[00:00:00] Adeel: Samantha, welcome to the podcast. Good to have you here. Thank

[00:00:03] Samantha: you. Thank you. I'm excited. I'm a huge fan of your

[00:00:05] Adeel: show. Oh, thank you. Yeah, so do you wanna Yeah, tell the audience a little bit about where you're located and what you do for a living.

[00:00:13] Samantha: Yeah, absolutely. I live in the Los Angeles area, and I am a licensed marriage and family therapist. And at this point I am primarily working with all with people and families dealing with misophonia.

[00:00:26] Adeel: Yeah. Okay. Wow, interesting. And actually, yeah, that reminds me. I, I know we I think we, I had coffee with the Bidler Uhhuh

I think it'll last again. And I think you mentioned one of our correspondence that you're familiar with her. Yeah. Maybe she's helped you out and stuff it's good to, that there's a little circle of MS related therapist growing. Definitely see

that.

[00:00:46] Samantha: Yeah. We helped each other out.

[00:00:48] Adeel: Yeah. Not a lot of people are helping us, so it's it's good to have it's good to have that kind of grassroots effort, absolutely. Hopefully that'll spread. And actually, yeah, the one difference is that you, I believe you don't have misho yourself, right? This is just , but do you wanna maybe talk about how Misson took over your life in so to speak?

[00:01:03] Samantha: Yeah. Yes, absolutely. That's a great way to put it. So my husband always had peculiar noise sensitivities, right? And in general, he's a pretty laid back guy. Definitely a really nice person. And when it came to certain noises he was, he struggled. It was really hard for him, and he had all of these sort of rules and it was really a tough thing.

And of course, we didn't know why or what it was called. was that since the

[00:01:28] Adeel: beginning, since you'd all always known him, correct. , or did it just gonna get worse over time?

[00:01:33] Samantha: No. Okay. No, it was, we start, we started dating really young and it was always a thing. Gotcha. Yeah. Okay. It was always a part of his life and we negotiated it, we managed through it, and then we had two kids and 2011 the New York Times article came out.

And, my mom called me very excited. Oh my gosh, this is what he has. It's a real thing, yeah. And so then we recognize this is an actual disorder, not just a personality quirk. Yeah. And at that point we had two kids and they were little. And so fast forward a little.

We recognized that our son had it. And I suspected when he was a toddler there were just some signs that I saw. What were, yeah. What were some

[00:02:16] Adeel: of those signs, just outta

[00:02:17] Samantha: curiosity? Yeah. We had this outdoor dining table and I just remember really vividly that people would move a plate on the dining table.

And he would cover his ears and hide his head in his lap. And it was, it, my husband hadn't have had misophonia. I would not have thought anything of it. , . I would've thought he's a sensory sensitive child. Cuz he is in general but it was very clear that it was more than that. It was, there was a physical reaction happening in his body. , and it was the same, with the metal chairs on the pavement. If we were anywhere at somebody's house or at a restaurant and somebody would move their chair on the cement, the metal?

Yeah. Oh yeah, I know . Yeah. He reacted like he was in pain and I thought, oh no, I think he, has this, same thing as his dad. And then by the time he was a, preteen I would say, 11 it became obvious that he had it. So we were dealing with that, and it was it was hard.

was very hard. And then we were doing, I reached out to experts and we were doing what we thought was right, and then a couple years later, we found out that my other child also had it. And I thought, no way this cannot be happening. , I can't manage any more of this, and.

unfortunately,

[00:03:27] Adeel: and around the same age, like the onset was around the same age. So you didn't notice it in him earlier, but maybe it showed up later?

[00:03:34] Samantha: I didn't notice, I didn't notice anything with with my younger child. I didn't notice any symptoms. And at first, in fact when she started saying that she was having the same problems, I thought, oh, this is, the little sister wanting the same attention as the big brother, right?

Like , because our lives in some ways revolved around him having misophonia, right? There were a lot of, does he have his headphones? Are the headphones charged? , what are we eating? There, there was a lot, it was a big topic of conversation and I thought, okay, she wants the same treatment, right?

So I just went along with it and said, okay, fine. But then it quickly became clear that she actually has Ms. Tony. Yeah. And then she started struggling. Actually far more than my son. And it was affecting her at school. Yeah, I was gonna

[00:04:17] Adeel: ask like how this manifested maybe at school for both of your kids.

Yeah,

[00:04:21] Samantha: so for her, it became a big deal at school. And I, that's when I jumped in, as a therapist, right? Because I , I now have two children that have misophonia and I could see that it was snowballing in a bad direction. And so I thought, okay, I know there's no cure, right? But I have to figure out what I can do as a therapist to understand this better so that I can get them whatever help I can get them, right?

And so at that point, I dove in and I, dove into contacting every professional that I could find. There aren't that many, as but I contacted all of them. , I got really into the research from the Duke center. Yeah. Zach's group. Yeah. Absolutely. And Dr. Brown. And then I also got really into the, as Misson Association and Marsha Johnson and that, that convention and just calling parents and talking to people and reading all the books and talking to whoever I could. And that led to it led to me doing the work as a therapist. That's

[00:05:20] Adeel: fantastic. That's inspiring. I hope. Yeah. I hope therapists listening , curious therapist listening. Yeah. Realized serious seriousness.

Like you did, you obviously had something at your home that made it crucial. But I'm curious how you're yeah, we'll get out to all that. Sorry. I, as you probably have heard from podcasts, I jump around, but I wanted to That's okay. Wanted to also remember how Hear about me.

How did your, how, like how was your hus, what were your husband's kind of reactions? I'm just trying to , visualize what it was like as your kids were growing up. Were they seeing reactions. I'm always, yeah. Just always curious about how, what's happening around the kids' lives around, around the time that, that this pops up.

I'm sure you've asked these questions as

[00:05:54] Samantha: well. Sure. Yeah. Absolutely. What I will say is that, my husband and I are incredibly mindful of what , what we share in front of the kids, and so I would say they were unaware, , and by that point

[00:06:07] Adeel: I try to do the same as well, by the way.

And yeah. I've heard that tr just not trying to not shine too much of a spotlight is the, I don't know. Seems the safest way to go. Absolutely. It doesn't always work, but yeah.

[00:06:18] Samantha: Yeah. I mean there definitely were times that he would ask them to please, yeah. I don't know.

Please do something differently. Yeah. , but I think it was more on the guise of manners. It was, yeah. I think that's how he would couch it. And, he, we had gotten to a point, we had worked on it enough in our marriage that I understood it enough and he understood enough, so that, he could ask me for help without being unkind. And so being able to say, would you mind please waiting with that snack or Right. And there were things that I just wouldn't do. I, by that point in our marriage, I was never going to, start eating popcorn or an apple.

Weren't when we're in the car. Or, even probably on the couch. So we had worked it out. So I don't think the kids, the kids had no idea. , when we, when I told my son, Hey, this thing that you're experiencing has a label and daddy has it too.

He had no idea.

[00:07:09] Adeel: Gotcha. Okay. Yeah. Yeah. No that's how I've been approaching it as, as well. And then maybe actually while from the top topic of we'll get to Yeah. The school stuff for your kids , I'm curious about what, obviously you probably talked to your husband about, like what, how, when did things start for him and what maybe what was going on in his life around, around the time when the, and you probably know where I'm going.

I, I've talked to Sarah Ler about, yeah. Trauma and those kinds of things. Yeah. Or small tea trauma, I curious, was there anything that was happening out of the ordinary maybe going back? Yeah.

[00:07:39] Samantha: Good question. I think that yes, I think that trauma with a small t is definitely affects.

Of course, it's gonna affect our nervous system, , but I also think we have to be really careful with it. And the reason is because I think our culture is really good at parent blaming, right? . And so I think, I don't, and I don't think it's possible to be human and not have trauma with a small team, right?

. That's my experience, right? As a human and as a therapist, I don't think that's possible. So yeah. He, he had some, there were some difficulties and strain in his relationship with his parents when he was a preteen and becoming an adolescent, there were very high standards that they had. And and it was not always easy. It was not a, it was a very loving family, but not a family that was talking about emotions or feelings. And it was, ,

[00:08:26] Adeel: which happens a lot and doesn't always lead to the, but it's just always well. So it's something that comes up.

And have you talked about have you thought about have you heard about the term, epigenetics and . Do you have any thought, I don't know, you have thoughts on that or a definition or that you can maybe talk about? Yeah. It's something that's relatively new to me.

[00:08:42] Samantha: of course. Absolutely. The way that I conceptualize this is very similar to how I conceptualize a lot of things that I work with in, in the mental health field, right? And so in other words people are born and they may have a predisposition towards any number of things, right? Some of which are categorized as mental health disorders and some of which are just personality traits, right?

. We may have a predisposition towards anxiety or a predisposition towards shyness, right? Because of our genetic. Yes. Now of course, that's going to interact with our environment and our life experience. And so that's the way I think of it. So what's interesting is that, we've done the genetic research and obviously my husband has the, this genetic mutation and I do as well.

And so I think my children had, this, ten two gene mutation from both parents.

[00:09:36] Adeel: I can you talk about the the 23andme tri? , that one. Yeah. Gotcha.

[00:09:39] Samantha: Okay. Yeah. So I think that there is a, there's a strong genetic component there, right? They got it from both sides.

. And so for both of them it has manifested now for me, what does that mean? Does that mean that it could have manifested for me? I've certainly had more trauma in my early life and adolescence than my husband by a long shot. And yet here I am not with Misson, and he has it

[00:10:01] Adeel: yeah. It's an important point that it yeah. It doesn't always manifest, but yeah. There could be, it could be influences, but we just, yeah. We just don't know what how things add up and make you who you are.

[00:10:11] Samantha: Yeah, exactly. And like I said, I think the only thing, I think it's important to just be careful because because I don't, I don't like that parent mind.

There's no simple answers.

[00:10:20] Adeel: Yeah.

[00:10:20] Samantha: Correct. Absolutely. And I think the better question is what do I do with this? Not where did it come from? I think to me, the more impactful question is, okay, this is how my brain works right now. What am I gonna do?

[00:10:32] Adeel: That was gonna be my, yeah.

Now that was gonna be my next question, getting outta the sciencey stuff. But back to you discovered, or you you got into action as you saw things spiraling for maybe your kids at school. What were some of the and you did all your, as much research as you could.

What were some of the initial takeaways and things that you tried?

[00:10:50] Samantha: Sure. My initial takeaway was that it was completely overwhelming, right? , because the the options for treatment, and I say treatment in air quotes the,

[00:10:59] Adeel: It's a loaded term

[00:10:59] Samantha: In this, in our community.

Exactly. Exactly. And, but the help I will say yeah, was the options for help. Were never ending and some of that and expensive, right. Time consuming and expensive and some of them outright contradict each other, right? Yeah. Yeah. There, there are some treatments that some people will say, no, that will harm you.

And so I felt completely overwhelmed. And. So what I went back to was, okay what do I know for sure? Because I don't know for sure. I don't know for sure if a bunch of different things out there might help. I don't , and I'm not gonna say they wouldn't help, right? I don't, I'm, I don't know.

I haven't studied them. But what do I know does help, right? And I had, I've been licensed therapist since 2006, so I do know that psychotherapy is a well-researched, very powerful medium, right? For helping people who have a million different ways that their brains or bodies work.

And then they come into therapy and we figure out how do I live my best life, right? , how do I find more peace, right? With the circumstances that I have, whatever those are. And so that was the approach that I took.

[00:12:11] Adeel: Yeah. Yeah. And did you try to specifically maybe at school, did you try to talk to some of the staff there, or was it more just working with your, with the kids directly on how to how to navigate as best they could on their own?

[00:12:25] Samantha: Yeah, so this was a little bit sticky, right? Because I can't do therapy for my own kids, and I really wanted to, right? And and I can't so that's a delicate balance. So for both of my kids I offered things, right? Like I say, Hey, I'm, I'm trying this with some kids at work.

, or I read this article and this has been really helpful. And to the extent that they are interested and open they do accept that and it's helpful for them one far more than the other , which, it's age appropriate, right? Yeah. Yeah. Cuz I'm their mom. , but I did find somebody to do some treatment with one of my kids.

And that was a learning experience for me because I, the treatment actually I don't think was that helpful. But I did find that it did teach me a lot about what I wanted to do as a therapist. When I'm working with families, right? , because it ultimately was helpful, but not in the way that I think the provider intended.

So it was a really fascinating learning experience for

[00:13:20] Adeel: me. Can I ask you a dumb question? You said you can't do therapy with your kids. Is that, is there like a legal reason or is it just cuz you're the mom and it's obviously Yeah.

[00:13:27] Samantha: Good question. Good question. It's two things.

It's an ethical principle, right? Yeah. Because I can't have a therapist client relationship is a really special, and to me it's sacred, right? It's a special relationship. And. , you can never have that when you have another relationship. So if I'm somebody's friend or somebody's coworker or somebody's mom I can offer them all kinds of my thoughts and opinions and ideas. Yeah. But it can never be their therapist because that's not our relationship. Gotcha.

[00:13:56] Adeel: Okay. Yeah. Yeah. Obviously there's, all kinds conflicts of interest, but I'm curious, this is what you were thinking. Okay. So alright. But yeah.

But, so this is where you start to get now, like even apart from reading and talking to people you're seeing like firsthand experience. But you, but at the time you were still doing your day job, the regular therapy . Yeah. I'm curious like how did that evolve?

Like how quickly that evolved into you being like, I just, I need to do this like full-time, ?

[00:14:20] Samantha: Yeah. Yeah. Yeah. Good question. So I had been hired back in 2013. I was hired to start a child and adolescent behavioral health department, so psychiatry department, ah, for a major healthcare firm on the West coast.

And so I worked, I was hired by them and I worked there and started this pediatrics department and I learned so much, working with psychiatrists and all kinds of other professionals. It was amazing. It was a great experience. And then and then ended up working with adults also after I transitioned out of that role.

And and so then what happened was when I dove into this world so deeply, I just recognize, okay, there are so few people that, that are offering this type of help and support, and I couldn't find a therapist. To who'd heard of misophonia to help my kid. And I thought, okay I now have enough information and understanding and sort of conceptualization and I've seen what's helped my kids that I think I could maybe be useful.

. And so I put it out there in a very passive way cuz I had a job and I thought, yeah. And I also had some imposter syndrome, right? I don't know if I can help people with this, right? This is really hard in my life, right? On a daily basis, so who am I to help anybody?

And I. Put it out there.

[00:15:39] Adeel: something you're not signing up for a 24 7 misophonia experience, cuz it's like Absolutely. You're not getting away from it at all. Anyways, I digress. No yeah and how did you put it out there, by the way? Is it, was it like a Facebook group or billboard down the highway?

Yeah. Pacific Highway. Definitely

[00:15:56] Samantha: the opposite of a billboard. I just told a colleague. That's all I did. Yeah. Okay. I said, yeah, I'm open to doing, I think I'm gonna start doing this. I'm open to doing this. And of course, my colleague got a phone call the next week, somebody looking for treatment and I dove into it and it rapidly snowballed.

And I at the beginning, the first, I don't know, the first 10 clients I worked with, I was legitimately shocked that at the responses I got that. How helpful, because I'm thinking , , there's no, this is such a big thing and I'm not an expert and I'm not a scientist, and I'm not an occupational therapist or an audiologist, and what am I gonna offer?

And the feedback that I got and the way that it spread was so meaningful for me. And so rewarding. To, I love therapy. I love my job. I think I have the greatest job in the world. But then to add on top of that, this other layer that I know what these families are experiencing , I get it in my bones. I know how painful it is. And to be able to help another family that's dealing with this was just it's inspiring. It's incredible. Yeah. And so it just snowballed and started to take over and I decided to leave my job and do this.

[00:17:07] Adeel: Yeah I wanna get into it like, you know what Yeah.

What you what you found was helpful and all that, and Sure. And I don't know what feedback they were giving you. I'm curious when you told your colleague and you started to get people, like where were they coming from? Because if there aren't a lot of people offering help, like how did they know to come to you?

Like how did the, Sure. Where did they hear about misophonia,

[00:17:23] Samantha: all this stuff yeah. Yeah. Absolutely. I think what happens is parents and teenagers Google, right? They Google their symptoms, right? And then they say, oh, this is what I have. I think, so what happened was the very first client that I worked with posted on a Facebook group and and I think I got 10 messages from that. And then more parents posted, and then more parents posted. And it's literally just gonna snowball. I have, yeah, I had one post. Not that long ago, and I had eight. I told them, I told somebody, I said, I think I got 12. People messaging me yesterday about this Facebook post and I put them all on a spreadsheet so I could get back to everybody and it was 18.

. Yeah. And, my goal ultimately is to be able to help others therapists do this work because obviously with that level of interest, I can't see all these people. And so ultimately that's my goal.

[00:18:15] Adeel: Yeah. No, that, that's, yeah. I totally agree.

I, and it's inter interesting that, I, do you see do, do you see more Ms funny specific therapists being out there, or do you want more general therapists to learn about ms. Funny do, or I don't, do you see five, 10 years down the road, like where this could be?

I'm just curious because, I'm sure a lot of therapists might, oh, I don't know. I don't know what they're thinking. Ni I think this is just probably I can deal with it. It's like anxiety or something, it's not a unique thing. Yeah. I'm just gonna kinda where you see the landscape from Mr.

Phone, a few kinda going That's,

[00:18:44] Samantha: yeah, that's a good question. I don't know that for most therapists don't specialize in one thing. , there, there are certainly some spec, some categories that, that people do. But generally speaking, I think, there are therapists that specialize in, three or four things.

And I think misophonia could certainly be one of them. I think for me the goal would be that. there, there are lots of good therapists out there. And so if somebody comes to their clinician or, calls, gets a referral from their friend and calls the therapist, that the therapist could say you know what, I'm, I don't know much about that, but let me look into it, right?

And them doing a little bit of research, could allow them to have the tools that they need to help the person . And then after that clinician does it one time, then they know how to do it right? Then they would have the familiarity and the tools. And I see it spreading in that way.

[00:19:34] Adeel: Yeah. Yeah. Do and when you talk to other general therapists, are you starting to see a, like a turn where they're more, are starting to take it seriously? Or is it folks like you and Sarah who are having to take all, take, take take it all on your shoulders.

.

[00:19:46] Samantha: . .

I think, look I think that for now, the colleagues that I know that are working on this are colleagues who have, there's two people that I'm thinking of, and they both have misophonia Yeah. And have a child with it. So I think for now, those of us that are, have chosen to dive into this world Yeah.

Are here for a reason. And my hope is, and what I'm seeing is that we are spreading it right to two colleagues who don't have it themselves or have a child who has it, but who can at least have the training and familiarity and skills so that they're not totally unequipped to help people.

And also so that they don't inadvertently make it worse.

[00:20:23] Adeel: Yeah. This is kind, it's interesting cuz it's or just we're early innings, early days of of miss treatment. I'm sure other, more quote unquote popular conditions also, were where we are right now, like long time ago.

That's true ago. True. That's true. Absolutely. So maybe let's get into I dunno, some of your Yeah. Some of the kinda the, maybe the, your opinions on some of the therapies that they provided, like what's, in a general level, and obviously, this is not a therapy session, but yeah. What do you feel like's worked? What patterns have you seen?

[00:20:48] Samantha: Yeah, absolutely. Good question. So I think essentially there's this fundamental question, which is, as a parent we wanna protect our children from pain and suffering , right? And when I saw my first child in pain suffering while we were eating dinner, I would've done anything to make his pain go away.

right? Yeah. That's just, anybody who's a parent, right? Or anybody who loves another human being even right? Can understand that and . And so what I was told was, from the research that I did at the time, and the professionals I contacted who were very well-meaning and trying to help, they said, protect him from these noises, shield him, right?

Allow him to shield himself, right? So that's what I did, right? I got the noise canceling headphones. We didn't have dinner at the table. We we just, we did everything we could to protect him because I saw my baby was hurting, right? Yeah. And so here's the problem. The problem that I then ran into is that if I shield him from all of these noises in the world, , how does he learn to be in the world?

[00:21:56] Adeel: It's not super sustainable. Yeah. I agree. I have all those tools and we all do, but yeah. We all, yes. We're realistic. I think ,

[00:22:02] Samantha: Not everybody. Yeah. Not everybody.

[00:22:04] Adeel: And I think Mo Yeah. Some of us try to be , but exactly. Anyways, I think we're, I know where you're going, so Yeah.

When I wanna hear about, Yeah. What are some of the ways that you're Yeah. Helping 'em navigate that. Absolutely.

[00:22:13] Samantha: So the way that I conceptualize it is that if your child has a broken leg you're gonna give your child crutches, right? , they're in pain, they're suffering, and they need assistance.

So you're gonna give them crutches. Okay, that makes sense. However, if you don't treat the underlying problem , is the broken leg, right? With whatever is needed, right? It could be physical therapy, it could be occupational therapy, it could be surgery or a cast, or Right. If you don't treat the underlying problem, you're always gonna need the crutches, right?

, your leg is gonna heal in some sort of, misaligned manner, and then maybe you're, you're stuck, right? And so what I advocate is, and this is very much what I've done with my children, and this is how my husband manages it himself, is that, yes, there are times when the most peaceful life-affirming choice I can make is to put on headphones or wear earplugs.

. , right? And that's fine. That's, there are times when that's a really good choice for self-care, right? However, , we also are working on how do I take care of myself when I don't wanna make that choice. So in other words, when I wanna be in a class and be able to hear the teacher, or I wanna go to a friend's house and kids are gonna be eating snacks.

Or I wanna be at a family dinner and, and so things that I might want to do out in the world how do I let myself be in charge of my own life and my choices rather than the misophonia being in control of my life and making the choices for me. Yeah.

[00:23:46] Adeel: It's an important thing to important tool to have this thing cuz we don't, we can't always grab those headphones and expect everyone to not make a noise.

[00:23:54] Samantha: And nor would you want to. That's the thing. I, cuz I work with. people who come in and they sometimes, they are always grabbing the headphones. , they are shielding themselves. , right? . , I work with teenagers who are, being homeschooled.

They're trying to completely shut it out because it's so painful. , and I certainly understand that. I really un I get it, but I have not met anybody who says, yes, that's how I wanna live my life. That I'm happy and content with this. If they are, that's great. I don't, I got no problem with that.

. But if they're coming to me, it's because they're not happy and content with it. And they don't want their life to be small because of misophonia. Gotcha. So then we look at, okay, how do we, address sort of the underlying issue, right? Which is this body reaction, this body response.

How do we address that so that I can live in the world? .

[00:24:41] Adeel: . And are some of these yeah because this gets into I'm assuming theories about the nervous system . , how, yeah. What are some of the, how do we kick that nervous system back into

[00:24:50] Samantha: shape?

Yeah, absolutely. Good question. So I think the basic approach is learning how to, right? So first of all, understanding the brain science and what's happening, right? Yeah. So people, really understanding, right? This fight or flight center of the brain, right? That's there to keep us alive, right?

And that most of the time is doing a good job. And that sometimes gets false alarms, right? , and the way I think about it is that misophonia, for whatever reason the brains of people with misophonia their fire alarm goes off. as if there is an immediate right. Life-threatening danger to these noises, which are not a threat.

Yeah. And so I think really understanding what's happening then allows us to figure out how we're gonna move forward with that. So I think, and there's two different components. There's a a cognitive component and then there's a physical component. Because in the moment the misophonia reaction that happens in the body is obviously not in anybody's control, right?

I wish it were , we could make it go away. And it's not. So then, okay, so that happens without your control, without your consent. Then what do we do with it? So some people can access their cognition and use that to override the system, right? And activate the parasympathetic nervous system.

and some people need a physical response first, and then they can, once they've activated the parasympathetic nervous system, then they can use that to come back into a healthy space. So there are a variety of things, right? That that we do that, that are me ways to give a message to the brain that we are safe,

[00:26:38] Adeel: because is does this involve having something to squeeze me?

I don't, I'm not thinking like a stress ball. I'm just yeah. I'm just curious to, are there Yeah. Physical tools that that, that are not headphones that, that can be used help train or Right. Are there also things like I've mentioned on the podcast, which about things like when you enter a situation.

Pre-training or pre-thinking about , this situation is temporary in terms of I'll be outta here soon, so maybe . Try to like what's think, basically think ahead and tell yourself that you're not in danger before there is a potential danger. Are these some of the things we're talking about?

Or am I just putting words ?

[00:27:11] Samantha: No. I love what you just said about, thinking about ahead of time. That very much goes along with the cognitive strategies. Yeah. Which I can elaborate on with for the physical, right? So the way I think about this is if you have a baby, right?

Or an animal that's, that you can't communicate with in language, right? , we have to figure out how do we communicate without language? Why? Because when your brain is in that fight, flight or freeze, right? Amygdala zone, the fire alarm's going off.

[00:27:41] Adeel: Yeah, there's not a lot of time, so that's fine.

Yeah. I'm curious, , what can you

[00:27:44] Samantha: possibly do with ? Exactly. And and so some, for some people doing, the physical response in that moment is what allows them to have enough space to then employ their cognitive faculties. So if you think about right, a baby, right? What are the things we might do with a baby, right?

The first thing that we do is we wrap them uptight, right? , we swaddle them uptight, right? . , we apply gentle but firm pressure, right? Why, for, for whatever the reasons the brain mechanisms are that, that that sort of pressure can send a message to the brain that we are, we're safe, like we're secure, right?

We're okay. And so I like to teach people things that they can do with, no device. , nothing. , nothing needed. So that it's always with you. So one of those things is just really firm hand pressure, right? Putting your palms together or on your legs. Yeah.

[00:28:39] Adeel: I've heard that.

I think I've about the convention, but just hugging, almost like hugging yourself or squeezing your arms

[00:28:44] Samantha: or something. Yeah, exactly. Exactly. And if you do it, if you just try it, right? , you do it like three or four times, so you press really hard count to five, and then release.

Yeah. And then pause for a minute and then do it again. Your nervous system will feel different. It has an effect that changes what's going on with that chemistry. And we have to remember when the fight or flight is activated, adrenaline, cortisol and norepinephrine are being dumped on your brain.

Yeah. And right. And it's, it, I think of it like, those if you're at a waterpark or a splash pad, and there are those buckets that they fill with water, drip drip, And then all of a sudden they reach a point where they're too full and they tip forward and the whole bucket comes pouring out.

Yeah. Yeah. That's how I think of those brain chemicals. Gotcha. And if you think about being in a misophonia moment, all of a sudden your brain is being flooded with those chemicals and hormones. And so there's something about that pressure on the body that can, just give us enough of a break that the brain can start to recognize, okay, I'm, I'm gonna be okay.

Gotcha.

[00:29:46] Adeel: Can I, Sure. Move that to something and I, I know we talked about multi-trauma, but I'm just fascinated by the topic sure. And does, unless needs to be related. But when you said when I first saw that the idea of holding yourself, just, I couldn't help, I just couldn't help think of thinking about if. If for some people this is related to the lack of maybe some, they needed some comfort or some kind of resolution to something that they experienced at a younger age, is this maybe a way to compensate for Yeah.

Maybe maybe that's the wrong word, but compensate for that or give yourself that that feeling of safety where maybe you didn't experience that when you were younger?

[00:30:17] Samantha: Sure. I think that's almost more cognitive what you're describing and I think it's beautiful.

And I'm a big fan of that type of work. That's a whole, that is a whole aspect of the work that I do around self-compassion. So that's huge. But I think in this moment, as far as in a misson moment, I think it's much more just about that's how human beings.

can feel safer and activate that parasympathetic nervous system.

[00:30:42] Adeel: Gotcha. No that's super interesting. I hadn't also hadn't really thought about the distinction between the physical and the cognitive. Like you've laid out. So yeah. This is, yeah, I wanted to make that clear for the Yeah.

For the for the listeners as well. Okay. So yeah. So applying pressure help, can you help reduce some of that chemical buildup that tipped that bucket at the splash pool in your

[00:31:01] Samantha: break? And we just, yeah. And we just need a second of a break, right? So there are several other strategies that's just one that I really like, but there are several others and we just need something that can give us a second so that we can access our cognition, right? Because, there's this debate, right? Is cognitive behavioral therapy helpful for misophonia?

And I think that physical piece is often what's missing because like I said, my experience is there are people who can go straight to the cognition and there are people who can't. So either way, if we give them the physical tools right. Then if they need to do that first, that's fine. Whatever works.

So

[00:31:36] Adeel: you're, okay, so just to go through the flow of activity Yes. And this all happens in very split second, but Right. Absolutely. It would get a trigger, Uhhuh, , they would apply pressure to some , predetermined, . , whatever works for them. Yes. And then that gives them just that enough of a Yeah.

Enough time to and you've probably, worked with them on the process, but take, yeah. Take a breath and then that gives them enough time to recalibrate or just think about what's happening and be able to calm down a little bit.

[00:32:02] Samantha: Yeah. To just remember, oh, I have strategies.

[00:32:04] Adeel: And that's yeah. That's interesting. Is sometimes all it takes is just realizing that you have tools. You don't have to apply all of them, but . Exactly.

[00:32:11] Samantha: Cause I think I, I think with misophonia it feels, what I've experienced with my family and with all these people that I've worked with, is that it feels completely like I'm being victimized, right?

, this misophonia is happening to me. I'm being hurt. I'm being victimized and I am powerless and helpless and Right. I think that's pretty much the worst of all human experiences.

[00:32:33] Adeel: And the loss control, which is probably

[00:32:34] Samantha: related to Yeah. Yeah, exactly. Helplessness, hopelessness.

I'm being victimized. If I'm the victim, I don't have control. You're exactly right. And so what I like to do with the cognitive component is flip the script around and say, yes, this is a way that my brain works. Yes. I am experiencing a misophonia moment right now, and I have choices and I'm going to take care of myself.

, right? So I don't have control over the fire alarm going off, right? , it's gonna go off. That's my chemistry, my wiring, how my brain works, whatever. But I do have control over what I do next. I'm not a victim of that.

[00:33:17] Adeel: Yeah. Yeah. That's powerful. , then maybe this is jumping around a little bit, but so there are a lot of people who are, or like trigger happens obviously don't use these tools, but then some of us can't, just can't get that trigger out of our out of our heads

So like, it feels, can't it's I follow you loop, basically. Absolutely. Absolutely. Does this obviously not, maybe not all the time, but is this, does this help that or does that still come separately from this and you have other tools to deal with? That recovery period.

Yeah.

[00:33:42] Samantha: I think that the answer is that the reason that it's looping, right? Is because you're still in fight slide or freeze. , you're still, the fire alarm's still going off. And so I think that's a great example of a time when you could use the cognitive to say, okay I have choices.

I'm gonna take care of myself, and what I'm gonna do right now is X, Y, or Z. And those would probably be physical things, right? To because on some level, right? So the body is in panic because it believes you're in danger. And so we have to do something with the body to help it get the message and really believe I am safe.

Yeah. And there are a variety, right? There's, a progressive muscle relaxation, which I teach people. There's a specific couple of specific breathing exercises that are very powerful in actually changing the part of the brain that's. In control, right? . And there are several other right.

Strategies and choices that you might have to say, okay, this trigger was happening for me. The trigger is now over. Which I think is what you're referring to, right? . But I'm still, my brain is still struggling with it, right? I'm not powerless over what I do next, right?

So what am I gonna choose to do to care for myself in this moment?

[00:34:51] Adeel: Yeah. Yeah. Okay. Yeah, in interesting. Okay. And so as you're trying to Yes. So many ways we can go here. And so as you're working with people, are they, so are these tools that they're you give, you work with them and then they go off and use them in the real world.

It's like, are you working long term with a lot of these people or is it figure out what's working for them, and then they can be independent, so to speak.

[00:35:12] Samantha: Good question. So I, for the vast majority of my work is short-term. And solution focused is what we, that's what we say in the therapy world.

And what does that mean? Results oriented. Yeah. Yeah, exactly. Because here's the truth. The truth is that therapy's a big investment of time and money. Yeah. Yeah. And so I think and the other truth is that there's so many people that want and need this help right now that I wanna be able to do as much as I can.

That's my mission. And so it, so what does that mean? That means that people come in and we talk really specifically about what their goals are, so , right? So I wanna know what their goal is, right? So is their goal to be, to not just make everyone shut up,

Exactly. Exactly. And, end all of these face noises forever. , and then we figure out, okay, how are you gonna make progress towards that goal? And the way I conceptualize that is I think about this a zero to 10 scale.

And I think of it like volume on the tv, right? If your volume is like mute or goes up to 10, I think about, I ask people, right? What is your level of suffering with your misophonia right now? Most days, just most days, I know it's different, but, and they'll say it's, seven to 10.

Okay, so the worst moments are 10, but a lot of days it's at least a seven, right? . So what I say to people is, listen, I am not gonna cure your misophonia. And if anybody tells you they are, you should run the other direction. , right? . However, what I have found in my experience is that we can learn enough things and practice enough strategies.

that we can turn the volume down. So maybe it's like a three to six . And so that you're just living in Yeah. It's huge. And you're living in a different zone. And so I, I work with a lot of people pretty short term. It just really depends because there are people that are, thriving in their lives or, teenagers that have very supportive families that are understanding and they just need a little bit, they just need the information and the tools and they go practice, they come back, we troubleshoot, they go practice again.

. And it's pretty quick. And then there are other situations where, There are connected issues, right? So there are other other things going on that are connected to the misophonia. And the truth is there are these, there are a lot of families where it, it gets to a place where it's really severe and, like I said, the kids are not going to school.

They're, basically hibernating in their rooms. Or kids that are yelling and screaming at their families, or, hitting people or breaking things. And there's a lot more underneath that. In addition to the misophonia. And those obviously are a different a different

[00:37:46] Adeel: approach.

You're mainly dealing with with families, I guess with young people with misophonia or

[00:37:51] Samantha: across the board? No, it runs, yeah, it's across the board. I would say predominantly it is children and adolescents but I have a lot of adults too. But it's still family work, right?

Because that's the thing, right? Even somebody who lives alone right, has family. They're still so I think it's always family work in one way or another. But yeah, and I work with families at the same time, right? I think that you can't, I don't think it's helpful to work with a child or adolescent on their own right?

And not include the family because there's such an interplay there. And I think that, that parents need a lot of help on understanding what's happening, understanding their child's experience. And then also there are just all these complicated questions that come up, right? Parents ask me all the time, okay, my child has a disorder.

If they have this neurological condition, how do I discipline? What do I do? So they're yelling and screaming at people, but they can't help it. Or they're hitting people and they can't help it. And so there's a lot there.

[00:38:50] Adeel: Yeah.

Yeah. Because yeah, it's not always as as quote unquote easy as pressing your knee when you get a trigger , and then you're able definitely not slow down. So there's probably definitely learning curve there. And then yeah, things could exasperate later. Actually, I was gonna get into obviously, we know that stress, lower stress, more sleep help. Are these some of the things or is there any other things that you try to kind of table stakes maybe, that you try to get people to adopt?

[00:39:14] Samantha: Yeah, absolutely. I think of it this way that there are two different things, right? There's the daily stuff that we need and then there's the in the moment stuff. So I tell people it's like your multivitamins that you're gonna take every day for maintenance. And then there's the Tylenol or the Advil that you're gonna take in the moment when you need it, right? You have great analogies, by the way. Thank you.

Thank you. It's how my brain works, I think. Yeah. So the multivitamins are things like lowering stress, which for children and teenagers, right? Often has a lot to do with my helping parents and family dynamics, right? . So there's, lowering stress then there's, sleep nutrition and exercise, right?

And those are not easy, right? None of those categories are easy, right? Oh, I can just sleep more and eat better. And , it's not easy. But I think those are the daily things. And I also think, there are other things. There's, journal writing, there's meditating, there's, progressive muscle relaxation.

Again, I highly recommend to everybody on a daily basis to just give that nervous system a little bit of a break. Yeah. And then like I said, then there's the in the moment stuff too. Interesting. Okay. Okay. Yeah. But I think, this comes up all the time. Sorry, I interrupted you.

This comes up all the time in families, right? So if there's underlying tension and like family life is hard, right? It just is. And parenting is hard. And if there's underlying tension, right? In parent relationships with their child, or between children or between adults, right? If there's underlying stress and tension and difficulty that has to be addressed also.

because it is definitely, I always say it is not causing the misophonia for sure, but it's also not helping. No, it's

[00:40:57] Adeel: making it worse in most stances. Exactly. If it's not causing it, it's gonna, some at some point make it worse or in some situations. Exactly. , let's talk about maybe I dunno, you're probably listen, reading research that's happening whether it's brain or therapy, anything interesting coming up or anything, any questions that, that you feel like directions that you feel like maybe researchers listening to this show might be, might wanna focus on?

Gosh,

[00:41:20] Samantha: interesting question. I think, obviously I think that the getting down to the ca the root of this, right? So understanding the motor basis for meas and Right. How that mimicry part of the brain, right? The role that plays I think is. Is fascinating and probably really important for where we're gonna go with treatment.

. And I

[00:41:42] Adeel: think wait, we're all waiting for Dr. Kumar to come with us. Exactly. The latest Exactly.

[00:41:46] Samantha: Best

[00:41:46] Adeel: seller. Exactly. Yeah. Miss upon your research

[00:41:49] Samantha: anyways. Yeah. Ex Exactly. No I think, for me, I think what interests me is is just how do we help people manage with what they're dealing with, right?

Because like I said, as a therapist, people come into me with every right relationship and or physical problem that you can imagine. And in the end they're asking for how do I suffer less and how do I live my life better? So I think to me that's that's the really I mean there's two different parts, right?

There's what is causing this and then what, if anything can be done about it, right? Yeah. But that feels to me big and pie in the sky, right? Yeah.

[00:42:26] Adeel: The research is not gonna get us anything tangible probably for a

[00:42:29] Samantha: while. So it doesn't feel like it. So then my head goes to, okay, then how, then what do we do?

How do we manage this? Because I think parents are, I think, look, I think the internet has played a huge role in this, as with so many things. Yeah. And so parents are googling their kids' symptoms much earlier and finding the term Estonia, thank goodness they're finding it. But then what, and

[00:42:52] Adeel: are you finding any you're probably dealing with a lot of supportive parents, but you're also maybe dealing with maybe parents who are like, oh, my kid's Googling too much, and they're just making this up. And do you ever come across that, and how do you deal with that kind of the doubt and that kind of

[00:43:05] Samantha: reaction?

Good question. Good question. There's two things, right? One thing that I deal with all the time consistently is parents who say, before we knew what this was, we were, horrible. And they feel so guilty because like most people would, right? They felt like your kids brush it off. Their child was, yeah, their child was being manipulative and difficult, right? And and they'll say things to me like we saw that, she could have cupcakes with her friends at the birthday party, and she was fine, but then when we were eating at home, she was rude to everybody, right? They thought I think most people do that it was just a control thing and their child being really frustrating and rude, right?

Quite frankly. And so there's a tremendous amount of guilt, right? That. I told my child to, suck it up and I, I yelled at them or I got mad at them, or I sent them to their room. So there's a lot of guilt. And then there are parents like you're describing what I mean, the truth is that most parents are not gonna seek out therapy if they don't.

Yeah. Believe that there's an issue. But what I do get is where one parent is calling me and asking for help and the other parent D isn't on board. Yeah. Yeah. And as far as how I deal with that, I try to share as the resources, just ignore

[00:44:19] Adeel: one of them and then kidding.

[00:44:21] Samantha: Yeah, exactly.

Just tell one of them not to join us. No, that's the parent you need to work with the most. And so I try to, I send them all the relevant articles in the research, because. If you contacted a hundred different therapists, you could get a hundred different opinions.

So I would rather give people research, right? Yeah. Here's what the research tells us. And then I also tell them that, oftentimes this is the dynamic. The dynamic is that the parent who thinks that the misophonia is the child being dramatic or manipulative, is frustrated with the other parent because they see that the other parent is letting the child behave.

, quote unquote, however they want. so that parent will say to me, okay, fine. May you know if this is a real thing like you're telling me, my spouse is allowing the kid to sit in the other room and watch TV and be rude to their sibling. And, sometimes they cry and have a fit.

Or they're rude and they storm off and so , that parent is feeling like if we concede that misophonia is a real condition, that it's affecting our child. What does that mean? That means then that we don't parent, or that we don't have any sort of rules for, kindness and respect.

And so once I can have that conversation with them and reassure them that, that is not at all my approach Yeah, it's

[00:45:32] Adeel: not quite that binary and Correct.

[00:45:35] Samantha: Correct. But until they get help, it feels that way. Because the one spouse is often saying it's misophonia. They, this child can't help it, they're in pain.

And then the other, and the other parent's trying to pull back in the other direction. So once I can have that conversation with that parent about the fact that the tri, yes, it's real, yes, this is a thing your child is struggling with, that is not their fault and not in their control.

However, once we get them some treatment and some tools and some strategies and parents are on board, then we absolutely do have expectations for behavior. Because like I said, I say this to parents all the time, your child is not responsible for that body reaction that they have.

, . That might include a really dirty look. However, we're gonna give them enough tools and strategies and support so that they can take care of themselves and make choices so that it's not then Okay to turn around and hit your sister. And then once they hear that they're usually on board.

[00:46:31] Adeel: No, that's, yeah. That's a great, that's a great way to put it. I hope that yeah. Hope a lot of people hear that. I promise we'll wind down it a little bit. Sure. Although we can, I'll talk about this

[00:46:38] Samantha: forever with you. Yeah. ,

[00:46:41] Adeel: like we said, you're doing this 24 7. I don't, yeah.

There's few people that I've met that, that, that are doing that that's amazing. But

[00:46:47] Samantha: one thing Holly did mine Oh. Sorry. A colleague of mine said to me, they should make a documentary about your family. And I laughed, and I said, that's not nice. , that's not a nice thing to say.

Nobody wants to have a family where it, yeah. There needs to be a documentary made about them. So

[00:47:02] Adeel: there was something Yeah, when you were talking that I wanted to talk about as well was just that idea of yeah go a friend going to a friend's house, having a cupcake, but then the same thing.

, , being triggered by the parents. For those situations where that kind of physical side, like how do you explain the fact that if, okay, if it's, if there's this physical component, then why is it only affecting , , one

[00:47:22] Samantha: source. Good question. So this is the way I describe it, right?

So imagine yourself at the end of a really long, hard day, right? You're tired you're hungry for dinner, you had a rough day, something went wrong, you didn't sleep well the night before. Okay. and you open your, you pick up your phone and you get a email with bad news. , right? Something else has gone wrong, okay?

And imagine that feeling at that particular moment, on that day, right? Okay, so leave that for a second. And now you're gonna picture Sunday brunch, right? So you slept in, you had a great Saturday, right? You've got no plan. It's a lazy Sunday, right? So then you pick up your phone and you get the same email with the same bad news, right?

So how would those two emails feel in those two different scenarios? ,

[00:48:14] Adeel: yeah. Different context can can make you react differently.

[00:48:17] Samantha: Yes, and it's context, but it's also where is our body at , where is our nervous system at? So this is where the daily the daily maintenance that we were talking about comes in.

So of course, a child who is exhausted and burnt out and, grumpy is going to react to noises that ordinarily when they're in a good mood, they might be mostly okay with . That's very normal, I think for anything in the human condition, for our patients or anxiety or sadness. That's just, that's how human beings.

[00:48:48] Adeel: Yeah. It's interesting. Yeah, I guess cuz when you are getting to that preteen tween ish age you might have a good family life, but you're probably, you're just around the same people so much. You're inevitably gonna be in situations where things aren't feeling like a friend's birthday party.

And so maybe yeah. Your nervous system isn't quite ready to handle

[00:49:08] Samantha: Yeah, absolutely. Reaction. I, yeah. I think of it like, how much reserves do you have, right? . When you're getting that email at the end of a long, rough day, you don't have any reserves. When you're getting that email at Sunday brunch, you have some reserves so you're resilience six year older Yeah. Ex Exactly. Perfect. Exactly. You have more resilience in that

[00:49:27] Adeel: moment. Cool. Yeah, no, that's interesting. Yeah, a great way to Put, put that put, put some shed some light on that. Yeah, that question that always comes up, why me and not other people as the trigger.

. Yeah. Gosh, I don't, I, yeah, we're, yeah, obviously a little bit over an hour here and I'm like, I could also go on forever, but I do have to return to some day job stuff, but maybe, yeah, maybe you're one of the, one of the people that I would love to maybe have on in the future at some point too.

Yeah. I would love that. See how things are going. But yeah, I don't for now you, anything else you want to share about about Misson, obviously or anything?

[00:49:57] Samantha: Yeah, I, about anything. How much time do you have at the end, ? I think the thing that I wanna share is that there, there is hope, right?

I talk to so many people who just feel so hopeless and . Yeah. This is never, like it's never gonna get better. There's no room for improvement. And I just have seen both personally and professionally that's not true. , I think, yes, we are not going to make it go away and make it be a thing that isn't a part of your life or, doesn't ever come up.

But there is hope, that it can get better. And I feel really strongly about that. I think that's so important.

[00:50:28] Adeel: No, it's a good message cuz I think for people who are, most people probably around the age that are coming into your practice, like they're seeing it on the upswing and so you're naturally probably thinking this is just gonna get worse and how am I gonna live?

But it's, yeah. I try to tell people too, it's like at a minimum even if you don't do anything, you're, as you're getting older, you have a little bit more agency as to what's around you and when you can take a break and whatnot or so you know, you have some amount of control.

Hopefully coming back to you, and then you can take these steps like, get more help. But yeah, that, that idea of that there is hope despite all the, bad stories. I hear on this podcast. I still, yeah. Believe that there, there definitely is hope even before Dr.

Kumar's magic pill that he's gonna give us. A few years .

[00:51:09] Samantha: Until then, we'll keep trudging along.

[00:51:11] Adeel: Cool. Yeah, Sam, this is amazing. Thank, thanks again

[00:51:14] Samantha: for coming on. Yeah, thanks for having me. It's an honor you've done. This has been so huge for the community. I can't even state enough, right?

How just recognizing that people are not alone and that they're not crazy, right? And they're not making this up and being able to access this podcast, I think is just such a gift for people.

[00:51:32] Adeel: Thank you, Samantha. Very enlightening and I know helpful. It's a very helpful episode for everyone listening.

Don't forget Samantha's website is in the show notes. See if you'd like more info. If you like this episode, don't forget to leave the quick review or just hit the five stars wherever you listen to this podcast. You can hit me up by email or hello miss podcast.com or go to the website miss podcast.com.

It's easiest to send a message on Instagram and MyPhone podcast. You can follow there or Facebook and on Twitter. You can find me at miss, at miss show and support the show by visiting the patreon patreon.com/miss podcast. The music, as always is by mob. Until next week, wishing you peace and quiet.