E228: Misophonia Does the Sound of Others Chewing Fill You with Rage with Tom Dozier | Mental Health Podcast

Michael: Hey! What's up, Unbroken Nation! Hope that you're doing well, wherever you are in the world today. I'm very excited to be back with you with another episode, with my guest Tom Dozier, who is a Behaviorist, who has researched and provided treatment for Misophonia as a reflex behavior condition since 2012 and is a Pioneer in misophonia research. I particularly am very excited about this episode because it's harkins memories for me as I've been thinking about and digesting what we're about to talk about. So Tom first and foremost thank you for being here, my friend, I would love if you would just take a moment introduce yourself and tell the audience, how you got to where you are today?

Tom: Okay. So my first career was as an engineering manager, I did that for 30 years. I was looking for something to do for the rest of my life because I don't sit around like to keep busy so, I went back to school and behavior science, and became a behavioral parenting coach, doing teaching parenting classes. And I had a mom of a kid with misophonia contact me for help and her daughter, had this unknown hearing disorder that was going to ruin her life, but she had auditory visual and olfactory triggers. So I go, well, that can't be a defect in the hearing neurology that has to be a reflect condition. Well, as a behaviorist, we have reflexes feelings and emotions, that's kind of one class of behavior and then we have the stuff, we do the math and talking and walking and all the doing stuff. And I thought they're surely, there's research to help with this and so I just said, hey, I'm going to go look at this and look at the problem be solved. When I went on to Google Scholar of all the journal articles in search for misophonia there were three; three only at that time and I recognize my daughter had this condition and I thought, hey, I'm going to, let's go look at this and see what we can find and that's what took me to where I am now. So, my primary career is a behavioral parenting coach, but 90% of my time is on misophonia now.

Michael: So Tom, I think the best thing to do would be to start with this. What is misophonia?

Tom: So kind of a common understanding of misophonia, is that a person hears, some sound like chewing or sniffing, and has this intense negative emotional reaction, that's kind of the fundamental, you know, non technical definition. And by the way, it's not just things you hear, it could be seeing something, like, somebody twirling their hair or shaking their legs, but just a really innocuously stimulus it's no big deal, normal everyday stuff and you just go, Oh, I can't stand that. And so that's basically what we recognize as misophonia. It is quite common, it affects probably 10 to 15 percent of adults in the United States, it typically begins in childhood with the average age in the 7 to 12 range, but it can begin at any time, it can you know begin us a grandma or grandpa or something. Again extreme negative reaction to common sights and sounds typically.

Michael: Are there specific triggers around this?

Tom: Yes, and no, how about that for a definite answer? So it's known like the subtitle of my book understanding and overcoming misophonia, the words I have on the cover, it says does the sound of others chewing fill you with rage. So chewing, eating, mouse sounds is by far the most common and a large study survey I conducted over a thousand people 95 or 96 percent had eating trick auditory triggers, but that means that there's four or five percent of the people who don't. So it's not that you have certain sounds every person has a unique set of misophonia triggers, one person may trigger to the sound of chicken squawking or roosters crowing and another person may be triggered by the sound of somebody clearing their throat or sniffing. So there was common sounds, mouth and nose sounds are by far the most common.

Michael: My first thought about is why? Because we all make those sounds, right? We all do the sniffle, we all do the weird phlegmy cough, we all on occasion while we probably shouldn't chew with your mouth open, I guess really the thing that I want to start with is, you know, where does that emotional and physical response like come from?

Tom: Okay, that's a great question. And the brainstem I like to call it your lizard brain, that just reacts to the world around you, it just does these reflexes, it's watching you, it's always watching and it's looking for a pattern, it's looking for a sound and something you'd happens in your body. It may be for babies for example, mom talks to the baby pick some up talks to the baby, pick some up, says, how kind of sweetie, I'm going to pick you up now and pick some up and they do that 10 or 15 times that brainstem notices that lala lalala voice goes with relaxing, well, that's pavlovian conditioning. And so with misophonia, I hear the sound of my brother chewing and I go he's not supposed to be doing that or that's not fair or why did Mom yell at me but it's not yelling at him? Sound-thought-action, and the lizard brain picks it up and so then it's sound reflex. So what happens is this physical reflex develops so that essentially you hear a stimulus or see a stimulus and your lizard brain tasers you somewhere. Hear we go.

So if it's like crunch and you get you get zapped, someplace crunch and that physical zap, then triggers the emotional explosion, and the intense negative emotions. So, fundamentally at its base, it's this physical reflex problem from a normal brain.  So I love the fact that this is unbroken because people with misophonia their neurology is not broken, it's normal adaptive learning by the brain stem, and it's called pavlovian conditioning and then once that physical jolt develops, then it's very natural that the negative emotions spent out of control on it.

Michael: The thing that comes to mind that I'm really curious about is, is this conditioning somehow tied into a survival mechanism like what purpose does this? Because here's why, I'm asking this question because I distinctly remember moments of time in childhood where, if my brothers were chewing, I would want to punch them and (Tom for full clarity) in the face because it's the hardest thing to, like, one of them also is like my brother brushing, his teeth like the way he brushed his teeth made me insane, what function or what purpose is this about survival? What service does this have for you in a practical sense?

Tom: Well, Michael, it the pavlovian conditioning, let's just not take this particular thing but pavlovian conditioning really allows us to adapt to the world around us. So for example, with food reflexes, if you eat a plate of spaghetti then your blood sugar spikes and your brain has to make all this insulin to bring it back down. Well, after a while your lizard brain sees that pattern and somebody the waiter puts a plate of spaghetti in front of you and before you start eating your little lizard brain as I call it, starts producing insulin so that your blood sugar actually drops a little bit and then raises up and then comes down. So we're smoothing it out, so it's really of adapting to the world.

And so whenever you're that little lizard brain, if your sees a situation and an action, situation, action or stimulus action stimulus, action, it goes, oh, I can do that for you, therefore, you don't have to think about it therefore, you can react faster without thought and it's a survival mechanism. Pavlovian conditioning is a survival neurological mechanism, but in this case, it's an accidental reflex that strengthens with more experience and so it's kind of gone out of control, but I don't think that in and of itself reacting to people chewing has any survival mechanism nor do I think it comes from the caveman days when, you know, you're fighting for, hoarding your food and fighting for your food and everything, this is really simple, human normal neurology.

Michael: What kind of activity is happening in the brain when this is transpiring? Because to me, I've always thought about this idea of mindset and controlling your thoughts and understanding now that it is conditioning. You know, I think I can look at that and go, Oh, well, of course that makes sense why when somebody does that thing I have that response. But what is actually happening in the brain that drives that response?

Tom: So, we know that the brain stays on the autonomic nervous system, which I call the lizard brain, is the heart and soul of any pavlovian conditioning, right? That's the part of the brain, that hears the sound, notices the sound, looks at the situation and the context, it depends on not just the sound but where you are and who's doing it and it has to go up to the hot brain to the cerebrum and say, where am I? What's happening? What's expected? Goes down into the mortar motor cortex and rumbles around and then it zaps the muscles. Now, that's the physical reflex that people do not notice. So Michael, when you were a teenager, a kid, and your brothers were chewing and brushing their teeth and making you so upset, did you notice that you were getting zapped or did you probably just noticed you were getting upset?

Michael: Yeah, it always felt like instantaneous.

Tom: Upset, right?

Michael: Like, yeah, just like a trigger.

Tom: Okay. So what happens is from the time, a trigger stimulus starts from the time you start hearing that crunch sound to the muscles firing wherever they are and it's unique to every person is about 200 milliseconds and then that's fed up into deep in the brain there in the cerebrum, there is anterior insula, and that's the anterior insular cortex (AIC) is a center for communication. So it gets all the external sensation and the internal sensations of touch, taste, smell, sight, hearing, muscle tension, body temperature, oxygen level, pain, whatever. So it gets all the inside in internal and external and that relays out to some spots behind your eyebrows so then for medial prefrontal cortex, which is an emotional reflex learning center, that takes something that's neutral and turns it into eat like a smell of Grandma's house, hey, I'm at Grandma's house or misophonia that crunch sounded like oh, that's horrible and so that little spot relays back to the anterior insula, which is by the way, right next to the limbic system, to the amygdala and the hippocampus and it just drives down, boom, boom, boom, boom, boom, boom, into the amygdala and hippocampus and it's just an explosion of emotion.

So probably by three-tenths of a second from the time you first, hear that trigger, your emotions are just flying but their emotional reflexes and it's made that way to help you react quickly. This little structure behind your eyebrows again it takes something that's neutral, a person's face and it becomes hey, there's my girlfriend or the other day, I was my wife for me, hey, there's my wife and it's creates a positive emotional reflex. So, these things help us adapt to the world around us, help us respond quickly, and it's great, it's really good stuff.

Michael: What comes to mind is are these then individual experiences are we predisposition to be biased in any way to certain stimulus? I guess the thing I'm trying to wrap my head around in this moment, is what exactly determines whether or not an individual, have a reaction versus another one? Because I know people listening right now, are probably in this thing where like chewing food, that never bothers me, but if you click your pen, I'm going to throw you out the window, right? Is there a cognitive bias in here? Like, how did the individual experiences play out in this?

Tom: So there's a difference between a sound that you hear and a misophonia trigger, because that's really a multi-sensory experience, you hear the trigger and then you're getting jabbed and your body somewhere. So it's a little bit like fingernails on a chalkboard which is genetic not learned, but people hear that screech and it go stop that, I can't stand that sound what they should be saying is, oh stop that I don't like shivering because the screech makes most people shiver and then they say I don't like that sound. So with misophonia everybody who has misophonia has uniquely learned that their trigger responses. So for example, my wife developed a trigger to the chicken squawking because she was concerned that the neighbors would be bothered and that she wants to bother the neighbors. And so she would hear the chicken squawking not just squawking, but when they're all squawking at the same time, just right out of her right in front of her desk, she faces her chicken area and she would have that thought, oh, no. I hope the neighbors were not bothered and she would hold her breath. So, after a while, when the chicken, the lizard brain saw that pattern and says, oh Pam, I can do that for you and now she hears the chicken squawk, and her chest muscles, go and lock and she stopped breathing and then she has this very negative emotional response.

Now, the negative emotions are probably ingrained as mammals that, it's called pain induced aggression. If somebody comes up and pops you in the back of the head, you’re immediately having this negative response. And so any kind of aversive negative stimulus causes an irritation and anger or an aggression response. So that part the fact that it all develops to anger is very common because we're mammals, and it's our part of our defending our self, but the individual sounds just depends on the person. So my wife developed it to the chicken squawking.

Another man that I worked with as a teenager, he had anxiety, he had shared a room with his brother who had allergies, so he could hear him breathing and he's laying there trying to go to sleep and after 20 or 30 minutes, he goes, oh, this is horrible and he goes to the couch, but after that one night, every time he heard his brother breathe for the next 30 years, it triggered him.

Michael: Well that that's fascinating to me because then I guess is a parlayed of that then was it all breathing that triggered him, or just the association made with that person?

Tom: So your lizard brain is deals with a complex stimulus for reflex. So it's not just the sound, it's the sound the setting who's there am I in the forest? Am I in my home? There's different context that change these reflexes. So for example, I was working with a woman, she was doing some relaxation training and she was relaxed, he says, oh just a second, I think there's kids playing behind my house, I said, oh, is that triggering you? She goes, Oh, yeah, she goes away, she comes back a minute later and says, oh they're doing some repair work, it's not a problem, let's continue. So when she thought it was children playing, it was a trigger when she found out, it was adults working it was not a trigger. So part of this is getting the right context and one person let's suppose this guy would trigger just to his brother and so for a while it probably was only his brothers breathing that triggered him.

Now, he was probably then in another situation a little bit stressed, notices the sound that seemed similar to his brother lizard brain says, that's close enough and and triggered him, and his case his shoulders were coming up and triggered him. And so, now, it's spread from that specific sound of that specific person to that sound by other people in other places and that's called a generalization of a reflex stimulus, and it spreads can spread to similar sounds, other people, other places and then it just starts to spread and spread and spread. And triggers grow in two ways, first off, they spread that way and then if there's a stimulus, I'm noticing while I'm being triggered, then, that stimulus becomes a trigger. So, for example, if I trigger to crunchy, chewing, eating and a person has a bag of chips and its crinkle crunch, crinkle crunch, the crinkle becomes a trigger, okay? Or I can be in a completely different place and being a little bit of an anxious person could by the way, that helps you develop misophonia if your little bit aware of the world and anxious about things, and you notice somebody's twirling their hair or balancing their leg and then you develop misophonia reflex from scratch again, and that can be a different muscle. So every time I hear chewing, my shoulders go up and it'll always be my shoulders very, once it's set is always going to be the same but then, when I hear somebody, see somebody twirling their hair, I might clench my fists, the lizard brain might clench my fists right? I don't. I call it, the initial physical reflex.

And one of the big problems here, Michael with misophonia and understanding it is that if I brought twenty people like you that had misophonia now or once upon a time and said, describe misophonia to me, you're going to describe the emotions. The emotions are so intense that's what you notice the most. And so, most misophonia experts, do not understand that misophonia begins a say condition physical flinch, and it's that flinch that drives the misophonia.

Michael: Man, that's so fascinating to me Tom, because I'm sitting here and, like, in real time I'm thinking about what my triggers are. And to come to mind, one particularly is people who walk hard, so if you have like hardwood floors, and you're barefoot and it's just that duh, it's so fascinating because I remember even just recently having a conversation with a friend who was over I was like, why do you walk so hard and they're like, what are you talking about? I'm like dude, if you walked any harder you're going to put a hole through this floor and just being like, why does that upset me at so arbitrary? But looking at and understanding this reflexive conditioning, I go, we'll wait a second and from a trauma scope, going, you weren't allowed to walk heavy in my house, that would be problematic. So like noticing that and having this conversation in real time, I'm like, oh, that makes so much sense to me. What I'm really curious about in the context of this is like, is there a how and why, to how misophonia like may actually become worse?

Because I found myself in certain moments of not getting the rage because I feel like I really learned how to control my reactions, and now be reactive to things, but just getting like perturbed would probably be the word best associated with this, but I know that there are people listening they're like, well, when my partner like clicks the button in the shower, like I want to freak out, and it didn't used to be so bad, and now it's really bad, or when I'm at work and the boss closes door it makes me want to like go and do whatever, but it didn't used to be that bad. Is there something as are worsening of this, that happens over time?

Tom: Yeah, and in part of this is that you understand how pavlovian conditioning actually works. So, I tell people that your lizard brain that's what drives our pavlovian conditioning is neurotic and insecure, it is always insecure, never confident. So it sees the situation, here's a crunch or whatever and it tightens that muscle 20% hits a 20% tightens to that muscle and then it goes, oh, no, did I do the right thing? And it watches that muscle and if that muscle tightens just a little bit, it goes, I predicted correctly, I did it right and if however I'm really annoyed because it's an annoying day and because I've been triggered several times or whatever problems. So I hear the crunch and the 20% hits and I go oh, when I go up to about 80% on that muscle or even I just go to 40% the lizard brain goes, hey, I did the right thing, but I didn't do it hard enough. Next time, I'll do a better job for Tom, next time I will hit that muscle harder because your lizard brain always follows the rules and every time it zaps you it turns, and it watches that muscle and says, did I do it right? And if you clench down on that muscle harder it goes, okay, I'll go up a little bit next time and so it just builds and builds and builds and builds.

Now, that's the physical reflex it drives emotion, but the emotional reflex it's coming out of your ventromedial prefrontal cortex behind your eyebrows it's also an emotional learning structure. So every time you have that sound and the little flinch and you have a negative emotion and you go, oh and then you wrote, then you go, oh, oh, and you give it more negative emotions that you hate it then that strengthens the neurology coming out of these little spots behind your eyebrows. In fact, that AIC and the amygdala, the whole area is strengthened it actually creates, strengthens the myelination or the little fatty sheath, that's on the neurons to make them, run harder, and faster so, with experience your supercharging, your anger neurons, and your strengthening that reflects more, and more, and more, and more intensely, and it just gets perpetually worse with normal experience.

Michael: And that feels like, I guess, what I want to understand here is there a way to control that?

Tom: Yes.

Michael: What does that look like Tom? Because I'm like and because the reason I was hesitant asking the question because I'm sitting here I'm like it’s so autonomic obviously, understanding looking at that, that you have to actually what I'm guessing is mitigate the reaction risk by doing something earlier. Would I be wrong in that?

Tom: Yes. Really good statement at, you're absolutely right on that. We talked about how misophonia physical reflexes get worse, right? And how the anger gets worse, the more you have a situation in the anger the more the anger kind of bills for the next time. Because your lizard brain is neurotic and insecure, you hear a crunch and it hits that muscle and then it's watching. Now if you were relaxed before the muscle flinch, and you just relax again just keep relaxing; the lizard brain goes, oh, no, I predict it incorrectly, I thought Tom was going to tighten that muscle but instead it relax I made an incorrect prediction about Tom's reflex. I will include that in my rules for how to zap Tom, how to help Tom and I will start backing off. So in as little as 20 or 30 minutes, if you were just fully relaxed that muscle then that misophonia can just back down.

So, I do parent coaching, I worked with a couple whose four-year-old was why I can kids at preschool and this was going on, really going well and toward the end of our series for the sun I mentioned misophonia because it's so common. In this, 40 year old Burly guy goes, Oh, yeah, that's me and I'm like, you're kidding, he goes, no, I had this friend as a teenager who chewed so loud I couldn't stand he says and now my kids know it bothers me, they chew around me on purpose, just to irritate me and it drives me nuts. And we found did some testing his reflex was in his jaw, so he's clenching his jaw, that's it, his lizard barin was zapping his tasering his jaw.

So I said look, if you will just since you're eating with your family as if you will just relax your jaw during dinner time it will drastically reduce your misophonia. Now, you can't relax your jaw and eat at the same time so you have to eat before or after your family. He says, okay, I'll give it a try.

Well, they went away, came back for weeks later for their last visit, the boy was doing great said, how's your misophonia? He says, oh, it's gone. So in less than four weeks after having misophonia for more than 20 years his misophonia was gone, so I said well, how long did it take? And I'm thinking what a week, 10 days, two weeks, you know, I don't know. And he goes well at first 30 minutes, I said 30 minutes, what do you mean? He says well, I would just relax my jaw and I could feel that jaw flinching and after 30 minutes it just stopped.

Now, there's something called spontaneous recovery of conditioned reflexes, which means that the lizard brain may have stopped zapping him and that moment because it's all him not tightening those muscles but overnight it says, maybe I should try that again. So the next night at dinner time, maybe his job would respond for 10 minutes and then stop and then the third night, maybe five and three and two and one and then you just stopped coming back. So relaxing, which is totally not what what you want to do when you're angry and you want to just punch somebody or stop them something, you know, physically stop them relaxing your muscles in advance of the trigger is a great treatment for misophonia. Now, the problem is for most people, they can't just relax, we learn to relax our muscles as we learn to play a musical instrument or a sport with lots of practice. So our hands were very good at relaxing, our jaws were very good at relaxing, most of the body shoulders were somewhat, okay, most of them were less rest of our body if we say relax we can't just relax those muscles.

So I have an app called misophonia muscle relaxation training only, Apple wouldn't let me put the fourth word there.

So misophonia muscle relaxation, which is a training, it's a free app and it allows you to do muscle relaxation training to develop the skill and the neurological connections to relax your body muscles on demand. And so, then relaxing, when there might be a trigger will start bring those down triggers down.

Michael: When I think about cognitive behavioral therapy, is there any aspects of that where you're basically reconditioning yourself in real time, like going through these practical, steps of relaxation, while being hit with the stimulus?

Tom: So I'll see, if I'm answering your question. So with the relaxation, it is not cognitive-behavioral, it is creating conditioning events or counter conditioning events that allow the reflex to come down but there are a couple of cognitive behavioral aspects of misophonia that can really help. One is working on your anticipatory anxiety because the more your kind of on edge worried that you're going to get zapped, get triggered, the more responsive you are. So trying to work on that anticipatory anxiety, and breathe, and relax, and focus on other things, and stop that heart rate coming up and normal tension and such that you may get from anticipating a getting zapped, that's a cognitive behavioral aspect.

And then at the far other end of the response chain after a trigger, that's what goes on in your mind. How long do you think, that's so unfair, that's so horrible, don't they know, they know that bothers me, is that triggers me, they know that upsets me, they don't care about me, I feel completely disrespected and people will spin on a trigger for minutes or even hours until they get it out of their system. So trying to willfully, mentally, shift your attention away from a trigger and focus on something that you can see are the details. If you look good all the little marks in the shapes and everything then that would be a way of reducing that kind of a reflex, that mental focus on it because the longer you focus on that mentally, the more you're telling your brain that was really important remember it next time.

Michael: Mmm, and that makes me think so much about this concept that I often come to is that where attention goes, energy follows, right? Because you're shifting effectively where you're putting your energy because we do get whooped and we do get stuck in these behavioral patterns, we do kind of go you're doing that on purpose and like the reality is generally speaking most people aren't doing things on purpose to piss you off like some sure I would imagine there's a percentage but in general your partner, your coworker, the guy at the gas station, he's not trying to ruin your day, but you get stuck in these loops in these patterns, which lead to that.

What I'm wondering here, Thomas, going kind of back to the beginning where we started, you know, this initial research study that you did with 1,000 people were there, any commonalities across the board that you noticed, that might be indicative of how people end up having misophonia?

Tom: So there's a couple of things that increase the change, the probability of developing misophonia, okay? You maybe you have the misophonia gene. The misophonia Gene was identified by twenty-three and me and if you have that gene, you are about eighteen percent, more likely to develop misophonia. So, let's just suppose misophonia effects 10% of adults then if you have that gene, the chances of you developing misophonia is 12%, instead of 10%. So, it's not a cause it just makes you more likely to develop misophonia, it seems that people who have anxiety and worry about things or more likely to develop misophonia. I found when I talk with people about, especially with Children and Youth but often I asked with adults, were you an emotionally sensitive child and emotionally sensitive children are much more likely to notice something that's going to upset mother or father or break a rule? And therefore, they're going to develop misophonia or there a rule follower, which kind of often, maybe a mostly sensitive as well. And so, if I know that the rule is to chew with my mouth closed, and my brother is smacking his lips, well, then he is violating a rule and oh, no, he's violating the rule and then that's going to cause me to develop misophonia. But there are a lot of people, I mean, the just happened to be at the wrong place at the wrong time.

I worked with this one man who was triggered by mocking birds chirping, and he was in his early 30s, never had any misophonia, he had a pair of mocking birds, build their nests outside of his bedroom is apartment bedroom, which sounds really cute, they had these little baby birds outside my window, I just love that, you know, no, the male mocking bird chirps 24 hours a day at certain times of the year and that bird chirped, and chirp and chirp and chirped, and he developed misophonia to that chirp. So, although there are commonalities people who have other psychological conditions or at least two, maybe even three times more likely to develop misophonia. So people with anxiety, people being a perfectionist often contributes to having people develop misophonia and then sometimes it's the strong-willed tenacious, it's not fair, it's got to be this way and that causes people to develop misophonia. So, there's really a large number of things that kind of put a person in a situation to hear a sound have a negative thought and develop a physical reflex, and again then the emotions develop, which is what the person recognizes not the physical reflex.

Michael: Yeah, and it almost sounds just like and this is not to be crass, Tom it almost sounds like just being a human being you have a likelihood of this occurring in your life.

Tom: Well, yes, absolutely you do because it is caused mine typical called normal neurology. And it really only develops where there is a repeating sound. If you hear a sound once or twice, it's not going to become a misophonia trigger because it's not, you may dislike it but it's not going to be a trigger because you haven't had enough repetition for your lizard brain to make it into a physical reflex.

Michael: Yeah. This is absolutely fascinating and such a fun conversation for me because I'm like, in real time, I'm just going to all these different things and I'm thinking about, okay, maybe I should get this app, and I need to go and do this thing, and let me try figure out. And it's so fascinating man, super curious about it. Tom tell everybody where they can learn and find out more about you before I ask my last question.

Tom: Okay. There's two places you can learn about me, misophoniatreatment.com, which is my profeossional website for misophonia treatment. And misophoniainstitute.org which is my nonprofit that I set up to for misophonia information and awareness. So those are the two places that people can go for good information on misophonia and misophonia treatment because a lot of places will tell you, we don't understand what misophonia is and there’s no treatment, so that's just not true. The other thing Michael is, I'm put up a web page for on misophoniatreatment.com/unbroken where people can go and get the free first half of my book understanding and overcoming misophonia.

So this is a free download, I'm not going to ask for your email address or anything, you can just go and get it there. But I'm here to help people and we really can make a difference, some people misophonia will go away, probably most people, it's a chronic condition you have to remember to relax when you hear those sounds, when you hear those footsteps, Michael, you need to just melt your body and let yourself relax, because that will make it go away.

Michael: Yeah. I love that. Thank you, Tom. And of course, we will put all of the links in the show notes. Tom, my friend, y last question for you is, what is it mean to you to be unbroken?

Tom: Well, from Misophonia perspective, I want to first say that having misophonia means that you don't have a defective brain, you're not broken with misophonia. People with misophonia think there's something wrong with their brain that they get so upset by these sounds and nobody else does and I tell people, you know, it's not that you have some chemical imbalance in your brain, it's not that you have neurons that are misfiring or cross-wired or some defect, in your upper brain telling you that these sounds are going to hurt you like caveman days or something are gonna hurt you. And the one thing I can guarantee is you're not being possessed by aliens, right? This is normal human neurology.

And so to me being unbroken with misophonia is learning to relax, learning to do something different to focus away from it that the more Michael, I'm sure you've talked with other people about things, like, depression, and anxiety and I don't know for sure about PTSD but the more you think about those things, the more you think that oh, no, I've hear my heart beating, maybe I'm going to have a heart attack, maybe I'm going my heart's going to explode and that just brings on a panic attack. So with Misophonia the more you focus away from it in those situations that helps your lizard brain to calm down and move away. So I really think being unbroken with misophonia means you're going to take care of it, you're going to address it, you're not going to just pretend it's going to go away or hope it's going to go away. You're going to actually need to do something to take care of your most misophonia rather than jumping in and trying to panic in the moment. And with misophonia, if you decide I'm going to sit here and I'm going to adore this sound until I stop reacting, you're gonna get tough with it, your reaction gets higher and higher and higher and higher the reflexes strengthen. The more you can walk away when you need to turn on a little noise, adding noise to the world, you know, if you have a partner that they're breathing sound triggers you then get some good ocean sounds and rain sounds going and you won't even hear them breathing. So with misophonia, don't endure it because it will break you. So to be unbroken is to focus away, add a little noise, be strategic and carry on with your life.

Michael: Powerful Tom! And thank you so much for this, my friend even today I'm just like, oh, there's so much I want to dive into this and so, I appreciate you being here.

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