Hyperacusis Vs. Sound Sensitivity

Dear Dr. Nagler,

Around the time my tinnitus started, I began to experience auditory distortions and a nails-on-a-chalkboard-like inner ear sensation in response to sharp, high frequencies, loud noises, and booming bass. It seems that many people describe this experience as "hyperacusis." According to my understanding, this is not correct. What would this experience be called, and how is it different from hyperacusis?

Thanks!

Dr Hubbard

 

Hi Dr. Hubbard -

The timing of your question regarding hyperacusis terminology is interesting - you'll see why shortly.

OK. Every authority in the world except one defines hyperacusis as a type of sound sensitivity wherein externally-generated sounds well-tolerated by others sound uncomfortably loud to the affected individual. On the other hand, if an externally-generated sound sounds distorted, that would best be termed dysacusis. (I think that's what you may be talking about.) Or if you have a separate internally-generated perception as a response to certain external sounds, that could possibly be viewed as a form of sound-sensitive fleeting tinnitus. So I guess it depends on whether these sharp high frequency or booming bass external sounds sound to you like nails-on-a-blackboard - or whether your brain generates a separate nails-on-a-blackboard response. Clear as mud, huh?

Well, here's something even muddier ...

The sole exception to the above definition of hyperacusis is the gentleman running the seminar you will be attending next month in Iowa City. For some reason - Lord only knows why - Dr. Rich Tyler insists that there are actually three types of hyperacusis: loudness hyperacusis, fear hyperacusis, and annoyance hyperacusis. Tyler's loudness hyperacusis is what everybody else calls hyperacusis. Tyler's fear hyperacusis is what everybody else calls phonophobia (which really isn't hyperacusis at all). And as best I can determine Tyler's annoyance hyperacusis is what many folks call misophonia, which like phonophobia really isn't hyperacusis at all.

So when Tyler gives his hyperacusis presentation (he spells it hyperacousis - go figure), I suggest you just practice some guided imagery and tune it out!

Dr. Stephen Nagler