Understanding Misophonia: Why Certain Sounds Trigger Strong Reactions and How to Manage It with EASE Therapy

Misophonia Therapy in Bergen County, NJ

Imagine sitting down for dinner, and the sound of someone chewing makes your skin crawl. Your heart races, your fists clench, and you feel an overwhelming urge to escape or lash out. This isn’t just a mild annoyance — it’s misophonia.

My name is Eliyahu Serkez. I specialize in the EASE protocol — the only published effective treatment for misophonia — in-person in Upper Saddle River and via telehealth throughout New Jersey & New York.

What is Misophonia?

Misophonia is an intense emotional reaction to specific sounds, often repetitive noises made by other people. Common triggers include:

  • Chewing, slurping, sipping
  • Pen clicking, foot tapping, keyboard typing
  • Sniffing, breathing, or throat clearing

For people with misophonia, these sounds don’t just cause irritation — they can trigger frustration, rage, anxiety, or panic, making social interactions and everyday life incredibly difficult.

Why Does Misophonia Happen?

Misophonia isn’t just about sound sensitivity; it involves psychological, emotional, and behavioral factors. Researchers propose that misophonia develops due to a combination of personality traits, learned responses, and psychological conditioning:

  1. Personality Traits
    Many individuals with misophonia tend to have perfectionistic or rigid personalities. They have a strong need for order and control, making unexpected or repetitive sounds feel unbearable.
  2. Learned Associations (Classical Conditioning)
    A person might initially feel frustrated with a family member for an unrelated reason. If that person makes a specific sound (e.g., chewing loudly), the brain associates the sound with frustration. Over time, the sound alone triggers an automatic emotional response.
  3. Avoidance and Reinforcement (Operant Conditioning)
    To escape the discomfort, people with misophonia may avoid meals, wear headphones, or isolate themselves. While avoidance provides temporary relief, it actually reinforces the brain’s sensitivity to trigger sounds, making the problem worse.
  4. Hypervigilance
    Misophonia sufferers often become hyper-aware of trigger sounds, constantly anticipating and dreading them. This heightened state of alertness leads to even more distress.

A New Approach to Treating Misophonia: EASE

I treat misophonia with a form of acceptance-based cognitive-behavioral therapy (CBT), which is based on a model of misophonia that explains how it first develops and persists. The treatment protocol, published in the Journal of Obsessive-Compulsive and Related Disorders in the paper “Misophonia: A psychological model and proposed treatment”, is called Experiential Acceptance and Stimulus Engagement (EASE). Click here to read the full study →

EASE (Experiential Acceptance and Stimulus Engagement) is a therapy that addresses these factors and helps sufferers change their relationship with trigger sounds rather than trying to eliminate them. The treatment has three main steps:

  1. Ending Toxic Hope
    Many misophonia sufferers hold on to the hope that other people will stop making the sounds. This “toxic hope” fuels frustration and makes them feel trapped. Therapy helps individuals accept that trigger sounds are a part of life and that focusing on changing others is unhelpful. Letting go of the idea that others "should" stop making trigger sounds is crucial for acceptance. A technique called “victorious surrender” is used, where individuals imagine themselves as powerless against the sound, which paradoxically reduces emotional resistance.
  2. Reducing Avoidance
    Avoiding trigger sounds only makes sensitivity worse. Treatment encourages people to gradually expose themselves to triggers in a controlled way. Identifying and eliminating different forms of avoidance, such as physical (leaving the room), cognitive (trying to ignore it), and social (asking others to stop), is essential.
  3. Stimulus Engagement
    Instead of fearing and avoiding sounds, individuals are guided to engage with them mindfully.

Why EASE Works

  • Breaks the avoidance cycle
  • Reduces emotional resistance
  • Encourages acceptance
  • Addresses underlying personality traits

Final Thoughts: Can Misophonia Be Managed?

While misophonia can feel isolating and overwhelming, research suggests that it can be managed with psychological interventions. The key is not to fight or avoid trigger sounds but to change the way the brain responds to them. By focusing on acceptance, reducing avoidance, and mindful engagement, people with misophonia can reclaim their quality of life.

You’re not alone, and help is available.

Ready to stop living in fear of everyday sounds?
Call or text (845) 288-3139 or send a confidential message here →