BDD by Proxy: A Surprising Member of the Misophonia Spectrum?

Have you ever felt irrationally disgusted by the way someone chews, breathes, or even blinks?
You’re not alone. That reaction may be part of a condition called misophonia—an intense emotional response to everyday sounds. For some, it’s the sound of chewing. For others, throat clearing, pen clicking, or breathing can feel downright unbearable. And while many people haven’t heard of misophonia, those who live with it know: it’s real, and it’s exhausting.

But what if your trigger isn’t a sound at all?

That’s where misokinesia comes in. It’s like misophonia’s visual cousin—where small movements like foot tapping, fidgeting, or facial expressions evoke a similar surge of disgust, panic, or rage. At our center, we group these conditions together under a broader umbrella: the miso-spectrum.

These conditions are more than just being “sensitive.” They’re rooted in a powerful emotional and psychological response—often connected to perfectionism, shame, and the deep feeling that something is wrong and shouldn’t be this way.

A Related Phenomenon: BDD by Proxy

Now here’s where it gets interesting. There’s another condition that shares an almost identical emotional blueprint—but most people have never heard of it.

It’s called BDD by Proxy.

To explain that, let’s back up.

BDD (Body Dysmorphic Disorder) is a condition where someone becomes obsessed with a perceived flaw in their own appearance. Even if no one else sees anything wrong, the person may feel deep distress and go to great lengths to hide or fix it.

In BDD by Proxy, the focus shifts: the obsession is about someone else’s appearance—often a partner or child.

John’s Story

Take John, for example.

He deeply loved his wife. But over time, he became increasingly bothered by the shape of her forehead. Not just mildly annoyed—repulsed. He felt an uncontrollable wave of disgust every time he looked at her face. He started avoiding well-lit rooms, sitting at specific angles, even fantasizing about how she might look if something were different.

And then came the shame. “What kind of person feels this way about their spouse?” he thought. But no matter how hard he tried to ignore or rationalize his reaction, it stuck. It hurt both of them—and John felt stuck in a loop he didn’t understand.

So... Is BDD by Proxy a Form of Misophonia?

While BDD by Proxy isn’t officially part of the misophonia family, we’d argue that it fits squarely within the miso-spectrum.

Here’s why:

• The emotional response is the same: disgust, anger, shame, avoidance.

• The triggers are sensory—whether auditory (misophonia), visual (misokinesia), or aesthetic (BDD by Proxy).

• The underlying structure is perfectionism: something feels wrong, unacceptable, and impossible to live with.

• And crucially, the reality doesn’t change—which only intensifies the pain.

Whether you’re reacting to chewing, tapping, or a loved one’s physical feature, the emotional experience is rooted in an inability to tolerate the unchangeable.

Healing with the EASE Model

So how do you treat something like this?

At our center, we use a framework called EASE, designed specifically for misophonia and related conditions. It stands for:

• External Acceptance
  Learning to accept that you can’t change what’s outside of you—whether it’s a sound, a movement, or a person’s appearance. This step builds cognitive and behavioral flexibility, so you stop wasting energy trying to fix the unfixable.

• Self Engagement
  Turning inward to face the real pain underneath: the disgust, the shame, the sadness, the helplessness. Instead of escaping or shutting down, this step teaches you emotional flexibility—so you can be with yourself, even when it hurts.

Through this process, clients begin to change—not by silencing the world, but by transforming the way they relate to it. And more importantly, the way they relate to themselves.

You’re Not Alone
If you’ve ever had a reaction that felt too big, too weird, or too shameful to explain—this might be your starting point. Whether it’s misophonia, misokinesia, or something like BDD by Proxy, your experience is real. And there’s a path forward.