Q: Why do I concentrate on trigger sounds so much? I don’t want to!

A: The brain of someone with misophonia has determined that specific sounds — trigger sounds — are harmful to them and that those sounds must be monitored. Our minds will focus on an important sound in order to understand speech in noise, specific sounds, or to determine the location of sound. It is a miracle how we can concentrate at will with other noise going on. When the brain has determined that a sound is important, other parts of the brain can actually make the sound louder within the brain.

Have you ever been at a party with lots of people talking, and someone 15 feet away says your name? Immediately we start to listen more closely to that conversation, trying to understand and determine what is being said. This same increase in the volume of the sound within the brain happens with misophonia, but the person with misophonia has not thoughtfully determined that the sound is important — something within their brain has made that determination. But having been made, the brain concentrates on it intently.

A person with misophonia can hear people sniffle a room away and zone in on that particular sound, perhaps feeling anger and disgust at the sound. Part of our brain — probably the amygdala in the limbic system — has determined that this sound is important and needs immediate attention. The amygdala then notifies a part of the brainstem — the reticular formation — to increase the volume of the sound. These two neurological structures can increase awareness of particular sounds, decrease awareness of them, or not adjust them at all.

There are a lot of sounds we don’t concentrate on and might be unaware of. For example, there are thousands of people who live next door to the train tracks and never hear the train pass by, but they might be aware of when it doesn’t pass by! But for a person with misophonia, the brain is always aware of trigger sounds, always trying to make them louder, always searching for them. It is no wonder that the person with misophonia feels anxiety and stress.