Pas si fort

This is what I look like at 7 a.m. when the incessant honking begins…

Recently, one of my clients shouted in French, “Pas si fort” after her neighbor repeatedly slammed his front door during our massage session. The sound was magnified by the thinness of her walls and affected her ability to fully relax. Translated to English it means “Not so strong.” The reality of living in a building with multiple apartments is the constant noise. While the sound levels vary, most people consider it a form of white noise. I am not one of those people. I don’t want to hear the next door neighbor screaming Farsi curses and the people upstairs throwing up in their bathroom at 1 a.m.  every night like clockwork. It’s an odd thing to know the intimate details of people’s patterns and routines without ever having a conversation with them. I feel voyeuristic; almost stalker-like. But these observations are hardly forgettable. I can’t help but listen.

I am one of a percentage of the population who has a heightened sensitivity to sound, also known as hyperacusis. It is characterized by a collapsed tolerance to environmental sounds of a certain volume that can happen gradually over time or suddenly when in crisis. Mine began about 2 years ago after being terrorized by constant partying and threats in my own home from the son of my then landlord. I barely slept and my nervous system was on high alert at all times. Consequently, the sound of sirens, loud music, screaming and beeping became almost intolerable when previously I had never been bothered by such things. Gone are the days of restful sleep through anything. I hear EVERYTHING now.

Is that who’s making all that noise outside my window???

Beyond a crisis, hyperacusis can be caused by hearing loss, where the tiny hairs in the inner ear have been damaged and become sensitive to certain frequencies played at louder levels. This is known as recruitment. Also, hypersensitivity to certain frequencies at louder levels can occur in conditions like Autism, which exist from birth. Phonophobia and misophonia can occur with hyperacusis. The former is a fear of the sound that one is intolerant to in the environment it is occurring in both real time and when anticipating its next occurrence. The latter has been associated with an adverse response to soft sounds like that of eating, chewing and lip movements. Interestingly, misophonia has been listed with specific diagnostic criteria in the diagnostic “bible” of psychological clinicians known as the DSM-5, but it’s not considered a discrete psychological disorder. Its origins are thought to be more neurological and need to be studied further. And speaking of the brain…

From an evolutionary standpoint, being able to pick up on sounds that others ignore lets me respond to potential danger much sooner and thus, will ensure my survival. DNA testing exists now that has isolated the gene that makes one more likely to have heightened sensitivity to sound. So it’s both environmental and biological – go epigenetics!! Nevertheless, those of us with sound sensitivity have to find a way to deal with the loud world that surrounds us. Aside from moving out of my apartment building and city limits, there are some therapeutic options. The main one is a combination of cognitive therapy and desensitization through retraining. Its goal is to get you to think about the sound with less of an emotional response and expose your ear to intolerable sounds in order to neutralize them. This weakens the neuronal activity associated with the fight-or-flight response these noises often produce. Other forms of treatment are cognitive behavioral therapy (CBT) alone, psycho-therapeutic hypnotherapy and occupational therapy. CBT allows the person to gain control of that automatic emotional response produced by the sound and desensitizes them to it. Hypnotherapy, through a reputable practitioner who is often a psychologist as well or recommended by one, uses the power of suggestion to overcome the emotions (usually the fear/rage response) to the sound. Lastly, occupational therapists deal with the sensitivity as a sensory processing disorder; therefore, they introduce each offensive sound at varying degrees of intensity along with other sounds in order to help the brain accommodate and then dismiss them. Guess I won’t have to move after all :-)