Shape clay into a vessel;

It is the space within that makes it useful.

Cut doors and windows for a room;

It is the holes which make it useful.

Verse 11, Tao Te Ching

When our family was new to misophonia in 2019, I felt surrounded by a whole lot of nothing. Everywhere we turned for research-based help and information, we came up empty-handed. No definition, no treatment, no professional help. Lack defined our experience. Each gap felt cruel.

What I couldn’t yet see is how productive those empty spaces were. The Tao Te Ching illuminates the flexible purposes emptiness can serve. Holes in a wall are not void, but complexly utilitarian. Human beings are impelled toward meaning. How do we define that empty space: vessel, door, or window? We don’t simply experience our circumstances. We give meaning and purpose to the forces shaping our lives.

The search for meaning takes on urgency when suffering is involved. Although most of misophonia’s terrain remains uncharted (empty), emerging research and anecdotal evidence expose legions of pain: about 5% of people experience clinically significant misophonia symptoms (Dixon et al., 2024). Consider the spheres of relationships that surround each of these people, and suffering ripples through millions more.

As a mother, sister-in-law, and daughter-in-law caught up in misophonia’s thrall, I have witnessed and experienced the condition’s devastation across generations. Misophonia’s terrible threats to intimacy separated me from my child. Although we lived in the same house, we painfully avoided each other’s presence for years. We did not talk or touch. Our experience is not uncommon. In families with misophonia, parents can lose straightforward access to children; siblings retreat and grow apart; life can be reduced to a lonely ordeal for all. No wonder the quest to better understand this condition occupies so many of us.

From professional scientist to conventionally credentialed therapist, to alternative practitioner (for example, homeopath, hypnotist), to parents like me, different types of people invested in misophonia have differing ideas ready to fill many voids. This vast network is producing a robust and decidedly confusing “misophonia marketplace” of ideas and therapies.

Although theories outside of professional science influence misophonia in varied and often invisible ways, professional science dominates this field of knowledge—which does not guarantee accuracy or even smooth sailing. Professional science is an industry of research within networks of government, healthcare, and university bureaucracies. This slow-moving sphere of knowledge production is not a space of unified or even compatible thinking.

Science is a tremendously heterogeneous network: scores of individual disciplines are grouped into broad categories of natural, social, and applied sciences. Most misophonia research comes from audiology, neuroscience, and psychology, nestling the field between natural and social sciences. After elbowing out so much competition, which or what combination of these three disciplines might ultimately define the field?

Staying with the concept of “emptiness” helps answer this question.

Imagine a sandy shoreline. A huge hole has been abandoned by the child who dug it. Waves lap a few feet away. The sun beats down and the wind flutters. The hole will fill with water, sand, or some seepy combination. How this happens and which dominates (sand or water) is determined by forces outside and independent of the hole. Gravity, tide, sand and other environmental elements determine what fills the hole—and let’s not forget rain, or the whims of beachgoers and their dogs, at a minimum. Nothing bubbles up from within. Processes outside of the hole control its future.

Knowledge production follows a similar pattern. Forces outside of misophonia determine what fills the gap. This counters our ideal of scientific knowledge as an enterprise of objectivity that excavates essential or organic attributes. For misophonia, tide and the random kick aren’t at play, but conditions equally distant from (and even disinterested in) misophonia are, including but not limited to, money, employment, and the self-sustaining, generative power of individual disciplines and institutions.

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Money is the most obvious example of this dynamic. Before the 2019 creation of the Misophonia Research Fund (MRF), money for misophonia research was a dribble. Fewer than 60 published papers span the condition’s first 18 years of scientific existence.

Founded by the parents of a child with misophonia, MRF’s influx of capital proved to be a high-octane jumpstart: search PubMed today and you’ll find over 400 studies and commentaries on misophonia, an increase of some 560%. An editorial introducing a 2023 misophonia-focused edition of Frontiers in Neuroscience credits the fund for the significant uptick in “the pace and quality of scientific research” (Rosenthal et al., 2023).

Money fills the gap.

MRF greased wheels that allowed studies in audiology, neuroscience, and psychology to roll in. Among these, psychology dominates. Think Swiss cheese, with psychology filling most gaps. Does that mean psychology is the condition’s appropriate conceptual home? Not necessarily.

Psychology had a big head start, and the wind remains at its back. The discipline stands out for its cultural clout and already-existing dominance in our daily lives. Psychology has spawned the concepts we use to explain relating—and we relate to pretty much everything, from objects and creatures in the world, to other people, to aspects of our own selves. A quick tour of the many topics covered on this website, Psychology Today, reveals the discipline’s expansive terrain.

Among the phalanx of scholars studying knowledge production, sociologist Nikolas Rose is notable for his assertion that psychology and related “psy” disciplines like psychiatry, play an outsize role in shaping our understanding of human interiority. Universal human processes from thinking to emoting to perceiving (seeing, hearing, feeling, etc.), are all bound up in the discipline’s domain. Rose and other critics question the veracity of psychology’s claims on human interiority.

Do these dynamics warrant a wholesale rejection of psychology as a legitimate misophonia authority? Not at all. The good/bad swivel of binary thinking does not serve us here.

For example, not only does the majority of misophonia research come from psychology, the influential Duke Center for Misophonia and Emotion (CMER), is primarily staffed and steered by psychologists/psychiatrists and psychology students. The advances in understanding misophonia’s embodied processes and tiptoe steps into clinical care brought to us by CMER and other misophonia research hubs around the world are profoundly positive, hopeful developments.

Still, those of us invested in misophonia’s future must be aware of the existing forces (akin to rain or sand) driving misophonia research. We continue to circle those blank spaces in misophonia. Window, vessel, door: who gets to inscribe misophonia’s meaning?

These uncertain processes are not easy for families like mine, where ending suffering is not an abstraction, but a series of daily decisions through webs of sight and sound. We don’t just experience these circumstances. We yearn for meaning and a purposeful path through the void—help that is still taking its shape.

As our families receive an influx of psychological theories about misophonia, it is important to keep our eyes on the dynamics driving these theories into the void and our attention. Misophonia’s meaning remains in the making. Perhaps psychology’s current dominance in the field tells us as much about knowledge production as it does about misophonia.