Despite the steady interest in ASMR, we have to admit that today the nature of the effect and the mechanism of action on the human psyche are still poorly studied. Publications for the period from 2015 to 2019 in scientific journals, where, one way or another, the topic of ASMR is touched - only about two dozen. And, unfortunately, the most important aspect - the ASMR safety aspect for the human psyche, has not been practically studied.
In this article we will try to understand the potential threats posed by ASMR and how to avoid negative consequences. Safe ASMR can be considered if all the factors of negative consequences when listening to it are minimized.
We decided to start our analysis of the potential threats that ASMR is fraught with with binaural sound. This is due to the production process of ASMR content, which, as a rule, is recorded in binaural form, that is, with the help of two microphones, which creates for a person a feeling of close proximity to a sound source 
The mechanism of action of binaural sound in humans
Today, the theme of binaural sounds is still popular - every day tens of thousands of people visit dedicated Internet resources to get acquainted and try this phenomenon in action. Usually binaural recording is performed using binaural microphones, with sensitivity and directional patterns similar to human hearing, the location of which mimics the anatomical structure of the human hearing organs.
When playing a binaural recording, a person perceives the sound as three-dimensional, that is, a person creates feelings of close proximity to the sound source, “volume” and sound direction. These effects occur due to the binaural sound recording mechanism. The binaural recording takes into account the basic elements of physical acoustics, including the difference in signal intensity between the ears (IID - interaural intensive difference), the interaural difference in signal arrival time (ITD - Interaural time difference) and the head transfer function (HRTF - Head related transfer function). 
It is important to understand the difference between stereo sound and binaural sound: unlike binaural sound recording, stereo recording does not take into account the natural distance between the ears, the “sound shadow” (the area where the sound is not heard) and the reflection of sound from the head and ears, which make changes in sound propagation.
Among the entire spectrum of binaural sounds, binaural rhythms are most common. The essence of binaural rhythms is that if you act on the brain with a sound of a certain frequency, then this sound will resonate with the corresponding rhythm of the brain, which will lead to an increase in a certain state of consciousness. Low-frequency monophonic sound (when the same signal plays in both headphones) is not enough for this, since a person may not hear it for physiological reasons (a person hears in the range from 20 Hz to 20 kHz). Therefore, for binaural beats, two-channel recording of sounds from an audible frequency range is used - separately for the left and right channel. The sound frequency in both channels should be close to each other, but not the same, for example, 1200 Hz and 1210 Hz. Typically, the frequency difference does not exceed 25 Hz. When listening to such recordings in the brain, there is a “mixing” of frequencies from the left and right channels, which subjectively a person perceives as a pulsation of sound. This ripple occurs in the upper olive (it is responsible for the transmission of acoustic information) located in the brain stem, and the resonant response goes to the quadruple area of the medulla oblongata (participates in the integration of sensory sensations from the eyes and hearing organs). The ripple frequency is respectively equal to the frequency difference between the two channels. If the difference between the frequencies is too large, then the person will simply hear both signals. From the point of view of acoustics, the “mixing” (superposition) of two sounds of a similar frequency and the same phase creates a secondary low-frequency signal with a frequency equal to the difference between the sounds in the left and right channels.
Simply put, a person hears not two real signals, but a “phantom” - a derivative sound created by the brain.  
Thus, this “phantom” acts on brain waves, thereby stimulating them to a certain state.  
The picture shows the binaural rhythm perception mechanism.
Separately, it is worth mentioning the so-called audio drugs. In essence, they are binaural beats and are positioned as sounds that cause a euphoric state similar to the effect of using real drugs. However, scientific evidence of this kind of impact on humans to this day does not exist. 
Relationship with Mental Disorders
Binaural rhythms can disrupt the normal activity of brain waves and their balance, which will lead to negative consequences for the psychophysical state of a person.
The corresponding types of disturbances in the activity of brain waves lead to the following consequences:
As far back as the 30s of the last century, British neuropathologist MacDonald Crichley described a series of cases in each of which music became the cause of the epileptic seizure. This effect was called - "Musical epilepsy." The researcher noted that epilepsy attacks were provoked not only by music with a clearly defined rhythm, but also by other musical compositions, regardless of tonality, types of musical instruments, etc.
Listening to binaural beats with a high degree of probability can cause an overload of sensory mechanisms and, as a result, provoke meltdown in people with autism spectrum disorders.
Well-known cases of negative effects of visual and sound effects on the psychophysical state of a person, which once again demonstrates the close relationship of sensory (visual and auditory) perception with impaired brain activity.
In 1997, an episode of "Pokemon" was shown on Japanese TV, in which there was a 5-second scene with a blinking red and blue sky. Consequences of varying severity (in the form of asthma attacks and seizures) were manifested in 12950 children. Symptoms were similar to an attack of epilepsy. The reason is a rapidly changing picture with frequencies occupying the 4-10 Hz band, affecting the frequency band of the alpha rhythm (8-10 Hz) - the leading rhythm of the brain. It turned out that chromatic flickering, with changes in contrast of more than 20%, is dangerous. Further studies have highlighted a new subcategory - chromatic epilepsy.
In the early 60s, pulsating light at discotheques came into fashion. As a result, a series of epileptic seizures on dance floors and discos.
In 1966, at the premiere of the experimental film “The Flicker” at the New York Festival, some spectators recorded cases of hallucinations and headaches. 
Hearing Health and ASMR
Ideally, a person should equally perceive sound with both ears. However, due to disturbed noise ecology, widespread use of headphones among young people, etc. the hearing health of the world's population has deteriorated sharply. According to WHO, more than 1 billion young people are at risk for hearing loss. Often, lowering the thresholds of sound perception occurs with a violation of the balance of sound perception.
It turns out that a person hears with one ear better than with the other. This negatively affects the binaural perception of sound - in humans, the mechanism of localization of its source is weakened. When listening to binaural recordings, the imbalance of the thresholds of sound perception between the ears distorts the very mechanism of perception of this kind of sound. Since binaural rhythms act on brain waves due to the derivative sound created by the brain, distortion of the perception of sound between the left and right ears will lead to negative consequences for the mental and physical condition of a person (headaches and migraines, cramps, distracted attention, provoking schizophrenia attacks, etc. .d.).   
The picture below shows an example of unequal sound perception.
The impact of headphones and recording conditions
For binaural beats, it is imperative that the phases of the signals supplied to the left and right channels are the same. Violation of the phases will lead to an incorrect interpretation by the brain of the sound information supplied to it, and, as a result, to a negative effect on the psychophysical state of a person.
The degradation of the headphone speakers that occurs as they are used will distort the signal level in the channels, which in its essence is similar to violating the thresholds of sound perception in humans.
Also, the cause of the imbalance can be a leaky fit of the headphones, problems with the contacts in the headphone jack, incorrect phasing of the headphones (factory defect), distortions in the system mixer or audio player (for example, incorrectly set parameters), distortions in the frequency response of the headphones (factory defect). The danger can be caused not only by the sound reproduction system, but also directly by the violation of conditions during sound recording. Such violations include the wrong choice of microphones, the scatter of the parameters of a sound recorder, etc.
Negative effects when listening to ASMR and their causes
One of the most common consequences of listening to excessively loud sound in headphones, including ASMR, is hearing loss. As a rule, people increase the overall volume of the sound, rather than the specific components of the signal that are worse heard, which leads to a deterioration in the thresholds of sound perception and the further development of hearing loss.
Frequency-dependent amplification methods allow you to adjust the volume level of the weakly audible components of the signal and balance the sound between the ears. The basis for these methods are the parameters of the sound perception of a particular person (audiogram). The essence of frequency-dependent amplification is to amplify not the entire frequency range, but the individual components of the sound to an audible level, taking into account the non-linearity of human hearing and the concept of equal volume. In this case, sound processing is performed for the left and right ear separately, which allows you to restore balance in the perception of sound.
Other reasons for the negative consequences when listening to ASMR due to distorted perception of binaural sound include:
- Headphone imbalance (phase disruption, speaker degradation, headphone leakage)
- Imbalance of thresholds of auditory perception between the ears,
- Distortions in the system mixer / audio player
- Violations when recording sound (incorrect selection of microphones, scatter of microphone parameters).
These factors can lead to disturbances in the activity of brain waves, which can cause mental disorders (for example, schizophrenia, epilepsy, the development of depressive conditions) and a deterioration in a person’s physical condition (for example, headaches and migraines, heart palpitations).
It is worth noting that these negative consequences and their causes are not manifested in all people and may be temporary.
You can improve security while listening to ASMR:
- Using headphones and players that personalize and balance the audio signal, depending on the levels of sound perception of the user. You can protect yourself from disturbances in binaural sound perception and protect your hearing from excessively high volume levels.
- Using high-quality headphones from famous brands
- Browsing the ASMR content of proven ASMR tists who follow the necessary rules when choosing recording equipment and in the recording process
- Immediately interrupting an ASMR listening session at the first sign of physical ailment or negative emotional manifestations