Alexithymia – Alexi what??

So, let me start with a definition of Alexithymia and where it first came from to describe an emotional/mental health condition. Note I say condition, as it is not seen as a specific diagnosis of a disorder.

It is not a widely known term in the world of emotional/mental health.

It can be seen as a “generalised deficit of interoception” – the inability to detect changes of your own internal state. It can be defined as personality trait – that is part of someone’s behaviour – permanent or triggered.

It is made up of the Greek words meaning: ‘lack of words for emotions’.

The term alexithymia was coined by psychotherapists John Case Nemiah and Peter Sifneos in 1972 after working with their patients for over 20 years. They used the word to describe a variety of symptoms shown in their clients that were unable to identify and express or describe their feelings, or show understanding/empathy for others.

It does however also feature in Freudian psychodynamic literature.

It is thought that 1 in 10 people struggle to recognise their own emotions.

New research suggests a link between our inability to sense our physical bodies and then connecting how we feel. And if we are not in the body of others, then we cannot therefore show understanding toward them either.

As I have spoken about previously, emotions are our driving factor to act. If we are unable to understand our own emotions then we can act out of context, over the top or not at all. The same way our reaction towards someone else may seem strange or inappropriate.

If I do not understand how I feel, or how you feel then my reaction may not suit the situation.
It also isn’t that alexithymic people don’t have emotions. They do, they just have no idea what it is they feel.

It can also be linked to autism, but not all alexithymic people are autistic and vice versa (around 50% of autistic people are also alexithymic).

With depression, some people may only know their negative emotions and find it hard to connect with positives.

Anxiety may be excitement, but if you only know anxiety then that is how you may think you feel leading to panic attacks.

Many people with alexithymia struggle in relationships with spouses, friends, and family and are especially likely to create conflict due to their difficulties in recognising the impacts their words and deeds have on others, or avoid any type of conflict resolution whatsoever.

What are the causes?

Well, to be honest, most researchers do not have a definitive answer to this, but it is highly linked with environmental factors in childhood and is often associated with trauma and neglect from a young age. It can also be related to severe physical or emotional trauma affecting the brain in later life.

One link to this is that it is more common in people that have parents with the same issues, so you don’t ‘learn emotions’. If, as a child you are not taught how to manage your emotions, shown how to self soothe or understand how you feel, you will likely grow up with a problem.

As you know, emotions can overwhelm you at times and if we are not sure how to manage them or name them then we can choose to disconnect from them, as this is easier than feeling.

Our brain is remarkably good at keeping us safe from pain and will disconnect from it if it deems this the most suitable
response. Unfortunately, shutting away from painful emotions can also lead to a disconnect to feeling at all.

If in childhood we are subjected to varying levels of emotional stress then their ability to decipher and understand them will be compromised without help.

Also, if a child is isolated from contact or is sent away to manage their emotions on their own, it can impact on their ability to understand how they feel.

The response you get from people when you feel as a child will generally dictate how you use that emotion in the future. If it confuses you then it is likely easier to avoid it and perhaps then disassociate from it. When it comes back in later life then you will not recognise it or be able to distinguish it from others.

You could also start to pretend that you feel certain things. If your parents want you to be happy all of the time then you may decide to do this.

As an adult you may just go around being happy, never in touch with your real feelings as this is what you learnt. This is what you ‘should’ do! In general, you can only keep up this pretence for so long before it becomes difficult to maintain.

Therefore, your emotions will never feel real of congruent. You may be very good at some emotions that you do recognise, so they may become your default ones.

People with alexithymia will find it difficult to be authentic and eventually the mask of the emotion that they have chosen they ‘should’ keep up will fall.

Symptoms of Alexithymia include:

• The inability to talk about your emotions or the emotions of others
• Difficulty reacting appropriately to other people’s emotions
• Struggling with empathy
• Being seen as unsentimental/excessively logical (but still being perceived as friendly/likeable)
• Rarely daydream/fantasize, lack creativity and/or imagination
• Suffer physiological reactions such as palpitations, stomach ache or hot flushes.

These features are offered only as a guide and are no substitute for proper assessment.

Treatment for Alexithymia

Understanding your relationships as a child and the reasons why you may have difficulty connecting with and understanding your emotions is a good first step.

Sitting with and writing down what happens emotionally and physically in your body and then reflecting on the circumstances can help to pin point what you may actually be feeling.

It is generally thought to be an issue with the wiring in your brain and we can always create new wiring. Neuroplasticity shows that we can create new neurones by carrying out new tasks consistently. This can help to re-connect within yourself.

Mindful activities will allow you to be present in the moment of your emotions.

If the connections in the brain have been severely disrupted it can be difficult to re-engage this part of the brain.
Do not punish yourself, or someone with this issue. Trying to understand what is going on is key.

Speak to a professional who can help you work through things.

Anti-depressants have been seen to useful in some extreme cases as the emotions are more easily managed as they do not escalate as much.

Questioning how people feel will give a better insight into the emotional and physical cues, don’t guess or assume. So just ask (I think this last one is also something we can all do).

The fall out in relationships because of Alexithymia can be difficult and it will have a major impact. In fact, any kind of emotional disturbance can have deep and long-term effects.

As a Transformational Relationship Coach, it is one of my priorities to help you to understand yourself and others, in order to have the healthiest and happiest relationships possible.

Please feel free to comment and if you would like to discuss this issue in more detail then contact me directly on here, call 07709 350019 or email

I look forward to hearing from you.

In the meantime, be good to yourself.


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