Psychologists, Psychiatrists, and Misophonia

Source: Courtesy Pixabay

By Dr. Jennifer Jo Brout and Shaylynn Hayes

Understand That Misophonia Sufferers Need Your Support

There is currently no evidence-based treatment for Misophonia. Due to this, many patients come to mental health professionals scared that they will be dismissed, told they are imagining their problems, or be misdiagnosed. As a mental health professional, your first goal with Misophonia patients should be to confirm with your patient that you believe them. Misophonia sufferers are particularly sensitive, since they are often told by parents, teachers, and friends that they are overreacting. You should not underestimate the power that affirming your patient’s concerns can have. Validation makes all the difference when dealing with a lesser-known condition, and many patients understand there is no treatment and are looking for understanding and empathy.

Learn about Misophonia

Many treatment providers are confused when faced with a patient with Misophonia. Since Misophonia does not appear in any diagnostics manuals, it is important for providers to develop as thorough an understanding of Misophonia as possible before attempting to treat patients. The following resources may assist clinicians in understanding Misophonia basics.

• Duke Misophonia Classes — The Duke Misophonia and Emotion Regulation Program hosts classes and webinars on Misophonia. Events listings will be posted on www.misophoniainternational.com when upcoming.

• Drexel Misophonia Course — This online course at Drexel offers a basic understanding of Misophonia (and CEU credits). Once you have completed this course, you are eligible to be listed on the IMRN & MI Misophonia Providers list (see link below).

• Misophonia Guide for Doctors — This free downloadable guide for doctors can help clinicians by providing an outline of Misophonia, as well as a direction for the treatment for patients.

• Misophonia Literature Review — The Misophonia Literature Review provides an overview of Misophonia literature to date, as well as research directions.

Be Wary of the Use of Medications

The following is a statement from the Misophonia and Emotion Regulation Program at Duke University:

There is no scientific evidence that any specific medication treats Misophonia. However, doctors are able to prescribe medications “off label,” which means that they can suggest you try medications developed for other problems that they believe may help reduce difficulties related to Misophonia. If a doctor prescribes medications for Misophonia, we believe it is appropriate that patients be aware that such medications are experimental. In such circumstances, we suggest patients ask their doctor to disclose (a) the clear rationale for the use of such medications, and (b) any possible side effects and risks.

Be Careful with “Treatments” Involving Graded Exposure Therapy

In a past article on this blog, I discussed various kinds of CBT and its merits for Misophonia, and I concluded that “graded exposure therapy for the purpose of habituating to sounds does not work.” Since there is not enough clinical research on Misophonia treatments, we simply do not know if CBT or other therapies will have long-term negative effects on Misophonia sufferers.

Use Coping-Skills to Help Misophonia Sufferers

While there is no treatment for Misophonia, you can help your patients by developing coping skills. Coping skills are necessary to help patients to understand their triggers, help regulate their reactions, and reassure the patient of their experiences. Coping skills should be adjusted based on the needs of the patient. You can find a brief overview of the parent’s version of the Regulate, Reason, & Reassure (RRR) program here.

Use a Multi-Disciplinary Approach to Work With Other Providers

Misophonia sufferers have a specific set of needs that may be best served by a multidisciplinary approach. Audiologists can help by testing patients' ears and ensuring that the aversion to sound is not related to an audiological condition. Audiologists can also provide patients with custom-molded earplugs or sound devices to help mask Misophonia triggers. A neurologist, similarly to an audiologist, can help rule out other conditions and is important if your patient has a sudden onset of symptoms. An occupational therapist can help Misophonia patients by developing personalized sensory diets and identifying their sensory needs.

As a psychologist or psychiatrist, you play an important role in the multidisciplinary approach by providing the patient with support and helping them to develop coping skills.