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McMahon 2024 showing an instance of exposure helping treat Misophonia

in a 2024 study testing the unified protocol to treat Misophonia, the authors have an interesting take on the use of exposure in Misophonia treatment. The authors suggest that building emotion regulation skills prior to engaging in exposure may explain why several patients showed large symptom improvements in later treatment sessions. Although exposure has been viewed negatively in misophonia treatment, patients responded positively in this study. Many endorsed core beliefs that their distress was intolerable and unmanageable without avoidance. The UP’s exposure module allowed patients to test these beliefs by confronting trigger sounds while actively using learned skills, consistent with an inhibitory learning model rather than habituation. The authors note that habituation-based approaches may reinforce maladaptive beliefs, whereas skill-based exposures create new learning experiences. Patients were receptive to exposures because they were framed as opportunities to practice skills in challenging situations, and many felt prepared by the time they reached this module. Those with less confidence benefited from flexibility in selecting exposure tasks. (McMahon et al., 2024)