In Romeo and Juliet, Shakespeare writes, “What’s in a name? That which we call a rose by any other name would smell as sweet”. Misophonia may not be sweet but it would still have the same characteristics regardless of what we call it.
Why is the name “misophonia” used in the first place?
In 2001, Dr.’s Jastreboff and Jastreboff named misophonia in their audiology practice when they noticed a phenomenon where patients were reacting to sounds that were not consistent with tinnitus or hyperacusis. The name misophonia meaning hatred of sound was chosen to explore this in literature. Dr. Marsha Johnson had previously referred to this phenomenon in her own practice as “4S” or Selective Sound Sensitivity Syndrome— a term ironically that triggers many with the repetitive sharp “s”.
The term misophonia picked up in popular press including the New York Times and an episode of 20/20. The name, suggesting persons with this idiosyncrasy hated sounds, was an easy sell as a quirky weird science fact. “Did you know some people have a fight-flight response to chewing?” became a topic of discussion with misophonia referred to by some as “chewing rage”.
Does “Misophonia” accurately describe the condition?
In my opinion, the term “misophonia” does not accurately describe the phenomenon where individuals have a fight-flight-freeze response to otherwise non-aversive auditory stimuli. While hatred may be felt by some after they have their initital fight-flight-freeze activation, the emotional aftermath is complex and includes many emotions including anger, disgust, fear, shame, and even sadness. The emotional response should also not be first, wherein the “hatred” of sound makes one believe that the condition is a top-down phenomenon where a dislike for a sound then causes the hatred and reaction. This is not how misophonia works. Instead, the nervous system’s incorrect identification of a threat (the sound) leads to physiological symptoms like a racing heart, sweaty palms, tight muscles, and then an emotional response that is complex and driven by the individual’s perception of the world. First comes the physiological, then comes the cognitive. Misophonia is not hatred because it is not an emotion at all— it is merely a neurophysiological response that causes a turbulent aftermath just as any form of attack on one’s system may.
Why do researchers and advocates continue to use the name?
Having a name for misophonia that can be tracked through scientific literature to compare phenomenons has been a useful tool for researchers and advocates alike. While the word is imperfect it has allowed advocacy and science to come together to discuss the phenomenon where a person experiences auditory dysregulation. However, this has also led to ignoring decades of sensory research that has already mapped out the phenomenon of a sensory dysfunction and over responsivity, which included auditory triggers with all other senses.
Where do we go from here?
I personally will use the term “misophonia” as it is known by researchers and the community, but I will also add the caveat that I am discussing sensory dysregulation, particularly with auditory triggers. Sensory dysregulation is a more encompassing term because we remove the confusion of, “well what if you have visual triggers? what about scent?”. These are already covered under a broader sensory umbrella where we consider misophonia to be one form of the nervous system inaccurately parsing information from sensory based stimuli and becoming over-stimulated or dysregulated. There are many nuances to dysregulation, and the term “misophonia” is far too simple to encapsulate them all. Yet, this is the term we have that has brought us together and created the scaffholding to have this conversation—as imperfect as it is, there is value in having shared language.
