Sunday, May 07, 2006

Alexithymia: What the Heck *Is* That?

Many believe that recognizing emotions is an automatic thing.

An instinct.

A given.

But, actually, there are many people who have trouble identifying their own feelings.

The clinical name for this is "Alexithymia" ~pronounced (Alex-ee-time-eeya) .

People who experience Alexithymia are unable to recognize their own emotions and their subtleties, to understand or describe these emotions, and they sometimes misunderstand the emotional experience of others.

Alexithymia was coined from the Greek word LEXIS, ("word") and THYMOS ("feelings"), and literally means "a lack of words for feelings".

Alexithymia has not been a well publicized issue and most professionals as well as non-professionals know little or nothing about it.

Alexithymia is not a disorder, but is seen as a trait. Some characteristics noted are:

*Difficulty identifying different types of feelings

*Difficulty distinguishing between emotional feelings and bodily feelings

* Limited understanding of what caused the feelings

* Difficulty verbalizing feelings

* Limited imagination

* Functional, constricted style of thinking

* Physical complaints

* Lack of enjoyment and pleasure-seeking

* Stiffened posture and/or facial expressions

Many individuals who have Alexithymia can sometimes find themselves doing counterproductive non-verbal activities to communicate their feelings. Activities like cutting, or breaking things, engaging in drinking or dabbling in drug use, for example. Learning to recognize feelings to productively verbalize and communicate is the goal here. And the goal is also to find productive non-verbal activities like art, exercise, and sports to allow for more meaningful experiences in life.

Alexithymia is not something to be afraid of. If you experience this, or know someone who does, there are ways to learn how to strengthen skills. Often a speech language therapist and/or a mental health professional can help to show you the way.

Taylor, G. J., & Bagby, R. M. (2000) An overview of the alexithymia construct, in ed. R. Bar-On & J. D. A. Parker, The Handbook of Emotional Intelligence, San Francisco: Jossey-Bass Inc., Ch.3, pp.41-67.


The Mass Defective said...

(Raising hand) I have this problem. Goes with the emotional dysregulation of my borderline. Luckily the next section of my DBT group discusses managing emotions. Maybe I'll learn something.

I do like that wheel of emotions. I should make something like that so I can warn my folks how I think I maybe feeling.

Take care,

Wanda's Wings said...

Intresting. How is it different from "just shut down" emotions to "protect" oneself

Dreaming again said...

(continuing Wanda's question here...) or a refusal to accept emotions as a part of life. Especially negative emotions.

Ian Lidster said...

When I was addictions counselling I ran into a number of clients who were assuredly alexithymic, and as you suggest, it was one of the elements that led them into abuse of alcohol and/or drugs. When first confronted with the condition, I was a bit confused by what was happening, so I did a bit of research on the subject at the time. Interesting to see it brought up again. God, I would have loved to have you as a resource person when I was in that line of work.

Nancy said...

is this like a form of Asperger Syndrome. My 13 year old neice who was abopted has been diagnosed with Aspergers, but her mom who is a nurse knew from the first few months that something was wrong. She never made eye contact and had a hard time coping with simple things. She use to have what I called "melt downs" for no reason. Now that we understand her frustrations life is most of the time on an even scale, but she still has her moments and probably always will. But she is has been the love our our family for 13 years. We have all learned from her. we are not all made the same, thank goodness.
take care

Traci said...

Shit. I spent my entire life being told how I felt and how I didn't feel. If I said I was angry, my parents would say "No you're not." If I said I was hungry, my parents said "No you're not." If I said I needed to cry, my parents said "No you don't." Are we seeing a pattern here? Now when someone asks me how I feel about anything, I literally have to stop and THINK about it. Sometimes the words and thoughts just leave my head totally and that is not an exaggeration. My therapist once said to me "You mean that quiet thing you do ISN'T about keeping things from me?!" I was like ummmmm DUH! So is this the same kind of thing?

jumpinginpuddles said...

has this ever been linked to autism ? Because they sound awfully familiar.

Leah said...

How interesting......I like the emotion wheel picture. I need one somewhere in my house so I can warn Em! HA!

Tai said...

Interesting stuff...I had heard of that before.
It CAN affect everyday life. Work, relationships; many things can suffer depending on the degree of the problem I'd think.

Meow said...

I ask the same question as other commenters ... is this related to Autism, or Aspergers ?? I have dealt with people with both, and they often share these characteristics you describe ??

Fallen Angels said...

I have similar experiences to Traci. After 4 1/2 years of therapy I am very slowly beginning to identify simple emotions.

Rose said...

I seen children who have autism with this condition. Outside of that, I haven't worked with or heard much alexithymia.

Deb S. said...

Very informational. I've learned something new today. I wonder if there is any way of determining the demographics of Americans who possess this trait.

kath said...

I had a vague idea of this ... but thank the gods do not suffer from it myself..

I cannot imagine how dreadful it must be.. one must feel so alone and shut out...

Tiesha said...

Great post! This is important information and a great consideration for nurses. Especially when people have trouble distinguishing between emotional and physical feelings. They may voice and emotion when feeling pain and I could see how pain management can be effected by something like this. It also provokes some insight abut things like cutting. I deal with a lot of that.

Beth said...

I'd never heard of that before, very interesting!

(unrelated - Have you read "The Mummy at the Dining Room Table?" I can't remember the authors. If you haven't, you should!)


Dr. Deborah Serani said...

Dear Sid @ Mass,
It is really great that you are in a DBT group and this is a subject that is covered. It *is* hard to identify and express, but so wonderful that you are in there workin' it.

Dear Wanda,
It is very different. Repression or other such defense mechanisms can protect emotions from being felt or expressed. Alexithymia is a true a puzzle, a real challenge for the person.

Dear Dreaming,
Again, denial, repression, suppression....these are defenses that keep trauma or unpleasant experiences from our awareness. Alexithymia is different.

Dear Ian,
It has been thought that those who need to numb themselves with drugs, alcohol or self-harm may have Alexithymia. I often agree, and work on helping such individuals learn the subtleties of their emotions. Many of us take for granted that we can feel the edges of emotions so well. Others cannot, and it is a struggle in many areas of their life. Sounds like you did alot of great work in the addiction field :)

Dear Nancy,
What an important question. Alexithymia is very much apart of the autism spectrum. There seems to be neurobiological components for Alexithymia as well as learned components that come from the psychological, social and cultural arenas.

Dear Traci,
I hear you. And it is a terrible thing to realize this. As the research keeps showing us Alexithymia has several origins. Yours was a learned one.You were told what to think, how to feel, and denied a great deal of you own personal experience. It is good that you see this now. And I feel that your fury and regret will fuel your healing. Entitlement is yours, my friend.

Dear JIP,
The trait of Alexithymia is present in the autism spectrum.

Dear Leah,
I think there is a market in there for this! Instead of "Look at the hand" we could say, "Look at the wheel".

Dear Tai,
I know that I experienced this as a young girl. Therapy helped me to fine tune my awareness. What a difference it makes when you can learn how to identify, feel, express and notice emotions.

Dear Meow,
Yup. You are right. It is a trait that is often associate with the autism spectrum. Many who do not have autism experience it as well. Alexithymia knows no boundaries.

Dear Fallen,
This is wonderful. Late is better than never :)

Dear Rose,
I am betting that you will notice more with others now. One need not have autism to have Alexithymia. I know that my hubby has great difficutly knowing and feeling his own emotional experiences.

Dear DCS,
Actually, I think some research is being done. I have felt that the culture of the United States is creating more Alexithymia in individuals. Children do not learn the social and emotional spheres of life like long ago. They are on the internet, they socialize less in person. They play video games where they face the tv and not each other. Things like this fail to teach children how to learn the cues of observing others. So , I think you raise a really great question. I am thinking that countries that have less technology may have less Alexithymia.

Dear McKait,
It is heartbreaking when I work with someone who cannot express their feelings to me. I know that it is not a ploy or a withholding when this happens. I liken the therapy to teaching a person a new language.

Dear Tiesha,
People who cut or self-harm often have Alexithymia. I agree that in the medical field, it would be great for professionals like yourself to be aware of Alexithymia. Sometimes individuals can't describe what they are feeling. Not that they are not intelligent or being manipulative. Often the cut represents the emotion that the person cannot express.


Dr. Deborah Serani said...

Dear Beth,
Putting that book on my list! Thanks.


dragonflyfilly said...

wow, sounds a bit like my ex-husband! ... no, just joking...well, he was never diagnosed, but.....

very good post, thanks!

i used to have the problem long time ago, when i thought i was sad and i cried a lot, but one day came to the astonishing realization (at a weight watcher's meeting!) that i was not crying because i was sad, but because i was angry...after that i had no problems loosing that excess weight...very interesting i thought...

alan said...

Saw a chart something like this hanging next to someone's job station at work and wondered what it was all about!

Thank you!


survivor said...

Thanks for the post. This is something I think I will talk to my counsellor about.

I'm not sure if I have this problem, when I first started therapy I couldn't identify any feelings, with much patience from my T and over a year of working together, I'm starting to identify feelings but now I'm also in denial and trying to block out those feelings!

The feeling wheel is awesome! I use feeling faces to help me identify the unknowns...

Sarebear said...

Sometimes I wonder if most men would fit into this! (C'mon, husband, talk about your feelings . . . .)

I hope you take that in the humor it's intended in, and not as a rude joke . . . (like I was offended when seeing that someone had named a set of beads they had made, Skitzo).

Sarebear said...

Actually, not that I can, or should, diagnose my husband, but he literally can't really tell me how he's feeling most of the time. Basic frustration, yeah, cause I frustrate him alot, but only when it's built up over aLONG time, or is one of our hot button issues. And, of course, he says he loves me.

Seriously, I find myself questioning him, the same way I gently probe with my high-functioning autistic daughter, to find out what's going on with what he/she is thinking/feeling, to try and figure out. I do this w/daughter so I can help her, because I know that often what is really going on is far different than what it LOOKS like is going on.

I AM SO FRUSTRATED with my husband being this way; he needs to learn to talk about his feelings. I misread him so much of the time it's practically all the time, as far as thinking he's angry, and he's not. But I can't NOT try to "read" him, because w/my anxiety disorder I have to try to figure out what's going on or I'll feel like I'm lost, like a big wave could crash down on me if I don't try to control it. If I figure out that he's angry (or think/misread that he is) at least then I can steel myself for something (which, generally, I guess, is not coming lol!). My anxieties make me do this.

Anyway, that was very rambly but perhaps a little picture of living with someone who doesn't have WORDS to describe what's going inside them, who seems to be searching for what they are feeling so they can tell me but can't seem to connect with anything, even though they are clearly feeling SOMETHING.

UGH. So when I make my joke, it's a humorous way of me trying to destress about living with him, NOT ridiculing anyone with it. Just to clear that up. 8^D

Sunnie Dee said...

I like many others have an extrememly hard time identifying what I am feeling but I believe its more because for years I wouldn't let myself feel anything. I still remember when I first started seeing a shrink and he would say "how are you feeling" and I couldn't even say what I was feeling

Carolina Introvert said...

Once again, your timing is amazing. Today in my therapy session, my therapist asked if I had been feeling "tired" or "depressed". I wasn't sure - they feel the same to me! She asked me to describe what I had been feeling and I don't have the right words. imagination? Physical complaints? Those aren't me. I just don't know how I feel and I don't know why I feel that way.

Chris said...

I have always thought that I just "shut down" feelings because it was easier to feel nothing than to hurt. I went through a long period after I lost my Mom that I couldn't feel happy or sad. When my husband started asking me about it, I realized that I had been doing this to a certain degree since I was a child (pretty crappy childhood). I finally figured out that I was just protecting myself from being hurt or scared like I was when I was small. I still find myself doing that at times without even realizing that I have slipped into that again.

Dr. Deborah Serani said...

Dear Dragonfly,
Sounds like you had a moment of really isolating a particular feeling. And it sure gave you liberation. How great!

Dear Alan,
They have posters like this in schools also. Never too soon to learna and differntiate emotions.

Dear Survivor,
Sounds to me that you and your T are doing great work together. So happy to know that :)

Dear Sarebear,
I agree some men can fall into this. Research has shown us that men and women are wired differently and process emotions and experiences differently as well. The humor is appreciated and not rude at all.

Dear Sonnie,
The good thing is that you are trying to do that now :)

Dear Carolina,
Tired and depressed are not the same, but can be part of the same experience. How's that for confusing. But, to understand emotional fatigue and sadness and the layers within are good things to learn. It's amazing the subtleties are feelings possess.

Dear Chris,
Shutting down may have been easier a long time ago. But what is deemed good in the short run often has fallout in the long run. I am glad that you are finding your voice now.


difficult patient said...

This sounds like a common trait of people with Asperger Syndrome . . .

healthpsych said...

Another really interesting subject. Thanks! I'd really like to get my hand on one of those wheels - perhaps then my husband could at least indicate what he's feeling even if he can't quite verbalise it!

A Flowered Purse said...

You know I get all my feelings lumped into one thing ANXIETY EEK EEK EEK
If i am angry, ill think its anxiety, sad anxiety, happy anxiety. I can't tell any difference between those emotions and anxiety except a few things like crying or smiling! you always choose such cool topics dr deb!
Have a great week

Leesa said...

Never heard of alexithymia. Cool name for the disorder, though.

brooklyn babe said...

Interesting... can I use this to call out of work?

mysti said...

I have never heard of Alexithymia. I know I might have it. Truthfully I am not sure. I also know that I have only been told that I have problems recognising my feelings is do to the fact I blocked out my feelings for so long I have lost the ability to know what I am feeling or how to describe what I am feeling. So do I have Alexithymia? Sounds like I do. Thank you for another wonderful topic.

Dr. Deborah Serani said...

Dear DP,
Yes, and other individuals who do not fall in the autism spectrum do as well.

Dear Healthpsych,
You made me LOL!

Dear Dianna,
Sometimes our reflext emotions get the best of us. I tend to be depressed, so sometimes I feel sad at first. Then I go deeper to feel the edges of an emotion. Sounds like you have that experience too.

Dear Leesa,
I think the origins of many names are interesting. But then again, I love words.

Dear Brooklyn Babe,
Hmmm. not sure, but you can give it a try :)

Dear Mysti,
Dissociation and detachment, which sounds to me like what you are describing, are different experiences.... but there can be Alexithymic quality. Just keep trying to feel, experience, label your emotions. Sounds like you are really doing good work :)


Rue said...

Really? I have never heard of this. Wow..that's very interesting. Although I have to think that alot more men have this trait then women ;) but I'm just being naughty!

Heidi said...

Very Interesting and thought provoking..You know the saying.. "You learn something new every day"..Coming here it's atleast once a week :) And that's a good thing!

astrorat said...

my my.. i didnet know that there was such a thing :D *oppss* fake psychologist lives up to the name.. ;)

Dr. Deborah Serani said...

Dear Rue,
I think that is true. The wiring of the male and female brain is different. Some of the theories of Alexithymia are neurobiological.

Dear Heidi,
I am a teacher at heart :)

Dear Astro,
Nah, you're not fake. There are things in the psychological field that I am not aware of. Doesn't make me or you fake. Makes me and you just human. We can't know everything :)


Dawn said...

I feel really stupid, when I can't figure out what emotion I'm feeling. i think to myself, how could i not know,these things are taught to us when we're very small; it's really aggravating.

i wish there were a wheel to spin every day, to *tell* me how to feel, like a jackpot-that'd be cool :)

thanks for the info :)

Miranda said...

Is this a hereditary trait?

Moof said...

Dr. Serani, how can this be distinguished from Asperger Syndrome?

Also, wouldn't this cause the same relational problems in families as AS would? (For example - Cassandra Affective disorder ... )

Todd and in Charge said...

Doc, would this fall within the autistic or Asperger's spectrum? Is it a data processing issue?

Ms.L said...

Very Interesting!
Kind of sounds like my hubby...hmmm

Cathy said...

VERY interesting! I am quite certain I don't have this, but it might help me to understand better some people who might!

Dinah said...
This comment has been removed by a blog administrator.
Dinah said...

Just to say Hi and thanks for visiting our new Blog...
The shrinks at Shrink Rap

Godwhacker said...

I learn something new virtually every time I read this blog ~ Thanks Deborah!

Mr. Death said...

That's a neat article...I think I can identify on some level or another, but it sounds a lot like my friend Allen.

Id it is said...

I'd never have known of the existence of such a condition! Interestingly informative.

Gina said...

I used to have trouble placing names on the emotions I was feeling. Today I am much better, but what you are saying is so true. If I am under a lot of stress I can still have a difficult time putting names on what I am feeling. At this time in my life one of my life's dreams is to be as healthy as I possibly can be .. mentally, emotionally, physically, financially, etc.

I was searching the web on how I could better achieve my life's
dreams and came upon your site. I found another site that has helped me tremendously and thought
you and your readers might be interested. The site is by Marcia Wieder. is the site. She is also giving away a maui dream retreat that I think would be the perfect place to renew, rejuvinate, restore, and set attainable goals!! Our world is changing so much that I am convinced the only way we can be successful and happy is to find our passion(s). Marcia helps in not only finding our passion but setting attainable goals to achieve our life dreams. This was not an easy concept for me to grasp because I seemed to have turned off many of my feelings at a young age. Today I have dreams and feelings with names and goals that go along with my passions.

Again, thank you for sharing and for such good information!!

May your day be filled richly with blessings and joy!


Dr. Deborah Serani said...

Dear Dawn,
It is not stupidity or ignorance or anything like that....and you must not make yourself feel badly. Alexithymia is a real thing. I think many people can learn the "language" of emotions. And I know you will!.

Dear Miranda,
Hmmm.....good question. I don't have research to say yes or no. But, I believe that it is.

Dear Moof,
Asperger's is part of the autism spectrum, and there are many other symptoms and behaviors to AD. Many people who have Alexithymia do not have any autism spectrum issues. The two may be related in the areas of brain processesing that help us to receive cues and make sense of them. Cassandra AD is not recongized "clinically" in the DSM. But I can see why you ask that question. Alexithymic individuals may have site specific areas of the brain that make learning and understanding social and emotional cues harder for them.

Dear Todd,
Yes, it is related to the autism spectrum, but one need not have an autistic disorder to have Alexithymia. In a sense, it is very much a data processing issue.

Dear Ms.L,

Dear Cathy,
I hope that this post CAN help others be more patient with those who may not be as emotionally aware.

Dear Dinah,
Good luck in your launching.

Dear Godwhacker,
And I learn at yours as well :)

Hey Johnny,
So glad you found the post helpful.

Dear Id It Is,
Actually, many in my own profession do not know that there is a name for not knowing or feeling emotions. I thought it would make a good post.

Dear Gina,
I will check out your site as well as the maui one. The best thing about blogging for me is meeting new people, exchanging ideas and sharing. Makes the world seem a lot smaller, which is so nice.


Nurse Practitioners Save Lives said...

That's interesting. I've never heard of that. Emotions are an integral part of humanity and expressing them can mean very different things in different areas.
I put a link to you on my other blog.. check it out at Nurse Practitioner News

Dr. Deborah Serani said...

Dear NPSL,
Thanks for the link. I will check out your other blog now. I didn't know you had another one!


Putti Angel said...

Wow, I know I'm throwing my two cents in rather late, but I just want to thank you for this amazing post!!! I remember sitting in a psychologist's office a few years ago and her asking me what I was feeling as tears were running down my face... and I honestly couldn't tell her, I had no idea what I was feeling in that moment... and she just sat there telling me that I "had to know what I was feeling, just think harder, just try harder to get in touch with my emotions"... All she did was make me feel like more of a failure because I really could not answer her question no matter how hard I tried... i think I gave up and just rattled off some emotions to shut her up... :(

Thank you for letting me know that I'm not emotionally stupid, and that it really is possible for me to not be able to identify and label my emotions... I thought I was just a dunce...

dixonpa1 said...

I am so glad that you are posting information about Alexthymia because it is fairly unknown and can impair one's quality of life. There is a great website that can help people gain more information. Also I think it needs to be said that more psychologist need to become aware of this trait, because it could and proably should significantly affect the way they provide treatment services. I

Dr. Deborah Serani said...

Dear Putty,
I am glad that you now know what it is you experience. Hope you'll visit again.

Dear Dixon,
Many of my colleagues were unaware of the term Alexithymia. I was surprised!


I'm Stranger than Fiction said...

I realise this is quite an old post, but I just had to comment. I didn't realise there was a name for what I go through!

At one of my hospitalisations for depression, I was given a 'feelings list' which helped tremendously! I was finally able to put names to emotions that I felt.

Anonymous said...

That sounds a bit like me.

I have had so many conversations where somebody has asked me how I feel/felt and all I can do is "ummm...", or make wild guesses. If I am pressed I just kind of melt down.

Anonymous said...

I donøt know if I have this.. Really. Sometimes I donøt feel anything. I don't knowif this sounds stupid, but ever since I was with a girl, I didnøt love, I have had these moments, where all my emotions kind of disappeared.. I canøt really explain how it feels, cause I don't feel it. That's kind of the point. I know how I might feel, in the situations it appears, but I canøt feel it myself. it's lige guessing what another person might feel.. I know this sounds wierd, and maybe i'm wrong, but can you 'break' your feelings?