#218 - Sara Barrick, LMFT, "Demystifying Misophonia"

Adeel [0:01]: Welcome to the Misophonia podcast. This is episode 218. My name is Adeel Ahmad, and I have Misophonia. This week, we're reconnecting with a guest who many of you will remember from one of our most popular episodes a couple years ago. Sarah Baric, formerly Sarah Bidler, has returned to share more of her invaluable insights. Since we last spoke, and actually just in the past few weeks, Sarah has published her book, Demystifying Misophonia, which I highly recommend to all our listeners. As a licensed marriage and family therapist specializing in misophonia and trauma healing, Sarah brings a unique perspective on understanding misophonia as a complex syndrome rather than a single condition. In her previous conversation, she opened many eyes to the role of the nervous system and implicit learning in her reaction to triggers. Today, we'll dive deeper into these concepts and explore the pathways toward healing that Sarah has discovered through her work. Take a look in the show notes for links or just go to demystifyingmystifonia.com for more on the book. After the show, let me know what you think. You can reach out to me by email at helloatmissiphoniapodcast.com or hit me up on Instagram or Facebook at Missiphonia Podcast. By the way, please do head over. They have a quick rating wherever you listen to the show. It really helps drive us up in those algorithms and reach more listeners. A few of my usual announcements will be real quick. If you want to come on the show, just go to misophoniapodcast.com and click the Be a Guest link. Thanks for the incredible ongoing support of our Patreon supporters. If you feel like contributing, you can read all about the various levels at patreon.com slash misophoniapodcast. All right, without further ado, here's my conversation with Sarah. Sarah, welcome to the podcast. Welcome back to the podcast. Great to have you here.

Barrick [1:58]: Yeah, great to be here. Thank you.

Adeel [2:00]: Yeah, so I know a lot of listeners have heard your previous episodes. Do you want to just kind of remind folks who you are, kind of where you are and what you do?

Unknown Speaker [2:13]: Sure. I'm Sarah Barrick, formerly Sarah Bidler. I am a licensed marriage and family therapist. I live in a suburb of the Twin Cities in Minnesota. I have a private practice and I do specialize in helping those with misophonia and also trauma healing. I suffered from misophonia for 25 years and have been free of it for six years now. And let's see, I have two boys, their school age, and I think that's about it.

Adeel [2:46]: yeah well the the exciting thing is that you have a new book out called demystifying misophonia which i think um you know basically goes through everything you've learned about misophonia and kind of your um your approach but um but far from me to kind of describe it i'd love to hear more more about that journey? How did that all start? And tell us kind of like, yeah, a bit about what's in it and what you hope it brings to the world.

Unknown Speaker [3:17]: Okay, thank you. Yeah, I have a lot more clarity about misophonia following writing the book, including how misophonia triggers are formed and how we unlearn having a threat response to them. You know, the saying is like, if you want to understand something really well, write a book explaining it. And that is definitely how it worked for me. But I didn't actually start writing the book with that intention. It was more about organizing the information and strategies I had gathered over the last five years, specializing in this into something more coherent and accessible. But as I started to put together the puzzle pieces I had just through that deliberate act and spending a considerable amount of time writing a book, it highlighted to me where I had missing pieces. And then I was able to seek those out. And then it was through sharing those new insights and perspectives on misophonia with clients. And that led to even more insights and connections and clarity. and clarity to the point that, you know, I can pretty much say like Misophonia is really not a mystery to me anymore. And that's how the name of the book, Demystifying Misophonia emerged. So that's kind of a summary. Yeah.

Adeel [4:37]: Yeah, no, that's fantastic. And I know we've, you know, we've talked about it at various meetings or you've kind of definitely helped my evolution of misophonia greatly increase over the past couple years. So I appreciate that. And I'm excited that that and many, many other things are in the book. Yeah, I mean, do you want to start talking about kind of like what you've learned and what people can expect to learn from the book?

Unknown Speaker [5:03]: yeah sure you know i'll start with my original and one of my original intentions in writing the book was to help people understand misophonia as a syndrome so with syndromes you know you have similar symptoms visible at the surface level what i refer to as the tip or the top of the iceberg But what produced and perpetuates those symptoms isn't the same for everyone with the syndrome. And that's the stuff at the base of one's iceberg. So to find healing, you got to address what's at the base of your iceberg. And while there's a number of common themes, it's not the same for everyone with misophonia. And therefore the healing journey is not going to look the same for everyone. So with all syndromes, other examples are like depression, fibromyalgia, OCD, chronic pain syndrome, et cetera, there's many inroads to the syndrome and therefore there's many outroads. So, you know, I think it's important. One of the things I'd, you know, like to suggest or I'm hoping for is that we kind of stop with the messaging of there's no cure for misophonia, which I actually fell into for a period of time myself. But I really think it's misleading. I think it has people thinking that healing isn't possible for them until a cure is found. When the truth is one size fits all solutions are rarely found or feasible for syndromes, but it doesn't mean healing isn't possible. So, you know, understanding misophonia as a syndrome is important because if you're waiting for, quote unquote, the cure for misophonia, you're likely to be waiting forever. But in reality, there are many things you can be doing to move towards healing. And along a similar thread, you know, if we're assuming the way someone else found healing, um must be the answer only to find out you don't have the same outcome it can make you feel even more hopeless and broken when it's really not about that it's about that person found healing because that method was a match for what was remaining at the bottom of their iceberg and it happened to not be a match for yours or it didn't target all of your remaining iceberg layers like it did for them so and then one other thing um in terms you know of understanding it as a syndrome is knowing that syndromes typically do not have a singular solution or a singular box to check to find relief. There's likely to be a number of factors or layers that have to be addressed at the bottom of your iceberg. But again, there's themes with those layers with misophonia, icebergs, things like perfectionism, troubling family dynamics or emotional boundaries, shame, unresolved trauma, maybe lots of repressed emotions, a lack of nervous system agency. A really common one I see is the person being a highly sensitive person, but that not being acknowledged and therefore the unique needs that come with that aren't getting met. It can be unaddressed pre-existing conditions. Those are the most common ones I see. And the common denominator with all of the risk factors I just named is that they result in a narrow, one having a narrow nervous system window of tolerance. Do you want me to talk a little bit about what a narrow, what I mean by that narrow nervous system window of tolerance?

Adeel [8:39]: Yeah. Especially as someone who, you know, in his mid forties, never didn't really fully understand what a nervous system was, what could impact it and, and, and how to kind of like think about it. I think there are a lot of people, not that I'm particularly well informed on any other things, but I think a lot of people are probably curious and could definitely benefit from this. Yes. Please continue.

Unknown Speaker [8:59]: okay okay so um first i'll say when we have a narrow window of tolerance it's why that's important is it means we're much more likely to have something that would ordinarily just be experienced as gross or annoying to have that end up overwhelming us so the metaphor i like to use is for narrow window tolerance or under just understanding window of tolerance is to picture life as you're navigating down a river on a raft And as long as you're in the river, you're in a regulated state or what we would call within your window of tolerance. And then things like excessive stress, unmet needs or unresolved trauma. Those are examples of things that narrow the river. and in this metaphor just day-to-day stressors and annoying disgusting stimuli i mean i think most of us can agree like the sound of chewing isn't you know no one like loves it or someone repeatedly clicking a pen in a meeting no one's like that's awesome um those kind of things are like you know rocks in the river ranging from small to large in size and so the narrower our river is the faster the current flows and the less room there is to maneuver around these rocks and consequently we're more likely to collide with one at some point throwing us on to the riverbank out of our window of tolerance and that what's happening there physiologically gets the lower survival brains attention and can warrant it to take, you know, the disturbing or most notable stimuli at the moment, adding it to what I call its threat list. So especially if that experience also gets coupled with an experience of helplessness. So that's kind of in a nutshell. I mean, there's different, sometimes it's a one-time bigger experience that then has this thing being added to the threat list. Sometimes it's more of that buildup and it hits a tipping point, it gets added. Sometimes it's the direct experience with the stimuli and sometimes it's more indirect. It's like we're distressed for another reason and that sound is happening. So I break those four primary ways that something gets added to the threat list down in the book and give an example of each of them.

Adeel [11:29]: Yeah, that's a fantastic metaphor. By the way, the book has a lot. I've read it kind of in advance and has a lot of great metaphors that I think will help people. The meerkat one that we have in Jane's book. There's a lot of other great ones in this one. Do you want to talk a little bit about, when you talk about the stimuli, I know you talk about implicit learning. Are you referring to that as part of this process here?

Unknown Speaker [11:55]: yes so essentially when we another way of saying overwhelm like nervous system overwhelm another other language that can be used for that is like emotional suffering like we're suffering emotionally um and anytime when we experience intense emotions That's often where what's called an emotional learning or an implicit learning gets formed. And we a lot of times aren't conscious of it or we aren't conscious of it shortly after it gets formed because it's happening in this more lower brain type state where our brain isn't fully integrated, like the upper conscious brain is not online so much. So what an emotional or implicit learning in this kind of situation is, is it's basically ending the sentence like, I'm suffering because, or I'm having, you know, I'm feeling this way or struggling because, and then into that sentence. And so where we get in trouble a lot of times is when something healthy gets tied to something unsafe. So I'm kind of jumping forward here, but like if we put words to the emotional learning with a misophonia trigger, and it's not the same learning for everybody. So please understand that I'm just giving examples here, but the most common would be along the lines of, you know, this sound, you know, dad chewing or whatever means we're headed for overwhelm and helplessness. And so if that's the learning, you know, that's the... what we've learned through that experience. Then there's a what do we do to not suffer again? And that's the second half of the learning. And kind of where I wanted to go next a little bit is that piece of helplessness and how that fits with fight flight. Because it's important to understand physiologically, helplessness is the less preferred option to fight flight according to the survival brain. When we are overwhelmed and also helpless, that is the worst, you know, or least preferred physiological state. Fight flight, if we're in that, it actually means we have some agency. We have some ability, you know, to take action. um so what happens if i'm going back to what i said earlier we're overwhelmed and then it also gets coupled with an experience of helplessness um you know where i see that happening with misophonia triggers is you know it's the sound of chewing or someone clicking their pen or whatever and we kind of at some level we know like There's what's to be said or done about this. You know, it's different if the maybe irrational thing is a centipede or a mouse or someone scraping their fork on a plate. and it's more socially acceptable to maybe kind of you know or or flee or stomp on you know the centipede or something to somehow um express agency or express that fight flight response um but when it's chewing when you when you go back when i've um this was one of the things working with clients going back to before the trigger formed, like what was happening. And you really get curious about that situation and you go, okay, so you were really stressed after school. You were in the car with mom. She's chomping gum. It's just feeling like a lot to you. You know, this person in your family, you know, passed earlier in the year. You're going through puberty, whatever. So window of tolerance is narrow. The gum chewing is feeling like a lot. What did you do? And when I asked clients that, what they did before, you know, it became this ingrained trigger, almost the answer is nothing. They did nothing. They felt like saying something would hurt their mom's feelings. They felt like ashamed for even having a problem with the chewing sound. They shut down, whatever. They didn't know what to do. And so, you know, of course, we kind of more easily end up helpless in a situation like that because there's often a number of things converging in a moment like that that has us overwhelmed by the chewing sound. And we can't piece that all together in that moment. So we're just like... something really random is happening here um and are very confused by it and you know and then embarrassed maybe or ashamed or something

Adeel [17:02]: That's fascinating. So when I hear you talk about a lot of these things, I don't hear so much about the actual audiological aspect of it. It's more there's some kind of meaning that is attached to this sensitivity. Do you want to talk a little bit about that?

Unknown Speaker [17:24]: Yeah. There's kind of a couple ways that ties in. So we're still sticking to risk factors at first. So You know, one of the main risk factors is that narrow window of tolerance. But another risk factor can be when the sound or visual or behavior this other person is doing symbolizes something additionally disturbing or revolting or infuriating. That can then heighten one's arousal and also make the sound or the visual that much more or less tolerable. So like, you know, the sound might mean to the person, I'm not going to be able to fall asleep tonight and I'm going to end up feeling miserable tomorrow. Or the gum chewing sound might mean I'm going to struggle to stay focused on this test and do my best. Or the sound might mean my mom or dad ends up healthy. or my partner is inconsiderate. And those meanings can be subjective or objective, you know, but typically by the time someone seeks therapy for misophonia, they've disconnected from the deeper meaning or meanings associated with their triggers and just fully focusing on the trigger itself as the issue. But whether they're aware of the meaning tied to the sound or behavior, whether they're aware of that or not, it still significantly influences how they are processing that sound or behavior so so that's one piece of in terms of meaning and then we have Once we've had the experience of overwhelm and likely helplessness, there's a meaning that comes out of that. So when humans just have a need to make sense of their suffering, and they will do that whether they have all the information to connect the dots correctly or not. And so again, when there's kind of a lot of number of things converging here, it's going to be pretty hard for us. I mean, what kid knows about narrow window of tolerance? It's like, oh, I might be having a hard time here.

Adeel [19:34]: I didn't know that as an adult.

Unknown Speaker [19:37]: So for me, you know, I was riding in the car with my mom to my clarinet lessons and struggling with her gum chewing. And I was not at all taking into context that... You know, I was anticipating being shamed by the teacher, which, you know, often it was he was a very talented teacher, but very strict. I don't think I ever practiced enough for him. And, you know, I'm a highly sensitive person. So I take that really to heart. I was trying to do hard. assignments for tough classes i was in i was spreading myself really thin in terms of extracurriculars and working and all of that so i wasn't understanding how all of that was coming together in that moment and making this thing that might otherwise just be annoying or kind of like okay um it was overwhelming me so and then when If what the lower brain concludes is, you know, it's going, why are we overwhelmed and why are we helpless? And if it concludes is this sound, the sound is what's making us overwhelmed and helpless. Now, when it encounters that sound in the future. it's because it's on the threat list. It has the option to activate the fight flight response as a response to it. And then we get, you know, we're even more confused. Like I'm having this huge emotional response and like all this, you know, these defensive urges in my body to get the heck away from this thing or get it stopped. But yet it's, it's gum chewing, but that makes no sense. And then that's where we add oftentimes extra layers onto the original problem of this thing being tagged as a thread. So now we're like, I need to make sense of why, you know, what does this mean about me that I'm having this irrational response, we think, to this thing. And often we might conclude I'm broken or I'm a brat or I'm, you know. something about herself or find younger people they often go more in the direction of my brother sister whoever must be meaning intending to make me feel this way they must be trying to make me feel mad um because that's how i'm feeling so um so we add on those kind of layers um we you know now at this point that it's a trigger and we're being fueled with all this fight-flight energy and chemicals and emotions, it's mostly at some point you're going to express it, especially with the people you're around with. And then that starts to cause tension in relationships and there's more confusion. And then on top of it, we might be discharging some of the fight-flight response by giving a dirty look or shouting or something, but we're not likely discharging all of it. And so then we're just getting this build up of unreleased fight flight energy and the nervous systems getting more and more dysregulated, aka being in a threat mode. You know, a lot of the times, which when it's in a threat mode, it's in list making mode. You know, it's looking for more, more threats. What's the problem here? And so. Two ways we can kind of get more triggers is one, that growing dysregulation, we're becoming more and more vulnerable to being in a state that results in something getting added to our threat list that's regularly happening in the space. And two, once something is on our threat list, it can then get generalized to similar type stimuli or generalized to more people. And this is another reason I was really motivated to write the book is to help people see where they can have agency in that. Because if we're seeing misophonia, you know, if we were struggling and we go, okay, I'm going to Google, why do I hate chewing sounds? And then we come across information that we interpret as, oh, I'm allergic to chewing sounds. Oh my gosh, there's a whole list of things I might be allergic to. um that creates more helplessness and helplessness just fuels this whole thing so we feel like my body is just doing this at random there's nothing i can do now we're just in this fear state a lot watching for these different sounds what might be the next thing added um and then when we're noticing something annoying or gross we're bracing around it and we're we don't even know it but we're we're essentially priming our body to add it to the threat list. So when misophonia is not understood, it really snowballs fast into an iceberg situation.

Adeel [24:38]: Yeah, this is all fascinating, especially, you know, you were saying how the body ends up disconnecting from the original meaning. This is a fascinating concept. I wonder, is this a good time to maybe bring up other sensitivities, like what's known as, you know, the visual triggers music kinesia? Because, you know, a lot of people think it's a distinct thing, but... I know there's an emerging school of thought that thinks that this is all related. And I think it makes sense with a lot of the sources that you've been talking about, how it's all related to a meaning that preceded the initial sensitivity.

Unknown Speaker [25:21]: Yeah. So when it comes to mesokinesia or visual triggers, it's the same process happening. there in terms of how triggers get formed. I think one of the things I learned in writing the book and doing research is when we're in more of a threat mode in the body, one of the first things that happens is orienting towards sound or orienting towards threat detection auditorily, I guess is the best way to say it. The way I make sense of that is like, you know, sound is most likely our first warning that a threat is coming or it's sound gives us the greatest chance of preparing and doing something. So let's say it's a tiger. If we hear the tiger coming through, you know, crackling on the sticks or the whatever. um you know we could have a fair amount of distance versus if our first uh sensory experience of the tiger is smelling it or tasting it or touching it we don't have a lot of time and so but visual gives us some time too so it makes sense to me that we you know are really prioritizing um sound in the space when the brain's trying to figure out what's the threat here. Um, and then that visuals can be there too. So, um, yeah.

Adeel [26:52]: Yeah. Does that answer? Absolutely. Yeah. No, that's the fascinating and kind of laid it out. And I've kind of like slowly come to that realization where, yeah, sound is often the first trigger and you can't, it's the hardest thing to block because even if you close your ears, um, you can't really block it, but you're right. If you're, uh, if you're to the point where you can taste the tiger is probably too late. You're probably going to lose.

Unknown Speaker [27:15]: Yeah. And same with like a car, right? Like if a fast car is coming, we probably are going to detect that first through the sound of it. Yeah. And then one other risk factor quick is, and this falls within the helplessness category, but just having a lack of nervous system regulation strategies. You know, so like go back to my example in the car on the way to lessons, like, you know, I didn't have an understanding of how I might alter my breathing, you know, or shift my attention to a resource like maybe my feet or legs feeling calm or to grab something cold to calm my body. or to even advocate for myself, say, hey, I don't know, that sounds just a lot for me right now. So this just kind of not knowing how to work with the physiology and the arousal that's showing up, that's one of the common risk factors I see too.

Adeel [28:11]: Okay, yeah, this is fascinating. So, you know, we've talked about, obviously, implicit learning and narrow wind of tolerance and, you know, all the different ways that, you know, people get, that bottom of the iceberg can form. Maybe let's talk about unlearning and kind of what you've learned, what you've seen has worked and kind of how you think about that.

Unknown Speaker [28:33]: yeah perfect yeah so in short like getting free from misophonia means unlearning the triggers as a threat and we're unlearning essentially that fight flight is the necessary response to these things So the scientifically proven process for unlearning and a lower brain learning is called memory reconsolidation. And I'd like to use the metaphor of a computer with this, like the files on a computer. So we need to, memory reconsolidation involves opening the file of the target learning, the one that we're wanting to modify and unlearn. And the way we do that, we have to get in touch with the emotions of that learning or feel, kind of feel it in the body, you know, that learning. And then while that file is open, we need to bring in evidence that contradicts the learning. And that creates what's called a jump position. And that puts the file into an editing mode. So it's almost like it takes the file out of being a zip drive and making a Word doc that we can edit. And while it's in editing mode, that target learning can be unlearned. The key piece is bringing both learnings, the old and the new, into the same space within that label, modifiable state window of time. And the contradictory evidence or learning must be experienced as true by the client in order for it to have an unlearning effect on the original emotional learning. So let me put this, make it more tangible. I'll put the learnings into words, just knowing implicit learnings don't exist in words prior to someone coming to therapy. Coherence therapy is one of the, it's a memory reconsolidation method. It's my preferred one. And it's big on actually putting words to what is the belief or the schema or the implicit learning that the person holds. And again, we need it to be specific to that person. So everyone with misophonia does not have the same learning at the base of their misophonia. But if I'm going to give you an example, the most common would be something like, this sound means we're headed for overwhelm and helplessness. And then an example of what the learning would be that we want to replace it with might be something like, I have the strength, support and tools needed to handle any discomfort I might experience with the sounds and behaviors of others. I'm doing what I need to maintain a healthy window of tolerance and fully capable of staying in control and I don't need to fear ending up overwhelmed, out of control or helpless. And that has to be felt, you know, as true. At least it doesn't have to be maybe 100% felt as true, but like, yeah, I can feel that that really is, you know, true. Now, in order to feel that as true, we've got to address what things are making you vulnerable to ending up overwhelmed and helpless. So let's say at the base, you know, part of what resulted in that for a person is they spread themselves really thin. They're overcommitted in their life. If they're still doing that, we're not likely to get the lower brain on board with seeing this as no longer a possibility of ending up overwhelmed and helplessness or overwhelmed and helpless. If they don't have regulation strategies and they don't practice them, brain's not going to get on board with that. If someone's a perfectionist, you know, way high standards for themselves, they're not getting the sleep they need. They're not getting the time in nature they need or whatever. We're not likely to get the lower brain. We're not going to be able to really feel the truth of that new learning. And I typically find with misophonia, so some symptoms, we could say the symptom is having a fight flight response, say to chewing sounds. know or the symptom might be depression or whatever some symptoms are supported by multiple files there's not just one word doc there's actually a folder of files in the brain that is part at the base of that symptom and we need to address each of the files so another way to say that is there's multiple layers you know the base of the iceberg Some people, when they come to therapy, they've already done, you know, other therapy or they've done a lot to address the risk factors that originally put them at risk for overwhelm and helplessness. And they're more ready to go right to that core learning of their misophonia. They've maybe cleaned up, really worked on self-care. They've learned how to put, you know, have healthy boundaries in their relationships, things like that. And so... but um you know typically you know if there's a lot of outer layers there still we need to address some of those so that we can actually have the experience of you know i can be around sounds and have agency um and be okay and i find two of the best ones layers to address first are any shame and confusion related to misophonia so the book hopefully i hope is really um helpful to people and clearing up confusion around misophonia because if we're not understanding what our body's doing and we just feel like it's turned against us and we're broken or whatever um that just keeps us in this helplessness and so having really clarity about what's happening and why and the way forward is really powerful And then, you know, addressing any shame we might carry that we picked up about why misophonia is happening is really powerful because shame lights up the brain the same as physical attack. Shame is keeping us, you know, one of those things that can be keeping us in a threat state and making it hard for our brain to unlearn it as a threat if we have shame tied to these triggers and things. So that's typically, yeah, where I start. Yeah, it's fascinating.

Adeel [35:11]: I'm just remembering, talking to Jane, that's also kind of where she starts is addressing some of that personal shame first. Yeah. Yeah, another fascinating thing you just mentioned, which I'm starting to think about a lot, is how you said a lot of people come to therapy and they've already addressed a bunch of things in the past. And going back to what you said about people have different paths into this iceberg, people address things in different ways and they can find relief sooner or later than others. Yeah. Do you want to dive a little bit more into that and what people do to kind of give themselves a better chance?

Unknown Speaker [35:55]: Yes. Yeah. Yeah. In the book, I refer to the bottom of the iceberg work as a ping pong process between memory reconsolidation work. So that's the unlearning work. and what I call scaffolding or adjunct work. So as a metaphor, memory reconsolidation, this is, I don't know, this is the best metaphor I could come up with with this one. It's a little out there. But memory reconsolidation work is like replacing a piece of fascia board on a multi-story house. So fascia is the trim board that runs along the edge of the roof. So if we're like, OK, that board is outdated or it needs to be replaced, um what's going to help us replace that board is the scaffolding work or we call adjunct work and that's you know the ladder or whatever that helps us get up there to make it much easier to replace so another way to look at that is like memory consolidation work you know that's done doing methods like internal family systems, EMDR, somatic experiencing, coherence therapy. There's a number of them on my list in the book. And scaffolding is a little more kind of CBT type methods and psychoeducation. So oftentimes we need to be doing some of the skills based stuff and have, you know, strong understanding of how the lower and upper brain, you know, work with each other to then get the lived experience you know we need to do the unlearning so um so again some people have done a fair amount of scaffolding um work which has them closer already it's more possible it's not such a big jump to replace that piece of fascia whether you even realize it or not probably and that's how i mean for me Um, you know, it, it, at first when I no longer experienced misophonia, it was like, whoa, it just was gone, you know? And, um, you know, I got through some significant life changes, but I knew like, that's, but that's not the answer, you know? And I knew kind of like it had there somehow the trauma work I had done working on boundaries. i had taken an eight-week course on mindfulness and been practicing that for years um improving my self-care, I knew somehow these things were tied into that. So it was actually like the life change I had was a memory consolidation experience in and of itself of unlearning just in general helplessness in terms of, you know, if I feel different about someone, about something, you know, my feelings are wrong, that sort of thing. um even further down the helplessness tied to a specific trigger was just general you know i think being a highly sensitive person and feeling you know a lot of times my feelings are wrong unless other people are having these feelings too so um so that got unlearned for me But what helped me unlearn it was all that stuff I was doing previous to that. So it's so hard. I hope the book also helps people see that bigger picture because I think it is really hard to keep that hope and maintain that perseverance when you're making all those changes, working on boundaries and self-care and meditating and whatever, and you're not seeing a difference. maybe right away with the top of the iceberg so hopefully you are you know maybe having some areas in your life where you're not as triggered as much um but it's hard to keep that bigger picture and know that all of that is making a difference um but until you actually replace that fashion board or replace that learning um you're gonna keep having the symptom especially under situations of higher stress the brain is gonna take that neural pathway if it still exists so um so in short just kind of conclusion like what we're looking to identify is you know what risk factors contributed to you experiencing overwhelming helplessness which ones have been addressed and which still need to be addressed And so that's kind of how I'm hoping to help people streamline. You know, their process is, you know, with the book, as they read it, really see and come to understand what were those risk factors for themselves and what's still there and what's not. And then I think it is... helpful to have some understanding of what that memory reconsolidation process is i know it keeps me more when i'm doing my own work in therapy keeps me more focused a lot of us like to kind of stay at a heady place you know we'd rather just talk about our problems but if we really If part of why we're having the issue is there's a lower brain learning, we got to do that. That has to be worked with in a lower brain way. It can't be resolved at the cognitive, just talk therapy level.

Adeel [41:24]: Yeah, it's a very multi-dimensional, multi-layered problem in a one-dimensional world that's seeking a quick fix. And I think another thing that I've kind of realized is like... you know, all these things to tackle misophonia have a lot of other benefits in your life and potentially want to be, you know, not the, the slight silver lining of misophonia is that if you really take it seriously and how to address it, you're actually addressing a lot of core, maybe hidden things that the misophonia is, is trying to be the flashlight for you. Exactly. Exactly.

Unknown Speaker [42:11]: Exactly. And, you know, a lot of people that have found freedom that is, you know, looking back, they're like, they're grateful for their misophonia. They're like, it led me to areas of my life that I didn't realize I was, you know, believing something really unhealthy for myself or was carrying this burden or had this unresolved trauma, whatever. So, yeah. page you know i've been working with um cresta dalrymple and sapporo weisman too gather these stories first and foremost for our own learning as providers um to better identify themes and stuff but also just to share that message of hope and um paige is one of the people we interviewed and she's like i see my miss pony as this just treasure chest of i just keep going back to for um understanding myself more fully and becoming more liberated and it really is the case that the things that are going to be involved in your journey to freedom are going to help you in a number of other ways in your life. So it's, it's a gift in a lot of ways.

Adeel [43:26]: Yeah. Pages. Actually, I think I've interviewed everybody. You just mentioned it. Oh yeah. Go back. It has a really wonderful mindset about it. Yeah. Yeah, fascinating. I mean, yeah, this little final bit there, especially, I think, is very under-talked about, under-appreciated in the Mississippian community, I think. So I'm glad we're talking about it. I mean, I don't know. One other thing that came to mind is just, you know, now that we're talking about this multidimensionality, you know, there are a lot of people out there. And by the way, you can skip this. But there are a lot of people out there who are looking for that quick fix, offering that quick fix. And, you know, people seem to be being helped. But do you want... I don't know. Do you want to frame that in terms of everything that you've kind of just talked about in terms of the different ways? Just to kind of give people... something to think about while they're reading and hearing about these stories.

Unknown Speaker [44:26]: Yeah, thank you. A couple things to think about if you're hearing of a quick fix, you know, I'd have to know specifically that situation to speak to it specifically, but it can be You know, it could be that that person has done a lot of scaffolding and that thing that they just did that appears to be the quick fix was actually the final layer, you know, that they needed to remove. And most likely that was the memory reconsolidation. It got at the root of what needed to be unlearned. So that was the case for Brooklyn Bish. We interviewed her as well. It was primarily rapid resolution therapy at the end of her journey that then she no longer experienced misophonia. But in interviewing her, we're like, well, what, did you do any stuff prior to that? And she had done a number of years of therapy. She had often a piece in the freedom story is just like taking one's power back. So she had an experience of taking her power back, realizing how strong she really is as a person. She had learned to practice boundaries. She kind of got, I think, her career a little more in line with her authentic self. things like that so um so when there is kind of when it happens it's like it's easy to go of course the mind goes oh that's the thing you know that's what was the magic bullet and we're forgetting um not seeing the larger context of it so so for that person it might have been you know the final um layer for them sometimes um I think there are people, I call them in my book, kind of like an amygdala whisperer almost, whether it's through hypnosis or something can get in there and do that on learning with something. But I've also seen where then the trigger can come back. And the way I'm making sense of that currently, is if we haven't addressed the risk factors you know we might be able to somehow unlearn chewing as a thread but then if we go on to continue to have you know high stress in our life due to perfectionism or we've got problematic dynamics in our close relationships or whatever, we're just still vulnerable. We're either going to form new triggers or we'll fall back into the old ones. So that's my thinking around that. Am I answering the question you were going for?

Adeel [47:12]: That is great. Well, yeah, no, Sarah, this has been great. I'd love to kind of like kind of end it kind of on that positive note of like, you know, there is hope. It takes some work, but there are multiple benefits. Do you want to, do you want to, you know, any, any last words you want to share? I'd love to, you know, hear about, um, where people can buy the book and, and, and things like that. And, uh, yeah. Love to have you on again. Talk about. Yeah.

Unknown Speaker [47:43]: Well, I'm really excited to just kind of see what people think of the book where. They have further questions, and I'd be happy to come back on and speak to those. Misophonia is a very complex syndrome. And so I think the book highlights that, but hopefully also brings you a lot of clarity. I try to use various metaphors to simplify what is. know the brain's complex and the nervous system and all that but to make it digestible and help you just hold on to that bigger picture so so the book is available on amazon and um it's called demystifying misophonia but if you type in a self-help book for misophonia or something like that should come up and then i have a website also it's demystifyingmisophonia.com where you can find more you know i have a list of top of the iceberg strategies. So while we're doing the unlearning and the base of the iceberg work, we do need strategies to mitigate those trigger situations. And so I also cover that in my book and have a number of things listed on my website for that. And I do offer consultation short term for those who are out of state to try to help you kind of get that bigger picture, get a roadmap and then continue that work with someone in your state. I realized there aren't a lot of specialists in misophonia, but if you really kind of become clear on what's at the base of your iceberg, there's a lot of people that can help with perfectionism and boundary issues and You know, those kind of things. We just need to identify and clarify what is at the base for you.

Adeel [49:41]: Awesome. Yeah. No, I didn't realize you had your website that actually has, you know, some of the material that you've talked about. So people can go check it out and see what clicks, if it clicks. Hopefully after this episode, which was amazing, I think people will realize a lot of the benefits of this thinking and approach. So, yeah, I'd love to have you on again, obviously. And thanks again. And I'm looking forward to seeing you.

Unknown Speaker [50:04]: Thanks so much for having me on, Adeel.

Adeel [50:07]: Thanks again, Sarah. Congrats again on the book, and I'm excited to hear what people think when they read it. You can go to demystifyingmissiphonia.com for more. If you liked this episode, don't forget to leave a quick review or just hit the five stars for every listener in this podcast. You can hit me up by email at helloatmissiphoneypodcast.com or go to the website, missiphoneypodcast.com. It's even easier to send a message on Instagram at missiphoneypodcast. Follow there and Facebook. And on Axis, Missiphoney Show. Support the show by visiting the Patreon at patreon.com slash missiphoneypodcast. The music, as always, is by Moby. And until next week, wishing you peace and quiet.

Unknown Speaker [51:10]: Thank you.