Does the Context of a 'Trigger Sound' Matter in Misophonia?
Reframing is useful in the aftermath of misophonia, but not the trigger moment.
Posted November 6, 2025 | Reviewed by Lybi Ma
For individuals with misophonia , a fight-flight-freeze response occurs when they are subjected to certain sounds or visuals. For these individuals, extreme emotional distress, panic , anger , frustration, and even disgust have been noted (Brout, 2018). Misophonia is a neurophysiological condition in which the amygdala becomes activated by sounds that should not be alarming or dangerous (Kumar, 2017).
The context of triggers—such as whether or not something is rude, offensive, or otherwise disgusting can affect the emotional aftermath of a trigger, but it does not change the aversive fight-flight-freeze response. An individual with misophonia may feel strong emotions over, for example, another person sniffling and try to contextualize their anger as being offended by rudeness (Rouw, 2018). These are cognitive ways to deal with a condition that is not cognitive. Without an explanation for distress, persons with misophonia are likely to come up with ‘logical’ reasons for their reaction. This emotional response does not change the severity of the trigger; rather, it is a way for the individual to cope with the physiological aftermath of fight-flight-freeze. If an unpleasant sound—such as chewing with an open mouth, which is considered rude in many cultures—is genuinely offensive, that doesn’t make the sound or trigger any better or worse to handle. It offers a cognitive rationale for the distress, regardless of how valid that rationale may be.
This question of context inevitably leads to trigger sounds that are necessary or not necessary, and whether or not the distress can be mitigated based on the necessity, or if a trigger is perceived as deliberate or accidental. While focusing on the cognitive reaction to triggers, such as deciding if a sound cannot be avoided, like sniffles during flu season, can offer some cognitive explanation, the fight-flight-freeze response and distress will remain. Since sensory information is cumulative (Tremblay, 2010), habituation—which is the state of becoming used to something—cannot occur. Without an official cure or explanation of why the physical processing part of the brain is identifying stimuli as triggers, the number one way to avoid distress with misophonia is to limit triggers whenever possible. Advice for cognitive restructuring and reframing that aligns with sorting whether triggers are necessary or not necessary should be considered as contextualizing to mitigate distress after the fact of misophonia, not to alleviate the fight-flight response altogether, as that is impossible and happens regardless of cognition . The fact remains that whether a trigger sound is made on purpose, by accident, necessary, or not necessary means very little to a physiological response that happens within milliseconds.
Cognitive reframing should be used as a tool to help individuals deal with their emotional aftermath, and should not be an assumption that the individual can “just deal with it” if the sound has been placed in the necessary category.
While the context of triggers can matter for the emotional aftermath—such as not wanting to go back to an environment because there may be triggers and then realizing that perhaps the trigger was associated with a cold or flu, or something that cannot be managed, this does not mean that the distress is alleviated. If a trigger sound is especially activating for an individual, reframing the situation may have little effect, as the brain might remain in a fight-flight-freeze state too long for rational reframing to take hold. With misophonia, regardless of the intent behind the trigger, less is always better for helping persons with misophonia remain regulated and calm. In situations where an individual has a trigger that cannot be accommodated, such as another person sniffling, chewing, or breathing, accommodations should focus on the best way possible to alleviate stress for the individual with misophonia while understanding practical reality . This may mean the person with misophonia leaves the room, has noise-cancelling earbuds, or the person who makes the sound leaves if possible. Quality of life for persons with misophonia is dramatically improved as exposure to triggers goes down. The reality is that no cognitive context will take away the cumulative effect on the nervous system that being in fight-flight-freeze constantly has.
Brout, J.J., et al. (2018). Investigating misophonia: A review of the empirical literature, clinical implications, and a research agenda. Frontiers in neuroscience. https://doi.org/10.3389/fnins.2018.00036 .
Hayes-Raymond, S. (2024). Misophonia matters: An advocacy-based approach to coping with misophonia for adults, teens, and clinicians [Kindle edition]. Misophonia International.
Kumar, S., Tansley-Hancock, O., Sedley, W., Winston, J.S., Callaghan, M.F., Allen, M., Cope, T.E., Gander, P.E., Bamiou, D.E., & Griffiths, T.D. (2017). The brain basis for misophonia. Current Biology, 27(4).
Tremblay KL, Inoue K, McClannahan K, Ross B (2010) Repeated Stimulus Exposure Alters the Way Sound Is Encoded in the Human Brain. PLOS ONE 5(4): e10283. https://doi.org/10.1371/journal.pone.0010283
Rouw R, Erfanian M. A Large-Scale Study of Misophonia. J Clin Psychol. 2018 Mar;74(3):453-479. doi: 10.1002/jclp.22500. Epub 2017 May 31. PMID: 28561277.
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Shaylynn Hayes-Raymond, MA , has a master's in counseling psychology and a bachelor's in political science. She is the director of the International Misophonia Foundation.
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