Since the summer of 1997, patinents with unusual cases of sound sensitivity have contacted my clinic to report symptoms that stray outside the 'regular' pattern of recognized and classic definitions for auditory disorders. One of these variations involves strong negative reaction to soft sounds, in particular, sounds associated with eating, breathing, speaking, or lip smacking. The first few cases were spaced out over a wide span of time, and I wondered at the signficance of the reported issues. Over time, however, it has become crystal clear that this condition affects more than only a few people. Initially, it was speculated that these symptoms were indicative of some odd form of hyperacusis. Since that time, however, over 1000 cases later, it is clear that 4S is a stand-alone problem and deserves its own name, investigation, and treatment approaches. It is not hyperacusis.
The onset of this type of sound sensitivity often appears to take place in childhood years, frequently around puberty onset, with a range variation of 10 + years. The youngest child that I have evaluated was six years old, and the latest onset appears to take place in the 20s. A few reports of later onset have been noted in anecdotal reports.
There are often a few other concerns about the patients, occasional ADD/HD or mild obsessive compulsive disorder, however not out of the norm for general population statistics for age, gender, or other demographic data that has been accumulated.
However, as a group they are high functioning, capable individuals. No remarkable medical history presents itself in the reporting of the patients as a whole. As a matter of fact, they tend to do well in school as a general rule, academically, enjoy social outings and friends, and participate in many different activities.
SInce 1997, I have evaluated hundreds of these cases personally, from near and far away including other countries. I have also rec'd stacks of emails and calls from other self-identified sufferers and their families. In addition, audiologists across the globe are contacting me with cases fo similar symptoms and need for treatment plans.
As these individuals grow up, they continue to suffer from their symptoms .
Clearly, this is a rather small subset of some condition that include symptoms of the auditory system, yet, an important one.
It has been my experience to date that most of these individuals bring their concerns to their physicians and are mostly routed to the mental/emotional health providers for therapy. Once in a while an audiologist will conduct a hearing test, but as the vast majority of these cases exhibit perfectly normal hearing, this avenue closes. There is no definitive test for this condition.
The vast majority of the patients who have contacted me so far have seen psychiatrists who attempt to diagnose an emotional disorder and most of the patients are then prescribed various chemicals such as anti-obsessive drugs, anti depressants, anti anxiety drugs, or other types of psychotropic medications. Most of these medications have negative side effects and often have not been well documented for side effects in children, effects on the developing brain, and so forth. In addition, many of these individuals have received extensive psychological counseling including cognitive therapies, adversive therapies, and other types of counseling. Both adults and pediatric 4S sufferers report small gains via these methods, to date, and vitrually no cases of complete recovery from any of these methods have ever been reported in the literature.
Noises that are identified as bothersome or extremely annoying most often relate to noises associated with the mouths or noses of other people. Biting, chewing, forks clicking on plates or teeth, tongues licking lips, lips smacking when opening or shutting, sssss sounds or other high frequency sounds, fingernail biting, or breathing sounds, can send these patients through the roof, out the door, into their rooms, and into seclusion. In many cases, it can be one particular person that presents the most difficulty for the sufferer.
Emotional reactions are closely related to this syndrome: victims may cry, yell, strike out, retreat, scream, withdraw, abuse others verbally or physically, in an effort to remove the negative stimulation. One patient described these very soft sounds as akin to 'fingernails on a million blackboards'. There is an irresistable urge to remove oneself. Often the condition emerges over a period of time, and there are increasingly severe responses to the stimuli. The use of earplugs is nearly universal but does not seem to be all that helpful as the hearing acuity is usually very good. Often, initially, there is one "trigger-sound" person, but over time, the number of 'trigger-sound" sources, increases.
One obvious symptom is the loss of the family dinner table tableau: in families where young people have this syndrome, this daily event is severely compromised. Ten year olds eat dinner alone in another room, teen agers take plates to the basement, and so forth. Just seeing another person 'prepare' to lift the fork to the mouth can set off a severe reaction. Dr. Johnson has termed this aspect of 4S, the "anticipatory" phase of 4S and often this phase presents as much difficulty as the actual exposure and can be triggered visually or even in simple recollection.
The symptoms seem to emerge rather rapidly over a period of weeks or even days. WIth the onset of the identification of certain sounds as annoying, then comes the psychological overlay of conditioned negative reflexes: even thinking about the possibility of exposure to these sounds can trigger a severe reaction. Familiar scenes such as the family dinner table can provoke an emotional outburst. Sometimes a particular person is associated with certain sounds, and then they must be avoided at all costs.
Headphones with music pop on at the slighest opportunity, background music is often played very loudly, the television has to be on 'high' and so forth for the sufferer to endure the presence of these irritating sounds. One method of self-help has been the use of any device that will raise the ambient noise levels, significantly, and preferably, devices that emit noise or sounds directly into the ear canals.
It is suspected that the loss of inhibitory functions of the efferent system of the auditory pathways (from brain to ear) plays a role in such cases. Other potential suspects include the very lowest and most primitive neurological systems including the autonomous nervous system and the emotional-reactive centers located in the lower brain areas. There are many theories about 4S, but very few facts. It is recognized widely that there is an abnormally strong reaction in the limbic or emotional center of the brain (feelings of rage, anxiety, worry, etc) as well as the autonomous nervous system (ANS) of the brain which controls such activities as heart rate, flight or fight responses, endocrine secretions, and other important functions.
The withdrawal from society, the use of earplugs to try to prevent exposure, the isolation from the annoying trigger sounds, and the use of sound as a masking attempt, are signs of an intelligent sentient being attempting to structure their universe.
However, this syndrome clearly takes its toll on the well being of the person, the family, the scholastic life, the social life, the work life and limits future opportunities. The sufferers will clearly express an understanding of what it was like 'before'. They are acutely aware of their problem and often try to hide it from others outside the family unit, and will go to great lengths to 'cover up' their concerns. They are often labelled with misdiagnosed syndromes, I believe.
Approaches that positively affect 4S can be found by visiting a qualified medical provider at
Here are some excerpts from correspondence that may be interesting:
I have had a problem with
eating sounds since I can remember. I cannot stand to
be around people who eat loudly or smack their lips;
also when people gulp liquid or chew gum it drives me
crazy and I actually get very angry. I would be happy
to help with your research by giving you any details
you may need.
I have posted on the board about my son, who may have both hyperacusis and hyperacuity? He's a complicated kid, Gifted and with APD, SDI, Asperger's, NLD diagnoses, the most sensitive hearing his OT has ever seen, and an almost post-traumatic stress type reaction to music.
I become very anxious when I hear people eating. Chewing, swallowing, dish clinking, ice in a glass, crunching, smacking, even sometimes breathing. My sensitivities are broad, but the sounds that cause me the most discomfort and anxiety are small sounds made by human bodies.
I agree chips and gum should be banned from the earth, I hate listening to people chew them. I have major anxiety attacks when eating in a quiet room with people crunching things, croutons, chips, nuts, crackers. I get major panic attacks and feel like i have to hit someone or run out of the room screaming. Luckily i can restrain these urges. You're not alone
My son has had a big problem with this since about 7 yrs old that was one of our first signs something was wrong. He could hear my husband's jaw popping when he eats he also could hear people eating or breathing hard trying to eat and he couldnt eat in the same room with us without louer noise to block out the noises.
He's now 14 yrs old and won't go to a quiet resturant but he will a loud one.
I was trying to figure out what my 12-year old daughter's problem is. She can't stand it when I pick my fingernails, when I swing my foot back and forth while sitting, when I talk on the phone, the ticking from the clock, it seems any motion I do repetitively. I think this is more than a noise problem. Can anyone point me in the right direction or have similar experiences? Any help would be greatly appreciated
I too, like your daughter have the exact same intolerances - noises, visual, even certain scents.
I remember my mother tapping her fingers or walking upstairs, or chewing gum and I would ask her to stop making the noise or to quit moving her fingers in front of me because it bothered me. She kept saying I was being ridiculous.
I now have problems with neighbors who play music outside (loud) from 9am to 8pm which drives me nuts. Other neighbors seem to tolerate it or are able to ignore it. My husband also wiggles his feet near my line of vision and when I ask him to stop he starts laughing and doing it more.
I hope your daughter is able to successfully cope with this but please try to understand how difficult it is for her and not make her feel that she is being "crazy" or silly.
Being supportive and knowing how this is painful for your daughter and giving her someone that she can talk to about it will help her vent her feelings.
If you ever get some postive results for your daughter I would appreciate you notifying me back.
Eating noises drive me crazy! (Mainly from my husband) I am a fairly passive person but when the room is quiet and I can hear him chewing, I get angry and want to throw something. I have no idea why I am like this.
TWO SIBLINGS, PLUS MYSELF, OUT OF SEVEN SEEM TO EXPERIENCE THE UTMOST INTOLERANCE WHEN IT COMES TO EATING NOISES. WE ARE ALSO BOTHERED BY THE "FOOT SWINGING".
THERE ARE OTHER NOISES TOO..CLOCKS, CLICKING WHEN TRIMMING NAILS, FINGERNAIL CLICKING...
ONE OF US EXPERIENCES THE "LOUD" NOISES SYNDROME WHERE THE LOUD NOISES ARE JUST TOO MUCH FOR HER. SHE ALSO HAS DOWNS SYNDROME.
MY OLDER SISTER AND MYSELF, CANNOT SLEEP WITH OUR MATES BECAUSE OF SNORING, AND ALOT OF TIMES, MUST EAT SEPARATELY FROM THEM.
THIS CAUSES MUCH STRESS ON OUR RELATIONSHIPS.
I googled "eating noises" and was very surprised to find I am not alone. I really thought I had a major social dysfunction. So, all my life I can't stand the sound of people eating. Why? It is so bad I isolate myself. What is to be done? Thanks.
The main thing is to have background noise too. When I eat with my husband, I always have the TV on or music playing. I know all the marriage counselors would say we should not do this and have conversation, but for my sanity and his, I simply can't eat in silence.
When my husband sleeps, he sounds like a polar bear because he snores so loudly so we have slept apart for many years. It was difficult at first but we both wake up feeling better.
The clanking of dishes makes me nuts too. So, folks just knowing you all are out there makes me feel a whole lot better. I am not alone!
I would just like to add - people SUCKING their teeth, those people who make the lip-smacky sound between every sentence they utter, people who SLURP coffee - all seem to have the same effect on me as my husband's eating popcorn. so i have to say, i'm glad its just not him. (and i NEVER tolerated the popcorn thing, even when we were just dating) PLUS, right now, i am sitting next to an IDIOT at work who is typing like he needs to put his finger right thru the keyboard, and talking/screaming on his cellphone. i can barely think to type this! so, its not just eating noises for me. as for stress-relieving exercises, i would love to relieve myself by putting my FIST thru his face right now....
I suffer from the same - I can't stand things from eating to people talking when I am trying to get to sleep, so I can never really feel relaxed. I don't know whether this is due to my mother and father from when I was a small child saying If I carry on the way I am (me developing my personality), then I will turn out like people you hear about that can't stand things like eating and whether my knowledge of it has caused this?Or the fact that I have become depressed in the past and that this is an escape route - concentrating on something like eating noises, people talking, to take my mind off other things. Or the fact that my mother has OCD (obsessive compulsive disorder) and whether a genetic factor of a form of control has resulted in me wanting a desire to control what I want to hear and what I don't want to hear? I really don't know the cause but I am researching psychology reasons for it. The only way I can really cope with it at the minute, is to be very strong willed and positive thinking which I have been recommeded to do every day can help control these feelings, but I think I might have to result to hypnosis as I have heard this can help an awful lot. My main fear is that it will get to be a lot worse - as from previous years to now it has deterioated, so thats why I know I have to do something about this before it ruins me altogether.
I get into MAJOR arguments with my father, over how he eats. He smacks, and just eats like a barbaric person.... it doesn't so much hurt, as drive me batty! I usually try to either eat after him, or eat in a different room. And with my thing with silverware, I can't go to a loud restaraunt.... I usually eat in seclusion, because between smacking and silverware, I can't stand it.... I'm not aware my dad knows that this is related to hyperacusis(I just found out!), so I never had much of an argument... I can't ask him not to because he says not to correct adults! ANYTHING he eats is annoying, be it chips, milkshake, chicken, steak, Salad... you name it! I used to try to subliminally cover my ears, but my dad gets mad at that and says "It's rude!". My worst nightmare is when we get snacks in the car.... Cause it is almost always to cold to roll down the window and stick my head out of it, so I have to deal with it! My dad always tells me "I need to get over it because in the real world you're gonna encounter people who eat ALOT worse than me.". What can I do?
Does anyone get physically angry when being subjected to these noises? I can be in a great mood, looking forward to a nice afternoon/evening, and the whole thing can be ruined simply by being exposed to eating noises. I'll get immediately angry and have the urge to slam my fist into the wall. It's temporary, and after I leave the room and get away from the noises I can quickly and readily return to 'normal', but during the exposure, I'm a mess. Jaw popping or loud crunching can literally force a physical reaction to cover my ears or get away from the sound, but the urge to physically lash out at it is always there as well. I can even catch a couple of crunching sonds as someone walks by at the office and be severely affected.
I imagine someone who doesn't mind these kinds of noises not being able to understand it, but I'm glad I've found that I'm not alone in being near completely intolerant to them.
I can trace back to my early childhood and being told to close my mouth while eating in a fairly angry manner by family members, so I'm guessing that I either inherited the intolerance in a much more vivid form, or I became overly sensitized to the noises during my childhood due to the constant angry reminders to keep my mouth closed while eating.
In any event, it hasn't improved over the years(I'm now 31), if anything it's increased in aggravation levels.
I am 15 years old, and I DESPISE crunching, smacking, licking fingers, toenail clipping etc. It just makes me want to throw something or hit something. Anyway, my mom has taken me to a psychologist when I was much younger, maybe around 5 or 6, because of these noises. The lady said that she thought it was because I had a "high intelligence" and was a lot more mature for my age. Im beginning to think that her conclusion COULD have been correct (not that I want to sound conceited :) ). I'm pretty sure it works for some people. So, yeah. level of intelligence could be one possible reason. I'm guessing that one with a high intelligences' brain works much different in ways as to one with an average intelligence....or low intelligence...I'm not sure...the brain I find is a quite mysterious thing...
Anyways, I just wanted to open up my opinion on this topic. Thanks for lsitening
My daughter, who is 12 years of age, began to show signs of sensitivity to noises mostly bodily and environmental at age 10. To her it is a fight or flight situation. Started with me eating crunchy cereal, father snorting loudly (clearing sinuses). The next six months it increased to blinker on car, walking on carpet, fingernail filing, etc. These trigger noises set off a horrible rage in her. We were living in Germany at the time and I did not have access to medical care, o.k. good medical care. I waited until we moved to N. C. and took her to a Child Psychiatrist who didn't have a clue, never had heard of the sensitivity to noise problem. I had a hard time trying to find help. Eventually, moved again and she has been diagnosed with Early Childhood Bipolar Disorder. Recently, at my insistence I asked to have her hearing evaluated because it seemed to me that the rage problems always came from the trigger noises. She was tested and determined to have hyperacusis. Her hearing range is in the negative decible range. Things like fingernail filing, crumbling of paper all are high frequency noises.
Eating noises enrage me! I suffer from Severe phonophobia/misophonia,
and if there was help or a cure, I would devote my ENTIRE LIFE to it. I have to wear earplugs constantly. Anyone know of a cure or help?
I've been close to boiling point and on the verge of exploding due to the noises a colleague makes at work. Loud coffee slurping, slurping melons, peaches. Wide open mouthed chewing, smacking noises, open mouthed crunching at a ridiculous volume!!! Coupled with a big gob, loud voice and ridiculously loud typing I would happily smash her face in! But how can I explain how I feel without appearing to be insane??
THe open mouthed chewing, of course, leads to increased air intake and an open mouthed belch which is either following by a baby giggle noise or a baby-voiced "excuuuuse me!".