The Insidious Mechanism

[Guest guest]

Like many of you, I've been struggling with 4S as long as I can

remember. I'm 43 now. I have a five-year-old son. I didn't understand

4S very well until recently, and felt like some sort of a freak.

Hyperacusis is easy to understand and communicate. Even SID. But the

trigger mechanism of 4S is just bizarre. This makes explanations

difficult to impossible. Again, like many of you, I had a parent who

just told me to " get over it. "

So I learned at an early age to avoid, to try and keep that inner rage

to myself (always a good strategy, of course), to hope for compassion

and understanding when I didn't even understand myself.

Last month, I decided it was time to take on this problem.

Unfortunately, the motivator was a failing marriage. My wife can't

handle being considerate any more, not when I have to avoid my own son

so much. She doesn't want to understand, or even help me through the

noise therapy process.

As I've read your posts here, for the first time in my life, I've felt

less of a freak. Maybe even a shred of hope that there's a physical

reason for this torture we all endure day after day. With that has

come some understanding of myself.

It's too late for my marriage, sadly. We are headed for divorce. She

has dreams of unstressed family dinners, of trips to Disneyland, of

being able to visit sniffly parents with a new husband, just of being

able to savor a clanky bowl of cereal without worrying about

displacing me from a common area. Seems shallow, but once the love is

gone, those things become more important.

I still want to pursue whatever treatment is available. I've done a

good job of isolating myself, easily going weeks without leaving the

house. That has to change. Maybe I'll never be able to go to a grocery

store without headphones, but hopefully I can enjoy preparing and

eating a meal again with someone I love some day. Or even having an

intimate conversation without fear it will be ruined by a wayward

lip-smack.

Over the last month, as I've grieved the loss of love, I've spent a

lot of time trying to figure out 4S. I have no background in

neuroscience, so when I read about how the amygdala develops early and

handles our fight-or-flight responses, it just seems like a little

blob amongst great big brain blobs.

But I also understand that recent research shows that parts of our

brain responsible for controlling the effects of that response still

develop during adulthood, so it's possible drugs might help us some

day. Too late for the adults here, no doubt, as we're still in the

blood-leeching era of the neuro-medical revolution. But maybe in time

to help our children, or our children's children.

What is this insidious mechanism, then?

How do we develop triggers, and why does this disease get worse as we

age, when clearly our hearing acuity declines over time?

Like many of you, my first memory of 4S comes from the dinner table

when I was a child. Scraping silverware. Even typing those words sends

an unpleasant feeling down my body. That was my first trigger. Then it

was sniffling, because my father was a two-pack-a-day smoker and

couldn't breathe properly through his nose. Then the food-smacking.

You all know the progression. By adulthood, it extended to

dog-barking, whistling, throat-clearing, the list just gets longer and

longer. There are also physical triggers, like being jostled when I'm

sitting, or the smell of buttered popcorn. All provoking that internal

rage and desire to flee the scene.

Why? Why are there always new triggers?

I think the answer lies in brain's development over time. For most

animals, with far less brain matter, the amygdala serves an essential

purpose. When stimulated, it releases those stress hormones that can

instantly provoke physical response. The faster the response, the more

likely the animal survives.

As the human brain evolved, new layers developed over the older

mechanisms. But the older layers still had the same mechanisms. So

those new layers would tie in the network somewhere, and would still

communicate with the older layers in some form.

At one time, animals survived by perceiving changes in their

environment that disrupted their understanding of peaceful and normal.

Today, human rely intently on communication with each other. Anything

that interferes with communication can cause problems. Anything that

repeatedly interferes with communication, therefore, can become a

threat to our long-term survival.

When someone is sniffling, or throat-clearing, or clanking silverware,

it generates a noise that makes it more difficult to understand their

communication.

That, in and of itself, doesn't provoke fight-or-flight. But when the

noise is repeated enough, we start unconsciously fearing the

interruption. That's when the trigger develops. When something has

interfered with communication enough for us to subconsciously fear

that specific interruption.

For " normal " people, the brain learns to filter out minor

interruptions. Our problem is that we lack an effective filter for

stimuli. We can not subconsciously train our brains to ignore the

sniffles or the smacking that makes speech harder to understand.

Over time, therefore, we develop triggers based on our environment. If

we live next door to a yappy dog, we start hating all barking because

we've developed a trigger based on our neighbor's dog.

That's why our lists have a lot in common, but it's not absolute. All

of our triggers interfere with communication, but our own personal

experiences in the workplace or in the family are not necessarily shared.

Anyhow, that's my understanding of 4S. With that in mind, " get over

it " is a very rational response. The problem is, we can't get over it.

We lack that filtering capacity and there's no easy way to develop it.

I'm heading down the path of the noise therapy, hoping that the white

or pink noise creates some filtering capacity, maybe enough to take

the edge off. And maybe cognitive therapy can help us remove triggers

slowly, when there's no immediate interference from those triggers.

I don't know. Maybe I have this all wrong. But for the first time in

my life some of this is starting to make sense. Thanks for your

patience in reading this.