For Whom the Bell Tolls: Misophonia as a complex experience of hope and dread in self-with-other regulation

ABSTRACT

Misophonia is a condition in which everyday sounds evoke pain and reactive aversion. The etiology of misophonia is largely unknown, with discordant conceptualizations of its roots, ranging from psychiatric, to neurological, to a combination of auditory processing and neurobiological dysfunction. Common protocols are focused on symptom reduction and management, though have not been proven to be clinically effective. For these reasons, it is generally considered to be difficult to treat. In this paper, I re-consider misophonia as a complex interweaving of auditory, neurobiological and relational experience. Reflecting upon a clinical case, I present misophonia in the context of self-with-other regulation from a developmental lens, traverse the landscape of misophonic self states, explore the complex toll of dissociation and intergenerational trauma in relational space, and consider ways in which the painful somatic-auditory bell of misophonia concretizes self and relational “hope” and “dread”. Finally, I will offer some thoughts on how psychoanalytic psychotherapy can create new relational-neurobiological pathways out of the misophonic experience.

KEYWORDS:

• Affect regulation
• dissociative identification
• intersubjectivity
• misophonia
• sadomasochistic systems
• surrender
• trauma

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

¹ Olin’s quote offers imagistic, phenomenologically valuable insight into potential self experience of a child on the autism spectrum. At the same time, the language of the paper’s title reflects the social-cultural diagnostic framework of his time, which, from this author’s point of view, is one that privileges an authoritative, other-centered, intrapsychic model of thinking that forecloses possibility for empathy and/or meaning-making, while perpetuating the othering of vulnerable children.

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Notes on contributors

Dayna Sharp

Dayna Sharp is a Licensed Clinical Social Worker in private practice in Haddonfield, NJ. She is a psychoanalytic candidate with the Institute for the Psychoanalytic Study of Subjectivity in New York City and teaches in the Fellowship Program for the Psychoanalytic Center of Philadelphia.