Sound Exposure Therapy

Sound exposure therapy is a structured treatment approach used primarily for hyperacusis and, in some cases, misophonia. It involves the gradual, controlled presentation of sounds at progressively increasing intensities over time, with the goal of reducing the auditory system's hypersensitivity to ordinary sound levels. The approach draws on principles from desensitization therapy used in cognitive and behavioral psychology.

In hyperacusis management, an audiologist works with the patient to build a systematic sound exposure hierarchy, starting with sounds at levels that are tolerable (even if still somewhat uncomfortable) and gradually increasing exposure as tolerance improves. This is different from tinnitus masking, where the goal is to reduce awareness of tinnitus. The goal in sound exposure therapy for hyperacusis is to widen the range of sounds and sound levels that can be heard comfortably.

Sound exposure therapy requires careful pacing and should not involve sudden or uncontrolled exposure to levels that trigger significant distress or pain. It is ideally delivered in coordination with counseling that addresses the cognitive and emotional components of sound sensitivity, particularly any avoidance behaviors that may be reinforcing the hyperacusis over time. In Canada, this therapy is provided through audiology clinics with expertise in tinnitus and sound tolerance disorders.