In Brief
Acceptance and Commitment Therapy (ACT) showed significant improvement in misophonia symptoms in a 2023 randomised controlled trial by Petersen & Twohig. Mindfulness meditation has been shown to physically alter brain structure, increasing grey matter density in areas involved in emotional regulation.
Mindfulness is not about ignoring triggers. It is not about pretending the sound does not bother you. It is about changing your relationship with the experience. learning to notice without being swept away.
For people with misophonia, this distinction is everything.
The Research
Schneider & Arch (2017) published a case study showing significant reduction in misophonia symptoms through a mindfulness-based intervention. The participant reported that while trigger sounds still produced an initial response, the secondary cascade (rage, panic, rumination) was noticeably reduced.
Spencer (2023) reported promising outcomes from mindfulness-based work with pediatric misophonia, suggesting that children and adolescents may be able to learn more space between trigger and response.
Petersen & Twohig (2023) helped establish Acceptance and Commitment Therapy (ACT) as a promising approach for misophonia. Early ACT work points toward reduced avoidance, greater values-based action, and a different relationship with the trigger response.
An online comparison study found that group mindfulness may perform comparably to group CBT for misophonia-related distress, suggesting that relational context (being with others) may matter alongside cognitive and attentional skills.
ACT: Acceptance and Commitment Therapy
ACT is not about accepting that triggers are fine. It is about accepting the reality of your internal experience while choosing to act according to your values rather than your reactions.
The ACT framework for misophonia: - Accept the trigger response (it is neurological, not a choice) - Defuse from the thoughts that follow ("I can't handle this" → "I am noticing the thought that I can't handle this") - Be present with the physical sensations without judging them - Observe self as the context for experience, not defined by it - Clarify values (what matters to you beyond avoiding triggers?) - Take committed action toward those values
Meditation and the Brain
Research outside misophonia specifically suggests that consistent meditation practice can change brain systems involved in attention and emotional regulation: - Increased grey matter in the prefrontal cortex (decision-making, impulse control) - Reduced amygdala reactivity (the threat centre becomes less trigger-happy) - Strengthened connections between prefrontal cortex and amygdala (better top-down regulation) - Increased insula awareness (you notice the sensation without being consumed by it)
For misophonia, these changes translate to a wider gap between trigger and response. Not eliminating the trigger. Widening the space in which you choose what happens next.
What This Looks Like in Practice
It is not sitting in silence and pretending sounds do not exist. It is:
- Noticing the sound arriving
- Feeling the body's response without fighting it
- Naming what is happening ("contraction in my chest. anger arising. urge to leave")
- Breathing through the peak of the wave
- Choosing your next action from awareness, not reactivity
Some days this works beautifully. Some days the wave swallows you whole. Both are part of the practice.
The Dial, Not the Switch
One man with 23 years of misophonia describes his relationship with mindfulness this way: after years of practice, he spent a month at a monastery without earplugs. Not because the sounds stopped bothering him, but because he learned that his response existed on a dial, not a switch. Some days the dial was at 2. Some days at 7. But it was never stuck at 10 anymore.
That is what mindfulness offers. Not perfection. Not cure. The dial.