Title:
How to Help: Treatment Strategies for Misophonia
Presenter:
M. Zachary Rosenthal, PhD
Description:
Misophonia is a newly defined disorder with a high prevalence in the US (4.6%; Dixon et al., 2024) that is characterized by unusually strong aversive responses to certain sounds and associated cues that cause significant impairment in functioning and/or psychological distress (Swedo et al., 2022). Triggering cues are commonly oral (e.g., eating, lip-smacking, throat-clearing) or facial (e.g., nasal breathing, sniffling) but can include a wide range of other sounds made by others repetitively. When triggered, people with misophonia have a wide range of symptoms, including uncontrollable intense emotions (anger, rage, social disgust, or anxiety) and associated behavioral (escape/avoidance), attentional (vigilance/distraction), somatic (heightened autonomic arousal), interpersonal (verbal aggression, inhibition), and cognitive (internalizing/externalizing attributions) symptoms. As misophonia is gaining recognition and scientific attention is rapidly increasing, it has become clear that clients and patients seeking help often do so through mental health providers. Unfortunately, mental health providers may be unfamiliar with misophonia, mistakenly believe they cannot be helpful, and not help the client. The purpose of this training is to provide an overview of process based therapy (PBT; Hayes and Hofmann, 2018) as a framework for individualizing psychotherapy to clients and patients with misophonia. PBT is flexible, integrative, and research-based. It emphasizes using common psychotherapy factors and individualized coping strategies to reduce impairment and change ineffective patterns. The approach is principled, practical and organized, aiming for the “sweet spot” between overly rigid treatment manuals and overly loose models of supportive therapy with unclear direction for change. Attendees will quickly be able to understand the rationale for PBT as a psychotherapy framework, learn the BASIC grid for identifying biopsychosocial processes to change, and identify known evidence-based treatment strategies to flexibly tailor, collaboratively, in order to help patients. This not a “cure” for misophonia. Instead, it is a way to help people change longstanding patterns causing significant impairment in everyday functioning.