Human beings are created to go through different emotions. It is such that we have found a name for almost everything we are going through. We are able to differentiate when we are angry from when we are sad or just stressed. But what if this process is disrupted and there are people who struggle to identify what they are feeling? What do we call it?
What is alexithymia?
Alexithymia is a psychological trait that involves difficulty identifying and describing your emotions. A person may know that something is happening inside them but struggle to understand exactly what the feeling is or put it into words. It is not simply a lack of vocabulary or poor communication, and it does not mean that the person has no emotions. Alexithymia exists on a spectrum, meaning that the difficulty can be mild for some people and more pronounced for others.
Many people may experience some of these difficulties without knowing there is a name for them.
According to an NIH-hosted review, alexithymia is a construct involving disrupted emotional awareness. It can make it difficult for a person to identify their feelings, describe them, and sometimes distinguish an emotion from the physical sensations that come with it, such as a racing heart, tight stomach or other bodily reactions. It is also linked to difficulties with emotional awareness and processing.
It is also important to understand that alexithymia does not mean a person cannot physically experience an emotion. Their body can still react. They may cry, feel their heart race, become tense or feel uncomfortable. The difficulty may be in recognising what that reaction means emotionally and being able to convey it.
Imagine someone getting home after a difficult day at work and suddenly feeling a tightness in their chest. They know something is wrong, but when a friend asks, “Are you okay?”, all they can say is, “I don't know.” They aren't sure whether they are angry, sad, anxious, disappointed, or simply tired. They may even become frustrated because they can feel the emotion but cannot find the words to explain it. This difficulty recognising and describing what is happening inside them is one way alexithymia can show up in everyday life.
What causes alexithymia?
There is no single cause of alexithymia. It is understood as a complex trait that can be influenced by different factors, including biological, psychological and developmental factors. Alexithymia can occur in people with mental or neurological conditions as well as in people without a diagnosed condition.
This means that struggling to identify or describe your emotions does not automatically mean you have a mental illness. For some people, it may simply be a long-standing difficulty with understanding and processing emotions.
Alexithymia and other mental health conditions
Alexithymia can occur alongside various mental health conditions, including depression, anxiety, PTSD and eating disorders. This does not mean that alexithymia is a symptom of these conditions. Rather, they can involve some overlapping difficulties with expressing emotions.
People with higher levels of alexithymia are more likely to experience anxiety, self-harm, substance use and other difficulties. One possible reason is that when a person has difficulty recognising and understanding what they feel, it may also be harder to know what they need, seek appropriate support or choose healthy ways to cope.
Signs of alexithymia
Alexithymia can be difficult to recognise because it does not mean a person lacks emotions. Instead, a person may experience emotions without being able to easily identify, understand or describe them. Some signs and experiences may include:
- Emotional confusion
- Difficulty identifying emotions
- Difficulty expressing emotions
- Difficulty describing feelings
- Limited emotional vocabulary
- Physical-emotional disconnect
- Difficulty showing affection
- Discomfort with emotional conversations
- Trouble understanding reactions
- Focusing on facts
- Feeling emotionally disconnected
- Difficulty recognising others’ emotions
- Frustration with feelings
How can you cope with alexithymia?
These are not things that will necessarily cure alexithymia. They are ways of becoming more aware of your emotions and making everyday emotional experiences easier to understand and communicate.
1. Pay attention to your body's signals
Notice changes such as a racing heart, tense muscles, tears, stomach discomfort or changes in your breathing. Instead of dismissing them, ask yourself what happened before you noticed the reaction and whether an emotion could be connected to it.
2. Build your emotional vocabulary
If you can only describe your emotions in very general terms, give yourself more options. Learning words such as frustrated, disappointed, embarrassed, overwhelmed, lonely or worried can make it easier to identify what you are experiencing.
3. Keep an emotion journal
Journaling can also help you pay closer attention to your emotions. Write about what happened, what you felt in your body, how you responded and what emotion you think may have been involved. Doing this regularly can help you recognise patterns that you may not have noticed before.
4. Use an emotions chart or feelings wheel
An emotions wheel is a visual tool that shows different emotions, often starting with basic feelings and branching into more specific ones. Looking through the different words can help you narrow down what you may be experiencing, especially when you know you feel something but cannot quite name it.
5. Give yourself time before responding
If you tend to react before understanding what is happening emotionally, pause when possible. Taking a little time to notice your thoughts, body and surroundings can help you respond rather than simply react.
When to seek professional help
You do not have to wait until you are in crisis before seeking help. If difficulty understanding your emotions is affecting your relationships, work, daily life or ability to cope, talking to a mental health professional can help you understand what you are experiencing.
Therapy can provide a space to explore emotions without having to already know how to explain them. A professional can also help you understand whether these difficulties are connected to alexithymia, another mental-health concern, or a physical condition, and help you find approaches that may be useful.
That feels less repetitive and more purposeful: first paragraph = when to seek help; second = what professional help can actually do.
Frequently asked questions
Is alexithymia a mental illness?
No. Alexithymia is generally described as a psychological construct or trait rather than a standalone mental illness or psychiatric diagnosis.
Can people with alexithymia feel emotions?
Yes. A person with alexithymia can experience emotions and physical reactions to emotions. The difficulty is often in identifying, understanding or describing what they are feeling.
Can alexithymia be treated?
Alexithymia can improve with psychological interventions for some people. Research has examined approaches including CBT and other forms of therapy, although there is no single standard treatment for everyone.
Does having alexithymia mean I have depression or anxiety?
No. Alexithymia can occur alongside depression, anxiety and other conditions, but having difficulty identifying your emotions does not automatically mean you have any of them.
