Is Misophonia OCD? What NYC Therapists Say [Quiz]

Clinically Reveiwed
April 21, 2025

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In a bustling city like New York, where sounds are as constant as the skyline, reactions to noise can range from mild annoyance to intense emotional distress. If you’ve ever found yourself triggered by the sound of someone chewing, breathing, or tapping a pen, you may have asked yourself:

Is this normal—or is it something more? For many, the answer leads to a lesser-known condition called Misophonia. And for others, the question arises: Is Misophonia a form of OCD?

This article explores the fine line between Misophonia and Obsessive-Compulsive Disorder (OCD), drawing insights from real NYC therapists, research-backed studies, and an interactive quiz to help you better understand what you’re experiencing. So let’s dive in—this might just be the clarity you’ve been searching for.

Understanding Misophonia

What is Misophonia?

Misophonia, a term that literally means “hatred of sound,” is a condition characterized by strong emotional reactions to specific trigger sounds. This isn’t just mild irritation—people with Misophonia often feel intense anger, disgust, or panic in response to particular auditory cues.

The term was first coined in the early 2000s, and while it’s still not officially classified as a distinct disorder in the DSM-5, awareness is growing rapidly, especially in large urban areas like New York City.

Typical triggers include:

Mouth noises (chewing, slurping, gum popping)
Breathing or sniffing sounds
Keyboard typing
Pen clicking

These triggers aren’t universally disturbing, which makes Misophonia so unique—and often misunderstood. If you’ve ever stormed out of a dinner because someone was eating too loudly, you’re not alone. This condition can be deeply distressing and even debilitating.

Common Triggers of Misophonia

Trigger sounds often originate from other people and tend to be repetitive. These include:

Oral sounds: chewing, crunching, slurping, lip smacking
Nasal sounds: sniffing, breathing, sneezing
Environmental sounds: clock ticking, typing, clicking, foot tapping

Interestingly, triggers can evolve over time. A sound that once was tolerable might suddenly become unbearable, particularly during high-stress periods. Some individuals also develop visual triggers, such as repetitive leg shaking or finger tapping.

Therapists in NYC frequently note how urban noise pollution may amplify the experience of Misophonia, given how constant and inescapable these stimuli can be.

Emotional and Physical Reactions

Misophonia isn’t just a mental experience—it often involves a fight-or-flight physical response. Common reactions include:

Increased heart rate
Sweating
Muscle tension
An urge to flee the situation
Intense irritability or rage

For many sufferers, the emotional toll is immense. It’s not uncommon to hear stories of strained relationships, workplace conflicts, and social withdrawal. The condition can also trigger deep shame or guilt, especially when others don’t understand the reaction. NYC therapists often emphasize the importance of validation, noting that many clients suffer in silence for years before seeking help.

What is OCD?

Definition and Characteristics

Obsessive-Compulsive Disorder, or OCD, is a chronic mental health condition marked by intrusive thoughts (obsessions) and repetitive behaviors (compulsions). These are not simple preferences or habits—these are disruptive patterns that interfere significantly with a person’s life.

Someone with OCD may experience:

Obsessions: Unwanted, persistent thoughts, urges, or images (e.g., fear of contamination, fear of harming others)
Compulsions: Ritualistic behaviors performed to neutralize the anxiety caused by obsessions (e.g., excessive cleaning, counting, checking)

Unlike Misophonia, which centers on specific sensory triggers, OCD is driven by anxiety and uncertainty. That said, both conditions can cause extreme distress and share some overlapping characteristics—which is where confusion often arises.

Types of OCD

OCD presents in various forms. Some of the more common types include:

Contamination OCD: Obsession with cleanliness and fear of germs
Checking OCD: Repeatedly checking things (like locks or stoves)
Symmetry OCD: Need for order or things to feel “just right”
Harm OCD: Fear of causing harm to oneself or others

Each type can manifest differently, but they all share the core loop of obsession and compulsion. Misophonia lacks this feedback loop, though some people may develop compulsive avoidance behaviors—blurring the diagnostic lines.

Common Symptoms

Persistent, unwanted thoughts
Ritualistic behaviors or routines
Fear of losing control
Compulsive need for reassurance
Emotional distress if rituals are not performed

OCD symptoms typically start in adolescence or early adulthood. Many NYC therapists note that early intervention is crucial, particularly when OCD begins to affect academic or social functioning.

Comparing Misophonia and OCD

Key Differences

At a glance, Misophonia and OCD might seem similar—they both involve overwhelming emotional responses and attempts to avoid distress. But they stem from different roots:

Misophonia is a neurological response to sensory stimuli.
OCD is an anxiety-driven disorder rooted in intrusive thoughts and compulsions.

Misophonia typically lacks the cognitive obsessions that define OCD. You don’t fear that something terrible will happen if you hear someone chewing—you just can’t stand the sound.

Overlapping Symptoms

There are some shared characteristics, including:

Avoidance behaviors (avoiding noisy restaurants or public spaces)
Distress from lack of control
Heightened sensitivity to external stimuli

This overlap can lead to misdiagnosis, especially by professionals unfamiliar with Misophonia. That’s why many people in NYC seek specialized therapists with expertise in both sensory processing and anxiety disorders.

The Role of Intrusive Thoughts

Intrusive thoughts are the hallmark of OCD. With Misophonia, intrusive thoughts may arise after a trigger—like replaying the sound over and over or obsessing about how to avoid it in the future. But the key difference is that these thoughts are reactionary, not initiating.

In OCD, thoughts trigger behavior. In Misophonia, behavior follows sound. This distinction, though subtle, is essential for accurate diagnosis and treatment.

Insights from NYC Therapists

Clinical Experiences with Misophonia

In the heart of New York City, where the population density makes silence a rare luxury, therapists encounter Misophonia more often than you’d think. Clients from all walks of life—from Wall Street executives to students—report being overwhelmed by everyday noises.

NYC therapists point out a recurring pattern: most people with Misophonia aren’t just “sensitive” to sound; their reactions are visceral and immediate.

Dr. Lisa Kamen, a licensed clinical psychologist in Manhattan, notes that many clients struggle with shame because their symptoms are often dismissed. “People are told they’re being dramatic or overly sensitive,” she says, “which only adds to the isolation.”

In a city that thrives on hustle and bustle, feeling emotionally ambushed by common sounds can make life feel unlivable.

Some NYC therapists integrate sensory processing therapy and mindfulness to help clients respond more calmly to triggers. Others use CBT-based approaches to reframe internal reactions.

But all agree: Misophonia is real, and it deserves clinical attention.

Therapeutic Perspectives on OCD

Therapists across NYC are also highly familiar with OCD, especially in its more nuanced forms. The urban lifestyle, with its high stress levels and constant stimuli, can exacerbate OCD symptoms.

Whether it’s a fear of germs while riding the subway or compulsive checking triggered by job performance anxiety, therapists in the city say OCD often gets tangled in the fast-paced rhythm of NYC life.

What stands out in therapy is the cycle of obsession-compulsion-relief, which is not present in Misophonia.

Dr. Elena Branson, a Brooklyn-based psychotherapist, shares that OCD often has a narrative behind the ritual:

“I check the stove because I fear a fire; I wash my hands to prevent illness.”

Misophonia lacks that narrative—it’s not about control, but rather the immediate need to escape.

Understanding this distinction is crucial, especially when diagnosing overlapping symptoms or comorbid conditions.

How NYC Experts Diagnose and Treat These Conditions

Because Misophonia isn’t listed in the DSM-5, diagnosing it can be tricky. NYC clinicians often rely on client-reported symptoms and behavioral observations. They use structured interviews and sensory response questionnaires to pinpoint whether someone is dealing with Misophonia, OCD, or another related issue like Sensory Processing Disorder (SPD) or Generalized Anxiety Disorder (GAD).

For OCD, tools like the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) help identify the severity and subtype. Treatment typically involves Exposure and Response Prevention (ERP), a specialized form of CBT, and sometimes medication like SSRIs.

Therapists emphasize that treatment for Misophonia must be tailored. There’s no one-size-fits-all. What works for one person may not help another, which is why working with a specialist—especially in a diverse and therapeutic-rich city like NYC—is often key.

Is Misophonia a Form of OCD?

What the Research Says

Misophonia and OCD might share similarities, but research suggests they are distinct conditions. According to a 2021 study published in Frontiers in Psychology, while individuals with Misophonia do exhibit heightened emotional reactivity and sometimes obsessive-like thoughts, these are typically reactive rather than preemptive.

Other studies have noted elevated rates of co-occurrence between Misophonia and anxiety disorders, including OCD. But correlation doesn’t equal causation. Just because someone has both doesn’t mean one is a form of the other.

One key point researchers emphasize: Misophonia may involve overactivation of the anterior insular cortex, a brain region involved in emotional processing of sensory input. OCD, on the other hand, is more closely linked to dysfunctions in cortico-striatal-thalamo-cortical (CSTC) circuits—totally different neurobiological pathways.

The Debate in the Mental Health Community

Despite emerging evidence, there’s still no consensus in the psychiatric world about where Misophonia fits. Some professionals argue it belongs under the umbrella of Obsessive-Compulsive and Related Disorders, while others believe it’s more aligned with auditory processing disorders or neurodiverse sensory experiences.

In NYC, this debate plays out in therapy rooms, forums, and research labs. Some therapists classify it under OCD for insurance coding purposes, while others treat it as its own unique challenge. The lack of formal recognition often means clients feel stuck in diagnostic limbo—another reason why local mental health advocates are pushing for more education and research.

Real-World Case Studies

Take Amanda, a graphic designer from Brooklyn. Her Misophonia was triggered by her partner’s breathing sounds at night. “I would get irrationally angry, then feel guilty about it,” she recalls. At first, her symptoms were misdiagnosed as anxiety. Later, a therapist helped her differentiate Misophonia from OCD, which led to targeted sound desensitization therapy.

Then there’s Joshua, a Columbia student who struggled with both OCD and Misophonia. For him, the compulsions around hand-washing were clearly OCD, but the aversion to clicking pens in lecture halls was Misophonia. With dual treatment plans, including ERP for OCD and sensory regulation for Misophonia, his symptoms improved dramatically.

These real-life stories show how complex—and deeply personal—this issue can be.

How Misophonia Affects Daily Life

Social Impact

Let’s be honest: dealing with Misophonia in a city as loud as New York can feel like fighting a battle you never signed up for. Triggers pop up everywhere—on the subway, in cafés, at the office. This makes socializing incredibly difficult.

Many sufferers report:

Avoiding meals with friends or family
Isolating during loud events like parties or concerts
Feeling misunderstood by peers and partners

In NYC, where social scenes often revolve around food and communal spaces, the impact is especially heavy. One client told her therapist she dreaded brunches more than dentist visits. It’s not about not liking people—it’s about the involuntary stress response certain noises evoke.

Therapists note that these social limitations can lead to depression, loneliness, and relationship strain. Communication is key. Being able to tell a loved one, “Hey, I have a condition that makes these sounds painful,” can help pave the way for empathy and accommodation.

Workplace Challenges

Noise is everywhere at work—from coworkers munching at their desks to typing and phone rings. For someone with Misophonia, this can be mentally and emotionally exhausting. Productivity drops, tempers rise, and anxiety skyrockets.

NYC professionals often report:

Wearing noise-canceling headphones to focus
Choosing remote work to avoid office triggers
Struggling with meetings or open office layouts

Some have even left jobs due to the lack of understanding from employers. Fortunately, NYC’s progressive employment landscape is catching on. More companies are incorporating sensory accommodations as part of their wellness programs. Under the Americans with Disabilities Act (ADA), reasonable workplace accommodations may be available for diagnosed conditions.

Relationship Struggles

The most heart-wrenching stories often involve romantic relationships. Imagine being triggered every time your partner eats chips or clears their throat. Misophonia can turn small, everyday moments into major emotional blowouts.

Without proper communication and understanding, this can create a toxic cycle of:

Guilt from the sufferer
Frustration from the partner
Emotional distance or even breakups

NYC couples therapists often work with clients to set sound boundaries, use white noise, and engage in joint therapy to foster empathy. The key takeaway? Misophonia doesn’t have to destroy relationships—it just requires mutual effort and education.

Diagnosing Misophonia and OCD

Diagnostic Criteria

Currently, Misophonia is not officially listed in the DSM-5, though there’s growing advocacy to include it. Diagnosis is typically based on:

Clinical interviews
Behavioral observation
Patient-reported distress and impairment

In contrast, OCD has established diagnostic criteria in the DSM-5, focusing on the presence of obsessions, compulsions, or both, and the degree to which they impair daily life.

This difference makes diagnosing Misophonia trickier, especially in traditional psychiatric settings. Many NYC clinicians rely on multidisciplinary collaboration—combining insights from psychologists, audiologists, and neurologists—to reach an accurate understanding.

Assessment Tools

Some useful tools for diagnosis include:

Amsterdam Misophonia Scale (A-MISO-S) for Misophonia
Y-BOCS for OCD
Sensory Profile Questionnaires

In NYC, access to these tools is easier due to the abundance of specialists. Still, misdiagnosis remains common, especially when clinicians lack training in sensory conditions.

Importance of Proper Diagnosis

Why does accurate diagnosis matter so much? Because treatment plans for OCD and Misophonia are completely different. Applying ERP to Misophonia may be ineffective, just as sound desensitization won’t help pure OCD.

A correct diagnosis can:

Reduce frustration and confusion
Help patients feel validated
Guide effective treatment strategies

In the fast-paced, noisy environment of NYC, clarity around what you’re experiencing is half the battle.

Effective Treatment Options

Cognitive Behavioral Therapy (CBT)

CBT remains a cornerstone in treating both OCD and Misophonia, though it’s tailored differently for each condition. In OCD, CBT focuses on challenging irrational thoughts and breaking the cycle of obsession and compulsion. In contrast, when used for Misophonia, CBT zeroes in on altering the emotional response to sound triggers.

Therapists in NYC often employ third-wave CBT techniques, such as:

Mindfulness-based CBT
Dialectical Behavior Therapy (DBT)
Acceptance and Commitment Therapy (ACT)

For Misophonia patients, the goal isn’t to make the sounds go away—it’s to reduce the distress they cause. This might involve cognitive restructuring, exposure to lower-volume triggers, and guided relaxation exercises.

CBT for Misophonia also emphasizes self-awareness, helping individuals understand why certain sounds evoke such visceral reactions. Over time, this can rewire emotional responses and reduce reactivity, even if the trigger remains.

Exposure Therapy and ERP

Exposure therapy, particularly Exposure and Response Prevention (ERP), is the gold standard for OCD treatment. ERP involves gradually exposing a person to their obsession (e.g., touching a “contaminated” surface) and preventing their usual compulsion (e.g., washing hands). Over time, the anxiety diminishes.

However, ERP isn’t as effective for Misophonia, since the distress is not rooted in obsessive thoughts but in sensory over-responsivity. For this reason, NYC clinicians usually do not recommend ERP for Misophonia alone, unless OCD is also present.

Instead, graded exposure techniques may be used—slowly increasing exposure to triggering sounds in controlled settings, often accompanied by relaxation strategies. This form of therapy is less about preventing a response and more about building tolerance and reducing sensitivity.

Medication and Alternative Therapies

While there’s no FDA-approved medication for Misophonia, some NYC psychiatrists may prescribe:

SSRIs (Selective Serotonin Reuptake Inhibitors) for co-occurring anxiety or depression
Beta-blockers for reducing physical symptoms like heart palpitations during trigger exposure
Anti-epileptic drugs (off-label) in severe sensory reactivity cases

For OCD, SSRIs like fluoxetine, sertraline, or fluvoxamine are commonly used, especially in conjunction with ERP.

Alternative therapies gaining traction in NYC include:

Sound therapy with audiologists
Biofeedback and neurofeedback
Somatic experiencing
EMDR (Eye Movement Desensitization and Reprocessing), especially for trauma-linked Misophonia

Holistic therapies like yoga, meditation, and acupuncture are also popular among NYC residents looking to manage stress that exacerbates sensory reactivity.

Tips for Coping with Misophonia

Lifestyle Adjustments

Coping with Misophonia starts with creating an environment that reduces exposure to triggers and increases comfort. Living in NYC makes this challenging—but not impossible. Here are some real-world strategies people use:

Invest in noise-canceling headphones
Use white noise machines or calming ambient apps like Noisli
Create quiet zones at home or in the office
Use earplugs in crowded areas or subways

Many Misophonia sufferers also benefit from structured daily routines, regular exercise, and avoiding stimulants like caffeine, which can heighten sensory sensitivity.

In NYC, where apartments are close and noises are constant, soundproofing measures can also make a difference—like heavy curtains, rugs, and door seals.

Coping Mechanisms and Support Groups

Having coping tools at your disposal can make the difference between a good day and a meltdown. NYC therapists recommend:

Journaling after triggers to process the emotional response
Practicing breathing techniques or progressive muscle relaxation
Carrying soothing items like calming scents or fidget tools

Support groups, both online and in-person, are lifelines. NYC hosts several Misophonia meetups and mental health organizations like:

Talking to others who truly “get it” can validate your experience and help reduce the isolation that often accompanies the condition.

NYC-Based Resources

New York offers a wealth of specialized services. Some standout options include:

Weill Cornell Center for Misophonia Research and Treatment
Columbia University’s Anxiety Disorders Clinic
NYU Langone’s Sensory Processing Research Lab

For those seeking therapy, platforms like Zencare and Psychology Today list licensed NYC therapists who specialize in Misophonia and OCD.

In a city that never sleeps, support is always just around the corner—you just have to know where to look.

Take the Misophonia-OCD Quiz

How the Quiz Works

Ready for some self-discovery? Our quiz isn’t a clinical tool, but it can help guide your thoughts and spark a conversation with a therapist. It’s built around common symptoms of Misophonia and OCD, designed with input from NYC mental health experts.

The quiz consists of 15 multiple-choice questions focusing on:

Your emotional responses to sounds
Presence of repetitive behaviors
Thoughts before, during, and after triggers
Impact on daily functioning

Answer honestly—there are no right or wrong answers, just insights.

Sample Questions

When I hear someone chewing loudly, I:
- a) Get mildly annoyed but move on
- b) Feel enraged or panicked
- c) Obsess over how to make it stop
I feel compelled to check or repeat certain actions to avoid bad outcomes:
- a) Never
- b) Sometimes
- c) Frequently
I avoid situations like family dinners or quiet classrooms because of sound triggers:
- a) Rarely
- b) Occasionally
- c) Almost always

These questions aim to help you notice patterns in behavior and emotional response—a crucial step in understanding what’s going on beneath the surface.

What Your Score Means

Your quiz results fall into three categories:

Mostly A’s: You may be experiencing normal sensory annoyance.
Mostly B’s: Possible signs of Misophonia—consider talking to a specialist.
Mostly C’s: Strong signs of OCD or comorbidity with Misophonia. Seek a licensed clinician for evaluation.

Quiz results aren’t a diagnosis, but they can be a catalyst. Print them, bring them to a therapy session, and use them to get the conversation started.

Why It’s Important to Seek Help

Breaking the Stigma

Misophonia might not be a household name yet, but that doesn’t mean it’s not valid. Too many people suffer in silence, believing their reactions are too “weird” or “dramatic” to be taken seriously. NYC therapists emphasize that every emotional experience deserves attention and empathy.

Breaking the stigma means talking about it, asking for support, and knowing that you’re not alone. Mental health awareness campaigns across NYC are starting to include sensory conditions, thanks to passionate advocates and open conversations.

When to See a Therapist

Not every annoyance needs a therapist—but if your life feels disrupted, it’s time. Consider reaching out if:

Your emotional responses to sound feel out of your control
You avoid places or people due to triggers
You’re experiencing anxiety, depression, or relationship issues linked to your condition

Don’t wait for a crisis. Therapy is about empowerment, not weakness.

Finding the Right NYC Therapist

When searching for a therapist in NYC, look for these keywords:

“Misophonia specialist”
“Sensory processing”
“OCD and anxiety treatment”
“CBT for auditory sensitivity”

Platforms like TherapyDen and Open Path Collective offer options by specialty and affordability.

Living a Full Life with Misophonia or OCD

Stories of Resilience

Living with Misophonia or OCD can feel like an uphill battle—but many people not only manage, they thrive. From artists who use headphones to filter their environment to finance pros who schedule “quiet hours,” the stories coming out of NYC show that resilience is absolutely possible.

Take Leila, a schoolteacher in Queens who started therapy for Misophonia and now helps others understand the condition through TikTok. Or Marcus, a chef with OCD, who built his kitchen workflow around his compulsions to reduce stress without sacrificing quality. These aren’t exceptions—they’re just people who found the right tools and support.

NYC’s diversity of experience creates a community of strength, showing that with the right mindset and help, you can still chase dreams, nurture relationships, and live boldly.

Tools for Thriving

Here’s a toolbox NYC therapists recommend:

Daily mindfulness practice (apps like Headspace or Calm)
Sound management tools like Loop Earplugs or Bose QuietComfort
Journaling triggers and emotional responses
Setting boundaries with friends, coworkers, and family about noise sensitivities

You can also create “safe spaces” in your home or workplace. It might be a soundproof nook, a meditation corner, or a café with headphones and a playlist. The goal is to take back control, one choice at a time.

Therapists also encourage celebrating small wins—like making it through a meal without reacting, or attending a crowded event with coping tools in place.

Mindfulness and Long-Term Wellness

The long game with Misophonia and OCD is wellness, not cure. That means cultivating habits that support your emotional and neurological health. NYC wellness experts often blend traditional therapy with:

Meditation
Yoga
Nutritional psychiatry
Art therapy

Mindfulness helps create space between the stimulus and the response. That space can be life-changing. Even if the sound never goes away, your relationship with it can transform dramatically.

Living in a high-stimulation environment like New York can actually make you stronger—because it forces you to build adaptive tools and emotional resilience.

The Future of Misophonia Research

Ongoing Studies

The future of Misophonia research is bright, especially in leading medical cities like NYC. Researchers at NYU Langone, Mount Sinai, and Columbia University are investigating:

The brain’s response to trigger sounds using fMRI
Links between Misophonia and neurodivergent traits
The potential for sound retraining therapies
Genetic factors that may predispose individuals

This research is helping push Misophonia toward official recognition in diagnostic manuals and healthcare systems.

NYC’s Role in Mental Health Innovation

NYC is a hub for psychological innovation. Institutions like Weill Cornell, The New School, and Hunter College regularly launch studies and awareness campaigns centered around underrepresented conditions like Misophonia.

New York’s diversity makes it an ideal testing ground for understanding how Misophonia affects people across cultures, ages, and professions. And with more funding and awareness, NYC is helping to set the stage for global change in how we perceive sensory-based conditions.

What’s on the Horizon

Here’s what to watch for:

Inclusion of Misophonia in the DSM-6
New therapies combining tech and psychology (think VR desensitization)
Expanded insurance coverage for sensory-based mental health treatments
More trained therapists specializing in Misophonia across NYC

As awareness grows, the hope is that fewer people will suffer in silence and more will find empowerment, resources, and community.

Conclusion

Misophonia and OCD are two separate but sometimes overlapping mental health experiences—and understanding their differences is the first step toward managing them. NYC therapists emphasize that while Misophonia isn’t currently classified as OCD, the distress it causes is very real and deserves thoughtful care.

If you’re constantly distracted or disturbed by certain sounds, or if you feel trapped by obsessive thoughts and rituals, you’re not alone—and you’re not broken. There are trained professionals, proven therapies, and thriving communities right here in NYC that can help.

Don’t wait for things to get unbearable. Start the conversation, take the quiz, and explore your options. Because a more peaceful, balanced life isn’t just possible—it’s within reach.

FAQs

Is Misophonia officially recognized as a mental disorder?

No, not yet. Misophonia is not listed in the DSM-5, but it is being increasingly studied and recognized by clinicians as a valid and treatable condition. Many therapists treat it based on client-reported distress and functional impairment.

Can Misophonia turn into OCD?

Not exactly. Misophonia and OCD are separate conditions. However, they can co-occur, and untreated Misophonia may contribute to heightened anxiety or compulsive behaviors that resemble OCD.

How can I tell if I have OCD or Misophonia?

OCD is marked by intrusive thoughts and compulsive rituals. Misophonia centers around intense emotional reactions to sound triggers. A licensed therapist or psychologist can help you distinguish between the two and guide you toward the right treatment.

Are there any support groups for Misophonia in NYC?

Yes! NYC has multiple support options, including in-person meetups and online communities through platforms like Meetup, Reddit, and Misophonia International. Check out the NYC Misophonia Support Group to get started.

What kind of therapist should I see for Misophonia or OCD?

Look for someone specializing in CBT, sensory processing disorders, or OCD treatment. In NYC, platforms like Zencare and Psychology Today allow you to filter by specialty.