Developing a model for Misophonia is not an easy charge. Misophonia has been shown to have a brain basis and potentially mirror neurons involved (Kumar, 2021). At this time, psychologists have been using treatments such as Cognitive Behavioural Therapy, but follow-ups have not been showing prolonged results. More importantly, for those who have Misophonia, these models have been shown as unfavourable or not showing lasting change. A model for Misophonia must have a sensory regulation basis, emotional basis, and an underlaying understanding of the auditory, nervous, and emotional regulation systems in a combined multidisciplinary setting (Brout, et al., 2018).
To be honest, there isn’t a single proposed model that I think works right now. Even more importantly, I don’t think the right questions are being asked of those who suffer from misophonia. I have heard numerous stories of people so grateful to even be listened to, that they didn’t have the heart to tell the researchers that this didn’t actually work. Follow ups are also non existent. This is disturbing. Can you imagine basing your child’s treatment on something that was approved simply because some one didn’t want to be rude?
Psychologists aiming to treat Misophonia are willfully blind to cognitive neuroscience, sensory regulation, and a multidisciplinary approach. All treatments for Misophonia should be seen through the lens of a brain disorder that is not yet fully realized, instead of shoe-horning the condition into pre-existing boxes. Through this, sufferers of Misophonia are left eternally in the dark with practitioners who are simply throwing whatever they can to the wall and seeing what sticks.
I can tell you, personally, as somebody who sufferers from Misophonia that the cognitive model is not only lacking, but simply does not understand the condition. No amount of restructuring thoughts helps a disorder that does not originate in thought.
Furthermore, those researching Misophonia have had the disgusting habit of researching with a blindness to the origins of studies. One particular “researcher” has been included in citations, whereas his work not only does not work, but is unscientific and through the lens of a behavioural analysist—for a non behavioural disorder. Yet, brain researchers and sensory regulation specialists are wholly ignored. This is disturbing to say the least.
It is my goal in my upcoming clinical career to come up with ideas for Misophonia that don’t include unverified nonsense, but also that consider psychology as a field for its limitations. People with Misophonia have varied life experiences, but we are also suffering from something that cannot be described by current and existing models. Believe me, if CBT worked, I would be throwing my hands up in the air in delight. It DOESN’T.
I am hoping to do surveys in the next year or two that focus on treatments that sufferers have tried, what worked (if anything), and what did not work (or only worked shortly). This preliminary work will then be published in our upcoming Misophonia journal – and then finally, the goal is to consult with other clinicians and researchers and come up with an idea and a plan to help sufferers in the meantime.
The next step will be academic studies and case studies using the model, followed by a guidebook published through the IMF.
References
Brout, J.J.; Edelstein, M.; Erfanian, M.; Mannino, M.; Miller, L.J.; Rouw, R.; Kumar, S.; Rosenthal, M.Z. Investigating Misophonia: A Review of the Empirical Literature, Clinical Implications, and a Research Agenda. Front. Neurosci. 2018, 12, 36
Kumar, S., Dheerendra, P., Erfanian, M., Benzaquén, E., Sedley, W., Gander, P. E., Lad, M., Bamiou, D. E., & Griffiths, T. D. (2021). The Motor Basis for Misophonia. The Journal of neuroscience : the official journal of the Society for Neuroscience, 41(26), 5762–5770. https://doi.org/10.1523/JNEUROSCI.0261-21.2021
