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When Emotions Hold No Meaning: Alexithymia

By Rimsha Shakeel


Introduction


Alexithymia translates to "no words for emotions" in Greek. Those with alexithymia have difficulty expressing and identifying emotions and feelings. They often present an impoverished narrative style. For instance, complaining about their physical health when they are feeling down. Such individuals often struggle in maintaining relationships due to their limited emotional functioning.


Alexithymia is a personality trait associated with various illnesses rather than a syndrome or disorder on its own. It has been found that symptoms for alexithymia begin to develop after experiencing traumatic events. It was first described by Peter E Sifneos in 1975 while treating patients with psychosomatic illness. Research shows that the trait is linked to psychological disorders like posttraumatic stress disorders, personality disorders, substance abuse disorders, depression, eating disorders and many more. It has been conceptualized as a deficit in cognitive processing and regulation of emotional states. Alexithymia is often misinterpreted as autism. While those who are autistic are more likely to exhibit traits of alexithymia, research has shown that the correlation between the two are inconclusive.


Causes


There have been multiple theories that attempt to explain the underlying causes of alexithymia. Some say that it is genetic; others say that it is a result of damage to the amygdala or environmental factors.


Diagnosis


Diagnosis for alexithymia includes questionnaires and scales:


Toronto Alexithymia Scale (TAS-20):

A 20-item, self-report scale widely used to measure alexithymia. It has three subscales:

  • Difficulty describing feelings -(5 items).

  • Difficulty identifying feelings- (7 items).

  • Externally-oriented thinking- (8 items).

The Bermond Vorst Alexithymia scale (BVAQ)

A 40-item questionnaire that follows five subscales:

  • Emotionalizing

  • Fantasizing

  • Identifying

  • Analyzing

  • Verbalizing

The Observer Alexithymia Scale (OAS):

A 33-item that follows five subscale-

  • Distant

  • Insightful

  • Somatizing

  • Humorless

  • Rigid

Treatment


There isn't a single treatment for alexithymia. According to Sifneos, traditional responses like psychoanalysis, a form of therapy that aims to treat mental disorders by bringing unconscious and conscious elements of our mind together, has not been proven to be effective. Since alexithymia occurs along with other mental disorders, treatment for such disorders can help reduce alexithymia.


Dialectical behavioral therapy, a form of cognitive behavioral therapy that tries to identify and change negative thinking patterns can help develop emotional literacy. Daily habits like journaling, taking part in expressive activities (art, music, dance, or acting) and reading novels can help. Tools like the emotional wheel developed by psychologist Rober Plutchik can allow you to learn about different emotions in varying degrees of complexity.


Building healthy relationships with those you trust is described to be a powerful healing tool for alexithymia. You could build a relationship with a friend or your therapist. They can help you identify what emotions you're feeling and provide an environment where you feel safe enough to express your emotions. This process can take time to show improvement.


References


What to know about alexithymia- Medical News Today https://www.medicalnewstoday.com/articles/326451#diagnosis

Toronto assessment Scale- ACBS https://contextualscience.org/TAS_Measure

Alexithymia: Do you know what you feel?- Psychology Today https://www.psychologytoday.com/us/blog/living-emotional-intensity/202102/alexithymia-do-you-know-what-you-feel#:~:text=Alexithymia%2C%20derived%20from%20the%20Greek,with%20feeling%20and%20expressing%20emotions.

Alexithymia and Autism Spectrum Disorder: a complex relationship- NIH https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6056680/

A Behavioural Analytical Interpretation- NIH https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4248666/

All About Alexithymia, or Difficulty in Recognizing Feelings- Healthline https://www.healthline.com/health/autism/alexithymia


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