(Illustration: Michelle Thompson)

As we sit down in a mostly empty Upper West Side restaurant in New York City, my two companions say, almost simultaneously, "We should go." They're in quiet distress.

For Susan Nesbit and Bill Kaufman, the sounds of the light rock music playing over the stereo and the clattering of silverware are intolerable. Nesbit and Kaufman identify as sufferers of a new, largely unexplored condition known as misophonia—the “hatred of sound.” As we politely decline our menus and begin to leave, I can’t help but think that takeout must be a misophonic’s best friend.

Walking into the brisk December night in search of a quieter eatery, Kaufman, a lanky small-business owner living in the suburbs of New Jersey, talks about his family’s skepticism when he first tried to explain misophonia two years ago. “I got the deer-in-the-headlights look from everyone,” he says.

Named in the early 2000s by the neurologists Pawel and Margaret Jastreboff, misophonia—also called selective sound sensitivity syndrome—is one of many symptom clusters that don’t have a clear etiology. Those who suffer from misophonia recoil from human-made noises like chewing and whistling. The risks of being tormented by everyday experiences, like going to the movies only to find themselves sitting near a popcorn-cruncher, can make them too anxious to leave the house.

Will people like Nesbit and Kaufman be better off having a label to affix to their previously unexpressed pain?

Both Nesbit and Kaufman are in their 60s, but, like many misophonics, they remember first being repulsed by sounds when they were young. Nesbit, a Brooklyn occupational therapist whose voice is as booming as her frame is tiny, says there are plenty of people, her own mother included, who don’t believe misophonia exists at all. “She feels it’s me—that I’m being controlling,” she says. Nesbit ardently believes misophonia is a neurological disorder. Over time, she has learned to cull especially loud co-workers, friends, and romantic partners from her life, she says, recalling with warmth an old boyfriend who switched to plastic utensils for her.

Kaufman, who has three college-age daughters, has inadvertently conditioned his children to cover their mouths while eating, and he admits that misophonia has caused strain in his marriage. “You feel like it’s trivial and you shouldn’t even be bringing it up,” he says, “but they don’t understand what’s going on inside and how it’s terrorizing your head.”

In 2013, a team of Dutch researchers published in PLoS One a study in which they recorded the shared characteristics of 42 misophonics. The authors concluded that misophonia should be classified as a distinct psychiatric condition. Other researchers have put forth the theory that misophonia involves a neurological dysfunction in the connections between the auditory and limbic systems. Such an explanation suggests that this condition is not new, but simply was ignored in previous times.

But the diversity of triggers described by sufferers suggests a more complicated picture. While there are widely cited triggers like lip-smacking or loud breathing, misophonics don’t often possess the exact same ones. Known cues tally in the hundreds, running the gamut from slurping to the sound of a zipper, and some don’t involve sound at all—sights like a bouncing foot or rapid blinking are also said to aggravate. These shifting symptoms undercut the idea that the disorder has a strictly biological origin.

Edward Shorter, a professor of psychiatry at the University of Toronto and a historian of medicine, suggests that the probability of misophonia being a previously undiscovered organic disorder is low, given the long-standing loudness of the world around us. “We’ve lived in a cocoon of noise for the last hundred years,” he notes.

As we politely decline our menus and begin to leave, I can't help but think that takeout must be a misophonic's best friend.

According to Shorter, misophonia is another in a long line of ailments that are created more by a combination of popular and professional consensus than anything resembling a scientific method.

Shorter doesn’t think these disorders are fake; rather, they’re expressions of pre-existing anxieties, unconsciously shaped by the cultural currents of one’s time and place. He warns, however, that when certain clusters of symptoms are given legitimacy, they can gain momentum. The process often begins with a group of patients and advocates sharing their experiences. They are then studied by healers and researchers, giving the disorder professional legitimacy. This is followed by reporters such as myself injecting the disorder into the public consciousness. And from there, the disorders can spread like a virus. There is a great deal of social pressure on the unconscious mind, Shorter explains, to only produce symptoms that are deemed legitimate.

Shorter isn’t unsympathetic to those claiming to suffer from what he suggests are culturally shaped, transient mental illnesses. “But we aren’t doing them any favors by encouraging them to believe that they have an independent psychiatric illness,” he says.

According to the McGill University cross-cultural psychiatrist Laurence Kirmayer, who has studied the remarkable variety of somatic illnesses around the world, the fact that some illnesses are not strictly biological does not necessarily make them less real. “[P]sychiatric distress, like all human experience, takes shape from cultural particulars,” he writes in a paper he co-authored. Since these particulars differ from one time and place to the next, he argues, it makes sense that symptoms might change.

After walking the length of the better part of the Upper West Side, Nesbit, Kaufman, and I settle for a fluorescent-lit café with only mildly annoying pop music. They describe to me what a relief it has been to have found a name for their condition and to have found others like themselves. Nesbit is the founder of the Brooklyn Misophonia Meetup, an in-person extension of the growing online misophonia community that has connected sufferers from across the world, allowing them to swap experiences and possible treatments. They meet, of course, in a library.

At the end of our conversation, Nesbit and Kaufman both thank me for taking the time to listen to their stories without judgment. Watching them leave, I wonder about the role I will play in the evolution of misophonia. If the condition is partly a cultural idiom, as Shorter says, it’s likely that the more people who hear about misophonia, the more will come to believe they suffer from it. Will those people be better off, like Nesbit and Kaufman say they are, having a label to affix to their previously unexpressed pain?

Making my way back to the subway, I become keenly aware of the scream of sirens a block away, the sizzling of halal kebab carts, the chattering of busy pedestrians. Even as a native New Yorker, I feel inundated by the symphony of Seventh Avenue. Heading down the stairs to catch the roaring train, I reach into my pocket, more thankful than ever for my old earphones.

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