Alexithymia

📖 Overview

Alexithymia is a neurological difference characterised by difficulty identifying, understanding, and describing emotions — both in oneself and in others. It is not the absence of emotion. People with alexithymia feel emotions, but the internal signalling system that translates physical sensations into recognised emotional states does not work in the typical way.

The term comes from the Greek meaning "no words for feelings." People with alexithymia may notice a physical sensation — tight chest, stomach knot, physical tension — without being able to identify what emotion that sensation represents. When asked how they feel, the honest answer is often "I don't know."

Alexithymia is present in a significant proportion of autistic people — estimates suggest 50% or more — but it also occurs independently of autism. It is not the same as having no empathy. Many people with alexithymia care deeply about others and have strong moral instincts — they simply cannot access their own emotional states easily.

Alexithymia affects relationships, as partners and family members may interpret the difficulty with emotional expression as coldness or lack of care. It affects mental and physical health, as people with alexithymia may not notice or report emotional distress until it becomes physical. It affects therapy and support, as approaches that rely on identifying and discussing feelings may be difficult to access.

Emotion charts, body scan exercises, keeping a physical sensation diary, and working backwards from physical sensations to possible emotions are strategies that can help. Therapy needs to be adapted for alexithymia rather than assuming standard emotional literacy approaches will work.