APPROACH: Dr. Fox-Thomas uses an audiological approach to managing misophonia that includes a combination of counseling (including tenets of cognitive behavioral therapy), sound therapy, and biofeedback. She embraces a person-centered, holistic approach to patient care that recognizes each individual's unique needs and preferences.
TESTIMONIALS: Dr. Fox-Thomas has treated over 100 children and adults with misophonia since 2010. Anecdotal and survey results of her clinical work have been presented regionally and nationally and accepted for presentation at the 2nd International Misophonia Symposium. Although data collection is ongoing, preliminary findings of survey data indicate the majority of survey respondents (61%) reported their misophonia is “better.” They reported less awareness and disturbance of triggers.
Subjective comments included "emotional regulation has somewhat improved with regard to misophonia triggers” and “can take short sessions of triggers.” Scores on the Misophonia Assessment Questionnaire (MAQ) also improved for the majority of respondents. Nearly 80% of the patients who participated in the survey reported using sound therapy. Several patients reported the “breathing exercises” (biofeedback) were helpful. In response to the question, “What was most and/or least helpful about the services you received…?,” patients commonly referred to validation of their condition (e.g., "“Being able to talk to someone who validated what I was feeling was the most helpful thing. I no longer felt alone.”
CREDENTIALS: State-licensed Audiologist (NC, VA, and SC); Certified by the American Speech-Language Hearing Association (CCC-A), Fellow of American Academy of Audiology (FAAA), Certified Healthcoach (CHC), Certified HeartMath Practitioner; Certified Integrated Listening Systems (iLs) practitioner including the Safe and Sound Protocol (SSP)
UNC Greensboro Speech and Hearing Center offers both online consultations and in-person evaluations as well as follow ups via telecare as needed. Telepractice laws usually require licensure in the state where the patient is located. At present, Dr. Fox-Thomas is licensed in North Carolina, Virginia, and South Carolina.
APPROACH: Relaxation training and counterconditioning therapy
I usually provide this treatment by video-chat. I teach the patient about misophonia and exercises that allow them to develop the skill of relaxing on demand. With this skill, I then teach them what to do around misophonia triggers that will change their fundamental reflex responses of misophonia. This causes their misophonia severity to gradually decrease. In some cases, very positive activities are planned so that the response to the trigger can be "counterconditioned" and fade away. We regularly measure misoponia severity and plot the data so we can adjust the treatment as needed. For examples, see https://youtu.be/z_jaLCvZHYU
CREDENTIALS: BCBA, Board Certified Behavior Analyst
Recent data shows the treatment is beneficial for 70-80% of people and those that respond well to the treatment have an average of over 70% reduction in misophonia severity.
Here is a recent, unsolicited testimonial: "Tom has been a tremendously positive force for our family. One of my children suffered tremendously from misophonia. She found Tom online and from his writings immediately self-diagnosed with misophonia. We contacted Tom, who ran his own analysis and agreed that she did indeed suffer from misophonia. We embarked on treatment with Tom, and within weeks, she substantially improved. We looked forward to our sessions, as he is kind, gentle, encouraging, positive, and data-driven, which creates a perfect combination. I can't recommend Tom more highly. His work is truly life-changing." (mother of a 12-year-old daughter with misophonia)
Samantha Bookman, LMFT
More Peaceful, With Misophonia
Treating Misophonia with Body Regulation & Family Systems Tools
My practice is all virtual. I don't accept insurance but I do short term, solution focused work.
Two Fold Approach, assisting the person with misophonia and their family simultaneously
Working with the person with Misophonia:
Using cognitive skills to practice how one will calm their nervous system during misophonia moments
Setting up a mental map for how one will care for themselves
Creating a greater sense of safety and security, “I have tools, there are things I can do to help myself, I will take care of my body and my emotions, I am not powerless in how I respond to misophonia”
Learning & practicing strategies to regulate the nervous system and bring it back into a calm (or calmer) state during and after a misophonia moment
Working with Family Dynamics:
How to balance avoiding harm for the person with misophonia without harming the rest of the family in the process (the “no harm” approach) Helping families understand what misophonia is doing in the brain and body of the person with it
Teaching family what that person is learning and how they will be caring for themselves
Looking at how we all (ideally) care for one another in a family
Once a child or teen has skills to practice so that they can feel safe(r), helping parents see how they can encourage practice and build motivation for a child who lacks it, “If I feel safer in my room with headphones on, why would I ever practice it if it makes me feel unsafe?”
Confronting the trade offs associated with sheltering from noises and learning ways to care for oneself in the midst of noises
Discuss limit setting with a child who is genuinely struggling and in pain (yes, you can feel enraged and take steps to care for yourself, but you can’t scream at people, say cruel things or physically lash out)
Investigate the balance between protecting our children from suffering and helping them feel okay being in the worldThe world isn’t going to stop making these noises (how much easier my life would be!). So, how do we arm our children with the skills they need to lead fulfilling lives that are not controlled by misophonia?
Addressing relationship struggles that are usually making misophonia reactions worse (For example, if a teen is already mad at their parents, misophonia will magnify that until underlying issues are addressed, if a parent has trouble setting limits around behavior in general - homework, chores, sibling relationships - it will be especially hard when misophonia enters the picture)
Licensed Marriage and Family Therapist (LMFT)
Social Media posts from the Parents of Children with Misophonia Website:
"I just wanted to share the contact information for a great thearpist we used for my daughter this fall right after she developed misophonia. Things still aren't perfect but they have improved a ton and my daughter really enjoyed their sessions. She has a husband and two kids with misophonia so she really gets what it's like to live with this on a daily basis."
"Wanted to share the therapist that we have been working with for a few weeks now. Samantha Bookman is very knowledgeable about misophonia and connected with my daughter on what miso is, how to respons ewhen in a trigger moments, how to explain it to friends and family, and overall just how to live with it. I highly recommened her. We did virtual visits and they worked great!"
"Samantha Bookman, an adolescent therapist who specializes in Misophonia, has recently helped my 15 year old so much! After just a few sessions, my kid is managing her food/cheweing/swallowing triggers so much better. Samantha really gets it (having kids of her own with miso) and gave my daughter tools and tricks to manage that fight / flight response and I feel much more hopeful that my daughter will lead a fully functional life. I know the miso won't go away, but being able to control those horrible trigger responses has made my daughter much happier"
"After struggling to find a local therapist that truly understands misophonia, we connected with Samantha Bookman and have done zoom sessions with her once a week for the past month or so. She has helped my 11 year old daughter a great deal in a relatively short amount of time. I believe she has been mentioned here before, but I wanted to recommend her again"
Notes from clients:
"There just seems to be so few people who actually understand what it even is and how debilitating it can be. It's been great to have somebody for her (and me!) who truly gets what we've been going through."
"Thank you for today. (my child) was super resistant to doing the session today, but after, she said she really liked you, and felt like you really understood her situation....so she's all for moving forward!!"
I am a Licensed Marriage and Family Therapist with a private mental health therapy practice in Minneapolis, MN. I offer in-person and telehealth sessions for those living in MN. If you live outside of MN, I can provide consultation or coaching sessions around minimizing the impact of misophonia on your life and/or household. While sessions are primarily one-on-one, I welcome working with as much of the family/household as possible to ensure everyone is educated about misophonia and engaged in the efforts that will help the miso and family best navigate this condition.
I create a safe space for my clients to process the difficult emotions that come with misophonia, help them explore influential thoughts/beliefs around the condition, brainstorm strategies for dealing with triggers and find ways (and the confidence) to advocate for oneself/one’s child. I encourage my clients to take a multidisciplinary approach (i.e. getting support from multiple helping professionals such as an audiologist, psychiatrist, OT, etc.).
My treatment approaches include: psychoeducational (understanding misophonia and how to manage it, understanding the nervous system); physiological (helping the miso increase their agency over their nervous system, primarily through Somatic Experiencing method techniques and use of polyvagal theory), cognitive and emotional(addressing problematic thoughts and emotions related to misophonia), behavioral (developing new behavioral patterns of responding; self-advocacy) and relational (having a shared understanding in the household, addressing dynamics that interfere with a sense of safety in the miso's primary relationships, use of healthy co-regulation strategies).
I have three years of specialized training in Somatic Experiencing, which I use to help clients learn how to be the operators of their nervous system. It is also a powerful approach for releasing trapped trauma/stress in the body, resulting in one having a greater “window of tolerance” for stress and triggers.
As someone who has had misophonia since the age of 12, I have a unique understanding of what it’s like to live with misophonia and passion for helping this population.
All of my miso clients have said I'm the first therapist they have seen that "gets it" and how valuable that is when it comes to trusting the therapy process, addressing shame they carry about misophonia, etc. As a result of therapy, several of my miso clients have taken steps to advocate for themselves at school or work and have experienced improved functioning as a result. Many of my clients have grown in their awareness of what's regulating/calming to their nervous system and as a result have increased their window of tolerance for triggers. I make it a practice to connect with the partners (or other household members) of my misophonia clients, which they have expressed as beneficial in terms of (not) taking the triggering personally and learning how to best support their miso partner (or family member) without walking on eggshells themselves.
Licensed Marriage and Family Therapist (Minnesota #1714); Advanced Level Somatic Experiencing Trainee, Member and Former Executive Director for the Minnesota Association for Marriage and Family Therapy.
In-person and teletherapy sessions available for those in Minnesota. Online misophonia consultation available for those outside of Minnesota.