Oxford Sparks

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Emily Elias: We’ve all been there. We’re on the bus, and then somebody takes a phone call on their speakerphone and they’re not using headphones. Or someone starts blasting this tinny EDM music with their friends, and we are slowly filled with rage that they aren’t adhering to the unspoken laws of public transportation. On this episode of the Oxford Sparks Big Questions podcast, we’re asking, why does a stranger’s phone noise annoy me?

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Emily: Hello, I’m Emily Elias, and this is the show where we seek out the brightest minds at the University of Oxford, and we ask them the big questions. And for this one, we have found a researcher who can help make some sense of this acoustic chaos.

Jane Gregory: I’m Jane Gregory, and I’m a clinical psychologist, and I’m doing research on something called misophonia.

Emily: What the heck is misophonia?

Jane: Misophonia is when people get a really intense reaction to sounds that other people either don’t even notice or would only be mildly annoyed by. And the most common ones are often sounds that are made by other people, things that are repetitive. So it might be chewing sounds, breathing, coughing, sniffing, that kind of thing, but also repetitive sounds in the environment. And that might include things like mobile phones or keyboards, typing, pens clicking, that kind of thing.

Emily: So like to explain it to me, when you hear the sound of somebody chewing or you hear the sound of somebody doing that sort of like sniffle, what happens to you?

Jane: So most people don’t like the sound of loud chewing. And we did some research on this, and eighty-five percent of a general population sample said they had some kind of negative reaction to the sound of loud chewing. But for people without misophonia, they said they felt irritated by it or disgusted by it. Whereas people with misophonia, they were more likely to say they felt like an anger or panic kind of feeling, so a much more intense response.

The other thing that happens with misophonia is that it’s impossible to ignore. So once you’ve heard the sound, you can’t filter it out. Most people, even if you don’t really like a sound, can tune it out after a little while and they just get on with what they’re doing. But for somebody with misophonia, myself included, once I’ve noticed that sound, I just can’t ignore it. And it’s like an alarm or a siren or something like that, that there are these sounds that our brains aren’t meant to ignore. But for somebody with misophonia, everyday sounds become like an alarm or like a siren where your brain just will not let it go.

Emily: Okay, so when I’m on a bus, because this is what we’re bringing it all back to, me being very annoyed when kids start playing their like tinny EDM music, does that fit into this sort of like misophonia family?

Jane: I think it’s safe to say that most people find that annoying if somebody is. There’s something about breaking the rules. So we’ve all agreed that we’re not going to do that, that if we’re going to listen to something on public transport or in public, we use headphones or hold it up to our ear so that other people don’t have to listen to it. So someone’s breaking the rules. That alone can be annoying because they’re not doing what we’ve all agreed to do.

But I think there’s something particularly annoying about that. So it comes down to the behaviour, like you’re not supposed to do it, but also the auditory acoustics of it. The speaker is designed to be in front of your face, so if you’re having to listen to it from any other angle, you’re not hearing it the way that it’s intended to. So you hear it in a distorted kind of way. And when our brain hears distorted sounds, it tries to fill in the gaps. It has to work really hard to make sense of the sound. And it doesn’t sound good, it doesn’t sound nice to listen to. So even if it’s music that you would otherwise enjoy listening to, if you’re listening to it at a strange angle or through somebody’s headphones because they’ve got their headphones up so loud, it sounds a bit off and our brains have to work really, really hard to process sounds that don’t sound quite right.

The other part is that if you’re listening to a conversation and you can hear one side of the conversation really well, and the other side of the conversation is distorted or a bit quieter and you can’t quite hear what it’s saying, your brain will automatically try and work out what is going on, even if you’re not remotely interested in that person’s doctor’s appointment or what time they’re going to be home for dinner. Your brain will try to hear the other side of the conversation. So if there are two people who are just chatting, you can hear both sides. Your brain goes, oh, okay, I don’t need to listen to that. You don’t keep listening to it. But when somebody’s on a phone and you can only partially hear the other end, it’s like your brain tunes in even more because it’s trying to work out whether this is important or not. And you can’t switch that off .

Emily: Because like I do find it annoying, but I do get off the bus and I kind of, like, within a few seconds just let it go and I move on with my life, with somebody who has misophonia, what happens to them when they are exposed to this sort of like rude public transport behaviour shall we categorise it as?

Jane: For people with misophonia when they’re in the moment, it’s not just that it’s annoying, it’s that the reaction just keeps getting stronger. Like so we often talk about desensitising. So desensitising is when you get used to something because it keeps going and there’s nothing new about it, and your brain just gets used to it and it feels more comfortable over time. What happens with misophonia is sometimes the opposite. It’s sensitising. And so the more that you’re listening to it, the more agitated you get, the more irritated you get, the more panicky or anxious angry that you get while you’re listening to it. So the reaction escalates with time, so when you’re stuck there, it can also just feel like that reaction is just going to keep going and going and going. And so that then adds to the intensity of the reaction. And that also means that when it stops, it takes longer to calm down afterwards. So the impact of it lasts beyond just the moment. And for some people with misophonia, once they’re away from the sound, actually they reset really quickly and it’s fine. And it’s just when they’re in the moment that it’s a problem. And for other people, it takes a long time to calm down, sometimes even a whole day – like if they’ve had a really intense moment, their body is just nervous and on edge for the rest of the day. It’s like it’s waiting for something disastrous to happen.

Emily: And how common is it to have misophonia?

Jane: It’s surprisingly common for something that a lot of people haven’t heard of.

So we did some research that found that nearly one in five people have misophonia to the what we’d call a subclinical level, which is where if you were stuck in a room and couldn’t get away from a particular sound, It would drive you crazy. You’d get that really intense reaction, but it doesn’t necessarily affect you on a day-to-day basis. You wouldn’t say, yeah, this impacts my life and it causes distress on a daily basis. So the number of people that experience it to that level is much smaller.

But we don’t know what that number is because we don’t yet have an agreement on how we diagnose it or categorise it and what actually constitutes a disorder level. But it’s probably more like one or two percent of people that are suffering to that level.

Emily: And how do you go about creating a criteria that somebody can just go and get a diagnosis? Where are you at with that?

Jane: Everything is still in the very early stages. The name misophonia is only just over twenty years old, and most of the research has been in the last two or three years.

Emily: Wow.

Jane: There’s been more research published in the last two or three years than there ever was before. So everything is just starting to happen now and people are coming at it from different angles. So I’m coming at it from a psychology angle. I’m really interested in the impact on people’s mental health. I’m interested in what it makes us do. I’m interested in how it makes us feel and some of the cycles that we get stuck in.

There are audiologists who are researching it, and they’re looking at it from an acoustic perspective, like, what are these kinds of sounds and why are we processing them differently from other sounds? And what can we do to cope in the moment with those sounds?

There’s people studying it from a neuroscience perspective, so they’re looking at what’s happening in the brain in people with misophonia compared to people without misophonia.

When we listen to these sounds and what’s happening in the brain, when we listen to these sounds, compared to other sounds that we all consider annoying but aren’t sort of typical misophonia sounds.

So there’s lots of different areas that are studying this, and that means that we’re all approaching it in different ways. So I’m thinking about, well, misophonia, for it to be a disorder, I would think it probably has to cause distress and have an impact on your day-to-day functioning. Whereas an audiologist or neuroscientist might be thinking about what are the hearing thresholds for this person, or what’s the brain doing? And they might be thinking about it from that perspective. So at the moment, we don’t really have a consensus on what it is, how we define it and how we diagnose it.

Emily: Well, it’s interesting though, because you come from it with a perspective of living with it. So what sort of insights do you have when you’re working with people who are coming to you with this sort of affliction and not really sure how to navigate it?

Jane: I think my own experience with it is – it’s kind of a blessing and a curse, like it helps me to believe people when they’re saying what’s going on. I can very strongly relate to what they’re telling me, but it also means that I’m sometimes limited in how I think about it, because I think about it in relation to my own experience. And so one of the things that I do with all of my research is I speak to a lot of people with misophonia to help at every stage of the research, so that I make sure that I’m not just thinking about it from my own perspective. I’m not just trying to solve my own problems here. I’m not just doing an entire research project, trying to work out why I can’t stand the sound of my husband breathing, but I’m trying to think about why other people can’t stand the sound of their partner’s breathing, and also really wanting to focus on what’s important to the community of people with misophonia, and not just what’s important to me.

Emily: If I’m somebody who’s listening to this podcast and all of a sudden a lot of the things that you’re saying are really, really ringing bells for me, and I think I maybe fall somewhere in this spectrum. What can they do? What resources are out there to help get more information?

Jane: I think just having the word to describe how you’re feeling can be extremely helpful. So for me, when I discovered there was a name for what I’d experienced my whole life. It was a relief, like I suddenly realised I wasn’t crazy. I wasn’t trying to control people around me. I actually… my brain just responds to sounds in a different way. And more importantly, I’m not the only person who has this reaction to sounds. It was it was a revelation just discovering that. So there are also some amazing charities out there that help support people with misophonia. So in the US there’s a charity called So Quiet and they’ve got loads of information. They publish information about research in a way that is easy to understand, so that you can learn a bit more about misophonia and the mechanics behind misophonia. They also do things like they create little cards so that if you’re being triggered, particularly by a sound and you don’t feel comfortable or able to talk to the person that’s making the sound, but you really need it to stop, you can hand them a card that explains what misophonia is, and asks them politely whether they could possibly stop making the sound. So it’s just these little strategies that help people to live with misophonia and to communicate with other people about their misophonia.

And at the moment, there are no established treatments for misophonia. That’s one of the things I’m trying to work on with my research is trying to work out what are the aspects of misophonia that can change in response to some kind of treatment? But it’s early days…

Emily: So your research is obviously got a lot of different avenues that it can travel down and probably a long road. Like having only two years of identifiable work into this, it almost feels like it’s like a baby in terms of like other diseases who have had hundreds of years of research into them. What’s it like for you to take on a project like this and try to unlock some of the mysteries behind misophonia?

Jane: It’s really exciting to be doing research on something that is at the beginning. It’s brand new. Everything that you find will be important. Information and everything that you do is helpful because it’s new and nobody knows that yet. But it also means that for me, I’m basing a lot of my research on ideas that I got from working with people with anxiety and obsessive compulsive disorder [OCD], and I’m finding that the results aren’t what I was expecting, because it’s not similar to anxiety and obsessive compulsive disorder.

So one of the things I was really interested in was avoidance. And we know that in both OCD and most anxiety disorders, that when you avoid things, it makes the anxiety worse over time. And what we’re finding with misophonia is that some level of avoidance is actually really helpful for people with misophonia, because it allows them to sort of reset their nervous system to cope better, to be kinder to the people around them, and that it doesn’t necessarily follow the same path that I was expecting based on previous experience with anxiety and OCD.

But what I’m also finding is these new things come to the surface that I discover along the way. So the role of attention in misophonia that once they hear the sound, it’s not just that they can’t ignore it, it’s that they try and find where it’s coming from. They try and work out what it is. They might stare at the person who’s making the sound, and that the more people do that over time, that actually makes the intensity of the reaction a little bit stronger over time because of the amount of attention you’re playing with it. And so something like that, that I didn’t go looking for in the first place, but it came out of the work that I was doing is really, really exciting.

Emily: So in these moments when I find myself getting upset on a bus because some teenager is blasting their music, is there any strategy that I could take away to try and cope and calm myself down, despite the fact that, you know, I know, hands up, I don’t have misophonia, what can I do to alleviate that? I don’t know, what do you call it? Like societal rage.

Jane: Firstly, I think that the societal rage is justified.

Emily: And thank you.

Jane: Maybe the first step is just to validate your experience of that rage that. Yeah, it’s really, really annoying.

Emily: I needed that so much. It’s so annoying.

Jane: But something that we can do because there’s a layer of the reaction that is based on what we think of the other person, what we think it means about the other person, or what we think it means they’re capable of. Like if they can break this rule, what other rules are they prepared to break? And so what we can do if you’re in a state of mind to do this, is, is try and create a little backstory for them that helps you to think a little bit more kindly towards them. So it could be like they’re having a really bad day. They’ve left their headphones at home, and this is the only thing that is going to help them get through this journey. And just creating a little story that is a little bit kinder than what you were already thinking. Sometimes that just that tiny shift can actually help us to feel a little bit better in that situation. It also gives us a little bit of a feeling of control over the situation, because you’re now interacting with what’s happening in a way that you’re in control of, whereas when it’s happening to you, it feels out of control and that makes it more distressing.

Emily: I really needed the validation. So thank you very much. Really, it goes a long way. I feel so seen.

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This podcast was brought to you by Oxford Sparks from the University of Oxford, with music by John Lyons, and a special thanks to Dr Jane Gregory.

Tell us what you think about this podcast. We are on the internet at Oxford Sparks or you can go to our website OxfordSparks.ox.ac.uk.

I’m Emily Elias. Bye for now.

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