Avoidance in Misophonia
Personal Perspective: Seeing avoidance as dysfunction vs. natural tool.
Posted November 21, 2025 | Reviewed by Monica Vilhauer Ph.D.
Like nearly everyone with misophonia , my young adult son avoids sights and sounds that trigger reactions. He removes himself or keeps away. These strategies appear universal. For example, someone triggered by chewing might avoid both a movie theater and a buffet. Avoidance is extremely effective. No trigger, no reaction, no problem. Coping costs no money. People consult neither doctor nor Tarot deck for this informal strategy. Avoidance is ubiquitous in misophonia.
The term misophonia limped into scientific literature in 2001 with a trickle of isolated studies. That snail’s pace is long gone. Scientific interest has surged. An informal search in PubMed for “misophonia” yields 15 results for the calendar year 2020. That same process for the past 12 months brings in 80, more than the total number during the condition’s first two decades.
While scientific knowledge about misophonia is in formative stages, people with misophonia have experiential knowledge at the ready. Lived experience can lead us where science cannot (yet) or illuminate the path where science stumbles.
For example, people with misophonia generally use “freeze/flight/fight” and “defense response” to describe reactions. The phrases paint an accurate picture of the body. Both objectively real threats and objectively benign triggers activate the autonomic nervous system . However, neither phrase describes the danger. Threat! Where, what? The way that language and the nonconscious defense system work draws attention to what's missing.
We are impelled to focus on the threat we cannot see.
But sufferers aren’t primarily avoiding the threat (trigger). Focus on the threat feels right, but leads us in the wrong direction. Sufferers are avoiding the trigger's inevitable aftermath. Your sister’s laugh or her gum aren’t real problems. The problem is the toll that reactions take on mind, body, psyche, spirit, your day, relationships—you name it.
Normally, the autonomic nervous system invisibly regulates the body’s non-negotiables, like blood circulation. When this steady service is interrupted by actions like a heartbeat uncontrollably revving up, it feels awful. A reaction takes the wheel. Violent veer!
Powerful negative emotions, thoughts, and physiological sensations rake mind and body. People report a primal need to leave or sever connection to the trigger. If this isn’t enough fun, this happens against someone’s will—maybe multiple times a day or even hour.
That's a lot of high drama to endure over a sniffle or sip. Why bother? People with misophonia would rather not.
The problem and—cruelty—of this otherwise effective avoidance strategy is that bodies in the environment emit triggers: parents, partners, coworkers. Once triggered, a person wants to avoid being triggered again, even at a price. Sidestepping the gum-chewing classmate might be tough, but not heart-wrenching. Keeping away from your beloved sister? Enter heartbreak.
But the sufferer is not avoiding sister or gum. They are avoiding the reaction. The nervous system does not want to go through upset again. The body remembers and avoids. We don’t just jerk our hand away from the flame. We keep our hand away.
Keeping away causes no end of grief in misophonia. When he was a teenager , my son Thomas was triggered by an overwhelming number of sights and sounds in his environment, especially coming from my body. Wherever I was, Thomas was not. His distance was dynamic and nonnegotiable. If he heard me coming, he was quickly elsewhere. On those rare times we spoke directly, he was halfway into an escape before we started, eyes fixed away. We didn’t have conversations. I talked, he flinched. How could we help our son confront something so bizarre and damaging?
Yet as painful as avoidance can be (very), it’s also the one thing about misophonia that instantly made sense to me. I avoid the hot iron; penicillin (allergic); the person walking toward me on the sidewalk. Contact with these things hurts me. It’s not just harm I avoid. We avoid what gets in our way. Avoidance so naturally runs throughout our lives that we don’t even notice we’re doing it.
It's survival, large and small.
We keep away from the traffic jam and disapproving great-uncle. Avoiding is routine and survival. I most certainly avoid the naysayer as closely as the jagged glass when climbing any peak. This seems like common sense and maybe even good practice.
Keeping away also appears in the APA definition of avoidance: “keeping away from particular situations, environments, individuals, or things because of either (a) the anticipated negative consequence of such an encounter or (b) anxious or painful feelings associated with them.”
Revising the script from a survival to psychological paradigm changes how the words land. People with misophonia rely on avoidance. That seems to be uncontroversial. How one interprets that is contested.
There are multiple ways avoidance might take a positive spin through research: that has yet to happen. The widely-used “freeze/flight/fight” beckons evolutionary psychology or at the very least, calls for a nuanced lens on avoidance. Instead—with the single exception of a sentence in a study led by a scientist with misophonia (Gregory, Graham, and Hayes, 2023)*—the first 25 years of the field have introduced, cemented, and circulated the idea that avoidance is pathology. That message has not kept to its scientific corner but has hit the streets and our psyches.
Dysfunction need not write the script. Yet that is exactly the narrative establishing misophonia as a subject of science. Avoidance as maladaptive is written throughout research, textbooks, conferences, training. The recent explosion of research does not reel in the message.
During September's Misophonia Collaboration Forum (an uplifting Misophonia Research Fund event bringing together sufferers, clinicians and researchers), a fellow parent participant asked me, “why do I feel so guilty?” All I could say was, me too.
Whether we experience reactions or their fallout, we are indicted. This is not imagination . Blame and pathology follow misophonia throughout research and training. Thankfully, that message often (but not always) loses steam in the skilled clinician's office, where avoidance is understood in ways that center the knowledge of lived experience. To some extent, these professionals go against the grain; many are devoted to redirecting the field toward lived experience. We are not there yet.
Our families desperately need science to offer us meaningful relief. Instead, we trade coping for dysfunction.
Thomas and I have a good relationship. We’re close in ways that don’t require physical presence. We never sit side-by-side and talk, but you will find us perched around corners in various states of silence and speech. In our house, this is love’s constellation. Countless families with misophonia navigate these same struggles. We help our family members skip the obstacle but sustain and even strengthen relationships. Two decades can't be undone, but misophonia research has the opportunity to redirect its focus and extend a more empathetic and effective hand in our direction.
*Oxford clinical psychologist Jane Gregory is, along with Misophonia Podcast founder Adeel Ahmad, author of Sounds like Misophonia: How to Stop Small Noises from Causing Extreme Reactions and the lead author of the 2023 article referencing a previous study (Dibb and Golding, 2022) in which avoidance did not operate quite as expected in terms of impairment. Gregory, Graham, and Hayes (2023) respond: “This suggests that it is possible that some avoidance behaviour may actually help reduce the impairment associated with misophonia.”
Dibb B and Golding SE (2022). A longitudinal investigation of quality of life and negative emotions in misophonia. Front. Neurosci. 16:9 00474. doi: 10.3389/fnins.2022.900474
Gregory J, Graham T, and Hayes B . (2023) Targeting beliefs and behaviours in misophonia: a case series from a UK specialist psychology service. Behavioural and Cognitive Psychotherapy . 13. https://doi.org/10.1017/S1352465823000462
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Mary Petrie, Ph.D., is a professor at Inver Hills Community College in Minnesota, where she founded the women's studies program.
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This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.