Within mainstream psychology and psychiatry, avoidance is frequently labeled as a “maladaptive” behavior—a flawed coping strategy that individuals use to escape discomfort, which supposedly reinforces anxiety and prevents long-term habituation. Because of this framework, clinicians often encourage patients to push through triggering situations. However, when applied to misophonia, this traditional critique falls short. It treats a deeply rooted neurophysiological crisis as if it were a simple cognitive phobia, ignoring a crucial reality: individuals with misophonia do not habituate to their triggers.
When we reframe misophonia through the lens of nervous system regulation, stepping away from a trigger sound is not a failure to cope. It is a highly rational, self-protective response to an immediate fight-or-flight cascade. After all, the most direct path to physiological stabilization is removing oneself from the stressor.
The Spectrum of Adaptive and Maladaptive Avoidance
Determining whether avoidance is healthy or harmful is not a matter of rigid clinical definitions. Instead, it depends entirely on the context, the individual, and the unique needs of their family unit.
Social and cultural expectations often complicate this decision. For instance, the traditional family dinner is heavily romanticized as a mandatory bonding experience. Yet, for someone with misophonia, the intense sensory distress experienced at a dinner table can easily eclipse any emotional benefit of the gathering. In these moments, forcing compliance under the guise of “healthy exposure” can do more harm than good, and families should be careful not to judge these choices too harshly.
Avoidance crosses the line into being truly maladaptive only when it begins to cause more distress than the triggers themselves. If an individual isolates to the point of profound loneliness, completely withdraws from meaningful relationships, or stops engaging with friends and family altogether, the behavior has become harmful. Even then, the root cause may not be the misophonia itself, but rather a lack of baseline safety and accommodation within those relationships. When a person feels secure and supported, they are far more capable of staying present.
Customizing Boundaries: The “Never, Sometimes, and Adapting” Framework
Because a person’s physiological, emotional, and cognitive capacity changes from day to day, their boundaries will naturally fluctuate. What is tolerable on a low-stress Tuesday might cause a complete autonomic hijack on a exhausting Friday.
Because many vital, daily noises cannot be eliminated, individuals and couples can benefit from actively negotiating their boundaries rather than relying on unexpressed assumptions. Categorizing triggers into a dynamic framework can help families collaborate:
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Never: Hard boundaries and situations that are consistently too damaging to navigate without severe distress (e.g., specific public environments like movie theaters).
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Sometimes: Context-dependent triggers that can be tolerated depending on the individual’s current sensory battery and energy levels.
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Adapting: Inevitable or necessary sounds (like a partner clearing their throat or snoring) where avoidance is impossible. In these scenarios, the focus shifts entirely to proactive accommodation—such as using white noise, loops, or ear protection—to allow the individual to safely coexist with the sound.
Ultimately, avoidance is neither inherently good nor bad. It is a tool for survival that changes depending on how often it is used, why it is used, and whether the surrounding environment is adapted to support the individual’s neurodivergent needs.
Shaylynn Hayes-Raymond, LCT-C is a Licensed Counselling Therapist-Candidate in New Brunswick, Canada. Shaylynn is the Director of The International Misophonia Foundation and Owner of Misophonia International. Shaylynn is the author of Cognitive Behavioural Therapy among other books, and offer counselling services in Canada and coping skills worldwide. You can learn more about Shaylynn’s counselling, coaching, and classes for sufferers of misophonia and clinicians here.
