Whether or not avoidance is a maladaptive coping mechanism is something that psychiatrists and psychologists debate. In the view of some authors, avoidance is a maladaptive behavior because it can hinder social events and learning engagement, and thus should be remedied. This view is simplistic and does not account for the lack of habituation that is shown in persons with misophonia. When we think of misophonia through the lens of sensory regulation and the fight-flight-freeze response, it is only natural that a person with misophonia would want to avoid a trigger or leave the room when it happens. The easiest way to not be distressed is to not be in the presence of the stressor!
Whether or not avoidance is maladaptive or adaptive depends on numerous factors, and almost all of them are up to the individual and, by extension, their families. Social expectations are largely cultural, and whether something like family dinner is something to be adapted to and coped with or something that can be avoided will be situational. For some, the distress at mealtimes is so great that even the cultural will to eat dinner with one’s family is not enough to overcome the urge to flee. It is important to not judge too harshly in these situations—even if it is yourself that you are judging.
There is a degree in which avoidance is a maladaptive coping mechanism, and that degree is whatever line the person with misophonia has drawn in the sand. For some, there are hard boundaries that cannot be crossed, such as restaurants or movie theatres. For others, these lines are more nuanced, and some days they can handle it and other days they cannot. This variance is to be expected when we consider self-regulation and remember that misophonia varies based on the physiological, cognitive, and emotional needs of a person, and not just on hard assumptions.
Of course, if a person with misophonia has become overly withdrawn, lonely, or is avoiding relationships with their friends and family altogether, this is a maladaptive behavior. However, it is possible that it is not necessarily misophonia causing this behavior, but rather a lack of accommodations and safety in the relationship, which helps the person with misophonia stay present. Unfortunately, some triggers cannot be covered (such as the sound of a person’s voice), so this can become tricky in these scenarios.
The answer to the question this post sought to answer—“Is avoidance adaptive or maladaptive?”—is that it entirely depends on how often the person is avoiding, why they are avoiding, and whether or not it is leading to more distress for the individual who is doing the avoiding. While that answer might seem convoluted, it is also one that might change through negotiating accommodations and developing coping mechanisms.
Negotiating Boundaries
Unfortunately, there are often triggers that cannot be avoided by the person with misophonia. An example of this is somebody who clears their throat or snores (barring sleep apnea, which should get checked out). Some sounds are necessary. More than that, some sounds (and visuals) are part of activities that are important to our partners. This chart is meant to help couples negotiate their “Never,” “Sometimes,” and “Adapting” triggers. Adapting sounds are ones that are necessary or unavoidable. The adapting portion comes in to help the couple negotiate ways for the misophonia sufferer to live in this environment where triggers are present. The following example is my own chart based on my own triggers, but each couple will have a chart tailored to their situations. These categories can change over time. For example, restaurants used to be in my “Never” category. This list should not be treated like scripture but rather used for couples to identify their needs and boundaries.
The following worksheet may help: