If You Can’t Stand People Fidgeting, You May Have Misokinesia

She explained that Handy had a fidgeting habit, and she found it very stressful to watch and be around. "Of course, I was concerned as a partner,” said Handy, a professor of psychology at the University of British Columbia. “But as a visual neuroscientist and somebody who studies visual attention, it really piqued my interest. I thought, 'Hey, what's going on here? This is a very interesting phenomenon.'”

It sounded to Handy like a visual version of misophonia—the “hatred of sound,” or "sound rage," a condition in which people have intense emotional and physical reactions to trigger noises, often chewing or lip smacking. When he consulted misophonia research, he found that a paper from 2013 had called a reaction to visual triggers misokinesia, or a "hatred of movement." He casually started to ask his lecture classes if anyone was bothered by seeing another person fidget.

“And literally a third of the class would raise their hands and you could just see this look on their faces they were like, ‘Oh, my gosh. He’s talking about something I'm suffering from.’”

Last week, Handy and his colleagues published the first study to focus solely on misokinesia in Nature Scientific Reports, with first author PhD student Sumeet Jaswal. The paper is mostly focused on determining how common misokinesia might be—and their findings remarkably resemble the impromptu surveys Handy did on his classes. In a total of over 4,000 people, one-third said they were sensitive to watching others fidget, and that it caused negative emotions like anger, anxiety, and frustration to arise. 

Arjan Schröder, a postdoctoral researcher at Amsterdam UMC and the first author on the 2013 paper that coined misokinesia, said this prevalence matched what he has seen in his misophonia patient samples. Yet, as Handy's work shows, misokinesia might also be quite common in general populations too. 

Handy and his colleagues first asked a group of students whether they ever had “strong negative feelings, thoughts, or physical reactions when seeing or viewing other peoples’ fidgeting or repetitive movements," like someone’s foot shaking, fingers tapping, or gum chewing. 38% of the students responded yes, and 31% reported having both misokinesia (visual) and misophonia (audio) sensitivity. 

Then they asked an older, more demographically diverse sample (not students) and found a similar prevalence: 36% of participants reported they had misokinesia sensitivity and 25.5% reported having both misokinesia and misophonia. 

It's an intriguing finding that misokinesia and misophonia seem to exist both together and in isolation. On the subreddit for misophonia, one person shared that noises didn’t bother them severely but fidgeting did. 

“If someone starts shaking [their] foot or tapping their hand, even if they make no sound whatsoever, I get very irrational and I have to block my view, usually with my hand,” they wrote. “EVERYONE shakes their foot. I can't live with this anymore. Everyday I encounter MULTIPLE PEOPLE AT ONCE shaking their feet and I only have two hands.'' Another remembered losing their temper as a child as a man in an elevator tapped his foot, so much so that they stomped on his foot on their way out. 

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Sometimes people can have both triggers, but one is more upsetting than the other. “My visual triggers are just as hard to handle as my audial triggers,” one person shared on Misophonia Education. “Sometimes they are worse. I find it nearly impossible to escape a sight in the room. Even when I close my eyes, and even hours or days later, the memory is still there. I want to cry as I think of these triggers. Legs shaking, people swaying, fingers and toes tapping.”

Having both audio and visual triggers can make interacting with the world all the more challenging. And whereas people with misophonia can wear headphones to block out noise, “I can’t wear earplugs for my eyes,” another shared on Misophonia Education. “I suppose I could wear a blindfold, but this has impractical applications. I am also more likely to remember visual triggers and never want to go back to the place. If I have been visually triggered somewhere in the past, I will not want to go back.”

Handy thinks the next big questions their study poses are how exactly misokinesia is related to misophonia, whether it can help better explain the mechanisms of misophonia, and whether it can potentially lead to coping strategies and treatments. 

Schröder believes there are likely similar mechanisms at play since both misokinesia and misophonia involve an irritability triggered by human cues: movements and sounds. “Both have a repetitive nature and some form of unpredictability: When will it stop, when will it start again?” He said. “Additionally, I think, there’s some moral assessment at play. The person who is experiencing the emotion thinks something of the trigger: Why is the source of the sound/fidgeting doing it? It seems useless! Why do you continue?” 

Elsewhere, there have been several attempts to understand the biology of misophonia. One study showed through fMRI imaging that there was an increased activation in a part of the brain called the anterior insular cortex in people with misophonia. This area of the brain is important for, among other things, sensing one’s own body and processing emotions. 

Recent work from Mercede Erfanian, a neuroscientist at University College London, found that misophonic's brains function differently in the premotor cortex: the premotor cortex and auditory cortex were hyper-connected and they were communicating more than is considered typical. "This means when sufferers listen to sounds, the premotor cortex also activates, and this does not happen in the brain of non-misophonic people,” Erfanian said. A similar pattern was found between the premotor cortex and visual cortex.

Erfanian thinks this could be a neurological basis for these reactions, and that it may implicate the involvement of mirror neurons, neurons that activate when we see others move, as well as when we move ourselves. It could help explain why some people with misophonia say that they mimic the sounds as a coping strategy, to cover up hearing the trigger noises with their own sounds, she said. 

The neuroscientist and author V.S. Ramachandran and his colleagues theorized that there might be similarities to synesthesia, when sensory stimuli trigger other sensations and emotions. Typically with synesthesia, letters evoke sounds, or sounds evoke colors, but in certain subtypes it can be more varied. In a case of tactile-emotion synesthesia, the feeling of sandpaper evoked a feeling of jealousy, and denim provoked the feeling of disgust and depression. 

Handy, as a scientist focused on attention, still has questions about whether misophonia or misokinesia triggers affect our attention in an outsized way—if they're somehow telling the brain that those triggers are important, and need to be attended to. So far, Handy said, they haven't found any definite links to attention. Misokinesia sensitivity wasn’t related to being better able to ignore distractions in the peripheral vision, nor to paying attention to sudden events in their periphery. 

While all of this is fodder for future research, Handy hopes that the immediate impact of their paper is that it helps people with misokinesia to feel validated if they're struggling and gives them a word to describe their reactions and tools to ask for accommodations or develop coping strategies. While there's currently no evidence for what treatment might work best for misokinesia, avoidance doesn’t work in the long term, Schröder said. Treatments that help misophonia, like cognitive behavioral therapy, could also be useful for misokinesia, but it will have to be tested in the future.

Schröder said that when he first started misophonia research in 2009, people with misophonia were relieved to finally have someone to listen to them and take their symptoms seriously. The same could be true for misokinesia. 

It's tempting to hear about misophonia and misokinesia and think, "Isn't everyone annoyed by fidgeting and loud chewing?" And while there is certainly a spectrum of how bothered people can be, on the extreme end of the spectrum, people can experience huge disruptions in their lives. The people Schröder works with can’t often eat with family members, or can’t work in offices with their colleagues. 

“Being annoyed by other people’s behavior is a common thing,” Schröder said. “We can all experience that. However, in misophonia (and possibly misokinesia too) it’s more than that.” 

On Allergic to Sound, a website that shares misophonia personal stories, one person wrote how misokinesia could interrupt something as basic as going to a movie with a friend—when said friend took a ring off his finger and began to play with it. 

“He then raised it to his mouth and spent the rest of the film popping it in and out of his mouth. He did this silently and didn’t make any dramatic or disruptive movements, but to me it felt like my whole world was on red alert. All I could focus on was that irritating movement out of the corner of my eye. It was so bad that I can’t remember a single thing that happened in the film – I don’t even remember what the film was called. What I do remember, in painstaking detail, is every single minute little movement he made with his hands.”

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