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Alexithymia, associated with autism, depression, PTSD, and eating disorders, is a state of being in which people find it very hard to identify and describe their own feelings and those of others. Could you be alexithymic?

Do you think you're not able to identify and verbalize your emotions the same way others can? Do you often have difficulty deducing how another person is feeling, perhaps being baffled by the idea that they expect you to correctly interpret their feelings even though they haven't outright told you what they need?

Alayna, a woman on the autism spectrum, knows what it's like to deal with emotional blindness. She says:

"I think of my emotions as a video that buffers for a really long time, only to start playing really loudly while you're in the bathroom. That's to say, I do have a vague general sense of whether I am feeling 'good' or 'bad', but finer details hit me much later — minutes, hours, days, or even months later. When things weren't going well at work, I noticed that I felt bad physically before I could identify the underlying emotion. Actually, my therapist told me I was anxious. I didn't know."​

If you have no idea what she's talking about, you can be pretty sure that you don't have alexithymia. If it sounds familiar, though, you may be interested to know that there is, indeed, a term for your way of processing emotions.

Alexi What?

Alexithymia. This pleasant-sounding word comes from three Greek words, namely those for "no", "word", and either "emotion" or "mood" [1], which could perhaps be translated into English roughly as "trouble with emotions". Some people also describe it as "emotion-blindness".

Alexithymia isn't a stand-alone mental disorder, but the experience of finding it difficult to identify and verbalize their own emotions as well as those of others [2]. Some say that people with alexithymia also have an "impoverished fantasy and imaginal life". Sometimes, being unable to distinguish bodily sensations from emotions ("my stomach hurts" as opposed to "I feel anxious") is another part of alexithymia. [3]

Alexithymia has been linked to a multitude of different conditions, including:

  • The autism spectrum, particularly that part of the spectrum that was previously labeled "Asperger's Syndrome". [3]
  • Post-traumatic stress disorder. 
  • Depression.
  • Substance abuse and addiction. [4]
  • Eating disorders (anorexia nervosa and bulimia nervosa). [5]

(This list isn't exhaustive but it does show, I think, that alexithymia isn't always something you're born with — you can develop it later in life if you're exposed to trauma. In some cases, this will also mean that the alexithymia is temporary.)

What Does That Actually Mean?

So far, so dry, and so very abstract and meaningless, right? I thought so too, and that's why I spoke to some people who can shed some light on what it might be like to live with alexithymia or with someone else who has it. 

Greg, the father of an eight-year-old autistic boy, says that his son describes every negative emotion or physical experience in the same way: "I don't feel so good." This is his go-to phrase, whether he's really tired, has a cold, his pet hamster just died, or he's just broken his arm. The boy is able to match pictures of graphics displaying certain emotions (happy, sad, scared) to the right emotions, but doesn't see how they apply to him personally. 

Alayna, who already shared some key features of her alexithymia, additionally shares:

"My alexithymia does not mean that I do not care about other people, by the way. It does mean that I find it really difficult to understand how someone else is feeling. This is especially true because neurotypical people often don't say what they mean, but expect you to be able to read between the lines. I can't do that, and your facial expressions and body language do not tell me much either."

Kate, who grew up in an abusive family, was diagnosed with PTSD, and has a history of depression, isn't sure whether or not she has alexithymia. She does believe that her emotions become "numbed" when she is depressed. Rather than reacting emotionally to those things most people would find profound, she feels nothing, or something unidentifiable. 

"I don't know if this is alexithymia, but I do strongly suspect it's just a coping mechanism. Feeling the feels has never served me well and just creates more pain. While other people experience sadness, cry, feel angry, feel outraged, and so on, my emotional fuse just blows and I don't feel much at all. If this is alexithymia, I am sure it's only one end of a spectrum. When I'm feeling healthier, I think I experience emotions quite normally."

Could You Have Alexithymia?

That's a tough one, right? You don't know, for sure, how your own experience differs from that of other people. You're not in their brain. Those people who have been told that they react strangely to emotional situations, are often asked to elaborate on their feelings and find themselves unable to do so, or realize that insights into their own emotional states often show up after the fact may wonder if they could have alexithymia, however. 

If you were to talk to a psychologist about it, you'd most likely encounter the so-called Toronto Alexithymia scale, which assesses three different areas related to alexithymia: difficulty identifying feelings, difficulty describing feelings, and concrete (as opposed to abstract) thinking, also called externally-oriented feeling. [6]

You may answer "yes" to rather a few of the following questions if you do have alexithymia:

  • I am often confused about what emotion I am feeling. 
  • When I am upset, I don't know if I am sad, frightened, or angry. 
  • I have feelings I can't quite identify. 
  • When I'm angry, I often don't know why. 
  • It's hard for me to find the right words to describe my feelings. 
  • People tell me to describe my feelings in more detail. 
  • I find it hard to reveal my innermost feelings, even to those I am closest to. [7]

Kate was right that alexithymia exists on a spectrum, and should you have it — as around 10 percent of the population does to a greater or lesser extent [8] — you may find that you struggle more in one area than another. You might know full well why you're angry, but still have difficulty explaining it to other people. You may find yourself in a neutral emotional state much of the time, only to suddenly be "hit" with feelings. No two people with alexithymia are the same. 

Is There Treatment For Alexithymia?

That depends on its underlying cause. People who have become alexithymic as a result of major depression will often regain their previous affective functioning after receiving treatment for the depression, research shows [9]. It is not a far stretch to speculate that the same is likely true in people with post-traumatic stress syndrome. 

For others, such as many adults on the autism spectrum, alexithymia is permanent. That doesn't mean there is no way to overcome challenges you may experience as the result of your alexithymia, however. If you dislike talking about feelings, you may prefer cognitive behavioral therapy as a more practical and analytical way of tackling issues you experience — most likely in social contexts — as the result of alexithymia. [3]

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