Misophonia is an intricate condition characterized by an intense emotional and physiological fight-flight-freeze response to specific auditory or visual triggers. Crucially, it is understood as a primary neurophysiological disorder, not a phobia or a fear-based condition, a distinction that fundamentally dictates the appropriate therapeutic approach. Treatment must therefore focus on surrounding the moment of distress and adapting to the complex emotions and behaviors that arise, rather than targeting the trigger itself.