Understanding Alexithymia: Why Some Individuals Struggle to Recognize Their Emotions

[Un article de The Conversation écrit par Jimmy Bordarie – Docteur, Maitre de conférences, Université de Tours, Alizée Richalley  – Doctorante en psychologie du développement, Université de Tours & Caroline à Giraudeau – Professeur des Universités en Psychologie du Développement, Université de Tours]

We often tend to think that we understand our emotions pretty well. However, using certain measurement instruments (Toronto scales), it is estimated that between 17 and 23 % of the population encounters major difficulties to identify and express their emotional states. This is called Alexithymia.

Despite its frequency, this peculiarity remains unknown to the general public, although it can negatively impact mental health, interpersonal relationships and more generally, the quality of life of the people concerned.

Note that to date, Alexithymia is not considered a disease. It is not mentioned in the last edition of Diagnosis and Statistical Manual of Mental Disorders (DSM-5), the manual ofAmerican Psychiatric Association which classifies mental pathologies, nor in the International Classification of Diseases (CIM-11) of the World Health Organization (WHO).

Etymology and history of the word “Alexithymia”

The term “Alexithymia”, derived from Greek has (without), lexis (word) and thymos (Mood, emotion) means “absence of words for emotions”. It was introduced in the 1970s by the psychiatrist Peter Sifneos. He designates a set of difficulties in identifying, describing and treating his own emotions.

To illustrate this, imagine that you are asked to describe a color that you have never seen – it is a situation closely close to the experience lived by an Alexithymic person when they try to explain what they feel.

Difficulties in identifying and describing your emotions

Research shows that alexithymia is linked to specificities in brain functioning, especially in areas involved in emotional treatment and self -awareness, such as the anterior insula and the prefrontal cortex.

Studies by neuroimaging have revealed reduced connectivity between these regions in Alexithymic people, which could represent a track to explain, in part, their difficulty in identifying and treating emotions.

Two types of alexithymia are mainly identified. Primary Alexithymia is considered a stable personality trait. Genetic or neurobiological and developmental factors seem to play a major role.

Secondary Alexithymia, on the other hand, appears following trauma, psychological stress, illnesses or mental health problems such as depression. It develops later in life and affects emotional treatment previously intact.

Emotions in the relationship with others and in the body

Alexithymia thus represents either a primary factor of personality which conditions a reaction unsuitable for stress, or a secondary factor with stressful situations, in which case it has a more defensive value. In any case, this emotional disconnection can affect interpersonal relationships.

It can be difficult for an alexithymic person to emotionally support a loved one even when she does not understand her own feelings. However, not understanding your emotions does not necessarily mean that one is alexitymic and that does not systematically have repercussions on physical or psychopathological health.

The people concerned know that emotions exist, but they find it difficult to discern or express them. Rather than describing specific emotions such as sadness, joy or anger, they often speak of general discomfort or feel out of step, without knowing why.

Sometimes they even feel physical symptoms linked to these misunderstood emotions. Because even if they struggle to verbalize their emotions, the Alexithymic people feel them. These unrecognized emotions can result in physical symptoms such as headache, stomach pain or fatigue – a phenomenon called somatization.

Indeed, when emotions cannot be expressed by words, they often manifest in the body, by unknowns or more or less localized pain. Moreover, some studies have shown that alexithymia is a vulnerability factor that affects general health, promotes depression, anxiety, and may constitute a risk factor for alcohol -dependence for example.

Lack of emotional warmth or defense mechanism?

An idea is to think that alexithymia is equivalent to a lack of emotional warmth. The difficulties encountered on the emotional level constitute two components of Alexithymia (the first is linked to the identification of emotions, the second is linked to their description), both associated with a third component (the operational thought open to the outside). The latter corresponds to a way of thinking turned towards the operational rather than the emotional.

Although the people concerned may seem detached, it is not a deliberate choice. Alexithymia is a cognitive difficulty which makes recognition and expression of emotions intrinsically complex. These individuals do not intentionally avoid their emotions, their brains treat them differently. If research on the involvement of the brain in Alexithymia has been able to lead to contradictory results, recent meta-analyzes consolidate the hypothesis of a neurobiological basis of Alexithymia.

In its secondary design, it could even constitute an unconscious defense mechanism, used to alleviate negative and painful emotions and/or to thwart the problematic consequences of certain stress factors.

“Heal” or learn to live with it?

Although Alexithymia is generally not healed since it is not a disease but a personality trait, in the same way as the hypersensitivity with which it is associated, there are ways to live better with.

Among the work on the subject, some studies point out that psychotherapy, in particular skills -based therapies, shows promising results. These therapies help individuals to recognize their emotions by focusing on their physical sensations and observable behaviors.

In addition, group or individual therapies can teach Alexithymic people to observe their internal states without judgment, gradually helping them to make the link between their bodily sensations and their emotions. Research continues on other therapeutic approaches.

Other studies are interested in therapies less centered on verbal expression, such as art therapy or music therapy. These approaches could offer Alexithymic people a way of better exploring and understanding their emotions, freeing themselves from the sometimes intimidating side of traditional therapies.

Understanding alexithymia for a more inclusive vision

Better understanding Alexithymia, its causes and its consequences, is a step towards a more inclusive and nuanced vision of emotional diversity. If the emotions are universal, our way of living them and expressing them is very individual. Recognizing these differences makes it possible to create benevolent and supporting environments for those who struggle to be in contact with their emotions.

Awareness of Alexithymia can also help to better understand the unique challenges that this characteristic implies, especially in interpersonal relationships, and trying to identify its origin would better understand its effects.