Eliyahu Serkez | Misokinisia Therapy | Misokinisia Specialist Ramsey NJ

MISOKINISIA

What is Misokinisia?

Misokinesia is a condition where people experience intense negative emotional or physical reactions to seeing repetitive or patterned movements made by others, such as fidgeting, leg shaking, or hair twirling.

Misokinisia means a "hatred of movements" and can lead to feelings of annoyance, irritation, and anger, sometimes even escalating to intense rage. While anxiety is associated with misokinesia, anger tends to be the predominant reaction.

There aren't specific criteria for the types of visual stimuli that can trigger a misokinetic response, but movements that are repetitive or patterned are commonly reported. In some cases, just the awareness that the trigger movement is happening, even if not seen, can provoke a misokinesic reaction.

What are some common triggers?

Fidgeting: Such as foot-tapping, leg-shaking, or finger-tapping.

Repetitive Movements: Like pen-clicking, knuckle-cracking, or nail-biting.

Oral Movements: Such as chewing, slurping, or lip-smacking.

Fidgeting with facial features: Touching the face, rubbing the nose, or twirling hair.

What does Misokinisia feel like?

Individuals with misokinesia often feel immediate irritation, annoyance and anxiety when exposed to certain movements. These feelings can sometimes escalate to intense anger or rage, significantly interfering with a person's concentration and enjoyment of social interactions. For those affected, even knowing that the triggering movement is occurring can provoke these strong emotional reactions.

People describe feeling intense stress and physical sensations and as if they are being "attacked" or trapped by the person making repetitive movements. Triggers can also increase in intensity during stressful days. Research indicates that these movements are often only triggering if made by specific people, such as close family members, and later can spread to others.

How do people with misokinisia feel?
People with misokinisia describe feeling an assault on their senses—they get instantly annoyed and agitated when they see fidgeting. Sometimes, it's not just annoyance; it escalates into intense anger or even rage, and it becomes nearly impossible to concentrate on anything else. It's like they can feel this tension building up in their body, making them incredibly uncomfortable.

They often find it confusing and frustrating because logically, they know the person isn't doing it to bother them, but it feels so personal, like they're deliberately trying to upset them. What's worse is that even if they can't see the movement, just knowing that it's happening is enough to set them off. This happens most often with people they're close to, like family members.

How do people usually respond to Misokinisia triggers?

To manage the discomfort of misokinesia, individuals often seek ways to make life more bearable. They may use objects or reposition themselves to disrupt visual triggers. However, many find that even the awareness of the trigger's occurrence can elicit a response. Ultimately, avoiding triggers can lead to decreased functionality and a lower quality of life. We call this the Vicious Cycle of Misokinisia (click here to learn more).

Does misophonia get better without treatment?

Unfortunately no.

We find that without treatment, misokinisia often extends to more people, situations, and new stimulus, making it increasingly challenging to manage. This may be because, although avoidance may work at times, people usually find that avoidance can increase sensitivity, making it even more difficult to cope with misokinisia triggers.

Is misokinisia a type of OCD?

Misokinisia shares some similarities with OCD, as both involve triggers that cause intense emotions and discomfort, leading to behaviors aimed at reducing these negative feelings. However, Misokinisia differs from OCD in a fundamental way. While OCD triggers an anxiety and fear response, causing individuals to engage in compulsions to decrease worry or reduce uncertainty, Misokinisia triggers lead to a response of anger towards the person making the sound.

This distinction is crucial as it necessitates different treatment approaches for Misokinisia

Is there treatment for Misokinisia?

Yes!

At The Anxiety & OCD Therapy Practice, we treat Misokinisia with a form of acceptance-based cognitive-behavioral therapy (CBT), which is based on a model of Misokinisia that explains how it first develops and persists. This treatment protocol, which was developed by Dr Cowen and recently published in the Journal for Obsessive-Compulsive and Related Disorders, is called Experiential Acceptance and Stimulus Engagement (EASE). This protocol is designed to address the factors that keep a person “stuck” in a vicious cycle of avoiding unwanted triggers only to find that the triggers are increasing and becoming less tolerable.

EASE is based on the premise that the more we avoid triggering movements and discomfort, the more we become aware and bothered by them. EASE teaches people how to stop engaging in efforts to avoid and change triggers that cannot be changed. Though difficult, as sufferers stop avoiding triggers, the movements will become less noticeable, leading to a decrease in misokinisia symptoms.

In addition to my work here at the Anxiety & OCD Therapy Practice, I am fortunate to work with Dr Cowen, a true pioneer in researching and treating Misophonia/Misokinisia. I presently spend some of my time at Dr Cowen’s "Center for OCD and Misophonia" where I continue to practice and apply EASE in the treatment of both Misophonia and Misokinisia.