What is Misokinesia?

By Ezra Cowan, PsyD

What is Misokinesia?

Misokenesia is characterized by experiencing deeply aversive reactions when visually perceiving certain human movements. The reactions usually involve a feeling of annoyance, irritation, anger, and often even intense rage. While anxiety is associated with misokinesia, anger tends to be reported as the predominant reaction consistently. There are no specific criteria for the types of visual perceptions or visual triggers which can illicit the misokinesic reaction. A commonly reported characteristic of visual triggers involves movements that are described as repetitive or patterned. At times, the person does not have to see that the visual trigger is occurring visually, but the mere awareness that it is happening can illicit a misokinesic reaction.

Common Examples of Misokinesic Visual Triggers (MVTs)

• Face Touching

• Playing with Fingers

• Hand Motions

• Mouth Movement

• Leg Shaking

• Finger Tapping

 Is Misokinesia related to Misophonia?

Yes. Based on my research and clinical work, there is no qualitative difference between misophonia and misokinesia. They both elicit the same reactions to triggers. The only difference is that a different sensory route perceives the trigger. In fact, it is very common for individuals to experience symptoms of both misophonia and misokinesia. This is one of the reasons that led me to believe that misophonia is not a hearing-related problem but rather psychological in nature. Click here to learn more about misophonia.

Why is Misophonia Significantly More well-known than Misokinesia?

The primary reason is likely related to how misophonia became known in the first place. Misophonia was born out of audiology research since individuals suffering from misophonia symptoms were often referred to audiologists. The term misophonia was actually coined in 2000 by audiologists (Drs. Pawel and Margaret Jastreboff). From within audiology, a growing research body started to develop on misophonia, and in 2013, the idea of misophonia being related to psychiatric variables was suggested. It was only through research into misophonia that symptoms of misokinesia were identified, as there is comorbidity between the two. Thus, misophonia was always the primary focus of research, and misokinesia was found later but never received the same level of attention.

Another reason is likely related to the research findings that misokinesia is reported to occur less often than misophonia. Nevertheless, further research is necessary to understand how prevalent misokinesia actually is.

Hierarchy of Annoyance: Who is the Most Triggering?

Usually, closest family members. Individuals with misokinesia often report that when their misokinesia initially developed, they were only triggered by a few people. This usually involves people from one’s immediate family, such as a mother, father, or sibling. Over time misokinetic triggers can “spread” to other people as well and eventually include anyone making the triggering sights (or sounds). However, not all triggers are equal, and some people are more triggering than others. Some research indicates that a person’s “triggering level” can vary such that one day, the person is very triggering, and on another, the person is not triggering at all.

 What Does Misokinesia Feel like?

When individuals with misokinesia perceive a trigger, the experience is often described as “being attacked.” Indeed, individuals feel that the person making the trigger is doing so intentionally. They report experiencing a feeling of being trapped, panicky, and overwhelmed. There is also a considerable amount of anxiety about future triggers, and they are often hypervigilant in preparation for the next “misokinetic attack.” People often report a physiological response such as the body tensing up and some other reflexive behaviors.

 What is the Most Common Response to Misokinesia Triggers?

The most common response to the visual triggers is anger. At times, it can be a mild irritation or annoyance. Often, however, the experience is described as intense anger and rage. People often feel a desire to punish or hurt the individual making the trigger. This reaction is something that individuals with misokinesia struggle with because they often view themselves as relatively easy-going individuals, and experiencing such feelings can in of itself be highly discomforting.

 Negative Effects of Misokinesia

Besides the terrible suffering individuals with misokinesia experience from the triggering sights, there are also unfortunate ramifications that come from coping by avoidance. When individuals avoid situations that are “trigger heavy,” the price can be doing less of what you they want to do. They might spend less time with family as a result. They might close themselves off in their room and not go out with friends. Indeed, they may not go to work. Avoidance and reduced engagement can also lead to depressive symptoms and, in extreme cases, thoughts about committing suicide. These are only a few examples of the negative effects of misokinesia.

 How Does Misokinesia Impact Relationships?

This depends on many factors. The idea that everyday bodily movements can be so aversive is something that many people find difficult to relate to. The misokinetic response is something that people who do not have misokinesia have a hard time relating to, and it is common for people to dismiss the issue and even accuse the person of faking a problem. Thus, relationships can suffer. However, many people with misokinesia figure out a way to make the relationship work through effective communication and the willingness of an empathetic partner.

 Does Misokinesia Get Worse or Better Over Time?

Misokinesia tends to “spread” and generalize to more people, situations, and new sights, which can make it increasingly more difficult to deal with. Often, however, people learn to adapt to their situation. It should be noted that misokinesia symptoms tend to get worse when one is experiencing increased stress.

 Is Misokinesia a Recognized Diagnosis?

Misokinesia is currently not a diagnosis. This does not mean that misokinesia is not a real and debilitating condition. It usually takes time for a strong body of research to emerge to support the development of a formal diagnosis. Research into misokinesia is very young!  The good news is that there is an increasing interest in understanding misokinesia, with more and more research coming out every year. The main effects of the lack of formal diagnosis is that the research tends to get less funding from major funding sources, and insurance companies are less likely to cover treatment.

 What Causes Misokinesia?

There are several theories regarding the cause of misokinesia, one of which I have developed. Many researchers believe that misokinesia is a neurological condition that causes sensitivity to certain sounds. While I do think there are likely some neurological or biological components, based on my extensive research into the literature and my clinical work, it seems there is minimal research supporting the claim that misokinesia is completely a neurological disorder. In fact, some theorists believe that misokinesia has a very strong psychological basis.

The research I spearheaded led to a theory that misokinesia is caused by a host of psychological and contextual variables. At the model's core, we have identified the main ingredients that cause misokinesia to be rigidity and avoidance. This former feature is related to one’s personality, or how one thinks and feels about the world. In short, someone with a rigid disposition (or a history of one) is at higher risk for developing misokinesia because of a principled intolerance of others making specific motions viewed as wrong. This characteristic, in combination with a range of psychological phenomena such as classical and operant conditioning, sets the conditions for developing misokinesia.

 Is There a Treatment for Misokinesia?

Yes. I treat misokinesia with a form of acceptance-based cognitive-behavioral therapy (CBT) which is based on a highly detailed model of misokinesia that explains how it first develops and then stays around. The treatment protocol is called experiential acceptance and stimulus engagement (EASE), which is designed to address the factors that keep a person “stuck” with unwanted triggers and offers a set of choices that a person can utilize to become “unstuck.” It gives the individual a set of tools that frees them from the shackles of misokinesia and allows for less anxiety and stress about being triggered. This protocol has helped many people gain control of their symptoms and live a more relaxed, socially connected, and vibrant life. This therapy can change your life, too.