Phonophobia - Fear of sounds

What is phonophobia?

Phonophobia is the psychological fear of certain sounds or a hypersensitivity to sounds and manifest itself in particular as a fear of loud noises. Phonophobia is often a result of noise trauma.

Why do sudden sounds scare you?

Many people who suffer from noise sensitivity or phonophobia find certain loud noises, such as horns or alarm signal, extremely unpleasant. In some cases, phonophobia symptoms can be triggered by a peripheral or central hearing impairment

Clinically speaking, phonophobia is how our bodies react to sound, even when it's not very loud, and it can trigger various potentially harmful responses. Immediate effects include changes in heart rate, breathing rate, muscle tension, and can even lead to symptoms like sweating, nausea, vomiting, and digestive issues. There are also neurophysiological reactions and reflexes to the sound stimulus, like alarm functions.

It's believed that people with phonophobia have negative reactions because they perceive these sounds as disturbing and excessively loud. They often fear being exposed to certain sounds, thinking they might harm their health. However, in reality, these sounds are often quite common and not at all harmful.

What are the symptoms of phonophobia?

A distinction is made between the following types of hypersensitivity to a sound:

Recruitment

This phenomenon is thought to be a distortion in the intensity how sound is perceived, causing it to seem much stronger than it actually is. Recruitment is linked to hearing loss due to a lesion in the organ of Corti.

Hearing loss

Hearing loss is associated with a general hypersensitivity to sounds of any frequency and intensity.

Phonophobia

Also known as fear of a specific sound, independent of the volume or intensity of the sound.

Misophonia

Misophonia, or “hatred of sounds”, associated with an adverse reaction to one or more sounds (e.g., a clock ticking, chewing, ringing, etc.), that manifests itself differently in each person and has a specific meaning. 

Understanding auditory disorders and reactions

While recruitment can be explained as a peripheral response resulting from the absence of sound modulation in the cochlear hair cells, phonophobia and misophonia are conditions involving the central processing of auditory stimuli and are not linked to peripheral diseases. In these cases, psychosomatic reactions are frequently associated.

What are the most common causes of phonophobia?

The specific causes of phonophobia can vary from person to person and can be caused by a range of factors, including hearing disorders, psychological trauma, medical conditions like migraines, anxiety disorders, sensory processing issues, and environmental influences.

How to treat phonophobia?

Treatment typically involves therapy and addressing any underlying conditions contributing to the phobia. In the past, therapy for phonophobia often involved avoiding the specific sounds or using earplugs to block out noise. However, this approach proved ineffective and could even worsen phonophobia by heightening the sensitivity of the nerve pathways transmitting sounds to the brain's cortical region. In the 1990s, a more effective treatment concept emerged, focusing on sound therapy, counseling, and cognitive behavioral therapy.

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