The Misophonia Response: Older and Newer Parts of the Brain
What is conscious and what is nonconscious?
Posted October 22, 2025 | Reviewed by Monica Vilhauer Ph.D.
What exactly is happening when an individual with misophonia is triggered? Well, we don’t know everything about misophonia’s underlying mechanisms, but we do know some things that are certain. Misophonia is a complex condition involving the body, the brain, and the conscious mind. That is, there is a neurological (brain) response that we are unaware of accompanied by physiological (body-based) changes, which are connected to cognitions (thoughts) and emotions (ways we consciously describe our feelings). These events all coalesce into a behavioral response (one that we can observe in ourselves or others). Here is the problem, each of these aspects of the misophonia response is in and of itself multifaceted and complex, and all of the phenomena interact with one another. Therefore, when we think about describing misophonia, an individual might say, “I feel so angry I could scream.” Here, the individual is consciously describing an emotion , the way they feel, and explaining their thought (cognition). Alternatively, an individual might say, “Every time I hear that sound, I start to shake.” This is a description of the physiological experience, but the emotional content is implied. Perhaps the individual means, “I am shaking because I am afraid, or anxious .” We see here how emotions, cognitions, and body states overlap and are difficult to parse out from each other.
Mostly, when a person describes misophonia, they do so by explaining their conscious emotional experiences or their feelings. However, we need to look deeper to understand the complexities of what emotion really is and to understand that misophonia involves the whole body. An emotion is not a concrete entity. It does not exist on its own. LeDoux describes an emotion as a conscious feeling that is created in the higher or “thinking” part of the brain. For clarity, then, when we refer to an emotion, we will follow LeDoux: an emotion is a conscious feeling (LeDoux, personal communication, 2025).
How Do Emotions Happen to Us?
There are many, many parts of the brain that are involved in emotion, some that are still unknown to science. However, we are going to concentrate on two very general functional brain areas (the higher and the lower) to explain the very complex nature of emotion.
What allows us to know and express an emotion? We can know what we feel and describe it because of the prefrontal cortex. The prefrontal cortex is the “thinking” part of the brain. It is part of the neocortex, which is a newer part of the brain that is more developed in human beings than in animals. The prefrontal cortex allows us to perform relatively sophisticated cognitive acts, such as appraisals and predictions about our surroundings. It enables us to plan and make decisions, all related to higher-order thinking (which is why we refer to it as a higher brain region).
LeDoux reserves the word emotion for that which is conscious – feelings that are knowable to the individual. “I feel angry, or worried, or happy.” These are thoughts (cognitions) that we formulate because we have a highly developed prefrontal cortex compared to other mammals. For the sake of clarity, let's define emotion, then, as a conscious feeling.
However, an emotion also includes nonconscious brain processing related to survival. Older (and lower) parts of the brain, such as the amygdala, hypothalamus, and the brain stem mediate automatic responses related to threat.
The amygdala detects threat, sends signals to the hypothalamus, which activates the part of the autonomic nervous system that prepares the body to act in the face of potential harm. The hypothalamus is connected to another complex system responsible for the release of hormones , such as adrenaline and cortisol. And the brainstem controls involuntary body functions such as heart rate and breathing. This is an oversimplification, as many other parts of the brain are also involved in threat behavior, such as those that are involved in the way body sensations are processed, memory , and other facets of perception. This mini-tour through the lower brain functions is important because an emotion is imbued with these lower and automatic responses.
Lower, less developed brain areas can initiate body responses and behavior before a conscious feeling is known. Yet, “emotions are played out “in the theatre of the body.” “Foundational neural responses give rise to emotion, but only after the higher brain regions have made an interpretation. Emotions and the survival response are not one in the same, but are inextricably related, and an emotion is part of a larger neurophysiological response.
Now that we have separated the idea of a conscious emotion and the innate, hard-wired defense response, let’s think more about how this all works and relate this to misophonia.
The defense response is also referred to as the defense cascade. Fight/flight is part of this, but it is not the entire picture. The defense cascade begins with arousal, which is the first step in the process. During the arousal stage, the sympathetic branch of the autonomic nervous system alerts to a possible threat. Physiological changes, such as muscle tension, accelerated breathing, and heart rate, occur as the system readies for further action. During arousal, the system is more alert and attention is narrowed to the potential threat. Arousal can lead directly to into fight/flight, but as you can see is very much an activated state on its own. Arousal may also lead to freeze. When we talk about misophonia, we are talking about arousal and fight/flight, but we don’t usually talk about freeze, nor has freeze been specifically researched in misophonia.
Freeze has not been the focus of research or in most descriptions of misophonia. However, I have heard numerous people tell me that they freeze in response to trigger sounds/sights. One way to conceptualize freeze within the defense cascade is to think of it as we see it in animals, as “fight/flight put on hold.” Fight/flight is active, whereas freezing is inactive. There are different types of freeze responses, all involving different parts of the brain from fight/flight, and each having a disparate outward manifestation. An animal may freeze at which point they are immobile, but still highly alert with heightened sensory awareness (orienting freeze). Freeze may progress to tonic immobility, also an involuntary response, in which muscle tension causes rigidity, helping the organism blend in better with its surroundings.
You might think of an animal “playing dead.” This is an extreme end of tonic immobility in which the body appears lifeless, a part of the defense cascade designed to ward off predators. The freeze response in animals involves the parasympathetic branch of the autonomic nervous system, which serves to slow the body down. Similar to arousal and fight/flight, the freeze response involves the amygdala, the brainstem, as well as other parts of the brain that enhance sensory perception . An animal may remain in various states of the freeze response until the threat passes, or until an escape opportunity arises, and the more action-oriented fight/flight response kicks back in.
Just like animals, human beings respond to threat by freezing when fleeing or fighting is not an option. However, unlike an animal, humans can make conscious decisions about a situation, sometimes even overriding this natural response as higher brain areas become involved. Therefore, we again enter the arena of emotion, where an automatic defense response mixes with a feeling that is known to the individual and can be expressed. Emotions connected to the freeze response often include feeling “shut down,” “disoriented,” “disassociated,” “stuck,” “numb,” or like a deer in headlights.” We do not know how this fits into misophonia yet, but I am hoping this will enter the research soon.
Because misophonia involves such a complex response, understanding the nuanced differences between the conscious and the nonconscious can help us target areas for self-help or for professional treatment.
Kozlowska K, Walker P, McLean L, Carrive P. Fear and the Defense Cascade: Clinical Implications and Management. Harv Rev Psychiatry. 2015 Jul-Aug;23(4):263-87. doi: 10.1097/HRP.0000000000000065. PMID: 26062169; PMCID: PMC4495877.
LeDoux, J. Personal communication, 2025
Share this post Facebook Bluesky Linkedin Email
There was a problem adding your email address. Please try again.
By submitting your information you agree to the Psychology Today Terms & Conditions and Privacy Policy
Jennifer Brout, Psy.D. , who suffers from misophonia, helped found the Sensory Processing and Emotion Regulation Program at Duke University.
Get the help you need from a therapist near you–a FREE service from Psychology Today.
This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.