6 1GT Monday October 5 2020 | the times
life
My daughter can’t bear the sounds my husband makes
Ask Professor Tanya Byron
co-exist. From what you describe,
your daughter is also showing other
controlling behaviours that are
probably linked to anxiety. This
anxiety is clearly coming from her
noise sensitivity, but also, from what
you describe, an atmosphere at home
that is tense and unhappy, driven by
her father’s controlling and
humiliating anger.
This is an important additional issue
to consider. With noise sensitivity,
stress plays a significant role in how
it is experienced. I notice that you
describe your husband as a “generous
and loving” man, but go on to describe
behaviour that must be extremely
upsetting and stressful for you and
your daughter. I wonder whether her
misophonia and anxiety-related
control issues are also associated with
her distress and anger at her father’s
behaviour. This needs to be thought
about and understood beyond hearing
sensitivity, and as a family you might
benefit from therapy to address what
sounds like a very difficult set-up.
Rarely are people “all bad”, but I
wonder whether your own history
of abuse has left you accepting,
normalising and managing your
husband’s behaviours in a way that
is also unhelpful for you and your
daughter, and enabling his behaviour
to continue. It is also important for
you to know that survivors of abuse
who struggle with anxiety and post-
traumatic stress disorder (PTSD) can
show an exaggerated startle response
(an extreme fight-or-flight response)
and extreme noise sensitivity.
I advise you talk everything through
with your GP — the hyperacusis and
the family issues. Ask for a referral to
an audiovestibular physician. Your
daughter would also benefit from
some psychological support (see:
bps.org.uk). You, too, need a
therapeutic space to work through
your trauma as well as the challenges
in your marriage. Your emotional
needs and noise sensitivity should be
compassionately understood.Q
NN
QQQ
My teenage daughter
has very sensitive
hearing. Some
sounds are extremely
irritating to her, to
the point of panic,anger and ultimately tears.
Specifically she finds the noises
made by her father, a generous and
loving (if complex) man, utterly
repulsive. His breathing, eating,
speaking on the phone, cutlery
on the plate reduce her to tears.
She can barely be in the same
room as him.
This is so hard to navigate. I have
the same sensitive hearing. In
younger years I ended relationships
because of this problem. I fear she
has inherited sensitive hearing from
me and picked up this revulsion for
her father from me. I have developed
ploys to manage this sensitivity —
I wear earplugs, listen to the radio
at mealtimes and have organised the
living room to not see or hear him
if we watch TV as a family. I was
abused as a child and link this aural
sensitivity to that. Some sounds are
a devastating trigger.
I have read that aural sensitivity is
a common phenomenon. I have tried
to help my daughter to understand
that her sensitivity to the perfectly
normal sounds her dad makes is
something we have to manage —
but it is complicated. My husband is
a difficult man. He has a kind heart,
but is troubled, often angry, and
controlling. We don’t venture out as
a family often because his temper is
humiliating. I am resolved to remain
until the children leave home (it
would be too hard for us to leave
now, and then they would have to see
him alone, without me to manage
his temper).
My heart breaks for my daughter.
She has started to control things
around her, more so since lockdown,
like food, to a worrying degree. How
can I help her?
Davina
A
NN
A
The noise sensitivity
you describe is called
selective sound
sensitivity syndrome,
or hyperacusis, when
the sounds of everyday
life are experienced as intrusively
loud and sometimes painful, causing
anxiety and agitation. It can affect
one or both ears and can develop
suddenly or over time. These sounds
can include chewing, car engines,
breathing, tapping, barking etc. It
has been estimated that about 2 per
cent of the adult population have
some degree of hyperacusis, with
a much smaller proportion being
severely affected.
As you describe, this condition can
make life, relationships, work and
school extremely challenging. Some
people find the condition mildly
annoying and learn to live with it.
However, for others it can have a
significant and life-changing impact. It
can lead to a withdrawal from social
and professional activities, isolation,
anxiety and depression, which then
make the condition worse.
Hyperacusis can be understood in a
number of ways. If particular sounds
cause anxiety it is called phonophobia,
whereas if they spark anger because
of a significant dislike and repulsion
triggered by those particular
sounds, the condition is described as
misophonia. If the sounds are made
by a specific individual or individuals
(eg when they chew or breathe) it can
cause significant difficulties in
relationships and lead to conflict or
withdrawal. From what you describe
it sounds as if you primarily struggle
with phonophobia and your daughter
with misophonia.
To understand hyperacusis further
and find out what can be done to
manage it, it is necessary to speak
to a GP who can refer a patient to
an audiovestibular physician (see
baap.org.uk). It is also important
to exclude any underlying medical
causes, such as migraines, Lymedisease, Williams syndrome and Bell’s
palsy. People with sensory processing
difficulties (eg people on the autistic
spectrum and people with ADHD) can
also struggle with noise sensitivity.
Hyperacusis is usually associated with
increased sensitivity in the central
auditory system (the hearing pathways
in the brain). This sensitivity can be
influenced by mood, negative life
events, exposure to sudden loud
noises and trauma.
One common feature of people with
hyperacusis is to try to avoid loud
sounds, but this actually increases
sensitivity to sound because as
environmental sound becomes quieter,
the auditory system becomes more
sensitive owing to lack of sound input.
Treatment for hyperacusis within an
auditory clinic will include reducing
the use of earplugs in a systematic
way, gently reintroducing sound into
life. Sound therapists can advise on
an ear device or a bedside sound
generator that produces white noise.
Additionally, cognitive behavioural
therapy (CBT) can help your daughter
to recognise what is and is not helpful
in everyday life when living with
hyperacusis. Issues such as
hypervigilance around sounds will be
addressed, and also anxiety and anger
management strategies (breathing,
relaxation and mindfulness
techniques) will be learnt. Regular
exercise, good quality sleep and
lifestyle changes to manage
stress make a difference. See also
the British Tinnitus Association
(tinnitus.org.uk/hyperacusis),
Action on Hearing Loss
(actiononhearingloss.org.uk)
and the Hyperacusis Network
(hyperacusis.net).
Symptoms are often reported
between the ages of 9 and 13,
more commonly in girls. People
with misophobia can be
misdiagnosed with other mental
health conditions, eg obsessive
compulsive disorder (an anxiety
condition), or the conditions cana
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If you have a problem
and would like
Professor Tanya
Byron’s help, email
proftanyabyron@
thetimes.co.uk