Abstract
As a relatively new condition, little is understood about the individual’s experience of misophonia. Twenty-four semi-structured interviews were carried out with people with self-reported misophonia. Thematic analysis was used to analyse the data and develop inductive themes. Three themes were developed, ‘the experience of the response to the trigger (with three subthemes: emotional, physiological, and behavioural)’, ‘the perceived impact of misophonia (with three subthemes: the impact on self-esteem, relationships and day-to-day life)’, and ‘Influencing factors (with three subthemes: coping, feeling understood, and exacerbating factors)’. The results give an in-depth understanding of the experience of a misophonic response, the impact on the self and interactions with others, and how they coped. The results suggest targeting the avoidant coping strategies and raising awareness of available treatment and support groups may be helpful for managing misophonia and reducing the negative impact of this condition.
Introduction
Misophonia is an extreme emotional and physical response to auditory triggers, for example, eating sounds (e.g. lip smacking, breathing, swallowing etc.; Edelstein et al., 2013; Jastreboff and Jastreboff, 2001; Schröder et al., 2013; Swedo et al., 2021). Identification of misophonia as a decreased tolerance to specific sounds first occurred in the early 2000s (Jastreboff and Jastreboff, 2001, 2002). While other sensory sensitivities are associated with adverse responses to intense sensory stimulation (Price et al., 2025; Woolley et al., 2025), misophonia is sensory intolerance specifically to everyday sound and not related to sound intensity. Although misophonia is recognised as distinct from other conditions, it is, however, still unclassified by the ICD-11 and the DSM-V (Brout et al., 2018; Dozier, 2017; Jager et al., 2020; Schröder et al., 2013; Swedo et al., 2021; Taylor, 2017). However, recent work on an agreed definition has now defined misophonia as ‘a disorder of decreased tolerance to specific sounds or stimuli associated with such sounds’ (Swedo et al., 2021: 22).
Misophonia is a lifelong condition which usually begins in childhood or adolescence, but the cause is unknown and subject to much debate (Jastreboff and Jastreboff, 2001). Reports of the incidence vary between 3.2% and 60% (Jastreboff and Jastreboff, 2001; Wu et al., 2014; Zhou et al., 2017). Individuals report mostly auditory triggers (e.g. mouth/eating and nose/breathing sounds), but some also report visual triggers, such as repetitive movements (Dibb and Golding, 2022; Jager et al., 2020). Although the response to the trigger varies between individuals, the typical response usually involves both emotive and physiological responses. Emotions such as anger, anxiety and disgust are commonly reported (Dibb and Golding, 2022; Jager et al., 2020; Ozuer et al., 2025). Physiological responses include increased heart rate and sweaty palms (Swedo et al., 2021).
Research into misophonia is growing with a focus on determining the nature of the condition (Dozier, 2017; Jager et al., 2020; Schröder et al., 2013; Swedo et al., 2021; Taylor, 2017), the triggers (Dozier, 2017; Edelstein et al., 2013; Jastreboff and Jastreboff, 2001; Schröder et al., 2013; Taylor, 2017; Wu et al., 2014) and treatments (Gregory et al., 2024; Jastreboff and Jastreboff, 2002; Schröder et al., 2017), however, there has been less of a focus on the day-to-day experience of living with this condition. This paper presents a study on the individual’s experience of life with misophonia.
Most of the research into misophonia is quantitative looking at causes, predictors and associations (e.g. Grandes et al., 2008; Jager et al., 2020; McKay et al., 2018; Rouw and Erfanian, 2018; Schröder et al., 2017; Wu et al., 2014; Zhou et al., 2017) and less is known about how misophonia is experienced, which is important for a deeper understanding of the lived experience (Levitt et al., 2018). Qualitative methods enable an in-depth study however, there are few qualitative studies looking at the lived experience of misophonia. A recent focus group study (seven people) showed that people with misophonia experience feelings of anger and rage, feel others are responsible for the trigger, and they feel a lack of autonomy (Ozuer et al., 2025). Another interview study with five participants (in preprint) reported that participants felt they were ‘bad’ people, felt out of control, and felt their misophonia impacted them negatively (Robinson and Zdravkova, 2023). A larger qualitative study to capture a wider range of experiences would benefit those, such as clinicians, who provide support for people with misophonia.
Materials and methods
Design
A qualitative design was followed using semi-structured interviews to explore the experiences of the individual with misophonia and a critical-realist epistemological approach was taken using thematic analysis to develop themes.
Participants
Twenty-four participants were recruited from the Misophonia Institute, USA. Inclusion criteria included being over the age of 18 years and having self-reported misophonia. In order to ensure we recruited participants with a range of misophonic responses, all participants completed the Misophonia Response Scale (MRS; Dibb et al., 2021), a validated scale measuring the magnitude of the misophonic response. Participants rated the intensity of their ‘typical response’ to a trigger using a 7-point Likert scale. Participants were mostly Female (n = 20 (83%)) and the mean age was 40.8 years (SD = 13.4; range 19–63 years). Twenty participants identified as white (83%), one as mixed white/Asian (4%), one as Black/African (4%), and one as Latino (4%). Two participants did not disclose their ethnicity (8%). The time since first symptom ranged from 4 to 55 years. The mean MRS score was 23.14 (SD = 7.07; range = 13.33–37). This sample is similar to other misophonia studies where the mean age ranged from 33 years (Taylor et al., 2014; Woolley et al., 2025) to 47.2 years , more women than men were recruited (Dibb et al., 2021; Taylor et al., 2014; Woolley et al., 2025), and a slightly lower MRS weighted score was reported (Dibb and Golding, 2022).
Procedure
Ethical permission was received from the University of Surrey (reference 128EGA). Using purposive sampling, interested participants responded to a recruitment advert sent out by the Misophonia Institute, USA, on behalf of the researchers. The advert included a link to the study information hosted on Qualtrics. After giving informed consent, participants completed screening questions where they indicated they had misophonia, were over 18 years of age and rated the extent of their response to triggers. Those who met the entry criteria were invited to an interview using Teams. All the interviews were carried out by AS and TK (12 interviews each, 24 total). The interviews lasted an average of 44 minutes and were recorded and transcribed verbatim.
Data collection and analysis
Semi-structured interviews were selected as the most appropriate method of data collection allowing probing and follow-up questions. The interview schedule (see Table 1 below) was designed to be open and participant-led, allowing participants to respond individually. The interviewers used follow-up questions and prompts to ask more in-depth questions about participants’ experiences. The interview schedule was piloted on two people with misophonia and as no changes were made the data were included with the sample (Holloway, 1997).
Interview schedule.
Thematic Analysis was used to analyse the transcripts (Braun and Clarke, 2006, 2022) as it is a versatile method of exploring the meaning within personal stories. Taking an inductive approach, the analysis followed the six steps recommended by Braun and Clark which include familiarisation, initial coding, clustering and theme development. In order to reduce bias, we took a reflexive approach to both the data collection and the data analysis. Authors AS and TK carried out the initial coding and initial clustering. Further clustering and theme development took place within the research team (all three authors) to ensure the themes were unbiased.
Results
Three themes were developed which tell a story of the individual’s experience of living with misophonia (see Table 2 below). The first theme, the experience of the response to a trigger, shows the extreme emotions (1.1) and the physiological responses (1.2) that the participants experienced. Subtheme 1.3, the behavioural response, shows the automatic actions participants made in response to the trigger. The second theme, the impact of misophonia, shows how misophonia is perceived to impact feelings of self-worth (2.1), family relationships (2.2), and daily social interactions (2.3). The third theme, influencing factors, describes how individuals coped with their misophonic response (3.1), the perceived benefits of knowing other people have similar experiences (3.2), and finally, the factors that exacerbated the response (3.3).
Master table of themes and subthemes.
Theme 1: The experience of a misophonic response
This theme was developed from reports describing details of how participants typically felt during a response to a trigger. There were distinct reports of extreme emotional, physiological, and behavioural responses, presented separately as three separate subthemes below.
Subtheme 1.1: ‘Blinding rage’ – the emotional response
All participants reported strong emotional responses which included anger and disgust. Participant 22 describes how angry and aggressive they felt during a response, including their envisioned aggressive response. The description shows how the emotional response is tied directly to the trigger – the aggression stops as suddenly as it begins, once the trigger has stopped. This quote also shows an awareness that these emotions are extreme. It’s just -just -just a blinding rage. It is every time when I experience something like this, it's just you know, you actually end up imagining, picturing it in your head that you go there and you smack this person in the face [. . .] It’s unbelievable anger, you know. And it’s like [. . .], the second they stop I don’t hate them anymore [. . .] Then that person at work, for example, is being nice and helpful and I’m thinking. . . how could have I just five minutes ago pictured that -that I am actually suffocating this person or -or just -just hitting their face repeatedly until they are unconscious. (P22)
Participant 7 also reports aggressive thoughts and feeling a desperate need to ‘make the trigger stop’, I’ve never acted on them, but you can get like quite violent and aggressive thoughts. Uhm, just whatever needs to happen to make that that trigger stop. (P7)
Again, the anger and hate are clear from Participant 10s comment where they describe their sudden change in emotions in response to pen clicking, And then I get really– I get angry at people but obviously I don’t actually express that to them ’cause they don’t actually know. But like the guy at my work, I was like, I actually hate– I liked him a lot, he’s very nice, but when he’s clicking his pen, I literally hate this man so much and it’s just like anger. (P10)
Some participants described their response as panic attacks. Snoring is really really bad for me. Like when I was dating someone they’d come over and I like I didn’t sleep sort of the entire night because I just couldn’t. And it was really weird because it felt like I was having like little mini panic attacks every time they snored and I’d just be waiting for it to come, ’cause it’s rhythmic as well. So, you’re kind of waiting for the next one to come and it’s all you can really focus on. So yeah, that was quite tough. (P9)
Disgust was also reported, often when the trigger was considered unnecessary. . . .when it’s things like slurping it makes it, I feel yeah, disgust. I think oh God, that’s disgusting. Stop doing those horrible noises. You don’t need to make that noise [. . .] whereas with a packet of crisps you can’t help that ’cause that is the snack. (P15)
Subtheme 1.2: ‘My heart rate goes up’ – the physiological response
Participants also reported noticing physiological changes during their misophonic response, which some related to the emotional response. The quotes below show the extent of their physiological response (feelings of about to explode, electrical shocks, and unwanted sexual feelings).
Participant 10 below reports noticing changes in their heart rate in response to their trigger, My heart rate goes up and it’s almost–I have to like squeeze my hand to like - it’s just really extreme frustration. (P10)
Participant 24 experiences muscle tension during their response, which they associate with anger, . . . I just kind of sit there and I just have this like anger in my body and like I feel like very rigid in my muscles. (P24)
Participant 14 describes their physiological changes as an ‘electrical shock’ all over their body, It’s in in in the way it feels in my body would be like almost getting like little shockwaves. You know, like even talking about it, I feel like -like my nerves just going like -like an electrical electric shock [. . .]I -I just feel like every like nerve in my body is shaking. (P14)
Some participants spoke of experiencing unwanted sexual arousal feelings, So yeah, this is something that’s not really spoken about a lot [. . .] the sounds can ’cause like an unwanted sexual reaction. So bearing in mind is like it’s not wanted but it’s like the physical feeling. (P24)
These feelings can be uncomfortable enough for them to leave the area, I mean the guy wasn’t even sitting near me [at work]. I could just hear his nose whistling and I could not even focus on the meeting. I just was like staring at him. Hi, can’t you stop? And uhm, just getting more and more irritated like with the itchy ears and the groin. And I had just. I just had to leave. (P19)
Subtheme 1.3: ‘Run!’ – the behavioural response
Behavioural responses were the involuntary responses, rather than a planned coping mechanism (3.1). Alluded to in the subthemes above, these responses included, staring at the sources of the sound, needing to flee the scene, and mimicking the sounds.
Participant 18, describes actively engaging in ‘hypervigilant’ behaviours, constantly alert for possible triggers, I’m hypervigilant. And it’s like I’m looking for someone almost, you know, like when you’re in a crowded room and you’re looking for someone. That’s how it feels. I’m scanning, I’m scanning the room for potential. (P18)
Staring was also reported, It probably gets to a point where it’s almost like I stare at them hoping that they’ll stop. (P19) I do find that I stare at people like I’ll stare at him [husband] [. . .] So instead of me sitting there staring at him while he eats a bowl of ice cream. I just get, I get up and I go to the, you know go to the bathroom basically and. Read my phone or something. (P14)
Participant 3 describes an urgent need to run away from the trigger, a feeling they find hard to ‘ignore’. They also show an awareness of the extreme nature of their behaviour. You know, it is the flight— you just want to get away, desperately want to get away from that noise. Every fibre of your being is telling you to run even though you know it’s ridiculous, but it’s– it’s a very much a kind of primeval response, I suppose, and– and it’s– it’s really hard to ignore it. (P3)
By contrast, others reacted with more physically aggressive means I was about 4 or 5 [. . .] I can remember sitting around my friend’s table. While they were eating tea and I was waiting for her to finish her tea and me hitting her leg so hard because I wanted to get away from the table because I just couldn’t stand the sound. (P15)
Mimicking was mentioned by some participants and usually involved involuntary mimicking of the sound, There’s this thing where it’s almost like you mimic the sound and it’s such a strange thing. And -and -and I still do it to this day. Almost like uh automatic, it comes out, but like it’s almost like a tick and it can, you know, I just mimicked the sound and -and -and I don’t know what that does [. . .] It’s a kind of like a small lisping sound with him [husband]. (P17)
Theme 2: The perceived impact of living with misophonia
Misophonia impacted the participants’ lives and this was evident in the view they held of themselves, their relationships, and their day-to-day lives.
Subtheme 2.1: ‘I thought I was a terrible person’ – the impact on self-esteem
Participants described how they viewed themselves negatively because of their misophonia. I definitely feel like it had a massive effect on myself esteem like I think for the longest time I just thought I was a terrible person. (P9)
Participant 12 expressed their experiences in terms of ‘self-hatred’ and thinking they are a ‘monster’, I think that like was a definite self-hatred thing because, I mean, it’s unwanted, it’s like you don’t know why it’s happening. So, I kind of grew up thinking I was this like secret, disgusting, monster like hating myself. (P24)
Participant 11 reflects the inner tension between prioritising themselves over those they live with and how they felt this is selfish behaviour, I realise I am a difficult person to live with. I do realise that. I appreciate that he tries, but I don’t feel– I don’t feel like guilty that he’s had to change, or maybe I should? But I don’t. I just feel like this is the only way I can live and if you want to live with me, this is what you’re gonna have to do. Which is maybe quite selfish. But yeah, I probably am quite a selfish person. (P11)
Subtheme 2.2: ‘Guilt and hate’ – the impact on relationships
Participants felt that the trigger-related emotions they experienced directly impacted on their close relationships, including romantic and child-parent relationships. Participant 2 below describes feelings of guilt about how they responded to their child’s breathing and playing noises. They show they were aware that their own behaviour was abnormal. The conflict they felt is clearly described, With regards to the kids, I feel horrendously guilty. Uhm, I go to bed feeling absolutely awful ’cause I’ve shouted at him for doing things that people do, ’cause he’s breathed too loud. He’s playing a game that’s completely innocent, but because of the noise he’s making, I’m telling him to stop. And when he turns around and says, “I’m sorry Mummy, I’ll go upstairs so you don’t have to listen to me”. It’s like I shouldn’t be doing that, and it breaks my heart. (P2)
Participant 14 gave another description of the impact on the mother-child relationship and how this participant also experienced anger towards her mother. Well, it made me hate my mother. I hated the way her mouth moved and the noise she made [. . .] I felt, uhm, angry and you know that she doesn’t care about me and she’s just always being mean and -and you know all that. And I got all that from chewing gum. (P14)
Romantic relationships were also a trigger, impacting the ability to do things together, It is more the intimacy. If you like, just by sitting on the couch and eating something together. I’d love to just be able to do that without thinking. Yeah, I wanna kill you [wife] in a minute. (P12)
For some participants, their misophonia led to the end of the relationship, when I started dating when I was in my, my teens and maybe a girl would like, trigger something. That would basically– uh, like I would end the relationship, you know. Or like figure out a way to get out like that in terms of relationships with people. (P1)
Subtheme 2.3: ‘You’re less sociable’ – the impact on daily life
Day-to-day life was impacted by the action taken to avoid being triggered, which links to the coping theme below. This includes an impact on social eating, I very rarely eat with people. (P16)
Family life was also affected as participants reported avoiding family social events and did not want to be a problem for their family members, Uh, so, you know, just at family events, I’m like sometimes I’d rather just not go. You know, why put myself in that situation if I know I’m gonna have problems, I’d rather just stay home and not be a problem for anybody around me. (P4)
Car journeys with others were also described as difficult. Participant 17 showed how being trapped in a small space with ‘nowhere to go’ makes them avoid travelling in a car, even with their husband, I’ve dreaded car journeys so I -I absolutely ’cause I’ve got, I’ve got nowhere to go [. . .] the thought of being in the car with my husband making you know that the sort of lisping sounds I -I -I couldn’t even do it. I would find a reason not to get in the car [. . .] it’s really the is that it’s it’s, whispering and -and I’m really in a really enclosed place, whispering and -and with the whispering sounds, uhm, are the worst. (P17)
Misophonia also impacted desires to study, so impacting on the gaining of new knowledge, skills and potentially, different careers. I couldn’t, for example, go back and study again I don’t think. I don’t think I’d manage in a classroom setting. And so, I guess that’s a bit of an impact. It’s, you know, it’s something I’d like to do but the miso[phonia] side of things probably stopped me from doing. So yeah, it can hold you back I think. (P7)
Work relationships where also affected where avoiding colleagues interfered with the ability to develop rapport, linking to subtheme 3.1 where avoiding situations is a common coping strategy, You don’t get the same closeness I think with colleagues, because you’re trying to avoid them some of the time or avoid certain situations so you’re less sociable and you’re probably sending out the wrong signals (P23).
Theme 3: Influencing factors
The final theme groups factors that participants found helpful and unhelpful. The helpful factors included how participants coped (3.1) and finding similar others was comforting (3.2). The unhelpful factors, exacerbating factors (3.3), show how stress and the source of the trigger can make their experience worse.
Subtheme 3.1: Coping with misophonia
Avoidance was a common coping mechanism to help avoid hearing or seeing the trigger. Avoidance strategies like avoiding completely, controlling the situation, and blocking were also mentioned frequently, I don’t go to cinemas at all because people eat and it goes quiet, you can hear people breathing. That’s all I would concentrate on. (P2)
Planning outings, including where they will sit and when they will arrive, helped to avoid the trigger, But uhm, on a day-to-day basis if I have to, if we go out it’s all about controlling my environment where I’m going to sit, what time I’m going to go to somewhere so that it’s not busy. [. . .] To be able to have some sort of environmental control, as best as I can, so that the anxiety doesn’t overwhelm, uhm, and then I can’t obviously enjoy, you know, normal stuff. (P5)
Participant 10 gives another example of how planning mealtimes is important, . . . So then for ages I couldn’t eat with my dad at all and then we can eat together now, but again I have to be really tactical about it. So like if I eat at his house, I’ll like sit– he’ll sit somewhere and then I’ll sit so that we’re not facing each other. If we eat in the restaurant, I will have to go to the toilet straight away and just wait while he picks his teeth. . . (P10)
In situations lacking control, tactics like distraction were used, So, I might try and distract a person, try and steer a conversation in a certain way. So, I might start a conversation that I’m not actually particularly interested in, but uhm, I’m just drawing their attention away from like bouncing their foot up and down. If you ask them a direct question, it kind of seems to stop them because, I don’t know, they’ve got something else to focus on. (P7)
Blocking the trigger using earplugs were also a common tactic. Participant 3 refers to them as an excellent way of appearing ‘normal’ as many people use earplugs – this alludes to the usually abnormal feelings that are common in people with misophonia, In terms of relief, the great thing about earplugs is you realize that you can live almost like a normal person in an environment and carry on. (P3)
Another blocking tactic was to look away from the source of the trigger, But a lot of times, I just have to look away. I’ll be eating and not looking at them, but I know it’s there. I know it’s right there, and that– so it doesn’t really, you know, help. (P1)
Some participants felt they could confront the person making the noise, I feel like I can control my brother, but I couldn’t control kids in school, so I -I never like said like stop shaking your leg or anything [. . .] I was older than him. You know that if I if he’s slurping, I can just be like stop slurping and I expect him to (P19)
Subtheme 3.2: ‘Someone understands how I feel’ – feeling understood
This subtheme highlights the psychological aspects of what helps living with misophonia. Participants showed how having this condition left them feeling isolated and misunderstood and discovering that others with misophonia with similar experiences provided comfort, . . . we went out for dinner with two friends [. . .] I was saying about noise intolerance “blah blah blah” and Geoff said ‘I’m very like that’ and he said ‘have you got misophonia?’ and it was like ‘Oh my God! Have you!?’, and then we had this whole conversation. . . It’s great. Someone understands how I feel. It’s very hard to describe to people how you feel, isn’t it? (P11)
The realisation that there are others out there with similar experiences left participants feeling a sense of relief, When I read this article online [. . .] I burst into tears because it said, oh my God there and it was about the mimicking. It was about, you know, the -the soft sounds everything and I -I -I. The sense of relief that other people that actually have this [. . .] I feel it makes me feel a whole lot better, I don’t feel like such a freak that I’ve got it now (P17).
The knowledge that other people had similar experiences made some feel confident to disclose their misophonia to others, I didn’t know that, uhm, other people had this, like I thought I was alone. . . So, when it became apparent that there was a word for it and there’s loads and loads of people that have these issues. It was such a relief that I wasn’t this weird, horrible, you know, person with these, you know, secret things and that was, you know, massive freedom for me to, you know, know that there wasn’t something I mean inherently wrong with me as such. You know? That I wasn’t just this mean person who wished death on people sometimes. It was, you know, it was actually quite common. So that was that was the real thing for me, and now I’m comfortable, I’m comfortable telling, you know, anybody. (P5)
Participant 1 describes how it was by joining a group that they became aware that ‘It wasn’t just me’, some of those social groups online where I can just hear people vent [. . .] I found out that it wasn’t just me, like, I thought I was the only person in the world that had a problem with this. I didn’t even know it was a thing. I just thought like, ‘oh I’m an asshole’, uhm, and I can’t control it. But then like once I started hearing things about it, people started doing research about it. A couple like you know, celebrities, so to speak, a kind of voiced out like that they have this issue. (P1)
Subtheme 3.3: ‘That’s gonna trigger me a lot more’ – exacerbating factors
A range of different factors were reported to negatively affect the response. Stress increased the likelihood of being triggered and increased severity and recovery time. it’s definitely, uhm, the higher the stress, the higher susceptibility to my triggers and the longer it takes to reset. (P1)
Participants also reported that the number of triggers grew over time when stressed. You kind of pick them up like bad habits as you go through life, I think. And when I’ve gone through periods of stress, inevitably, I tend to acquire another trigger. (P3)
The identity of the person making the sound also influenced how they responded to the trigger. Family members were more likely to be a trigger, So, it’s like– and it’s weird because it’s only with certain people. It’s mainly with my parents [. . .] some people can do it and it doesn’t bother me. But with my parents it’s just I’m like [Participant winces in frustration]. (P10)
Participants believed that family were their triggers because they knew about the participants’ misophonia and yet still made the noise. if it’s someone that like knows I’ve got misophonia and kind of like knows the triggers, and so I kind of hope that they try to avoid them more. That’s gonna trigger me a lot more than somebody who I just met and is clueless about everything. (P6)
Participant 21 describes the apprehension they felt while spending time with their mother, showing both that family members can be triggers the anticipation exacerbates it., If I’m gonna go hang out with my mom. [. . .] I know it’s gonna happen and I -I work myself up and and I just have this anxiety building, building, building, building and it just feels physically exhausting and,[. . .] It’s kind of like being on a roller coaster [. . .] that go tick, tick, tick, tick all the way to the top and you -you know it’s coming and you’re scared. But it gets worse and worse and worse and then when it finally happens, it’s not like oh it’s over, it’s like it just gets worse. (P21)
Discussion
Living with misophonia is evidenced in the three main themes; the ‘experience of the response’ (the emotional, physiological, and behavioural response), ‘the perceived impact’ (self-esteem, daily life, and relationships), and ‘influencing factors’ (coping, feeling understood, and exacerbating factors). While some of the subthemes reflect scale items used for measuring the misophonic response the results in this study give more depth and contribute nuanced detail of the experience.
The ‘experience of the response’ provides an in-depth view of the experience of the trigger including the emotional, the physiological, and the automatic behavioural response. The participants spoke of overwhelming feelings of anger and rage. Many also spoke of feeling aggressive and a minority acted on these feelings. A minority of participants also reported unwanted sexual feelings, which supports earlier findings (Dibb et al., 2021; Siepsiak et al., 2020). Raising awareness of these feelings is an important function of research so increasing understanding of why some people behave in certain ways in certain situations. These results support other studies where these strong emotions have also been reported, albeit many of them recorded quantitatively. Anxiety, anger, disgust and irritation have all been reported as common emotional responses (Dibb and Golding, 2022; Dozier, 2017; Edelstein et al., 2013; Jastreboff and Jastreboff, 2001; Ozuer et al., 2025; Schröder et al., 2013; Swedo et al., 2021; Taylor, 2017; Tunç and Başbuğ, 2017) and are included in several measures of misophonia (Dibb et al., 2021; Siepsiak et al., 2020; Vitoratou et al., 2021). What our study brings is a contextual description of how sudden these responses can be and how difficult they are to deal with at the time, showing what the actual experience is like for the individual. We get a sense of the struggle that our participants felt during their response to triggers and knowledge of this can help those who care for and support people with misophonia.
The behavioural responses subtheme presented the automatic, instinctive responses, as opposed to coping, which is deliberate, considered, and effortful (Lazarus and Folkman, 1987). While there is recognition that the behavioural responses vary greatly between individuals (Swedo et al., 2021), responses in this study included staring and a need to get away or stop the source of the trigger (Altimus et al., 2019; Schröder et al., 2013; Siepsiak et al., 2020; Wu et al., 2014), showing similarities with other sensory sensitivities (Price et al., 2025). Hypervigilance and staring were also reported which show an attempt to control the situation (Edelstein et al., 2013; Jager et al., 2020; Rinaldi et al., 2023). Mimicking was also reported as an automatic response and supporting other studies (Edelstein et al., 2013).
The perceived impact theme (theme 2) details the impact on day-to-day life in terms of restricted interactions with others, lower perceptions of self-worth, and the impact on relationships. As other people are often the source of the trigger for many people, it was not surprising to hear descriptions of these interactions. The perceived impact on self-worth shows how experiencing a condition such as misophonia can negatively impact perceptions of the self. Models of adjustment to living with chronic conditions, for example the Cognitive Adaptation Theory, propose that a drop in self-esteem is indeed a common experience (Taylor, 1983). Previous work on measurement design also showed their participants to feel negatively about themselves, for example, they feel like they are ‘crazy’ (Vitoratou et al., 2021).
The second subtheme, the impact on relationships, emphasises the impact on family life and how difficult it is to maintain relationships with children and/or parents when they are the trigger, and the feelings of guilt associated with this. Participants reported negative (unpleasant) social interactions and reduced social interactions (due to avoidance). This supports research showing how misophonia is negatively associated with quality of life and reduced social interactions (Dibb and Golding, 2022; Edelstein et al., 2013; Jager et al., 2020; Price et al., 2025; Zhou et al., 2017). Linking to our coping theme, where avoidance was a common strategy, our participants spoke of avoiding family situations or communal mealtimes to avoid being triggered, so showing how family life and social interactions are affected. Avoidance of social interactions is important to note as not only can it impact the quality of the relationship, but increased isolation has been found to be associated with loneliness and negative health outcomes such as depression and anxiety (Alekri and Al Saif, 2019; Dibb and Golding, 2022; Kim et al., 2018; McKay et al., 2018; Nowland et al., 2018; Quek et al., 2018; Simner et al., 2024). The negative impact on social interactions also influenced daily activities (being in a car with others) and the quality of work relationships, so showing the wider impact.
Our third theme, influencing factors, demonstrates on the one hand how participants both coped and managed their lives and how feeling understood by others was received positively, and on the other hand, factors found to exacerbate the misophonic response. The coping subtheme gives examples of avoidance of triggers by planning activities to manage the situations and environments, strategies used by people with other sensory sensitivities (Price et al., 2025). The avoidance of triggers was also evident in the form of blocking out the sound (e.g. using headphones) in order to not be triggered. This links well with theme 2 (impact) where participants spoke of avoiding eating with others. Avoiding the trigger supports other studies also reporting avoidance (Dibb et al., 2021; Jager et al., 2020; Rinaldi et al., 2023; Robinson and Zdravkova, 2023; Sanchez and da Silva, 2018; Schröder et al., 2013; Siepsiak et al., 2020). While avoidance and controlling one’s environment are successful strategies, they are essentially avoidant coping strategies which do not prepare the individual for situations where they are not able to avoid the trigger (Lazarus and Folkman, 1987) and avoidance of triggers has been shown to negatively impact quality of life (Dibb and Golding, 2022).
The second subtheme, feeling understood, described the relief felt when realising that they were not the only ones with misophonia and there were other people who had similar experiences. Valuing similar others is one of the therapeutic factors identified as important within therapy and support groups (Andersen et al., 2014; Barlow et al., 2009; Yalom, 2005). This finding supports the earlier work by Borkman (1976) on the value of experiential knowledge where when uncertainty is high and information is scarce, the best source of information is other people with the same condition (e.g. Kaiser et al., 2021; Vermorken et al., 2023). While further work is needed, this suggests that future treatment strategies could include group therapies.
The exacerbating factors subtheme includes factors that impacted the misophonic experience, for example, stress, anticipating the trigger, and the identity of the person (the trigger). These factors were reported to make the participant more susceptible to having a misophonic response, to the response being stronger than otherwise, and a longer recovery period. Stress has been proposed to result from unpredictable triggers (Schröder et al., 2013) and our results indicate that anticipated triggers can also bring about stress and exacerbate the experience of the response. Similar effects of stress are experienced with other sensory sensitivities (Price et al., 2025) and is associated with negative outcomes in many other conditions (e.g. Heijmans et al., 2004). The source of the trigger was often a family member which participants felt was due to their family knowing about their misophonia and yet persisting with the noise (Dibb and Golding, 2022).
Our study is not without limitations. We recruited our participants through the Misophonia Institute, USA, and it is possible that those not connected with the institute may differ in some way. We also recruited participants with self-reported misophonia and, while all participants completed the MRS to ensure they were experiencing a response to triggers, we cannot be certain that they did in fact have misophonia.
The study strengths of this study include the rigorous and reflexive approach to the data collection and analysis. As this is fairly unknown condition we recruited a large sample for a qualitative study (Guest et al., 2006) to ensure that we collected a wide range of experiences. In addition, all the interviews yielded in-depth data which allowed us to analyse inductively and develop meaningful themes.
While our results contribute detail to a growing field, there is much to still learn about misophonia, and further work would benefit clinical and research communities. In particular, research into understanding the social complexities of living with misophonia would be beneficial. As social beings and since eating with others plays a big part in many social and cultural activities, misophonia has the potential to impact many facets of life. Understanding these complexities will benefit people living with misophonia and people who care for those with misophonia.
Another area for future research is the coping strategies used by people with misophonia. Avoidant coping strategies were also reported frequently in people with other sensory sensitivities (Borda-Mas et al., 2025; Price et al., 2025) so further work developing effective coping strategies, while important for people with misophonia, may also benefit a wider group of people (Rosenthal et al., 2021) so improving quality of life and preventing the development of further mental health problems.
This study presents in-depth understanding of the experience of a response to a trigger for people with misophonia. The results present the individual’s perspective of the overwhelming emotional and physiological response they experience during a response to a trigger, including the difficulties they face. This condition often means people avoid situations where they may be triggered and this includes situations where they interact with other people, so impacting family and social relationships negatively. Providing peer support, guidance on effective coping strategies and raising awareness may help to reduce the sense of isolation felt by this group.
Footnotes
Acknowledgements
We would like to thank the participants for their time and honesty when talking to us. We would also like to thank the Misophonia Institute, USA, for assisting with the recruitment by forwarding on our recruitment letter to those associated with the Institute.
Ethical considerations
Ethical approval was received from the University of Surrey Ethics Committee (reference number: 128EGA).
Consent to participate
All participants gave informed consent to participate. Written consent was gained before the interview and verbal consent was gained at the time of the interview.
Consent for publication
All participants gave informed consent to publish the anonymised results. Written consent was gained before the interview and verbal consent was gained at the time of the interview.
Author contributions
BD: Conceptual, Methodology, Project Administration, Supervision, Validation, Visualisation, Writing (original draft; editing and review). TK and AS: Data Curation, Formal Analysis, Investigation, Writing (editing and review).
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was not funded however, both AS and TK received a small bursary from the Misophonia Institute, USA to encourage research in misophonia.
Declaration of conflicting interests
The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: BD reports no conflicts of interest. Both AS and TK received a small bursary from the Misophonia Institute, USA which was offered to encourage research into misophonia. AS is an employee at The Lancet.
Data availability statement
Anonymized data that support the findings of this study are available upon reasonable request from the corresponding author.*