It wasn’t that long ago that I discovered that I most likely have a condition called misophonia.The definition of misophonia is that it’s a condition where certain sounds cause a strong negative reaction. It’s a neurological disorder, meaning that a person living with misophonia can do very little to avoid it, apart from avoiding the sounds and repetitive actions that cause it.

Having misophonia means having coping mechanisms, because when it triggers, the reaction is often (for me) very strong, and it can affect me for hours after I’ve heard the noise or sound. My strongest trigger is whistling, but I also react very strongly to chewing, clicking teeth when chewing, slurping and crunching. Usually this is a reaction on other people’s noise, but on occasion I’ve had to stop eating or drinking because the noises I make myself completely disrupts my day.

Before you go thinking that this sounds (ha!) like a trivial problem, and that it’s nothing to get upset about, keep in mind that these noises trigger severe psychological and emotional stress. This in effect means that certain noises cause an autonomic nervous system arousal and negative emotional reaction, such as irritation, anger and anxiety, together with a decreased tolerance for that noise.

Personally I get angry, irritated and anxious as well as stressed, in particular if I can’t get away from the noise. Imagine having a switch in your head. One minute you’re fine, happy and content. The next minute you’re irritated, angry as hell and super stressed out and all it takes is someone in the supermarket queue, whistling and going about their day. But your day is completely disrupted and no matter what you do, the noise is going to rattle around in your head for hours, continuing to disrupt your day.

It’s not really a socially acceptable problem. You’ll get looked at funny if you tell the main in the supermarket to stop whistling, or if you ask the girl next to you on the bus to stop chewing that motherfucking chewing gum so outrageously loud. I think it might be hard for people without misophonia to understand what it’s like living with it. It means top of the line headphones with noise cancellation. It means always lugging around earplugs. It means having your day disrupted at the drop of a hat.

My favourite games have very little in the way of disruptive audio cues, but recently they pop up more and more, all in the name of “realism” and accessibility.

The first game that drove me crazy was Assassin’s Creed: Origins. In the cities of Egypt, especially at the blacksmiths, whistling is a thing. The coping strategy in that particular case was for me to turn off the sound whenever I was getting close to the Blacksmith, or I could just turn off the entire game and wait until I’d calmed down.

In Assassin’s Creed: Odyssey there’s an entire island that’s populated by crickets. The cricket audio… man that was above and beyond. I turn off audio when I’m on that island or I wait until night when the noises aren’t quite as loud.

In God of War 4, Kratos’s son Atreus keeps yelling during combat. There’s no way to turn the audio cues off, rendering the game unplayable with audio for me. In Atreus’s case, it’s the constant repetition of the same dialogue lines (and honestly, kids screaming at me… no.) Another quirk with misophonia is that repetition triggers a neurological response. The reaction is as with all other audio reactions autonomous, which means that I have as little influence over being triggered as I have over my heart beating.

What to do then? Well, for audio designers I recommend reading up on what the affliction means and what audio usually triggers it and avoid using those kinds of audio cues in game. For game and UX designers I recommend having audio layers as well as visual layers in the HUD. If I could turn off Atreus I could play the game, but alas, there’s no way to turn off the audio cues. Since I don’t feel like experiencing irrational anger, I will most likely never finish God of War 4.

Because misophonia seems to be rather common, one number I saw at a research page about misophonia, quoted as much as 15% of the population suffering from it. Compared to color deficient vision which is about 8%, it might be worth adapting games from an audio perspective as well as a visual one.