Please be aware that there is no actual scientific misophonia test or misophonia scale and this exercise is not a diagnostic tool. Nor is it intended to be medical advice.
Since there is no current diagnostic test for misophonia, people with sensory sensitivities need to use the information and tools currently available to assess their possible involvement with misophonia. To that end, this exercise was developed to help people focus on the signs and symptoms of misophonia. It was developed using information collected from various sources: the monthly misophonia.com online survey, comments and discussions in the Support Forum, feedback to the What Misophonia Means to You inquiry, and discussions in the Facebook Support Group.
Level One: Annoyance with an Edge.
Everyone has things they dislike. But the things that bother people with misophonia have an uncomfortable edge to them. The trigger sound could be something like sniffling. When a person with misophonia hears sniffling, it immediately draws their attention. It cannot be ignored. Although it may not be much more than an annoyance at this point, there is some other unpleasant quality to the experience. If this is as far as it goes, we could call this Level One misophonia.
Level Two: Focused Attention
When a trigger event occurs, the person with misophonia intently focuses on that sound. It overtakes all other sensory input. The sound is then in the foreground of the person’s awareness and perceived quite negatively. Other unpleasant emotions may also be present. This sustained attention exists until the trigger events stop or the person can distance themselves from the event.
Level Three: Reality of Physicality.
Level Three misophonia may include uncomfortable physical symptoms. Among other things, people have reported having a nervous stomach, headache, and muscle tension. Like the trigger set, physical symptoms vary from person to person. Sometimes, people identify that they “carry” their stress in the area of their shoulders. Or that they feel a little nauseous when confronted. The physical symptoms of misophonia follow a similar path.
Level Four: Psychological Predicament.
Misophonia is thought to be a neurological condition but it can contribute to a wide range of psychological problems. Some of these problems are common to the condition and others are unique to the individual. Nervousness, apprehension, fear, disgust, and rage are some of the feelings that people experience when confronted with a trigger. These feelings range from mild to wild and can be one of the hardest components of misophonia to endure. Psychological pain can be as much of a problem to deal with as physical pain. Some say that it can be even worse because sometimes physical pains have simple fixes. But quick fixes are not so readily available for alleviating complex psychological issues.
Also, people begin to have more difficulties with interpersonal relationships at this stage. This is partly due to the emotions a person may exhibit while triggered. Expressing frustration, disgust, or anger with others can easily cause friction or hard feelings to arise.
Level Five: Fear, Freeze, Fight or Flight.
In addition to psychological and physical symptoms, the hallmark feature of misophonia is autonomic reactions. An autonomic reaction is a physical change made in the face of anxiety or fear. People report respiratory problems, stomach issues, palpitations and other physiologic issues. Panic is not unusual in those with intense sensitivities. People sometimes experience automatic fight or flight responses. They feel compelled to escape the trigger or immediately remove themselves from the triggering environment. This reaction cannot be intentionally controlled. It’s an automatic physiological response to something that is perceived as a serious threat.
Level Six: Extreme Challenges.
After experiencing some combination of the preceding levels of misophonia, some people escalate up to actual violence. This is the worst-case scenario. Both the thought of violence and actual violence (harm to self or others) constitutes the highest level of misophonia.
Misophonia can cause a serious strain on interpersonal relationships. Coupled with the lack of effective treatments the situation can become critical. It is possible that social isolation and continual pain and/or a sustained high-stress level creates a sense of hopelessness. And in rare cases, some people report having suicidal thoughts.
A person may have the signs/symptoms of only one level of misophonia as described in this exercise. But it’s more common to have a mix of symptoms from different levels. The intensity of each level’s symptoms increases as the level rises. But people do not always progress through each group sequentially.
Note that symptoms and reactions presented in each level are subjective. Triggers that affect one person may not have a negative effect on another. Everyone has their own unique trigger set.
You can use the information in this misophonia self test in your plan for coping with misophonia. Make your own assessment of the value of this experience and take away from it the knowledge that you are not alone. Other people struggle with similar issues and you can have a dialogue with others by joining the Misophonia Support Group on Facebook.
Have a question about misophonia? Go to the Misophonia Question & Answer Forum!