Individual therapy

Misophonia Therapy

Therapy for misophonia: the chewing, sniffing, tapping, and breathing sounds that flip a switch nobody else can see. It's not irritability and it's not rudeness — it's a reflex, wired in before you get a vote. The reflex may not be your fault, but there's real work that changes what it costs you.

50-55 minute sessions ND-affirming, no gimmicks 100% online · TX · ME · MT · NH
Is this you?

"Just ignore it" — said by everyone who's never had it.

To everyone else it's a person eating an apple. To your nervous system it's an air-raid siren. The rage or disgust arrives in under a second, fully formed, before any thought gets involved — and then you spend your energy hiding it from the very people triggering it. If this sounds familiar:

  • Specific sounds — chewing, sniffing, throat-clearing, pen-clicking, certain breathing — cause instant rage, disgust, or panic
  • The sounds hit hardest from the people you love most: your partner at dinner, your parent on the phone, your kid in the back seat
  • You've become a sound detector: you hear the trigger before it fully happens, and you brace for rooms before entering them
  • Meals, movie nights, open offices, and car rides are endurance events you perform calm through
  • Afterward comes the guilt — you snapped, or fled, or seethed silently at someone who was just eating cereal
  • People keep offering the same advice: relax, ignore it, stop being so sensitive. None of it has ever touched the reflex.
Understanding the cycle

The reflex is fast. The cycle around it is where the life gets lost.

Misophonia isn't a fear you talked yourself into, and it can't be reasoned away — the trigger response is automatic. But around that split-second reflex sits a much larger cycle of bracing, escaping, and dreading, and that cycle is where most of the suffering actually lives. That's also where the work happens.

The misophonia cycle A cycle of five stages connected by arrows in a circle: a trigger sound, an instant alarm of rage disgust or panic, escape or suppression, an aftermath of guilt and conflict, and anticipation and scanning that primes the nervous system for the next trigger, feeding back around. The center is labeled: a reflex, not rudeness. A reflex, not rudeness and around again — a primed system triggers faster The trigger chewing, sniffing, tapping Instant alarm fight-or-flight: rage, disgust Escape or suppress flee, mask, white-knuckle it The aftermath guilt, conflict, exhaustion Anticipation scanning, bracing, dreading

The dread costs more than the trigger. The reflex lasts seconds; the scanning, bracing, and aftermath fill the hours between. Therapy works the whole cycle — not by forcing you to endure sounds, but by shrinking what they take from you.

Who I work with

Wherever the sounds are costing you most

Misophonia shows up differently at every dinner table and in every open office. Your trigger map — which sounds, which people, which rooms — is the one we work from.

Lifelong misophonia

It started around age 9-13, it never left, and nobody has ever taken it seriously.

Partners & families

When dinner is a battleground, the misophonia and the relationship both need tending.

Neurodivergent adults

Misophonia often travels with autism and ADHD — the sensory picture gets mapped together.

Workers & students

Open offices, shared classrooms, video calls — performing focus through a siren.

Visual triggers too

Misokinesia — leg-jiggling, chewing motions, repetitive movement — works the same cycle.

What we work on

Four fronts, worked together

An honest starting point: there's no proven cure for misophonia, and anyone promising one is selling something. What there is: real, workable ground on every side of the reflex.

Shrinking the dread

For most people the anticipation — scanning rooms, bracing at the sound of a snack wrapper — costs more waking hours than the triggers themselves. That layer is anxiety, and anxiety is workable. We take the dread apart first.

Regulating and recovering

You can't stop the alarm from firing, but you can change what happens next: how fast your body comes back down, what you do in the surge instead of snapping or fleeing, and how much of the day the trigger gets to keep.

Designing your environment

Headphones, seating, sound masking, meal logistics, workplace accommodations — engineered deliberately instead of improvised in shame. Accommodation isn't giving up; it's what you do for a real condition.

Protecting the relationships

The cruelest part of misophonia is that it aims at the people you love. We build the language, agreements, and repair skills that keep the condition from being read as contempt — including partner or family sessions when useful.

How treatment works

Honest work on a condition medicine is still catching up to

Misophonia isn't yet a formal diagnosis, and the research is young — which is exactly why you deserve a therapist who says so, instead of one who treats it like ordinary anxiety. The work here draws on cognitive-behavioral and acceptance-based approaches (ACT) and nervous-system regulation skills, aimed at the parts of the cycle that respond: the dread, the recovery time, the environment, and the relationships. Sessions are 50-55 minutes.

One thing you won't find here: forced sound exposure. For misophonia, gritting your teeth through triggers tends to sensitize the reflex rather than tame it — many people arrive having accidentally run that experiment for years. Nothing in this work asks you to endure sounds to prove a point.

Misophonia also travels closely with neurodivergence. If sound sensitivity is one thread in a bigger sensory picture, the late-identified autism & ADHD and neurodivergent burnout pages describe that work.

How online therapy works →

1

Assessment

Your trigger map: sounds, people, rooms, and what each one currently costs.

2

Stabilize

Environment design and regulation skills, so daily life stops being an ambush.

3

Work the cycle

Shrinking the dread and the aftermath, and repairing the relational strain.

4

Consolidation

A durable toolkit, agreements with the people around you, and a plan for hard seasons.

Format

All sessions online via secure, HIPAA-compliant video. You must be physically located in Texas, Maine, Montana, or New Hampshire at the time of session. Online has a quiet advantage here: you join from a sound environment you control, with your own headphones, at your own volume.

Investment

Sagebrush Counseling is private pay, and superbills are available for out-of-network reimbursement. Visit the services page for current rates and details.

Approach

ND-affirming, sensory-aware therapy with training in ACT and DBT-informed skills for neurodivergent clients. I'm Amiti Grozdon, M.Ed., LPC, licensed in four states. Meet your therapist →

Common questions

About misophonia therapy

Quick answers. The full FAQ page has the rest.

Honestly: there's no established cure, and the research is still young. What's realistic — and what people actually experience in this work — is a smaller footprint: less dread between triggers, faster recovery after them, an environment that stops ambushing you, and relationships that stop absorbing the damage. That difference is often the difference between a condition and a life sentence.
This is one of misophonia's most consistent and most painful features: triggers are strongest from close others — partners, parents, siblings — and often barely register from strangers. It's not a hidden grudge and it's not about the relationship. But because it looks personal, it gets read as contempt, which is why the relational side of the work matters as much as the individual side.
No — not the endure-the-sound kind. For classic phobias, graded exposure is the gold standard; for misophonia, forcing yourself through triggers tends to make the reflex stronger, not weaker. Most people arrive having already run that experiment at every family dinner for a decade. The work here targets the parts of the cycle that actually respond: the anticipation, the recovery, the environment, and the aftermath.
It's its own thing, but it keeps close company: misophonia is more common in autistic and ADHD adults, and for many people it's one thread in a wider sensory profile. If that might be you, we map the whole picture rather than treating one sound at a time — sometimes that mapping is how people first recognize their neurodivergence. Nothing here treats sensitivity as a flaw.
They're a tool, and you're allowed tools. The useful question isn't "should I need them" but "am I choosing when to use them, or is dread choosing for me?" Strategic accommodation — headphones, seating, sound masking, meal timing — is part of managing a real condition. We design it deliberately so it serves your life instead of quietly shrinking it.
Yes, when it would help. Misophonia lands hard on households, and a session that gives your partner or family an accurate picture — it's a reflex, here's what helps, here's what makes it worse — can change the temperature at home faster than months of explaining. I also work with couples where sensory differences are part of the dynamic.

You've been white-knuckling this alone long enough.

The consultation is free and short. We'll talk by phone (I'll call you at the time you schedule) and see if we're a fit. No pressure, no commitment.

Free 15-min consultation