Alexithymia is a personality construct characterized by the subclinical inability to identify and describe emotions in the self. The core characteristics of alexithymia are marked dysfunction in emotional awareness, social attachment, and interpersonal relating. Furthermore, individuals with high levels of alexithymia have difficulty distinguishing and appreciating the emotions of others, which is thought to lead to unempathic and ineffective emotional responding. Alexithymia is prevalent in approximately 10% of the general population and is known to be comorbid with a number of psychiatric conditions.
What is Alexithymia?
Alexithymia literally means “without words for emotions”. It refers to the inability to identify and describe emotions in the self. The core characteristics of alexithymia are:
- Difficulty identifying feelings and distinguishing between feelings and the bodily sensations of emotional arousal
- Difficulty describing feelings to other people
- Constricted imaginal processes, as evidenced by a scarcity of fantasies
- A stimulus-bound, externally oriented cognitive style
People with alexithymia have trouble recognizing and verbalizing their own emotions. They tend to lack imagination and intuition. Their thinking is concrete, literal, and reality-based.
Alexithymia occurs in about 10% of the general population and is known to be comorbid with a number of psychiatric conditions.
What Causes Alexithymia?
The causes of alexithymia are not fully understood, but research suggests that both biological and psychological factors play a role:
- Genetics – Twin studies indicate that genetics account for 30-33% of variance in alexithymia.
- Altered brain structure – Some studies have found less activation in the anterior cingulate cortex and insula among alexithymic individuals. These areas are involved in emotional processing.
- Altered hemispheric function – Increased right hemispheric activation and reduced interhemispheric communication have been observed.
So there is some evidence that the brains of people with alexithymia may be structured and function differently than those without alexithymia.
- Early childhood trauma – Neglect, abuse, loss of a parent, and dysfunctional family environments in childhood have been linked to alexithymia.
- Insecure attachment – Insecure and disorganized attachment styles often lead to problems identifying and describing emotions.
- Modeling deficits – Individuals may not have had adequate modeling of emotional expression and regulation as children.
Psychological trauma and disruptions in early caregiving experiences can impair the development of emotional awareness and expression.
Types of Trauma Linked to Alexithymia
A number of different types of childhood trauma have been associated with alexithymia:
Being the victim of violence, assault, and physical punishment as a child is linked to difficulties identifying and describing feelings later in life. Abuse likely impairs the development of emotional self-awareness.
Survivors of childhood sexual abuse often struggle to make sense of their emotional pain. They tend to disconnect from their feelings as a way of coping. This can lead to alexithymia.
When caregivers fail to provide adequate emotional nurturance and support, children do not learn how to understand or express their feelings. Emotional neglect is a strong predictor of alexithymia.
Losing a parent or experiencing prolonged separation can be traumatic. The resulting distress and insecure attachment takes a toll on a child’s emotional development.
Growing up in a home with domestic violence often forces children to repress their feelings. The constant atmosphere of fear and danger requires emotional constriction.
Being bullied leads to feelings of fear, anger and shame that children struggle to process. Victims of bullying can become alexithymic later in life.
|Type of Trauma
|Impact on Emotional Development
|Impairs emotional self-awareness
|Forces disconnection from feelings
|Fails to teach emotional understanding
|Disrupts emotional development
|Requires repression of feelings
|Overwhelms capacity to process emotions
Impact of Alexithymia
Alexithymia can have wide-ranging effects on mental health and interpersonal functioning:
- Difficulty regulating emotions – Prone to anxiety, depression, anger, substance abuse, eating disorders, panic, etc.
- Impaired social skills – Struggle reading social cues, communicating, relating to others.
- Problems with intimacy – Challenges with emotional intimacy and attachments in relationships.
- Somatic complaints – Increased complaints of physical symptoms related to stress/emotion.
- Lower quality of life – Poorer psychological well-being and life satisfaction.
Alexithymia is associated with increased mental health and interpersonal problems. Treatment is aimed at improving emotion regulation skills.
Treatments for Alexithymia
Though challenging to treat, alexithymia is amenable to improvement through psychological interventions:
Talk therapy provides a chance to identify, acknowledge and put words to feelings. This enhances emotional awareness and expression.
Learning about emotions, their triggers and physical manifestations improves emotional literacy.
Techniques like meditation, mindfulness, yoga and deep breathing help patients focus on inner experiences.
Sharing with others with similar struggles reduces isolation and provides modeling of emotional communication.
Creative Arts Therapies
Art, music and dance therapy access emotions through non-verbal creative expression.
With professional help, individuals can learn to become more attuned to, accepting of and articulate about their inner emotional world.
Alexithymia appears to arise largely from early childhood trauma and disrupted attachment experiences. Abuse, loss, neglect, witnessing domestic violence and dysfunctional family environments can all impair emotional development. This results in a core deficit in the ability to identify, describe and process feelings.
People with alexithymia suffer increased mental health problems, difficulties with relationships, and an impoverished quality of life. Though challenging, psychological interventions aimed at enhancing emotional awareness and expression show promise in ameliorating alexithymia. With care and compassion, emotional recovery and growth are possible.