Misophonia Therapy: Experiential Acceptance and Stimulus Engagement (EASE)

 Can misophonia actually be treated? If you or someone you know suffers from misophonia, this question surely has crossed your mind. The answer is yes! However, you may be somewhat skeptical—understandably— so I wanted to share with you how misophonia can be treated. This article aims to show you how I treat misophonia utilizing a protocol I developed called experiential acceptance and stimulus engagement (EASE). This therapy is the product of extensive research and clinical work and is based on the psychological model of misophonia (PMM). EASE has been effective in helping many people free themselves from misophonia.

EASE is a form of psychotherapy. EASE aims to address the psychological factors that lead an individual to experience misophonic reactions to everyday triggers such as chewing, breathing, and tapping. The aim of the therapy is to help misophonia sufferers reduce the likelihood of getting triggered in the first place. It’s a set of core skills that enable the sufferer to make powerful choices before and in response to triggering situations--choices you may not have realized you had. EASE is about tapping into your real reservoirs of power and control.

Unless you have misophonia, it is really hard to fathom how distressing misophonia is. Misophonia is a very painful and upsetting condition. Specifically, because it is so uncomfortable, it leads to all sorts of ways to cope and avoid the triggers. This is extremely understandable. At the same time, as described by the PMM, trying to avoid the triggers also leads to more problems. An important factor in recovering from misophonia is understanding that there is a set of thoughts and behaviors that keep the individual with misophonia stuck with misophonia. Specifically, avoidance keeps people stuck in misophonia. The very good news is that because we have discovered that misophonia involves behaviors and cognitions that a person can choose to change, misophonia can be treated by changing these behaviors and cognitions.

Thus, one primary goal of the therapy is to address the avoidance. The first step is understanding what constitutes avoidance. Turns out, there are many ways one can try to avoid the triggers. One can either physically leave the presence of the trigger, employ distraction themselves, or wear headphones. Or you can try to ask the person making the trigger to stop doing so. The list goes on.

Behind these attempts to avoid the triggers is a hope that the triggers will disappear. A person would not try to escape the triggers if they felt that their behaviors were pointless. In other words, a person feels like the triggers can end.  The problem is that people will likely never stop making the triggers. People will likely continue to eat and breathe and do all the things that create so much anger and distress inside of you or a sufferer. 

Could the triggers stop? People can, in theory, technically be aware of their actions and avoid triggering you. This may be true. However, if we look at the situation practically, for most people, this is unlikely going to happen.

This is really the where the therapy begins: being presented with a choice of trying to escape the triggers through all the methods available, or coming to terms with the reality that the triggers are likely going to continue even though they are wrong (or very much feel that way).

This is frightening proposition. It feels scary to even entertain the idea of not trying to escape. However, it is specifically the attempts to escape the triggers that make the triggers a trigger. Further, it is the expectations and hope that (1) somehow the triggers will not be there and that (2) people might just one day stop making the triggers or (3) that one day the sounds themselves will not be triggering anymore that fuels the avoidance.

When people are faced with a situation which they know they are powerless to change it, they can learn to accept the situation. We see this all time. We don’t tell that person who lost a loved one “don’t give up—keep trying to get him back alive.” While perhaps well-meaning, that encouragement will only lead to more disappointment and heart ache. With misophonia the problem is that people try to escape the triggers because there is a belief that the something can be done, when in fact nothing can be done. The healing comes from when the sufferer chooses to make choices that are consistent with what has been most consistent: the triggers will not disappear—even if they technically could.

It is true people are wrong for eating so loud, but yet it will likely not change. EASE teaches people how to stop engaging in the efforts to avoid and change things that cannot be changed which in turn creates us stuck with the triggers. The more we avoid, the more we become aware and stuck with the sounds. The less we avoid, the sounds will become less noticeable. Eventually, you may not even notice that you are not noticing them.

If you are suffering from misophonia, EASE is a powerful therapy that can offer you relief from misophonia.