Difficulty Expressing Emotions in Adults: Causes, Symptoms, and Help
As we all know, emotions can be incredibly complex, so putting them into words can often feel very difficult. Still, most of us manage to do so when the situation calls for it. But some people find expressing emotions so difficult that it feels almost impossible to move beyond the most basic feelings.
However, in some cases, people may find identifying what they’re feeling to be an impassable challenge. This experience is known as “alexithymia,” a difficulty in recognising and expressing emotion.
Alexithymia can have a variety of causes and could be connected to
If you suspect that you or your loved one may be suffering from expressing emotion, this page will take you through:
- What difficulty expressing emotions can look like in adults
- What alexithymia means
- What causes alexithymia
- How alexithymia can affect daily life
- How alexithymia is treated
- How to tell if you have trouble expressing emotions
- Where to find treatment for alexithymia
What Does Difficulty Expressing Emotions In Adults Look Like?
It may seem like an odd place to start, as we all know what it’s like to stumble on our words to describe emotions, but it’s an area worth clearing up. The fact is, we all experience moments that are difficult to put into words. It could be seeing a beautiful sunset or meeting your firstborn for the first time. But it’s not just positive moments that take your words away; it could be something heartbreaking, like losing a loved one or being dismissed unexpectedly from your job.
These moments can leave anyone speechless and unsure how to articulate what they’re feeling, which is quite natural. So, if you’ve been through a sequence of events like these and find yourself stumbling over words to describe them, this doesn’t necessarily mean you have difficulty expressing emotions overall. What we’re focusing on here is when most emotions felt or recognized can’t be expressed on a regular basis.
If you’ve noticed that some of the signs below are happening on a regular basis, this may indicate something worth taking a closer look at:1
- Struggling to find the right words to describe feelings
- Avoiding emotional conversations with others
- Feeling detached during emotional experiences
- Shutting down when emotions start to surface
- Becoming tense when asked about personal feelings
- Feeling nothing in moments that should feel emotional
Naturally, the next question might be: Why does this happen, and what causes it? This is exactly what we’ll look at in the next section.
What Is Alexithymia?
Alexithymia is a term used to describe when a person finds it difficult to identify or express emotions.2 The word comes from a Greek meaning, which, when broken down, roughly translates to “no words for feelings,” something which accurately captures what it feels like to have alexithymic traits
The condition was originally identified in patients with psychosomatic disorders, but in the current day, it is estimated to affect around 10% of adults.3
Alexithymia symptoms may include:
- Difficulty identifying personal emotions
- Trouble distinguishing physical sensations
- Limited vocabulary to describe feelings
- Difficulty recognising emotions in others
- Appearing detached in emotional situations
- Preferring facts over emotional discussion
Alexithymia isn’t listed in the DSM-5 as a standalone diagnosis, but it’s still very much recognized by professionals. It has a high comorbidity with other mental health and psychiatric conditions like depression, anxiety, ptsd, autism spectrum disorder, and long-term stress,3 meaning it shouldn’t be dismissed.
What Are the Potential Causes of Alexithymia?
The cause of alexitymia is a tough one to unpack, especially when the evidence suggests we’re dealing with a chicken or the egg paradox…which one came first?
When scientists studied the biology of people with alexithymia, they found that certain genetic and neural factors can make a person more likely to have difficulty recognizing and describing emotions.4 In fact, it was found that genetic factors account for 42% of individual differences in alexithymia, with unshared environmental factors also playing an important role.
From a psychological and social perspective, early life adversity, emotionally distant family environments, and ongoing stress can also play a part in shaping alexithymic traits or making them worse.5 These experiences can teach someone to suppress emotions rather than understand or express them, which could continue into adulthood.
Yet, on the other side of the coin, alexithymia itself could contribute to mental and physical health problems.3,6 When emotions are hard to recognize, they’re also harder to regulate, which can leave a person more prone to distress or illness.
How Can Alexithymia Affect Daily Life?
Dealing with alexithymia may seem somewhat avoidable on the surface, especially if you’ve never experienced it yourself. It’s not really causing you or others any visible harm, so it’s not worth wasting time on getting a diagnosis, right?
Well, unfortunately, alexithymia can, in fact, impact many different areas of a person’s life and those around them. We discuss some of these impacts in the following sections.
Relationships and Social Life
Alexithymia has the ability to make relationships feel unbalanced, both for the person experiencing it and those around them.
For example, take someone who struggles to recognize when they should be more caring in situations where their partner is feeling sad. For the person with alexithymia, they’re not recognizing it’s their “turn” to lend a shoulder, while the “sad” partner is left wondering if the other even cares.
While this is just an example, you can start to see how it could cause couples communication issues, making it hard for people around them to sense a genuine connection.
Further, research backs this up, as it has found that people with alexithymia tend to experience low emotional empathy. This means they typically find it difficult to understand or share another person’s feelings.7 This doesn’t mean they lack compassion totally, but it may mean that the signals that guide empathy are harder to access. Emotional exchanges may feel one-sided, leaving others unsure where they stand.
Sudden Emotional Outburst
Managing any form of emotions starts with recognizing what the emotion itself actually is, but for someone with alexithymia, this step can be missing.8 When feelings go unnamed, they’re much harder to calm or redirect. So, instead of being processed gradually, they can build unnoticed beneath the surface until they spill out all at once.
Research shows that difficulty identifying emotions is linked to poor regulation and higher distress levels.8 For someone who can’t pinpoint what they’re feeling in the moment, small frustrations or tensions can accumulate until they turn into sudden anger or complete withdrawal. These moments can seem to appear from nowhere, both to the person experiencing them and to those nearby.
A Small Emotional Vocabulary
People with alexithymia tend to have a limited range of words to describe how they feel, so instead of naming emotions directly, they might use broad terms like “fine” or “upset.”9 They may even focus on physical sensations, such as saying “I have a headache” instead of “I feel sad.” These word substitutions may reflect how difficult it is to translate feelings into words, and while that’s not inherently bad on the surface, it can cause issues.
For example, in conversation, this word substitution could sound detached or matter-of-fact, especially when emotional topics are at play. A loved one might notice short answers or complete silence when trying to discuss feelings, and to them, this can seem unresponsive or uninterested. In reality, it’s more like trying to describe colors you’ve never learned the names for: the emotions are there, but finding the language for them takes time and guidance.
A Lack of Bodily Awareness
Another way alexithymia affects daily life is through reduced awareness of bodily sensations, known as “interoception.”10 When this awareness is dulled, even basic needs can go unnoticed. Some people may skip meals without realizing they’re hungry until they feel dizzy, while others might push through fatigue or illness without recognizing the signs that their body needs rest.
For example, one person with alexithymia noted that she couldn’t tell the difference between the pain of a stubbed toe and a broken bone.11 Understandably, this lack of recognition in their own body can lead to injury or untreated medical issues, showing just how serious it can be.
Difficulties With Everyday Decision-Making
Emotions play an important role in daily choices and can even act as internal cues that guide decisions, like a “gut feeling” that something isn’t right. For someone with alexithymia, these emotional signals can feel muted or missing altogether, making decision-making more difficult than it might appear to be from the outside
To demonstrate this, researchers used the Iowa Gambling Task to see how people with alexithymia reacted in situations where intuition would be needed to complete a task.12
It was found that when a situation has clear rules or visible outcomes, decision-making may feel normal for those with alexithymia. But when a choice depends on sensing what “feels” right, people with alexithymia may find recognizing internal signals challenging.
When we translate these findings into real life, it could mean that those with alexithymia may find it harder than others to trust their own instinct. Or, they might even approach risks that others would naturally avoid.
Can Alexithymia Be Treated?
Because alexithymia, or a lack of expressing emotions, is more of a trait rather than a standalone diagnosis, there’s no specific therapy designed to treat only this area. Even so, many available therapies include elements that help with emotional regulation and expression, meaning they may still be used to support someone dealing with alexithymia.
Treatment approaches that could be used to treat alexithymia include the following.
Cognitive Behavioral Therapy
CBT helps you identify emotions as they arise and challenge the thoughts that block expression. This help talking about feelings also encourages small behavioral changes that aim to bring genuine feelings back into daily life. Therefore, CBT can be especially useful for those seeking therapy to improve communication with loved ones.
Mindfulness-Based Approaches
Practicing mindfulness techniques encourages awareness of the present moment and helps people recognize emotions that in the past may have slipped through the recognition filters. A meta-analysis found that mindfulness-based programs lowered alexithymia by around five points on average, showing consistent benefits.13
Mindfulness could also support better connections during interpersonal communication therapy, where the goal is to build emotional presence in everyday conversations.
Dialectical Behavior Therapy
DBT provides a clear process to calm the body and express feelings more clearly. These DBT emotional expression skills can make relationships feel safer and more stable, especially when communication tends to shut down during emotional conflict.
Emotion-Focused and Interpersonal Therapies
These approaches build connection by exploring how emotions influence relationships, helping clients express what they feel in a more natural way. They are particularly beneficial as forms of interpersonal communication therapy for people who want to better understand both their own emotions and those of others.
Do I Have Trouble Expressing Emotions?
As we touched on earlier, it’s perfectly normal to have moments when emotions feel hard to express. Life throws up experiences that can leave anyone speechless, whether they’re painful or deeply moving. The issue lies in when these difficulties become a regular pattern, suggesting something more serious is at play.
The questions below are designed to help you reflect on your emotional awareness, and if you answer “yes” to several of them, it could suggest some difficulty expressing emotions. However, these questions aren’t diagnostic, so if you suspect you find identifying and expressing emotions challenging, a mental health professional can help you find clarity.
Ask yourself:
- Do I find it difficult to describe how I feel?
- After an emotional event, do I tend to focus on what happened rather than how it made me feel?
- Have I struggled to understand my own emotional reactions during emotionally charged situations?
- Do I consistently avoid conversations that involve sharing feelings?
- Do I find it hard to recognize emotions in myself?
- Do I only realize what I was feeling after a situation has ended?
If you’ve answered “yes” to one or more of these questions, it’s worth reaching out for further direction. In fact, many people find relief once they understand why expressing emotions has been difficult. As one person with alexithymia described, finally having a name for their experience made them feel empowered to learn more about emotions and practice new tools to reconnect with them.14
Mission Connection: Your Bridge To Expressing Emotions
If you or someone you care about has been struggling to express emotions, or you’ve been searching for mental health treatment near you, know that Mission Connection is here to help.
We have extensive experience treating people who live with emotional awareness challenges such as alexithymia. Many of our clients come to us after experiencing:
- Depression and emotional detachment
- Anxiety coupled with the inability to share feelings
- Trauma with emotional suppression
- Psychosis
Our licensed mental health professionals understand how difficult it can be to live with this kind of disconnection. This is why our therapies are designed around support for emotional expression and therapy to improve communication. Through talk-based sessions and mindfulness-based practices, you’ll learn to identify what you feel and communicate these emotions more openly.
If emotional numbness has made life feel smaller than it should, you don’t have to continue living with it. Mission Connection provides emotional numbness treatment in facilities across the US, which helps people rebuild trust in their emotions and begin to live with greater understanding and connection.
Contact us today to take the first step toward emotional clarity and renewed confidence in how you express yourself.
References
- Leonard, J. (2025, April 29). Alexithymia: Symptoms, diagnosis, and links with mental health. Www.medicalnewstoday.com. https://www.medicalnewstoday.com/articles/326451#symptoms
- Swart, M., Kortekaas, R., & Aleman, A. (2009). Dealing with Feelings: Characterization of Trait Alexithymia on Emotion Regulation Strategies and Cognitive-Emotional Processing. PLoS ONE, 4(6), e5751. https://doi.org/10.1371/journal.pone.0005751
- Goerlich, K. S. (2018). The Multifaceted Nature of Alexithymia – A Neuroscientific Perspective. Frontiers in Psychology, 9. https://doi.org/10.3389/fpsyg.2018.01614
- Picardi, A., Fagnani, C., Gigantesco, A., Toccaceli, V., Lega, I., & Stazi, M. A. (2011). Genetic influences on alexithymia and their relationship with depressive symptoms. Journal of Psychosomatic Research, 71(4), 256–263. https://doi.org/10.1016/j.jpsychores.2011.02.016
- Ogłodek, E. A. (2022). Alexithymia and Emotional Deficits Related to Posttraumatic Stress Disorder: An Investigation of Content and Process Disturbances. Case Reports in Psychiatry, 1–5. https://doi.org/10.1155/2022/7760988
- Shibata, M., Ninomiya, T., Jensen, M. P., Anno, K., Yonemoto, K., Makino, S., Iwaki, R., Yamashiro, K., Yoshida, T., Imada, Y., Kubo, C., Kiyohara, Y., Sudo, N., & Hosoi, M. (2014). Alexithymia Is Associated with Greater Risk of Chronic Pain and Negative Affect and with Lower Life Satisfaction in a General Population: The Hisayama Study. PLoS ONE, 9(3), e90984. https://doi.org/10.1371/journal.pone.0090984
- Lovering, N. (2022, September 7). Alexithymia in Relationships: Effects and Communication Tips. Psych Central. https://psychcentral.com/relationships/alexithymia-in-relationships
- Koppelberg, P., Kersting, A., & Suslow, T. (2023). Alexithymia and interpersonal problems in healthy young individuals. BMC Psychiatry, 23(1). https://doi.org/10.1186/s12888-023-05191-z
- Lee, K. S., Murphy, J., Catmur, C., Bird, G., & Hobson, H. (2022). Furthering the language hypothesis of alexithymia: An integrated review and meta-analysis. Neuroscience & Biobehavioral Reviews, 141, 104864. https://doi.org/10.1016/j.neubiorev.2022.104864
- Brewer, R., Cook, R., & Bird, G. (2016). Alexithymia: a general deficit of interoception. Royal Society Open Science, 3(10), 150664. https://doi.org/10.1098/rsos.150664
- Penot, J. (2023). What It’s Like to Live With Alexithymia. Psychology Today. https://www.psychologytoday.com/us/blog/the-forgotten-women/202308/what-its-like-to-live-with-alexithymia
- Zhang, L., Wang, X., Zhu, Y., Li, H., Zhu, C., Yu, F., & Wang, K. (2017). Selective impairment of decision making under ambiguity in alexithymia. BMC Psychiatry, 17(1). https://doi.org/10.1186/s12888-017-1537-2
- Quinto, R. M., Russo, F., Scafuto, F., Innamorati, M., & Ghiroldi, S. (2025). Effects of a Body-Based Mindfulness Program on Alexithymia, Dispositional Mindfulness, and Distress Symptoms: A Pilot Clinical Trial. Behavioral Sciences, 15(1), 55. https://doi.org/10.3390/bs15010055
- The Transmitter. (2019, February 22). For people with alexithymia, emotions are a mystery. The Transmitter: Neuroscience News and Perspectives. https://www.thetransmitter.org/spectrum/people-alexithymia-emotions-mystery/
