Last Updated on March 12, 2023 by Mike Robinson

Phonophobia is a fear, anger, or anxiety at hearing certain sounds that, while not strong, trigger negative emotions in those suffering from this condition.
Some researchers believe that phonophobia is an extreme case of misophonia.

This irritability occurs in some people when they hear certain everyday noises, such as the chewing or coughing of another person. Fortunately, there are effective treatments. Do you want to know more about phonophobia and misophonia? Please continue reading.

Characteristics of phonophobia

Phonophobia is an irrational fear of certain noises which are not necessarily loud. It is not an auditory disease; people with phonophobia have an anxiety disorder. For example, you may have phonophobia if you start to sweat and your heart beats fast when you hear someone chewing gum or the cutlery makes a noise when hitting the plate.

A Legitimate Disorder

Phonophobia was recognized as a disease a short time ago. Many doctors still do not know it and cannot diagnose it adequately. For this reason, many may tell you your problem is not “real.” Your phobia is simply a trickery that plays in your mind.

However, phonophobia is a real problem, and researchers have proven it.  A researcher at the University of California, San Diego, conducted a fascinating study on this disease, placing electrodes on the skin of people with phonophobia.

When you feel anxiety, the sweat glands of the skin increase their excretion, and the electrical conductivity of the skin increases, thanks to the electrolytes. 

Perspiration Test

For this group of people with phonophobia, electrodes were placed on the skin to measure their conductivity, and they had to listen to a series of sounds. The conductivity of his skin increased because the sounds caused a physiological response in their bodies.

This study confirmed that phonophobia is a legitimate mental disorder. It causes the body to react to sound in specific ways. 

Symptoms of Phonophobia

These are some of the most common symptoms:

• Disgust.
• Anger.
• Irritability.
• Anxiety.
• Pain.
• Stress.
• You have tachycardia.
• Your hands are sweating
• Avoid crowded and noisy places.

Low tolerance to sound: hyperacusis, misophonia, and phonophobia

If you are irritated by noises, certain people make when chewing, the clink of cutlery, and the voices of certain people, then you have misophonia. If the negative emotions that these sounds provoke include extreme anxiety, sweating in the hands, tachycardia, and a desire to flee, then it is phonophobia.

Both conditions indicate a low tolerance to sound. The same is true for hyperacusis. However, hyperacusis is a different disease.

Here are the differences:

Hyperacusis occurs when you are disturbed or afraid of loud noises, such as fireworks or a balloon exploding. If you have hyperacusis, you will lower the TV volume when you first turn it on. Then gradually turn up the volume to avoid sudden noise. Additionally, you avoid going to parties with loud music, drums, or fireworks.

There may be an issue with your perception of sound when there is hyperacusis. The auditory pathways are more sensitive than those of other people. Therefore, they overreact to loud noises, making them easy to irritate.

If you have misophonia, you are disturbed by certain noises that are not necessarily loud or sharp. It can be any sound, like the noise from clicking your tongue, running water, or the sizzling of a bonfire.

In cases of misophonia or phonophobia, there is no hypersensitivity in the auditory pathways; there is only an association of negative emotions, which can include extreme anxiety and fear, in the presence of certain sounds.

It is important to note that many people with hyperacusis can develop, secondarily, misophonia or phonophobia because they also associate loud sounds with negative emotions due to the hypersensitivity of their auditory pathways.

Causes of Phonophobia

It is unclear why some people’s hearing is extremely sensitive to loud sounds. Some people associate negative emotions and feel anxiety when they hear certain sounds. These people do not have a particular sensitivity in their auditory pathways.

In the case of hyperacusis, experts believe that chronic exposure to noisy environments or a traumatic experience associated with loud noises can cause hypersensitivity of the auditory pathways. In the case of misophonia or phonophobia, the trigger can be a traumatic event associated with a specific sound. 

Phonophobia can also have organic causes. A skull surgery, especially if it is near the ear, migraine, autism, or certain genetic diseases, can also cause phonophobia.

Impact on Daily Activities

Those who suffer from hyperacusis, misophonia, or phonophobia, can experience negative consequences in their lives. Most people try to avoid the sounds that bother them or cause anxiety.

But think about the following:

If you have phonophobia and are highly irritated by the sound of silverware clinking, you will have serious problems going to a restaurant. Some detest chewing noise and can no longer tolerate eating with certain people.

Thus, low tolerance for sound can affect your family, work, and social life. Even if you have moderate intolerance to certain sounds, you may have trouble driving your car to the movies or mall.

If the noise of the vacuum cleaner, the hair dryer, or the lawn mower bothers you, your low tolerance for sounds will not leave you alone, even in your home.

Diagnosis of Phonophobia, Misophonia, and Hyperacusis

These diseases are similar, and it isn’t easy to distinguish them. It is possible to perform a test by exposing the patient to different sounds. Then check their level of displeasure with each one. Patients with hyperacusis typically show greater discomfort as the decibels increase.

But this may not happen in patients with misophonia or phonophobia. Therefore, it is necessary to combine several tools to arrive at an accurate diagnosis.

One test uses an audiogram and a detailed questionnaire given to the patient. Then a detailed description of their symptoms is documented. This sound tolerance test can determine which diseases the patient has.

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Treatment Options for Phonophobia

Phonophobia and other disorders involving low tolerance to sound are not yet well known. Therefore, some doctors do not know how to handle them. You may have consulted a doctor who told you he could do nothing. He also may have suggested avoiding the sounds that bother you or wearing earplugs.

However, you have to know that avoiding noise that irritates you or provokes anxiety will not solve your problem. Avoid all kinds of celebrations, parties, or demonstrations.

What will you do when you have to go to lunch in a crowded restaurant? You can only avoid family reunions for a while. On the other hand, placing plugs in your ears will only make the problem worse. 

So, what is the solution?

There are several possible treatments for hyperacusis, misophonia, and phonophobia, and they are as follows:

Gradual Exposure Therapy

This technique will be especially effective if you have hyperacusis. If your ears are sensitive to loud noises, a solution may be to start exposing them to loud sounds gradually until the hypersensitivity disappears.

At the same time, it would be convenient for you to be in an environment rich in sounds all day and night, as this will also help diminish the sensitivity in your hearing pathways.

Cognitive Behavioral Therapy

CBT (Cognitive Behavior Therapy) will be especially effective if you have misophonia. The therapist will try to give you tools that will help you overcome anxiety and negative emotions when you hear the sounds that irritate you.

On the other hand, try to change those negative emotions for positive ones associated with today’s sounds that are an unpleasant stimulus for your ears.

Relaxation Techniques

Relaxation techniques that include breathing exercises and progressive muscle relaxation may also help control the symptoms of any of these disorders that involve a low tolerance to sounds.

These techniques will help you control the anger, frustration, and anxiety the sounds cause.

Before starting any treatment, it is best to have a professional consultation.

Research work at the Academic Medical Center of Amsterdam

Currently, very few institutions worldwide consider phonophobia a disease important enough to research it. Among these institutions is the Academic Medical Center of Amsterdam, where Dr. Arjan Schroder, a psychiatrist, studies the causes, effects, and possible treatments for phonophobia.

The group of researchers at this center has been working for several years on this issue, and every week, according to Dr. Schroder, two or three people come for help. Almost everyone feels a certain rejection toward certain noises that people make, but in some people, the symptoms are so severe that they cause suffering.

People with phonophobia can, in many cases, not eat or sleep in the same room as other people or even stop going to work. It is a conditioning process, says Dr. Schroder. A connection between a neutral sound and a negative emotion takes place. And if you then start avoiding that sound, the problem gets worse.

Although its causes are still not well understood, phonophobia is treatable. At the Amsterdam Medical Center, patients with phonophobia perform group therapy.

In the sessions, therapists apply techniques that allow patients to disconnect from the sounds of negative emotions. It’s like “reprogramming” your brain, and therefore, getting positive results takes a certain amount of time, but getting them is perfectly possible.

Case Study Example

A 12-year-old girl went to the ENT because she was very uncomfortable listening to certain sounds, such as the sound of a plastic bag or the noise of a small balloon explosion. When I heard these sounds, the girl had tachycardia, was sweating a lot, and was crying. 

The symptoms began after the girl saw fireworks a few months ago. After several studies, the doctors did not detect any physical abnormalities in his ears or brain, and he was diagnosed with phonophobia.

At the beginning of her treatment, she attended two weekly psychotherapy sessions with her parents and learned relaxation exercises. At the same time, he received gradual exposure to a series of sounds to increase his tolerance for them gradually.

In only three months of treatment, the girl showed a significant improvement; at six months, she could witness fireworks shows again.

Also Read: Alzheimer’s Disease: Symptoms, Causes, and Treatment

This could also be your case. If you think you have phonophobia, consult the right professionals to get the correct treatment for your condition.