Misophonia is not a fear of sounds. It is an intense reaction and response to particular sounds (often repetitive sounds like chewing, smacking, coughing) .
A phobia is a fear of a situation/object that causes high levels of distress, avoidance, and impairment. There are both physical and cognitive elements to phobias. Whenever a person encounters the phobic situation, they become fearful. Their brain has had repeated experiences where it categories the feared situation as dangerous. To treat a phobia, you can expose a person to the fear and relearn that it's not dangerous--as well as challenge thoughts around the danger. If you’re afraid of dogs, we can create a hierarchy of exposures and slowly get you used to dogs while challenging your belief that dogs are actually dangerous.
Misophonia also has physical and cognitive elements, but unlike a phobia, repeatedly exposing a person to sounds does not stop your body from reacting, it just causes extreme discomfort and distress. The brain reacts as if the sound is dangerous, but there isn't an initial cognitive process where a person with misophonia is fearful of the sound. Instead they're experiencing a reflexive danger reaction. The cognitive elements of misophonia often occur with time. Even though individuals with misophonia may develop anxiety about sounds (anticipating triggers, preparing for triggers, avoiding environments with possible triggers), that doesn’t mean misophonia is a phobia nor should misophonia be treated like a phobia.
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