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Comment by jonnathanson | Hacker News Reader

I must be a particularly interesting case study. I can ASMR, but I also suffer from misophonia, which is sort of like ASMR's evil stepsister: an intense anger/aversion reaction to certain sound triggers. I've also got what I'd describe as a very low-grade and occasional capability for synesthesia.

I wonder if any of these conditions are related somehow.

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My brother (he's adopted so no blood relation) has misophonia. He absolutely cannot stand the sound of paper and plastic bags and has difficulty hearing people eat. Those specific sounds absolutely enrage him. He runs a business and when he has to do paperwork he locks himself into his office so he can control the noise all the paperwork makes. When he emerges, he's visibly shaking with rage.

When he was younger he had some low grade Tourette's-like symptoms and various other neurological issues. Misophonia is supposed to have some kind of possible connection to Tourette's.

However, he may also frisson or ASMR (or something in the category) and has an intense interest in certain kinds of music and has built quite a few home-made ultra high end home stereos out of car audio components.

Amazingly, almost none of the things we're talking about here are well recognized by the psychiatric or neuroscience communities.

For me the major miso-triggers are the sounds of people eating and the sounds of people typing -- which are wonderful triggers to have in the tech industry. :) Weirdly, these sounds only seem to set me off in an otherwise quiet environment. I can handle the sound of a thousand keyboards aflutter in a busy office. I cannot handle a totally quiet room with one person's typing in it. I can handle a group meal, but if I'm alone in a room, listening to one or two people eating, it drives me nuts.

There are also visual triggers, to make matters worse. For some reason beyond my understanding, I hate when people bounce their legs around in their seats, or tap their feet repeatedly on the floor. Drives me insane.

I've never had Tourette's, or any Tourette's-like symptoms, but I completely sympathize with those who do. My symptoms are similarly uncontrollable. I know they're weird, and I know that telling people about them generally pisses people off. So I am consigned to my own special hell, quietly mustering the mental energy to block these stimuli out in everyday life, knowing that nobody understands the problem nor has the slightest sympathy. Medical research barely takes the condition seriously, and a lot of doctors still refuse to acknowledge that it's real, and not some Freudian, neurotic symptom.

In a way, I feel like what someone with Tourette's must have felt like, back before Tourette's was medically or societally acknowledged. Every now and then, misophonia gets a cursory writeup in a major newspaper or magazine -- but even that coverage typically ends with some dismissive caveat, such as "Medical science doesn't currently acknowledge this as a legitimate condition." Well, I'm certainly not doing this for the fun of it. :)

...or its some Freudian neurotic symptom. Why not? What evidence distinguishes it?

If I'm being completely objective and intellectually honest? I can't rule that out for sure. But it seems unlikely, given that most of Freudian psychology is outdated and quasi-animistic. If I have to choose between Freud and neuroscience, I'll take the latter almost every time. But more to the point, Freudian psychology isn't useful for this condition. It offers no answers and no practical guidance. It also offers a sort of intellectual dead-end. By filing this conveniently in the bucket of "neurosis," a doctor or researcher can basically wave his hand and say there's nothing he can do, and no further scientific inquiry is needed. Affected patients just need to "get over it" or "work through it" somehow. Even more sophisticated and modern psychological tools, such as behavioral therapy and sensitization training, don't have a great track record for successfully treating this condition.

As for the neurological explanations: as the previous poster mentioned, recent studies have implicated a lot of the same brain and nervous system structures in misophonia that are believed to be responsible for Tourette's. There is a high degree of comorbidity. While the two aren't causally related, there appears to be a physical/structural cause that results in either or both conditions with a fair amount of frequency.

Again, I have no definitive way of ruling out some blanket neurosis as the underlying cause. But it seems scientifically dubious, and more important, it's often unproductive as a line of inquiry.

I always wondered why I can't stand the sound of people eating with an open mouth ('smacking their lips') or a dog licking themselves/chewing on a rawhide. For some reason, closed mouth eating and a dog biting themselves are tolerable. Our dogs are either very good at being dead silent or they do it all at night (and it sometimes wakes me up). I can also relate in how it isn't bothersome if it is amongst a sea of sounds, though I think a group of people eating would bother me quite a bit...

I suppose I have a name for this now...

> I can handle a group meal, but if I'm alone in a room, listening to one or two people eating, it drives me nuts.

Hell yeah, my experience exactly. When I'm eating meals with family, I need there to be a conversation going, or at least a TV or radio running in a background - if there's only silence and sounds of eating, I'm starting to go crazy.

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