Alexithymia: the inability to identify and express emotions

Published Dec 26, 2023 • By Candice Salomé

Our constant interactions with other people and with the environment require us to feel a whole range of emotions. Yet some people find it difficult to identify and express their emotions. This is called "alexithymia".

So what exactly is alexithymia? What causes it and how does it manifest itself? Is it possible to overcome it?

We explain it all in our article!

Alexithymia: the inability to identify and express emotions

What is alexithymia? 

The term "alexithymia" was introduced into medicine in 1972 by the psychiatrist Peter E. Sifneos. At the time, alexithymia mainly referred to people who had difficulty expressing the feeling of love with the help of words. It was only later that the term "alexithymia" was extended to people with difficulties with emotions in general.

Alexithymia is an emotional regulation disorder, widely observed in psychosomatic illnesses. It affects around 10% of the world's population, and more often men than women. It reflects an individual's difficulty in recognizing their emotions and expressing them verbally.

An individual affected by alexithymia encounters a number of complications in everyday life that are linked to the lack of discernment of what they are feeling. For example, a lack of empathy or sensitivity, which can ultimately lead to low self-esteem and isolation.

What are the symptoms of alexithymia? 

Difficulty in recognizing one's emotions 

People suffering with alexithymia have difficulty identifying their emotions, both pleasant and unpleasant. Emotions such as sadness, joy, anger or fear are well-known terms because of their definition and the contexts in which they are experienced, but it is difficult for those affected to make a connection between their own state and the emotion.

Focusing on the exterior 

Increased heart rate, excessive sweating, muscle tension, etc. - these signs often reflect a specific emotion: anger, fear, anxiety, among others. The attention of alexithymic people is focused solely on these external signs, which become the only indicators of their inner state. As a result, they manage to develop a finer sense of all external stimuli, whether caused by their own body or their environment.

Individuals affected by alexithymia are also more vulnerable to developing somatic disorders such as eczema, high blood pressure, eating disorders or digestive problems, because their connection with their feelings is altered.

Lack of emotional empathy

People with alexithymia have a significant lack of empathy. This can often be one of the frequent criticisms of those close to them. It is nevertheless possible for the emotional charge of the speaker to be perceived through their body language and the words they use. But it is difficult to decipher the emotion involved.

Limited verbal communication 

People with alexithymia are often perceived as people who speak little, who are too serious and tend to limit their interactions with others.

However, this is mainly linked to a limitation in verbal communication. A person affected with alexithymia often lacks the words to describe a situation or an event, making it difficult to fully express their thoughts, which leads to a barrier between the person and those close to them, and sometimes results in isolation.

Low capacity for introspection 

Analysing their feelings is extremely difficult for alexithymics, as they are unable to identify and describe their emotions, making introspection complicated. These individuals are disconnected from their deep-rooted needs and real desires.

They also have:

  • Difficulty forming bonds with others;
  • Maximum avoidance of conflict but, if the situation deteriorates, a tendency to overreact;
  • Lack of imagination, creativity, humor and flexibility.

What causes alexithymia? 

Alexithymia results from a combination of neuropsychological and psychological impairments. The causes are multifactorial, but their origins lie mainly in childhood and in early developmental deficiencies.

There are two types of alexithymia: primary and secondary.

  • Primary alexithymia is the result of a childhood trauma or negative interactions with the child's carers. It is also considered to be a genetically determined personality trait, which is thought to affect the structure and function of certain brain regions.
  • Secondary alexithymia is linked to a past traumatic event. It is a defense mechanism, with the person trying to protect themselves by cutting themselves off from their emotions, thereby avoiding suffering and confronting what they have experienced.

How is alexithymia diagnosed? 

Alexithymia is still not recognized by official classifications of illnesses. However, it can be diagnosed using various measures and scales, such as:

  • the Toronto Alexithymia Scale 20: a questionnaire to be completed by the patient, in which it is possible to assess difficulties in identifying and describing emotions, and the ability to turn towards others.
  • the Bermond-Vorst Alexithymia Questionnaire, in which two affective facets are added to measure the lack of capacity for imagination and poor emotional response.
  • semi-structured clinical interviews based on the same principle as the questionnaires.

The aim of these tools is to determine the extent to which a person does or does not display alexithymic traits, and whether he or she exceeds a certain threshold that qualifies him or her as alexithymic. Based on these results, an MRI scan can be used to identify possible alterations in the neural substrates involved in alexithymia.

How can alexithymia be treated? 

Alexithymia is a neuropsychological and psychological condition requiring therapy.

Nevertheless, psychiatrists believe that treating alexithymia is not easy. Since the success of psychotherapy depends on the patient's capacity for introspection, their interest in their own psychological functioning and knowledge of their emotions, it is difficult to work efficiently with alexithymic individuals as they lack these particular skills.

In fact, the psychotherapist's main aim in treating a person affected with alexithymia, is to bring the patient out of their emotional silence. They have to gradually re-assign the language, associating emotions with what the patient feels on a physical level, and with the situations he or she has experienced.

Step by step, the patient learns to express all their emotions, to understand them and to listen to their body.

The psychotherapist is there to help the patient rebuild and manage these new sensations.

Was this article helpful to you?

Share your thoughts and questions with the community in the comments below!

Take care!

avatar Candice Salomé

Author: Candice Salomé, Health Writer

Candice is a content creator at Carenity and specialzes in writing health articles. She has a particular interest in the fields of women's health, well-being and sports. 

Candice holds a master's degree in... >> Learn more


on 12/28/23

Hi. Alexithymia. Wow, I wonder if that ails me?? I have problems connecting emotions to physical, somatic, feelings. Have autism, so am developmentally delayed, + seasonal depression ( SAD). Sleep apnea also doesn't help, Sleep deprived. What are others thinking?

on 12/28/23

Wow, what a reality slap. I have been at various degrees of everything above. I have CPTSD with many potential life ending medical issues yet I see today how my desire to not die kept me here, but my emotions are frozen in time. I don’t know how to thaw them out yet. I put everything into what I had to do by myself to stay alive and keep working in my career to pay the bills and keep me housed. All emotions of terror and fear became blended along with physical emotional and psychological trauma I experienced along the decades. Life became a blur and. I couldn’t see the edges anymore-Level 10 GRIEF was added next- buried 3 husbands and my only daughter- then my animals and parents and I was put on hospice in 2007- in between that were the level 10 moments of immense JOY AND HAPPINESS. I have a -100 to positive 100 emotional response and I’m working on a middle range addition to my library via my spiritual relationship, acupuncture and other calming activities.

I was bullied so bad growing up and suffered horrible sexual assaults which left me with one identifiable emotion-RAGE-Problem was my heart felt such need to be accepted I molded into a life of serving abusive people- I now desire to understand the ranges of emotions but feel empty. I am a vessel waiting to understand the options we all have. I am eager to learn how

thanks for being here

You will also like

"Scentimental": The power of fragrance on our mental health!

Read the article
What are the dangers associated with the over-the-counter sale of certain medicines?

What are the dangers associated with the over-the-counter sale of certain medicines?

Read the article
Meet Lee, Your Community Manager

Meet Lee, Your Community Manager

Read the article
Telemedicine: Remote examinations and operations are here!

Telemedicine: Remote examinations and operations are here!

Read the article

Most commented discussions