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
- Brewer, R., Cook, R., & Bird, G. (2016). Alexithymia: A general deficit of interoception. Royal Society Open Science, 3(10), 150664.
- Levant, R. F., Hall, R. J., Williams, C. M., & Hasan, N. T. (2009). Gender differences in alexithymia. Psychology of Men & Masculinity, (3), 190.
- Parker, J. D., Taylor, G. J., & Bagby, R. M. (2001). The relationship between emotional intelligence and alexithymia. Personality and Individual Differences, 30(1), 107-115.
- Taylor, G. J., & Bagby, R. M. (2004). New trends in alexithymia research. Psychotherapy and Psychosomatics, 73(2), 68-77.
- Vanheule, S., Desmet, M., Meganck, R., & Bogaerts, S. (2007). Alexithymia and interpersonal problems. Journal of Clinical Psychology, 63(1), 109-117.
- Wikipedia: Alexithymia
There’s more on emotions in the post Identifying Emotions.
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.
What confuses me a bit is that ‘Alexithymia involves an inability to identify and describe emotions’ as you said but does it mean that there are no (little) feelings present? Because when it’s expressing emotions in a gradual way by wording them or ‘working them through’ (imo) that would be a problem also for BPD.
On something completely different, the last article you referenced is written in my university. Stijn Vanheule was a starting assistant when I graduated.
Oh interesting!
I think it’s more of a recognition issue rather than emotional numbness or lack of emotion, and the inability to articulate in words stems from an inability to recognize internal sensations in the first place.
Research is not easy on that subject I think. On the other hand emotions and sensations can make things complicated. Most of people are not used to interact without (many) emotions, so that creates some problems.
Good point.
This is really interesting! I do have some this to some degree – particularly when it comes to negative emotions (identifying and exploring negative emotions is something I’ve been trying to work on in therapy actually). I hadn’t realized there was a term for this and so much research on it!
That’s good that you’re working on that with your therapist.
I find it interesting that you say that BPD seems to be the opposite of alexithymia. Honestly I disagree, because even though people with alexithymia have trouble identifying feelings, they can have strong emotions. I for one scored high on an alexithymia scale some years ago, even though I also have BPD (traits). Then again, I mostly scored high on the inability to describe emotions and pretty low on the aphantasia and disinterest in emotions things. I can’t remember wh ich the scales really were, so sorry for my vague comment.
That definitely makes sense.
Oh, I think my comment landed in the spam queue. I elaborated a bit on my personal e xperience with some traits of alexithymia as well as BPD. Too lazy to type it out again.
It showed up.
Interesting. In the autism support group/course I went to for 10 weeks last year, we did a session on differences in recognising emotions. I was absolutely astounded to learn that some people in the group could mistake e.g. hunger for anxiety! They simply had to ‘remember’ to eat, apparently! It’s impossible to imagine, especially since hunger comes with a lot of other cues too— rumbling in your stomach, fatigue, lower concentration.
We had a piece of paper with an outline of a person on it, and were asked to label emotions to parts of the body. I could do it with very high fidelity, and I had a lot to write! I think I am the opposite of alexithymic (is there an adjective for it?).
But it was very useful for understanding other members of my family. I can see that some of them must experience this quite strongly, especially my dad, and therefore with understanding my own emotions. I can totally see how alexithymia would lead to having low emotional intelligence.
Interesting labeling exercise.
Yeah :). I realised that I feel frustration/anger in the whole of my body, like it becomes energised. Also when maximally contented (after vigorous whole-body exercise), I feel that in my whole body. Exercise had the beautiful effect of turning that seething anger/rage into a beautiful feeling of contentedness. Cannot describe that! Euphoric/nirvana.
Nice!
Oh good. Something else I may have.
Very interesting! I certainly struggle with identifying some of my emotions. I avoid them a lot, but they always find a way to grab my attention
They’re like a bad smell that way. You can spray Febreeze, but the smell is still there.
“Interoception helps you understand and feel what’s going on inside your body. For instance, you know if your heart is beating fast or if you need to breathe more deeply. You’re able to tell if you need to use the bathroom. You know if you’re hungry, full, hot, cold, thirsty, nauseated, itchy or ticklish.” I just got this bit on google somewhere.
And it’s making me think – cos since I got TM, which is lesions on my spine, I have this – I don’t know when to go to the bathroom, or when I’m hungry or full up. Basically the lesions on my spine stop messages getting from my body to my brain i.e. I can scald myself and have a massive blister, but not know it. And vice versa, the message from my brain i.e. bend my toes doesn’t work – I can’t bend them lol.
Sorry to ramble, but the point I’m making is that if I was born with these lesions, and couldn’t feel burns etc, I wonder if I’d have the alexithymia? So, I’m also wondering about that point ‘nature or nurture’ in alexithymia?
Very interesting questions.
This is an interesting term to come across
🙂 Thanks to you, I now know what alexithymia is.
Very interesting! Had never heard of that illness before now! Thanks for sharing!! Tanya
You know…I’m wondering if this could be part of Borderline too? Very interesting post!
Thanks!
Great post and article! I am very well acquainted with this one, as it is one of my personality traits. It took me a really long time to find out what it was though and like how it related to me. It was really relieving when I did come to know more of it and what it meant etc.
I hate to correct you, but autism spectrum disorder is not a mental illness. Or at least to me it’s not. 🙂 I even argue with society it is not even a disorder. Though the spectru is very wide and it can be viewed as a disorder. My personal autism is not a disorder as I truly believe it is an important part of me and it made me who I am today. I embrace it. It sucks some days, but it has given me many gifts….one being I am totally cool with social distancing right now. 😛 (kinda joking on that last one haha)
I definitely get what you mean. I should probably have said DSM diagnoses.
No worries, you are all good! I just saw that and it was like a glaring error I felt I had to point out. But like I know you meant well and I know what you meant.
Reading this was insightful. I sometimes have times where I’m unable to describe how I’m feeling. People would ask me what’s wrong and I would never be able to tell them. I know that something isn’t right but I just can’t describe the feeling. It’s interesting, I never knew it had a name until now.
Yeah it’s not something that seems to be talked much about, yet probably quite a few people experience it.
Hopefully more research will be done on it. It’s a very interesting topic.
I agree.
I believe I have it. I often spend therapy sessions trying to identify how I feel… My trademark sentences are “I feel weird”, “I don’t know how I feel” and “I feel bad/yucky”. Last session, I spent 45 minutes(!!!) going on about my family dynamics, unable to answer “How do you feel?” until my therapist was like “you’re clearly feeling very helpless”.
I used to be unable to identify shame, sadness, anger… my body would exhibit things, if asked I could say “my chest feels heavy” but I couldn’t ID it as “sadness” or “anger” or “shame” for a very long time
That sort of brings to mind the title of Bessel van der Kolk’s book The Body Keeps the Score.
A good book! I ought to reread it. I’ve learned that if I start fidgeting in a VERY specific way (I never fidget like that in other scenarios) while reading something, it means I’ve unresolved stuff being brought up 😂😂
I still haven’t gotten around to reading it, although it’s been on my to read list for quite a while.
It’s very heavy to read due to the content though it isn’t very academic. I’ve witnessed a lot of people in Facebook support groups reporting that they find their brains “skipping over” passages. Like they read but their brain doesn’t take it in.
That makes sense.