The Unspoken Agony of Misophonia
With the exception of a mild irritation at the rasping of emery boards or the squeak of dried-out pencil erasers on paper, the excruciating experience of misophonia had always been foreign to me.
Today, I’m dictating this post to Siri while gridlocked in DC Beltway traffic, returning from a visit to Virginia. I had just spent the afternoon with a woman whose only wish is peace—from the relentless mental agony triggered by soft, everyday sounds.
Most people are annoyed by the scrape of fingernails on a chalkboard or the shrill cry of a toddler. But misophonia isn’t annoyance—it’s a fight-or-flight reaction. It’s visceral. It’s consuming. And until now, I don’t think I truly understood that difference.
“When I hear people slurping or chewing ice, it can feel physically painful,” she told me, adjusting her glasses and rubbing her cheekbone as though bracing herself for what might come next.
We sat side-by-side at a table in Panera, and I was painfully aware that even the smallest sounds from my spoon or cup might be triggering. She caught my hesitation. “Don’t worry about it,” she said gently, noticing me eyeing my wild rice and chicken soup. “I have kids. I have a husband. Do you think they go out of their way to be careful for me?”
After she ordered her broccoli cheese soup and sandwich, we got to work—a real-world, in-the-moment low-gain hearing aid fitting for misophonia. I’ve worked with many patients with misophonia who found relief through hearing aids with specific programming, but the process is still far from exact. There is no algorithm. No magic formula. Just careful trial and error. Leave no stone unturned.
Most of the patients I’ve seen also deal with secondary sensory conditions like auditory processing disorder, hyperacusis, or tinnitus. But this case was different. This patient had no comorbidities—just misophonia—and she was highly articulate, emotionally aware, and professionally grounded. She was exactly who I needed to work with to begin understanding what’s actually helpful.
What made this especially valuable was her professional background in a field adjacent to audiology. She already understood the limitations of the tools I use. She had no illusions about what hearing aids can and can’t do. That meant we could skip the superficial explanations and focus on what was real.
And that’s exactly what I wanted: real data. Real feedback. Not placebo. Not magical thinking. Not hope disguised as progress. I wasn’t looking to “fix” her—I was looking to find something that helped.
Because here’s the truth: there is no miracle cure. But that doesn’t mean we stop searching. It means we keep testing, keep listening, and keep pushing forward—until relief is more than a wish.
Visual Description:
This cartoon-style illustration shows two women sitting across from each other at a small table inside a Panera café. The setting is cozy, with warm tones, simple details, and a relaxed atmosphere. A “Panera” sign is visible on the wall behind them. On the table are two bowls of soup and a plate with a sandwich and a cookie. One woman—on the left—has curly dark hair, a slightly furrowed brow, and her hand gently resting on the side of her face, clearly deep in thought or slightly distressed. The other woman, wearing glasses and a teal shirt, is speaking and gesturing with one hand. A laptop sits open in front of her.
Why I Chose This Picture:
The curly-haired woman is me.
This image reflects the reality of what it feels like to sit with someone who is hurting in a world full of noise—both literal and emotional. It illustrates the weight of clinical work that’s rooted in empathy, listening, and problem-solving when there is no clear solution. I chose this picture because it captures that moment of sitting across from someone who trusts you enough to let you into their pain, and your responsibility not to flinch.
The laptop symbolizes the tools I bring into that space—not as a barrier, but as a bridge. And the food on the table reminds me of how we must sometimes do this work in real-world spaces, not sound booths. This is what it looks like to meet people where they are—in a Panera, mid-soup, balancing science, compassion, and silence.
