The term phonophobia indicates a psychological fear of certain sounds that usually derives from sound traumas.
Hypersensitivity to a sound, a common event that many individuals experience, can be determined by both peripheral and central hearing disorders, and is characterized by intense suffering at a specific sound event. Different types include:
While "recruitment" can be described as a peripheral reaction caused by a lack of sound modulation of the hair cells of the cochlea, hyperacusis, phonophobia and misophonia represent disturbances of central auditory processing without peripheral pathology, often associated with psychosomatic reactions .
For people who suffer from phonophobia, the peripheral auditory functions are generally intact, but some learning processes lead to the development of intense specific reactions (fear, anxiety, avoidance) and the avoiding of certain acoustic stimuli. This tendency aimed not only at avoiding possible sources of noise but also towards social activities, with consequent isolation and tendency to depression, acquires all the characteristics of a medical problem on a psychological basis.
On a clinical level, phonophobia represents the body's reaction to an acoustic stress (even of low intensity), which activates a series of potentially harmful events. The most immediate effects are alterations of cardiorespiratory rhythm and muscle tone and vasovagal syndrome (sweating, nausea, vomiting, gastrointestinal disorders, etc.), neurophysiological reactions and reflexes to the noisy stimulus (alert phenomena). This negative condition would be the result of a cognitive evaluation that attributes values of excess and harmfulness to the stimuli. This means that people with phonophobia are afraid to expose himself to certain sounds, because they consider them particularly harmful to their health. Often these sounds are those of everyday life or even barely noticeable noises that cannot induce any kind of damage.
In terms of therapy, the approach used in the past was the indiscriminate avoidance of any sound and / or noise with, or even the use of earplugs to block the ears. This method did not lead to any kind of benefit, and even caused a worsening of phonophobia because the reduction in acoustic stimulation increased the sensitivity of the nerve pathways responsible for the transmission of sounds to the cortical region. In the nineties, a new concept of treatment based on sound therapy, counselling and cognitive behavioral therapy was introduced.