Metacognitive Interpersonal Therapy for Misophonia: A Single-Case Study

Abstract

Background: Misophonia is a chronic condition in which the exposure to specific sounds increases the arousal and recurrence of specific intense negative emotions. We hypothesized that misophonia may be strongly related to maladaptive interpersonal schemas that create difficulties in interpersonal relationships. Subjects with maladaptive interpersonal schemas think that other people try to subjugate, criticize, dominate, exploit, deceive, disregard, and humiliate them. Furthermore, these patients typically endorse a representation of self as mistreated, constricted, harmed, damaged, humiliated, impotent, inadequate, or fragile. Methods: We describe the course of a treatment of Metacognitive Interpersonal Therapy (MIT) in a young man presenting misophonia and co-occurrent obsessive–compulsive personality disorder (OCPD) and avoidant personality disorder (AvPD), with narcissistic traits and normal hearing. We collected qualitative and quantitative data at the beginning of the intervention and at 2 years follow-up. Results: The therapy aimed at increasing awareness of maladaptive interpersonal schemas and promoting a healthy self. The results reported a significant decrease in misophonia; behavioural experiments were used to increase the quality of social relationships and tolerance to the trigger sounds. Conclusions: MIT can be an effective therapy for the treatment of misophonia.

Keywords

• misophonia
• maladaptive schema
• Metacognitive Interpersonal Therapy
• personality disorder
• hearing disorder