1. is a 26-year-old man who decided to get professional help because of increasing mixed symptoms of depression, anxiety, obsessions, and misophonia that he has been experiencing. Symptoms that he has to occur
    such as being extremely triggered by certain sounds, having a lack of excitement for the things he used to like, can not participating in crowded activities such as family dinners, focusing on indoor sounds, being a pessimist, having social anxiety, and extreme sweating on social events. H. is a college graduate and works as a civil servant for two years and lives with his family.
  2. grew up in a chaotic environment and he witnessed types of physical and emotional abuse, he was also a victim of the abuses that have mentioned above when he was a child. After a rough childhood, he started having tough times in social situations and started losing his confidence. H. has mentioned that he was feeling lonely in his adolescent years because of the way he used to be humiliated and excluded by his family.
    H. has defined his mom as a person who has extremely depressive affect and someone who is complaining a lot. Besides, he mentioned that his father was someone who diagnosed with a paranoid disorder, and he was being treated because of his disorder. H. is not the only child of the family who is struggling with the atmosphere of the family. It become more unbearable when his sisters left for university and marriage.

Misophonic symptoms of H. have raged especially in the evening whenever he has to have dinner with his father. Eating sounds that his father produces trigger him and H’s solution for that is locking himself in his room to isolate himself from the triggering sounds that might appear. H. is feeling tension and he gets obsessive thoughts whenever he faces a trigger sound which causes him to have sleeping troubles and impossible to feel relaxed afterward. Usually, the tension caused by the triggering sounds follows the next day as well. H. has trouble tolerating the sounds his colleagues produce as well such as typing on a keyboard, Mouse-clicking, and eating sounds at lunchtime. He usually is really quick to leave the dining hall of the office because of the triggered symptoms of misophonia. H. has not been eating well since his misophonia symptoms got worse which is leading to other health problems such as feeling dizzy all the time, feeling nauseous, and weak. Besides, H. mentioned that misophonia caused him to lose his self-respect at the first clinical interview. He received antidepressant treatment which lasted about three years but he could not get enough benefit from this treatment due to a lack of social support and irregular medicine usage.

  1. started to get psychotherapy at the age of twenty-six and he says that CBT has been beneficial for him especially when it comes to training his mind towards the triggering sounds and he became aware of his cognitive distortions. H. has learned to take his body under control too as he realized the connection between of his social anxiety and his underlying negative self-beliefs. He overcame his discomfort about triggering sounds with breathing exercises to control his anxiety while experiencing the misophonia symptoms that caused the anxiety. In addition, H. is describing the methods of CBT and cognitive training as quite beneficial to calm his feelings that he is experiencing such as helplessness and anger.