What is Autonomous Sensory Meridian Response (ASMR)? A Narrative Review and Comparative Analysis of Related Phenomena

Aidan Mahady,

Marcel Takac,

Alexander De Foe

School of Health and Biomedical Sciences, RMIT University, Australia

Faculty of Education, Monash University, Australia

Introduction and Overview of ASMR

  • Autonomous Sensory Meridian Response (ASMR) emerged as a sensationalized internet trend starting in 2008 (Andersen, 2014) and has since gained significant academic traction regarding its clinical efficacy and underlying psychological mechanisms.

  • ASMR is defined as an experience-dependent sensation where specific audio, visual, and/or tactile stimuli (referred to as "triggers") induce a pleasant tingling sensation, typically localized around the scalp and spine (Barratt & Davis, 2015).

  • Unlike many sensory psychological phenomena captured first in laboratories, ASMR followed an "inverse pattern," being observed in informal online discussion boards before moving into formal study.

  • The online community, known as the "ASMR community" or "Whisper Community," originated in small forums and expanded significantly via YouTube, with some creators (known as ASMRtists) garnering more than 2×1062 \times 10^6 subscribers.

  • Previous reviews were often brief and intended for medical professionals unaware of the phenomenon (Niven & Scott, 2021; Reddy & Mohabbat, 2020); this review provides an exhaustive overview including clinical outcomes, individual differences, and neurophysiology.

Definitional Factors and Triggers

  • The ASMR tingling sensation is characterized as involuntary, atypical, non-medical, and non-harmful, and it is accompanied by deep feelings of relaxation and calmness (Valtakari, 2019).

  • Triggers are typically gentle, low frequency, and repetitive. Specific examples include:

    • Auditory: Whispering, soft speaking, tapping on plastic objects, fingernail tapping, and crinkling sounds (Barratt et al., 2017).

    • Visual: Slow, repetitive hand movements that emulate touching the viewer's face or moving toward the camera (Zappavigna, 2020).

    • Tactile: Simulated touch involving microphones treated as the viewer's ears.

    • Emotional: Interpersonal elements, such as being closely examined (e.g., a clinical roleplay) or witnessing a favor being done (Ahuja, 2013; Smith & Snider, 2019).

  • Distinctions in Terminology: Research recommends differentiating between the sensation itself and the content used to induce it. Recommended terms include "ASMR content," "ASMR stimuli," or "ASMR videos" for the media, and "ASMR experiencers" or "ASMR users" for those susceptible to the sensation (Smith & Snider, 2019).

  • The sensation path usually begins in the head, scalp, and spine, traveling slowly toward the limbs (Barratt & Davis, 2015).

  • Physiological markers associated with ASMR include increased skin conductance (indicating arousal) and reduced heart rate (indicating relaxation) (Poerio et al., 2018; Valtakari, 2019).

  • The experience has been described as a state of "low-grade euphoria" (Ahuja, 2013).

Therapeutic Potential and Clinical Studies

  • ASMR videos are most commonly utilized for relaxation, falling asleep, and stress relief (Barratt et al., 2017).

  • Mood Improvement: ASMR experiencers report significant mood improvement after listening to content; research indicates a significant main effect on mood (Barratt & Davis, 2015; Engelbregt et al., 2022).

  • Stress Management: A pilot study (Paszkiel et al., 2020) found stress levels reduced faster in ASMR listeners compared to a control group.

  • Chronic Pain: Some respondents claim ASMR helps manage chronic pain, though empirical data is currently lacking (Barratt & Davis, 2015).

  • Persistence: Electrophysiological decay effects can persist for up to 45 minutes45\,minutes after the experience ends, suggesting long-term well-being benefits (Swart et al., 2022).

  • Auditory Sleep Aid Research:

    • Williamson (1992) found ocean sounds improved sleep depth and quality compared to no sound.

    • Umbas et al. (2021) categorized rain sounds as ASMR and found that listening for 1 hour1\,hour per night for 30 days30\,days significantly decreased Pittsburgh Sleep Quality Index (PSQI) scores.

    • Hardian et al. (2020) used ASMR roleplay videos and found improved PSQI scores and subjective sleep quality.

    • Wang & Li (2020) used ASMR in conjunction with a specialized pillow; 66%66\% of participants reported good sleep after 7 days7\,days, and the number of participants unable to sleep steadily dropped from 56%56\% to 11%11\%

  • Sleep Latency: Sleep latency (the time taken to fall asleep) under 30 minutes30\,minutes is a key indicator of sleep quality; studies show ASMR can effectively reduce this latency (Lichstein et al., 2003; Yoon & Baek, 2022).

Comparative Analysis of Related Sensorial Phenomena

  • ASMR is compared to several other phenomena (paresthesia, frisson, synesthesia, and misophonia):

  • Paresthesia: An umbrella term for abnormal skin sensations like tingling or prickling (NINDS, 2019). ASMR differs as it is positively valenced and non-medical, whereas clinical paresthesia often relates to conditions like MS or carpal tunnel.

  • Frisson ("Aesthetic Chills"): Tingling resulting from intense aesthetic appreciation, often music-induced during climactic moments (e.g., key changes or volume increases) (Blood & Zatorre, 2001).

    • Contrast: Frisson is excitatory/thrilling, while ASMR is relaxing. Frisson is rapid and fleeting; ASMR is slow and radiates. A weak positive correlation (r = 0.25, p < .001) was found between the two (Roberts et al., 2019).

  • Synesthesia: A condition (affecting approx. 4.4%4.4\% of the population) where one sensory domain triggers another (e.g., grapheme-color or chromesthesia) (Rich & Mattingley, 2002).

    • ASMR Correlation: 5.9%5.9\% of ASMR experiencers self-identify as synesthetes (Barratt & Davis, 2015). Some scholars view ASMR as a form of auditory-tactile synesthesia.

  • Misophonia ("Hatred of Sound"): A disorder where specific repetitive sounds (chewing, breathing) trigger rage or physical discomfort (Brout et al., 2018).

    • Paradox: Those with misophonia are more likely to also experience ASMR, suggesting a general high sensitivity to auditory stimuli (Janik McErlean & Banissy, 2018).

Individual Differences and Personality Profiles

  • Sensory Processing Sensitivity (SPS): High sensitivity of the central nervous system measured by the Highly Sensitive Person Scale (HSPS) correlates with ASMR sensitivity (Roberts et al., 2020b).

  • Personality Traits (Five-Factor Model/BFI):

    • High Openness to Experience: Reflects curiosity and appreciation for unconventional aesthetics (Janik McErlean & Banissy, 2017).

    • High Neuroticism: Prone to stress, which may drive these individuals to use ASMR for relief (Fredborg et al., 2017).

    • Low Conscientiousness: Observed in ASMR users and associated with increased reactivity to stressors (Fredborg et al., 2018).

  • Cognitive Traits:

    • High Absorption and Fantasizing: Capability to immerse oneself deeply in media to the point of losing track of time (Janik McErlean & Osborne-Ford, 2020).

    • Empathic Concern: Higher scores on the Inter-Personal Reactivity Index (IRI) (Janik McErlean & Banissy, 2017).

    • Transliminality: A lack of separation between mental processes (mystical experiences, absorption) (Lange et al., 2000).

    • Sensory Suggestibility: ASMR experiencers score significantly higher on the Sensory Suggestibility Scale (SSS), meaning they are more likely to respond to illusory physical sensations implied by a researcher (Keizer et al., 2020).

Neurophysiological Bases and Brain Connectivity

  • Functional Connectivity: Neuronal firing in one region associated with firing in another (Friston, 1994). ASMR experiencers exhibit "de-compartmentalization" of brain networks (Smith et al., 2017).

  • Default Mode Network (DMN): Associated with internal thought/attention. ASMR listeners show reduced functional connectivity in the DMN, salience, and visual networks, but atypical connectivity in central executive and sensorimotor networks (Smith et al., 2019b).

  • Executive Function: Set shifting and inhibitory control were found to be impeded after ASMR, supporting the theory that ASMR stems from an inability to inhibit sensory motor experiences (Wang et al., 2020).

  • Activation Zones (fMRI studies):

    • Increased activity in the cingulate gyrus, right paracentral lobule, and bilateral thalamus (emotion, alertness, attention) (Smith et al., 2019a).

    • Activity in the insulae, nuclei accumbens (reward), and supplementary motor areas (SMA) associated with tingles (Lochte et al., 2018).

  • Global Emotional Moment Model: Proposed by McGeoch and Rouw (2020); firings in the auditory cortex cross-activate with the anterior insula cortex. ASMR involves a shift toward the parasympathetic nervous system, while misophonia shifts toward the sympathetic.

    • Right Insula = Sympathetic activity; Left Insula = Parasympathetic activity (Oppenheimer et al., 1992).

Electroencephalography (EEG) and Brain Oscillations

  • Alpha Power (8−13 Hz8-13\,Hz): Associated with suppression of distractor stimuli and relaxed states. EEG studies show increased alpha power in parietal, frontal, and temporal regions during ASMR content viewing (Fredborg et al., 2021).

  • Beta Oscillations (12−25 Hz12-25\,Hz): Associated with focused attention and immersion during ASMR (Engelbregt et al., 2022).

  • Sensorimotor Rhythm (12−15 Hz12-15\,Hz) and Gamma Power (>30\,Hz): Observed specifically during tingling sensations (Fredborg et al., 2021).

  • Conflicting Findings: Engelbregt et al. (2022) observed a decrease in alpha in some subjects experiencing tingles, suggesting focused attention over general relaxation.

Attentional Concepts: Mindfulness, Flow, and Arousing Relaxation

  • Mindfulness: Trait mindfulness predicts frequency of ASMR induction. ASMR involves high present-moment awareness and "observing" but lacks the non-judgmental detachment of classical mindfulness (del Campo, 2019; Scofield, 2019).

  • Flow State: A state of focus and immersion activity (Csikszentmihalyi, 1991). ASMR susceptibility is linked to greater flow experiences (Barratt & Davis, 2015).

  • Arousing Relaxation: A paradoxical blend of physiological markers:

    • Sympathetic activation: Increased skin conductance and pupil dilation.

    • Parasympathetic activation: Reduced heart rate.

    • This unique response could be explained by "directional fractionation" accompanying attention to the external environment (Libby et al., 1973).

  • Alertness Variability:

    • Phasic Alertness: Temporary high capacity to react to stimuli.

    • Tonic Alertness: Optimal vigilance lasting for extended time, co-occurring with relaxation and parasympathetic activity (Britton et al., 2014; Posner, 2008).

Socio-Emotional Dimensions: Co-presence and Social Grooming

  • Co-presence (Social Presence): The digital sensation of being with others and perceiving/being perceived by them (Zhao, 2003; Zappavigna, 2020).

  • Roleplay Characteristics: Personal attention through clinical settings (doctors, hairdressers) using binaural audio (mimicking human hearing with lateralized left/right microphones).

  • Social Grooming: In animals (social bonding via cleaning), grooming releases endorphins. ASMR may simulate this "affiliate behavior," facilitating well-being through digital intimacy (Dunbar, 2010; Poerio et al., 2018).

Sexuality and Sensuality in ASMR Content

  • Myths of ASMR: A common public perception exists that ASMR is inherently sexual (Brand, 2015). However, surveys show most listeners do not use it for sexual stimulation (Barratt et al., 2017).

  • Sensuality: Defined as pleasurable stimulation of senses (non-sexual) vs. sexual phenomena (Heathwood, 2007).

  • S-ASMR (Sexual ASMR): Distinguished from conventional ASMR by production techniques, linguistic choices, and "downcast framing" targeting the "male gaze" (Mulvey, 1975; Starr et al., 2020).

  • Chinese Government Ban: In 2018, ASMR was banned in China due to "vulgar" content being labeled as ASMR to circumvent pornography bans (SHDF, 2018).

  • S-ASMR frequently includes mouth sounds (kissing, breathing) and "ahegao" facial expressions (Starr et al., 2020). Such content is noted on platforms like Twitch.tv (e.g., Amouranth winning "Best ASMR Streamer" in 2021).

The Role of Expectancy, Placebo, and Context

  • The Expectancy Hypothesis: Cash et al. (2018) found that while non-users were susceptible to instruction-based expectancy (priming), actual ASMR users were not; their pre-existing "schemas" overrode experimental instructions.

  • Placebo in Roleplay: Ahuja & Ahuja (2019) argue that medical roleplays are effectively placebo interventions, reaping benefits of medical encounters without clinical substance.

  • Unintentional ASMR: Scenes not originally intended for ASMR (painting tutorials, actual medical exams) can induce tingles and could serve as more effective controls in study designs.

  • Contextual Sensitivity: ASMR is less likely to occur in noisy/stressful environments (Barratt et al., 2017). Semantic judgment plays a role, similar to how "ambiguous nature sounds" are only preferred if identified as natural (Haga et al., 2016; Van Hedger et al., 2019).

  • Control Factors: The ability to decide triggers and volume in videos (control and active participation) aids induction compared to real-life triggers occurring naturalistically.

Proposed Criteria for ASMR

  • Based on the review and the work of Roberts et al. (2019), characteristic features of ASMR include:

    1. Sensation (Tingling): Pleasant sensation often around the scalp/spine.

    2. Altered Consciousness: Deviation from regular waking function (time distortion, immersion).

    3. Relaxation: A marked presence of physiological or psychological calm.

    4. Positive Feelings: Satisfaction, aesthetic pleasure, or engagement.

    5. Context: Necessity of an environment conducive to immersion.

    6. Willingness to Experience: Predisposed belief and investment in the video's veracity.

Consumer Discussion and Qualitative Comments

  • Diya (2021) on YouTube: Noted that while a cousin's mouth sounds were "disgusting," the same sounds in a video (Frivolous Fox) were "satisfying."

  • Orfgorf (2020) on Reddit: Explicitly stated hatred for real-life chewing sounds/misophonia triggers but found ASMR enjoyable.

  • perk1444 (2020) on Reddit: Emphasized that "context matters a lot" for the transition from annoyance to pleasure.

  • Tyla Mchugh (2019) on YouTube: Remarked on the strangeness of hating loud chewing IRL while wanting "more more" when trying to sleep.