Alexithymia: Symptoms, Causes & Treatment Options
Emotions are a part of our everyday life. They’re an essential element of how we communicate with other people and how we make sense of the world around us. But for some people, recognizing or describing what they are feeling is far more difficult than it is for others.
This experience is known as “alexithymia.” While it doesn’t affect how deeply someone feels their emotions, it can be harder to recognize their own emotional cues or understand why they react the way they do in certain situations.
On this page, we’ll explore:
- What alexithymia is.
- The symptoms and potential causes of alexithymia.
- Whether alexithymia can be diagnosed.
- Treatment options for alexithymia.
- Where to find professional support.
What Is Alexithymia?
Alexithymia is a term used to describe difficulty in identifying, understanding, and expressing emotions.[1] It is also sometimes colloquially referred to as “emotional blindness.”
It’s important to highlight that a person experiencing alexithymia does not lack emotions, but instead finds it hard to recognize what they’re feeling and put those feelings into words.[2]
Originally, the word “alexithymia” comes from the Greek language – “a” means “without”, “lexis” means “word”, and “thymos” means “emotion.” So it roughly translates to “no words for emotions.” The term was first introduced in the early 1970s by Peter Sifneos, a psychiatrist and professor emeritus at Harvard Medical School.[3]
A person with alexithymia may know that something feels “off” but not be able to identify whether they are feeling:
- Anxious.
- Sad.
- Disappointed.
- Frustrated.
They may also find it difficult to connect physical sensations (like a tight chest or a racing heart) with the emotions causing them. Some people with alexithymia also struggle to recognize emotional cues in other people, meaning average social situations may be more challenging for them.
However, alexithymia is not considered a mental health disorder or a clinical diagnosis of its own. It is understood as a characteristic that can occur alongside some mental health, neurological, or developmental conditions.
For instance, alexithymia can occur in people with:
- Depression.
- Autism spectrum disorder.
- A traumatic brain injury.
Yet not everyone with these conditions will experience alexithymia.
While alexithymia is often not well known or well understood, it is more common than you might expect. In fact, research shows that around 10% of the general population experiences alexithymia, and that it may be more common in males than females.[4][5]
Symptoms of Alexithymia
Some of the most common signs of alexithymia include:
- Difficulty identifying your emotions accurately or precisely. You may know that something doesn’t feel right, but not be able to distinguish it as fear, anxiety, disappointment, anger, and so on.
- Finding it very uncomfortable or even impossible to describe your emotions to other people. For instance, you may describe physical sensations or simply say you are “fine” or “tired” without knowing how to explain the emotions behind the sensations.
- Having a more practical way of communicating, like describing events, routines, or ordinary details of your day rather than thoughts or feelings.
- Finding it hard to read people’s facial cues, tone of voice, or body language, which can lead to misunderstandings or awkwardness in relationships and social interactions.
- Finding your emotions hard to process, which can lead to higher levels of stress, often manifesting in physical symptoms like headaches, fatigue, muscle tension, and stomach discomfort.
Many people find it hard to process or explain their emotions at times. So it’s important to remember that simply experiencing one or two of these characteristics does not mean a person has alexithymia.
Alexithymia is different because these symptoms are persistent and affect a person’s daily life and relationships. For example, a person with alexithymia might find it hard to understand why they feel overwhelmed or distressed, which can make it more difficult for them to communicate their needs or seek support in difficult times.
Sometimes, friends, partners, or loved ones of people with alexithymia can also mistakenly interpret their communication challenges as apathy or disinterest, even when the person may care deeply.
What Causes Alexithymia?
Researchers don’t fully understand what causes alexithymia. However, current evidence suggests that it may develop through a combination of genetic, neurological, and environmental factors. Possible causes include:
- Early childhood experiences: People who grow up in environments with trauma, neglect, or chronic emotional stress may learn to disconnect from their emotions as a way to cope.
- Damage to the brain: Some studies suggest that damage or changes to the insula (the part of the brain involved in emotional processing) may contribute to alexithymia.[6]
- Genetics: Twin studies have found that alexithymia tends to run in families.[7] Some people may have a genetic predisposition to developing it, but genes do not explain the condition entirely.
Alexithymia also co-occurs with a number of conditions, and is particularly common among people with:
- Autism spectrum disorder (ASD): Some studies suggest that nearly 50% of people with ASD may also experience alexithymia. Many experts have also suggested that some of the emotional and empathy-related difficulties attributed to autism may actually be co-occurring alexithymia.[4]
- Depression and post-traumatic stress disorder (PTSD).
- Attention-deficit hyperactivity disorder (ADHD).
- Neurological conditions and brain injuries, including Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, epilepsy, stroke, and traumatic brain injury.[8]
Researchers continue to learn more about alexithymia, but it is clear that there is no single explanation for why and how it develops.
Mission Connection is here to help you or your loved one take the next steps towards an improved mental well-being.
Can Alexithymia Be Diagnosed?
Since alexithymia is not listed as a condition in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) and is not considered a mental health disorder on its own, it cannot be diagnosed through a single test.
However, a qualified mental health professional can assess whether someone shows significant alexithymic traits. For this, they usually perform a detailed clinical evaluation, in which they ask about the person’s:
- Emotional experiences.
- Coping strategies.
- Relationships.
- Symptoms of other mental health conditions.
In some cases, a clinician may also use standardized questionnaires to support their assessment.[9] These may include the following:
- Twenty-Item Toronto Alexithymia Scale (TAS-20): A commonly used screening questionnaire that measures a person’s ability to describe and identify emotions, and whether they can distinguish emotions from physical sensations.
- Bermond–Vorst Alexithymia Questionnaire (BVAQ): A 40-item questionnaire measuring a person’s ability to identify, analyze, and verbalize emotions. It also measures emotional responsiveness and imagination.
- Observer Alexithymia Scale (OAS): An assessment completed by someone who knows the person well (rather than the person suspected of having alexithymia answering the questions themselves).
Usually, clinicians use these assessments to understand how emotional processing difficulties are affecting a person’s life, rather than assigning a formal diagnosis of alexithymia.
Also, since alexithymia often occurs alongside conditions like autism spectrum disorder, depression, or trauma, an assessment is important to determine whether another condition is contributing to someone’s difficulty with emotional processing.
Treatment of Alexithymia
There is currently no single treatment or “cure” for alexithymia. Researchers are still working to better understand how alexithymia works, so no specific therapy or treatment has been proven to work for everyone.
That being said, many people can benefit from working with a mental health professional. Professional support can be especially helpful if alexithymia is affecting someone’s relationships or is occurring with mental health conditions such as:
For example, some therapeutic approaches a clinician might choose to use include:[10]
- Cognitive behavioral therapy (CBT).
- Dialectical behavior therapy (DBT).
- Psychotherapy.
- Group therapy.
The “best” approach for you or a loved one will come down to the potential causes of emotional processing issues.
Rather than attempting to “fix” alexithymia, treatment can help people build emotional awareness, recognize physical signs of emotion, and learn to express their thoughts and feelings to other people.
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Get Professional Support for Alexithymia at Mission Connection
If you feel like you’re “just bad at emotions” or that emotional conversations always seem harder than they should, you don’t have to continue feeling this way. Healthy emotional awareness and processing is a skill that can very much be developed at any stage in life.
At Mission Connection, our team of licensed mental health professionals goes beyond traditional treatment and provides life-changing care. We offer several options for effective outpatient treatment, including in-person programs at our locations in California, Virginia, and Washington, virtual telehealth, and a hybrid program that combines in-person and virtual care.
We create a structured, personalized care plan for every patient that consists of evidence-based therapies and medication management when appropriate. Mission Connection is Joint Commission-accredited. We also accept most major insurance providers, so that your recovery is not hindered due to financial issues.
Reach out to us online or call us at 866-833-1822 to find out how we can support your long-term recovery.
Alexithymia FAQ
If you suspect that you or a loved one has alexithymia, you may have some ongoing questions. To help provide clarity, we’ve answered some questions we commonly receive below.
Can you have alexithymia and still feel emotions?
Absolutely, yes. People with alexithymia can still feel their emotions. But their difficulties may arise from recognizing, interpreting, or expressing what they’re feeling to others.
What does alexithymia feel like?
Alexithymia can feel like something is going on, but an unsureness of what. For instance, someone with it might be able to tell they’re uncomfortable, but find it hard to name why.
Can alexithymia go away?
With the right support, techniques, and practice, people with alexithymia can learn how to recognize, understand, and process their emotions – at any stage of life.
Professional support for dealing with the issue may be especially important if it stems from mental health conditions like depression or neurodevelopmental conditions such as ASD.