What Is… Alexithymia

head with cogs inside

In this series, I dig a little deeper into the meaning of psychology-related terms. This week’s term is alexithymia.

Alexithymia involves an inability to identify and describe emotions. It’s considered a personality trait that can be present to varying degrees and is relatively stable over time. It’s been associated with a number of DSM diagnoses including autism spectrum disorder, depression, PTSD, and eating disorders, but it’s not an illness in and of itself.

I’ve written before about emotional intelligence, and low emotional intelligence is associated with high alexithymia. While the two constructs have a lot of overlap, they’re still considered to be separate things.

Besides difficulty identifying bodily sensations related to emotion, people with alexithymia tend to have problems interpreting internal sensations in general, which is known as interoceptive impairment. A study by Brewer and colleagues found that interoceptive impairment was consistent in alexithymic individuals regardless of whether or not mental illness was also present.

Possible causes

The role of nature vs. nurture is unclear. There have been a number of studies that identified areas of the brain that may be involved, but it doesn’t look like there have been any definitive conclusions.

Some studies have been done that looked at a link to attachment, but nothing has been clearly established. People who are alexithymic may be more likely to have difficulties in interpersonal relationships, specifically in the areas of being cold/distant and nonassertive.

The “normative male alexithymia” hypothesis suggested that it’s a product of gender role socialization.  A meta-analysis conducted by Levant and colleagues found that alexithymia is more common in males than females, but the difference is small, which would suggest that gender socialization isn’t a major factor.

Measurement

The Toronto Alexithymia Scale seems to be the most often used measurement test, but it’s proprietary, so instead I’ll link to the Perth Alexithymia Questionnaire. Scoring is a bit of a production, but your raw score really isn’t all that meaningful anyway. Simply answering the questions will give you a pretty good idea of whether or not you lean in an alexithymic direction.

Management

Since alexithymia isn’t considered an illness, it doesn’t have a treatment. When I was looking to find articles on this subject, most of them related to whether or not being alexithymic would get in the way of treatment for other conditions (there didn’t seem to be any definitive conclusions on that). One paper I saw said that psychodynamic therapy was helpful, but I’m not convinced of the reliability of that particular source. However, it appears that a lot of the research that’s looked at the nurture factor is done from a psychoanalytic theoretical perspective.

I find the range of different human experiences fascinating. Is alexithymia something that you think you have to some degree or another?

References

There’s more on emotions in the post Identifying Emotions.

The Psychology Corner: Insights into psychology and psychological tests

The Psychology Corner has an overview of terms covered in the What Is… series, along with a collection of scientifically validated psychological tests.

Ashley L. Peterson

BScPharm BSN MPN

Ashley is a former mental health nurse and pharmacist and the author of four books.

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