesn’t always agree on the classification I think gives me some “freedom” in categorizing in attempting to clarify.
Additionally, the field of noise and sound sensitivity is still in its infancy, and for most sufferers it’s less about what’s the classification and more about what’s the treatment available, right?
This article has been written for those suffering with these conditions and at the end of this article you’ll find some additional resources I’ve compiled to help you decide on next steps.
TYPES OF NOISE AND SOUND SENSITIVITY:
In the medical world today, there are four types of sound sensitivities: 1) Hyperacusis, 2) Recruitment, 3) Hyperacute Hearing, and 4) Misophonia and Phonophobia.
I’m going to use non-medical language to describe these terms but I’ve linked to resources later where you can get absorbed in more science if you wish.
Hyperacusis: This is a conditioned diagnosed when you’re got a sensitivity to a range of frequencies that often fall into the everyday sounds in the environment. The medical community is unsure how it develops but suspects there’s many different factors that can bring it on.
These factors range from damage to the ear through deterioration or a sudden loud event to genetics, stress or ill-health. Musicians are known to become intolerant to loud sounds and in particular members of rock bands subjected to long bouts of music at high decibels!
People suffering from Hyperacusis describe it as living in a world where the volume is constantly turned up intolerably loud. Sudden high-pitch sounds we may take as normal and brush-off become irritating and painful for sufferers and can include, alarms, children’s screams, and squealing truck brakes.
A high percentage of people diagnosed with Hyperacusis also suffer with Tinnitus – see below.
Science does not understand fully what happens, but the theory is there’s some hearing loss at specific frequencies and so sounds at this pitch do not impact a person but when the sound reaches a certain level the hearing cells covering the increased volume kick in – are “recruited” so to speak.
But because the high sound level is sudden, and not incrementally increased as for a normal person, it causes major discomfort and even pain for the individual sufferer.
Here’s an example based on one provided by Dr. Stephen Nagler about one of his parents to illustrate Recruitment: Say you were calling to your mother and you said “Mum.” She heard nothing, and didn’t respond. So, you’d say it a bit louder. Still nothing. A bit louder than that. Still nothing. And then … just a very tiny bit louder. She would respond: “Stop yelling so loud, I hear you fine!”
Recruitment is diagnosed mostly with people in cultures where people are bombarded with loud noise on a continual basis such as western cultures where loud everything seems to be the everyday norm.
Hyperacute Hearing: This classification is reserved for those who are sound sensitive at birth at certain frequencies and sound levels. Prime example is autistic children where some frequencies at some levels cause extreme discomfort where other frequencies at normal to loud levels don’t seem to bother them.
There’s debate on whether the condition is caused by an exaggerated response by the nerves in the ear or whether its by the listener – that is somewhat psychosomatically induced. Science is still working through this classification as its not restricted to autistic children.
Misophonia and Phonophobia: These are symptoms that usually accompany Hyperacusis but are usually addressed separately and in addition to Hyperacusis. Misophonia is dislike of some sounds and Phonophobia is fear of sounds. Science is suggesting Phonophobia is a sub-category of Misophonia.
Misophonia is not impacted by sound level but by a particular sound. The person afflicted can become angry at the following: eating or chewing sounds, lip licking and smacking, but of others rather than themselves generating the sound, or spoken sounds by themselves and others, such as words with specific consonants in them.
Misophonia is also known as Selective Sound Sensitivity Syndrome or 4S for short.
Whatever causes Misophonia those suffering can become enraged and intolerant of the sounds and have to avoid eating with others or using certain words. It can be extremely impactful on a person’s life.
No less impactful is Phonophobia, because in fearing sounds sufferers end up avoiding circumstances where sound will impact them, which means planning their day or events in the future to avoid situations where they’ll experience this fear. This usually means becoming more and more isolated, which is the reverse of what is needed to help overcome the intolerance by keeping the ears active to rebuild the necessary tolerance.
Tinnitus: As previously mentioned Tinnitus can be a symptom in those diagnosed with Hyperacusis. It isn’t a noise or sound sensitivity as regards being triggered by an external sound, in fact it’s a perception of phantom sounds internally and isn’t a condition by itself but a symptom.
While its usually described as a constant “ringing in the ears”, the noise can be hissing, buzzing, roaring, or clicking in addition to ringing.
The sound can come and go or be constant and be in either or both ears.
Most forms of tinnitus are caused by damage to the ear nerves or nerves in the brain that help interpret sound. Treatments developed for Tinnitus, as you’ll read, are used to aid with the noise and sound sensitivity issues discussed already.
TREATMENTS FOR NOISE AND SOUND SENSITIVITY CONDITIONS:
Below you’ll find some information on treatments and further resources for each of the conditions and symptoms mentioned above. In particular sound therapy using white noise is commonly used in treatments. One common element not adequately covered in any treatment plan is dealing with stress. As stress is a key symptom of all these conditions sometimes its difficult to “draw the line” between cause and effect.
While relieving the stress is not likely to make any of these conditions go away on its own , nonetheless historically we know a body under significant stress is prone to become a “sick body” which can aggravate and exaggerate existing conditions.
I would draw your attention to therapeutic hypnosis being helpful in getting stress under control, and thereby reducing the impact of your condition, as a good starting point for the other specific treatments below.
If you want to explore getting your stress under control further, then there’s a link in the resource section for more information.
Hyperacusis: Currently, there is no surgery or medical procedure for treating hyperacusis. The common treatment for Hyperacusis is Retraining Therapy which uses a combination of counseling and a sound generator.
The counseling helps sufferers cope better with the onset of hyperacusis to reduce the impact, and the sound generator uses broadband noise to retrain the auditory nerves and brain to tolerate normal environmental sounds.
The therapy can take anywhere from three months to two years to see improvements and can be expensive and typically not covered by insurance.
Next step should be reaching out to your primary physician to get referred to a specialist. You may need to search for an audiologist familiar with TRT (Tinnitus Retraining Therapy) or a specialist in TRT. I found if I went into Google search and typed in “tinnitus retraining therapy [town or city name]” I would get search results covering people treating tinnitus with TRT in my local area.
Most large hospitals or eye & ear departments will be familiar with TRT and put you in touch with audiologists and therapists familiar with the treatment.
Many times, people with the issue have been using ear plugs for many years, but this unfortunately reduces the symptoms but doesn’t help improving the condition.
Seek out through your primary care for an audiologist to help with the sound generation and proper setting of your hearing aid when they confirm you have Recruitment.
If you have issues with finding a referral, especially, with TRT training audiologists, reach out to your local city hospital or use the online search capability explained above under Hyperacusis.
Hyperacute Hearing: This information about treatment is taken from the AIT Institute website.
Commonly autistic children who have hyperacute hearing are treated with auditory integration therapy (AIT). AIT takes regular music and filters out the problem frequencies through a special machine called an audiokinetron. Somehow this therapy seems to ‘retune‘ their ears and normalizes their hearing tolerances. The music is listened to at decibel levels which can peak up to 90 decibels.
AIT can be used as a treatment in a number of non-hearing conditions and learning disorders involving speech and language. The UK website listed in the resources below covers the different disabilities where AIT training can help.
Misophonia and Phonophobia: As previously mentioned Misophonia and Phonophobia are not hearing issues per se but neurological problems. Because they can be present in sound sensitivity issues they are treated distinctly from the predominant sound issue.
There is no known cure for Misophonia but particular therapies have helped with reducing the symptoms. These include TRT as previously mentioned, Habituation Therapy, and Cognitive Behavioral Therapy (CBT).
In addition to these treatments there’s a new one coming out of UK which is a hypnotherapy procedure specifically aimed at treating Misophonia called Sequent Repatterning. It’s developed by Chris Pearson a clinical hypnotherapist. Currently, few people are trained in its use and if you’re in the U.S. I would suggest you visit Chris’ site directly for more information about the procedure and determine next step.
A link to the website can be found below along with a group of sites covering Misophonia. There’s a discount for the 8-week program if you come through the Misophonia Treatment Institute for the Sequent Repatterning program and I’ve provided that link below.
Hypnosis Downloads has an inexpensive but popular session on noise sensitivity covering Misophonia and you can read more about it here >>>
As Phonophobia is considered an anxiety disorder common treatments include Exposure Therapy and Cognitive Behavioral Therapy (CBT). This description of Exposure Therapy is taken from the Psychcentral.com website:
In phobias, exposure therapy is used in conjunction with relaxation exercises and/or imagery. In conjunction with learning how to bring about a relaxed state at-will, the therapy technique gradually exposes patients to what frightens them and helps them cope with their fears.
A link to basic information on CBT treatment can be found in the resource section below.
Tinnitus: There is no proven cure for chronic Tinnitus but several treatments help reduce the impact on a sufferer’s life by helping them manage their condition. The American Tinnitus Association (ATA) website lists several treatments to help.
Depending on the original cause of the condition some or all of these may help. Attention to general wellness, hearing aids to recover hearing loss, sound therapies which includes Tinnitus Retraining Therapy (TRT) described earlier, and Behavioral Therapies to reduce the stress and anxiety responses.
The ATA website has a provider network search capability and so your next step should be to check this out to see if a provider resource is available close to your location. Also, reach out to your primary physician as they may be able to provide a referral to a specialist or a city hospital with an ear treatment specialization.
Kevin Hogan, Psy, D was a Tinnitus sufferer who had such a severe case he contemplated suicide. He wrote a book on how he got his condition under control and came back from the brink – he explains what “cure” means for him. Kevin can be controversial so if you read his section on Tinnitus at his website linked to in the resource section, you’ll get his blunt opinions on some of the treatments already discussed. Kevin also subscribes to the notion that the intensity of the tinnitus being experienced can be linked to what is going on in personal life and unresolved issues, and this needs to be addressed as part of your individual program.
OTHER TREATMENTS TO RESEARCH:
There are two additional therapy treatments I suggest the reader explores further particularly for those conditions where stress and anxiety are major contributors to the intensity of the symptoms as in Misophonia and Phonophobia.
However, as noted earlier stress and anxiety accompanies many of the other noise and sound sensitivity conditions as a symptom needing to be addressed, so there’s value in exploring these treatments for any of these conditions.
EMDR: Eye Movement Desensitization Reprocessing is a therapy developed to aid physiological healing of distress associated with traumatic memories. Its also been used in reducing PTSD symptoms.
Individual research is underway on determining if EMDR is an appropriate therapy for dealing with Misophonia and I would recommend you look for studies being offered to determine if appropriate for you. I’ve placed a link below for more information on what EMDR is all about.
IEMT: Integral Eye Movement Therapy shares with EMDR the basic model of eye movement but then they differ substantially. While EMDR developed for dealing with trauma uses imagery central to its work, IEMT has application beyond PTSD but imagery is largely irrelevant for its process. Andrew T. Austin in the UK developed IEMT. Again, I’ve placed a link in the resource section for more information but be aware this is a site for practitioners.
ADDITIONAL RESOURCES RELATED TO NOISE SENSITIVTY:
For some this may be the most important section of the article as it can help you find the right help and next step towards “recovery” and “cure” and I put that in quotes as it will have a different definition for each of us. These website and links to articles were ones I found useful in understanding the conditions and treatments available. I sincerely hope they help you or a loved one dealing with any of these issues.
I welcome comments about this article with a desire to keep it updated and as accurate as possible. Links to resources over time become updated or broken so email me if you find something not sending you to the place you expected.
If you want to consider working directly with me through my online or in-office sessions then check out my Hypnosis Services or if you’ve a specific question about this articel or seeking help then contact me here.
When I started researching for this article I really didn’t find one place that brought multiple conditions and multiple treatments together, and I’ve humbly attempted to overcome that challenge here. It turned out to be a mammoth exercise and I do hope those who suffer with any noise and sound sensitivity issues finds it a useful resource.
If you did find it useful please share with others and for therapists and practitioners feel free to link to it.
Erika Slater CH
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