Misophonia and ASMR: Same Sounds, Opposite Reactions

ASMR and misophonia are reactions to the same kind of sounds, going in opposite directions. ASMR is a pleasant, tingling, relaxing response to sounds like whispering or crisp tapping. Misophonia is a strong negative reaction, such as anger or disgust, to specific sounds like chewing or lip smacking. Researchers have noticed that both are triggered mainly by sounds people make, that mouth sounds sit right at the crossroads, and that many people experience both.

I have misophonia, and mouth sounds are my hardest trigger. So the idea that millions of people watch videos of those exact sounds to relax has always fascinated me. Here's what the research says.

What is ASMR?

ASMR stands for autonomous sensory meridian response. In the first scientific study of it, researchers described it as "a tingling, static-like sensation across the scalp, back of the neck and at times further areas in response to specific triggering audio and visual stimuli", usually accompanied by "feelings of relaxation and well-being" (Barratt & Davis, PeerJ, 2015).

In that study of 475 people who experience ASMR, the most common triggers were whispering (75%), personal attention (69%), crisp sounds (64%) and slow movements (53%).

ASMR is more than a feeling. In a later experiment, people who experience ASMR showed a lower heart rate while watching ASMR videos, by 3.41 beats per minute on average (Poerio et al., PLOS ONE, 2018). How common it is remains uncertain: one study tentatively estimated that around one in five people experience it, while stressing that this needs to be confirmed (Poerio, Ueda & Kondo, 2022).

What is misophonia?

The 2022 consensus definition describes misophonia as "a disorder of decreased tolerance to specific sounds or stimuli associated with such sounds". These triggers "are experienced as unpleasant or distressing and tend to evoke strong negative emotional, physiological, and behavioral responses that are not seen in most other people" (Swedo et al., 2022).

If chewing and mouth sounds affect you strongly, why do chewing sounds bother me so much? explains it in more detail.

Same sounds, opposite reactions

The overlap struck researchers from the start. Barratt and Davis noted that "in both phenomena, triggering sounds originate from human movements and behaviours", and that misophonia's negative reactions are "the opposite of what can be observed in reactions to specific audio stimuli in ASMR" (Barratt & Davis, 2015).

Mouth sounds are the clearest example. A later study put it this way: "for some people the sound of chewing or lip-smacking is highly relaxing, while for others it is highly aversive, and mouth sounds are frequently mentioned in studies of the two phenomena". The authors added, candidly, that "there does not appear to be a good reason why different people should respond so differently to the same stimulus" (Barratt, Spence & Davis, PeerJ, 2017).

Context seems to matter too. Researchers have suggested that "eating sounds may trigger ASMR in one context, but misophonia in another" (Poerio, Ueda & Kondo, 2022).

Can you have both ASMR and misophonia?

Yes, and it seems to be common. Several studies point the same way:

• In a large study of people with misophonia, 49% recognised ASMR-like sensations: euphoric, relaxing tingles in response to particular sounds or sights (Rouw & Erfanian, 2018).
• In a study of people who experience ASMR, about 43% said they also had misophonia, and another 17% weren't sure (Barratt, Spence & Davis, 2017).
• People who experience ASMR scored higher than a control group on every misophonia scale measured. The authors concluded that "individuals reporting ASMR experience have elevated levels of misophonia" (Janik McErlean & Banissy, PeerJ, 2018). One honest caveat: the difference in clinically significant misophonia, 12.5% versus 6%, was not statistically significant.

This led researchers to suggest that ASMR and misophonia "may indeed represent two ends of the same sound sensitivity spectrum and that they can co-occur in the same individuals" (Janik McErlean & Banissy, 2018).

Having both doesn't cancel misophonia out, though. In the study of people with misophonia, the authors concluded that ASMR "adds positive emotions to the scale of sound-induced emotions but does not significantly decrease the negative effects of misophonia" (Rouw & Erfanian, 2018).

What happens in the brain

Brain research on ASMR is still at an early stage. In a small brain imaging study of 10 people, those who experienced ASMR showed activation in regions associated with reward and with emotional arousal, a pattern the authors compared to the chills some people get from music (Lochte et al., 2018). With so few participants, these results need confirming.

Misophonia looks very different. In people with misophonia, trigger sounds produced "greatly exaggerated" responses in the anterior insular cortex, a region involved in emotion and in deciding what deserves attention, along with a higher heart rate and skin conductance (Kumar et al., Current Biology, 2017). Where ASMR seems to engage reward, misophonia seems to set off an alarm.

Even ASMR fans find eating sounds divisive

Eating sounds are a special case. In one study, 25.3% of people who experience ASMR rated eating sounds as unpleasant and uncomfortable, by far the most negative rating of all the triggers listed (cited in Janik McErlean & Banissy, 2018). Researchers have even recommended that ASMR creators avoid mouth sounds "due to their divisiveness" (Barratt, Spence & Davis, 2017).

If you have misophonia and ASMR keeps showing up

ASMR is popular on YouTube, so it tends to appear in recommendations whether you want it or not. You can tell YouTube you're "Not interested" in a video, or that you don't want a channel recommended, and remove videos you watched by accident from your history. I go through these settings in how to watch YouTube with misophonia.

The harder case is mouth sounds in videos that aren't ASMR at all: a creator eating while they talk, or a close microphone that picks up every lip smack. That's what I built CalmEar for. It's a Chrome extension that reduces mouth smacks and lip smacking in YouTube videos as they play.

Why do mouth sounds relax me?

If whispering, tapping or mouth sounds give you pleasant tingles and calm you down, you are probably experiencing ASMR. It's a recognised, studied phenomenon, and nothing to worry about. And if the same sounds relax you in a video but irritate you at the dinner table, you're not alone either: researchers think context plays a big part.

A note on the research

Most of these studies rely on people describing their own experiences in online surveys, and some are small. They show consistent patterns, but there is still a lot scientists don't know about why the same sound can soothe one person and distress another.

Frequently asked questions

Is ASMR the opposite of misophonia?

In a sense. Both are strong reactions to specific human-made sounds, but ASMR is pleasant and relaxing, while misophonia brings anger, irritation or disgust. Researchers have suggested they may be two ends of the same spectrum.

Can you have ASMR and misophonia at the same time?

Yes. In one study, about half of people with misophonia also recognised ASMR sensations, and in another, about 43% of people with ASMR said they also had misophonia.

Why are mouth sounds used in ASMR?

Crisp, close sounds are among the most common ASMR triggers, and for some people mouth sounds are deeply relaxing. For others they are the worst possible trigger, which is why researchers describe mouth sounds as divisive.

Does watching ASMR help misophonia?

There's no good evidence that it does. In a large study of people with misophonia, experiencing ASMR added positive feelings but did not significantly reduce the negative effects of misophonia.

Sources

• Barratt E. L., Davis N. J. (2015). Autonomous Sensory Meridian Response (ASMR): a flow-like mental state. PeerJ.
• Barratt E. L., Spence C., Davis N. J. (2017). Sensory determinants of the autonomous sensory meridian response (ASMR): understanding the triggers. PeerJ.
• Poerio G. L. et al. (2018). More than a feeling: Autonomous sensory meridian response (ASMR) is characterized by reliable changes in affect and physiology. PLOS ONE.
• Poerio G. L., Ueda M., Kondo H. M. (2022). Similar but different: High prevalence of synesthesia in autonomous sensory meridian response (ASMR). Frontiers in Psychology.
• Janik McErlean A. B., Banissy M. J. (2018). Increased misophonia in self-reported Autonomous Sensory Meridian Response. PeerJ.
• Rouw R., Erfanian M. (2018). A Large-Scale Study of Misophonia. Journal of Clinical Psychology.
• Lochte B. C. et al. (2018). An fMRI investigation of the neural correlates underlying the autonomous sensory meridian response (ASMR). BioImpacts.
• Kumar S. et al. (2017). The Brain Basis for Misophonia. Current Biology.
• Swedo S. E. et al. (2022). Consensus Definition of Misophonia: A Delphi Study. Frontiers in Neuroscience.